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The Connectome Brain network interactions in health and disease

A growing body of research has identified the presence of multiple brain networks supporting human behavior. These networks include a salience network involving dorsal anterior cingulate and anterior insula regions thought to be relevant to attending to survival-relevant events in the environment; a central executive network (CEN) consisting of regions in the middle and inferior prefrontal and parietal cortices engaged by many higher level cognitive tasks and thought to be involved in adaptive cognitive control; and a default mode network (DMN) consisting of regions in medial frontal cortex and posterior cingulate, among others, that reliably reduce their activity during active cognitive demands and which may be involved in attention to internal emotional states or self-referential processing [1]. Palaniyappan et al. [2] examined how deficits in the reciprocal causal interactions between two of these brain networks – the salience system and CEN – may be impaired in schizophrenia and contribute to deficits in symptoms and cognition. Palaniyappan et al. focused on the insula, a key node in the salience system, and the dorsolateral prefrontal cortex (DLPFC), a key CEN node. They report impairments in the excitatory causal outlow of the anterior insula to the DLPFC, as well as deficits in the inhibitory feedback of the DLPFC on the anterior insula and the dorsal anterior cingulate (another putative node in the salience network). Further, they found that the severity of deficits in the interactions between the salience and CEN systems predicted the degree of impairment in a factor reflecting symptom severity and processing speed. It is absolutely critical to the field of psychopathology to move towards examining interactions between systems, as the complexity and range of impairments present in disorders such as schizophrenia are highly unlikely to be due to impairments in a single system, let alone a single brain region. Researchers have long thought of schizophrenia as