Schmitter Christina V, Pazen Mareike, Uhlmann Lukas, van Kemenade Bianca M, Kircher Tilo, Straube Benjamin
Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Strasse 8, Marburg, Germany.
Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Hans-Meerwein-Strasse 6, Marburg, Germany.
Transl Psychiatry. 2025 Mar 17;15(1):85. doi: 10.1038/s41398-025-03306-6.
Schizophrenia spectrum disorders (SSD) have been linked to dysfunctions in the predictive neural suppression of sensory input elicited by one's own actions. Such motor predictions become particularly challenging during tool use and when feedback from multiple sensory modalities is present. In this study, we investigated the neural correlates and potential dysfunctions of action feedback processing in SSD during tool use actions and bimodal sensory feedback presentation. Patients with SSD (N = 42; schizophrenia N = 34; schizoaffective disorder N = 6; other N = 2) and healthy controls (HC, N = 27) performed active or passive hand movements with or without a tool and received unimodal (visual; a video of their hand movement) or bimodal (visual and auditory) feedback with various delays (0, 83, 167, 250, 333, 417 ms). Subjects reported whether they detected a delay. A subgroup (N = 20; N = 20) participated in an identical fMRI experiment. Both groups reported fewer delays in active than passive conditions and exhibited neural suppression in all conditions in occipital and temporoparietal regions, cerebellum, and SMA. Group differences emerged in right cuneus, calcarine, and middle occipital gyrus, with reduced active-passive differences in patients during tool use actions and in bimodal trials during actions performed without a tool. These results demonstrate for the first time that, although patients and HC show similarities in neural suppression, higher-level visual processing areas fail to adequately distinguish between self- and externally generated sensory input in patients, particularly in complex action feedback scenarios involving bimodal action feedback and feedback elicited by tool use actions.
精神分裂症谱系障碍（SSD）与个体自身行为引发的感觉输入的预测性神经抑制功能障碍有关。在使用工具以及存在多种感觉模态反馈的情况下，这种运动预测变得尤其具有挑战性。在本研究中，我们调查了在使用工具动作和双峰感觉反馈呈现过程中，SSD患者动作反馈处理的神经关联和潜在功能障碍。SSD患者（N = 42；精神分裂症患者N = 34；分裂情感性障碍患者N = 6；其他患者N = 2）和健康对照者（HC，N = 27）进行有或无工具的主动或被动手部动作，并接受具有不同延迟（0、83、167、250、333、417毫秒）的单峰（视觉；其手部动作的视频）或双峰（视觉和听觉）反馈。受试者报告他们是否检测到延迟。一个亚组（N = 20；N = 20）参与了相同的功能磁共振成像实验。两组均报告主动条件下检测到的延迟比被动条件下少，并且在枕叶、颞顶叶区域、小脑和辅助运动区的所有条件下均表现出神经抑制。在右侧楔叶、距状裂和枕中回出现了组间差异，在使用工具动作期间患者的主动 - 被动差异减小，在无工具执行动作的双峰试验中也是如此。这些结果首次表明，尽管患者和健康对照者在神经抑制方面表现出相似性，但在患者中，高级视觉处理区域无法充分区分自我产生和外部产生的感觉输入，特别是在涉及双峰动作反馈和工具使用动作引发的反馈的复杂动作反馈场景中。
