Koreki Akihiro, Terasawa Yuri, Oi Hiroki, Mouri Takuya, Takenaka Aki, Koizumi Teruki, Onaya Mitsumoto, Yogarajah Mahinda, Critchley Hugo, Nuruki Atsuo
Department of Psychiatry NHO Shimofusa Psychiatric Medical Center Chiba Japan.
Department of Psychiatry NHO Chibahigashi National Hospital Chiba Japan.
PCN Rep. 2025 May 2;4(2):e70106. doi: 10.1002/pcn5.70106. eCollection 2025 Jun.
Schizophrenia (SZ) is characterized by abnormalities in self-representation, including an aberrant sense of agency (SoA). Experimentally observed abnormalities in force matching and intentional binding tasks suggest that the SoA in SZ is compromised at the implicit level. However, these task effects have been reported independently, leading to inconsistencies that complicate the understanding of SZ pathophysiology.
Thirty-three patients with SZ and 37 nonclinical (healthy) controls (HCs) performed force matching and intentional binding tasks. The former task assessed sensory attenuation, while the latter evaluated an intentional binding effect, both measuring implicit levels of SoA. We previously observed that the cardiac phase (systole vs diastole) influences intentional binding. Therefore, we investigated the relationship between sensory attenuation and intentional binding, including this "cardiac effect," which refers to the influence of cardiac interoceptive signals.
In SZ, significantly reduced sensory attenuation, a greater but nonsignificant intentional binding effect, and a significant opposite cardiac effect were observed compared with HCs. Sensory attenuation and intentional binding were significantly and positively correlated in the SZ group but not in the HC group. Across all participants, sensory attenuation correlated with the cardiac effect on intentional binding. This effect remained significant in the HC group but not in the SZ group.
Group differences and task associations suggest shared mechanisms and pathophysiology in SZ, potentially involving impaired predictive processes and the failure of sensory attenuation. The cardiac effect may be explained by interoceptive sensory attenuation, and its failure could lead to a disturbed SoA in patients with SZ.
精神分裂症（SZ）的特征在于自我表征异常，包括异常的 agency 感（SoA）。在力匹配和意向性绑定任务中通过实验观察到的异常表明，SZ 中的 SoA 在隐性水平上受到损害。然而，这些任务效应是独立报道的，导致了一些不一致性，这使得对 SZ 病理生理学的理解变得复杂。
33 名 SZ 患者和 37 名非临床（健康）对照（HCs）进行了力匹配和意向性绑定任务。前一项任务评估感觉衰减，而后一项任务评估意向性绑定效应，两者均测量 SoA 的隐性水平。我们之前观察到心脏相位（收缩期与舒张期）会影响意向性绑定。因此，我们研究了感觉衰减与意向性绑定之间的关系，包括这种“心脏效应”，即心脏内感受信号的影响。
与 HCs 相比，在 SZ 患者中观察到感觉衰减显著降低、意向性绑定效应更大但不显著，以及显著相反的心脏效应。在 SZ 组中，感觉衰减与意向性绑定显著正相关，而在 HC 组中则不然。在所有参与者中，感觉衰减与心脏对意向性绑定的效应相关。这种效应在 HC 组中仍然显著，但在 SZ 组中不显著。
组间差异和任务关联表明 SZ 存在共同的机制和病理生理学，可能涉及预测过程受损和感觉衰减失败。心脏效应可能由内感受性感觉衰减来解释，其失败可能导致 SZ 患者的 SoA 紊乱。
