F90. EMOTION PROCESSING AND WHITE MATTER STRUCTURAL CONNECTIVITY IN SCHIZOPHRENIA. (9th April 2019)

• Record Type: Journal Article
• Authors: Koevoets, Martijn; Prikken, Merel; Hagenaar, Doesjka; Kahn, René; Haren, Neeltje Van
• Is Part Of: Schizophrenia bulletin. Volume 45(2019)Supplement 2
• Page Start: S287
• Page End: S288
• Publication Date: 2019-04-09
• Subjects: Schizophrenia -- Periodicals; Schizophrenia -- Research -- Periodicals; 616.898005
• DOI: 10.1093/schbul/sbz018.502
• Languages: English
• ISSNs: 0586-7614

Abstract

Abstract: Background: Impairments in emotion perception (e.g. recognition and discrimination of emotional expressions) are a robust finding in patients with schizophrenia. We set out to investigate whether deficits in recognizing emotional facial expressions is associated with experiencing emotions in reaction to emotions of another person, i.e. affective empathy (AE). Both adequate emotional face recognition (EFR) and AE contribute to relationship-maintaining behavior and are key in maintaining an adequate social interaction. We investigated whether schizophrenia patients' problems in both EFR and AE may be found in altered connectivity of the brain's network as prefrontal and temporo-parietal areas and their connecting tracts have been proposed to underlie emotion processing. Methods: A total of 47 schizophrenia patients and 47 controls participated. EFR and AE were measured in one combined task (adapted from Tettamanti et al., 2012). Participants were asked to choose one of four answer options (neutral, sad, happy or fearful) that best matches the emotional expression portrayed in the picture of a face (30 pictures in total). We counted the number of correct answers. Subsequently, participants were shown a 10 sec film clip of the same person, i.e. the film clip matches the emotional content of the previously shown image. Participants were asked again to identify the portrayed emotion, as well as to evaluate to what extent they experienced specific emotions on two AE subscales (empathic concern: warm, compassionate, soft-hearted, tender, and moved; personal distress: worried, distressed, disturbed, upset, troubled, and agitated) on a 7-point Likert scale. Mean score per subscale and the total AE score were calculated. T1-weighted and diffusion weighted brain scans were acquired. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were estimated. Results: Patients performed significantly worse on EFR (p=0.037). Patients reported significantly higher empathic concern (p=0.007) and personal distress (p<0.001) after watching the movie clips. Empathic concern and personal distress were highly correlated (r=0.867, p<0.001) and showed high internal consistency (Cronbach's α=0.91 in both groups). Therefore, the mean of all items is used as a measure of AE. EFR interacted with AE. That is, patients who performed low (PTlow) on EFR reported significantly higher AE than controls (p<0.001) than patients who performed at a normal level (PTnormal; p=0.01). Moreover, PTnormal experienced significantly higher AE than controls (p=0.043). Finally, we found a significant interaction effect of group (PTnormal, PTlow, controls) on the association between AE and AD in the anterior thalamic radiation (p=0.017, d=0.43). Pairwise comparisons were all significant and showed that in controls higher AE was related to higher AD, while in patients this association is reversed, and the slope was steeper in PTlow than in PTnormal. Discussion: Surprisingly, in a performance-based task we showed higher empathic concern in patients than in controls. A high correlation between empathic concern and personal distress implies that patients are capable of showing strong empathic response to emotions in others, but when doing so experience more distress than do healthy people. Importantly, we showed that in patients decreased EFR is related to increased AE to social situations. Most importantly, the reduced structural connectivity in the anterior thalamic radiation can potentially explain higher AE in schizophrenia patients with low and normal performance on EFR. This is in line with previous findings showing the involvement of the frontal lobe in EFR and the association between the thalamus and empathic accuracy.