Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd, Ann Arbor MI 48109-2700, USA.
J Psychiatr Res. 2011 Apr;45(4):526-38. doi: 10.1016/j.jpsychires.2010.08.004. Epub 2010 Aug 24.
Persons with schizophrenia often appraise other individuals as threatening or persecutory. To evaluate social appraisal in schizophrenia, we probed brain networks with a task in which subjects judged whether or not they liked face stimuli with emotional expressions. We predicted that appraising negative expressions would engage patients, more than controls, and negative faces would be related to higher levels of negative affect and produce increased activity in the medial frontal cortex, an area involved in social appraisal. Twenty-one stable outpatients with chronic non-affective psychosis (16 schizophrenic, 5 schizoaffective) and 21 healthy subjects underwent functional magnetic resonance imaging. Compared with the control subjects, patients were slower to respond, but particularly slow when they judged negatively-valenced faces, a slowness correlated with negative affect in the psychosis patients. Appraisal activated the medial prefrontal cortex (mPFC) across all face valences. For negative expressions, patients exhibited greater activation of the dorsal anterior cingulate cortex (dACC). A psychophysiological interaction analysis of the dACC revealed co-modulation of the mPFC in controls, significantly less in patients, and a trend for co-modulation of occipital cortex in the patients. Activity in occipital cortex correlated with poor social adjustment and impaired social cognition, and co-modulation of the occipital gyrus by the dACC was correlated with poorer social cognition. The findings link appraisal of negative affect with aberrant activation of the medial frontal cortex, while early sensory processing of this social cognitive task was linked with poor social function, reflecting either top-down or bottom-up influences.
精神分裂症患者常将他人评价为具有威胁性或迫害性。为了评估精神分裂症患者的社会评价，我们使用了一项任务来探测大脑网络，要求被试判断他们是否喜欢带有情绪表达的面孔刺激。我们预测，评价负面表情会使患者比对照组更投入，而负面面孔会与更高水平的负面情绪相关，并在参与社会评价的中额前皮质中产生更多的活动。21 名稳定的慢性非情感性精神病门诊患者（16 名精神分裂症患者，5 名分裂情感性精神病患者）和 21 名健康受试者接受了功能磁共振成像。与对照组相比，患者的反应速度较慢，但当他们判断出负面价值的面孔时，反应速度尤其慢，这种缓慢与精神病患者的负面情绪相关。评价激活了中额前皮质（mPFC）的所有面孔。对于负面表情，患者的背侧前扣带皮质（dACC）表现出更大的激活。对 dACC 的心理生理交互分析显示，对照组的 mPFC 存在共同调节，而患者的共同调节显著减少，患者的枕叶也存在共同调节的趋势。枕叶皮层的活动与较差的社会适应和受损的社会认知相关，而 dACC 对枕叶回的共同调节与较差的社会认知相关。这些发现将负面情绪的评价与中额前皮质的异常激活联系起来，而这一社会认知任务的早期感觉处理与较差的社会功能有关，反映了自上而下或自下而上的影响。
