Visual motion integration in schizophrenia patients, their first-degree relatives, and patients with bipolar disorder

Many schizophrenia patients show degraded detection of coherent motion. This visual deficit may (1) be a consequence of having a specifically schizophrenic psychosis, (2) be a non-specific effect of suffering from a severe illness (i.e., "generalized deficit"), or (3) reflect properties of the visual motion processing system that play an antecedent, possibly causal role in the pathophysiology of a disposition to schizophrenia. To distinguish among these possibilities, we measured the accuracy of detecting the direction of coherent motion in 29 schizophrenia patients, 20 first-degree relatives of schizophrenia patients, 19 patients with bipolar disorder and 33 normal controls. The task requires the integration of dynamic signals from stochastic random dot patterns in order to discern the direction of their motion. Schizophrenia patients, as a group, showed significantly elevated thresholds for detecting the direction of coherent motion, but relatives of schizophrenia patients and patients with bipolar disorder did not differ from normal controls on this task. The results indicate that visual motion integration, normally mediated in motion-sensitive brain areas such as the Middle Temporal Area, is impaired in patients with a clinically manifest schizophrenic psychosis, but is intact in patients with a non-schizophrenic psychosis (bipolar disorder) and in the relatives of schizophrenia patients. Our findings suggest that deficiencies in integrating motion signals, while specific for schizophrenia, do not seem to be a co-familial trait.     

Motion perception in schizophrenia

BACKGROUND: Eye-tracking dysfunction has been found in many patients with schizophrenia and in about 40% of their first-degree biological relatives. We hypothesized that a deficit in motion processing is associated with eye-tracking dysfunction because both motion signals and the brain regions responsible for processing motion signals are implicated in the generation of smooth pursuit. We examined several aspects of visual perception, including motion perception, in patients with schizophrenia. METHODS: To evaluate motion perception, contrast sensitivity for velocity discrimination was measured in patients with schizophrenia (n=15) and normal control subjects (n=18). Contrast sensitivities for orientation discrimination and contrast detection were measured as control tasks. RESULTS: Patients with schizophrenia showed significantly lower contrast sensitivity (ie, higher thresholds) than normal controls for the discrimination of small velocity differences (eg, 11 vs 9 degrees/s). This reduction in contrast sensitivity was severe (up to 10-fold) in about 40% of the patients. No group differences were found on the other tasks. CONCLUSION: The discrimination of small velocity differences is impaired in a subgroup of patients with schizophrenia.     

Deficits and recovery of first‐ and second‐order motion perception in patients with unilateral cortical lesions

Unilateral lesions in the posterior parietal cortex can degrade motion perception in the contralesional visual hemifield. Our aim was to investigate whether deficits caused by cortical lesions may be different for first- and second-order motion perception, and to study the time scale of any potential recovery. In nine patients with circumscribed lesions mainly in the parietal and fronto-parietal cortex, thresholds for direction discrimination were measured for stimuli presented peripherally in their ipsi- and contralesional hemifield. Subjects had to identify the direction of a vertically moving object embedded in a background of dynamic random dot noise. The object consisted of various proportions of signal and noise dots. Signal dots were either (a) coherently moving in the same direction as the object (first-order), (b) stationary (second-order: drift-balanced), or (c) coherently moving in the opposite direction (second-order: theta). Noise dots were flickering. Two patients showed significant threshold elevations for all three types of motion stimuli presented in their contralesional hemifield, while thresholds for ipsilesional targets were unaffected. Neither showed any selective deficit of first- versus second-order motion perception, but second-order motion was more impaired. Their lesions probably included the motion area V5-MT, which was spared in the other seven patients. One of the patients, who was retested several times during a 27-month postlesional period, showed complete recovery for first- and second-order motion direction discrimination, as well as for the detection of speed differences.     

Impairment of temporal attention in patients with schizophrenia

Evidence is accumulating that attention impairment is a core cognitive deficit in patients with schizophrenia. Here we investigate whether they are impaired in the temporal deployment of attention. Specifically, we explore how allocation of processing resources at one time point might affect the processing of a subsequent event differently in normal and schizophrenia subjects. Thirty patients and 31 age- and education-matched control subjects participated in a rapid serial visual presentation task, in which two targets (T1 and T2) were presented in rapid succession among a number of distractors. Subjects were required to identify T1 and detect T2. The sensitivity of T2 detection was analyzed with signal detection theory. The results showed that the attentional blink (the impairment in T2 detection following the identification of T1) is increased in magnitude and protracted in the patients. This observation suggests a less efficient mechanism in temporal gating of attention and in processing rapidly changing visual stimuli in schizophrenia patients.     

Cross-modal integration of auditory and visual motion signals

Real-world moving objects are usually defined by correlated information in multiple sensory modalities such as vision and hearing. The aim of our study was to assess whether simultaneous auditory supra-threshold motion introduces a bias or affects the sensitivity in a visual motion detection task. We demonstrate a bias in the perceived direction of visual motion that is consistent with the direction of the auditory motion (audio-visual motion capture). This bias effect is robust and occurs even if the auditory and visual motion signals come from different locations or move at different speeds. We also show that visual motion detection thresholds are higher for consistent auditory motion than for inconsistent motion, provided the stimuli move at the same speed and are co-localised.     

An eye-tracking investigation of intentional motion perception in patients with schizophrenia

Background

Schizophrenia has been characterized by an impaired attribution of intentions in social interactions. However, it remains unclear to what extent poor performance may be due to low-level processes or to later, higher-level stages or to what extent the deficit reflects an over-(hypermentalization) or underattribution of intentions (hypomentalization).

Methods

We evaluated intentional motion perception using a chasing detection paradigm in individuals with schizophrenia or schizoaffective disorder and in healthy controls while eye movements were recorded. Smooth pursuit was measured as a control task. Eye-tracking was used to dissociate ocular from cognitive stages of processing.

Results

We included 27 patients with schizophrenia, 2 with schizoaffective disorder and 29 controls in our analysis. As a group, patients had lower sensitivity to the detection of chasing than controls, but showed no bias toward the chasing present response. Patients showed a slightly different visual exploration strategy, which affected their ocular sensitivity to chasing. They also showed a decreased cognitive sensitivity to chasing that was not explained by differences in smooth pursuit ability, in visual exploration strategy or in general cognitive abilities.

Limitations

It is not clear whether the deficit in intentional motion detection demonstrated in this study might be explained by a general deficit in motion perception in individuals with schizophrenia or whether it is specific to the social domain.

Conclusion

Participants with schizophrenia showed a hypomentalization deficit: they adopted suboptimal visual exploration strategies and had difficulties deciding whether a chase was present or not, even when their eye movement revealed that chasing information had been seen correctly.     

Perception of global gestalt by temporal integration in simultanagnosia

Patients with bilateral parieto-occipital brain damage may show intact processing of individual objects, while their perception of multiple objects is disturbed at the same time. The deficit is termed 'simultanagnosia' and has been discussed in the context of restricted visual working memory and impaired visuo-spatial attention. Recent observations indicated that the recognition of global shapes can be modulated by the spatial distance between individual objects in patients with simultanagnosia and thus is not an all-or-nothing phenomenon depending on spatial continuity. However, grouping mechanisms not only require the spatial integration of visual information, but also involve integration processes over time. The present study investigated motion-defined integration mechanisms in two patients with simultanagnosia. We applied hierarchical organized stimuli of global objects that consisted of coherently moving dots ('shape-from-motion'). In addition, we tested the patients' ability to recognize biological motion by presenting characteristic human movements ('point-light-walker'). The data revealed largely preserved perception of biological motion, while the perception of motion-defined shapes was impaired. Our findings suggest separate mechanisms underlying the recognition of biological motion and shapes defined by coherently moving dots. They thus argue against a restriction in the overall capacity of visual working memory over time as a general explanation for the impaired global shape recognition in patients with simultanagnosia.     

Visual mismatch negativity among patients with schizophrenia

Event related potentials (ERPs) provide an insight into sensory and cognitive processes in health and disease. Studies of an ERP negative amplitude deflection elicited by a change in a series of auditory stimuli is known as mismatch negativity (MMN). The generation of MMN is impaired in schizophrenia. Its deficit is associated with lower everyday functioning and may be also interpreted as the marker of progression in schizophrenia. MMN elicited by visual stimuli (vMMN) was described by several research teams, but it has not been investigated in schizophrenia as yet. Using a motion-direction paradigm, we elicited visual MMN in 24 patients with schizophrenia and schizoaffective disorder. The vMMN was computed as differences in areas under curve of visual ERPs to standard and deviant motion-direction stimuli recorded from midline derivations at the interval of 100-200 ms. They were compared between groups of patients with schizophrenia and healthy controls. The significantly smaller vMMN indicated an impaired generation of mismatch negativity in patients with schizophrenia. In secondary analyses there was an association of vMMN impairment among patients with higher dose of medication, lower level of functioning and the presence of deficit syndrome. This impairment appears analogous to the impairment of MMN in the auditory domain and is probably related to early visual information processing. Its relationship to cognitive functioning of patients with schizophrenia deserves further attention.     

Impaired visual recognition of biological motion in schizophrenia

BACKGROUND: Motion perception deficits have been suggested to be an important feature of schizophrenia but the behavioral consequences of such deficits are unknown. Biological motion refers to the movements generated by living beings. The human visual system rapidly and effortlessly detects and extracts socially relevant information from biological motion. A deficit in biological motion perception may have significant consequences for detecting and interpreting social information. METHODS: Schizophrenia patients and matched healthy controls were tested on two visual tasks: recognition of human activity portrayed in point-light animations (biological motion task) and a perceptual control task involving detection of a grouped figure against the background noise (global-form task). Both tasks required detection of a global form against background noise but only the biological motion task required the extraction of motion-related information. RESULTS: Schizophrenia patients performed as well as the controls in the global-form task, but were significantly impaired on the biological motion task. In addition, deficits in biological motion perception correlated with impaired social functioning as measured by the Zigler social competence scale [Zigler, E., Levine, J. (1981). Premorbid competence in schizophrenia: what is being measured? Journal of Consulting and Clinical Psychology, 49, 96-105.]. CONCLUSION: The deficit in biological motion processing, which may be related to the previously documented deficit in global motion processing, could contribute to abnormal social functioning in schizophrenia.     

Processing of global,but not local,motion direction is deficient in schizophrenia

Visual motion processing is compromised in a substantial proportion of schizophrenic patients, but precise neural mechanisms underlying the motion-processing deficit have not yet been elaborated. The visual motion pathway includes a local and a global processing stage, each of which has distinct neural substrates. Here, we attempt to identify the stage(s) that are implicated in impaired motion processing of schizophrenia-local, global, or both. For schizophrenia patients (n=23) and normal controls (n=26), we measured (1) the thresholds for detecting the motion direction of a random dot pattern, a task that requires global motion processing, and (2) the thresholds for detecting the motion direction of a grating, a task that requires only local motion processing, using psychophysical methods. Schizophrenia patients showed elevated thresholds for detecting the direction of coherent motion, particularly for the high dot-density target. In contrast, schizophrenia patients showed normal thresholds for detecting the direction of motion of a grating. The results indicate that the global, but not the local, processing stage of the visual motion system is compromised in schizophrenia patients, thus implicating motion-sensitive brain areas that possess large receptive fields for spatial and temporal integration, such as Middle Temporal Area/Medial Superior Temporal Area.     

Compromised late-stage motion processing in schizophrenia.

BACKGROUND: Visual motion processing is compromised in schizophrenia, as shown in deficient velocity discrimination. Processing of motion signals comprises progressive stages along the geniculate-striate-extrastriate-cortex pathway. Based on neurophysiologic and brain lesion studies, a velocity discrimination deficit can implicate early-stage motion processing if it is contrast-dependent or late-stage motion processing if it is contrast-independent. METHODS: To determine which stage underlies the deficient velocity discrimination in schizophrenia, we examined the effects of visual contrast on velocity discrimination. We measured velocity discrimination thresholds in schizophrenia patients (n = 34) and normal control subjects (n = 17) at both low and high contrasts, using each subject's contrast detection threshold to equate contrast levels. RESULTS: Schizophrenia patients showed poor velocity discrimination that improved little with high contrast, whereas normal control subjects showed enhanced velocity discrimination with increased contrast. CONCLUSIONS: The finding that the velocity discrimination deficit in schizophrenia is independent of contrast modulation implicates the later, rather than the earlier, stages of motion processing, which is mediated in the extrastriate cortex.     

Bipolar and schizophrenic patients differ in patterns of visual motion discrimination

BACKGROUND: Since Kraepelin's early distinction between bipolar disorder and schizophrenia, it has been assumed that these disorders represent two different pathophysiological processes, although they share many clinical symptoms. Previous studies showed that velocity discrimination, a sensitive psychophysiological measure of the visual motion system, is deficient in schizophrenia. Here we examined whether the motion processing impairment found in schizophrenia also occurs in bipolar disorder. METHODS: We compared 16 bipolar patients, 25 schizophrenic patients, and 25 normal controls on a velocity discrimination task. We measured the psychophysical threshold for velocity discrimination and contrast detection (as a control task) in all subjects. RESULTS: Bipolar patients showed normal velocity discrimination thresholds at intermediate velocities, the range in which velocity cues dominate velocity discrimination, and at low velocities. Schizophrenic patients, however, showed elevated velocity discrimination thresholds at intermediate and low velocities. At higher velocities, both bipolar and schizophrenic patients showed elevated thresholds. All subjects showed normal contrast detection thresholds. CONCLUSIONS: Normal velocity discrimination in the intermediate range of velocity indicates unimpaired motion processing in bipolar disorder. The abnormal velocity discrimination of both schizophrenic and bipolar patients at higher velocities may reflect impaired temporal processing rather than impaired motion processing per se. These results suggest that the pathophysiological processes of bipolar disorder and schizophrenia diverge at the stage of visual motion processing, a sensory component mediated primarily in the extrastriate cortex.     

Impaired multisensory processing in schizophrenia: deficits in the visual enhancement of speech comprehension under noisy environmental conditions

BACKGROUND: Viewing a speaker's articulatory movements substantially improves a listener's ability to understand spoken words, especially under noisy environmental conditions. In this study we investigated the ability of patients with schizophrenia to integrate visual and auditory speech. Our objective was to determine to what extent they experience benefit from visual articulation and to detail under what listening conditions they might show the greatest impairments. METHODS: We assessed the ability to recognize auditory and audiovisual speech in different levels of noise in 18 patients with schizophrenia and compared their performance with that of 18 healthy volunteers. We used a large set of monosyllabic words as our stimuli in order to more closely approximate performance in everyday situations. RESULTS: Patients with schizophrenia showed deficits in their ability to derive benefit from visual articulatory motion. This impairment was most pronounced at signal-to-noise levels where multisensory gain is known to be maximal in healthy control subjects. A surprising finding was that despite known early auditory sensory processing deficits and reports of impairments in speech processing in schizophrenia, patients' performance in unisensory auditory speech perception remained fully intact. CONCLUSIONS: Thus, the results showed a specific deficit in multisensory speech processing in the absence of any measurable deficit in unisensory speech processing and suggest that sensory integration dysfunction may be an important and, to date, rather overlooked aspect of schizophrenia.     

Disruption of auditory and visual attention in schizophrenia

Disruption of attention is a hallmark symptom of schizophrenia, and event-related potentials have been instrumental in studying this cognitive deficit. Event-related potentials (ERPs) have been used to study attention and its disruption in schizophrenia, with the most common finding of a reduced P300 component in auditory tasks. Some studies have found sparing of the P300 in visual attention, but reduction of an earlier attention-sensitive N2b, suggesting that the N2b may be a more sensitive index of attention disruption in schizophrenia. The current study compared visual and auditory attention using both unimodal and bimodal stimulus presentation in the same participants to examine the impact of schizophrenia on attention at both the early N2b and later P300 stages. Both N2b and P300 showed attention effects, being larger to targets than non-targets in all tasks. The N2b was reduced in the patient group in all tasks except the bimodal attend visual task, while the P300 was not reduced in the patients in any condition. This indicates that early attention, as indexed by the N2b, is differentially impaired in patients with schizophrenia, even when later attention, indexed by the P300, is intact.     

Magnocellular contributions to impaired motion processing in schizophrenia

Patients with schizophrenia show impairments in motion processing, along with deficits in lower level processing primarily involving the magnocellular visual pathway. The present study investigates potential magnocellular contributions to impaired motion processing in schizophrenia using a combined neurophysiological and behavioral approach. As compared to prior motion studies in schizophrenia, thresholds were determined for both incoherent and coherent visual motion. In this study, velocity discrimination thresholds were measured for schizophrenia patients (n=14) and age-matched normal control subjects (n=16) using a staircase procedure. Early visual processing was evaluated using steady-state visual evoked potentials (ssVEP), with stimuli biased toward activation of either the magnocellular or parvocellular visual pathways through luminance contrast manipulation. Patients with schizophrenia showed poor velocity discrimination for both incoherent and coherent motion, with no significant group x task interaction. Further, when coherent motion performance was measured at individually determined incoherent motion thresholds, accuracy levels for patients were similar to controls, also indicating similarity of deficit for incoherent vs. coherent motion discrimination. Impairments in velocity discrimination correlated significantly with reduced amplitude of ssVEP elicited by magnocellular -- but not parvocellular -- selective stimuli. This study demonstrates that deficits in motion processing in schizophrenia are significantly related to reduced activation of the magnocellular visual system. Further, this study supports and extends prior reports of impaired motion processing in schizophrenia, and indicates significant bottom-up contributions to higher-order cognitive impairments.     

Dyslexia: verbal impairments in the absence of magnocellular impairments

Sensitivity to dynamic visual and auditory stimuli was assessed in dyslexic children (Grade 7) who at school entrance had suffered from the well-established double-deficit of impaired phonological sensitivity and deficient rapid naming performance. A visual magnocellular deficit was assessed by the coherent motion detection task of the Oxford group. An auditory magnocellular deficit was assessed by the illusory sound movement perception task of Hari and Kiesil?. On both tasks our dyslexic subjects' performance was similar or even better than the performance of normally reading controls. Differences in the inclusion of ADHD cases in dyslexic samples is discussed as a potential explanation of differences in results.     

Dynamic modulation of visual detection by auditory cues in spatial neglect

One of the most constant findings of studies about selective attention is that detection of visual stimuli is enhanced when a visual cue is presented at the position of the upcoming target. In healthy participants, comparable benefits were reported when the cue was presented in a different modality than the target. The aim of this study was to examine spatial and temporal dynamics of visual attention following auditory cues in patients with spatial neglect. Twelve healthy subjects and five patients with left-sided neglect were asked to react to a small vertical line presented randomly at one of four positions. The target appeared 150 or 1000 ms after an auditory cue that was either static (continuous 380 Hz tone presented to the left or right ear) or dynamic (380 Hz tone moving from the left to the right ear or vice versa). The reaction time pattern of healthy participants was unaffected by the different tones. In contrast, reaction times of neglect patients were significantly faster to left targets following a dynamic tone moving from right to left in comparison to a tone moving from left to right. Interestingly, static unilateral tones modulated visual attention of neglect patients to a lesser degree than dynamic tones. The modulation of visual attention by dynamic auditory cues was of short duration and disappeared after 1000 ms. These results demonstrate a fast automatic shift of spatial attention in the direction of a moving tone, suggesting strong dynamic links between visual and auditory attention in patients with a severe spatial deficit.     

The "motion-blind" patient: low-level spatial and temporal filters

The "motion-blind" patient previously described by Zihl et al. (1983) was investigated using standard psychophysical procedures with stimuli whose spatial and temporal properties could be separately manipulated. Detection experiments for sinewave grating stimuli of varying spatial and temporal frequency showed sensitivity in this patient to be only slightly impaired. Temporal integration for stimuli of varying spatiotemporal frequency exhibited the expected space-time covariation seen in normal vision. An examination of the suprathreshold discriminative capacity of this patient was undertaken for spatial frequency, contrast, and temporal frequency. Although all of these discriminative functions were impaired, those concerning temporal frequency or velocity were dramatically reduced. No similar loss was seen for spatial frequency discrimination for moving or temporally varying stimuli. No measurable temporal frequency discrimination was present above 6 Hz and no velocity discrimination above 6 degrees/sec. Experiments involving the direction discrimination of suprathreshold drifting gratings of arrays of random dots revealed an inability to perceive direction of movement above a velocity of about 6 degrees/sec. Contrast thresholds contingent on direction of motion of a drifting grating also showed a much greater deficit than simple detection. Apparent motion using 2-flash random dot kinematograms revealed that the residual motion vision of this patient corresponded to the "short-range" motion process of normal vision. This process originally defined by Braddick (1974) operates over restricted space and time intervals. Apparent motion could only be supported by a narrow range of intermediate spatial displacements. These results suggest that this patient does exhibit some residual motion perception, probably corresponding to a severely impaired "short-range" mechanism. The patient's relatively intact ability to perform simple types of discrimination but severe impairment of performance at making judgments relevant to the nature of motion of the same stimuli suggests that while the components necessary for the analysis of motion are intact their more global associations have been disrupted. This implicates an extrastriate locus of the brain damage. Alternative explanations for the nature of the deficit are discussed.     

The signal detection ability of patients with auditory hallucination: Analysis using the continuous performance test

Signal detection theory is appropriate for analyzing the problem of whether auditory hallucination arises from a sensory or judgmental disorder. In the present study the sensory discrimination ability and decision bias of psychiatric patients with auditory hallucination was investigated by using the visual continuous performance test. Based on signal detection theory the d' (d prime) and the lnbeta value (the natural logarithm of the beta value) were calculated. The d' is indicator of discriminating ability, whereas the lnbeta value is an indicator of decision bias. The psychiatric inpatients with the diagnosis of schizophrenia mainly were divided into 11 patients with auditory hallucinations (AH(+)) and 11 patients without hallucinations (AH(-)). As compared with the AH(-) group, the AH(+) group showed the same d' value and a significantly lower lnbeta value. As compared with the normal control group, the AH(+) group showed a significantly lower d' value and a nearly normal lnbeta value. These results suggest that auditory hallucination is characterized by a cognitive deficit of unreasonably maintaining a relatively risk-taking decision bias in spite of decreased discriminating ability, which opposes the interpretation of Bentall and Slade (1985). The AH(+) group was divided into subgroups with bizarre delusions (BD(+)) and without bizarre delusions (BD(-)). The BD(+) group showed a stronger tendency toward a lower d' value and normal lnbeta value, which the AH(+) group had.     

Evidence of schizophrenia patients' reduced perceptual biases in response to emotion chimera

The goal of the study was to determine whether dextral individuals with schizophrenia display atypical perceptual biases in response to faces in general, or whether they display atypical perceptual biases in response to emotional facial cues. To this end, we assessed perceptual processing in schizophrenia patients with four types of free-vision chimeric stimuli. Perceptual biases were evaluated in 45 schizophrenia patients and in 46 controls using two face (emotion, gender) tasks and two nonface (dots, gradients) tasks. In response to the emotion chimera, the patients with schizophrenia displayed a reduced left perceptual bias. The two groups did not differ significantly in their response to the gender chimera or to the two nonface chimera. These findings are consistent with the assertion that schizophrenia patients have impaired emotional perception. In the discussion we consider possible reasons for schizophrenia patients' difficulty comprehending emotional facial stimuli. We suggest that schizophrenia patients' reduced perceptual bias in response to the emotion chimera reflects a hypothesized affective information-processing deficit.