Combined EEG-eye Movement Technique To Explore The Impairment Mechanism Of Inhibition Of Return In Schizophrenia

Objective:Based on the return of inhibition(IOR)cognitive processing theory,the study used a single-cue task and a dual-cue cue task adapted From the cue-target paradigm,which separates three stages of sensory processing of cued stimuli,attentional reorientation,and spatial response,combined with eye-movement characteristics and ERP indicators to explore the characteristics of IOR processing in schizophrenia and reveal the mechanism of IOR impairment in patients.Methods:1.Behavioral study: 37 patients with schizophrenia were included according to DSM-5 diagnostic criteria,and 40 matched healthy controls were included.A mixed experimental design of 2(between-group: SZ group,HC group)× 2(cue type: valid cue,invalid cue)× 4(SOA: 200,300,600,800ms)× 4(cue stimulus type: positive Face,neutral Face,negative Face,nonsense cue)was adopted For the single-cue task and dual-cue task,and the correct and incorrect responses to the target stimuli in the experimental task were recorded and incorrect responses to the target stimuli in the experimental task in terms of mean reaction times(RTs)as well as accuracy(correct response rate).Exploring IOR processing characteristics in schizophrenic patients.2.Eye movement study: 44 patients with schizophrenia were included according to DSM-5 diagnostic criteria,and 30 matched healthy controls were included.A single-cue task and a reorientation task were used,and a mixed experimental design of 2(between-group: SZ group,HC group)× 3(SOA: 300,600,800ms)× 4(cue stimulus type:positive Face,neutral Face,negative Face,nonsense cue)was adopted based on the eye-tracking technique,and the eye-movement indexes were taken as the First gaze time to the target stimulus and the area of interest(AOI)gaze ratio,and the subjects’ gaze trajectories to the cued stimuli were recorded.The effects of perceptual processing of cued stimuli on IOR and the mechanism of IOR impairment in patients were explored by the subjects’ attentional eye movement patterns to the cued stimuli.3.ERP study: 10 patients with schizophrenia were included according to DSM-5diagnostic criteria,and 29 matched healthy controls were included.A mixed experimental design of 2(between groups: SZ group,HC group)× 2(SOA: 300,600ms)× 4(cued stimulus types: positive Face,neutral Face,negative Face,nonsense cue)was adopted,and ERP acquisition indexes were P1,N1 and P3 indexes of individual responses to target stimuli.The neurophysiological mechanisms underlying the patients’ IOR impairment were explored by comparing the differences in ERP components between the two groups to measure the differences in their attentional IOR processing mechanisms.Results:1.Behavioral results:(1)In the single-cue cueing task,there was a significant difference in cue effects between the two groups at 200ms(t=4.675,P<0.001),300ms(t=4.900,P<0.001)and800ms(t=2.907,P=0.006);in the dual-cue cueing task,there was no significant difference in the cue effect between the two groups at 200ms(t=0.232,P=0.818),300ms(t=-1.012,P=0.317),600ms(t=1.249,P=0.216)and 800ms(t=-1.173,P=0.248).(2)There was a significant difference between the two experimental cue effects under SOA at 200ms(t=-4.969,P<0.001),300ms(t=-4.116,P<0.001)and 800ms(t=-2.058,P<0.001)in the SZ groups.(3)there was a significant difference in the amount of IOR change between the two groups at nonsense cue(t=-2.430,P=0.018)and negative cue(t=-2.567,P=0.014)under200ms SOA,positive cue(t=-2.748,P=0.009)under 300 ms SOA,nonsense cue Z=-2.642,P=0.008)under 800 ms SOA,and negative cues(Z=-2.561,P=0.010).2.Eye movement study results:(1)The SZ group showed significant promotion effect at 300ms(t=-3.572,P=0.001)and 600ms(t=-3.539,P=0.001)for the single-cue task;the SZ group showed significant IOR effects at 300ms(t=2.905,P=0.006),600ms(t=2.588,P= 0.013)and 800ms(t=2.972,P=0.006)for the dual-cue task.(2)Subjects in both groups were subjected to all three emotional faces for eyes(positive stimulus: Z=-4.046,P<0.001;neutral stimulus: Z=-5.996,P<0.001;negative stimulus: Z=-4.996,P<0.001),nose(positive stimulus: Z=-7.561,P<0.001;neutral stimulus: Z=-8.064,P<0.001;negative stimulus: Z=-5.537,P<0.001)and mouth(positive stimulus: Z=-7.821,P<0.001;neutral stimulus: Z=-6.911,P<0.001;negative stimulus:Z=-5.948,P<0.001)showed significant differences in gaze rates.(3)The gaze pattern of all subjects to emotional face cues was divided into two groups: Group1(t(35)= 7.257;P < 0.001,d = 1.21,95% CI [0.39,0.69])and Group2(t(37)= 11.85;P<0.001,d=1.92,95% CI [0.52,0.73]).Based on the corresponding a priori values and distributions of the HMM,the eye movement pattern of Group1 was named partial gaze and the eye movement pattern of Group2 was named holistic gaze.(4)Under the single-cue cueing task,patients could produce more amount of IOR when using the holistic gaze pattern for negative emotional faces(r=-0.335,P=0.026).However,under the dual-cue cueing task,patients produced more IOR when they used more partial gaze patterns on negative emotional faces(r=0.301,P=0.047).(5)There was a significant correlation between patients’ eye movement patterns and information processing speed(r=-0.310,P=0.049),and working memory(r=-0.320,P=0.041).The slower the patient’s information processing speed and the poorer the working memory when the patient favored a holistic gaze.3.ERP study results:(1)In occipital P1 amplitude,the P1 amplitude activity of the invalid cue was significantly greater than that of the valid cue in the patient group at 300 ms under the dual-cue cueing task(t=2.422,P<0.001).In occipital P1 latency,there was a significant difference between experiment types in the patient group under the 300 ms valid cue condition(t=0.391,P=0.032).(2)In the N1 amplitude under the Cz channel,there was a significant difference between the two groups in the 600 ms invalid cue under a single cueing task(t=2.084,P=0.044);in the N1 latency under the Cz channel,there was a significant difference between the two groups in the 600 ms valid cue(t=3.382,P=0.002)and invalid cue condition(t=2.111,P=0.042)under the dual-cue cueing task.(3)In the P300 amplitude under the Cz channel,there were significant differences between the two groups in the 600 ms invalid cue(t=-2.182,P=0.036)in the single-cue cueing task,the 600-ms valid cue(t=-2.723,P=0.010)and invalid cue(t=-2.310,P=0.044)conditions in the dual-cue cue task.In the Cz channel under the P300 latency,there was a significant difference between the two groups in the 300 ms invalid cue(t=-2.078,P=0.045)and 600 ms invalid cue(t=-2.606,P=0.013)conditions in the single-cue cue task.(4)The SZ groups had significant between valid cues(r=-0.538,P=0.014)and invalid cues(r=-0.595,P=0.006)for the single-cue cue task,valid cues(r=-0.690,P=0.001)and invalid cues(r=-0.686,P=0.001)for the dual-cue cue task and the P300 amplitude of the Cz channel.negative correlation.The valid cues for the dual-cue cueing task(r=-0.583,P=0.007)had a significant negative correlation with P1 of the Cz channel.Conclusion:(1)The study found that schizophrenic patients have deficits in attentional IOR function,but after centring cues can facilitate the emergence of IOR in SZ patients,it is clear that reorientation impairment in SZ patients is one of the reasons for their IOR delayed phenomenon.(2)Patients’ gaze patterns on emotional face cues under different tasks were significantly correlated with IOR.Thus,IOR impairment in schizophrenic patients has both cue stimulation effect and reorientation impairment.(3)Patients’ IOR activation was mainly associated with its late component P300.Second,changes in the early component of the occipital lobe may provide evidence for patient IOR reorientation.