TY - JOUR
T1 - Affective flattening in patients with schizophrenia: Differential association with amygdala response to threat-related facial expression under automatic and controlled processing conditions
AU - Lindner, Christian
AU - Dannlowski, Udo
AU - Bauer, Jochen
AU - Ohrmann, Patricia
AU - Lencer, Rebekka
AU - Zwitserlood, Pienie
AU - Kugel, Harald
AU - Suslow, Thomas
N1 - Publisher Copyright:
© 2016 Korean Neuropsychiatric Association.
Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.
PY - 2016/1
Y1 - 2016/1
N2 - Objective: Early neuroimaging studies have demonstrated amygdala hypoactivation in schizophrenia but more recent research based on paradigms with minimal cognitive loads or examining automatic processing has observed amygdala hyperactivation. Hyperactivation was found to be related to affective flattening. In this study, amygdala responsivity to threat-related facial expression was investigated in patients as a function of automatic versus controlled processing and patients’ flat affect. Methods: Functional magnetic resonance imaging was used to measure amygdala activation in 36 patients with schizophrenia and 42 healthy controls. During scanning, a viewing task with masked and unmasked fearful and neutral faces was presented. Results: Patients exhibited increased amygdala response to unmasked fearful faces. With respect to masked fearful faces, no between-group differences emerged for the sample as a whole but a subsample of patients with flat affect showed heightened amygdala activation. The amygdala response to masked fearful faces was positively correlated with the degree of flat affect. Conversely, amygdala response to unmasked fearful faces was negatively correlated to the severity of affective flattening. In patients, amygdala responses to masked and unmasked fearful faces showed an inverse correlation. Conclusion: Our findings suggest that amygdala hyperresponsivity to unmasked fearful faces might be a functional characteristic of schizophrenia. Amygdala hyperresponsivity to masked fearful faces might be a specific characteristic of patients with affective flattening. A model of flat affect as a response mechanism to emotional overload is proposed.
AB - Objective: Early neuroimaging studies have demonstrated amygdala hypoactivation in schizophrenia but more recent research based on paradigms with minimal cognitive loads or examining automatic processing has observed amygdala hyperactivation. Hyperactivation was found to be related to affective flattening. In this study, amygdala responsivity to threat-related facial expression was investigated in patients as a function of automatic versus controlled processing and patients’ flat affect. Methods: Functional magnetic resonance imaging was used to measure amygdala activation in 36 patients with schizophrenia and 42 healthy controls. During scanning, a viewing task with masked and unmasked fearful and neutral faces was presented. Results: Patients exhibited increased amygdala response to unmasked fearful faces. With respect to masked fearful faces, no between-group differences emerged for the sample as a whole but a subsample of patients with flat affect showed heightened amygdala activation. The amygdala response to masked fearful faces was positively correlated with the degree of flat affect. Conversely, amygdala response to unmasked fearful faces was negatively correlated to the severity of affective flattening. In patients, amygdala responses to masked and unmasked fearful faces showed an inverse correlation. Conclusion: Our findings suggest that amygdala hyperresponsivity to unmasked fearful faces might be a functional characteristic of schizophrenia. Amygdala hyperresponsivity to masked fearful faces might be a specific characteristic of patients with affective flattening. A model of flat affect as a response mechanism to emotional overload is proposed.
UR - http://www.scopus.com/inward/record.url?scp=84956896117&partnerID=8YFLogxK
U2 - 10.4306/pi.2016.13.1.102
DO - 10.4306/pi.2016.13.1.102
M3 - Journal articles
AN - SCOPUS:84956896117
SN - 1738-3684
VL - 13
SP - 102
EP - 111
JO - Psychiatry Investigation
JF - Psychiatry Investigation
IS - 1
ER -