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J Korean Neuropsychiatr Assoc. 2008 May;47(3):239-246. Korean. Original Article.
Choi SH , Kim JJ , Park IH , Kim SY , Ku J , Lee HR , Yoon KJ , Kim IY , Kim SI .
Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Gwangju, Korea.
Department of Biomedical Engineering, Hanyang University, Seoul, Korea.
St. Peter's Hospital, Seoul, Korea.

OBJECTIVES: Virtual reality has been increasingly used in the psychiatric field. Presence, the sense of "being there," is an essential concept in terms of the effectiveness of the virtual reality. The present study aimed to investigate the characteristics of the presence-related brain regions in patients with schizophrenia. METHODS: Using fMRI, brain activities were measured while performing the virtual reality tasks in fifteen healthy normal subjects and fifteen patients with schizophrenia. The tasks consisted of listening to some stories and inferring the content of the previous events. Ambiguous information was given for the experimental task, whereas clear information was given for the control task. Correlations between the image contrast values and the presence scores were analyzed. RESULTS: The presence-related brain regions in healthy controls were identified in the two discrete region groups that could be referred to as the cognitive neural correlates and the perceptual neural correlates. The former included the anterior cingulate, the left inferior temporal gyrus, the right lingual gyrus, and the right cuneus, whereas the latter consisted of the right posterior cingulate, the left lingual gyrus and the right fusiform gyrus. Compared with healthy controls, regional correlation patterns were different in patients with schizophrenia, including that the posterior cingulate had significant correlations. CONCLUSION: These results suggest that patients with schizophrenia utilize perceptual apparatus for the presence more than the cognitive aspect. A peculiar pattern of the presence in schizophrenia may be related to increased correlations between the posterior cingulate and other brain regions.

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