title: Reduced white matter integrity and facial emotion perception in never-medicated patients with first-episode schizophrenia: A diffusion tensor imaging study.
abstract: Facial emotion perception is impaired in schizophrenia. Although the pathology of schizophrenia is thought to involve abnormality in white matter (WM), few studies have examined the correlation between facial emotion perception and WM abnormalities in never-medicated patients with first-episode schizophrenia. The present study tested associations between facial emotion perception and WM integrity in order to investigate the neural basis of impaired facial emotion perception in schizophrenia.
  
  
  
  Sixty-three schizophrenic patients and thirty control subjects underwent facial emotion categorization (FEC). The FEC data was inserted into a logistic function model with subsequent analysis by independent-samples T test and the shift point and slope as outcome measurements. Severity of symptoms was measured using a five-factor model of the Positive and Negative Syndrome Scale (PANSS). Voxelwise group comparison of WM fractional anisotropy (FA) was operated using tract-based spatial statistics (TBSS). The correlation between impaired facial emotion perception and FA reduction was examined in patients using simple regression analysis within brain areas that showed a significant FA reduction in patients compared with controls. The same correlation analysis was also performed for control subjects in the whole brain.
  
  
  
  The patients with schizophrenia reported a higher shift point and a steeper slope than control subjects in FEC. The patients showed a significant FA reduction in left deep WM in the parietal, temporal and occipital lobes, a small portion of the corpus callosum (CC), and the corona radiata. In voxelwise correlation analysis, we found that facial emotion perception significantly correlated with reduced FA in various WM regions, including left forceps major (FM), inferior longitudinal fasciculus (ILF), inferior fronto-occipital fasciculus (IFOF), Left splenium of CC, and left ILF. The correlation analyses in healthy controls revealed no significant correlation of FA with FEC task.
  
  
  
  These results showed disrupted WM integrity in these regions constitutes a potential neural basis for the facial emotion perception impairments in schizophrenia.
authors.affiliation: Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Xiaoxin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China.. Electronic address: suiyuxiu@aliyun.com.
authors.forename: Yuxiu
authors.initials: Y
authors.lastname: Sui
authors.affiliation: Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Yao
authors.affiliation: Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Yiding
authors.initials: Y
authors.lastname: Lv
authors.affiliation: Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Xinyue
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Zhuma
authors.initials: Z
authors.lastname: Jin
authors.affiliation: Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Lijun
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Xiangrong
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D016880:Anisotropy; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging; D004644:Emotions; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D059906:Neuroimaging; D010775:Photic Stimulation; D012559:Schizophrenia / Q000473:pathology*; D014796:Visual Perception; D066127:White Matter / Q000473:pathology*; D055815:Young Adult
keywords: Diffusion tensor imaging; Facial emotion perception; Schizophrenia