Interactive effects of background facial emotion stimulus and target salience on sustained attention performance in schizophrenia

Facial expression-based indicators of schizophrenia: Evidence from recent research

Impaired ability to recognize emotion in other's face (decoding) or to express emotion through the face (encoding) are considered critical in schizophrenia. The topic of research draws considerable attention since clinicians rely heavily on the patient's facial expressions for diagnosis and on the patient's ability to understand the clinician's communicative intent. While most researchers argue in favor of a generalized emotion deficit, others indicate an emotion-specific deficit in schizophrenia. An early review (Mandal et al., 1998) indicated a possible breakdown in perception-expression-experience link of emotion; later reviews (Kohler et al., 2010; Chan et al., 2010) pointed to a generalized emotion processing deficit due to perceptual deficits in schizophrenia. The present review (2010-2022) revisits this controversy with 47 published studies (37 decoding, 10 encoding) conducted on 2364 patients in 20 countries. Schizophrenia is characterized by reduced emotion processing ability, especially with negative symptoms and at an acute state of illness. It is however still unclear whether this dysfunction is independent of a generalized face perception deficit or of subjective experience of emotion in schizophrenia.

Common and distinct dysfunctional patterns contribute to triple network model in schizophrenia and depression: A preliminary study

BACKGROUND

Schizophrenia (SCH) and depression (DEP) are prevalent psychiatric disorders and share common and distinguished elements in their pathophysiology. A triple network model composed of the default mode network (DMN), salience network (SN) and central executive network (CEN) may represent a major abnormality across several psychiatric disorders including SCH and DEP. However, common and distinct dysfunctional patterns between SCH and DEP across three core networks remain unclear.

METHOD

Resting-state functional magnetic resonance imaging (fMRI) was obtained in 20 patients with SCH, 20 patients with DEP and 20 healthy controls (HC). Both functional connectivity (FC) and Granger causal connectivity across DMN, SN and CEN were evaluated to uncover common and distinct dysfunctional patterns between SCH and DEP.

RESULTS

Two patient groups showed identical abnormal causal connectivity between key nodes of DMN and SN, as well as opposing aberrant FC of DMN-CEN and SN-CEN. Compared with HC, the FC between CEN and DMN was increased in SCH while decreased in DEP. Conversely, DEP showed enhanced FC between CEN and SN, whereas SCH showed decreased FC.

LIMITATIONS

The sample size was relatively small, and all participants were taking medication.

CONCLUSIONS

Our results identified common patterns including dysconnectivity between DMN and SN, which may contribute to shared cognitive and affective impairment in DEP and SCH. Moreover, opposing dysconnectivity patterns of DMN-CEN may be associated with different self-referential processing abnormalities. These opposing dysconnectivity patterns may indicate an unbalanced recruitment between SN and CEN. Therefore, this study provides dysconnectivity patterns to advance the understanding of the triple network model with regard to psychiatric disorders.

RETRACTED: The effects of perceptual load in processing emotional facial expression in psychotic disorders

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the authors and Editor-in-Chief. The Authors have recently discovered an error in the database that affects the results and, consequently, the discussion, conclusions and abstract of this article on the effects of perceptual load and task-irrelevant facial expression during a target-letter discrimination task in psychotic disorders. The error was discovered by the Authors during the analysis of new data using the same experimental task, but collected from a distinct clinical sample, and involves a systematic error in the database: pictures of one actor were coded as depicting the same valence (angry, happy, neutral) during the programming of the experimental task, regardless of the real facial expression portraited by the picture in each trial. As a result, the information provided by the ‘Emotion’ variable in the database, created by the E-Prime software for each participant during the performance of the task, was not correct. Because the Authors used the ‘Emotion’ variable to perform the statistical analysis, the results of lower accuracy for individuals diagnosed with psychotic disorders in trials where the task-irrelevant stimuli are happy facial expressions - as revealed by a significant interaction between group and facial expression (p = .016) and between group, perceptual load and facial expression (p = .027) - are not correct, thus partially affecting the discussion, conclusions and abstract of the manuscript. Besides the ‘Emotion’ variable, the raw database contains the filename of the picture presented in each trial. Therefore, the Authors were able to correct the error and to re-analyse the data, and will proceed with the submission for publication of the corrected version of the manuscript. The error had no influence on the design and procedure of the experimental task, as the order of the pictures was fully randomized per participant. The Authors apologize for the inconvenience caused by these mistakes and agree with the retraction. The Authors advise all researchers to pay special attention when scripting/coding the stimuli to be used in the experimental tasks, and to confirm all scripting/coding with independent researchers, whenever possible, to prevent mistakes (Strand, 2021). The Journal apologizes that these errors were not detected during peer review.

Disconnection Between Amygdala and Medial Prefrontal Cortex in Psychotic Disorders

Distracting emotional information impairs attention more in schizophrenia (SCZ) than in never-psychotic individuals. However, it is unclear whether this impairment and its neural circuitry is indicative generally of psychosis, or specifically of SCZ, and whether it is even more specific to certain SCZ symptoms (eg, deficit syndrome). It is also unclear if this abnormality contributes to impaired behavioral performance and real-world functioning. Functional imaging data were recorded while individuals with SCZ, bipolar disorder with psychosis (BDP) and no history of psychotic disorders (CON) attended to identity of faces while ignoring their emotional expressions. We examined group differences in functional connectivity between amygdala, involved in emotional evaluation, and sub-regions of medial prefrontal cortex (MPFC), involved in emotion regulation and cognitive control. Additionally, we examined correlation of this connectivity with deficit syndrome and real-world functioning. Behaviorally, SCZ showed the worst accuracy when matching the identity of emotional vs neutral faces. Neurally, SCZ showed lower amygdala-MPFC connectivity than BDP and CON. BPD did not differ from CON, neurally or behaviorally. In patients, reduced amygdala-MPFC connectivity during emotional distractors was related to worse emotional vs neutral accuracy, greater deficit syndrome severity, and unemployment. Thus, reduced amygdala-MPFC functional connectivity during emotional distractors reflects a deficit that is specific to SCZ. This reduction in connectivity is associated with worse clinical and real-world functioning. Overall, these findings provide support for the specificity and clinical utility of amygdala-MPFC functional connectivity as a potential neural marker of SCZ.

Variable prenatal stress results in impairments of sustained attention and inhibitory response control in a 5-choice serial reaction time task in rats

Rats repeatedly exposed to variable prenatal stress (PNS) exhibit schizophrenia-like behavioral signs such as social withdrawal, elevations in amphetamine-induced locomotor activity, deficits in sensory-motor gating, as well as impairments in memory-related task performance. However, to date there have been no studies designed to test the hypothesis that variable PNS would lead to disruptions in sustained attention and inhibitory response control (i.e., symptoms also commonly observed in schizophrenia and other neuropsychiatric disorders such as attention-deficit hyperactivity disorder). In the current study, the effects of variable PNS in rats were evaluated in fixed and variable stimulus duration (VSD) as well as variable intertrial interval (VITI) versions of a 5-choice serial reaction time task (5C-SRTT). In a separate series of experiments, the glutamate (N-methyl-d-aspartate [NMDA]) antagonist, MK-801 (0.025-0.05 mg/kg), and the norepinephrine reuptake inhibitor, atomoxetine (0.30-3.0mg/kg), were administered acutely to assess the sensitivity of PNS subjects to glutamatergic and noradrenergic manipulations. The results indicated that exposure to variable PNS significantly impaired accuracy in the VSD version of the 5C-SRTT and increased premature and timeout responses in the VITI version. In addition, both doses of MK-801 impaired accuracy, increased premature and timeout responses in PNS, but not control subjects. In contrast, atomoxetine decreased premature and timeout responses in both PNS and control subjects in the VITI version of the task and improved accuracy in the PNS subjects. The results suggest that exposure to variable PNS in rats results in impairments of sustained attention and inhibitory response control and that these deficits can be exacerbated by NMDA antagonism and improved by a norepinephrine uptake inhibitor. Collectively, these data further support the premise that variable PNS in rats is a valid model system for the study of neuropsychiatric disorders and their treatment.