Background: Schizophrenia patients have vocal affect (prosody) deficits that are treatment resistant and associated with negativesymptoms and poor outcome. The neural correlates of this dysfunction are unclear. Prior study has suggested that schizophrenia vocal affectperception deficits stem from an inability to use acoustic cues, notably pitch, in decoding emotion.

Methods: Functional magnetic resonance imaging was performed in 24 schizophrenia patients and 28 healthy control subjects, during theperformance of a four-choice (happiness, fear, anger, neutral) vocal affect identification task in which items for each emotion variedparametrically in affective salient acoustic cue levels.

Results: We observed that parametric increases in cue levels in schizophrenia failed to produce the same identification rate increases as incontrol subjects. These deficits correlated with diminished reciprocal activation changes in superior temporal and inferior frontal gyri andreduced temporo-frontal connectivity. Task activation also correlated with independent measures of pitch perception and negativesymptom severity.

Conclusions: These findings illustrate the interplay between sensory and higher-order cognitive dysfunction in schizophrenia. Sensorycontributions to vocal affect deficits also suggest that this neurobehavioral marker could be targeted by pharmacological or behavioralremediation of acoustic feature discrimination.