Clinical and Structural Differences in Delusions Across Diagnoses: A Systematic Review
Delusions are marked, fixed beliefs that are incongruent with reality. Delusions, with comorbid hallucinations, are a hallmark of certain psychotic disorders (e.g., schizophrenia). Delusions can present transdiagnostically, in neurodegenerative (e.g., Alzheimer's disease and fronto-temporal dem...
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| Format: | Article |
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Integrative Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnint.2021.726321/full |
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| author | Kelly Rootes-Murdy Kelly Rootes-Murdy David R. Goldsmith Jessica A. Turner Jessica A. Turner |
| author_facet | Kelly Rootes-Murdy Kelly Rootes-Murdy David R. Goldsmith Jessica A. Turner Jessica A. Turner |
| author_sort | Kelly Rootes-Murdy |
| collection | DOAJ |
| description | Delusions are marked, fixed beliefs that are incongruent with reality. Delusions, with comorbid hallucinations, are a hallmark of certain psychotic disorders (e.g., schizophrenia). Delusions can present transdiagnostically, in neurodegenerative (e.g., Alzheimer's disease and fronto-temporal dementia), nervous system disorders (e.g., Parkinson's disease) and across other psychiatric disorders (e.g., bipolar disorder). The burden of delusions is severe and understanding the heterogeneity of delusions may delineate a more valid nosology of not only psychiatric disorders but also neurodegenerative and nervous system disorders. We systematically reviewed structural neuroimaging studies reporting on delusions in four disorder types [schizophrenia (SZ), bipolar disorder (BP), Alzheimer's disease (AD), and Parkinson's disease (PD)] to provide a comprehensive overview of neural changes and clinical presentations associated with delusions. Twenty-eight eligible studies were identified. This review found delusions were most associated with gray matter reductions in the dorsolateral prefrontal cortex (SZ, BP, and AD), left claustrum (SZ and AD), hippocampus (SZ and AD), insula (SZ, BP, and AD), amygdala (SZ and BP), thalamus (SZ and AD), superior temporal gyrus (SZ, BP, and AD), and middle frontal gyrus (SZ, BP, AD, and PD). However, there was a great deal of variability in the findings of each disorder. There is some support for the current dopaminergic hypothesis of psychosis, but we also propose new hypotheses related to the belief formation network and cognitive biases. We also propose a standardization of assessments to aid future transdiagnostic study approaches. Future studies should explore the neural and biological underpinnings of delusions to hopefully, inform future treatment. |
| first_indexed | 2024-12-13T13:42:12Z |
| format | Article |
| id | doaj.art-1df6006eed19431585d09f4a039d5542 |
| institution | Directory Open Access Journal |
| issn | 1662-5145 |
| language | English |
| last_indexed | 2024-12-13T13:42:12Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Integrative Neuroscience |
| spelling | doaj.art-1df6006eed19431585d09f4a039d55422022-12-21T23:43:32ZengFrontiers Media S.A.Frontiers in Integrative Neuroscience1662-51452022-01-011510.3389/fnint.2021.726321726321Clinical and Structural Differences in Delusions Across Diagnoses: A Systematic ReviewKelly Rootes-Murdy0Kelly Rootes-Murdy1David R. Goldsmith2Jessica A. Turner3Jessica A. Turner4Department of Psychology, Georgia State University, Atlanta, GA, United StatesTri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology and Emory University, Atlanta, GA, United StatesDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United StatesDepartment of Psychology, Georgia State University, Atlanta, GA, United StatesTri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology and Emory University, Atlanta, GA, United StatesDelusions are marked, fixed beliefs that are incongruent with reality. Delusions, with comorbid hallucinations, are a hallmark of certain psychotic disorders (e.g., schizophrenia). Delusions can present transdiagnostically, in neurodegenerative (e.g., Alzheimer's disease and fronto-temporal dementia), nervous system disorders (e.g., Parkinson's disease) and across other psychiatric disorders (e.g., bipolar disorder). The burden of delusions is severe and understanding the heterogeneity of delusions may delineate a more valid nosology of not only psychiatric disorders but also neurodegenerative and nervous system disorders. We systematically reviewed structural neuroimaging studies reporting on delusions in four disorder types [schizophrenia (SZ), bipolar disorder (BP), Alzheimer's disease (AD), and Parkinson's disease (PD)] to provide a comprehensive overview of neural changes and clinical presentations associated with delusions. Twenty-eight eligible studies were identified. This review found delusions were most associated with gray matter reductions in the dorsolateral prefrontal cortex (SZ, BP, and AD), left claustrum (SZ and AD), hippocampus (SZ and AD), insula (SZ, BP, and AD), amygdala (SZ and BP), thalamus (SZ and AD), superior temporal gyrus (SZ, BP, and AD), and middle frontal gyrus (SZ, BP, AD, and PD). However, there was a great deal of variability in the findings of each disorder. There is some support for the current dopaminergic hypothesis of psychosis, but we also propose new hypotheses related to the belief formation network and cognitive biases. We also propose a standardization of assessments to aid future transdiagnostic study approaches. Future studies should explore the neural and biological underpinnings of delusions to hopefully, inform future treatment.https://www.frontiersin.org/articles/10.3389/fnint.2021.726321/fulldelusiontransdiagnosticstructuralschizophreniaAlzheimer's diseaseParkinson's disease |
| spellingShingle | Kelly Rootes-Murdy Kelly Rootes-Murdy David R. Goldsmith Jessica A. Turner Jessica A. Turner Clinical and Structural Differences in Delusions Across Diagnoses: A Systematic Review Frontiers in Integrative Neuroscience delusion transdiagnostic structural schizophrenia Alzheimer's disease Parkinson's disease |
| title | Clinical and Structural Differences in Delusions Across Diagnoses: A Systematic Review |
| title_full | Clinical and Structural Differences in Delusions Across Diagnoses: A Systematic Review |
| title_fullStr | Clinical and Structural Differences in Delusions Across Diagnoses: A Systematic Review |
| title_full_unstemmed | Clinical and Structural Differences in Delusions Across Diagnoses: A Systematic Review |
| title_short | Clinical and Structural Differences in Delusions Across Diagnoses: A Systematic Review |
| title_sort | clinical and structural differences in delusions across diagnoses a systematic review |
| topic | delusion transdiagnostic structural schizophrenia Alzheimer's disease Parkinson's disease |
| url | https://www.frontiersin.org/articles/10.3389/fnint.2021.726321/full |
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