Self-awareness in schizophrenia: identifying common neural oscillatory parameters underlying altered sense of self-agency and reduced prefrontal cortex excitability

Abstract

The review examined disease-specific Electroencephalography frequency–power abnormalities and their relationship with compromised insight in patients with schizophrenia (SZ). Furthermore, we aimed to shed light on neural oscillatory activity parameters that predict altered self-awareness states in SZ. Reduced connectivity within anterior default mode network (DMN) seems to underlie excessive resting frontal alpha power and is consistently linked to compromised prefrontal cortex region activity and to disruptions in regulating the storage of sensory information in SZ spectrum disorders. Increased power within slow and fast wave oscillations in SZ is likely to result in distorted perceptions of self-agency. Alterations in frontal midline theta and frontal gamma power are related to poor insight of mental illness. Overall, the review concludes that increasing prefrontal cortex excitability using focalized noninvasive brain stimulation treatments can improve insight and self-agency perception and may suppress pathological gamma synchrony in SZ.