title: Not pitch perfect: sensory contributions to affective communication impairment in schizophrenia.
abstract: 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.
authors.affiliation: Department of Psychiatry-Neuropsychiatry Program, Brain Behavior Laboratory, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-4283, USA. leitman@mail.med.upenn.edu
authors.forename: David I
authors.initials: DI
authors.lastname: Leitman
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Wolf
authors.forename: Petri
authors.initials: P
authors.lastname: Laukka
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Ragland
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Valdez
authors.forename: Bruce I
authors.initials: BI
authors.lastname: Turetsky
authors.forename: Raquel E
authors.initials: RE
authors.lastname: Gur
authors.forename: Ruben C
authors.initials: RC
authors.lastname: Gur
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D000328:Adult; D000679:Amygdala / Q000503:physiopathology; D001308:Auditory Perceptual Disorders / Q000150:complications / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods / Q000523:psychology; D016022:Case-Control Studies; D003463:Cues; D004192:Discrimination, Psychological; D004644:Emotions / Q000502:physiology*; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000523:psychology; D008297:Male; D009434:Neural Pathways / Q000503:physiopathology; D010898:Pitch Perception / Q000502:physiology*; D011597:Psychomotor Performance / Q000502:physiology; D012559:Schizophrenia / Q000150:complications / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D013702:Temporal Lobe / Q000503:physiopathology*