Social alienation in schizophrenia patients: association with insula responsiveness to facial expressions of disgust

Loneliness is associated with more trust but worse trustworthiness expectations

Subjective feelings of loneliness emerge due to unsatisfactory social relationships, representing a major risk for mental and physical well-being. Despite its social nature, evidence on how loneliness affects social behaviours and expectations is lacking. Using Bayesian analyses and economic games, we show in three different studies that lonelier individuals trusted their partners to a greater extent despite less favourable trustworthiness expectations, showing a greater discrepancy between their trusting behaviours and their expectations of others' trustworthiness. Such discrepancy was reversed in extravert individuals who also reported to be less lonely. These results provide evidence on two opposing effects of loneliness as a motivator for social connections and promoter of social withdrawal, and demonstrate the moderating role of personality traits. This work contributes to a better understanding of how loneliness impacts social behaviour and social expectations, with important downstream clinical implications for varying health conditions associated with heightened feelings of loneliness.

Emotional Contagion and Emotional Mimicry in Individuals with Schizophrenia: A Systematic Review

Background: Individuals with schizophrenia often exhibit social interaction deficits, which can affect their ability to engage effectively with others. Emotional processes, such as emotional contagion (the transfer of emotion between individuals) and emotional mimicry (the imitation of emotional expressions), are crucial for enhancing the quality of social interactions. Methods: We conducted a PubMed, Web of Science, and PsycInfo database search. The inclusion and exclusion criteria were established based on the definitions of emotional contagion and emotional mimicry, rather than relying on specific terminology from various research fields. Forty-two studies were included in the review, including six emotional mimicry studies and thirty-six emotional contagion studies. Results: The current findings suggest decreased or inappropriate emotional mimicry in individuals with schizophrenia. Relating to emotional contagion, the results showed altered brain and psychophysiological activity in individuals with schizophrenia, whereas the self-reported measures indicated no difference between the groups. The relationships between emotional contagion, emotional mimicry, and psychotic symptom severity showed variability across the studies, whereas no associations between antipsychotic dosage and either emotional mimicry or emotional contagion were found. Discussion: This review highlights the need to further evaluate and train emotional contagion and emotional mimicry in individuals with schizophrenia because these processess influence social interaction quality. Clinical implications and guidelines for future studies are discussed.

Social dysfunction relates to shifts within socioaffective brain systems among Schizophrenia and Alzheimer's disease patients

Social dysfunction represents one of the most common signs of neuropsychiatric disorders, such as Schizophrenia (SZ) and Alzheimer's disease (AD). Perturbed socioaffective neural processing is crucially implicated in SZ/AD and generally linked to social dysfunction. Yet, transdiagnostic properties of social dysfunction and its neurobiological underpinnings remain unknown. As part of the European PRISM project, we examined whether social dysfunction maps onto shifts within socioaffective brain systems across SZ and AD patients. We probed coupling of social dysfunction with socioaffective neural processing, as indexed by an implicit facial emotional processing fMRI task, across SZ (N = 46), AD (N = 40) and two age-matched healthy control (HC) groups (N = 26 HC-younger and N = 27 HC-older). Behavioural (i.e., social withdrawal, interpersonal dysfunction, diminished prosocial or recreational activity) and subjective (i.e., feelings of loneliness) aspects of social dysfunction were assessed using the Social Functioning Scale and De Jong-Gierveld loneliness questionnaire, respectively. Across SZ/AD/HC participants, more severe behavioural social dysfunction related to hyperactivity within fronto-parieto-limbic brain systems in response to sad emotions (P = 0.0078), along with hypoactivity of these brain systems in response to happy emotions (P = 0.0418). Such relationships were not found for subjective experiences of social dysfunction. These effects were independent of diagnosis, and not confounded by clinical and sociodemographic factors. In conclusion, behavioural aspects of social dysfunction across SZ/AD/HC participants are associated with shifts within fronto-parieto-limbic brain systems. These findings pinpoint altered socioaffective neural processing as a putative marker for social dysfunction, and could aid personalized care initiatives grounded in social behaviour.

Away from the herd: loneliness as a dysfunction of social alignment

The tendency of all humans to experience loneliness at some point in their lives implies that it serves an adaptive function. Building on biological theories of herding in animals, according to which collective movement emerges from local interactions that are based on principles of attraction, repulsion and alignment, we propose an approach that synthesizes these principles with theories of loneliness in humans. We present here the 'herding model of loneliness' that extends these principles into the psychological domain. We hold that these principles serve as basic building blocks of human interactions and propose that distorted attraction and repulsion tendencies may lead to inability to align properly with others, which may be a core component in loneliness emergence and perpetuation. We describe a neural model of herding in humans and suggest that loneliness may be associated with altered interactions between the gap/error detection, reward signaling, threat and observation-execution systems. The proposed model offers a framework to predict the behavior of lonely individuals and thus may inform intervention designs for reducing loneliness intensity.

Emotions behind a mask: the value of disgust

The impact of face masks on social cognition and interaction became a popular topic due to the long-lasting COVID-19 pandemic. This theme persists in the focus of attention beyond the pandemic, since face covering not only reduces the overall amount of face information available but also introduces biases and prejudices affecting social perception at large. Many questions are still open. One of them is whether gender of beholders affects inferring of emotions covered by face masks. Reading covered faces may be particularly challenging for individuals with mental disorders, most of which are gender-specific. Previous findings are not only sparse, but inconclusive because most research had been conducted online with resulting samples heavily dominated by females. Here in a face-to-face study, females and males were presented with a randomized set of faces covered by masks. In a two-alternative forced-choice paradigm, participants had to indicate facial emotions displayed by posers. In general, the outcome dovetails with earlier findings that face masks affect emotion recognition in a dissimilar way: Inferring some emotions suffers more severely than others, with the most pronounced influence of mask wearing on disgust and close to ceiling recognition of fear and neutral expressions. Contrary to our expectations, however, males were on overall more proficient in emotion recognition. In particular, males substantially excelled in inferring disgust. The findings help to understand gender differences in recognition of disgust, the forgotten emotion of psychiatry, that is of substantial value for a wide range of mental disorders including schizophrenia. Watch Prof. Marina Pavlova discussing this her work and this article: https://vimeo.com/860126397/5966610f49?share=copy .

The role of the insula in cognitive impairment of schizophrenia

Cognitive impairment is one of the core clinical symptom domains of schizophrenia. Research shows that cognitive deficits in this neuropsychiatric syndrome is associated with neurodevelopmental pathology affecting multiple brain regions such as the dorsolateral prefrontal cortex, the hippocampus and the parietal lobe. The insula is a relatively small structure that is highly connected with several brain regions as well as multiple brain networks. A large number of studies have reported the involvement of the insula in many of the psychotic and nonpsychotic manifestations of schizophrenia. Here we review the role of the insula as a hub across key neurocircuits which have been implicated in the various cognitive pathologies in schizophrenia. Structural and functional abnormalities in the right and left insulae may serve as a biomarker for susceptibility to schizophrenia.

Disgust as a transdiagnostic index of mental illness: A narrative review of clinical populations

Disgust is a basic emotion of rejection, providing an ancestral defensive mechanism against illness. Based on research that documents altered experiences of disgust across several psychopathological conditions, we conducted a narrative review to address the hypothesis that altered disgust may serve as a transdiagnostic index of mental illness. Our synthesis of the literature from past decades suggests that, compared to healthy populations, patients with mental disorders exhibit abnormal processing of disgust in at least one of the analyzed dimensions. We also outline evidence of alterations in brain areas relevant to disgust processing, such as the insula and the interconnected limbic network. Overall, we provide preliminary support for the hypothesis that altered disgust processing may serve as a transdiagnostic index of mental illness.

Meta-analytic evidence for the cognitive control model of loneliness in emotion processing

Loneliness is strongly related to affective dysregulation. However, the neuropsychological mechanisms underpinning the loneliness-affective processing relationships remain unclear. Here, we first utilised the coordinate-based activation likelihood estimation method to confirm functional clusters related to loneliness, including the striatum, superior and medial frontal gyrus, insula, and cuneus. Meta-analytic connectivity modelling was then performed to characterise the functional connectivity of these clusters across studies using emotion tasks. Our results revealed that these clusters co-activated with the cognitive control networks. From the literature, we understand that loneliness and its neural correlates are highly related to regulating the attention biases to social rewards and social cues. Therefore, our findings provide a proof-of-concept that loneliness up-regulates the cognitive control networks to process socio-affective information. Prolonged up-regulation thus exhausts cognitive resources and hence, affective dysregulation. This study offers insight into the intricate role of cognitive and affective regulation in loneliness and social perception and provides meta-analytic evidence of the cognitive control model of loneliness and loneliness-related affective dysregulation, bringing significant clinical implications.

Facial emotion perception abilities are related to grey matter volume in the culmen of cerebellum anterior lobe in drug-naïve patients with first-episode schizophrenia

Impaired capability for understanding and interpreting the expressions on other people's faces manifests itself as a core feature of schizophrenia, contributing to social dysfunction. With the purpose of better understanding of the neurobiological basis of facial emotion perception deficits in schizophrenia, we investigated facial emotion perception abilities and regional structural brain abnormalities in drug-naïve patients with first-episode schizophrenia, and then examined the correlation between them. Fifty-two drug-naive patients with first-episode schizophrenia and 29 group-matched healthy controls were examined for facial emotion perception abilities assessed with the Facial Emotion Categorization and performed magnetic resonance imaging. The Facial Emotion Categorization data were inserted into a logistic function model so as to calculate shift point and slope as outcome measurements. Voxel-based morphometry was applied to investigate regional grey matter volume (GMV) alterations. The relationship between facial emotion perception and GMV was explored in patients using voxel-wise correlation analysis within brain regions that showed a significant GMV alterations in patients compared with controls. The schizophrenic patients performed differently on Facial Emotion Categorization tasks from the controls and presented a higher shift point and a steeper slope. Relative to the controls, patients showed GMV reductions in the superior temporal gyrus, middle occipital gyrus, parahippocampa gyrus, posterior cingulate, the culmen of cerebellum anterior lobe, cerebellar tonsil, and the declive of cerebellum posterior lobe. Importantly, abnormal performance on Facial Emotion Categorization was found correlated with GMV alterations in the culmen of cerebellum anterior lobe in schizophrenia. This study suggests that reduced GMV in the culmen of cerebellum anterior lobe occurs in first-episode schizophrenia, constituting a potential neuropathological basis for the impaired facial emotion perception in schizophrenia.

Socioemotional mechanisms of loneliness in subclinical psychosis

Loneliness is an important predictor of physical and mental health in the general population and in individuals across the psychosis spectrum, including those experiencing subclinical psychotic-like experiences (PLEs). However, the mechanisms underlying loneliness in the psychosis spectrum are not well understood. Emotion processing deficits are well described across the psychosis spectrum, and socioemotional processing biases are critical for the development and maintenance of loneliness through altered social appraisal, including judgements of rejection. Therefore, we propose that PLEs are associated with increased loneliness, and the relationship is mediated by alterations in socioemotional processing. We also explored how this pathway may be affected by mood and anxiety symptoms, which have been associated with loneliness across the psychosis spectrum. As part of the Human Connectome Project, generally healthy adults (n = 1180) reported symptomatology and social functioning and completed the Penn Emotion Recognition Task to assess efficiency in identifying emotions. We found that higher reported PLEs were associated with elevated levels of loneliness and perceived rejection and that these factors were linked by multiple independent pathways. First, anxiety/depression and emotion processing efficiency independently mediated the PLE-loneliness relationship. Second, we found that the association between PLEs and loneliness was serially mediated through inefficient emotion recognition then higher levels of perceived rejection. These separable mechanisms of increased loneliness in subclinical psychosis have implications for treatment and continued study of social functioning in the psychosis spectrum.

Neurobiology of loneliness: a systematic review

Loneliness is associated with increased morbidity and mortality. Deeper understanding of neurobiological mechanisms underlying loneliness is needed to identify potential intervention targets. We did not find any systematic review of neurobiology of loneliness. Using MEDLINE and PsycINFO online databases, we conducted a search for peer-reviewed publications examining loneliness and neurobiology. We identified 41 studies (n = 16,771 participants) that had employed various methods including computer tomography (CT), structural magnetic resonance imaging (MRI), functional MRI (fMRI), electroencephalography (EEG), diffusion tensor imaging (DTI), single-photon emission computed tomography (SPECT), positron emission tomography (PET), and post-mortem brain tissue RNA analysis or pathological analysis. Our synthesis of the published findings shows abnormal structure (gray matter volume or white matter integrity) and/or activity (response to pleasant versus stressful images in social versus nonsocial contexts) in the prefrontal cortex (especially medial and dorsolateral), insula (particularly anterior), amygdala, hippocampus, and posterior superior temporal cortex. The findings related to ventral striatum and cerebellum were mixed. fMRI studies reported links between loneliness and differential activation of attentional networks, visual networks, and default mode network. Loneliness was also related to biological markers associated with Alzheimer's disease (e.g., amyloid and tau burden). Although the published investigations have limitations, this review suggests relationships of loneliness with altered structure and function in specific brain regions and networks. We found a notable overlap in the regions involved in loneliness and compassion, the two personality traits that are inversely correlated in previous studies. We have offered recommendations for future research studies of neurobiology of loneliness.

Neuroanatomical Correlates of Social Intelligence Measured by the Guilford Test

Social interactions are a crucial aspect of human behaviour. Numerous neurophysiological studies have focused on socio-cognitive processes associated with the so-called theory of mind-the ability to attribute mental states to oneself and others. Theory of mind is closely related to social intelligence defined as a set of abilities that facilitate effective social interactions. Social intelligence encompasses multiple theory of mind components and can be measured by the Four Factor Test of Social Intelligence (the Guilford-Sullivan test). However, it is unclear whether the differences in social intelligence are reflected in structural brain differences. During the experiment, 48 healthy right-handed individuals completed the Guilford-Sullivan test. T1-weighted structural MRI images were obtained for all participants. Voxel-based morphometry analysis was performed to reveal grey matter volume differences between the two groups (24 subjects in each)-with high social intelligence scores and with low social intelligence scores, respectively. Participants with high social intelligence scores had larger grey matter volumes of the bilateral caudate. The obtained results suggest the caudate nucleus involvement in the neural system of socio-cognitive processes, reflected by its structural characteristics.

A bottom-up model of functional outcome in schizophrenia

Schizophrenia results in poor functional outcomes owing to numerous factors. This study provides the first test of a bottom-up causal model of functional outcome in schizophrenia, using neurocognition, vocal emotional cognition, alexithymia, and negative symptoms as predictors of functional outcome. We investigated a cross-sectional sample of 135 individuals with schizophrenia and 78 controls. Using a series of structural equation modelling analyses, a single pathway was generated among scores from the MATRICS Consensus Cognitive Battery (MCCB), vocal emotion recognition test, Toronto Alexithymia Scale (TAS), Brief Negative Symptom Scale, and the Personal and Social Performance Scale. The scores for each dimension of the MCCB in the schizophrenia group were significantly lower than that in the control group. The recognition accuracy for different emotions (anger, disgust, fear, sadness, surprise, and satire, but not calm was significantly lower in the schizophrenia group than in the control group. Moreover, the scores on the three dimensions of TAS were significantly higher in the schizophrenia group than in the control group. On path analysis modelling, the proposed bottom-up causal model showed a strong fit with the data and formed a single pathway, from neurocognition to vocal emotional cognition, to alexithymia, to negative symptoms, and to poor functional outcomes. The study results strongly support the proposed bottom-up causal model of functional outcome in schizophrenia. The model could be used to better understand the causal factors related to the functional outcome, as well as for the development of intervention strategies to improve functional outcomes in schizophrenia.

Imaging the "social brain" in schizophrenia: A systematic review of neuroimaging studies of social reward and punishment

Decreased social functioning and high levels of loneliness and social isolation are common in schizophrenia spectrum disorders (SSD), contributing to reduced quality of life. One key contributor to social impairment is low social motivation, which may stem from aberrant neural processing of socially rewarding or punishing stimuli. To summarize research on the neurobiology of social motivation in SSD, we performed a systematic literature review of neuroimaging studies involving the presentation of social stimuli intended to elicit feelings of reward and/or punishment. Across 11 studies meeting criteria, people with SSD demonstrated weaker modulation of brain activity in regions within a proposed social interaction network, including prefrontal, cingulate, and striatal regions, as well as the amygdala and insula. Firm conclusions regarding neural differences in SSD in these regions, as well as connections within networks, are limited due to conceptual and methodological inconsistencies across the available studies. We conclude by making recommendations for the study of social reward and punishment processing in SSD in future research.

Connectome-based individualized prediction of loneliness

Loneliness is an increasingly prevalent condition linking with enhanced morbidity and premature mortality. Despite recent proposal on medicalization of loneliness, so far no effort has been made to establish a model capable of predicting loneliness at the individual level. Here, we applied a machine-learning approach to decode loneliness from whole-brain resting-state functional connectivity (RSFC). The relationship between whole-brain RSFC and loneliness was examined in a linear predictive model. The results revealed that individual loneliness could be predicted by within- and between-network connectivity of prefrontal, limbic and temporal systems, which are involved in cognitive control, emotional processing and social perceptions and communications, respectively. Key nodes that contributed to the prediction model comprised regions previously implicated in loneliness, including the dorsolateral prefrontal cortex, lateral orbital frontal cortex, ventromedial prefrontal cortex, caudate, amygdala and temporal regions. Our findings also demonstrated that both loneliness and associated neural substrates are modulated by levels of neuroticism and extraversion. The current data-driven approach provides the first evidence on the predictive brain features of loneliness based on organizations of intrinsic brain networks. Our work represents initial efforts in the direction of making individualized prediction of loneliness that could be useful for diagnosis, prognosis and treatment.

Loneliness and the psychosis continuum: a meta-analysis on positive psychotic experiences and a meta-analysis on negative psychotic experiences

There is an increase in interest in the relationships between loneliness and psychosis. The notion of psychosis continuum implies that psychotic experiences extend from clinical populations with psychotic disorders to non-clinical populations. This meta-analytic review aimed to examine the respective associations of loneliness with positive and negative psychotic experiences along the psychosis continuum. A systematic database search was conducted and a total of 30 studies were included in the first meta-analysis and 15 studies were included in the second meta-analysis. There was a medium association between loneliness and positive psychotic experiences (r = 0.302, p < 0.001). In particular, the association between loneliness and paranoia was robust (r = 0.448, p < 0.001). The second meta-analysis revealed a medium association between loneliness and negative psychotic experiences (r = 0.347, p < 0.001). The associations between loneliness and both positive and negative psychotic experiences were found to be smaller among clinical than non-clinical samples. The above findings provided evidence for the associations between loneliness and the two core dimensions of psychotic experiences along the phenomenological continuum. Future research should examine the dynamics of these relationships in both clinical and non-clinical samples, preferably using a single-symptom approach.

Meta-analysis of functional magnetic resonance imaging studies of timing and cognitive control in schizophrenia and bipolar disorder: Evidence of a primary time deficit

Schizophrenia (SZ) and Bipolar Disorder (BD) are associated with deficits in both timing and cognitive control functions. However, the underlying neurological dysfunctions remain poorly understood. The main goal of this study was to identify brain structures activated both by increases in cognitive activity and during timing tasks in patients with SZ and BD relative to controls. We conducted two signed differential mapping (SDM) meta-analyses of functional magnetic resonance imaging studies assessing the brain response to increasing levels of cognitive difficulty: one concerned SZ, and the other BD patients. We conducted a similar SDM meta-analysis on neuroimaging of timing in SZ (no studies in BD could be included). Finally, we carried out a multimodal meta-analysis to identify common brain regions in the findings of the two previous meta-analyses. We found that SZ patients showed hypoactivation in timing-related cortical-subcortical areas. The dysfunction observed during timing partially coincided with deficits for cognitive control functions. We hypothesize that a dysfunctional temporal/cognitive control network underlies the persistent cognitive impairment observed in SZ.

Core, social and moral disgust are bounded: A review on behavioral and neural bases of repugnance in clinical disorders

Disgust is a multifaceted experience that might affect several aspects of life. Here, we reviewed research on neurological and psychiatric disorders that are characterized by abnormal disgust processing to test the hypothesis of a shared neurocognitive architecture in the representation of three disgust domains: i) personal experience of 'core disgust'; ii) social disgust, i.e., sensitivity to others' expressions of disgust; iii) moral disgust, i.e., sensitivity to ethical violations. Our review provides some support to the shared neurocognitive hypothesis and suggests that the insula might be the "hub" structure linking the three domains of disgust sensitivity, while other brain regions may subserve specific facets of the multidimensional experience. Our review also suggests a role of serotonin core and moral disgust, supporting "neo-sentimentalist" theories of morality, which posit a causal role of affect in moral judgment.

The relationship between childhood trauma, emotion recognition, and irritability in schizophrenia patients

This study investigated the relationship between childhood trauma, irritability, and emotion recognition, in schizophrenia patients during a psychotic break. Thirty-six schizophrenia inpatients and 36 healthy controls were assessed with the Irritability Questionnaire (IRQ) and two facial emotion recognition tasks, the Emotion Discrimination Test (EDT) and Emotion Identification Test (EIT). Patients were further assessed with the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II), the Positive and Negative Symptom Scale (PANSS), and the Childhood Trauma Questionnaire-28 (CTQ-28). EDT and EIT performance was significantly impaired in patients compared to healthy controls. Furthermore, patients tended to misidentify sad, surprised, or angry faces as showing fear, and this misidentification correlated with the patients' irritability. Childhood adversity increased irritability both directly and indirectly through emotion misidentification.

Loneliness in schizophrenia and its possible correlates. An exploratory study

Social attachment is a biological and affective need. When this need is not met, people experience loneliness. Loneliness is associated with impaired social cognition, and is a risk factor for broad based morbidity across the adult lifespan even after controlling for multiple factors. However, little is known about loneliness in schizophrenia. Eighty-seven non-depressed individuals with schizophrenia or schizoaffective disorder (including 51 inpatients) and 58 control subjects completed the revised UCLA Loneliness scale. Social cognition was assessed with a self-report questionnaire and a performance-based task. Social trait perception was assessed with a facial task. Comorbid medical diagnoses were available for all inpatients. Patients reported greater loneliness levels than controls, while in- and out-patients did not significantly differ. In patients, loneliness was associated with self-report measures of social cognition. Patients' loneliness scores predicted a diagnosis of drug abuse/dependence, number of drugs used, hypertension and abnormal hemoglobin A1c levels. Patients experienced higher levels of loneliness than controls, independently of their objective social isolation. Loneliness did not rely on the same psychological processes in patients than in controls. Loneliness in schizophrenia is a symptom that deserves more scrutiny, particularly as it relates to the high prevalence of metabolic syndrome in this population.

Functional abnormalities of the right posterior insula are related to the altered self-experience in schizophrenia

The insula is involved in detecting the salience of internal and external stimuli, and it plays a critical role in psychosis. Previous studies have demonstrated the structural and functional alterations of the insula in schizophrenia. To acquire a full picture of the functional alterations of the insula in schizophrenia, the resting-state fMRI data of 46 patients with schizophrenia and 46 healthy control subjects were collected. We used clustering analysis to divide the insula into three subregions: the dorsal anterior insula (dAI), ventral anterior insula (vAI) and posterior insula (PI). Then, whole-brain functional connectivity analysis was conducted based on these subregions. The results showed that the right dAI and PI in patients exhibited altered functional connections with the primary sensorimotor area. In addition, the right PI of the patients exhibited increased functional correlations with the thalamus. More importantly, the altered functional properties of the right PI were significantly correlated with the severity of the delusion and poor insight in schizophrenia. The results suggested that the right PI might play an important role in self-experience processing in schizophrenia. Accordingly, the right PI should be considered very important in the pathological mechanism of schizophrenia.

Early changes of brain connectivity in primary open angle glaucoma

Our aim was to assess in primary open angle glaucoma (POAG), a major cause of irreversible blindness worldwide, whether diffuse brain changes recently shown in advanced stage can be detected since the early stage. We used multimodal magnetic resonance imaging (MRI) in 57 patients with the three POAG stages and in 29 age-matched normal controls (NC). Voxelwise statistics was performed with nonparametric permutation testing. Compared with NC, disrupted anatomical connectivity (AC) was found in the whole POAG group along the visual pathway and in nonvisual white matter tracts (P < 0.001). Moreover, POAG patients showed decreased functional connectivity (FC) in the visual (P = 0.004) and working memory (P < 0.001) networks whereas an increase occurred in the default mode (P = 0.002) and subcortical (P < 0.001) networks. Altered AC and FC were already present in early POAG (n = 14) in both visual and nonvisual systems (P ≤ 0.01). Only severe POAG (n = 30) showed gray matter atrophy and this mapped on visual cortex (P < 0.001) and hippocampus (P < 0.001). Increasing POAG stage was associated with worsening AC in both visual and nonvisual pathway (P < 0.001), progressive atrophy in the hippocampus and frontal cortex (P < 0.003). Most of the structural and functional alterations within and outside the visual system showed correlation (P < 0.001 to 0.02) with computerized visual field and retinal nerve fiber layer thickness. In conclusion, the complex pathogenesis of POAG includes widespread damage of AC and altered FC within and beyond the visual system since the early disease stage. The association of brain MRI changes with measures of visual severity emphasizes the clinical relevance of our findings. Hum Brain Mapp 37:4581-4596, 2016. © 2016 Wiley Periodicals, Inc.

Alterations in event-related potential responses to empathy for pain in schizophrenia

Lack of empathy is a critical factor impacting on social functioning and quality of life in schizophrenia. There is, however, a paucity of research into the underlying neurophysiological correlates of empathy deficits in this disorder. Accordingly, we sought: (1) to identify whether dysfunctional empathic abilities in schizophrenia are related to alterations in early or late brain processes, and (2) to explore the potential relationship between brain activity and mood, self-reported empathy and symptom severity. Eighteen patients with schizophrenia and 21 healthy matched controls performed an empathy-for-pain paradigm where photographs of hands in neutral or painful situations were shown while we recorded their electroencephalography (EEG), and we examined mood, empathic concern for others and symptom severity. Significant group differences between patients and controls emerged in early (50-150ms after stimulus onset) and late (after 300ms) timeframes. Moreover, brain activity was related with unpleasantness ratings in all participants, with self-reported empathic concern only in controls and with negative mood and personal distress only in patients. Differences in social behavior in schizophrenia may be explained by early as well as late differences, affecting mostly the early frontocentral ERPs, i.e. those suggested to correspond to the emotional sharing component of empathy.

Meta-Analysis of Functional Neuroimaging and Cognitive Control Studies in Schizophrenia: Preliminary Elucidation of a Core Dysfunctional Timing Network

Timing and other cognitive processes demanding cognitive control become interlinked when there is an increase in the level of difficulty or effort required. Both functions are interrelated and share neuroanatomical bases. A previous meta-analysis of neuroimaging studies found that people with schizophrenia had significantly lower activation, relative to normal controls, of most right hemisphere regions of the time circuit. This finding suggests that a pattern of disconnectivity of this circuit, particularly in the supplementary motor area, is a trait of this mental disease. We hypothesize that a dysfunctional temporal/cognitive control network underlies both cognitive and psychiatric symptoms of schizophrenia and that timing dysfunction is at the root of the cognitive deficits observed. The goal of our study was to look, in schizophrenia patients, for brain structures activated both by execution of cognitive tasks requiring increased effort and by performance of time perception tasks. We conducted a signed differential mapping (SDM) meta-analysis of functional neuroimaging studies in schizophrenia patients assessing the brain response to increasing levels of cognitive difficulty. Then, we performed a multimodal meta-analysis to identify common brain regions in the findings of that SDM meta-analysis and our previously-published activation likelihood estimate (ALE) meta-analysis of neuroimaging of time perception in schizophrenia patients. The current study supports the hypothesis that there exists an overlap between neural structures engaged by both timing tasks and non-temporal cognitive tasks of escalating difficulty in schizophrenia. The implication is that a deficit in timing can be considered as a trait marker of the schizophrenia cognitive profile.

Functional Connectivity Density Mapping of Depressive Symptoms and Loneliness in Non-Demented Elderly Male

Background: Depression and loneliness are prevalent and highly correlated phenomena among the elderly and influence both physical and mental health. Brain functional connectivity changes associated with depressive symptoms and loneliness are not fully understood.

Methods: A cross-sectional functional MRI study was conducted among 85 non-demented male elders. Geriatric depression scale-short form (GDS) and loneliness scale were used to evaluate the severity of depressive symptoms and loneliness, respectively. Whole brain voxel-wise resting-state functional connectivity density (FCD) mapping was performed to delineate short-range FCD (SFCD) and long-range FCD (LFCD). Regional correlations between depressive symptoms or loneliness and SFCD or LFCD were examined using general linear model (GLM), with age incorporated as a covariate and depressive symptoms and loneliness as predictors.

Results: Positive correlations between depressive symptoms and LFCD were observed in left rectal gyrus, left superior frontal gyrus, right supraorbital gyrus, and left inferior temporal gyrus. Positive correlations between depressive symptoms and SFCD were observed in left middle frontal gyrus, left superior frontal gyrus, bilateral superior medial frontal gyrus, left inferior temporal gyrus, and left middle occipital region. Positive correlations between SFCD and loneliness were centered over bilateral lingual gyrus.

Conclusion: Depressive symptoms are associated with FCD changes over frontal and temporal regions, which may involve the cognitive control, affective regulation, and default mode networks. Loneliness is associated with FCD changes in bilateral lingual gyri that are known to be important in social cognition. Depressive symptoms and loneliness may be associated with different brain regions in non-demented elderly male.

Phase-locking index and power of 40-Hz auditory steady-state response are not related to major personality trait dimensions

Although a number of studies have demonstrated state-related dependence of auditory steady-state responses (ASSRs), the investigations assessing trait-related ASSR changes are limited. Five consistently identified major trait dimensions, also referred to as "big five" (Neuroticism, Extraversion, Openness, Agreeableness and Conscientiousness), are considered to account for virtually all personality variances in both healthy people and those with psychiatric disorders. The purpose of the present study was, for the first time, to establish the link between 40-Hz ASSR and "big five" major personality trait dimensions in young healthy adults. Ninety-four young healthy volunteers participated (38 males and 56 females; mean age ± SD 22.180 ± 2.75). The 40-Hz click trains were presented for each subject 30 times with an inter-train interval of 1-1.5 s. The EEG responses were recorded from F3, Fz, F4, C3, Cz, C4, P3, Pz and P4 locations according to 10/20 electrode placement system. Phase-locking index (PLI) and event-related power perturbation (ERSP) were calculated, each providing the following characteristics: peak time, entrainment frequency, peak value and mean value. For assessing "big five" personality traits, NEO Personality Inventory Revised (NEO-PI-R) was used. No significant correlation between 40-Hz ASSR PLI or ERSP and "big five" personality traits was observed. Our results indicate that there is no dependence between 40-Hz ASSR entrainment and personality traits, demonstrating low individual 40-Hz variability in this domain. Our results support further development of 40-Hz ASSR as a neurophysiological marker allowing distinguishing between healthy population and patients with psychiatric disorders.

Converging evidence of social avoidant behavior in schizophrenia from two approach-avoidance tasks

Many people with schizophrenia suffer from social impairments characterized by active social avoidance, which is related to social phobia common in schizophrenia, while motivational impairments can also result in passive social withdrawal. Although social avoidance is frequently reported in this population, this is the first study to directly compare approach-avoidance tendencies in schizophrenia patients (N = 37) and healthy controls (N = 29). Participants performed two tasks: a computerized approach-avoidance task (AAT) to assess response tendencies toward images of happy and angry faces with direct or averted gaze and a one-to-one personal space test (PST) to gauge more naturalistic approach-avoidance behaviors toward a real person bearing a neutral expression. The AAT results showed that both groups showed faster avoidance responses to angry faces and faster approach responses to happy faces with a direct gaze. Happy faces with averted gaze, however, resulted in faster avoidance responses in the patient group only. On the PST, the patients approached the experimenter less than healthy controls did. This measure of interpersonal distance was positively related to positive symptom severity. Delusions of reference and increased sensitivity to social rejection may explain the patients' avoidance tendencies in response to pictures of happy faces with averted gaze and in the presence of an actual person. The current findings demonstrate the importance of others adopting positive and unambiguous attitudes when interacting with schizophrenia patients to minimize behavioral avoidance patterns, which is particularly relevant for relatives and clinicians whose interactions with the patients are crucial to facilitating treatment and promoting healthy social relationships.

Structural and functional brain changes beyond visual system in patients with advanced glaucoma

In order to test the hypothesis that in primary open angle glaucoma (POAG), an important cause of irreversible blindness, a spreading of neurodegeneration occurs through the brain, we performed multimodal MRI and subsequent whole-brain explorative voxelwise analyses in 13 advanced POAG patients and 12 age-matched normal controls (NC). Altered integrity (decreased fractional anisotropy or increased diffusivities) of white matter (WM) tracts was found not only along the visual pathway of POAG but also in nonvisual WM tracts (superior longitudinal fascicle, anterior thalamic radiation, corticospinal tract, middle cerebellar peduncle). POAG patients also showed brain atrophy in both visual cortex and other distant grey matter (GM) regions (frontoparietal cortex, hippocampi and cerebellar cortex), decreased functional connectivity (FC) in visual, working memory and dorsal attention networks and increased FC in visual and executive networks. In POAG, abnormalities in structure and FC within and outside visual system correlated with visual field parameters in the poorer performing eyes, thus emphasizing their clinical relevance. Altogether, this represents evidence that a vision disorder such as POAG can be considered a widespread neurodegenerative condition.