Neural evidence for faster and further automatic spreading activation in schizophrenic thought disorder

The 'L-factor': Language as a transdiagnostic dimension in psychopathology

Thoughts and moods constituting our mental life incessantly change. When the steady flow of this dynamics diverges in clinical directions, the possible pathways involved are captured through discrete diagnostic labels. Yet a single vulnerable neurocognitive system may be causally involved in psychopathological deviations transdiagnostically. We argue that language viewed as integrating cortical functions is the best current candidate, whose forms of breakdown along its different dimensions are then manifest as symptoms - from prosodic abnormalities and rumination in depression to distortions of speech perception in verbal hallucinations, distortions of meaning and content in delusions, or disorganized speech in formal thought disorder. Spontaneous connected speech provides continuous objective readouts generating a highly accessible bio-behavioral marker with the potential of revolutionizing neuropsychological measurement. This argument turns language into a transdiagnostic 'L-factor' providing an analytical and mechanistic substrate for previously proposed latent general factors of psychopathology ('p-factor') and cognitive functioning ('c-factor'). Together with immense practical opportunities afforded by rapidly advancing natural language processing (NLP) technologies and abundantly available data, this suggests a new era of translational clinical psychiatry, in which both psychopathology and language may be rethought together.

N400 event-related brain potential index of semantic processing and two-year clinical outcomes in persons at high risk for psychosis: A longitudinal study

The N400 event-related brain potential (ERP) semantic priming effect reflects greater activation of contextually related versus unrelated concepts in long-term semantic memory. Deficits in this measure have been found in persons with schizophrenia and those at clinical high risk (CHR) for this disorder. In CHR patients, we previously found that these deficits predict poorer social functional outcomes after 1 year. In the present study, we tested whether these deficits predicted greater psychosis-spectrum symptom severity and functional impairment over 2 years. We measured N400 semantic priming effects at baseline in CHR patients (n = 47) who viewed prime words each followed by a related/unrelated target word at stimulus-onset asynchronies (SOAs) of 300 or 750 ms. We measured psychosis-spectrum symptoms using the Structured Interview for Prodromal Symptoms and role and social functioning with the Global Functioning: Role and Social scales, at baseline, 1 (n = 29) and 2 years (n = 25). There was a significant interaction between the N400 semantic priming effect at the 300-ms SOA and time on GF:Role scores, indicating that, contrary to expectations, smaller baseline N400 semantic priming effects were associated with more improvement in role functioning from baseline to Year 1, but baseline N400 priming effects did not predict role functioning at Year 2. N400 priming effects were not significantly associated with different trajectories in psychosis-spectrum symptoms or social functioning. Thus, CHR patients' N400 semantic priming effects did not predict clinical outcomes over 2 years, suggesting that this ERP measure may have greater value as a state or short-term prognostic neurophysiological biomarker.

We both say tomato: Intact lexical alignment in schizophrenia and bipolar disorder

In people with schizophrenia and related disorders, impairments in communication and social functioning can negatively impact social interactions and quality of life. In the present study, we investigated the cognitive basis of a specific aspect of linguistic communication-lexical alignment-in people with schizophrenia and bipolar disorder. We probed lexical alignment as participants played a collaborative picture-naming game with the experimenter, in which the two players alternated between naming a dual-name picture (e.g., rabbit/bunny) and listening to their partner name a picture. We found evidence of lexical alignment in all three groups, with no differences between the patient groups and the controls. We argue that these typical patterns of lexical alignment in patients were supported by preserved-and in some cases increased-bottom-up mechanisms, which balanced out impairments in top-down perspective-taking.

N400 event-related brain potential and functional outcome in persons at clinical high risk for psychosis: A longitudinal study

BACKGROUND

The N400 event-related brain potential (ERP) semantic priming effect is thought to reflect activation by meaningful stimuli of related concepts in semantic memory and has been found to be deficient in schizophrenia. We tested the hypothesis that, among individuals at clinical high risk (CHR) for psychosis, N400 semantic priming deficits predict worse symptomatic and functional outcomes after one year.

METHODS

We measured N400 semantic priming at baseline in CHR patients (n = 47) and healthy control participants (n = 25) who viewed prime words each followed by a related or unrelated target word, at stimulus-onset asynchronies (SOAs) of 300 or 750 ms. We measured patients' psychosis-like symptoms with the Scale of Prodromal Symptoms (SOPS) Positive subscale, and academic/occupational and social functioning with the Global Functioning (GF):Role and Social scales, respectively, at baseline and one-year follow-up (n = 29).

RESULTS

CHR patients exhibited less N400 semantic priming than controls across SOAs; planned contrasts indicated this difference was significant at the 750-ms but not the 300-ms SOA. In patients, reduced N400 semantic priming at the 750-ms SOA was associated with lower GF:Social scores at follow-up, and greater GF:Social decrements from baseline to follow-up. Patients' N400 semantic priming was not associated with SOPS Positive or GF:Role scores at follow-up, or change in these from baseline to follow-up.

CONCLUSIONS

In CHR patients, reduced N400 semantic priming at baseline predicted worse social functioning after one year, and greater decline in social functioning over this period. Thus, the N400 may be a useful prognostic biomarker of real-world functional outcome in CHR patients.

Semantic priming and neurobiology in schizophrenia: A theoretical review

In this theoretical review we bridge the cognitive and neurobiological sciences to shed light on the neurocognitive foundations of the semantic priming effect in schizophrenia. We review and theoretically evaluate the neurotransmitter systems (dopaminergic, GABAergic and glutamatergic) and neurobiological underpinnings of behavioural and electrophysiological (N400) semantic priming in the pathology, and the main hypotheses on their geneses: a disinhibition of the semantic spread of activation, a disorganised semantic storage or noisy lexical-semantic associations, a psychomotor artefact, an artefact of relatedness proportions, or an inability to mobilise contextual information. We further assess the literature on the endophenotype of Formal Thought Disorder from multiple standpoints, ranging from neurophysiology to cognition: considerations are weaved on neuronal (PV basket cell, SST, VIP) and receptor deficits (DRD1, NMDA), neurotransmitter imbalances (dopamine), cortical and dopaminergic lateralisation, inter alia. In conclusion, we put forth novel postulates on the underlying causes of controlled hypopriming, automatic hyperpriming, N400 reversals (larger amplitudes for close associations), indirect versus direct hyperpriming, and the endophenotype of lexical-semantic disturbances in schizophrenia.

Does adding beer to coffee enhance the activation of drinks? An ERP study of semantic category priming

Categorization - whether of objects, ideas, or events - is a cognitive process that is essential for human thinking, reasoning, and making sense of everyday experiences. Categorization abilities are typically measured by the Wechsler Adult Intelligence Scale (WAIS) similarity subtest, which consists of naming the shared category of two items (e.g., 'How are beer and coffee alike'). Previous studies show that categorization, as measured by similarity tasks, requires executive control functions. However, other theories and studies indicate that semantic memory is organized into taxonomic and thematic categories that can be activated implicitly in semantic priming tasks. To explore whether categories can be primed during a similarity task, we developed a double semantic priming paradigm. We measured the priming effect of two primes on a target word that was taxonomically or thematically related to both primes (double priming) or only one of them (single priming). Our results show a larger and additive priming effect in the double priming condition compared to the single priming condition, as measured by both response times and, more consistently, event-related potentials. Our results support the view that taxonomic and thematic categorization can occur during a double priming task and contribute to improving our knowledge on the organization of semantic memory into categories. These findings show how abstract categories can be activated, which likely shapes the way we think and interact with our environment. Our study also provides a new cognitive tool that could be useful to understand the categorization difficulties of neurological patients.

N400 event-related brain potential as an index of real-world and neurocognitive function in patients at clinical high risk for schizophrenia

AIM

The N400 event-related potential is a neurophysiological index of cognitive processing of real-world knowledge. In healthy populations, N400 amplitude is smaller in response to stimuli that are more related to preceding context. This 'N400 semantic priming effect' is thought to reflect activation of contextually related information in semantic memory (SM). N400 semantic priming deficits have been found in schizophrenia, and in patients at clinical high risk (CHR) for this disorder. Because this abnormality in processing relationships between meaningful stimuli could affect ability to navigate everyday situations, we hypothesized it would be associated with real-world functional impairment in CHR patients. Second, we hypothesized it would correlate with global neurocognitive impairment in this group.

METHODS

We measured N400 semantic priming in 35 CHR patients who viewed prime words each followed by a related or unrelated target word, at stimulus-onset asynchrony (SOA) of 300 or 750 ms. We measured academic/occupational and social function with the global function (GF): Role and Social scales, and cognitive function with the MATRICS Consensus Cognitive Battery (MCCB).

RESULTS

Decreased N400 semantic priming at the 300-ms SOA correlated with lower GF:Role scores. Decreased N400 semantic priming at the 750-ms SOA correlated with lower MCCB composite scores.

CONCLUSIONS

Deficits in activating contextually related concepts in SM over short time intervals may contribute to functional impairment in CHR patients. Furthermore, N400 priming deficits over longer intervals may be a biomarker of global cognitive dysfunction in this population. Longitudinal studies are needed to determine whether these deficits are associated with schizophrenia risk within this population.

Language-Related Neurophysiological Deficits in Schizophrenia

Schizophrenia is a severe psychiatric disorder that affects all aspects of one's life with several cognitive and social dysfunctions. However, there is still no objective and universal index for diagnosis and treatment of this disease. Many researchers have studied language processing in schizophrenia since most of the patients show symptoms related to language processing, such as thought disorder, auditory verbal hallucinations, or delusions. Electroencephalography (EEG) and magnetoencephalography (MEG) with millisecond order high temporal resolution, have been applied to reveal the abnormalities in language processing in schizophrenia. The aims of this review are (a) to provide an overview of recent findings in language processing in schizophrenia with EEG and MEG using neurophysiological indices, providing insights into underlying language related pathophysiological deficits in this disease and (b) to emphasize the advantage of EEG and MEG in research on language processing in schizophrenia.

Anomalies in language as a biomarker for schizophrenia

PURPOSE OF REVIEW

After more than a century of neuroscience research, reproducible, clinically relevant biomarkers for schizophrenia have not yet been established. This article reviews current advances in evaluating the use of language as a diagnostic or prognostic tool in schizophrenia.

RECENT FINDINGS

The development of computational linguistic tools to quantify language disturbances is rapidly gaining ground in the field of schizophrenia research. Current applications are the use of semantic space models and acoustic analyses focused on phonetic markers. These features are used in machine learning models to distinguish patients with schizophrenia from healthy controls or to predict conversion to psychosis in high-risk groups, reaching accuracy scores (generally ranging from 80 to 90%) that exceed clinical raters. Other potential applications for a language biomarker in schizophrenia are monitoring of side effects, differential diagnostics and relapse prevention.

SUMMARY

Language disturbances are a key feature of schizophrenia. Although in its early stages, the emerging field of research focused on computational linguistics suggests an important role for language analyses in the diagnosis and prognosis of schizophrenia. Spoken language as a biomarker for schizophrenia has important advantages because it can be objectively and reproducibly quantified. Furthermore, language analyses are low-cost, time efficient and noninvasive in nature.

Neuronal mechanisms for sequential activation of memory items: Dynamics and reliability

In this article we present a biologically inspired model of activation of memory items in a sequence. Our model produces two types of sequences, corresponding to two different types of cerebral functions: activation of regular or irregular sequences. The switch between the two types of activation occurs through the modulation of biological parameters, without altering the connectivity matrix. Some of the parameters included in our model are neuronal gain, strength of inhibition, synaptic depression and noise. We investigate how these parameters enable the existence of sequences and influence the type of sequences observed. In particular we show that synaptic depression and noise drive the transitions from one memory item to the next and neuronal gain controls the switching between regular and irregular (random) activation.

Aberrant activity in conceptual networks underlies N400 deficits and unusual thoughts in schizophrenia

BACKGROUND

The N400 event-related potential (ERP) is triggered by meaningful stimuli that are incongruous, or unmatched, with their semantic context. Functional magnetic resonance imaging (fMRI) studies have identified brain regions activated by semantic incongruity, but their precise links to the N400 ERP are unclear. In schizophrenia (SZ), N400 amplitude reduction is thought to reflect overly broad associations in semantic networks, but the abnormalities in brain networks underlying deficient N400 remain unknown. We utilized joint independent component analysis (JICA) to link temporal patterns in ERPs to neuroanatomical patterns from fMRI and investigate relationships between N400 amplitude and neuroanatomical activation in SZ patients and healthy controls (HC).

METHODS

SZ patients (n = 24) and HC participants (n = 25) performed a picture-word matching task, in which words were either matched (APPLE→apple) by preceding pictures, or were unmatched by semantically related (in-category; IC, APPLE→lemon) or unrelated (out of category; OC, APPLE→cow) pictures, in separate ERP and fMRI sessions. A JICA "data fusion" analysis was conducted to identify the fMRI brain regions specifically associated with the ERP N400 component. SZ and HC loading weights were compared and correlations with clinical symptoms were assessed.

RESULTS

JICA identified an ERP-fMRI "fused" component that captured the N400, with loading weights that were reduced in SZ. The JICA map for the IC condition showed peaks of activation in the cingulate, precuneus, bilateral temporal poles and cerebellum, whereas the JICA map from the OC condition was linked primarily to visual cortical activation and the left temporal pole. Among SZ patients, fMRI activity from the IC condition was inversely correlated with unusual thought content.

CONCLUSIONS

The neural networks associated with the N400 ERP response to semantic violations depends on conceptual relatedness. These findings are consistent with a distributed network underlying neural responses to semantic incongruity including unimodal visual areas as well as integrative, transmodal areas. Unusual thoughts in SZ may reflect impaired processing in transmodal hub regions such as the precuneus, leading to overly broad semantic associations.

Multimodal neuroimaging evidence for looser lexico-semantic networks in schizophrenia:Evidence from masked indirect semantic priming

It has been hypothesized that schizophrenia is characterized by overly broad automatic activity within lexico-semantic networks. We used two complementary neuroimaging techniques, Magnetoencephalography (MEG) and functional Magnetic Resonance Imaging (fMRI), in combination with a highly automatic indirect semantic priming paradigm, to spatiotemporally localize this abnormality in the brain. Eighteen people with schizophrenia and 20 demographically-matched control participants viewed target words ("bell") preceded by directly related ("church"), indirectly related ("priest"), or unrelated ("hammer") prime words in MEG and fMRI sessions. To minimize top-down processing, the prime was masked, the target appeared only 140 ms after prime onset, and participants simply monitored for words within a particular semantic category that appeared in filler trials. Both techniques revealed a significantly larger automatic indirect priming effect in people with schizophrenia than in control participants. MEG temporally localized this enhanced effect to the N400 time window (300-500 ms) - the critical stage of accessing meaning from words. fMRI spatially localized the effect to the left temporal fusiform cortex, which plays a role in mapping of orthographic word-form on to meaning. There was no evidence of an enhanced automatic direct semantic priming effect in the schizophrenia group. These findings provide converging neural evidence for abnormally broad highly automatic lexico-semantic activity in schizophrenia. We argue that, rather than arising from an unconstrained spread of automatic activation across semantic memory, this broader automatic lexico-semantic activity stems from looser mappings between the form and meaning of words.

Deficits in nominal reference identify thought disordered speech in a narrative production task

Formal thought disorder (TD) is a neuropathology manifest in formal language dysfunction, but few behavioural linguistic studies exist. These have highlighted problems in the domain of semantics and more specifically of reference. Here we aimed for a more complete and systematic linguistic model of TD, focused on (i) a more in-depth analysis of anomalies of reference as depending on the grammatical construction type in which they occur, and (ii) measures of formal grammatical complexity and errors. Narrative speech obtained from 40 patients with schizophrenia, 20 with TD and 20 without, and from 14 healthy controls matched on pre-morbid IQ, was rated blindly. Results showed that of 10 linguistic variables annotated, 4 showed significant differences between groups, including the two patient groups. These all concerned mis-uses of noun phrases (NPs) for purposes of reference, but showed sensitivity to how NPs were classed: definite and pronominal forms of reference were more affected than indefinite and non-pronominal (lexical) NPs. None of the measures of formal grammatical complexity and errors distinguished groups. We conclude that TD exhibits a specific and differentiated linguistic profile, which can illuminate TD neuro-cognitively and inform future neuroimaging studies, and can have clinical utility as a linguistic biomarker.

The impact of auditory white noise on semantic priming

It has been proposed that white noise can improve cognitive performance for some individuals, particularly those with lower attention, and that this effect may be mediated by dopaminergic circuitry. Given existing evidence that semantic priming is modulated by dopamine, this study investigated whether white noise can facilitate semantic priming. Seventy-eight adults completed an auditory semantic priming task with and without white noise, at either a short or long inter-stimulus interval (ISI). Measures of both direct and indirect semantic priming were examined. Analysis of the results revealed significant direct and indirect priming effects at each ISI in noise and silence, however noise significantly reduced the magnitude of indirect priming. Analyses of subgroups with higher versus lower attention revealed a reduction to indirect priming in noise relative to silence for participants with lower executive and orienting attention. These findings suggest that white noise focuses automatic spreading activation, which may be driven by modulation of dopaminergic circuitry.

The effect of associative strength on semantic priming in schizophrenia

The present research was designed to investigate the pattern of semantic priming in schizophrenia as a function of strength of association (or semantic distance between concepts in the semantic network). Thirty schizophrenia patients, without formal thought disorder, and twenty-nine healthy controls participated in a lexical decision task in which prime-target associative strength (strong, weak and not related) and stimulus-onset asynchrony (SOA: 250ms and 750ms) were manipulated. Patients and controls showed the same associative strength effect on RTs. In the short SOA condition priming effects were obtained for both strong and weak prime-target associative conditions. However in the long SOA priming was only significant for strongly associated pairs. This pattern of priming effects was similar in both groups, with higher priming on the short SOA and strong association conditions. Altogether results suggest that automatic semantic spreading activation is unimpaired in schizophrenia patients without formal thought disorder. These results are in line with the general evidence of impaired implicit priming observed only in patients with formal thought disorder. At the same time patients use context as controls to facilitate word processing. Finally, these findings evidence that, prime-target associative strength could moderate results in studies of semantic memory deficits in schizophrenia.

Priming production: Neural evidence for enhanced automatic semantic activity preceding language production in schizophrenia

Introduction

Lexico-semantic disturbances are considered central to schizophrenia. Clinically, their clearest manifestation is in language production. However, most studies probing their underlying mechanisms have used comprehension or categorization tasks. Here, we probed automatic semantic activity prior to language production in schizophrenia using event-related potentials (ERPs).

Methods

19 people with schizophrenia and 16 demographically-matched healthy controls named target pictures that were very quickly preceded by masked prime words. To probe automatic semantic activity prior to production, we measured the N400 ERP component evoked by these targets. To determine the origin of any automatic semantic abnormalities, we manipulated the type of relationship between prime and target such that they overlapped in (a) their semantic features (semantically related, e.g. "cake" preceding a < picture of a pie >, (b) their initial phonemes (phonemically related, e.g. "stomach" preceding a < picture of a starfish >), or (c) both their semantic features and their orthographic/phonological word form (identity related, e.g. "socks" preceding a < picture of socks >). For each of these three types of relationship, the same targets were paired with unrelated prime words (counterbalanced across lists). We contrasted ERPs and naming times to each type of related target with its corresponding unrelated target.

Results

People with schizophrenia showed abnormal N400 modulation prior to naming identity related (versus unrelated) targets: whereas healthy control participants produced a smaller amplitude N400 to identity related than unrelated targets, patients showed the opposite pattern, producing a larger N400 to identity related than unrelated targets. This abnormality was specific to the identity related targets. Just like healthy control participants, people with schizophrenia produced a smaller N400 to semantically related than to unrelated targets, and showed no difference in the N400 evoked by phonemically related and unrelated targets. There were no differences between the two groups in the pattern of naming times across conditions.

Conclusion

People with schizophrenia can show abnormal neural activity associated with automatic semantic processing prior to language production. The specificity of this abnormality to the identity related targets suggests that that, rather than arising from abnormalities of either semantic features or lexical form alone, it may stem from disruptions of mappings (connections) between the meaning of words and their form.

Can RDoC Help Find Order in Thought Disorder?

Thought disorder is a pernicious and nonspecific aspect of numerous serious mental illnesses (SMIs) and related conditions. Despite decades of empirical research on thought disorder, our present understanding of it is poor, our clinical assessments focus on a limited set of extreme behaviors, and treatments are palliative at best. Applying a Research Domain Criteria (RDoC) framework to thought disorder research offers advantages to explicate its phenotype; isolate its mechanisms; and develop more effective assessments, treatments, and potential cures. In this commentary, we discuss ways in which thought disorder can be understood within the RDoC framework. We propose operationalizing thought disorder within the RDoC construct of language using psycholinguistic sciences, to help objectify and quantify language within individuals; technologically sophisticated paradigms, to allow naturalistic behavioral sampling techniques with unprecedented ecological validity; and computational modeling, to account for a network of interconnected and dynamic linguistic, cognitive, affective, and social functions. We also highlight challenges for understanding thought disorder within an RDoC framework. Thought disorder likely does not occur as an isomorphic dysfunction in a single RDoC construct, but rather, as multiple potential dysfunctions in a network of RDoC constructs. Moreover, thought disorder is dynamic over time and context within individuals. In sum, RDoC is a useful framework to integrate multidisciplinary research efforts aimed at operationalizing, understanding, and ameliorating thought disorder.

The Acquisition of Orthographic Knowledge: Evidence from the Lexicality Effects on N400

This study aimed to understand how reading ability shapes the lexicality effects on N400. Fifty-three typical developing children from the second to the sixth grades were asked to perform the pronounceability judgment task on a set of Chinese real characters (RC), pseudocharacters (PC) and non-characters (NC), as ERPs were recorded. The cluster-based permutation analysis revealed that children with low- to medium-reading ability showed greater negativity to NCs than to RCs and PCs in frontal sites from 300 to 450 ms, while children with high ability group showed a greater positivity to NCs than both RCs and PCs at central to posterior sites. Furthermore, the linear mixed model (LMM) analysis was applied to investigate the relationship between lexicality effects on N400 and reading-related behavioral assessments on a set of standardized tests (including character recognition, vocabulary size, phonological awareness, and working memory). The results found that in children with lower reading ability, the N400 elicited by NCs becomes more negative in the frontal sites. For children with higher reading ability, the N400 elicited by NCs became more positive than that elicited by RCs or PCs in the posterior sites. These findings demonstrate the developmental changes in the lexicality effects on N400 as children become more advanced readers and suggested that the lexicality effects on N400 can serve as neural markers for the evaluation of orthographic proficiency in reading development.

Abnormal N400 Semantic Priming Effect May Reflect Psychopathological Processes in Schizophrenia: A Twin Study

OBJECTIVE

Activation of semantic networks is indexed by the N400 effect. We used a twin study design to investigate whether N400 effect abnormalities reflect genetic/trait liability or are related to psychopathological processes in schizophrenia.

METHODS

We employed robust linear regression to compare N400 and behavioral priming effects across 36 monozygotic twin pairs (6 pairs concordant for schizophrenia/schizoaffective disorder, 11 discordant pairs, and 19 healthy control pairs) performing a lexical decision task. Moreover, we examined the correlation between Brief Psychiatric Rating Scale (BPRS) score and the N400 effect and the influence of medication status on this effect.

RESULTS

Regression yielded a significant main effect of group on the N400 effect only in the direct priming condition (p = 0.003). Indirect condition and behavioral priming effect showed no significant effect of group. Planned contrasts with the control group as a reference group revealed that affected concordant twins had significantly reduced N400 effect compared to controls, and discordant affected twins had a statistical trend for reduced N400 effect compared to controls. The unaffected twins did not differ significantly from the controls. There was a trend for correlation between reduced N400 effect and higher BPRS scores, and the N400 effect did not differ significantly between medicated and unmedicated patients.

CONCLUSIONS

Reduced N400 effect may reflect disease-specific processes in schizophrenia implicating frontotemporal brain network in schizophrenia pathology.

Impaired Self-Monitoring of Inner Speech in Schizophrenia Patients with Verbal Hallucinations and in Non-clinical Individuals Prone to Hallucinations

BACKGROUND

Previous research has shown that various memory errors reflecting failure in the self-monitoring of speech were associated with auditory/verbal hallucinations in schizophrenia patients and with proneness to hallucinations in non-clinical individuals.

METHOD

We administered to 57 schizophrenia patients and 60 healthy participants a verbal memory task involving free recall and recognition of lists of words with different structures (high-frequency, low-frequency, and semantically organisable words). Extra-list intrusions in free recall were tallied, and the response bias reflecting tendency to make false recognitions of non-presented words was computed for each list.

RESULTS

In the male patient subsample, extra-list intrusions were positively associated with verbal hallucinations and inversely associated with negative symptoms. In the healthy participants the extra-list intrusions were positively associated with proneness to hallucinations. A liberal response bias in the recognition of the high-frequency words was associated with verbal hallucinations in male patients and with proneness to hallucinations in healthy men. Meanwhile, a conservative response bias for these high-frequency words was associated with negative symptoms in male patients and with social anhedonia in healthy men.

CONCLUSION

Misattribution of inner speech to an external source, reflected by false recollection of familiar material, seems to underlie both clinical and non-clinical hallucinations. Further, both clinical and non-clinical negative symptoms may exert on verbal memory errors an effect opposite to that of hallucinations.

Individual differences in the executive control of attention, memory, and thought, and their associations with schizotypy

A large correlational study took a latent-variable approach to the generality of executive control by testing the individual-differences structure of executive-attention capabilities and assessing their prediction of schizotypy, a multidimensional construct (with negative, positive, disorganized, and paranoid factors) conveying risk for schizophrenia. Although schizophrenia is convincingly linked to executive deficits, the schizotypy literature is equivocal. Subjects completed tasks of working memory capacity (WMC), attention restraint (inhibiting prepotent responses), and attention constraint (focusing visual attention amid distractors), the latter 2 in an effort to fractionate the "inhibition" construct. We also assessed mind-wandering propensity (via in-task thought probes) and coefficient of variation in response times (RT CoV) from several tasks as more novel indices of executive attention. WMC, attention restraint, attention constraint, mind wandering, and RT CoV were correlated but separable constructs, indicating some distinctions among "attention control" abilities; WMC correlated more strongly with attentional restraint than constraint, and mind wandering correlated more strongly with attentional restraint, attentional constraint, and RT CoV than with WMC. Across structural models, no executive construct predicted negative schizotypy and only mind wandering and RT CoV consistently (but modestly) predicted positive, disorganized, and paranoid schizotypy; stalwart executive constructs in the schizophrenia literature-WMC and attention restraint-showed little to no predictive power, beyond restraint's prediction of paranoia. Either executive deficits are consequences rather than risk factors for schizophrenia, or executive failures barely precede or precipitate diagnosable schizophrenia symptoms. (PsycINFO Database Record

Examining the cognitive costs of counterfactual language comprehension: Evidence from ERPs

Recent empirical research suggests that understanding a counterfactual event (e.g. 'If Josie had revised, she would have passed her exams') activates mental representations of both the factual and counterfactual versions of events. However, it remains unclear when readers switch between these models during comprehension, and whether representing multiple 'worlds' is cognitively effortful. This paper reports two ERP studies where participants read contexts that set up a factual or counterfactual scenario, followed by a second sentence describing a consequence of this event. Critically, this sentence included a noun that was either consistent or inconsistent with the preceding context, and either included a modal verb to indicate reference to the counterfactual-world or not (thus referring to the factual-world). Experiment 2 used adapted versions of the materials used in Experiment 1 to examine the degree to which representing multiple versions of a counterfactual situation makes heavy demands on cognitive resources by measuring individuals' working memory capacity. Results showed that when reference to the counterfactual-world was maintained by the ongoing discourse, readers correctly interpreted events according to the counterfactual-world (i.e. showed larger N400 for inconsistent than consistent words). In contrast, when cues referred back to the factual-world, readers showed no difference between consistent and inconsistent critical words, suggesting that they simultaneously compared information against both possible worlds. These results support previous dual-representation accounts for counterfactuals, and provide new evidence that linguistic cues can guide the reader in selecting which world model to evaluate incoming information against. Crucially, we reveal evidence that maintaining and updating a hypothetical model over time relies upon the availability of cognitive resources.

Creativity and positive symptoms in schizophrenia revisited: Structural connectivity analysis with diffusion tensor imaging

Both creativity and schizotypy are suggested to be manifestations of the hyperactivation of unusual or remote concepts/words. However, the results of studies on creativity in schizophrenia are diverse, possibly due to the multifaceted aspects of creativity and difficulties of differentiating adaptive creativity from pathological schizotypy/positive symptoms. To date, there have been no detailed studies comprehensively investigating creativity, positive symptoms including delusions, and their neural bases in schizophrenia. In this study, we investigated 43 schizophrenia and 36 healthy participants using diffusion tensor imaging. We used idea, design, and verbal (semantic and phonological) fluency tests as creativity scores and Peters Delusions Inventory as delusion scores. Subsequently, we investigated group differences in every psychological score, correlations between fluency and delusions, and relationships between these scores and white matter integrity using tract-based spatial statistics (TBSS). In schizophrenia, idea and verbal fluency were significantly lower in general, and delusion score was higher than in healthy controls, whereas there were no group differences in design fluency. We also found positive correlation between phonological fluency and delusions in schizophrenia. By correlation analyses using TBSS, we found that the anterior part of corpus callosum was the substantially overlapped area, negatively correlated with both phonological fluency and delusion severity. Our results suggest that the anterior interhemispheric dysconnectivity might be associated with executive dysfunction, and disinhibited automatic spreading activation in the semantic network was manifested as uncontrollable phonological fluency or delusions. This dysconnectivity could be one possible neural basis that differentiates pathological positive symptoms from adaptive creativity.

An incongruent reality: the N400 in relation to psychosis and recovery

BACKGROUND

Cognitive impairments and delusions are hallmarks of schizophrenia, and are thought to be due in part to abnormalities in semantic priming. The N400, a neural measure of semantic processing, is found to be reduced in schizophrenia. However, it is unclear if individuals with other psychoses (e.g., mood disorders or substance abuse with psychotic features) also show this impairment, and whether N400 reduction relates to real-world functioning and recovery.

METHODS

Eighty-nine individuals from the Suffolk County Mental Health Project, a longitudinal study of first-admission psychosis, and 35 healthy adults were assessed using matched, related, and unrelated picture-word pairs to elicit the N400. Patients' real-world functioning, symptomatology, and recovery were tracked since first hospitalization; EEG assessment was completed during year 15 of the study.

RESULTS

Participants with schizophrenia had slower reaction times and reduced N400 to semantically incongruent stimuli relative to healthy participants. Schizophrenia and other psychoses did not differ on N400, suggesting that N400 abnormalities characterize psychosis broadly. When grouped by recovery status, patients who remained ill had a significantly blunted N400, while those who recovered did not differ from healthy adults. Few patients with schizophrenia achieved recovery; therefore recovery results are limited to the other psychosis group. Furthermore, reduced N400 and increased reaction times correlated with greater psychotic symptoms, worse global assessment of functioning scores, unemployment, and impaired social functioning.

CONCLUSIONS

Abnormalities in the N400 are not specific to schizophrenia; in addition, the N400 may be a useful neural correlate of recovery and real-world functioning across psychotic disorders.

Test-retest reliability of N400 event-related brain potential measures in a word-pair semantic priming paradigm in patients with schizophrenia

The N400 event-related brain potential (ERP), a negative voltage deflection occurring approximately 400ms after onset of any meaningful stimulus, is reduced in amplitude when the stimulus is preceded by related context. Previous work has found this N400 semantic priming effect to be decreased in schizophrenia, suggesting impairment in using meaningful context to activate related concepts in semantic memory. Thus, N400 amplitude may be a useful biomarker of abnormal semantic processing and its response to treatment in schizophrenia. To help assess the validity of N400 amplitude as a longitudinal measure in schizophrenia, we evaluated its test-retest reliability. ERPs were recorded in sixteen schizophrenia patients who viewed prime words, each followed at 300- or 750-ms stimulus-onset asynchrony (SOA) by a target that was either a related or unrelated word, or nonword. Participants' task was to indicate whether or not the target was a real word. They were retested on the same procedure one week later. Test-retest reliability was assessed by calculating Pearson's r and intraclass correlation coefficients (ICCs) across timepoints for N400 amplitudes for related and unrelated targets, at each SOA. Consistent with previous results, there were no significant differences between patients' N400 amplitudes for related and unrelated targets, at any SOA/timepoint combination. Pearson's r and ICCs for N400 amplitudes at Fz across timepoints were significant for both target types at each SOA (ranges: r 0.52-0.64, ICC 0.52-0.63; all p<.04). The results suggest potential utility of N400 amplitude as a longitudinal neurophysiological biomarker of semantic processing abnormalities in schizophrenia.

Higher-order semantic processing in formal thought disorder in schizophrenia

Higher-order semantic impairments and lack of sensitivity to linguistic context have both been implicated in formal thought disorder (FTD) in schizophrenia. Most investigations have focused on comprehension. We investigated the processing of higher-order semantic relations and the role of emotional arousal in FTD patients' linguistic comprehension and production. We compared FTD schizophrenia patients (n=14) with non-FTD schizophrenia patients (n=18) and healthy controls (n=15) on sense-judgment and repetition tasks, in emotionally negative and neutral conditions. We predicted that the FTD group would display poor sensitivity compared to the other two groups in comprehension and production, and that this would be exacerbated by sentence complexity and negative emotional arousal. The emotional manipulation was not robustly successful, and did not affect task performance in the patient groups. FTD patients made significantly more errors on sense-judgments and repetition than the other two groups. Complexity affected all groups to a similar extent in sense-judgments, but affected FTD patients disproportionately in the repetition task. These results support the view that a lack of sensitivity to context underlies FTD in comprehension and production stages of processing. Patients fail to utilise linguistic context to integrate lexical forms into a global whole and guide their access to lexical targets.

Natural speech comprehension in bipolar disorders: an event-related brain potential study among manic patients

BACKGROUND

Thought and language disturbances are crucial clinical features in Bipolar Disorders (BD), and constitute a fundamental basis for social cognition. In BD, clinical manifestations such as disorganization and formal thought disorders may play a role in communication disturbances. However, only few studies have explored language disturbances in BD at a neurophysiological level. Two main Event-Related brain Potentials (ERPs) have been used in language comprehension research: the N400 component, elicited by incongruous word with the preceding semantic context, and the Late Positive Component (LPC), associated with non-specifically semantic and more general cognitive processes. Previous studies provided contradictory results regarding N400 in mood disorders, showing either preserved N400 in depression or dysthymia, or altered N400 in BD during semantic priming paradigm. The aim of our study was to explore N400 and LPC among patients with BD in natural speech conditions.

METHODS

ERPs from 19 bipolar type I patients with manic or hypomanic symptomatology and 19 healthy controls were recorded. Participants were asked to listen to congruous and incongruous complete sentences and to judge the match between the final word and the sentence context. Behavioral results and ERPs data were analyzed.

RESULTS

At the behavioral level, patients with BD show worst performances than healthy participants. At the electrophysiological level, our results show preserved N400 component in BD. LPC elicited under natural speech conditions shows preserved amplitude but delayed latency in difference waves.

LIMITATIONS

Small size of samples, absence of schizophrenic group and medication status.

CONCLUSIONS

In contrast with the only previous N400 study in BD that uses written semantic priming, our results show a preserved N400 component in ecological and natural speech conditions among patients with BD. Possible implications in terms of clinical specificity are discussed.

Event-related brain potential study of semantic priming in unaffected first-degree relatives of schizophrenia patients

Schizophrenia is associated with abnormalities in using meaningful stimuli to activate or prime related concepts in semantic long-term memory. A neurophysiological index of this activation is the N400, an event-related brain potential (ERP) waveform elicited by meaningful stimuli, which is normally reduced (made less negative) by relatedness between the eliciting stimulus and preceding ones (N400 semantic priming). Schizophrenia patients exhibit N400 semantic priming deficits, suggesting impairment in using meaningful context to activate related concepts. To address whether this abnormality is a trait-like marker of liability to schizophrenia or, alternatively, a biomarker of the illness itself, we tested for its presence in schizophrenia patients' unaffected biological relatives. We recorded ERPs from 12 unaffected first-degree relatives of schizophrenia patients, 12 schizophrenia patients, and 12 normal control participants (NCPs) who viewed prime words each followed at 300- or 750-ms stimulus-onset asynchrony (SOA) by an unrelated or related target word, or a nonword, in a lexical-decision task. As expected, across SOAs, NCPs exhibited smaller (less negative) N400 amplitudes for related versus unrelated targets. The same pattern held in relatives, whose N400 amplitudes for related and unrelated targets did not differ from NCPs'. In contrast, consistent with previous results, schizophrenia patients exhibited larger N400 amplitudes than NCPs (and relatives) for related targets, such that patients' N400 amplitudes for related and unrelated targets did not differ. N400 amplitudes for unrelated targets did not differ between the three groups. Thus, N400 semantic priming deficits in a visual word-pair paradigm may be an illness biomarker for schizophrenia.

Investigating thought disorder in schizophrenia: evidence for pathological activation

Background

Previous research has yielded evidence for enhanced semantic priming in formal thought-disordered schizophrenia patients, a result that fits well with the hypothesis of disinhibited processes of spreading activation in this population.

Objective

The current study examined whether hyper priming among schizophrenia patients is an outcome of further spreading of activation of a node or a result of farther activation of nodes in the semantic network. We also try to shed light on the fate of this activation.

Methods

The present study tested this hypothesis by using semantic and identical priming in two different experiments. SOA (stimulus onset asynchrony) was manipulated (240 ms vs. 740 ms) within block. It is assumed that among healthy individuals, performance relies on a balance between activation and inhibition processes, contrary to in schizophrenic individuals. In order to examine this hypothesis, we compared formal thought-disordered schizophrenia patients, non thought-disordered schizophrenia patients, and healthy controls.

Results

For thought-disordered schizophrenia patients, we found a large positive semantic effect and identical priming effect (129 ms and 154 ms, respectively) only with short SOA. SOA and type of priming did not modulate priming effects in the control groups.

Conclusions

This result supports the claim that there is a lack of inhibitory processes among thought-disordered patients. Hyper priming in the thought-disorder group may be an outcome of hyper activation followed by rapid decay below baseline threshold.

Altered language network activity in young people at familial high-risk for schizophrenia

BACKGROUND

Abnormalities in language and language neural circuitry are observed in schizophrenia (SZ). Similar, but less pronounced language deficits are also seen in young first-degree relatives of people with SZ, who are at higher familial risk (FHR) for the disorder than the general population. The neural underpinnings of these deficits in people with FHR are unclear.

METHODS

Participants were 43 people with FHR and 32 comparable controls. fMRI scans were collected while participants viewed associated and unrelated word pairs, and performed a lexical decision task. fMRI analyses conducted in SPM8 examined group differences in the modulation of hemodynamic activity by semantic association.

RESULTS

There were no group differences in demographics, IQ or behavioral semantic priming, but FHR participants had more schizotypal traits than controls. Controls exhibited the expected suppression of hemodynamic activity to associated versus unrelated word pairs. Compared to controls, FHR participants showed an opposite pattern of hemodynamic modulation to associated versus unrelated word pairs, in the left inferior frontal gyrus (IFG), right superior and middle temporal gyrus (STG) and the left cerebellum. Group differences in activation were significant, FWE-corrected for multiple comparisons (p<0.05). Activity within the IFG during the unrelated condition predicted schizotypal symptoms in FHR participants.

CONCLUSIONS

FHR for SZ is associated with abnormally increased neural activity to semantic associates within an inferior frontal/temporal network. This might increase the risk of developing unusual ideas, perceptions and disorganized language that characterize schizotypal traits, potentially predicting which individuals are at greater risk to develop a psychotic disorder.

A review of recent literature employing electroencephalographic techniques to study the pathophysiology, phenomenology, and treatment response of schizophrenia

Clinical experience and research findings suggest that schizophrenia is a disorder comprised of multiple genetic and neurophysiological subtypes with differential response to treatment. Electroencephalography (EEG) is a non-invasive, inexpensive and useful tool for investigating the neurobiology of schizophrenia and its subtypes. EEG studies elucidate the neurophysiological mechanisms potentially underlying clinical symptomatology. In this review article recent advances in applying EEG to study pathophysiology, phenomenology, and treatment response in schizophrenia are discussed. Investigative strategies employed include: analyzing quantitative EEG (QEEG) spectral power during the resting state and cognitive tasks; applying machine learning methods to identify QEEG indicators of diagnosis and treatment response; and using the event-related brain potential (ERP) technique to characterize the neurocognitive processes underlying clinical symptoms. Studies attempting to validate potential EEG biomarkers of schizophrenia and its symptoms, which could be useful in assessing familial risk and treatment response, are also reviewed.

Abnormal functioning of the semantic network in schizophrenia patients with thought disorganization. An exemplar production task

Numerous studies have indicated that thought disorganization in schizophrenia is associated with an enhanced semantic priming effect. This suggests abnormal functioning of the semantic network in these patients, with disinhibited spreading of semantic activation. We investigated whether thought disorganization is also associated with atypical responses in the production of semantic category exemplars. An exemplar production task was administered to 43 patients with schizophrenia and 24 healthy controls. The names of 16 semantic categories were provided, and the participants were requested to produce an exemplar for each category. The typicality of the response was rated according to norms. Higher ratings of thought disorganization were associated with the production of more atypical exemplars. In addition, the patients with high thought disorganization scores were significantly more atypical in their responses than were the healthy controls. In contrast, the patients with low thought disorganization scores were equivalent to the healthy controls. Higher ratings of affective flattening were associated with the production of less atypical exemplars. The results corroborate, within a different paradigm than semantic priming, the theory that thought disorganization is associated with faster and more distant connections within the semantic network. This effect is counteracted by affective flattening.

Cognitive and neuroplasticity mechanisms by which congenital or early blindness may confer a protective effect against schizophrenia

Several authors have noted that there are no reported cases of people with schizophrenia who were born blind or who developed blindness shortly after birth, suggesting that congenital or early (C/E) blindness may serve as a protective factor against schizophrenia. By what mechanisms might this effect operate? Here, we hypothesize that C/E blindness offers protection by strengthening cognitive functions whose impairment characterizes schizophrenia, and by constraining cognitive processes that exhibit excessive flexibility in schizophrenia. After briefly summarizing evidence that schizophrenia is fundamentally a cognitive disorder, we review areas of perceptual and cognitive function that are both impaired in the illness and augmented in C/E blindness, as compared to healthy sighted individuals. We next discuss: (1) the role of neuroplasticity in driving these cognitive changes in C/E blindness; (2) evidence that C/E blindness does not confer protective effects against other mental disorders; and (3) evidence that other forms of C/E sensory loss (e.g., deafness) do not reduce the risk of schizophrenia. We conclude by discussing implications of these data for designing cognitive training interventions to reduce schizophrenia-related cognitive impairment, and perhaps to reduce the likelihood of the development of the disorder itself.

Association of abnormal semantic processing with delusion-like ideation in frequent cannabis users: an electrophysiological study

RATIONALE

Frequent cannabis use is a risk marker for schizophrenia and delusions, but the neurocognitive mechanisms of this relationship remain unclear.

OBJECTIVES

We sought evidence that cannabis users have deficits in processing relationships between meaningful stimuli, similar to abnormalities reported in schizophrenia, and that these deficits are associated with delusion-like ideation. We used the N400 event-related brain potential (ERP) waveform as a neurophysiological probe of activation of concepts in semantic memory. We hypothesized that cannabis users would exhibit larger (more negative) than normal N400 amplitudes in response to stimuli meaningfully related to a preceding prime-reflecting deficient activation of concepts related to the prime. We further hypothesized that the magnitude of this abnormality would correlate with severity of delusion-like ideation.

METHODS

We recorded ERPs in 24 frequent cannabis users and 24 non-using comparison participants who viewed prime words followed by targets which were either words related or unrelated to the prime or pronounceable nonwords. The participants' task was to indicate whether the target was a word. Delusion-like ideation was measured via the Schizotypal Personality Questionnaire.

RESULTS

Contrary to our hypothesis, cannabis users exhibited smaller than normal N400s to both related and unrelated targets. These abnormalities correlated with delusion-like ideation in cannabis users only.

CONCLUSIONS

The results are consistent with a generalized abnormality of activation within semantic memory neural networks in cannabis users. Further research is needed to investigate whether such an abnormality plays a role in the development of delusion-like ideation in cannabis users.

Semantic network disconnection in formal thought disorder

BACKGROUND

Structural and functional findings in schizophrenic patients with formal thought disorder (FTD) show abnormalities within left-side semantic areas. The present study investigate the network function of the involved brain regions as a function of FTD severity.

METHODS

We examined a group of 16 schizophrenia patients differing in FTD, but not in overall symptom severity, and 18 matched healthy controls. A passive word reading paradigm was applied during functional MRI (fMRI). A concatenated independent component analysis approach separated the fMRI signal into independent components, and spatial similarity was used to estimate the individual differences in spatial configuration of networks.

RESULTS

The semantic network was identified for both groups encompassing structures of the left inferior frontal gyrus, the left angular gyrus and the left middle temporal gyrus. The differences between the semantic networks of patients and controls increased with increasing severity of FTD. This difference was due to a decreasing contribution of the left inferior frontal gyrus (Brodmann area 45 and 47).

CONCLUSION

Severity of FTD was correlated with a disruption of the left semantic network in schizophrenic patients. We suggest that FTD is a consequence of a frontal-parietal/temporal disconnection due to a complex interaction between structural and functional abnormalities within the left semantic network.

Test-retest reliability and stability of N400 effects in a word-pair semantic priming paradigm

OBJECTIVE

Elicited by any meaningful stimulus, the N400 event-related potential (ERP) component is reduced when the stimulus is related to a preceding one. This N400 semantic priming effect has been used to probe abnormal semantic relationship processing in clinical disorders, and suggested as a possible biomarker for treatment studies. Validating N400 semantic priming effects as a clinical biomarker requires characterizing their test-retest reliability.

METHODS

We assessed test-retest reliability of N400 semantic priming in 16 healthy adults who viewed the same related and unrelated prime-target word pairs in two sessions one week apart.

RESULTS

As expected, N400 amplitudes were smaller for related versus unrelated targets across sessions. N400 priming effects (amplitude differences between unrelated and related targets) were highly correlated across sessions (r=0.85, P<0.0001), but smaller in the second session due to larger N400s to related targets.

CONCLUSIONS

N400 priming effects have high reliability over a one-week interval. They may decrease with repeat testing, possibly because of motivational changes.

SIGNIFICANCE

Use of N400 priming effects in treatment studies should account for possible magnitude decreases with repeat testing. Further research is needed to delineate N400 priming effects' test-retest reliability and stability in different age and clinical groups, and with different stimulus types.

Differential alteration of automatic semantic processing in treated patients affected by bipolar mania and schizophrenia: an N400 study

BACKGROUND

Various formal thought disorders are presented as symptoms by manic patients including pressure of speech, flight of ideas, and more complex speech with strong emotional components. N400 is the event-related potential, in which amplitude is suggested to be a general index of efforts to retrieve stored semantic context, which depends on the stored representation itself and the retrieval cue stimuli. The present study examines N400 components induced by a word-matching task in manic patients, and compare these responses to those induced by the task in schizophrenia and healthy controls.

METHODS

Twenty manic patients, twenty schizophrenic patients, and twenty healthy controls performed the word-matching task, in which they were presented with 120 (60 congruent and 60 incongruent) word pairs, they were instructed to discriminate whether each word pair was congruent or incongruent. During the task, we recorded the electroencephalogram.

RESULTS

Reaction time analysis revealed a main effect for priming, in which reaction times were longer in response to incongruent words than to congruent words in all three participant groups (F=43.1, p<0.001) with no group effects (F=2.3, p=0.11). N400 analysis showed the main effect for priming (F=30.2, p<0.001), for group (F=5.0, p=0.01), and the interaction of priming×group (F=4.6, p=0.02). Post-hoc analysis of this interaction revealed larger N400 amplitudes to congruent words in manic patients (F=4.0, p=0.02) and smaller N400 to incongruent words in schizophrenic patients than in other groups (F=6.1, p=0.004). No correlations were found between N400 and symptom severity within patient groups.

CONCLUSIONS

These findings suggest that priming effects of contextually related word pairs are decreased in patients with bipolar mania, whereas priming N400 responses of contextually unrelated word pairs are increased in schizophrenia. This may be the neurophysiological evidence of abnormal automatic semantic processing in patients with bipolar mania, and it also reflects a qualitative difference in thought and speech disorders between bipolar manic and schizophrenia.

Electrophysiological evidence for primary semantic memory functional organization deficits in schizophrenia

N400, an event-related brain potential (ERP) waveform elicited by meaningful stimuli, is normally reduced by stimulus repetition (N400 repetition priming), and relatedness between the eliciting stimulus and preceding ones (relatedness priming). Schizophrenia patients' N400 relatedness priming deficits suggest impairment in using meaningful prime stimuli to facilitate processing of related concepts in semantic memory. To examine whether this deficiency arises from difficulty activating the prime concept per se, as indexed by reduced N400 repetition priming; or from impaired functional connections among concepts in semantic memory, as reflected by reduced relatedness priming but normal repetition priming; we recorded ERPs from 16 schizophrenia patients and 16 controls who viewed prime words each followed at 300- or 750-ms stimulus-onset asynchrony (SOA) by an unrelated, related or repeated target word, or a nonword, in a lexical-decision task. In both groups, N400s were largest (most negative) for unrelated, intermediate for related, and smallest for repeated targets. Schizophrenia patients exhibited subnormal N400 relatedness priming at the 300-ms SOA, but normal repetition priming at both SOAs, suggesting that their impairment in using prime words to activate related concepts results from abnormal functional connections among concepts within semantic memory, rather than inability to activate the prime concept itself.

Cognitive control and discourse comprehension in schizophrenia

Cognitive deficits across a wide range of domains have been consistently observed in schizophrenia and are linked to poor functional outcome (Green, 1996; Carter, 2006). Language abnormalities are among the most salient and include disorganized speech as well as deficits in comprehension. In this review, we aim to evaluate impairments of language processing in schizophrenia in relation to a domain-general control deficit. We first provide an overview of language comprehension in the healthy human brain, stressing the role of cognitive control processes, especially during discourse comprehension. We then discuss cognitive control deficits in schizophrenia, before turning to evidence suggesting that schizophrenia patients are particularly impaired at processing meaningful discourse as a result of deficits in control functions. We conclude that domain-general control mechanisms are impaired in schizophrenia and that during language comprehension this is most likely to result in difficulties during the processing of discourse-level context, which involves integrating and maintaining multiple levels of meaning. Finally, we predict that language comprehension in schizophrenia patients will be most impaired during discourse processing. We further suggest that discourse comprehension problems in schizophrenia might be mitigated when conflicting information is absent and strong relations amongst individual words are present in the discourse context."There is no "centre of Speech" in the brain any more than there is a faculty of Speech in the mind.The entire brain, more or less, is at work in a man who uses language"William JamesFrom The Principles of Psychology, 1890"The mind in dementia praecox is like an orchestra without a conductor"Kraepelin, 1919.

Depth-of-processing effects on semantic activation deficits in schizophrenia: an electrophysiological investigation

N400, an event-related brain potential (ERP) waveform elicited by meaningful stimuli, is normally reduced (made less negative) by relatedness between the eliciting stimulus and preceding ones (N400 semantic priming). Schizophrenia patients' N400 semantic priming deficits suggest impairment in using meaningful context to activate related concepts in semantic memory. We aimed to examine the degree to which this impairment can be ameliorated by task instructions that more explicitly require processing of stimulus meaning. We recorded ERPs from 16 schizophrenia patients and 16 controls who viewed prime words each followed at 750-ms stimulus-onset asynchrony by an unrelated or related target word, or a nonword, in a non-semantic task (indicating whether a letter occurred in the target) compared to an explicit semantic task (judging prime-target relatedness). Consistent with previous work, controls exhibited greater N400 semantic priming (larger amplitude reductions for related versus unrelated targets) in the semantic task than in the orthographic task. Schizophrenia patients showed this same pattern, although their N400 semantic priming effects were smaller than controls' across tasks. Nevertheless, patients' priming effects increased as much as did controls' from the orthographic to the semantic task. Thus, connections among related concepts in schizophrenia patients' semantic memory appear grossly intact, such that, given a meaningful stimulus, they can make use of explicit cues to activate related concepts at a neurophysiological level, although their ability to do so remains less than normal. These data provide support for further research on semantic-cueing strategies for cognitive remediation of verbal memory in schizophrenia.

Semantic processing disturbance in patients with schizophrenia: a meta-analysis of the N400 component

BACKGROUND

Theoretically semantic processing can be separated into early automatic semantic activation and late contextualization. Semantic processing deficits have been suggested in patients with schizophrenia, however it is not clear which stage of semantic processing is impaired. We attempted to clarify this issue by conducting a meta-analysis of the N400 component.

METHODS

Twenty-one studies met the inclusion criteria for the meta-analysis procedure. The Comprehensive Meta-Analysis software package was used to compute pooled effect sizes and homogeneity.

RESULTS

Studies favoring early automatic activation produced a significant effect size of -0.41 for the N400 effect. Studies favoring late contextualization generated a significant effect size of -0.36 for the N400 effect, a significant effect size of -0.52 for N400 for congruent/related target words, and a significant effect size of 0.82 for the N400 peak latency.

CONCLUSION

These findings suggest the automatic spreading activation process in patients with schizophrenia is very similar for closely related concepts and weakly or remotely related concepts, while late contextualization may be associated with impairments in processing semantically congruent context accompanied by slow processing speed.

Slow and steady: sustained effects of lexico-semantic associations can mediate referential impairments in schizophrenia

The present study investigated the contribution of lexico-semantic associations to impairments in establishing reference in schizophrenia. We examined event-related potentials as schizophrenia patients and healthy, demographically matched controls read five-sentence scenarios. Sentence 4 introduced a noun that referred back to three possible referents introduced in Sentences 1-3. These referents were contextually appropriate, contextually inappropriate but lexico-semantically associated, and contextually inappropriate and lexico-semantically nonassociated. In order to determine whether participants had correctly linked the anaphor to its referent, the final sentence reintroduced each referent, and participants indicated whether the last two sentences referred to the same entity. Results indicated that between 300 and 400 ms, patients, like healthy controls, used discourse context to link the noun with its preceding referent. However, between 400 and 500 ms, neural activity in patients was modulated only by lexico-semantic associations, rather than by discourse context. Moreover, patients were also more likely than controls to incorrectly link the noun with contextually inappropriate but lexico-semantically associated referents. These results suggest that at least some types of referential impairments may be driven by sustained activation of contextually inappropriate lexico-semantic associations.