Prefrontal Cortex Activity During Facial Affect Processing in Schizophrenia: Association with Clinical Symptoms and Social Cognitive Functions

Abstract

In the present study, we aimed to investigate the prefrontal cortex (PFC) activity during facial affect recognition in schizophrenia, as well as the association of this activity with symptom severity and with the higher order social cognitive functions, namely recognition of false beliefs, faux-pas and hinting. Functional near infrared spectroscopy (fNIRS) was used to measure frontal cortical activity during a neuroimaging task prepared with a standard set of pictures of facial affect. The data of the Index Group (IG) consisting of 27 subjects with DSM-IV based diagnoses of schizophrenia and schizophreniform disorder and control group (CG) (N=25) were compared. The control condition was to detect nonaffective changes on a neutral face. Associations with frontal activity during affect recognition and clinical symptoms, false belief recognition, hinting and faux-pas were investigated. Prefrontal activity during both affective and non-affective conditions was higher in the IG than the CG. The IG performed worse than the CG in social cognitive tests. Social cognitive test performance was not correlated with cortical activity. There were no correlations between education status, age and PFC activity in both groups. In the IG, right ventral prefrontal cortex (VPFC) and right medial prefrontal cortex (mPFC) activities were associated with hallucination severity. These results suggest the presence of hyperfrontality during face processing in schizophrenia. Results also suggest that schizophrenia patients require more frontal resources to achieve a performance comparable to that of healthy controls in order to detect both affective and non-affective changes on a face. There might be a relationship between facial processing and hallucinations.