Increased neural response related to neutral faces in individuals at risk for psychosis. Neuroimage

Department of Psychiatry and Psychotherapy, RWTH Aachen University, Pauwelsstrasse 30, Aachen, Germany.
NeuroImage (Impact Factor: 6.36). 04/2008; 40(1):289-97. DOI: 10.1016/j.neuroimage.2007.11.020
Source: PubMed


The reliable discrimination of emotional expressions in faces is essential for adequate social interaction. Deficits in facial emotion processing are an important impairment in schizophrenia with major consequences for social functioning and subjective well-being. Whether neural circuits underlying emotion processing are already altered before illness onset is yet unclear. Investigating neural correlates of emotion processing in individuals clinically at risk for psychosis offers the possibility to examine neural processes unchanged by the manifest disorder and to study trait aspects of emotion dysfunctions.
Twelve subjects clinically at risk for psychosis and 12 matched control subjects participated in this study. fMRI data were acquired during an emotion discrimination task consisting of standardized photographs of faces displaying different emotions (happiness, sadness, anger, fear) as well as faces with neutral facial expression.
There were no group differences in behavioral performance. Emotion discrimination was associated with hyperactivations in high-risk subjects in the right lingual and fusiform gyrus as well as the left middle occipital gyrus. Further, high-risk compared to control subjects exhibited stronger activation related to neutral faces relative to emotional faces in the inferior and superior frontal gyri, the cuneus, the thalamus and the hippocampus.
The present study indicates that individuals clinically at risk for psychosis show differences in brain activation associated with processing of emotional and--more pronounced--neutral facial expressions despite an adequate behavioral performance. The proneness to attribute salience to neutral stimuli might indicate a biological risk marker for psychosis.

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    • "Most studies examining emotion recognition in CHR individuals have focused on prosody and facial affect processing. Although the majority of studies observed deficits in emotion recognition in CHR individuals when compared to healthy controls (Addington et al., 2008; Amminger et al., 2012; Comparelli et al., 2013; Green et al., 2012a; Kohler et al., 2014; van Rijn et al., 2011; Wölwer et al., 2012), mixed findings have been reported, with some studies not finding a deficit (Gee et al., 2012; Pinkham et al., 2007; Seiferth et al., 2008; Thompson et al., 2012) and others showing selective deficits in a sub-set of negative emotions (Amminger et al., 2011). Studies that did not find a significant deficit in emotion recognition tended to have smaller samples, typically less than 20 participants. "
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    ABSTRACT: Social cognition, the mental operations that underlie social interactions, is a major construct to investigate in schizophrenia. Impairments in social cognition are present before the onset of psychosis, and even in unaffected first-degree relatives, suggesting that social cognition may be a trait marker of the illness. In a large cohort of individuals at clinical high risk for psychosis (CHR) and healthy controls, three domains of social cognition (theory of mind, facial emotion recognition and social perception) were assessed to clarify which domains are impaired in this population. Six-hundred and seventy-five CHR individuals and 264 controls, who were part of the multi-site North American Prodromal Longitudinal Study, completed The Awareness of Social Inference Test, the Penn Emotion Recognition task, the Penn Emotion Differentiation task, and the Relationship Across Domains, measures of theory of mind, facial emotion recognition, and social perception, respectively. Social cognition was not related to positive and negative symptom severity, but was associated with age and IQ. CHR individuals demonstrated poorer performance on all measures of social cognition. However, after controlling for age and IQ, the group differences remained significant for measures of theory of mind and social perception, but not for facial emotion recognition. Theory of mind and social perception are impaired in individuals at CHR for psychosis. Age and IQ seem to play an important role in the arising of deficits in facial affect recognition. Future studies should examine the stability of social cognition deficits over time and their role, if any, in the development of psychosis.
    Schizophrenia Research 12/2015; in press. DOI:10.1016/j.scog.2015.04.004 · 3.92 Impact Factor
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    • "The electronic database and manual searches yielded 317 studies, and 22 studies were included in the meta-analysis (see Fig. 1 for the flowchart). Some studies were excluded because they shared the same subjects (Seiferth et al., 2008; van Rijn et al., 2011a; Amminger et al., 2012) or shared some subjects and had a smaller sample size (Chung et al., 2008; Kim et al., 2011). The 22 included studies reported data for 1229 individuals at CHR and 825 healthy controls. "
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    ABSTRACT: There is substantial evidence regarding a social cognitive deficit in schizophrenia, and it has been suggested to be a trait-marker of this disorder. However, a domain-by-domain analysis of social cognitive deficits in individuals at clinical high risk (CHR) for psychosis has not been performed. Electronic databases were searched for studies regarding social cognitive performance in individuals at CHR. The included social cognitive domains, which were classified based on the Social Cognition Psychometric Evaluation (SCOPE) initiative of the National Institute of Mental Health (NIMH), were as follows: theory of mind (ToM), social perception (SP), attributional bias (AB), and emotion processing (EP). Twenty studies that included 1229 individuals at CHR and 825 healthy controls met the inclusion criteria. The overall effect size for social cognition was medium (g=-0.477). The largest effect size was identified for AB (g=-0.708). A medium effect size was identified for EP (g=-0.446) and ToM (g=-0.425), and small effects were identified for SP (g=-0.383). This is the first quantitative domain-by-domain social cognitive meta-analysis regarding CHR individuals. The present study indicated that individuals at CHR exhibited significant impairments in all domains of social cognition compared with healthy controls, with the largest effect size identified for AB. The identification of social cognitive domains that reflect an increased risk for impending psychosis and of predictors of the conversion to psychosis via a longitudinal follow-up study is required. Copyright © 2015 Elsevier B.V. All rights reserved.
    Schizophrenia Research 03/2015; 164(1-3):28-34. DOI:10.1016/j.schres.2015.02.008 · 3.92 Impact Factor
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    • "First, patients with SZ were medicated during study participation, which may have affected the results. However, subjects at risk of psychosis (Seiferth et al., 2008) and unmedicated, unaffected siblings of SZ patients (Kee et al., 2004) have been shown to exhibit emotional perception deficits. Medicated patients did not differ from unmedicated patients regarding their behavioral performance of facial emotion perception in a metaanalysis (Kohler et al., 2010). "
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    ABSTRACT: Introduction: Patients with schizophrenia (SZ) have deficits of facial emotion processing and cognitive inhibition, but the brain pathophysiology underlying these deficits and their interaction are not clearly understood. We tested brain activity during an emotional face go/no-go task that requires rapid executive control affected by emotional stimuli in patients with SZ using functional near-infrared spectroscopy (fNIRS). Methods: Twenty-five patients with SZ and 28 healthy control subjects were studied. We evaluated behavioral performance and used fNIRS to measure oxygenated hemoglobin concentration changes in fronto-temporal areas during the emotional go/no-go task with emotional and non-emotional blocks. Results: Patients with SZ made more errors and had longer reaction times in both test blocks compared with healthy subjects. Significantly greater activation in the inferior, superior, middle, and orbital frontal regions were observed in healthy subjects during the emotional go/no-go block compared to the non-emotional go/no-go block, but this difference was not observed in patients with SZ. Relative to healthy subjects, patients with SZ showed less activation in the superior and orbital frontal and middle temporal regions during the emotional go/no-go block. Discussion: Our results suggest that fronto-temporal dysfunction in patients with SZ is due to an interaction between abnormal processing of emotional facial expressions with negative valence and cognitive inhibition, especially during the rapid selection of rule-based associations that override automatic emotional response tendencies. They indicate that fronto-temporal dysfunction is involved in the pathophysiology of emotional-cognitive deficits in patients with SZ.
    Schizophrenia Research 01/2015; 162(1-3). DOI:10.1016/j.schres.2014.12.038 · 3.92 Impact Factor
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