Eye Movement Patterns Can Distinguish Schizophrenia From the Major Affective Disorders and Healthy Control Subjects.

Background and hypothesis: No objective tests are currently available to help diagnosis of major psychiatric disorders. This study evaluates the potential of eye movement behavior patterns to predict schizophrenia subjects compared to those with major affective disorders and control groups. Study design: Eye movements were recorded from a training set of UK subjects with schizophrenia (SCZ; n = 120), bipolar affective disorder (BPAD; n = 141), major depressive disorder (MDD; n = 136), and healthy controls (CON; n = 142), and from a hold-out set of 133 individuals with proportional group sizes. A German cohort of SCZ (n = 60) and a Scottish cohort of CON subjects (n = 184) acted as a second semi-independent test set. All patients met DSMIV and ICD10 criteria for SCZ, BPAD, and MDD. Data from 98 eye movement features were extracted. We employed a gradient boosted (GB) decision tree multiclass classifier to develop a predictive model. We calculated the area under the curve (AUC) as the primary performance metric. Study results: Estimates of AUC in one-versus-all comparisons were: SCZ (0.85), BPAD (0.78), MDD (0.76), and CON (0.85). Estimates on part-external validation were SCZ (0.89) and CON (0.65). In all cases, there was good specificity but only moderate sensitivity. The best individual discriminators included free viewing, fixation duration, and smooth pursuit tasks. The findings appear robust to potential confounders such as age, sex, medication, or mental state at the time of testing. Conclusions: Eye movement patterns can discriminate schizophrenia from major mood disorders and control subjects with around 80% predictive accuracy.

Sensory auditory interval perception errors in developmental dyslexia.

Developmental dyslexia (DD) is a heritable condition associated with reading, visual and auditory deficits. Atypical processes involved in low-level sensory coding have been implicated. We tested the contribution made by auditory magnocellular function using a behavioural task which considered the temporal difference between pairs of identical sinewave tones. Adult undergraduates with an existing diagnosis of DD (n = 78) were compared with controls (n = 111) from the same population on error rates and response times at different interval durations. Error rates and response times increased in both groups with increasing task difficulty. However, on average the DD group made uniformly more errors and slower decisions than controls. Unsupervised learning of error patterns exposed a trait continuum associated with individual differences in response efficiency. Difficulty in using temporal information in DD arising from impaired sensory coding in the auditory thalamus is suggested. The results provide strong support for the idea that auditory processing difficulties in dyslexia, along with visual and sensorimotor deficits, have a common neurodevelopmental cause.

Extracting prototypical facial images from exemplars.

A computer graphic method for extracting a natural image of an individual's facial prototype, or average appearance, from a number of different images of that individual is presented. The process improves upon previous photographic and computational techniques. Synthesis of a person's average expression and pose from a sample of images is derived in an automatic and quantitative way. Possible uses of composite faces produced in this manner in psychological investigations of facial qualities (eg attractiveness) and in applied areas such as telecommunication are pointed out.

Simple viewing tests can detect eye movement abnormalities that distinguish schizophrenia cases from controls with exceptional accuracy.

BACKGROUND: We have investigated which eye-movement tests alone and combined can best discriminate schizophrenia cases from control subjects and their predictive validity. METHODS: A training set of 88 schizophrenia cases and 88 controls had a range of eye movements recorded; the predictive validity of the tests was then examined on eye-movement data from 34 9-month retest cases and controls, and from 36 novel schizophrenia cases and 52 control subjects. Eye movements were recorded during smooth pursuit, fixation stability, and free-viewing tasks. Group differences on performance measures were examined by univariate and multivariate analyses. Model fitting was used to compare regression, boosted tree, and probabilistic neural network approaches. RESULTS: As a group, schizophrenia cases differed from control subjects on almost all eye-movement tests, including horizontal and Lissajous pursuit, visual scanpath, and fixation stability; fixation dispersal during free viewing was the best single discriminator. Effects were stable over time, and independent of sex, medication, or cigarette smoking. A boosted tree model achieved perfect separation of the 88 training cases from 88 control subjects; its predictive validity on retest assessments and novel cases and control subjects was 87.8%. However, when we examined the whole data set of 298 assessments, a cross-validated probabilistic neural network model was superior and could discriminate all cases from controls with near perfect accuracy at 98.3%. CONCLUSIONS: Simple viewing patterns can detect eye-movement abnormalities that can discriminate schizophrenia cases from control subjects with exceptional accuracy.

Body image, shape, and volumetric assessments using 3D whole body laser scanning and 2D digital photography in females with a diagnosed eating disorder: preliminary novel findings.

We piloted three-dimensional (3D) body scanning in eating disorder (ED) patients. Assessments of 22 ED patients (including nine anorexia nervosa (AN) patients, 12 bulimia nervosa (BN) patients, and one patient with eating disorder not otherwise specified) and 22 matched controls are presented. Volunteers underwent visual screening, two-dimensional (2D) digital photography to assess perception and dissatisfaction (via computerized image distortion), and adjunctive 3D full-body scanning. Patients and controls perceived themselves as bigger than their true shape (except in the chest region for controls and anorexia patients). All participants wished to be smaller across all body regions. Patients had poorer veridical perception and greater dissatisfaction than controls. Perception was generally poorer and dissatisfaction greater in bulimia compared with anorexia patients. 3D-volume:2D-area relationships showed that anorexia cases had least tissue on the torso and most on the arms and legs relative to frontal area. The engagement of patients with the scanning process suggests a validation study is viable. This would enable mental constructs of body image to be aligned with segmental volume of body areas, overcoming limitations, and errors associated with 2D instruments restricted to frontal (coronal) shapes. These novel data could inform the design of clinical trials in adjunctive treatments for eating disorders.

Smooth pursuit and visual scanpaths: Independence of two candidate oculomotor risk markers for schizophrenia.

OBJECTIVES: Smooth pursuit and visual scanpath deficits are candidate trait markers for schizophrenia. It is not clear whether eye tracking dysfunction (ETD) and atypical scanpath behaviour are the product of the same underlying neurobiological processes. We have examined co-occurrence of ETD and scanpath disturbance in individuals with schizophrenia and healthy volunteers. METHODS: Eye movements of individuals with schizophrenia (N = 96) and non-clinical age-matched comparison participants (N = 100) were recorded using non-invasive infrared oculography during smooth pursuit in both predictable (horizontal sinusoid) and less predictable (Lissajous sinusoid) conditions and a free viewing scanpath task. RESULTS: Individuals with schizophrenia demonstrated scanning deficits in both tasks. There was no association between performance measures of smooth pursuit and scene scanpaths in patient or control groups. Odds ratios comparing the likelihood of scanpath dysfunction when ETD was present, and the likelihood of finding scanpath dysfunction when ETD was absent were not significant in patients or controls in either pursuit variant, suggesting that ETD and scanpath dysfunction are independent anomalies in schizophrenia. CONCLUSION: ETD and scanpath disturbance appear to reflect independent oculomotor or neurocognitive deficits in schizophrenia. Each task may confer unique information about the pathophysiology of psychosis.

Atypical scanpaths in schizophrenia: evidence of a trait- or state-dependent phenomenon?

The development of trait markers of schizophrenia would represent an important advance in understanding the genetic architecture of the disease. To date, no candidate markers have satisfied all of the trait marker criteria, and many are not specific to the schizophrenia spectrum. Abnormalities in visual scanpaths are frequently reported in patients with schizophrenia and are emerging as a novel candidate for a schizophrenia biomarker. Here we review the suitability of scanpath measures as a target for trait marker research in schizophrenia. Papers reporting scanpath patterns in patients with schizophrenia were identified by PubMed and Google Scholar searches and by scanning reference lists in relevant articles. Search terms included "schizophrenia," "psychosis," "scanpath," "scan path," "fixation," "saccade" and "eye movement." Scanpath abnormalities afford impressive sensitivity and specificity and appear largely independent of psychotropic medications. Scanpaths may demonstrate some fluctuation with symptomatology and may be useful in illuminating illness state or subtypes. However, there is evidence that viewing behaviours remain atypical regardless of symptom remission and may be present in unaffected relatives of individuals with schizophrenia. This research is in its early stages, and further investigation regarding patterns of inheritance is required. Our findings support scanpath measures as a favourable topic for further investigation as a trait marker.

Amygdala activation to masked happy facial expressions.

The amygdala has a key role in automatic non-conscious processing of emotions. Highly salient emotional stimuli elicit amygdala activity, and happy faces are among the most rapidly perceived facial expressions. In backward masking paradigms, an image is presented briefly and then masked by another stimulus. However, reports of amygdala responses to masked happy faces have been mixed. In the present study, we used functional magnetic resonance imaging (fMRI) to examine amygdala activation to masked happy, sad, and neutral facial expressions. Masked happy faces elicited greater amygdala activation bilaterally as compared to masked sad faces. Our findings indicate that the amygdala is highly responsive to non-consciously perceived happy facial expressions.

Visual scan paths in first-episode schizophrenia and cannabis-induced psychosis.

OBJECTIVE: Patterns of successive saccades and fixations (scan paths) that are made while viewing images are often spatially restricted in schizophrenia, but the relation with cannabis-induced psychosis has not been examined. We used higher-order statistical methods to examine spatiotemporal characteristics of scan paths to determine whether viewing behaviour was distinguishable on a continuum. METHODS: Patients with early acute first-episode paranoid schizophrenia (SCH; n = 11), cannabis-induced psychosis (CIP; n = 6) and unaffected control subjects (n = 22) undertook a task requiring free viewing of facial, fractal and landscape images for 5 seconds while their eye movements were recorded. Frequencies and distributions of saccades and fixations were calculated in relation to image regions examined during each trial. RESULTS: Findings were independent of image category, indicating generalized scanning deficits. Compared with control subjects, patients with SCH and CIP made fewer saccades and fewer fixations of longer duration. In turn, the spatial distribution of fixations in CIP patients was more clustered than in SCH and control subjects. The diversity of features fixated in subjects with CIP was also lower than in SCH patients and control subjects. CONCLUSION: A continuous approach to characterizing scan path changes in different phenotypes suggests that CIP shares some of the abnormalities of SCH but can be distinguished with measures that are sensitive to cognitive strategies active or inhibited during visual exploration.

Global visual scanning abnormalities in schizophrenia and bipolar disorder.

Visual scanning of face images is widely reported to be abnormal in schizophrenia. This impaired processing has been proposed to be partly responsible for patients' disturbance in social interactions. The present study was designed to determine whether abnormal scanning is specific to images with social content or extends to other types of stimuli. Individuals with schizophrenia (n=22), bipolar disorder (n=19) and healthy controls (n=37) were asked to view a series of 28 images with or without socially important content (i.e. faces, landscapes, fractals and noise patterns) while their eye movements were recorded video-oculographically. Temporal and spatial characteristics of scan paths were compared for each patient group and picture type. Independent of image content, patients with schizophrenia exhibited fewer fixations, longer fixation duration, longer saccade duration and peak velocity, and smaller saccade amplitude compared with healthy controls. Patients with schizophrenia and bipolar disorder did not differ significantly from one another on any of the temporal variables recorded. Fixation location distributions of participants with schizophrenia differed significantly from that of healthy controls on all picture types and from patients with bipolar disorder on all but face images. Abnormal scanning in schizophrenia and also bipolar disorder was independent of stimulus type and therefore reflects a global visual scanning impairment not specific to faces. Spatial scanning characteristics but not temporal ones may serve as biomarkers in the functional psychoses.

Digit ratio (2D:4D) and the spatial representation of magnitude.

Digit ratio (as a putative indicator of prenatal androgen exposure) is related to a range of sexually dimorphic abilities, including spatial skills and mathematical ability. This study examined a phenomenon known as the SNARC effect (Spatial Numerical Association of Response Codes), which is taken as evidence of a mental representation of magnitude along a left-right-oriented number line, with low magnitudes associated with the left side of space, and high numbers with the right side of space. Participants made a parity judgement of numbers with responses made with a left key to odd numbers and a right key to even numbers. This was reversed for a second block of trials. Response times to numbers one to nine with both the right and left hand were calculated, and regression analyses conducted to analyse whether lower magnitudes were responded to faster with the left hand and higher magnitudes with the right hand. Participants with lower (more masculine) digit ratios on the right hand showed a stronger SNARC effect compared to participants with high digit ratios. This pattern of results was also found when the analyses were conducted separately for men and women. Results from left hand digit ratios indicated that only low digit ratio females showed a significant SNARC effect. These findings add to a growing literature on the relationship between digit ratio and cognitive abilities; in this case, simple cognitive representations that are accessed automatically rather than complex skills such as mental rotation or "mathematics" where a variety of solution strategies may be utilised.

Pattern motion is present in V1 of awake but not anaesthetized monkeys.

We compared responses of neurons, recorded in striate cortex (area V1) of awake, fixating monkeys, to a single drifting grating with those to a 'plaid' pattern comprised of two superimposed drifting gratings separated in orientation by 90 degrees. Five out of 54 (9%) of V1 direction selective neurons responded to the direction of motion of the whole pattern [pattern motion (PM) selectivity]. Tuning curves for plaid stimuli were similar in both optimum direction and width of tuning to those for single gratings. Twenty nine out of 54 (54%) responded simply to the motion of individual orientated gratings within the pattern [component motion (CM) selectivity]. The remaining 37% (20/54) neurons were unclassified. In control experiments, 39 direction selective neurons were recorded in area V1 of anaesthetized monkey and cats. Unlike area V1 in behaving monkeys, none of these neurons exhibited PM selectivity to the drifting plaids. Twenty eight out of 39 (72%) of them responded to the direction of the component gratings and were classified as CM selectivity. Our results indicate that although most V1 neurons are CM selective, as described in anaesthetized animals, a subpopulation is clearly PM selective in behaving monkeys, reflecting integration of locally derived motion signals. Neurons in V1 therefore carry signals that may contribute to pattern motion processing and perception. This perceptual interpretation in V1 might depend much more critically on information integration mechanisms that only function properly in awake, perceiving animals.

Measurement of body size and shape perception in eating-disordered and control observers using body-shape software.

A disturbance in the perception of personal body size and shape is a key feature of both anorexia and bulimia nervosa, but it has proved difficult to quantify. Previous attempts have used methods like the distorting video technique (DVT), which alters an image by stretching the figure in either the X- or Y-axis. This is a poor representation of the way fat is added to or lost from the body, and the pattern of distortion provides a host of cues to the degree to which the image has been altered. To overcome these problems we have used a specially designed software system that uses biometric data based on real body shapes, instead of simply stretching or compressing images of bodies. This technique also allows individual body parts to be altered separately, so we can determine whether a specific body part is overestimated relative to others. We can also calculate the apparent body mass index (BMI) of our modified pictures, using the perimeter-area ratio (PAR). This allows us to compare an observer's actual BMI with that calculated for their estimated and ideal bodies. We tested 30 anorexic, 30 bulimic and 137 control observers. Our results show that all three observer groups tend to overestimate their body size, but not significantly so. Both the control and bulimic observers prefer an ideal body with a BMI of 20, which is at the lower end of the 'normal' BMI range. However, the anorexics ideal BMI is 15, which is on the border between the emaciated and underweight BMI categories.

Body image perception, satisfaction and somatotype in male and female athletes and non-athletes: results using a novel morphing technique.

Thirty-six adults (24 males, 12 females) were assessed for anthropometric somatotype and body image (perception and satisfaction) by a novel technique using quantitative distortion of a digital still image. Software produced random distortions in nine body regions. The participants manipulated interactive slider controls to adjust each body feature in turn, recreate their perceived image and indicate their desired image. There were no differences in perception between the sexes. However, the ideal-actual differences (i.e. satisfaction) indicated that males desired larger and females smaller features, respectively, in the chest and thighs (P < 0.001) and arms and calves (P < 0.01). When the male-derived data were partitioned by sport (strength, endurance, team-sport and controls), differences were found in the perceived image size in the chest and rib regions (P < 0.01 and P < 0.05, respectively). Strength athletes perceived these areas to be smaller and the control group perceived these areas to be larger than the true values. Somatotype analysis indicated that the physique associated with minimal dissatisfaction was 2.0-5.0-3.0 for males and 3.0-2.5-3.0 for females. Cluster analysis, combining anthropometric and satisfaction data, revealed seven distinct subgroups distinguished by particular attributes of physical appearance. We conclude that the method is reliable and that body image includes sex-specific, anthropometric, perceptual and personality-related components.

Children's recognition of caricatures.

This study examined children's and adults' perception and recognition of facial stimuli that were either systematically exaggerated (caricatures) or de-exaggerated (anticaricatures) relative to a norm face. The results showed that all age groups perceived caricatures as the most distinctive versions of a face and anticaricatures as the least distinctive, although the effect was smallest for 6-year-olds. In general, caricatures were identified as quickly as the veridical faces and faster than the anticaricatures. Across all age groups, participants' familiarity with the stimulus faces interacted with degree of caricature to determine speed of processing as well as choice of best likeness. The results are discussed in relation to the idea that distinctiveness information in a face is represented in relation to a norm.