The Role of Error Signals for Awareness of Cognitive Deficits
Research type
Research Study
Full title
The critical role of the Error-Related Negativity (ERN) as a predictor of awareness of cognitive deficits in schizophrenia - an EEG study
IRAS ID
195309
Contact name
James Gilleen
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
1 years, 8 months, 0 days
Research summary
Patients with schizophrenia frequently lack insight into their symptoms and cognitive deficits (Gilleen et al., 2011). This lack of awareness gravely impacts on a patient's treatment compliance and prognosis, which can in turn lead to greater patient distress and increased burden for caregivers and relatives. A precise understanding of what factors lead a patient to have, or lack, such insight is yet to be fully determined. Further, lack of insight can also differ in different domains, such as awareness of cognition, or of illness and symptoms, and we have identified a variety of contributing factors to these different domains of insight (Gilleen et al., 2013).
Recent work from our team has suggested that in patients with good cognition, the ‘metacognitive’ (thinking about thinking) factor of self-reflection and the capacity to do so adequately in order to update beliefs, specifically determines level of awareness. Elsewhere, EEG brain imaging analyses have shown that a specific brain signal is evident when people commit errors during cognitive tasks (Ne; Falkenstein et al., 1991; or ERN; Gehring et al., 1993). We propose that this signal is a necessary upstream factor in determining awareness – in that, the error signal forms the ‘input’ signal (that ‘I am making errors’) upon which the self-reflection acts in order to afford good awareness of cognitive deficits.
The current project aims to test this hypothesis by conducting a battery of clinical, self-¬report, cognitive and neuropsychological measures and questionnaires alongside EEG in patients with schizophrenia, and a matched healthy participant group, to (i) first identify these error signals and (ii) examine the degree to which these signals, along with self-reflection determine awareness of cognitive deficits. This study will enable us to expand on previous research, and provide a better understanding of insight of cognitive deficits in patients with schizophrenia.REC name
London - Surrey Research Ethics Committee
REC reference
16/LO/0064
Date of REC Opinion
1 Feb 2016
REC opinion
Further Information Favourable Opinion