Please cite this article in press as: Tseng, H.-H., et al., A systematic review of multisensory cognitive–affective integration in schizophre- nia. Neurosci. Biobehav. Rev. (2015), http://dx.doi.org/10.1016/j.neubiorev.2015.04.019 ARTICLE IN PRESS G Model NBR 2181 1–9 Neuroscience and Biobehavioral Reviews xxx (2015) xxx–xxx Contents lists available at ScienceDirect Neuroscience and Biobehavioral Reviews jou rn al h om epage: www.elsevier.com/locate/neubiorev Review A systematic review of multisensory cognitive–affective integration in schizophrenia Huai-Hsuan Tseng a,b,c,* Q1 , Matthijs G. Bossong a , Gemma Modinos a , Kuan-Ming Chen d , Philip McGuire a , Paul Allen a a Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, United Kingdom Q2 b Research Imaging Centre, Centre of Addiction and Mental Health, University of Toronto, Toronto, ON, Canada c Ju Shan Hospital, Taoyuan, Taiwan d Science Education Center, National Taiwan Normal University, Taipei, Taiwan a r t i c l e i n f o Article history: Received 17 July 2014 Received in revised form 25 March 2015 Accepted 26 April 2015 Available online xxx Keywords: Multi-sensory integration Schizophrenia Emotion Congruent facilitation Incongruent Interference Functional magnetic resonance imaging a b s t r a c t The etymology of schizophrenia implies poor functional integration of sensory, cognitive and affective processes. Multisensory integration (MSI) is a spontaneous perceptual–cognitive process by which rele- vant information from multiple sensory modalities is extracted to generate a holistic experience. Deficits in MSI may hinder prompt and appropriate behavioural responses in a complex and transient environ- ment. Despite extensive investigation of sensory, cognitive and affective processing in patients with schizophrenia, little is known about how MSI is affected in the illness. We systemically searched the PubMed electronic database and reviewed twenty-nine behavioural and neuroimaging studies examin- ing MSI in patients with schizophrenia. The available evidence indicates impaired MSI for non-emotional stimuli in schizophrenia, especially for linguistic information. There is also evidence for altered MSI for emotional stimuli, although findings are inconsistent and may be modality-specific. Brain functional alterations in the superior temporal cortex and inferior frontal cortex appear to underlie the deficits in both non-emotional and emotional MSI. The limitations of the experimental paradigms used and directions for future research are also discussed. © 2015 Published by Elsevier Ltd. Contents 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 2. Multi-sensory integration (MSI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 3. Search strategy and results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 4. Non-emotional multisensory integration in schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 5. Emotional MSI in schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 6. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 7. Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 8. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 Role of the funding source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 00 1. Introduction Q4 The etymology of schizophrenia means “splitting of men- tal functions”; implying defective functional integration of * Corresponding author at: Department of Psychosis Studies, Institute of Psy- Q3 chiatry, King’s College London, 16 De Crespigny Park, London, United Kingdom. Tel.: +16477715311. E-mail address: socwind@gmail.com (H.-H. Tseng). information. In addition to widespread cognitive impairment, patients with schizophrenia have prominent deficits in emotional processing (Edwards et al., 2002), and this is closely related to problems with social cognition and interpersonal functioning (e.g., Brittain et al., 2010; Penn et al., 1997; Pinkham et al., 2003) and psy- chotic symptoms (Laroi et al., 2010; Tseng et al., 2013). Studies of social cognition in schizophrenia have used emotion-laden stimuli usually presented in a single sensory modality, such as visual face (Gur et al., 2002; Kohler et al., 2003; Pinkham et al., 2005) or http://dx.doi.org/10.1016/j.neubiorev.2015.04.019 0149-7634/© 2015 Published by Elsevier Ltd. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52