An fMRI study of facial emotion processing in patients with schizophrenia.
OBJECTIVE
Emotion processing deficits are notable in schizophrenia. The authors evaluated cerebral blood flow response in schizophrenia patients during facial emotion processing to test the hypothesis of diminished limbic activation related to emotional relevance of facial stimuli.


METHODS
Fourteen patients with schizophrenia and 14 matched comparison subjects viewed facial displays of happiness, sadness, anger, fear, and disgust as well as neutral faces. Functional magnetic resonance imaging was used to measure blood-oxygen-level-dependent signal changes as the subjects alternated between tasks of discriminating emotional valence (positive versus negative) and age (over 30 versus under 30) of the faces with an interleaved crosshair reference condition.


RESULTS
The groups did not differ in performance on either task. For both tasks, healthy participants showed activation in the fusiform gyrus, occipital lobe, and inferior frontal cortex relative to the resting baseline condition. The increase was greater in the amygdala and hippocampus during the emotional valence discrimination task than during the age discrimination task. In the patients with schizophrenia, minimal focal response was observed for all tasks relative to the resting baseline condition. Contrasting patients and comparison subjects on the emotional valence discrimination task revealed voxels in the left amygdala and bilateral hippocampus in which the comparison subjects had significantly greater activation.


CONCLUSIONS
Failure to activate limbic regions during emotional valence discrimination may explain emotion processing deficits in patients with schizophrenia. While the lack of limbic recruitment did not significantly impair simple valence discrimination performance in this clinically stable group, it may impact performance of more demanding tasks.
Gur
Raquel E
RE
Section of Neuropsychiatry, Department of Psychiatry, Gates Bldg. 10th Floor, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA. raquel@bbl.med.upenn.edu
McGrath
Claire
C
Chan
Robin M
RM
Schroeder
Lee
L
Turner
Travis
T
Turetsky
Bruce I
BI
Kohler
Christian
C
Alsop
David
D
Maldjian
Joseph
J
Ragland
J Daniel
JD
Gur
Ruben C
RC
D000339:Affect; D000679:Amygdala / Q000002:abnormalities / Q000503:physiopathology; D001921:Brain / Q000002:abnormalities* / Q000503:physiopathology*; D004192:Discrimination, Psychological; D005149:Facial Expression; D006801:Humans; D008279:Magnetic Resonance Imaging; D012559:Schizophrenia / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D013997:Time Factors