Lin Yi, Ding Hongwei, Zhang Yang
Institute of Cross-Linguistic Processing and Cognition, School of Foreign Languages, Shanghai Jiao Tong University, Shanghai 200240, China.
Department of Speech-Language-Hearing Sciences & Center for Neurobehavioral Development, University of Minnesota, Twin Cities, MN 55455, USA.
J Clin Med. 2018 Oct 17;7(10):363. doi: 10.3390/jcm7100363.
Emotional prosody (EP) has been increasingly recognized as an important area of schizophrenic patients' dysfunctions in their language use and social communication. The present review aims to provide an updated synopsis on emotional prosody processing (EPP) in schizophrenic disorders, with a specific focus on performance characteristics, the influential factors and underlying neural mechanisms. A literature search up to 2018 was conducted with online databases, and final selections were limited to empirical studies which investigated the prosodic processing of at least one of the six basic emotions in patients with a clear diagnosis of schizophrenia without co-morbid diseases. A narrative synthesis was performed, covering the range of research topics, task paradigms, stimulus presentation, study populations and statistical power with a quantitative meta-analytic approach in Comprehensive Meta-Analysis Version 2.0. Study outcomes indicated that schizophrenic patients' EPP deficits were consistently observed across studies ( = -0.92, 95% CI = -1.06 < δ < -0.78), with identification tasks ( = -0.95, 95% CI = -1.11 < δ < -0.80) being more difficult to process than discrimination tasks ( = -0.74, 95% CI = -1.03 < δ < -0.44) and emotional stimuli being more difficult than neutral stimuli. Patients' performance was influenced by both participant- and experiment-related factors. Their social cognitive deficits in EP could be further explained by right-lateralized impairments and abnormalities in primary auditory cortex, medial prefrontal cortex and auditory-insula connectivity. The data pointed to impaired pre-attentive and attentive processes, both of which played important roles in the abnormal EPP in the schizophrenic population. The current selective review and meta-analysis support the clinical advocacy of including EP in early diagnosis and rehabilitation in the general framework of social cognition and neurocognition deficits in schizophrenic disorders. Future cross-sectional and longitudinal studies are further suggested to investigate schizophrenic patients' perception and production of EP in different languages and cultures, modality forms and neuro-cognitive domains.
情感韵律（EP）越来越被认为是精神分裂症患者语言使用和社会交往功能障碍的一个重要领域。本综述旨在提供关于精神分裂症情感韵律加工（EPP）的最新概述，特别关注其表现特征、影响因素和潜在神经机制。利用在线数据库对截至2018年的文献进行了检索，最终入选的研究仅限于对明确诊断为精神分裂症且无共病的患者六种基本情绪中至少一种的韵律加工进行调查的实证研究。采用叙述性综合方法，在综合元分析2.0版本中运用定量元分析方法，涵盖研究主题范围、任务范式、刺激呈现、研究人群和统计效力。研究结果表明，在各项研究中均一致观察到精神分裂症患者存在EPP缺陷（ = -0.92，95%可信区间 = -1.06 < δ < -0.78），其中识别任务（ = -0.95，95%可信区间 = -1.11 < δ < -0.80）比辨别任务（ = -0.74，95%可信区间 = -1.03 < δ < -0.44）更难处理，且情感刺激比中性刺激更难处理。患者的表现受参与者相关因素和实验相关因素的影响。他们在EP方面的社会认知缺陷可进一步由右侧化损伤以及初级听觉皮层、内侧前额叶皮层和听觉-脑岛连接异常来解释。数据表明，前注意和注意过程受损，这两者在精神分裂症患者异常的EPP中均起重要作用。当前的选择性综述和元分析支持在精神分裂症社会认知和神经认知缺陷的总体框架内，将EP纳入早期诊断和康复的临床主张。进一步建议未来进行横断面和纵向研究，以调查精神分裂症患者在不同语言和文化、模态形式及神经认知领域中对EP的感知和产生情况。
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