Covert visual attention in schizophrenia spectrum personality disordered subjects: visuospatial cuing and alerting effects

Altered Visuospatial Processing in Schizophrenia: An Event-related Potential Microstate Analysis Comparing Patients with and without Hallucinations with Healthy Controls

Patients with schizophrenia present with various symptoms related to different domains. Abnormalities of auditory and visual perception are parts of a more general problem. Nevertheless, the relationship between the lifetime history of auditory verbal hallucination (AVH), one of the most prevalent symptoms in schizophrenia, and visuospatial deficits remains unclear. This study aimed to investigate differences in hemispheric involvement and visuospatial processing between healthy controls (HCs) and schizophrenia patients with and without AVHs. HCs (N = 20), schizophrenia patients with AVH (AVH group, N = 16), and schizophrenia patients without hallucinations (NH group, N = 10) participated in a 4-choice reaction task with lateralized stimuli. An event-related potential (ERP)-microstate approach was used to analyze ERP differences between the conditions and groups. The schizophrenia patients without hallucinations had slower responses than the HCs. An early visual N1 contralateral to stimulation side was prominent in all groups of participants but with decreased amplitude in the patients with schizophrenia, especially in the AVH group over the right hemisphere. The amplitude of P3b, a cognitive evaluation component, was also decreased in schizophrenia. Compared to AVH and HC groups, the patients in the NH group had altered microstate patterns: P3b was replaced by a novelty component, P3a. Although the difference between both patient groups was only based on the presence of AVHs, our findings indicated that patients had specific visuospatial deficits associated with a lifetime history of hallucinations: patients with AVHs showed early visual component alterations in the right hemisphere, and those without AVHs had more prominent visuospatial impairment.

RT Slowing to Valid Cues on a Reflexive Attention Task in Children and Young Adults

Peripheral cueing tasks can be used to measure reflexive (automatic) attention. In these tasks, increases in response time or RT (costs) typically follow contralateral (invalid) cues as attention must move from the location of the cue to the target. Reductions in RT (benefits) to a target typically follow ipsilateral (valid) cues because the cue draws attention to where the target will appear. Two exceptions to RT benefits are inhibition of return (IOR) and masking. IOR is the tendency to respond slower to targets that appear in locations attended within the last 200–2000 ms. Masking occurs when the visibility of a target is blocked by another stimulus (e.g., the cue). Herein, we describe two experiments, both using a modified Posner task with “earth rockets” as cues and “alien spaceships” as targets. Cues were equally likely to appear on the left or right side of a display following targets. Participants were instructed to press a left or right key corresponding to a left or right target. In Experiment 1, we obtained data from 203 children (10.58–16.55 years old). We discovered unexpected costs following cues that typically provide RT benefits. In Experiment 2, we explored IOR, masking, and age differences in the occurrence of these costs. We manipulated the cue-target temporal distance (“stimulus onset asynchrony” or SOA) to explore IOR and the cue-target spatial distance to explore masking. We also considered a wider age range. Sixty-three children and 41 young adults participated. Experiment 2 revealed a three-way interaction between SOA, spatial distance, and age. At the shorter SOA (100 ms) and moderate spatial distance, unexpected costs followed valid cues for younger children (7.07–10.15 years old). These costs also occurred in young adults (18.00–23.02 years old) following far distance cues at this SOA. At the longer SOA (200 ms), these costs followed moderate and far cues for younger children and near cues for young adults. Older children (10.31–14.92 years) did not have unexpected costs. We explain the findings in terms of masking, IOR, and possible developmental mechanisms.

Enhanced facilitation of spatial attention in schizophrenia

OBJECTIVE

While attentional functions are usually found to be impaired in schizophrenia, a review of the literature on the orienting of spatial attention in schizophrenia suggested that voluntary attentional orienting in response to a valid cue might be paradoxically enhanced. We tested this hypothesis with orienting tasks involving the cued detection of a laterally presented target stimulus.

METHOD

Subjects were chronic schizophrenia patients (SZ) and matched healthy control subjects (HC). In Experiment 1 (15 SZ, 16 HC), cues were endogenous (arrows) and could be valid (100% predictive) or neutral with respect to the subsequent target position. In Experiment 2 (16 SZ, 16 HC), subjects performed a standard orienting task with unpredictive exogenous cues (brightening of the target boxes).

RESULTS

In Experiment 1, SZ showed a larger attentional facilitation effect on reaction time than HC. In Experiment 2, no clear sign of enhanced attentional facilitation was found in SZ.

CONCLUSIONS

The voluntary, facilitatory shifting of spatial attention may be relatively enhanced in individuals with schizophrenia in comparison to healthy individuals. This effect bears resemblance to other relative enhancements of information processing in schizophrenia such as saccade speed and semantic priming.

Nonverbal delayed recognition in the relatives of schizophrenia patients with or without schizophrenia spectrum

BACKGROUND

There is increased interest in the study of cognitive deficits as possible endophenotypic markers for schizophrenia. The main goal of this study was to determine how familiality and schizophrenia spectrum personality symptomatology are related to performance of auditory and visuospatial delayed recognition memory tasks.

METHODS

The study sample consisted of 162 subjects divided into five groups. The groups included 39 patients with a DSM-IV diagnosis of schizophrenia or schizophreniform disorder; first-degree relatives of schizophrenia patients, 22 with and 31 without schizophrenia spectrum personality traits; and healthy control subjects with no family history of psychosis, 22 with and 48 without schizophrenia spectrum traits. Auditory and visuospatial delayed recognition memory performance was assessed.

RESULTS

Significant differences were observed between patients and healthy control subjects in both auditory [F(1,79) = 7.358 p = .008] and visual [F(1,47) = 34.67, p < .001] delayed recognition tasks. When comparing the four non-patient groups, auditory and visuospatial discriminability decreased as a function of familiality of schizophrenia (p < .05). Deficits were more pronounced in relatives with schizophrenia spectrum traits [auditory d = .7114; visual d = 1.0199].

CONCLUSIONS

A biological relationship to schizophrenia increases the likelihood of impaired delayed recognition memory. Likewise, poorer performance is associated with schizophrenia spectrum phenotype only when combined with familiality.

Effects of repeated amphetamine administration on antisaccade in schizophrenia spectrum personality

Repeated amphetamine administration is used to examine the responsivity of cerebral dopaminergic systems. Schizophrenia spectrum personality (SSP) provides a unique opportunity to study the pathophysiology of schizophrenia because of shared neurobiology without the confounding factors of acute psychosis and psychotropic exposure. Previously we noted that on repeated amphetamine administration, dyskinesia and SSP symptoms were less likely to worsen in SSP than in healthy volunteers. In the current study, we report the effects of repeated amphetamine on antisaccade task performance. Eleven SSP and seven healthy subjects were given placebo once and amphetamine (30 mg) twice, in randomized double-blind fashion at least 1 week apart. Antisaccade eye measurements (error rate and latency) were recorded over 30 trials in each direction. Analysis of error rate showed no significant main effects of the drug. There was a significant group by field by drug interaction effect on the antisaccade latency. The SSP group showed a significant reduction in antisaccade latency for right field targets whereas no significant effects were noted in healthy control subjects. Findings from this preliminary study suggest SSP may be more receptive to the beneficial effects of repeated amphetamine on cognition than healthy controls.

Thalamic reductions in children with chromosome 22q11.2 deletion syndrome

Children with chromosome 22q11.2 deletion syndrome (22q) suffer from physical and behavioral dysfunctions, including neuroanatomical anomalies, visuo-spatial processing deficits, and increased risk for psychopathology. Reduced total brain volume, parietal lobe volume, and cerebellar volumes, enlarged ventricles, and increased basal ganglia volumes have been reported. Since previous literature has related the pulvinar nucleus of the thalamus to visuo-spatial processing, we compared the thalamic volume in children with 22q to typically developing controls. Children with 22q showed a significant reduction of the thalamus compared with normally developing children, specifically in the posterior portion of the thalamus, including the pulvinar nucleus. These results provide the first evidence for a potential relationship between posterior thalamic reductions and the characteristic visuo-spatial deficits demonstrated in this group.

Blunted inhibition of return in schizophrenia-evidence from a longitudinal study

Previous cross-sectional studies on covert orienting of visual attention in schizophrenia have been inconsistent. In the present longitudinal study, we examined 40 medicated acutely ill inpatients with a covert orienting of attention task (COVAT) shortly after admission, and again 12-16 weeks after the initial examination, while most patients were in (partial) remission. We administered a COVAT with nonpredictive peripheral cues and two stimulus-onset asynchronies (SOA; 100 and 800 ms). In addition, we examined 34 healthy control subjects twice (2 weeks apart). The most important finding was a lack of inhibition of return (IOR) in patients with schizophrenia, both at the first examination in an acute psychotic state and at the follow-up examination after considerable clinical improvement. The IOR deficit was unrelated to psychopathology, length of illness, number of previous psychotic episodes, and type of neuroleptic (NL) medication. Deficient IOR in patients with schizophrenia appears to be state-independent and might be viewed as a trait or vulnerability marker of the disorder. Subsequent studies with never-medicated populations and with schizotypal or high-risk subjects are needed in order to further analyze the possible role of NL medications and to clarify whether blunted IOR might represent a vulnerability marker of schizophrenia.

Auditory discrimination in female adolescents varying in schizotypal features: preliminary findings

Earlier experiments have suggested impaired auditory perception in patients with schizophrenia. The purpose of the present study was to investigate auditory discrimination in young adults varying in schizotypal features. Three hundred and forty-nine female adolescent subjects were rated with the Schizotypal Personality Questionnaire (SPQ) and the Perceptual Aberration Scale (PAS) and with questions from the Chinese Health Questionnaire (CHQ) that address non-psychotic, psychological status of the subjects. Sixty-one subjects were selected to participate in an auditory detection and discrimination task, with 20 subjects each with low and high, and 21 subjects with intermediate, SPQ scores. The sensitivity in auditory discrimination and the response bias were computed, using signal detection theory. The results show that the ratings of the subjects in the three questionnaires correlate with one another and that subjects with higher SPQ scores appear to perform worse in auditory discrimination. The impaired performance occurs for most of the signal-to-noise ratios. Taken together, these preliminary findings are consistent with earlier studies demonstrating impaired auditory processing in schizophrenia patients. In contrast, the significant correlation between both the SPQ and PAS scores and the CHQ score suggests that further studies are required to rule out the effect of non-psychotic factors such as anxiety on the current results. Second, the three groups of subjects did not differ in the response bias. This latter finding provides evidence at odds with the 'self-monitoring' model of auditory hallucination.

The allocation of attention during smooth pursuit eye movements

The spatial-temporal allocation of attention during smooth pursuit eye movements is poorly understood. In this chapter we review evidence showing that attention contributes to both saccades and smooth pursuit. We then discuss results from our own recent studies using a dual-task paradigm in which subjects pursued a moving stimulus and pressed a button when targets appeared in the periphery. The results from these studies are consistent with the hypothesis that the allocation of attention is biased to a location just in front of the pursuit stimulus and that this bias can be altered by pursuit velocity.

Interhemispheric transfer and laterality effects in simple visual reaction time in schizophrenics

INTRODUCTION

There is evidence that schizophrenics have an abnormal corpus callosum and an abnormal pattern of cerebral asymmetries. We investigated whether there are corresponding functional abnormalities in interhemispheric transfer (IT) and laterality effects.

METHODS

Medicated schizophrenic patients and matched controls were tested in the Poffenberger paradigm, that is, a simple manual reaction time (RT) paradigm with laterally presented visual stimuli designed to provide a behavioural estimate of IT. By subtracting RT averaged across the uncrossed hand-hemifield conditions, from RT averaged across the crossed hand-hemifield conditions, one can obtain an estimate of IT time.

RESULTS

In schizophrenic patients the difference between crossed and uncrossed conditions was 0 because of an unusually prolonged RT in the uncrossed condition right hand/ right field. A broadly similar result has been obtained previously in the tactile modality (Ditchfield & Hemsley, 1990) and is consistent with a left hemisphere impairment. This effect was still present when the patients were retested about 2 years later.

CONCLUSIONS

These results demonstrate the existence in schizophrenic patients of a consistent slowing down of simple visuomotor responses subserved by the left hemisphere.

Lateralized perceptual organization deficits on the global-local task in schizotypal personality disorder

Right and left hemisphere contributions to perceptual organization functions were examined using a divided-attention version of the global-local task in a sample of 21 unmedicated participants diagnosed with schizotypal personality disorder (SPD) and 20 controls. The SPD participants showed an abnormal global processing advantage. When the visual angle of the hierarchical stimuli was increased from 3 degrees to 9 degrees, the controls showed an increasing local processing advantage, but the SPD participants continued to show an abnormal global processing advantage. These findings suggest a local processing deficit on divided-attention versions of the global-local task in schizophrenia spectrum disorders. Female SPD participants, who had less severe interpersonal deficit symptoms, showed a more abnormal global processing advantage. Hemispheric and processing resource mechanisms that might explain these findings are discussed.

Saccadic eye movement abnormalities in relatives of patients with schizophrenia

Recent studies note abnormalities in saccadic eye movements of relatives of patients with schizophrenia. The current study examined which aspects of the saccadic system are affected, whether these saccadic abnormalities are associated with schizophrenia spectrum personality symptoms (SSP), and whether such an association is dependent on a family history of schizophrenia. Furthermore, the study examined what proportion of relatives have the saccadic abnormality(ies). Fifty-five first-degree relatives with no DSM-III-R Axis I diagnosis participated in the study. Twenty-one of these relatives experienced SSP symptoms and 34 had no Axis II diagnosis. Sixty-two subjects with no Axis I diagnosis were recruited from the community. Twenty-five experienced SSP symptoms and 37 had no Axis II diagnosis. Prosaccades (saccades toward the target) and antisaccades (saccades made in the opposite direction of the target jump) were examined. Relatives, particularly those with SSP, had difficulties with the antisaccade task as suggested by higher error rates and longer antisaccade latency. Prosaccades were not different in relatives compared to the community subjects, although the effects of field were different in the two groups on some measures. The antisaccade latency was 'abnormal' in only a small proportion (1.6%) of community subjects compared to 14.9% of all relatives (35.3% of SSP relatives and 3.3% of non-SSP relatives). Relatives of patients with schizophrenia have deficits in aspects of the saccadic system involved in generating internally driven saccades and inhibition of unwanted saccades. These deficits implicate frontal ocular motor neuronal circuitry involving frontal cortical and basal ganglia areas. These deficits are associated with SSP symptoms, but not in the absence of a blood relationship to schizophrenia. The relatively high prevalence rate of the abnormality in at-risk subjects may have relevance for use of these measures in linkage analysis.