Maladaptive connectivity of Broca’s area in schizophrenia during audiovisual speech perception: An fMRI study

Abnormal connectivity and activation during audiovisual speech perception in schizophrenia

The unconscious integration of vocal and facial cues during speech perception facilitates face-to-face communication. Recent studies have provided substantial behavioural evidence concerning impairments in audiovisual (AV) speech perception in schizophrenia. However, the specific neurophysiological mechanism underlying these deficits remains unknown. Here, we investigated activities and connectivities centered on the auditory cortex during AV speech perception in schizophrenia. Using magnetoencephalography, we recorded and analysed event-related fields in response to auditory (A: voice), visual (V: face) and AV (voice-face) stimuli in 23 schizophrenia patients (13 males) and 22 healthy controls (13 males). The functional connectivity associated with the subadditive response to AV stimulus (i.e., [AV] < [A] + [V]) was also compared between the two groups. Within the healthy control group, [AV] activity was smaller than the sum of [A] and [V] at latencies of approximately 100 ms in the posterior ramus of the lateral sulcus in only the left hemisphere, demonstrating a subadditive N1m effect. Conversely, the schizophrenia group did not show such a subadditive response. Furthermore, weaker functional connectivity from the posterior ramus of the lateral sulcus of the left hemisphere to the fusiform gyrus of the right hemisphere was observed in schizophrenia. Notably, this weakened connectivity was associated with the severity of negative symptoms. These results demonstrate abnormalities in connectivity between speech- and face-related cortical areas in schizophrenia. This aberrant subadditive response and connectivity deficits for integrating speech and facial information may be the neural basis of social communication dysfunctions in schizophrenia.

Anterior cingulate glutamate levels associate with functional activation and connectivity during sensory integration in schizophrenia: a multimodal 1H-MRS and fMRI study

BACKGROUND

Glutamatergic dysfunction has been implicated in sensory integration deficits in schizophrenia, yet how glutamatergic function contributes to behavioural impairments and neural activities of sensory integration remains unknown.

METHODS

Fifty schizophrenia patients and 43 healthy controls completed behavioural assessments for sensory integration and underwent magnetic resonance spectroscopy (MRS) for measuring the anterior cingulate cortex (ACC) glutamate levels. The correlation between glutamate levels and behavioural sensory integration deficits was examined in each group. A subsample of 20 pairs of patients and controls further completed an audiovisual sensory integration functional magnetic resonance imaging (fMRI) task. Blood Oxygenation Level Dependent (BOLD) activation and task-dependent functional connectivity (FC) were assessed based on fMRI data. Full factorial analyses were performed to examine the Group-by-Glutamate Level interaction effects on fMRI measurements (group differences in correlation between glutamate levels and fMRI measurements) and the correlation between glutamate levels and fMRI measurements within each group.

RESULTS

We found that schizophrenia patients exhibited impaired sensory integration which was positively correlated with ACC glutamate levels. Multimodal analyses showed significantly Group-by-Glutamate Level interaction effects on BOLD activation as well as task-dependent FC in a 'cortico-subcortical-cortical' network (including medial frontal gyrus, precuneus, ACC, middle cingulate gyrus, thalamus and caudate) with positive correlations in patients and negative in controls.

CONCLUSIONS

Our findings indicate that ACC glutamate influences neural activities in a large-scale network during sensory integration, but the effects have opposite directionality between schizophrenia patients and healthy people. This implicates the crucial role of glutamatergic system in sensory integration processing in schizophrenia.

Deficient Audiovisual Speech Perception in Schizophrenia: An ERP Study

In everyday verbal communication, auditory speech perception is often disturbed by background noise. Especially in disadvantageous hearing conditions, additional visual articulatory information (e.g., lip movement) can positively contribute to speech comprehension. Patients with schizophrenia (SZs) demonstrate an aberrant ability to integrate visual and auditory sensory input during speech perception. Current findings about underlying neural mechanisms of this deficit are inconsistent. Particularly and despite the importance of early sensory processing in speech perception, very few studies have addressed these processes in SZs. Thus, in the present study, we examined 20 adult subjects with SZ and 21 healthy controls (HCs) while presenting audiovisual spoken words (disyllabic nouns) either superimposed by white noise (-12 dB signal-to-noise ratio) or not. In addition to behavioral data, event-related brain potentials (ERPs) were recorded. Our results demonstrate reduced speech comprehension for SZs compared to HCs under noisy conditions. Moreover, we found altered N1 amplitudes in SZ during speech perception, while P2 amplitudes and the N1-P2 complex were similar to HCs, indicating that there may be disturbances in multimodal speech perception at an early stage of processing, which may be due to deficits in auditory speech perception. Moreover, a positive relationship between fronto-central N1 amplitudes and the positive subscale of the Positive and Negative Syndrome Scale (PANSS) has been observed.

Early evoked brain activity underlies auditory and audiovisual speech recognition deficits in schizophrenia

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Reduced N1 amplitudes reflect speech processing deficits in schizophrenia (SZ).

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Crossmodal N1 amplitude suppression in audiovisual speech is preserved in SZ.

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N1 amplitudes correlate with speech recognition performance in controls but not in SZ.

Objectives

People with Schizophrenia (SZ) show deficits in auditory and audiovisual speech recognition. It is possible that these deficits are related to aberrant early sensory processing, combined with an impaired ability to utilize visual cues to improve speech recognition. In this electroencephalography study we tested this by having SZ and healthy controls (HC) identify different unisensory auditory and bisensory audiovisual syllables at different auditory noise levels.

Methods

SZ (N = 24) and HC (N = 21) identified one of three different syllables (/da/, /ga/, /ta/) at three different noise levels (no, low, high). Half the trials were unisensory auditory and the other half provided additional visual input of moving lips. Task-evoked mediofrontal N1 and P2 brain potentials triggered to the onset of the auditory syllables were derived and related to behavioral performance.

Results

In comparison to HC, SZ showed speech recognition deficits for unisensory and bisensory stimuli. These deficits were primarily found in the no noise condition. Paralleling these observations, reduced N1 amplitudes to unisensory and bisensory stimuli in SZ were found in the no noise condition. In HC the N1 amplitudes were positively related to the speech recognition performance, whereas no such relationships were found in SZ. Moreover, no group differences in multisensory speech recognition benefits and N1 suppression effects for bisensory stimuli were observed.

Conclusion

Our study suggests that reduced N1 amplitudes reflect early auditory and audiovisual speech processing deficits in SZ. The findings that the amplitude effects were confined to salient speech stimuli and the attenuated relationship with behavioral performance in patients compared to HC, indicates a diminished decoding of the auditory speech signals in SZs. Our study also revealed relatively intact multisensory benefits in SZs, which implies that the observed auditory and audiovisual speech recognition deficits were primarily related to aberrant processing of the auditory syllables.

A systematic review of the neural correlates of multisensory integration in schizophrenia

Multisensory integration (MSI), in which sensory signals from different modalities are unified, is necessary for our comprehensive perception of and effective adaptation to the objects and events around us. However, individuals with schizophrenia suffer from impairments in MSI, which could explain typical symptoms like hallucination and reality distortion. Because the neural correlates of aberrant MSI in schizophrenia help us understand the physiognomy of this psychiatric disorder, we performed a systematic review of the current research on this subject. The literature search concerned investigated MSI in diagnosed schizophrenia patients compared to healthy controls using brain imaging. Seventeen of 317 identified studies were finally included. To assess risk of bias, the Newcastle-Ottawa quality assessment was used, and the review was written according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The results indicated that multisensory processes in schizophrenia are associated with aberrant, mainly reduced, neural activity in several brain regions, as measured by event-related potentials, oscillations, activity and connectivity. The conclusion is that a fronto-temporal region, comprising the frontal inferior gyrus, middle temporal gyrus and superior temporal gyrus/sulcus, along with the fusiform gyrus and dorsal visual stream in the occipital-parietal lobe are possible key regions of deficient MSI in schizophrenia.

Audiovisual incongruence differentially impacts left and right hemisphere sensorimotor oscillations: Potential applications to production

Speech production gives rise to distinct auditory and somatosensory feedback signals which are dynamically integrated to enable online monitoring and error correction, though it remains unclear how the sensorimotor system supports the integration of these multimodal signals. Capitalizing on the parity of sensorimotor processes supporting perception and production, the current study employed the McGurk paradigm to induce multimodal sensory congruence/incongruence. EEG data from a cohort of 39 typical speakers were decomposed with independent component analysis to identify bilateral mu rhythms; indices of sensorimotor activity. Subsequent time-frequency analyses revealed bilateral patterns of event related desynchronization (ERD) across alpha and beta frequency ranges over the time course of perceptual events. Right mu activity was characterized by reduced ERD during all cases of audiovisual incongruence, while left mu activity was attenuated and protracted in McGurk trials eliciting sensory fusion. Results were interpreted to suggest distinct hemispheric contributions, with right hemisphere mu activity supporting a coarse incongruence detection process and left hemisphere mu activity reflecting a more granular level of analysis including phonological identification and incongruence resolution. Findings are also considered in regard to incongruence detection and resolution processes during production.

Influence of prior beliefs on perception in early psychosis: Effects of illness stage and hierarchical level of belief

Alterations in the balance between prior expectations and sensory evidence may account for faulty perceptions and inferences leading to psychosis. However, uncertainties remain about the nature of altered prior expectations and the degree to which they vary with the emergence of psychosis. We explored how expectations arising at two different levels—cognitive and perceptual—influenced processing of sensory information and whether relative influences of higher- and lower-level priors differed across people with prodromal symptoms and those with psychotic illness. In two complementary auditory perception experiments, 91 participants (30 with first-episode psychosis, 29 at clinical risk for psychosis, and 32 controls) were required to decipher a phoneme within ambiguous auditory input. Expectations were generated in two ways: an accompanying visual input of lip movements observed during auditory presentation or through written presentation of a phoneme provided prior to auditory presentation. We determined how these different types of information shaped auditory perceptual experience, how this was altered across the prodromal and established phases of psychosis, and how this relates to cingulate glutamate levels assessed by magnetic resonance spectroscopy. The psychosis group relied more on high-level cognitive priors compared to both healthy controls and those at clinical risk for psychosis and relied more on low-level perceptual priors than the clinical risk group. The risk group was marginally less reliant on low-level perceptual priors than controls. The results are consistent with previous theory that influences of prior expectations in perceptions in psychosis differ according to level of prior and illness phase.

What we perceive and believe in any given moment will allow us to form expectations about what we will experience in the next. In psychosis, it is believed that the influence of these so-called perceptual and cognitive “prior” expectations on perception are altered, thereby giving rise to the symptoms seen in psychosis. However, research thus far has found mixed evidence, some suggesting an increase in the influence of priors and some finding a decrease. Here we test the hypothesis that perceptual and cognitive priors are differentially affected in individuals at risk for psychosis and individuals with a first episode of psychosis, thereby partially explaining the mixed findings in the literature. We indeed found evidence in favor of this hypothesis, finding weaker perceptual priors in individuals at risk but stronger cognitive priors in individuals with first-episode psychosis.

Multisensory Integration of Emotion in Schizophrenic Patients

Multisensory integration (MSI) of emotion has been increasingly recognized as an essential element of schizophrenic patients' impairments, leading to the breakdown of their interpersonal functioning. The present review provides an updated synopsis of schizophrenics' MSI abilities in emotion processing by examining relevant behavioral and neurological research. Existing behavioral studies have adopted well-established experimental paradigms to investigate how participants understand multisensory emotion stimuli, and interpret their reciprocal interactions. Yet it remains controversial with regard to congruence-induced facilitation effects, modality dominance effects, and generalized vs specific impairment hypotheses. Such inconsistencies are likely due to differences and variations in experimental manipulations, participants' clinical symptomatology, and cognitive abilities. Recent electrophysiological and neuroimaging research has revealed aberrant indices in event-related potential (ERP) and brain activation patterns, further suggesting impaired temporal processing and dysfunctional brain regions, connectivity and circuities at different stages of MSI in emotion processing. The limitations of existing studies and implications for future MSI work are discussed in light of research designs and techniques, study samples and stimuli, and clinical applications.

Auditory Deficits in Audiovisual Speech Perception in Adult Asperger's Syndrome: fMRI Study

Audiovisual (AV) integration deficits have been proposed to underlie difficulties in speech perception in Asperger’s syndrome (AS). It is not known, if the AV deficits are related to alterations in sensory processing at the level of unisensory processing or at levels of conjoint multisensory processing. Functional Magnetic-resonance images (MRI) was performed in 16 adult subjects with AS and 16 healthy controls (HC) matched for age, gender, and verbal IQ as they were exposed to disyllabic AV congruent and AV incongruent nouns. A simple semantic categorization task was used to ensure subjects’ attention to the stimuli. The left auditory cortex (BA41) showed stronger activation in HC than in subjects with AS with no interaction regarding AV congruency. This suggests that alterations in auditory processing in unimodal low-level areas underlie AV speech perception deficits in AS. Whether this is signaling a difficulty in the deployment of attention remains to be demonstrated.

Temporal processing deficit leads to impaired multisensory binding in schizophrenia

INTRODUCTION

Schizophrenia has been characterised by neurodevelopmental dysconnectivity resulting in cognitive and perceptual dysmetria. Hence patients with schizophrenia may be impaired to detect the temporal relationship between stimuli in different sensory modalities. However, only a few studies described deficit in perception of temporally asynchronous multisensory stimuli in schizophrenia.

METHODS

We examined the perceptual bias and the processing time of synchronous and delayed sounds in the streaming-bouncing illusion in 16 patients with schizophrenia and a matched control group of 18 participants.

RESULTS

Equal for patients and controls, the synchronous sound biased the percept of two moving squares towards bouncing as opposed to the more frequent streaming percept in the condition without sound. In healthy controls, a delay of the sound presentation significantly reduced the bias and led to prolonged processing time whereas patients with schizophrenia did not differentiate between this condition and the condition with synchronous sound.

CONCLUSION

Schizophrenia leads to a prolonged window of simultaneity for audiovisual stimuli. Therefore, temporal processing deficit in schizophrenia can lead to hyperintegration of temporally unmatched multisensory stimuli.

Abnormal Connectional Fingerprint in Schizophrenia: A Novel Network Analysis of Diffusion Tensor Imaging Data

The graph theoretical analysis of structural magnetic resonance imaging (MRI) data has received a great deal of interest in recent years to characterize the organizational principles of brain networks and their alterations in psychiatric disorders, such as schizophrenia. However, the characterization of networks in clinical populations can be challenging, since the comparison of connectivity between groups is influenced by several factors, such as the overall number of connections and the structural abnormalities of the seed regions. To overcome these limitations, the current study employed the whole-brain analysis of connectional fingerprints in diffusion tensor imaging data obtained at 3 T of chronic schizophrenia patients (n = 16) and healthy, age-matched control participants (n = 17). Probabilistic tractography was performed to quantify the connectivity of 110 brain areas. The connectional fingerprint of a brain area represents the set of relative connection probabilities to all its target areas and is, hence, less affected by overall white and gray matter changes than absolute connectivity measures. After detecting brain regions with abnormal connectional fingerprints through similarity measures, we tested each of its relative connection probability between groups. We found altered connectional fingerprints in schizophrenia patients consistent with a dysconnectivity syndrome. While the medial frontal gyrus showed only reduced connectivity, the connectional fingerprints of the inferior frontal gyrus and the putamen mainly contained relatively increased connection probabilities to areas in the frontal, limbic, and subcortical areas. These findings are in line with previous studies that reported abnormalities in striatal-frontal circuits in the pathophysiology of schizophrenia, highlighting the potential utility of connectional fingerprints for the analysis of anatomical networks in the disorder.