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Research Articles, Behavioral/Cognitive

Disruption of Conscious Access in Psychosis Is Associated with Altered Structural Brain Connectivity

Lucie Berkovitch, Lucie Charles, Antoine Del Cul, Nora Hamdani, Marine Delavest, Samuel Sarrazin, Jean-François Mangin, Pamela Guevara, Ellen Ji, Marc-Antoine d'Albis, Raphaël Gaillard, Frank Bellivier, Cyril Poupon, Marion Leboyer, Ryad Tamouza, Stanislas Dehaene and Josselin Houenou
Journal of Neuroscience 20 January 2021, 41 (3) 513-523; DOI: https://doi.org/10.1523/JNEUROSCI.0945-20.2020
Lucie Berkovitch
1Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Service Hospitalo-Universitaire Pôle Hospitalo-Universitaire Psychiatrie Paris 15, 75014 Paris, France
2Université Paris Saclay, CEA, Neurospin, F-91191, Gif-sur-Yvette, France
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Lucie Charles
3Institute of Cognitive Neuroscience, UCL, London WC1E 6BT, United Kingdom
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Antoine Del Cul
4Service de Psychiatrie d'Adultes, Hôpital Universitaire Pitié Salpêtrière, 75013 Paris, France
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Nora Hamdani
5AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, FHU ADAPT, F-94010, Créteil, France
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Marine Delavest
6Pôle neurosciences, Groupe Hospitalier Saint-Louis, Lariboisière Fernand Widal Assistance Publique-Hôpitaux de Paris, 75010 Paris, France
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Samuel Sarrazin
2Université Paris Saclay, CEA, Neurospin, F-91191, Gif-sur-Yvette, France
7Centre Médical Pasteur, 94550 Chevilly-Larue, France
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Jean-François Mangin
2Université Paris Saclay, CEA, Neurospin, F-91191, Gif-sur-Yvette, France
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Pamela Guevara
8Faculty of Engineering, Universidad de Concepción, Concepción 4070386, Chile
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Ellen Ji
2Université Paris Saclay, CEA, Neurospin, F-91191, Gif-sur-Yvette, France
9Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010, Créteil, France
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Marc-Antoine d'Albis
2Université Paris Saclay, CEA, Neurospin, F-91191, Gif-sur-Yvette, France
5AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, FHU ADAPT, F-94010, Créteil, France
9Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010, Créteil, France
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Raphaël Gaillard
1Groupe Hospitalier Universitaire Paris Psychiatrie et Neurosciences, Service Hospitalo-Universitaire Pôle Hospitalo-Universitaire Psychiatrie Paris 15, 75014 Paris, France
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Frank Bellivier
6Pôle neurosciences, Groupe Hospitalier Saint-Louis, Lariboisière Fernand Widal Assistance Publique-Hôpitaux de Paris, 75010 Paris, France
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Cyril Poupon
2Université Paris Saclay, CEA, Neurospin, F-91191, Gif-sur-Yvette, France
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Marion Leboyer
5AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, FHU ADAPT, F-94010, Créteil, France
9Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010, Créteil, France
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Ryad Tamouza
5AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, FHU ADAPT, F-94010, Créteil, France
9Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010, Créteil, France
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Stanislas Dehaene
2Université Paris Saclay, CEA, Neurospin, F-91191, Gif-sur-Yvette, France
10Collège de France, Paris 75005, France
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Josselin Houenou
2Université Paris Saclay, CEA, Neurospin, F-91191, Gif-sur-Yvette, France
5AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, FHU ADAPT, F-94010, Créteil, France
9Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, F-94010, Créteil, France
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Abstract

According to global neuronal workspace (GNW) theory, conscious access relies on long-distance cerebral connectivity to allow a global neuronal ignition coding for conscious content. In patients with schizophrenia and bipolar disorder, both alterations in cerebral connectivity and an increased threshold for conscious perception have been reported. The implications of abnormal structural connectivity for disrupted conscious access and the relationship between these two deficits and psychopathology remain unclear. The aim of this study was to determine the extent to which structural connectivity is correlated with consciousness threshold, particularly in psychosis. We used a visual masking paradigm to measure consciousness threshold, and diffusion MRI tractography to assess structural connectivity in 97 humans of either sex with varying degrees of psychosis: healthy control subjects (n = 46), schizophrenia patients (n = 25), and bipolar disorder patients with (n = 17) and without (n = 9) a history of psychosis. Patients with psychosis (schizophrenia and bipolar disorder with psychotic features) had an elevated masking threshold compared with control subjects and bipolar disorder patients without psychotic features. Masking threshold correlated negatively with the mean general fractional anisotropy of white matter tracts exclusively within the GNW network (inferior frontal-occipital fasciculus, cingulum, and corpus callosum). Mediation analysis demonstrated that alterations in long-distance connectivity were associated with an increased masking threshold, which in turn was linked to psychotic symptoms. Our findings support the hypothesis that long-distance structural connectivity within the GNW plays a crucial role in conscious access, and that conscious access may mediate the association between impaired structural connectivity and psychosis.

  • bipolar disorder
  • cerebral connectivity
  • consciousness
  • global neuronal workspace
  • schizophrenia
  • tractography

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The Journal of Neuroscience: 41 (3)
Journal of Neuroscience
Vol. 41, Issue 3
20 Jan 2021
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Disruption of Conscious Access in Psychosis Is Associated with Altered Structural Brain Connectivity
Lucie Berkovitch, Lucie Charles, Antoine Del Cul, Nora Hamdani, Marine Delavest, Samuel Sarrazin, Jean-François Mangin, Pamela Guevara, Ellen Ji, Marc-Antoine d'Albis, Raphaël Gaillard, Frank Bellivier, Cyril Poupon, Marion Leboyer, Ryad Tamouza, Stanislas Dehaene, Josselin Houenou
Journal of Neuroscience 20 January 2021, 41 (3) 513-523; DOI: 10.1523/JNEUROSCI.0945-20.2020

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Disruption of Conscious Access in Psychosis Is Associated with Altered Structural Brain Connectivity
Lucie Berkovitch, Lucie Charles, Antoine Del Cul, Nora Hamdani, Marine Delavest, Samuel Sarrazin, Jean-François Mangin, Pamela Guevara, Ellen Ji, Marc-Antoine d'Albis, Raphaël Gaillard, Frank Bellivier, Cyril Poupon, Marion Leboyer, Ryad Tamouza, Stanislas Dehaene, Josselin Houenou
Journal of Neuroscience 20 January 2021, 41 (3) 513-523; DOI: 10.1523/JNEUROSCI.0945-20.2020
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Keywords

  • bipolar disorder
  • cerebral connectivity
  • consciousness
  • global neuronal workspace
  • schizophrenia
  • tractography

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