Deficits in Emotional Face Processing Indexed by N170 Modulation in Chronic and in First Hospitalized Schizophrenia

Introduction Facial emotion recognition is impaired in schizophrenia and contributes to profound social impairments. Healthy adults exhibit larger N170 amplitudes to emotional compared to neutral faces. Preliminary evidence suggests an inability to modulate N170 amplitude by emotional expression during chronic stages of the illness. The present investigation examined N170 modulation by emotion among patients with chronic (ChSz) and first hospitalized (FHSz) schizophrenia. Methods EEG was recorded from 26 FHSz and 28 ChSz participants as well as 19 young (YC) and 21 older (OC) matched controls. Participants were asked to detect neutral faces among happy, angry, disgusted, fearful, and sad faces. N170 amplitudes were measured from P9/P10 electrodes. Symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Results N170 amplitude modulation by facial emotion was observed across FHSz and YC ( P < .001), though the typical right-hemisphere lateralization of this response observed in YC ( P = .001) was absent in FHSz ( P = .56). In contrast to OC ( P = .009), ChSz did not exhibit N170 modulation by emotion ( P = .32). Among ChSz, N170 modulation (mean N170 across emotional expressions minus N170 to neutral faces) at P9 were inversely correlated with PANSS negative scores (r = −.53). Discussion Results suggests a progressive impairment of emotional facial expression processing as indexed by N170 modulation across illness stage. While losing the hemispheric specialization of face processing, FHSz exhibited preserved N170 amplitude modulation by facial emotion in contrast to ChSz. This deficit was also associated with negative symptoms, implicating progressive pathology of N170 generators in persistent and debilitating symptoms of the disorder.