A systematic review on dysconnectivity in face and emotion processing networks in schizophrenia

Schizophrenia is a complex psychiatric disorder that affects approximately 20 million people worldwide. Patients show face-processing deficits that significantly affect their social interactions and social cognitive abilities (e.g., recognizing human faces). Although face processing has been extensively studied by using functional magnetic resonance imaging (fMRI), there have been very few systematic reviews investigating links between social-cognitive dysfunction, face processing networks, and clinical symptoms associated with key large-scale brain networks, such as the triple networks. We review brain networks, their dysconnectivity across patient subtypes, and relationships to clinical symptoms. Reviewed studies from 2020-2025 were 1) written in English, 2) focused on face and/or emotion processing in schizophrenia (not limited to first episode psychosis [FEP]), and 3) were resting or task-based fMRI studies investigating neural networks subserving face/emotion processing. PubMed, PsycINFO, Web of Science, and Google Scholar were utilized. Nine articles were reviewed. Resting-state studies and task-based fMRI studies showed elevated Positive and Negative Syndrome Scale (PANSS) positive scores in FEP patients coupled with social cognition deficits. Dysconnectivity was most consistently observed in the executive function network, the ToM /mentalizing network, the default mode network, limbic regions, and the visual-perceptual systems. Subtype dysconnectivity patterns included broad deficits in social cognition, empathy, emotion processing and face/emotion recognition. Social-cognitive deficits broadly stem from challenges in recognizing and processing negative emotional faces. Factors, such as trauma, suicidality, and inflammation, should be further examined, along with subtype presentations.