What's in a face? Effects of stimulus duration and inversion on face processing in schizophrenia

A number of studies show deficits in early-stage visual processing in schizophrenia. Deficits are also seen at more complex levels, such as ability to discriminate faces. This study investigated the "face inversion" effect, which reflects intrinsic cortical processing within the ventral visual stream, as well as contrast sensitivity, which reflects low-level visual processing, in order to evaluate integrity of specific stages of face processing in schizophrenia. Patients with schizophrenia and controls discriminated between pairs of upright or inverted faces or houses that had been manipulated to differ in the shape of the parts or the spatial distance among parts. The duration threshold for above chance performance on upright stimuli was obtained for patients using a house discrimination task. Contrast sensitivity was assessed for gratings of three spatial frequencies ranging from 0.5 to 21 cycles/degree. Patients needed significantly longer time to obtain 70% correct for upright stimuli and showed decreased contrast sensitivity. Increased duration threshold correlated with reduced contrast sensitivity to low (magnocellular-biased) but not medium or high spatial frequency stimuli. Using increased durations, patients showed significant inversion effects that were equivalent to those of controls on the face part and spacing tasks. Like controls, patients did not show inversion effects on the house tasks. These findings show that patients have difficulty integrating visual information as shown by increased duration thresholds. However, when faces were presented at these longer duration thresholds, patients showed the same relative processing ability for upright vs. inverted faces as controls, suggesting preserved intrinsic processing within cortical face processing regions. Similar inversion effects for face part and spacing for both groups suggest that they are using the same holistic face processing mechanism.