Facial emotion processing in patients with schizophrenia and their non-psychotic siblings: a functional magnetic resonance imaging study

Background: Previous studies have shown that patients with schizophrenia show abnormalities in brain activation when processing emotional faces. However, very few studies have examined if such abnormalities are also found in non-western patient samples and in at-risk individuals. The current study explored whether patients with schizophrenia and siblings of patients in China would show abnormal brain activation during processing of emotional faces.

Methods: Thirty-six participants (three groups of twelve each of patients with schizophrenia, nonpsychotic siblings, and healthy controls) took part in the study. They were administered a task to judge emotional valence of three types of faces (viz., happy, fearful, and neutral), during fMRI scanning.

Results: Results of this study demonstrated that patients with schizophrenia showed abnormalities in the social brain neural circuit during facial emotion processing, in comparison with nonpsychotic siblings and healthy controls. Patients with schizophrenia demonstrated lower activation right superior and middle frontal gyrus, left precentral gyrus, left middle temporal gyrus and left insula in comparison with healthy controls; and showed abnormal activation in bilateral inferior and middle frontal gyri, right orbital frontal gyrus, left superior and middle temporal gyrus, bilateral insula, and right superior parietal gyrus/postcentral gyrus when compared with their nonpyschotic siblings. Meanwhile, patients with schizophrenia showed greater activation in left middle frontal gyrus than healthy controls, and overactivation in bilateral middle frontal gyri, right orbital frontal gyrus and left middle temporal gyrus than their nonpsychotic siblings during processing of fearful faces. Moreover, nonpsychotic siblings seemed to share some similar dysfunctions in processing facial expressions as their psychotic probands, the two groups both showed abnormal activation in precentral and superior frontal gyri, and such abnormal activation lied between patients with schizophrenia and healthy controls.

Conclusions: The current findings support the universality of emotion perception impairments in schizophrenia, and also suggest that facial emotion perception might be a potential endophenotype of schizophrenia.