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Involvement of the dorsolateral prefrontal cortex and superior temporal sulcus in impaired social perception in schizophrenia

Contents lists available at Progress in Neuro-Psychopharmacology & Biological Involvement of the dorsolateral prefrontal cortex and superior temporalsulcus in impaired social perception in schizophrenia Jung Eun Shin ,, Soo-Hee Choi Hyeongrae Lee , Young Seok Shin , Dong-Pyo Jang Jae-Jin Kim ,a Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Koreab Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Koreac Department of Psychiatry, Seoul National University College of Medicine and Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Koread Magnetoencephalography center, Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Koreae Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Koreaf Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea Background: Schizophrenia is a mental disorder characterized by impairments in diverse thinking and emotional Received 12 September 2014 responses, which are related to social perception dysfunction. This fMRI study was designed to investigate a Received in revised form 5 December 2014 neurobiological basis of social perception deficits of patients with schizophrenia in various social situations of Accepted 19 December 2014 daily life and their relationship with clinical symptoms and social dysfunction.
Available online 27 December 2014 Methods: Seventeen patients and 19 controls underwent functional magnetic resonance imaging, during whichparticipants performed a virtual social perception task, containing an avatar's speech with positive, negative or neutral emotion in a virtual reality space. Participants were asked to determine whether or not the avatar's Daily lifeDorsolateral prefrontal cortex speech was appropriate to each situation.
Results: The significant group × appropriateness interaction was seen in the left dorsolateral prefrontal cortex Social perception (DLPFC), resulting from lower activity in patients in the inappropriate condition, and left DLPFC activity was Superior temporal sulcus negatively correlated with the severity of negative symptoms and positively correlated with the level of socialfunctioning. The significant appropriateness × emotion interaction observed in the left superior temporal sulcus(STS) was present in controls, but absent in patients, resulting from the existence and absence of a differencebetween the inappropriate positive and negative conditions, respectively.
Conclusions: These findings indicate that dysfunction of the DLPFC-STS network may underlie patients' abnormalsocial perception in various social situations of daily life. Abnormal functioning of this network may contribute toincreases of negative symptoms and decreases of social functioning.
2014 Elsevier Inc. All rights reserved.
Social dysfunction in schizophrenia maybe lifelong and predictive of longer hospitalization Schizophrenia is a mental disorder characterized by impairment in In particular, deficits in social cognition including social perception have thinking and emotional responses. Clinical symptoms including posi- been linked to poor functional outcome in schizophrenia ( tive, negative and disorganized symptoms as well as various cognitive Social perception involves the ability to identify social deficits lead to social dysfunction, such as ineffective social interaction, roles, rules and context and to make inferences about complex or am- poor social skills and the inability to remain employed ( biguous social situations Socialperception is the first step in social cognition, and it is further involvedin processes of organizing behavioral responses directly or indirectly), suggesting that abnormal behaviors observed in Abbreviations: fMRI, functional magnetic resonance imaging; DLPFC, dorsolateral pre- schizophrenia may be initiated by impaired social perception.
frontal cortex; STS, superior temporal sulcus; DMPFC, dorsomedial prefrontal cortex; TPJ, To understand social perception, previous researchers have used temporo-parietal junction; DSM-IV-TR, Diagnostic and Statistical Manual, 4th Edition,Test-Revised; RPM, Raven's progressive matrices; SAS, Social Anhedonia Scale; PANSS, various stimuli. Human faces are frequently used stimuli because they Positive and Negative Syndrome Scale; SC-LFS, Strauss–Carpenter Level of Functioning are the basic component of social perception and provide diverse infor- Scale; TE, echo time; TR, repetition time; BOLD, blood oxygen level dependent.
mation for social communication ( ⁎ Corresponding author at: Department of Psychiatry, Gangnam Severance Hospital, ). Patients with schizophrenia have deficits in both face and 211 Eonju-ro, Gangnam-gu, Seoul, 135–720, Republic of Korea. Tel.: +82 2 2019 3341; facial affect recognition with less accurate and slower responses than fax: +82 2 3462 4304.
E-mail address: (J.-J. Kim).
control participants ( 0278-5846/ 2014 Elsevier Inc. All rights reserved.
J.E. Shin et al. / Progress in Neuro-Psychopharmacology & Biological Psychiatry 58 (2015) 81–88 and they have functional abnormalities in the fusiform gyrus during the for schizophrenia without other comorbid psychiatric disorders and facial information processing ). Another useful were taking antipsychotics with a mean chlorpromazine-equivalent method is biological motion. Patients with schizophrenia have impaired dosage of 503.3 ± 226.4 mg. The Structural Clinical Interview for gaze discrimination with longer reaction time and hyper-perception DSM-IV ) was used for the diagnosis of schizophrenia (and often show difficulties in dis- in patients, who were recruited in the psychiatric outpatient clinic, criminating biological motion due to abnormalities in the superior tem- and the exclusion of any psychiatric disorders in controls, who were re- poral sulcus (STS) and inferior parietal lobe ( cruited by poster advertisements. Any subjects with a past or present ). In particular, the STS is involved in un- history of medical or neurological illness or with left-handedness were derstanding other people's actions and intentions ( excluded. After a complete description of this study was presented, all and has been considered to be one of the core regions for the interaction subjects gave written informed consent to the protocols, which were of social perception and emotional processing approved by the local institutional review board.
Participants' general intellectual ability was measured by the While perceiving others' behaviors in social situations, patients with Raven's progressive matrices (RPM) (), and the ability to schizophrenia show dysfunction in the intention network, including the experience pleasure from social stimuli was measured by the Social dorsomedial prefrontal cortex (DMPFC) and temporo-parietal junction Anhedonia Scale (SAS) ). In addition, the clinical (TPJ) ). In addition, patients with status of each patient was measured using the Positive and Negative schizophrenia have shown aberrant responses in the occipital and Syndrome Scale (PANSS) () for the severity of schizo- temporal regions while processing situational pictures as social cues phrenic symptoms and the Strauss–Carpenter Level of Functioning (marked decreases in dorsolateral Scale (SC-LFS) for various domains of prefrontal cortex (DLPFC) activation during audiovisual integration social functioning such as social contacts, useful work and fullness of (), and ventral premotor dysfunction during video- watching (Particularly, giventhat the DLPFC plays an important role in cognitive control in social 2.2. Experimental design situations (), DLPFC hypofunction may be a lead-ing factor regarding dysfunctional social perception in patients with Participants performed the virtual social perception task during fMRI scanning. As shown in , social situations were created in a virtual Despite the accumulation of vast amount of knowledge, social per- reality space in which an avatar made conversation with someone. Par- ception remains an actively studied area because of its complexity and ticipants were asked to determine whether or not the avatar's speech diversity. More complex social situations have been increasingly needed was appropriate to the situation by pressing a corresponding button.
to discover how the brain works with a plethora of stimuli. Since the The task consisted of 126 experimental trials; there were 21 real-life sit- 1990s, several behavioral studies have used social situations as a stimu- uations that each included six different conditions. The avatar's speech lus. The examples are the social feature recognition test was either well or poorly matched to the situation, in 63 appropriate ) and the social cue recognition videotaped test and 63 inappropriate conditions, respectively, and was emotionally demonstrating that patients with schizophrenia are positive, negative or neutral, in 42 positive, 42 negative, and 42 neutral less accurate in situational feature recognition or social cue recognition conditions, respectively. The trials were presented randomly in an than controls. Recently, it has been reported that these deficits in social event-related design. Each trial consisted of listening to the avatar's perception may be related to abnormal eye gaze in interactive social sit- speech for 3 s, followed by 1 s of silence during which participants uations However, complex social situations have were expected to respond, and seeing a screen with a cross on a black never been used in a functional magnetic resonance imaging (fMRI) background for 1 s. Null events were added in varying durations of study. It therefore remains unclear how the brain mechanism of deficits 0.625 to 7.5 s, and the total session time was approximately 14 min.
in social perception underlies the experiences of patients with schizo-phrenia in their daily lives. This unclear mechanism can be addressedby an fMRI study using a virtual reality task reflecting social perception 2.3. MRI acquisition and analysis in daily lives, as virtual reality provides an immersive environment sim-ulating complex social situations In The fMRI experiment was conducted on a research-dedicated, fact, virtual reality tasks using avatars have been used to assess patients' whole-body, 1.5 T MRI system (Sigma Eclipse; GE Medical Systems, behavioral and emotional characteristics objectively and to train pa- Milwaukee, WI, USA) using a standard quadrature, bird-cage head tients to cope effectively with various social situations ).
coil. Functional images were obtained using an echo planar imaging se- This fMRI study was designed to investigate a neurobiological basis quence (matrix size = 64 × 64, number of slices = 30, slice thickness = of social perception deficits in schizophrenia using social situations 5 mm, spatial resolution = 3.75 × 3.75 × 5 mm3, TE = 22 ms, TR = 2.5 s, that patients would face in their daily lives. For these purposes, we field of view = 240 mm, flip angle = 90°). High-resolution anatomical developed a virtual social perception task in which participants were images were obtained using a gradient echo sequence (matrix size = asked to determine the appropriateness of various ways of speech in 256 × 256, number of slices = 115, slice thickness = 1.5 mm, spatial different social situations. In this study using dynamic stimuli and func- resolution = 0.94 × 0.94 × 1.5 mm3, TE = 1.8 ms, TR = 8.5 ms, field tional outcome measures, we hypothesized that patients with schizo- of view = 240 mm, flip angle = 12°) after the functional scans.
phrenia would show altered activation in various social perception- Images were preprocessed using SPM8 (Welcome Institute of Cogni- related regions including the prefrontal cortex and STS, and that the tive Neurology, London, UK; and bad slices degree of altered activation would be correlated with the clinical and were detected and discarded using ArtRepair software social functioning scale scores.
). After correcting for differences in slice acquisition time andhead motion, the functional images were co-registered to the T1- weighted image. The co-registered images were spatially normalizedusing the transformation functions, which were obtained by normaliz- 2.1. Participants and clinical measurements ing the T1-weighted image to the standard T1 template using nonlineartransformation. These normalized images were smoothed by a Gaussian Seventeen patients with schizophrenia and 19 healthy control sub- kernel of 8 mm full-width-half-maximum. A high-pass filter (128 s) was jects participated in this study. All patients met the DSM-IV-TR criteria applied on the image time series to eliminate low frequency signals.

J.E. Shin et al. / Progress in Neuro-Psychopharmacology & Biological Psychiatry 58 (2015) 81–88 Fig. 1. An example of the experimental stimuli. In a scene of "at the kiosk," a woman says something to a storekeeper for 3 s. As shown on the right side, there are six different trials perscene. In the appropriate positive condition (APP-POS), her statement ("Thanks. I hope you to sell a lot!") is positive and well matched with the situation. On the other hand, in theinappropriate positive condition (INA-POS), she says "Help yourself to as much as you want," and this statement is positive, but unmatched with the situation. Four other trials includedthe appropriate negative (APP-NEG), inappropriate negative (INA-NEG), appropriate neutral (APP-NEU), and inappropriate neutral (INA-NEU) conditions. Twenty other scenes with sixconditions were used to express diverse social situations.
Functional data were analyzed using a general linear model. To ex- clude activities related to the processing of neutral emotion, individualcontrast maps were generated by contrasting positive or negative emo- 3.1. Participants' characteristics and behavioral performances tional events with neutral ones at the first-level analysis. The resultingset of contrast images were then entered into a second-level analysis As shown in , patients and controls did not significantly differ using a flexible factorial model. The activation maps for the main effects in age, sex and educational level. However, patients showed lower gen- and interactions were analyzed by a 2 (group: patients and controls) × 2 eral intellectual ability (p b 0.05) and higher social anhedonia scores (appropriateness: appropriate and inappropriate) × 2 (emotion; posi- (p b 0.05) than controls.
tive and negative) flexible factorial model. In addition, the appropriate- Accuracy and reaction time are shown in . The main effect of ness × emotion interaction was analyzed in each group. For the accuracy was found for group (F1,203 = 27.37, p b 0.001), but not for comparison between trial types, activation was determined by uncor- appropriateness and emotion. Post hoc analyses revealed that patients rected p values of less than 0.001 with a cluster extent threshold of answered less correctly than controls (p b 0.001). The interaction effect 20 voxels and by corrected p value of less than 0.05 after the false was found for the appropriateness × emotion (F2,203 = 3.26, p b .05).
discovery rate across the entire brain.
The statistic power for these positive results was 0.9 and 0.7 (α = Finally, to ascertain the clusters related to task performance, a region 0.05) with N95% confidence interval in the group effect and appropri- of interest correlation analysis was performed. Based on our hypothesis ateness × emotion interaction effect of accuracy, respectively. The that patients with schizophrenia would show altered activation in the mean differences between emotions for appropriate speech were 0.48 prefrontal cortex and STS during social perception, we selected two (positive and neutral), 13.84 (positive and negative), and 13.36 (nega- clusters in the DLPFC identified by the result of the group × appropriate- tive and neutral). For inappropriate speech, however, the mean differ- ness interaction and the STS identified by the appropriateness × ences between emotions were −0.30, −6.76, and −6.46, respectively.
emotion interaction under each group. The % BOLD signal changes of No significant interaction effect was found for group × appropriateness the clusters were obtained using MarsBaR version 0.41 or group × emotion, and group × appropriateness × emotion. For reac- and then non-parametric correlation analyses between tion time, there were no significant main or interaction effects.
cluster activities and clinical scales in each group were done at a signifi-cance level of p-values less than 0.05. In these correlation analyses, the 3.2. Imaging findings duration of illness and chlorpromazine equivalent dose were used ascovariates for the patient group.
Imaging results of the main effects for group, appropriateness, and emotion are provided in Supplementary Table 1. On an analysis offunctional neuroimaging, data of three patients and one control were 2.4. Statistical analysis of the behavioral data excluded due to a quality problem as bad slices were discarded usingArtRepair software. The main effect of group was found in a variety of Demographic and clinical characteristics were compared between the neocortical and subcortical regions, including the various prefrontal groups with independent-sample t-tests and chi-square tests. Accuracy gyri, various temporal gyri, STS, supramarginal and angular gyrus, and reaction time were analyzed using linear mixed model. The main precuneus and cuneus, globus pallidus, and cerebellum. The main effect and interaction effects of group, appropriateness, and emotion were of appropriateness was found in the relatively restricted regions, includ- included as fixed effects. In the post hoc analysis the least square ing the inferior frontal gyrus, middle temporal gyrus and precuneus.
means of 3 emotions were estimated by the MIXED procedure at appro- The main effect of emotion was also restricted to the precentral gyrus, priate or inappropriate.
middle temporal gyrus, caudate, and cerebellum.
J.E. Shin et al. / Progress in Neuro-Psychopharmacology & Biological Psychiatry 58 (2015) 81–88 Table 1Demographic information about patients with schizophrenia and controls.
Sex (male/female) Education level (years) Intelligence quotient Social anhedonia scale (0–40) SC–LFS (0–36) Duration of illness Chlorpromazine equivalent dosage of antipsychotics PANSS, Positive and Negative Syndrome Scale; SC–LFS, Strauss–Carpenter Level of Functioning Scale.
⁎ The medicine was amisulpride (2), aripiprazole (3), clozapine (3), haloperidol (1), olanzapine (3), paliperidone (1), quetiapine (1), and risperidone (4).
As presented in , the group × appropriateness interaction was that such a virtual reality system was useful in assessing social percep- exhibited in the left DLPFC, right precentral gyrus and left supramarginal tion of patients with schizophrenia as well as normal subjects ( gyrus. In the post hoc test for the a priori regions, as shown in , left In the diverse social situations of daily lives, participants DLPFC activity in the appropriate condition was not significantly differ- differently responded according to the conditions. Particularly, low ac- ent between the two groups, whereas left DLPFC activity in the inappro- curacy in the appropriate negative condition suggests that both patients priate condition was significantly lower in patients than in controls (t = and controls might consider negative events to be unfamiliar and un- 2.6, p b 0.05). Correlation analysis revealed that left DLPFC activity in comfortable because bad news and unlucky events happen less often the inappropriate condition was negatively correlated with the PANSS than ordinary ones and occur suddenly, and thus both groups might per- negative scores (r = −0.650, p b 0.05) and positively correlated with ceive situations with neutral or positive contents as being relatively more the SC-LFS scores (r = 0.691, p b 0.05), but not with any other scale comfortable and natural. In contrast, high accuracy for inappropriate scores. A group × emotion interaction was not found in any region.
negative speech suggests that such a condition seems to make both An appropriateness × emotion interaction was observed in various groups feel awkward.
brain regions including the right DMPFC, left DLPFC, left STS, right supe- The most characteristic group difference while experiencing the so- rior temporal gyrus, several occipital regions, and right cerebellum. An cial situations was found in the left DLPFC. Significantly decreased activ- appropriateness × emotion interaction in each group indicated that dif- ity in the left DLPFC was found during the inappropriate condition in ferent regions were involved. In particular, as shown in , an appro- patients compared to controls. Previous studies have recognized that priateness × emotion interaction in the left STS was found in controls, the DLPFC plays an important role in various cognitive processes ( but not in patients. Post hoc analysis revealed that left STS activity in pa- Typically, this region is engaged tients was significantly higher in the appropriate negative condition in cognitive flexibility when people face new and unexpected situations than in the appropriate positive condition (t = −3.1, p b 0.01), but to restructure knowledge in multiple ways ( not significantly different between the inappropriate negative and ) and in abstract thinking when regarding situations in general and inappropriate positive conditions. Left STS activity in controls was also symbolic modes The role of the DLPFC in cognitive significantly higher in the appropriate negative condition than in the control has been shown in social situations of inconsistent conditions appropriate positive condition (t = −2.1, p b 0.05), but significantly (). Therefore, our finding of DLPFC hypoactivity lower in the inappropriate negative condition than in the inappropriate in patients suggests that impairment in perceiving socially unusual positive condition (t = 3.9, p b 0.01).
situations may stem from dysfunction in cognitive control. This viewis supported by previous findings that patients with schizophrenia expressed cognitive rigidity in real life and abnormalabstract thinking, which was associated with impaired DLPFC function In the present study, we investigated the brain mechanisms involved in perceiving appropriateness and emotion in social situations. Using In addition, our study showed that DLPFC activity in patients had a the MR-compatible virtual reality system, we presented diverse social negative correlation with the severity of negative symptoms and a pos- situations to participants. Previously, our research group demonstrated itive correlation with the level of social functioning. Decreased metabol-ic activity in the DLPFC has been considered to be a core feature relatedto the predominance of negative symptoms in schizophrenia ( ). Cortical volumetric abnormalities in The accuracy and reaction time for the virtual social perception task (mean ± standard the DLPFC and disruption of the white matter tracts connecting to the DLPFC have also been regarded as a major feature of deficit schizophre- Patients (n = 17) Controls (n = 19) nia, which is characterized by the presence of primary and enduring negative symptoms (Deficitschizophrenia has been associated with greater impairment in cognitive Accuracy (%)Positive ability and social cognition In particular, negative symptoms include an inclination toward stereotyped thinking () and are Reaction time (ms) closely related to social functioning ). Therefore, 722.88 ± 291.65 704.26 ± 244.07 672.25 ± 324.75 691.77 ± 330.59 DLPFC hypoactivity-related cognitive inflexibility may lead to social 676.69 ± 280.83 722.01 ± 235.16 685.49 ± 336.77 663.87 ± 332.05 dysfunction in patients with schizophrenia ( Negative 784.25 ± 239.88 705.85 ± 286.88 727.74 ± 336.22 655.22 ± 330.45 Taken together, DLPFC dysfunction in schizophrenia

J.E. Shin et al. / Progress in Neuro-Psychopharmacology & Biological Psychiatry 58 (2015) 81–88 Table 3Brain regions showing the significant interaction effect of group, appropriateness, and emotion.
Group × Appropriateness Dorsolateral prefrontal cortex (8)* Precentral gyrus (6) Supramarginal gyrus (40) Appropriateness × Emotion Dorsomedial prefrontal cortex (8)* Dorsolateral prefrontal cortex (9)* Superior temporal sulcus (22)* Superior temporal gyrus (22) Inferior occipital gyrus (17)* Fusiform gyrus (37)* Appropriateness × Emotion in patients Appropriateness × Emotion in controls Superior temporal sulcus (22)* Lingual gyrus (18) Presented regions had a threshold of uncorrected p b 0.001 and more than 20 voxels. *Regions which survived after false discovery rate corrected p b 0.05.
may reflect a deficit in cognitive control during social perception, which appropriate speech was significantly lower in negative speech than in contributes to negative symptoms and decreased social functioning.
positive speech. The STS is activated by passive viewing of biological Another region showing a noteworthy feature was the left STS, in motion (and is further engaged in analyzing the inten- which the interaction effect between appropriateness and emotion tions of observed biological motions was present in controls, but absent in patients. In the appropriate con- . STS activity tends to be increased in unexpected compared dition, both groups showed significantly higher left STS activity in to expected situations In the appropri- response to negative speech than to positive speech. This feature of ac- ate situations of our experiment, positive speech appeared to be experi- tivity may be connected to the behavioral observation that accuracy for enced as typical, in contrast to the perception of negative speech as Fig. 2. (A) Dorsolateral prefrontal cortex (DLPFC) activity showing the interaction of group × appropriateness and the comparison of DLFPC activity in each condition between patients andcontrols, and (B) correlations of DLPFC activity in the inappropriate condition with the severity of negative symptoms and the level of social functioning (*p b .05).

J.E. Shin et al. / Progress in Neuro-Psychopharmacology & Biological Psychiatry 58 (2015) 81–88 Fig. 3. Left superior temporal sulcus activity showing the interaction of appropriateness and emotion that exists only in controls, and the comparison of signal changes in the superiortemporal sulcus based on conditions in each group (* p b .05, ** p b .01).
being a relatively uncommon occurrence. This situational unusualness network. Dysfunction of the DLPFC-STS network is striking in the salient of appropriate but negative speech might have led to the discrepancy stimuli such as inappropriate situations, though there is no direct evi- in response accuracy and STS activity, with both patients and controls dence of connectional dysfunction between these two regions in our acting in a similar fashion under this appropriate condition. In the inap- findings. However, since abnormal connectivity between the DLPFC propriate condition, however, controls demonstrated significantly and STS is important in individuals with autism spectrum disorder higher STS activity in response to positive speech than to negative (it is possible that impaired connectivity between speech, whereas patients showed no difference between the two condi- the two regions may underlie social perception dysfunction in patients tions. This reverse finding in controls led to an interaction effect be- with schizophrenia. This interpretation is supported by another report tween appropriateness and emotion in the left STS, which is consistent on schizophrenia, which demonstrated the inferior frontal gyrus-STS with the previous notion that the STS plays a key role in the interactive disconnection during the processing of metaphoric gestures ( processing of social and emotional information ).
Given that STS activity is sensitive to the congruency between observed There are some limitations in our study. The generalizability of our action and emotion ), the different STS features be- results may be limited due to the relatively small sample size. Because tween the appropriate and inappropriate conditions in controls may all patients in our study were medicated and we did not evaluate the be additional evidence for the role of this region in analyzing the inten- side effects of the antipsychotic medications, the effects of the antipsy- tion of others. Furthermore, the absence of this conditional difference in chotics could not be excluded from the results. Further studies including patients seems consistent with their difficulties in discriminating bio- drug-naïve patients need to be done to avoid the confounding effects of medication. Another limitation is that social functioning was assessed ). Consistently, our research group has recently reported that only by the SC-LFS. Many social functioning scales, which greatly vary patients with schizophrenia did not show normal STS hyperactivity in in terms of the number and types of domains, have been used for schizo- a socially interactive situation that was designed to simulate social re- phrenia studies (). The SC-LFS includes domains jection ), supporting the presence of patients' deficits of interpersonal and occupational function but has a weakness in per- in the perception of social acts.
sonal domains. In addition, although cognitive control or flexibility In contrast to our expectations, MPFC activity was not significantly was considered to be an important factor in social perception, executive different between patients and controls in our study. The MPFC has functions were not evaluated. Given that there was a significant differ- been regarded as a representative brain region in the theory of mind ence in general intelligence between patients and controls, executive network together with the STS (). In particular, the functions would be different between the two groups and this differ- MPFC has been implicated in mentalization, such as making inferences ence could affect the performances.
about others' intentions and mental states, and attributions of emotions In summary, we investigated the neural basis of social perception to self and others The ab- dysfunction in daily life of patients with schizophrenia and its relation- sence of a positive finding in this region could be attributed to a charac- ship with their clinical symptoms and social functioning. The results teristic of our task for measuring social perception in daily life that provide useful information on the important role of the DLPFC in social might recruit cognitive control or cognitive flexibility rather than perception and its relationship with negative symptoms and social mentalization. In other words, our social perception task may provoke dysfunction in patients with schizophrenia. The findings also affirm activation of the DLPFC-STS network rather than the MPFC-STS the key role of abnormal STS activity in social perception dysfunction J.E. Shin et al. / Progress in Neuro-Psychopharmacology & Biological Psychiatry 58 (2015) 81–88 in schizophrenia. These results suggest the possibility that dysfunction Han K, Kim IY, Kim JJ. of the DLPFC-STS network may underlie patients' abnormal social per- ception in various social situations of daily life.
Harrow M, Adler D, Hanf E. Supplementary data to this article can be found online at Hooker C, Park S. Hunter R, Barry S. Kanwisher N, McDermott J, Chun MM. SHC and JJK designed the study. SHC, HL and YSS collected the orig- Kay SR, Fiszbein A, Opler LA. inal imaging data. JES, YSS and DPJ managed and analyzed the imaging Kim K, Kim JJ, Kim J, Park DE, Jang HJ, Ku J, et al. data. JES and JJK wrote the first draft of the manuscript. All authors contributed to and have approved the final manuscript.
Kim SI, Ku J, Han K, Lee H, Park J, Kim JJ, et al. Kim C, Johnson NF, Cilles SE, Gold BT. Kim J, Park S, Blake R. This work was supported by the National Research Foundation of Kramer UM, Mohammadi B, Donamayor N, Sami A, Munte TF. Korea (NRF) grant funded by the Korea government (MEST) (No. NRF- 2013R1A2A2A03068342). We would like to thank Dr. Kang Joon Yoon Lahnakoski JM, Glerean E, Salmi J, Jaaskelainen I, Sams M, Hari R, et al. and Mr. Sang Il Kim for his valuable technical support.
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