A vision science perspective on schizophrenia

Pre-stimulus EEG phase coherence predicts visual target detection failures in schizophrenia: A pilot study

Impaired visual target detection is a common finding in schizophrenia that is linked to poor functional outcomes. However, the neural mechanisms that contribute to this deficit remain unclear. Recent research in healthy samples has identified relationships between the phase of pre-stimulus electroencephalographic (EEG) activity in the alpha band (8-12 Hz) or theta band (4-7 Hz) and the likelihood of visual target detection with and without attentional cueing, but these effects have not yet been explored in schizophrenia. We performed a study to investigate such effects in schizophrenia (n = 19) and healthy participants (n = 14), using a visual target detection task with attentional cues. We found significant relationships between pre-stimulus EEG phase properties and visual target detection in both groups, but also clear differences in the effects as a function of frequency, group, and attentional cueing. Alpha-band phase effects were relatively uniform across groups and conditions. By contrast, theta-band phase effects showed differences by group and attentional condition which could be consistent with attentional hyperfocusing in the schizophrenia group. Thus, our results elucidate a novel neural mechanism that may help to explain known impairments affecting both visual target detection and attention in schizophrenia.

Hypothesis of subcortical visual pathway impairment in schizophrenia

Schizophrenia is a severe mental disease involving both neurological and psychiatric abnormalities. Previous studies mainly focus on damage to high-order cognitive dysfunction, which is related to high-level cortical regions such as the prefrontal and temporal lobes. Recent research reveals that impairment of low-level sensory processing occurs in the early stage of schizophrenia, which may be due to impairment of the subcortical magnocellular visual pathway. Moreover, the structure and function of some important nuclei in a subcortical visual pathway are reported to be abnormal in patients with schizophrenia. Inspired by the above evidence, we propose a hypothesis that impairment of the Superior Colliculus-Pulvinar-Amygdala subcortical visual pathway may be involved in the pathological mechanisms of early stages of schizophrenia. And we propose a possible method to detect dysfunction of this subcortical pathway through examining topological processing, which may help early diagnosis of schizophrenia.

Colour discrimination among patients with schizophrenia in Lebanon

Background: Abnormalities and contrast sensitivity have already been studied in schizophrenia. However, the relationship between symptom severity in schizophrenia and colour vision sensitivity has not been studied systematically.Aim: Our objective was to evaluate colour discrimination in patients with schizophrenia compared to controls and examine if this colour discrimination is correlated with schizophrenia symptoms' severity.Methods: This case-control study, performed between January and April 2017, included 50 schizophrenic patients and 50 healthy controls matched for age and sex. The Positive and Negative Symptoms Scale (PANSS) was used to determine the schizophrenia symptoms' severity. Colour discrimination was evaluated using the total error score (TES) generated using the Farnsworth D-15 test. The higher the TES, the more severe colourblindness.Results: A significantly higher mean TES was found in schizophrenics (30.32) compared to healthy patients (13.07) (p < 0.001). Colour blindness was correlated to the severity of schizophrenic symptoms only in the subgroup of patients with severe schizophrenia.Conclusion: Colour vision defect is a common feature in schizophrenia, and may be more significant when related to psychotic symptoms.KEY POINTSA significantly higher mean TES was found in schizophrenics compared to healthy patients.Colour blindness was correlated to the severity of schizophrenic symptoms only in the subgroup of patients with severe schizophrenia.Colour vision defect is a common feature in schizophrenia, and may be more significant when related to psychotic symptoms.

Impaired Binocular Depth Perception in First-Episode Drug-Naive Patients With Schizophrenia

Binocular depth perception (BDP) is one of the most demanding visual function that involves both dorsal and ventral visual information streams. Substantial research has been conducted on the disruption of BDP in patients with schizophrenia. However, research on first-episode and drug-naive patients with schizophrenia (FEDN) is limited. To assess the BDP of schizophrenia patients while controlling for the effects of antipsychotics and the duration of illness. We investigated BDP in patients with schizophrenia via the Titmus Stereopsis Test in this study, by matching the patients into three groups: FEDN (n = 17), long duration of illness and medicine treatment (LDMT) (n = 31) and the healthy control group (n = 40). Results showed that both the FEDN (mean = 1.71, 95% confidence interval [CI]: [1.57, 1.84]) and LDMT (1.73, 95% CI: [1.66, 1.81]) patients displayed a significant decline (p = 0.01, Cohen's d = 0.67, p = 0.001, Cohen's d = 0.92, respectively) in depth perception compared to the healthy control (1.55, 95% CI: [1.48, 1.61]) group. Additionally, there were no significant differences (p = 0.68, Cohen's d = 0.11) between the FEDN and LDMT groups, and no correlation (Pearson r = -0.16, p = 0.38, R2 = 0.03) was observed between the duration of illness and impaired BDP in the LDMT group. The proportion of individuals with stereopsis detection in either FEDN (12/17) or LDMT (26/31) groups under stereo threshold 63 arc seconds (″), were significantly lower (Pearson χ2 = 6.29, p = 0.043, φc = 0.27) compared to the healthy control group (38/40). Significant difference in stereopsis detection also occurred at 50″ (Pearson χ2 = 12.31, p = 0.001, φc = 0.37), 40″ (Pearson χ2 = 12.38, p = 0.002, φc = 0.38), 32″ (Pearson χ2 = 6.69, p = 0.035, φc = 0.28), 25″ (Pearson χ2 = 14.82, p = 0.001, φc = 0.41) and 20″ (Pearson χ2 = 6.73, p = 0.034, φc = 0.28) between the three groups. These findings showed a moderately strong association between schizophrenia and defective stereopsis.

Visual perceptual remediation for individuals with schizophrenia: Rationale, method, and three case studies

OBJECTIVE

Few studies have evaluated the effects of visual remediation strategies in schizophrenia despite abundant evidence of visual-processing alterations in this condition. We report preliminary, case-study-based evidence regarding the effects of visual remediation in this population.

METHOD

We describe implementation of a visual-perceptual training program called ULTIMEYES (UE) and initial results through 3 brief case studies of individuals with schizophrenia. UE targets broad-based visual function, including low-level processes (e.g., acuity, contrast sensitivity) as well as higher level visual functions. Three inpatients, recruited from a research unit, participated in at least 38 sessions 3 to 4 times per week for approximately 25 min per session. Contrast sensitivity (a trained task), as well as acuity and perceptual organization (untrained tasks), were assessed before and after the intervention. Levels of progression through the task are also reported.

RESULTS

UE was well tolerated by the participants and led to improvements in contrast sensitivity, as well as more generalized gains in visual acuity in all 3 participants and perceptual organization in 2 participants. Symptom profiles were somewhat different for each participant, but all were symptomatic during the intervention. Despite this, they were able to focus on and benefit from training. The adaptive nature of the training was well suited to the slower progression of 2 participants.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

These case studies set the stage for further research, such as larger, randomized controlled trials of the intervention that include additional assessments of perceptual function and measures of cognition, social cognition, and functional outcomes. (PsycINFO Database Record