Different levels of facial expression recognition in patients with first-episode schizophrenia: A functional MRI study

BACKGROUND: The impairment of facial expression recognition has become a biomarker for early identification of first-episode schizophrenia, and this kind of research is increasing. AIMS: To explore the differences in brain area activation using different degrees of disgusted facial expression recognition in antipsychotic-naïve patients with first-episode schizophrenia and healthy controls. METHODS: In this study, facial expression recognition tests were performed on 30 first-episode, antipsychotic-naïve patients with schizophrenia (treatment group) and 30 healthy subjects (control group) with matched age, educational attainment and gender. Functional MRI was used for comparing the differences of the brain areas of activation between the two groups. RESULTS: The average response time difference between the patient group and the control group in the ‘high degree of disgust’ facial expression recognition task was statistically significant (1.359 (0.408)/2.193 (0.625), F=26.65, p<0.001), and the correct recognition rate of the treatment group was lower than that of the control group (41.05 (22.25)/59.84 (13.91, F=19.81, p<0.001). Compared with the control group, the left thalamus, right lingual gyrus and right middle temporal gyrus were negatively activated in the patients with first-episode schizophrenia in the ‘high degree of disgust’ emotion recognition, and there was a significant activation in the left and right middle temporal gyrus and the right caudate nucleus. However, there was no significant activation difference in the ‘low degree of disgust’ recognition. CONCLUSIONS: In patients with first-episode schizophrenia, the areas of facial recognition impairment are significantly different in different degrees of disgust facial expression recognition.