Structural and functional brain changes in delusional disorder

Br J Psychiatry. 2016 Feb;208(2):153-9. doi: 10.1192/bjp.bp.114.159087. Epub 2015 Sep 17.


Background: Delusional disorder has been the subject of very little investigation using brain imaging.

Aims: To examine potential structural and/or functional brain abnormalities in this disorder.

Method: We used structural imaging (voxel-based morphometry, VBM) and functional imaging (during performance of the n-back task and whole-brain resting connectivity analysis) to examine 22 patients meeting DSM-IV criteria for delusional disorder and 44 matched healthy controls.

Results: The patients showed grey matter reductions in the medial frontal/anterior cingulate cortex and bilateral insula on unmodulated (but not on modulated) VBM analysis, failure of de-activation in the medial frontal/anterior cingulate cortex during performance of the n-back task, and decreased resting-state connectivity in the bilateral insula.

Conclusions: The findings provide evidence of brain abnormality in the medial frontal/anterior cingulate cortex and insula in delusional disorder. A role for the former region in the pathogenesis of delusions is consistent with several other lines of evidence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain Mapping
  • Case-Control Studies
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Gray Matter / pathology*
  • Gyrus Cinguli / pathology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Regression Analysis
  • Schizophrenia, Paranoid / physiopathology*