Neuropsychiatric Disease and Treatment (Jun 2021)

Cortical Pathways or Mechanism in the Face Inversion Effect in Patients with First-Episode Schizophrenia

  • Liu Y,
  • Bi T,
  • Kuang Q,
  • Zhang B,
  • Wu H,
  • Li H,
  • Zhang B,
  • Zhao J,
  • Ning Y,
  • She S,
  • Zheng Y

Journal volume & issue
Vol. Volume 17
pp. 1893 – 1906

Abstract

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Yi Liu,1 Taiyong Bi,2 Qijie Kuang,1 Bei Zhang,3 Huawang Wu,1 Haijing Li,1 Bin Zhang,1 Jingping Zhao,4 Yuping Ning,1 Shenglin She,1 Yingjun Zheng1 1Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, 510370, People’s Republic of China; 2Centre for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, Guizhou, 563000, People’s Republic of China; 3General and Experimental Psychology, Department of Psychology, LMU, Munich, Germany; 4Mental Health Institute of the Second Xiangya Hospital, Central South University; Chinese National Clinical Research Center on Mental Disorders; Chinese National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, People’s Republic of ChinaCorrespondence: Yingjun Zheng; Shenglin She Email [email protected]; [email protected]: Impaired face perception is considered as a hallmark of social disability in schizophrenia. It is widely believed that inverted faces and upright faces are processed by distinct mechanisms. Previous studies have identified that individuals with schizophrenia display poorer face processing than controls. However, the mechanisms underlying the face inversion effect (FIE) in patients with first-episode schizophrenia (FSZ) remain unclear.Methods: We designed an fMRI task to investigate the FIE mechanism in patients with schizophrenia. Thirty-four patients with FSZ and thirty-five healthy controls (CON) underwent task-related fMRI scanning, clinical assessment, anhedonia experience examination, and social function and cognitive function evaluation.Results: The patients with FSZ exhibited distinct functional activity regarding upright and inverted face processing within the cortical face and non-face network. These results suggest that the differences in quantitative processing might mediate the FIE in schizophrenia. Compared with controls, affected patients showed impairments in processing both upright and inverted faces; and for these patients with FSZ, upright face processing was associated with more severe and broader impairment than inverted face processing. Reduced response in the left middle occipital gyrus for upright face processing was related to poorer performance of social function outcomes evaluated using the Personal and Social Performance Scale.Conclusion: Our data suggested that patients with FSZ exhibited similar performance in processing inverted faces and upright faces, but were less efficient than controls; and for these patients, inverted faces are processed less efficiently than upright faces. We also provided a clue that the mechanism under abnormal FIE might be related to an aberrant activation of non-face-selective areas instead of abnormal activation of face-specific areas in patients with schizophrenia. Finally, our study indicated that the neural pathway for upright recognition might be relevant in determining the functional outcomes of this devastating disorder.Keywords: first-episode schizophrenia, face inversion effect, task-related fMRI, face recognition, social functional outcome

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