Neural mechanisms of mood-induced modulation of reality monitoring in schizophrenia

Reality monitoring is the ability to accurately distinguish the source of self-generated information from externally-presented information. Although people with schizophrenia (SZ) show impaired reality monitoring, nothing is known about how mood state influences this higher-order cognitive process. Accordingly, we induced positive, neutral and negative mood states to test how different mood states modulate subsequent reality monitoring performance. Our findings indicate that mood affected reality monitoring performance in HC and SZ participants in both similar and dissociable ways. Only a positive mood facilitated task performance in Healthy Control (HC) subjects, whereas a negative mood facilitated task performance in SZ subjects. Yet, when both HC and SZ participants were in a positive mood, they recruited medial prefrontal cortex (mPFC) to bias better subsequent self-generated item identification, despite the fact that mPFC signal was reduced in SZ participants. Additionally, in SZ subjects, negative mood states also modulated left and right dorsal mPFC signal to bias better externally-presented item identification. Together our findings reveal that although the mPFC is hypoactive in SZ participants, mPFC signal plays a functional role in mood–cognition interactions during both positive and negative mood states to facilitate subsequent reality monitoring decision-making.