Comparison of auditory and visual oddball fMRI in schizophrenia.

Individuals with schizophrenia often suffer from attentional deficits, both in focusing on task-relevant targets and in inhibiting responses to distractors. Schizophrenia also has a differential impact on attention depending on modality: auditory or visual. However, it remains unclear how abnormal activation of attentional circuitry differs between auditory and visual modalities, as these two modalities have not been directly compared in the same individuals with schizophrenia. We utilized event-related functional magnetic resonance imaging (fMRI) to compare patterns of brain activation during an auditory and visual oddball task in order to identify modality-specific attentional impairment. Healthy controls (n=22) and patients with schizophrenia (n=20) completed auditory and visual oddball tasks in separate sessions. For responses to targets, the auditory modality yielded greater activation than the visual modality (A-V) in auditory cortex, insula, and parietal operculum, but visual activation was greater than auditory (V-A) in visual cortex. For responses to novels, A-V differences were found in auditory cortex, insula, and supramarginal gyrus; and V-A differences in the visual cortex, inferior temporal gyrus, and superior parietal lobule. Group differences in modality-specific activation were found only for novel stimuli; controls showed larger A-V differences than patients in prefrontal cortex and the putamen. Furthermore, for patients, greater severity of negative symptoms was associated with greater divergence of A-V novel activation in the visual cortex. Our results demonstrate that patients have more pronounced activation abnormalities in auditory compared to visual attention, and link modality specific abnormalities to negative symptom severity.

Not pitch perfect: sensory contributions to affective communication impairment in schizophrenia.

BACKGROUND: Schizophrenia patients have vocal affect (prosody) deficits that are treatment resistant and associated with negative symptoms and poor outcome. The neural correlates of this dysfunction are unclear. Prior study has suggested that schizophrenia vocal affect perception deficits stem from an inability to use acoustic cues, notably pitch, in decoding emotion. METHODS: Functional magnetic resonance imaging was performed in 24 schizophrenia patients and 28 healthy control subjects, during the performance of a four-choice (happiness, fear, anger, neutral) vocal affect identification task in which items for each emotion varied parametrically in affective salient acoustic cue levels. RESULTS: We observed that parametric increases in cue levels in schizophrenia failed to produce the same identification rate increases as in control subjects. These deficits correlated with diminished reciprocal activation changes in superior temporal and inferior frontal gyri and reduced temporo-frontal connectivity. Task activation also correlated with independent measures of pitch perception and negative symptom severity. CONCLUSIONS: These findings illustrate the interplay between sensory and higher-order cognitive dysfunction in schizophrenia. Sensory contributions to vocal affect deficits also suggest that this neurobehavioral marker could be targeted by pharmacological or behavioral remediation of acoustic feature discrimination.

Levels-of-processing effect on frontotemporal function in schizophrenia during word encoding and recognition.

OBJECTIVE: Patients with schizophrenia improve episodic memory accuracy when given organizational strategies through levels-of-processing paradigms. This study tested if improvement is accompanied by normalized frontotemporal function. METHOD: Event-related blood-oxygen-level-dependent functional magnetic resonance imaging (fMRI) was used to measure activation during shallow (perceptual) and deep (semantic) word encoding and recognition in 14 patients with schizophrenia and 14 healthy comparison subjects. RESULTS: Despite slower and less accurate overall word classification, the patients showed normal levels-of-processing effects, with faster and more accurate recognition of deeply processed words. These effects were accompanied by left ventrolateral prefrontal activation during encoding in both groups, although the thalamus, hippocampus, and lingual gyrus were overactivated in the patients. During word recognition, the patients showed overactivation in the left frontal pole and had a less robust right prefrontal response. CONCLUSIONS: Evidence of normal levels-of-processing effects and left prefrontal activation suggests that patients with schizophrenia can form and maintain semantic representations when they are provided with organizational cues and can improve their word encoding and retrieval. Areas of overactivation suggest residual inefficiencies. Nevertheless, the effect of teaching organizational strategies on episodic memory and brain function is a worthwhile topic for future interventional studies.