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Not Pitch Perfect: Sensory Contributions to Affective Communication Impairment in Schizophrenia

  • David I. Leitman
    Correspondence
    Address correspondence to David I. Leitman, Ph.D., Department of Psychiatry, University of Pennsylvania, Gates Pavilion 10th floor, 3400 Spruce St., Philadelphia, PA 19104-4283
    Affiliations
    Department of Psychiatry-Neuropsychiatry Program, Brain Behavior Laboratory, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Daniel H. Wolf
    Affiliations
    Department of Psychiatry-Neuropsychiatry Program, Brain Behavior Laboratory, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Petri Laukka
    Affiliations
    Department of Psychology, Stockholm University, Stockholm, Sweden
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  • J. Daniel Ragland
    Affiliations
    Department of Psychiatry, University of California at Davis, School of Medicine, Sacramento, California
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  • Jeffrey N. Valdez
    Affiliations
    Department of Psychiatry-Neuropsychiatry Program, Brain Behavior Laboratory, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Bruce I. Turetsky
    Affiliations
    Department of Psychiatry-Neuropsychiatry Program, Brain Behavior Laboratory, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Raquel E. Gur
    Affiliations
    Department of Psychiatry-Neuropsychiatry Program, Brain Behavior Laboratory, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

    Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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  • Ruben C. Gur
    Affiliations
    Department of Psychiatry-Neuropsychiatry Program, Brain Behavior Laboratory, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

    Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

    Philadelphia Veterans Administration Medical Center, Philadelphia, Pennsylvania
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      Background

      Schizophrenia patients have vocal affect (prosody) deficits that are treatment resistant and associated with negative symptoms and poor outcome. The neural correlates of this dysfunction are unclear. Prior study has suggested that schizophrenia vocal affect perception deficits stem from an inability to use acoustic cues, notably pitch, in decoding emotion.

      Methods

      Functional magnetic resonance imaging was performed in 24 schizophrenia patients and 28 healthy control subjects, during the performance of a four-choice (happiness, fear, anger, neutral) vocal affect identification task in which items for each emotion varied parametrically in affective salient acoustic cue levels.

      Results

      We observed that parametric increases in cue levels in schizophrenia failed to produce the same identification rate increases as in control subjects. These deficits correlated with diminished reciprocal activation changes in superior temporal and inferior frontal gyri and reduced temporo-frontal connectivity. Task activation also correlated with independent measures of pitch perception and negative symptom severity.

      Conclusions

      These findings illustrate the interplay between sensory and higher-order cognitive dysfunction in schizophrenia. Sensory contributions to vocal affect deficits also suggest that this neurobehavioral marker could be targeted by pharmacological or behavioral remediation of acoustic feature discrimination.

      Key Words

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