A key component of social cognition, facial expression recognition, is one of the hallmark deficits of schizophrenia (Schneider et al, 2006). Although people with schizophrenia may show deficits in other aspects of face perception (Hall et al, 2004), only expression recognition performance has been related to social dysfunction (Hooker & Park, 2002).
Studies have implicated interaction between the amygdala and prefrontal and temporal cortex in facial expression processing (Krolak-Salmon et al, 2004). In schizophrenia this deficit has been related to amygdala -hippocampal complex (AHC) dysfunction (Gur et al, 2002), although the frontal and temporal cortex may also have a role (Streit et al, 2001).
Many of these regions, including the amygdala and the prefrontal and superior temporal cortices, are known to be reduced in volume in schizophrenia – see reviews by Lawrie & Abukmeil (1998) and Wong & Van Tol (2003) and the meta-analysis by Wright et al (2000). Interestingly, despite a recent contradictory result (McDonald et al, 2006), reduced volume of the AHC has been consistently reported in healthy siblings of patients (Lawrie et al, 1999; Aleman & Kahn, 2005).
However, some methodological issues (inclusion criteria, regions of interest, medial temporal lobe considered as a whole) could account for these discrepancies. Moreover, siblings show poor perception of non-verbal social -emotional cues (Toomey et al, 1999). Facial expression recognition is one of the most crucial vectors of non-verbal communication relying on amygdala integrity and may therefore be impaired in healthy relatives of patients, although this has never been evidenced.
Epidemiological studies of schizophrenia suggest that this disorder has a substantial genetic component. Cognitive and social abilities, as well as the volumes of brain regions involved in emotion processing, have been found to be distributed along a continuum when comparing patients, siblings and controls, with siblings showing intermediate scores.
Aims To establish whether facial expression recognition is impaired in unaffected siblings of patients.
Method Emotion and gender recognition were evaluated in a three-group pre – post study design in drugnaive patients with first-episode schizophrenia (n=40) and their unaffected siblings (n=30) compared with controls (n=26).
Results Patients and their healthy siblings showed impaired emotion recognition but normal gender recognition compared with controls. Patients’performance did not improve despite effective clinical stabilisation.
Conclusions Impaired performance in healthy siblings and time stability in patients provides evidence of impairment of facial emotion recognition as an actual phenotype of schizophrenia.
BENOIT BEDIOU, PhD
University of Lyon, Centre Hospitalier Le Vinatier, Bron and Institut Fe’de’ratif des Neurosciences de Lyon, Bron, France
FATIMA ASRI, MD
University of Marrakech, Morocco
JEROME BRUNELIN, PhD
University of Lyon, Centre Hospitalier Le Vinatier and Institut Fe’de’ratif des Neurosciences de Lyon, Bron, France
PIERRE KROLAK-SALMON, MD, PhD
Institut National de la Sante’ et de la Recherche (INSERM) and Centre Hospitalier Le Vinatier, Bron
THIERRY D’AMATO, MD, PhD and MOHAMED SAOUD, MD, PhD
University of Lyon, Centre Hospitalier Le Vinatier and Institut Fe’de’ratif des Neurosciences de Lyon, Bron, France
BENOIT BEDIOU, PhD
University of Lyon, Centre Hospitalier Le Vinatier, Bron and Institut Fe’de’ratif des Neurosciences de Lyon, Bron, France
FATIMA ASRI, MD
University of Marrakech, Morocco
JEROME BRUNELIN, PhD
University of Lyon, Centre Hospitalier Le Vinatier and Institut Fe’de’ratif des Neurosciences de Lyon, Bron, France
PIERRE KROLAK-SALMON, MD, PhD
Institut National de la Sante’ et de la Recherche (INSERM) and Centre Hospitalier Le Vinatier, Bron
THIERRY D’AMATO, MD, PhD and MOHAMED SAOUD, MD, PhD
University of Lyon, Centre Hospitalier Le Vinatier and Institut Fe’de’ratif des Neurosciences de Lyon, Bron, France
IMANE TAZI, MD
University of Marrakech, Morocco
Correspondence: Dr Benoit Bediou,CH Le Vinatier,University of Lyon, EA 3092, 95 Boulevard Pinel, 69677 Bron Cedex, France. Email: benoit.bediou@ch-le-vinatier.fr
University of Marrakech, Morocco
Correspondence: Dr Benoit Bediou,CH Le Vinatier,University of Lyon, EA 3092, 95 Boulevard Pinel, 69677 Bron Cedex, France. Email: benoit.bediou@ch-le-vinatier.fr