Is the Sense of Agency in Schizophrenia Influenced by Resting-State Variation in Self-Referential Regions of the Brain?

Summary

Schizophrenia involves a disturbance of the self, particularly the sense of agency—the feeling of controlling one's own actions and thoughts. Current models of agency involve both bottom-up sensory processes and top-down cognitive influences. This review proposes that ongoing brain activity in self-referential regions, especially the default mode network, adds a deeper layer of influence. Neuroimaging studies show that aberrant activity in these regions in schizophrenia can lead to misattributing internally generated stimuli as external, producing symptoms like thought insertion and delusions of control. This framework suggests neuroimaging can improve conceptualization, measurement, and treatment of agency disturbances.

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Abstract

Schizophrenia is a disturbance of the self, of which the attribution of agency is a major component. In this article, we review current theories of the Sense of Agency, their relevance to schizophrenia, and propose a novel framework for future research. We explore some of the models of agency, in which both bottom-up and top-down processes are implicated in the genesis of agency. We further this line of inquiry by suggesting that ongoing neurological activity (the brain's resting state) in self-referential regions of the brain can provide a deeper level of influence beyond what the current models capture. Based on neuroimaging studies, we suggest that aberrant activity in regions such as the default mode network of individuals with schizophrenia can lead to a misattribution of internally/externally generated stimuli. This can result in symptoms such as thought insertion and delusions of control. Consequently, neuroimaging can contribute to a more comprehensive conceptualization and measurement of agency and potential treatment implications.

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