Emotional Prosody Processing in the Schizophrenia Spectrum.

THESIS ABSTRACT Emotional prosody processing impairment is proposed to be a main contributing factor for the formation of auditory verbal hallucinations in patients with schizophrenia. In order to evaluate such assumption, five experiments in healthy, highly schizotypal and schizophrenia populations are presented. The first part of the thesis seeks to reveal the neural underpinnings of emotional prosody comprehension (EPC) in a non-clinical population as well as the modulation of prosodic abilities by hallucination traits. By revealing the brain representation of EPC, an overlap at the neural level between EPC and auditory verbal hallucinations (AVH) was strongly suggested. By assessing the influence of hallucinatory traits on EPC abilities, a continuum in the schizophrenia spectrum in which high schizotypal population mirrors the neurocognitive profile of schizophrenia patients was established. Moreover, by studying the relation between AVH and EPC in non-clinical population, potential confounding effects of medication influencing the findings were minimized. The second part of the thesis assessed two EPC related abilities in schizophrenia patients with and without hallucinations. Firstly, voice identity recognition, a skill which relies on the analysis of some of the same acoustical features as EPC, has been evaluated in patients and controls. Finally, the last study presented in the current thesis, assessed the influence that implicit processing of emotional prosody has on selective attention in patients and controls. Both patients studies demonstrate that voice identity recognition deficits as well as abnormal modulation of selective attention by implicit emotion prosody are related to hallucinations exclusively and not to schizophrenia in general. In the final discussion, a model in which EPC deficits are a crucial factor in the formation of AVH is evaluated. Experimental findings presented in the previous chapters strongly suggests that the perception of prosodic features is impaired in patients with AVH, resulting in aberrant perception of irrelevant auditory objects with emotional prosody salience which captures the attention of the hearer and which sources (speaker identity) cannot be recognized. Such impairments may be due to structural and functional abnormalities in a network which comprises the superior temporal gyrus as a central element