Orbitofrontal functional network: the mediating role between violence and childhood trauma in patients with schizophrenia.

A growing body of evidence has indicated an increased risk of violence among patients with schizophrenia. While childhood trauma (CT) has been robustly associated with increased violent behavior in schizophrenia spectrum disorders, the neurobiological mechanisms underlying this relationship remain underexplored. The objectives of this study are to investigate the potential role of functional connectivity (FC) in the relationship between CT and violence. This study enrolled 55 patients with schizophrenia and 36 healthy controls. Seed-based functional connectivity between a predefined seed in the orbitofrontal cortex and other brain voxels was compared across groups, with significant results regarding FC used in further mediation analysis. The seed-based analysis revealed decreased FC between the right orbital part of the inferior frontal gyrus (ORBinf) and the right middle temporal gyrus as well as the right superior frontal gyrus in violent schizophrenia patients (VSP) compared to both healthy controls (HC) and non-violent schizophrenia patients (NVSP). VSP also exhibited decreased FC between the right ORBinf and the right middle frontal gyrus compared to NVSP. Furthermore, the mediation analysis indicated that the relationship between CT and violence was completely mediated by the strength of FC between the right ORBinf and the right MTG. The present study suggested that alterations of FC between certain brain regions may be associated with violence and offer valuable insights into potential neural targets for interventions aiming to address CT and violence in patients with schizophrenia.