Neural Correlates of Facial Emotion Recognition in Non-help-seeking University Students With Ultra-High Risk for Psychosis

Jiaojiao Hou; Simon Schmitt; Xudong Zhao; Jiayi Wang; Jianxing Chen; Ziyu Mao; Ansi Qi; Zheng Lu; Tilo Kircher; Yunbo Yang; Jingyu Shi

doi:10.3389/fpsyg.2022.812208

Neural Correlates of Facial Emotion Recognition in Non-help-seeking University Students With Ultra-High Risk for Psychosis

Front Psychol. 2022 Jun 9:13:812208. doi: 10.3389/fpsyg.2022.812208. eCollection 2022.

Authors

Jiaojiao Hou^{1

2}, Simon Schmitt^{2

3

4}, Xudong Zhao^{1

5}, Jiayi Wang⁶, Jianxing Chen⁶, Ziyu Mao⁷, Ansi Qi⁸, Zheng Lu^{9

10}, Tilo Kircher^{2

3}, Yunbo Yang², Jingyu Shi^{5

11}

Affiliations

¹ Department of Psychosomatic Medicine, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China.
² Department of Psychiatry, University of Marburg, Marburg, Germany.
³ Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany.
⁴ Hannover Medical School, Clinics for Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany.
⁵ Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China.
⁶ Tongji University School of Medicine, Shanghai, China.
⁷ Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
⁸ Department of Medical Psychology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.
⁹ Department of Psychiatry, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
¹⁰ Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹¹ Division of Medical Humanities and Behavioral Sciences, Tongji University School of Medicine, Shanghai, China.

Abstract

Background: Since the introduction of the neurodevelopmental perspective of schizophrenia research on individuals at ultra-high risk for psychosis (UHR) has gained increasing interest, aiming at early detection and intervention. Results from fMRI studies investigating behavioral and brain functional changes in UHR during facial emotion recognition, an essential component of social cognition, showed heterogenous results, probably due clinical diversity across these investigations. This fMRI study investigated emotion recognition in a sub-group of the UHR spectrum, namely non-help-seeking, drug-naïve UHR with high cognitive functioning to reveal the neurofunctional underpinnings of their social functioning in comparison to healthy controls.

Methods: Two large cohorts of students from an elite University (n ₁ = 4,040, n ₂ = 4,364) were screened firstly with the Prodromal Questionnaires and by surpassing predefined cut-offs then interviewed with the semi-structured Interview for Psychosis-Risk Syndromes to verify their UHR status. Twenty-one identified non-help-seeking UHR and 23 non-UHR control subjects were scanned with functional magnetic resonance imaging while classifying emotions (i.e., neutral, happy, disgust and fear) in a facial emotion recognition task.

Results: Behaviorally, no group differences were found concerning accuracy, reaction times, sensitivity or specificity, except that non-help-seeking UHR showed higher specificity when recognizing neutral facial expressions. In comparison to healthy non-UHR controls, non-help-seeking UHR showed generally higher activation in the superior temporal and left Heschl's gyrus as well as in the somatosensory, insular and midcingulate cortex than the control subjects during the entire recognition task regardless of the emotion categories. In an exploratory analysis, in the non-help-seeking UHR group, functional activity in the left superior temporal gyrus was significantly correlated with deficits in the ability to experience emotions at uncorrected statistical thresholds.

Conclusions: Compared to healthy controls, non-help-seeking UHR show no behavioral deficits during facial emotion recognition, but functional hyperactivities in brain regions associated with this cognitive process. Our study may inspire future early intervention and provide loci for treatment using neural stimulation.

Keywords: clinical high risk for psychosis; facial emotion recognition; functional magnetic resonance imaging (fMRI); prodromal psychosis; social cognition; superior temporal gyrus.