Exploring facial emotion perception in schizophrenia using transcranial magnetic stimulation and spatial filtering

Schizophrenia patients have difficulty extracting emotional information from facial expressions. Perception of facial emotion can be examined by systematically altering the spatial frequency of stimuli and suppressing visual processing with temporal precision using transcranial magnetic stimulation (TMS). In the present study, we compared 25 schizophrenia patients and 27 healthy controls using a facial emotion identification task. Spatial processing was examined by presenting facial photographs that contained either high (HSF), low (LSF), or broadband/unfiltered (BSF) spatial frequencies. Temporal processing was manipulated using a single-pulse TMS delivered to the visual cortex either before (forward masking) or after (backward masking) photograph presentation. Consistent with previous studies, schizophrenia patients performed significantly below controls across all three spatial frequencies. A spatial frequency by forward/backward masking interaction effect demonstrated reduced performance in the forward masking component in the BSF condition and a reversed performance pattern in the HSF condition, with no significant differences between forward and backward masking in the LSF condition. However, the group by spatial frequency interaction was not significant. These findings indicate that manipulating visual suppression of emotional information at the level of the primary visual cortex results in comparable effects on both groups. This suggests that patients' deficits in facial emotion identification are not explained by low-level processes in the retino-geniculo-striate projection, but may rather depend on deficits of affect perception occurring at later integrative processing stages.