Neural and functional correlates of impaired reading ability in schizophrenia.

Deficits in early auditory processing (EAP) are a core component of schizophrenia (SZ) and contribute significantly to impaired overall function. Here, we evaluate the potential contributions of EAP-related impairments in reading to functional capacity and outcome, relative to effects of auditory social cognitive and general neurocognitive dysfunction. Participants included 30-SZ and 28-controls of similar age, sex, and educational achievement. EAP was assessed using an auditory working memory (tone-matching) task. Phonological processing and reading Fluency were assessed using the Comprehensive Test of Phonological Processing and Woodcock-Johnson reading batteries, respectively. Auditory-related social cognition was assessed using measures of emotion/sarcasm recognition. Functional capacity and outcome were assessed using the UCSD Performance-based Skills Assessment and Specific Level of Functioning scale, respectively. fMRI resting-state functional-connectivity (rsFC) was used to evaluate potential underlying substrates. As predicted, SZ patients showed significant and interrelated deficits in both phonological processing (d = 0.74, p = 0.009) and reading fluency (d = 1.24, p < 0.00005). By contrast, single word reading (d = 0.35, p = 0.31) was intact. In SZ, deficits in EAP and phonological reading ability significantly predicted reduced functional capacity, but not functional outcome. By contrast, deficits in reading fluency significantly predicted impairments in both functional capacity and functional outcome. Moreover, deficits in reading fluency correlated with rsFC alterations among auditory thalamus, early auditory and auditory association regions. These findings indicate significant contributions of EAP deficits and functional connectivity changes in subcortical and early auditory regions to reductions in reading fluency, and of impaired reading ability to impaired functional outcome in SZ.

Differential Patterns of Visual Sensory Alteration Underlying Face Emotion Recognition Impairment and Motion Perception Deficits in Schizophrenia and Autism Spectrum Disorder.

BACKGROUND: Impaired face emotion recognition (FER) and abnormal motion processing are core features in schizophrenia (SZ) and autism spectrum disorder (ASD) that have been linked to atypical activity within the visual cortex. Despite overlaps, only a few studies have directly explored convergent versus divergent neural mechanisms of altered visual processing in ASD and SZ. We employed a multimodal imaging approach to evaluate FER and motion perception in relation to functioning of subcortical and cortical visual regions. METHODS: Subjects were 20 high-functioning adults with ASD, 19 patients with SZ, and 17 control participants. Behavioral measures of coherent motion sensitivity and FER along with electrophysiological and functional magnetic resonance imaging measures of visual pattern and motion processing were obtained. Resting-state functional magnetic resonance imaging was used to assess the relationship between corticocortical and thalamocortical connectivity and atypical visual processing. RESULTS: SZ and ASD participants had intercorrelated deficits in FER and motion sensitivity. In both groups, reduced motion sensitivity was associated with reduced functional magnetic resonance imaging activation in the occipitotemporal cortex and lower delta-band electroencephalogram power. In ASD, FER deficits correlated with hyperactivation of dorsal stream regions and increased evoked theta power. Activation of the pulvinar correlated with abnormal alpha-band modulation in SZ and ASD with under- and overmodulation, respectively, predicting increased clinical symptoms in both groups. CONCLUSIONS: SZ and ASD participants showed equivalent deficits in FER and motion sensitivity but markedly different profiles of physiological dysfunction. The specific pattern of deficits observed in each group may help guide development of treatments designed to downregulate versus upregulate visual processing within the respective clinical groups.

Developmental trajectory of mismatch negativity and visual event-related potentials in healthy controls: Implications for neurodevelopmental vs. neurodegenerative models of schizophrenia.

Sensory processing deficits are core features of schizophrenia, reflected in impaired generation of event-related potential (ERP) measures such as auditory mismatch negativity (MMN) and visual P1. To understand the potential time course of development of deficits in schizophrenia, we obtained MMN to unattended duration, intensity and frequency deviants, and visual P1 to attended LSF stimuli, in 43 healthy individuals ages 6 to 25years (mean 17), and compared results to data from 30 adult schizophrenia patients (mean age 38). We analyzed "time-domain" measures of amplitude and latency, and event-related spectral perturbation (ERSP, "time-frequency") to evaluate underlying neurophysiological mechanisms. Duration and intensity MMN amplitudes increased from childhood to late adolescence, while frequency MMN reached maximum amplitude during early development. As reported previously, in ERSP analyses, MMN activity corresponded primarily to theta-band (4-7Hz) activity, while responses to standards occurred primarily in alpha (8-12Hz) across age groups. Both deviant-induced theta and standard-induced alpha activity declined significantly with age for all deviant types. Likewise, visual P1 also showed an amplitude decline over development, reflecting a reduction in both evoked power and ITC. While MMN "difference" waveform ERP data suggest failure of maturation in schizophrenia, MMN ERSP analyses instead support a neurodegenerative process, as these isolate responses to deviants and standards, showing large low-frequency evoked power for both in children. Neurodegenerative processes are also supported by large visual P1 amplitudes and large low-frequency evoked power in children, in contrast with adult schizophrenia. Sensory processing deficits in schizophrenia may be related to accelerated synaptic pruning.

Mismatch negativity as a biomarker of theta band oscillatory dysfunction in schizophrenia.

Mismatch negativity (MMN) is among the best established biomarkers of cortical dysfunction in schizophrenia. MMN generators are localized primarily to primary and secondary auditory regions, and are known to reflect activity mediated by cortical N-methyl-d-aspartate-type glutamate receptors (NMDAR). Nevertheless, mechanisms underlying MMN generation at the local circuit level remain incompletely understood. This review synthesizes recent advances in circuit-level conceptualization of MMN based upon neuro-oscillatory findings. In the neuro-oscillatory (aka event-related spectral perturbation, ERSP) approach, responses to sensory stimuli are decomposed into underlying frequency bands prior to analysis. MMN reflects activity primarily in theta (4-7Hz) frequency band, which is thought to depend primarily upon interplay between cortical pyramidal neurons and somatostatin (SST)-type local circuit GABAergic interneurons. Schizophrenia-related deficits in theta generation are also observed not only in MMN, but also in other auditory and visual contexts. At the local circuit level, SST interneurons are known to maintain tonic inhibition over cortical pyramidal interneurons. SST interneurons, in turn, are inhibited by a class of interneurons expressing vasoactive intestinal polypeptide (VIP). In rodents, SST interneurons have been shown to respond differentially to deviant vs. standard stimuli, and inhibition of SST interneurons has been found to selectively inhibit deviance-related activity in rodent visual cortex. Here we propose that deficits in theta frequency generation, as exemplified by MMN, may contribute significantly to cortical dysfunction in schizophrenia, and may be tied to impaired interplay between cortical pyramidal neurons and local circuit SST-type GABAergic interneurons.

A tale of two sites: Differential impairment of frequency and duration mismatch negativity across a primarily inpatient versus a primarily outpatient site in schizophrenia.

Deficits in mismatch negativity (MMN) generation are among the best replicated neurophysiological deficits in schizophrenia, with reduced amplitude reflecting impaired information processing at the level of supratemporal auditory cortex. Differential patterns of MMN dysfunction according to deviant types have been reported across studies, with some research groups showing impairment in duration MMN but not frequency MMN, and other research groups reporting both findings. We evaluate the hypothesis that recruitment setting, reflecting current functional status, might be an important determinant of the pattern of MMN dysfunction. Here, we evaluated patterns of MMN dysfunction, along with tone matching and neuropsychological performance in subjects drawn from 1) a predominant inpatient/residential care setting (Nathan Kline Institute) and 2) a predominant outpatient setting (Columbia University). As predicted, compared to healthy controls, deficits in duration MMN were observed across sites, whereas deficits in frequency MMN/tone matching were confined to the chronic inpatient setting. Within patients, the frequency MMN deficit was highly correlated with impairments in tone matching ability across sites (r=-0.52, p<0.0001), as well as impairments in verbal learning (r=-0.54, p<0.0001). Responses to standard stimuli in the MMN paradigm were assessed using measures of alpha evoked power and inter-trial coherence (ITC). While deficits in alpha ITC were observed across sites (both p<0.05), deficits in alpha power were observed at the inpatient (p=0.001) but not outpatient (p=0.2) site. Overall, these finding indicate that impairments of frequency MMN generation and response power to standard stimuli could be particularly linked to forms of schizophrenia that are associated with poor functional outcome.

Sounds activate visual cortex and improve visual discrimination.

A recent study in humans (McDonald et al., 2013) found that peripheral, task-irrelevant sounds activated contralateral visual cortex automatically as revealed by an auditory-evoked contralateral occipital positivity (ACOP) recorded from the scalp. The present study investigated the functional significance of this cross-modal activation of visual cortex, in particular whether the sound-evoked ACOP is predictive of improved perceptual processing of a subsequent visual target. A trial-by-trial analysis showed that the ACOP amplitude was markedly larger preceding correct than incorrect pattern discriminations of visual targets that were colocalized with the preceding sound. Dipole modeling of the scalp topography of the ACOP localized its neural generators to the ventrolateral extrastriate visual cortex. These results provide direct evidence that the cross-modal activation of contralateral visual cortex by a spatially nonpredictive but salient sound facilitates the discriminative processing of a subsequent visual target event at the location of the sound. Recordings of event-related potentials to the targets support the hypothesis that the ACOP is a neural consequence of the automatic orienting of visual attention to the location of the sound.

Salient sounds activate human visual cortex automatically.

Sudden changes in the acoustic environment enhance perceptual processing of subsequent visual stimuli that appear in close spatial proximity. Little is known, however, about the neural mechanisms by which salient sounds affect visual processing. In particular, it is unclear whether such sounds automatically activate visual cortex. To shed light on this issue, this study examined event-related brain potentials (ERPs) that were triggered either by peripheral sounds that preceded task-relevant visual targets (Experiment 1) or were presented during purely auditory tasks (Experiments 2-4). In all experiments the sounds elicited a contralateral ERP over the occipital scalp that was localized to neural generators in extrastriate visual cortex of the ventral occipital lobe. The amplitude of this cross-modal ERP was predictive of perceptual judgments about the contrast of colocalized visual targets. These findings demonstrate that sudden, intrusive sounds reflexively activate human visual cortex in a spatially specific manner, even during purely auditory tasks when the sounds are not relevant to the ongoing task.

Effect of attention on early cortical processes associated with the sound-induced extra flash illusion.

When a single flash of light is presented interposed between two brief auditory stimuli separated by 60-100 msec, subjects typically report perceiving two flashes [Shams, L., Kamitani, Y., & Shimojo, S. Visual illusion induced by sound. Brain Research, Cognitive Brain Research, 14, 147-152, 2002; Shams, L., Kamitani, Y., & Shimojo, S. Illusions. What you see is what you hear. Nature, 408, 788, 2000]. Using ERP recordings, we previously found that perception of the illusory extra flash was accompanied by a rapid dynamic interplay between auditory and visual cortical areas that was triggered by the second sound [Mishra, J., Martínez, A., Sejnowski, T. J., & Hillyard, S. A. Early cross-modal interactions in auditory and visual cortex underlie a sound-induced visual illusion. Journal of Neuroscience, 27, 4120-4131, 2007]. In the current study, we investigated the effect of attention on the ERP components associated with the illusory extra flash in 15 individuals who perceived this cross-modal illusion frequently. All early ERP components in the cross-modal difference wave associated with the extra flash illusion were significantly enhanced by selective spatial attention. The earliest attention-related modulation was an amplitude increase of the positive-going PD110/PD120 component, which was previously shown to be correlated with an individual's propensity to perceive the illusory second flash [Mishra, J., Martínez, A., Sejnowski, T. J., & Hillyard, S. A. Early cross-modal interactions in auditory and visual cortex underlie a sound-induced visual illusion. Journal of Neuroscience, 27, 4120-4131, 2007]. The polarity of the early PD110/PD120 component did not differ as a function of the visual field (upper vs. lower) of stimulus presentation. This, along with the source localization of the component, suggested that its principal generator lies in extrastriate visual cortex. These results indicate that neural processes previously shown to be associated with the extra flash illusion can be modulated by attention, and thus are not the result of a wholly automatic cross-modal integration process.

Cortical processes underlying sound-induced flash fusion.

When two brief flashes presented in rapid succession (<100 ms apart) are paired with a single auditory stimulus, subjects often report perceiving only a single flash [Andersen, T.S., Tiippana, K., Sams, M., 2004. Factors influencing audiovisual fission and fusion illusions. Brain Res. Cogn. Brain Res. 21, 301-308; Shams, L., Iwaki, S., Chawla, A., Bhattacharya, J., 2005a. Early modulation of visual cortex by sound: an MEG study. Neurosci. Lett. 378, 76-81, Shams, L., Ma, W.J., Beierholm, U., 2005b. Sound-induced flash illusion as an optimal percept. Neuroreport 16, 1923-1927]. We used event-related potentials (ERPs) to investigate the timing and localization of the cortical processes that underlie this sound induced flash fusion, which is complementary to the sound-induced extra flash illusion that we analyzed previously [Mishra, J., Martinez, A., Sejnowski, T.J. and Hillyard, S.A., Early cross-modal interactions in auditory and visual cortex underlie a sound-induced visual illusion. J. Neurosci. 27 (2007) 4120-4131]. The difference ERP that represented the cross-modal interaction between the visual (two flashes) and auditory (one sound) constituents of the bimodal stimulus revealed a positive component elicited 160-190 ms after stimulus onset, which was markedly attenuated in subjects who did not perceive the second flash. This component, previously designated as PD180 [Mishra, J., Martinez, A., Sejnowski, T.J. and Hillyard, S.A., Early cross-modal interactions in auditory and visual cortex underlie a sound-induced visual illusion. J. Neurosci. 27 (2007) 4120-4131], was localized by dipole modeling to polysensory superior temporal cortex. PD180 was found to covary in amplitude across subjects with the visual evoked N1 component (148-184 ms), suggesting that inter-individual differences in perceiving the illusion are based at least in part on differences in visual processing. A trial-by-trial analysis found that the PD180 as well as a subsequent modulation in visual cortex at 228-248 ms was diminished on trials when the two flashes were perceived as one relative to trials when two flashes were correctly reported. These results suggest that the sound induced flash fusion is based on an interaction between polysensory and visual cortical areas.

Object-based attention is multisensory: co-activation of an object's representations in ignored sensory modalities.

Within the visual modality, it has been shown that attention to a single visual feature of an object such as speed of motion, results in an automatic transfer of attention to other task-irrelevant features (e.g. colour). An extension of this logic might lead one to predict that such mechanisms also operate across sensory systems. But, connectivity patterns between feature modules across sensory systems are thought to be sparser to those within a given sensory system, where interareal connectivity is extensive. It is not clear that transfer of attention between sensory systems will operate as it does within a sensory system. Using high-density electrical mapping of the event-related potential (ERP) in humans, we tested whether attending to objects in one sensory modality resulted in the preferential processing of that object's features within another task-irrelevant sensory modality. Clear evidence for cross-sensory attention effects was seen, such that for multisensory stimuli responses to ignored task-irrelevant information in the auditory and visual domains were selectively enhanced when they were features of the explicitly attended object presented in the attended sensory modality. We conclude that attending to an object within one sensory modality results in coactivation of that object's representations in ignored sensory modalities. The data further suggest that transfer of attention from visual-to-auditory features operates in a fundamentally different manner than transfer from auditory-to-visual features, and indicate that visual-object representations have a greater influence on their auditory counterparts than vice-versa. These data are discussed in terms of 'priming' vs. 'spreading' accounts of attentional transfer.

Auditory-somatosensory multisensory processing in auditory association cortex: an fMRI study.

Using high-field (3 Tesla) functional magnetic resonance imaging (fMRI), we demonstrate that auditory and somatosensory inputs converge in a subregion of human auditory cortex along the superior temporal gyrus. Further, simultaneous stimulation in both sensory modalities resulted in activity exceeding that predicted by summing the responses to the unisensory inputs, thereby showing multisensory integration in this convergence region. Recently, intracranial recordings in macaque monkeys have shown similar auditory-somatosensory convergence in a subregion of auditory cortex directly caudomedial to primary auditory cortex (area CM). The multisensory region identified in the present investigation may be the human homologue of CM. Our finding of auditory-somatosensory convergence in early auditory cortices contributes to mounting evidence for multisensory integration early in the cortical processing hierarchy, in brain regions that were previously assumed to be unisensory.