Shared brain basis for altered self-referential processing across psychiatric disorders? A systematic review and meta-analysis of neuroimaging studies

Self-referential processing is a fundamental cognitive function, and abnormalities in its neural implementation have been reported across a range of psychiatric disorders, leading to the proposal that such alterations may constitute a transdiagnostic neurobiological feature. Yet claiming transdiagnostic requires rigorous evidence. Here, we examined the evidence for such a hypothesis by conducting a systematic review and coordinate-based meta-analysis of psychiatric neuroimaging studies that employed self-referential tasks. The systematic review identified 36 neuroimaging studies across 9 broad categories of psychiatric disorders, suggesting that the neural aberrancy of self-referential processing is indeed of great interest across different diagnosis. Of these, 27 studies were eligible for the ALE meta-analysis. The ALE results revealed hypoactivation of the right precuneus in psychiatric groups relative to health controls, alongside hyperactivation of the right triangular part of the inferior frontal gyrus (IFGtri) during self-referential processing in psychiatric groups. Notably the precuneus and IFGtri are core nodes of the default mode network and the frontal-parietal control network, respectively, suggesting that aberrant self-referential processing across psychiatric disorders may be characterized by disrupted default mode network engagement accompanied by compensatory or maladaptive recruitment of control-related frontal regions. Together, our findings revealed a strong research interest in neural aberrancy of self-referential processing as a transdiagnostic feature. However, available evidence only provided preliminary evidence for such statement. To move forward, the field needs coordinated efforts to systematically accumulate data and collecting new datasets.