The Deficit of Multimodal Perception of Congruent and Non-Congruent Fearful Expressions in Patients with Schizophrenia: The ERP Study

Emotional dysfunction, including flat affect and emotional perception deficits, is a specific symptom of schizophrenia disorder. We used a modified multimodal odd-ball paradigm with fearful facial expressions accompanied by congruent and non-congruent emotional vocalizations (sounds of women screaming and laughing) to investigate the impairment of emotional perception and reactions to other people's emotions in schizophrenia. We compared subjective ratings of emotional state and event-related potentials (EPPs) in response to congruent and non-congruent stimuli in patients with schizophrenia and healthy controls. The results showed the altered multimodal perception of fearful stimuli in patients with schizophrenia. The amplitude of N50 was significantly higher for non-congruent stimuli than congruent ones in the control group and did not differ in patients. The P100 and N200 amplitudes were higher in response to non-congruent stimuli in patients than in controls, implying impaired sensory gating in schizophrenia. The observed decrease of P3a and P3b amplitudes in patients could be associated with less attention, less emotional arousal, or incorrect interpretation of emotional valence, as patients differed from healthy controls in the emotion scores of non-congruent stimuli. The difficulties in identifying the incoherence of facial and audial components of emotional expression could be significant in understanding the psychopathology of schizophrenia.