The Conflict between Top-down and Bottom-up Impairments in Consciousness Disorder in Schizophrenia

Page: [291 - 296] Pages: 6

  • * (Excluding Mailing and Handling)

Abstract

Introduction: Schizophrenia, a complex psychiatric disorder, is often associated with consciousness disorders, typically characterized by an elevated threshold of conscious perception. Over the years, a multitude of research has been dedicated to uncovering the primary cause of these disorders, leading to the development of several theories.

Methods: In this article, two central answers to this problem have been reviewed. For this, the articles that were more related to the topic were selected. Based on the relevance to the subject of research, the main ideas of targeted articles are reordered to be comprehensible for the readers. Finally, the judgment and conclusion of the authors about the discussed problem are presented in this study.

Discussion: The first theory, which we will explore in this article, suggests that the root cause of these disorders lies in defects within bottom-up processes. These processes, fundamental to our understanding of the world, involve the progression of sensory information from low-level perception to high-level awareness. In individuals with schizophrenia, these processes are believed to be compromised, leading to a distorted perception of reality. The second theory, in contrast, attributes the cause to impairments in top-down processes. These processes, which refer to the influence of high-level cognitive functions on lower-level sensory perception, are also considered dysfunctional in schizophrenic patients. This dysfunction is thought to disrupt the integration of sensory information, thereby affecting the individual's consciousness. However, a third perspective has emerged, suggesting the coexistence of impairments in both bottom- up and top-down processing. This perspective argues that to fully comprehend the nature of consciousness disorders in schizophrenia, it is crucial to determine the type and severity of both bottom-up and top-down impairments.

Conclusion: In this review, we delve into these theories, examining the evidence supporting each and discussing their implications for our understanding of schizophrenia. Considering both bottom-up and top-down impairments, the third perspective offers a more holistic explanation for these disorders. We further argue that this perspective underscores the need for a more nuanced approach to studying schizophrenia. It suggests that future research should not only focus on these processes in isolation but also explore their interaction and the potential synergistic effects of their impairment. By doing so, we can hope to gain a more comprehensive understanding of consciousness disorders in schizophrenia, which could ultimately lead to more effective treatment strategies.

Graphical Abstract

[1]
Oorschot M, Lataster T, Thewissen V, Bentall R, Delespaul P, Myin-Germeys I. Temporal dynamics of visual and auditory hallucinations in psychosis. Schizophr Res 2012; 140(1-3): 77-82.
[http://dx.doi.org/10.1016/j.schres.2012.06.010] [PMID: 22784687]
[2]
Yaron I, Melloni L, Pitts M, Mudrik L. The ConTraSt database for analysing and comparing empirical studies of consciousness theories. Nat Hum Behav 2022; 6(4): 593-604.
[http://dx.doi.org/10.1038/s41562-021-01284-5] [PMID: 35190711]
[3]
Lefebvre S, Very E, Jardri R, et al. The neural correlates of the visual consciousness in schizophrenia: An fMRI study. Eur Arch Psychiatry Clin Neurosci 2021; 271(4): 661-75.
[http://dx.doi.org/10.1007/s00406-020-01167-2] [PMID: 32813032]
[4]
Del Cul A, Dehaene S, Leboyer M. Preserved subliminal processing and impaired conscious access in schizophrenia. Arch Gen Psychiatry 2006; 63(12): 1313-23.
[http://dx.doi.org/10.1001/archpsyc.63.12.1313] [PMID: 17146006]
[5]
Liu Y, Zhang D, Zhao Y, Tan S, Luo Y. Deficits in attentional processing of fearful facial expressions in schizophrenic patients. Sci Rep 2016; 6(1): 32594.
[http://dx.doi.org/10.1038/srep32594] [PMID: 27586404]
[6]
Sun Q, Fang Y, Shi Y, Wang L, Peng X, Tan L. Inhibitory top-down control deficits in schizophrenia with auditory verbal hallucinations: A Go/NoGo Task. Front Psychiatry 2021; 12: 544746.
[http://dx.doi.org/10.3389/fpsyt.2021.544746] [PMID: 34149464]
[7]
Caruana N, Seymour K. Bottom-up processing of fearful and angry facial expressions is intact in schizophrenia. Cogn Neuropsychiatry 2021; 26(3): 183-98.
[http://dx.doi.org/10.1080/13546805.2021.1902794] [PMID: 33752551]
[8]
Gagné AM, Hébert M, Maziade M. Revisiting visual dysfunctions in schizophrenia from the retina to the cortical cells: A manifestation of defective neurodevelopment. Prog Neuropsychopharmacol Biol Psychiatry 2015; 62: 29-34.
[http://dx.doi.org/10.1016/j.pnpbp.2015.04.007] [PMID: 25934388]
[9]
Reavis EA, Lee J, Wynn JK, et al. Linking optic radiation volume to visual perception in schizophrenia and bipolar disorder. Schizophr Res 2017; 190: 102-6.
[http://dx.doi.org/10.1016/j.schres.2017.03.027] [PMID: 28318839]
[10]
Shen L, Liu D, Huang Y. Hypothesis of subcortical visual pathway impairment in schizophrenia. Med Hypotheses 2021; 156: 110686.
[http://dx.doi.org/10.1016/j.mehy.2021.110686] [PMID: 34583308]
[11]
Poeppel D, Mangun GR, Gazzaniga MS. The cognitive neurosciences. Cambridge, Massachusetts: MIT Press 2020.
[http://dx.doi.org/10.7551/mitpress/11442.001.0001]
[12]
Butler PD, Hoptman MJ, Nierenberg J, Foxe JJ, Javitt DC, Lim KO. Visual white matter integrity in schizophrenia. Am J Psychiatry 2006; 163(11): 2011-3.
[http://dx.doi.org/10.1176/ajp.2006.163.11.2011] [PMID: 17074957]
[13]
Moschovakis AK. The superior colliculus and eye movement control. Curr Opin Neurobiol 1996; 6(6): 811-6.
[http://dx.doi.org/10.1016/S0959-4388(96)80032-8] [PMID: 9000018]
[14]
Cutsuridis V, Kumari V, Ettinger U. Antisaccade performance in schizophrenia: A neural model of decision making in the superior colliculus. Front Neurosci 2014; 8: 13.
[http://dx.doi.org/10.3389/fnins.2014.00013] [PMID: 24574953]
[15]
Arend I, Machado L, Ward R, McGrath M, Ro T, Rafal RD. The role of the human pulvinar in visual attention and action: Evidence from temporal-order judgment, saccade decision, and antisaccade tasks. Prog Brain Res 2008; 171: 475-83.
[http://dx.doi.org/10.1016/S0079-6123(08)00669-9] [PMID: 18718343]
[16]
Kemether EM, Buchsbaum MS, Byne W, et al. Magnetic resonance imaging of mediodorsal, pulvinar, and centromedian nuclei of the thalamus in patients with schizophrenia. Arch Gen Psychiatry 2003; 60(10): 983-91.
[http://dx.doi.org/10.1001/archpsyc.60.9.983] [PMID: 14557143]
[17]
Meier MH, Shalev I, Moffitt TE, et al. Microvascular abnormality in schizophrenia as shown by retinal imaging. Am J Psychiatry 2013; 170(12): 1451-9.
[http://dx.doi.org/10.1176/appi.ajp.2013.13020234] [PMID: 24030514]
[18]
Rich AM, Cho YT, Tang Y, et al. Amygdala volume is reduced in early course schizophrenia. Psychiatry Res Neuroimaging 2016; 250: 50-60.
[http://dx.doi.org/10.1016/j.pscychresns.2016.02.006] [PMID: 27035063]
[19]
Chance SA, Esiri MM, Crow TJ. Amygdala volume in schizophrenia: Post-mortem study and review of magnetic resonance imaging findings. Br J Psychiatry 2002; 180(4): 331-8.
[http://dx.doi.org/10.1192/bjp.180.4.331] [PMID: 11925356]
[20]
Das P, Kemp A, Flynn G, et al. Functional disconnections in the direct and indirect amygdala pathways for fear processing in schizophrenia. Schizophr Res 2007; 90(1-3): 284-94.
[http://dx.doi.org/10.1016/j.schres.2006.11.023] [PMID: 17222539]
[21]
Dorph-Petersen KA, Pierri JN, Wu Q, Sampson AR, Lewis DA. Primary visual cortex volume and total neuron number are reduced in schizophrenia. J Comp Neurol 2007; 501(2): 290-301.
[http://dx.doi.org/10.1002/cne.21243] [PMID: 17226750]
[22]
Wang L, Yang L-C, Meng Q-L, Ma Y-Y. Superior colliculus-pulvinar-amygdala subcortical visual pathway and its biological significance. Acta Physiol Sin 2018; 70(1): 79-84.
[23]
Berkovitch L, Dehaene S, Gaillard R. Disruption of conscious access in schizophrenia. Trends Cogn Sci 2017; 21(11): 878-92.
[http://dx.doi.org/10.1016/j.tics.2017.08.006] [PMID: 28967533]
[24]
Green MF, Lee J, Wynn JK, Mathis KI. Visual masking in schizophrenia: Overview and theoretical implications. Schizophr Bull 2011; 37(4): 700-8.
[http://dx.doi.org/10.1093/schbul/sbr051] [PMID: 21606322]
[25]
VandenBos GR. APA dictionary of psychology. Washington, DC: American Psychological Association 2007.
[26]
Tsuchiya N, Koch C, Gilroy LA, Blake R. Depth of interocular suppression associated with continuous flash suppression, flash suppression, and binocular rivalry. J Vis 2006; 6(10): 6.
[http://dx.doi.org/10.1167/6.10.6] [PMID: 17132078]
[27]
Gessler S, Cutting J, Frith CD, Weinman J. Schizophrenic inability to judge facial emotion: A controlled study. Br J Clin Psychol 1989; 28(1): 19-29.
[http://dx.doi.org/10.1111/j.2044-8260.1989.tb00808.x] [PMID: 2924024]
[28]
Caruana N, Inkley C, Zein ME, Seymour K. No influence of eye gaze on emotional face processing in the absence of conscious awareness. Sci Rep 2019; 9(1): 16198.
[http://dx.doi.org/10.1038/s41598-019-52728-y] [PMID: 31700080]
[29]
Gao Z, Zhao W, Liu S, Liu Z, Yang C, Xu Y. Facial emotion recognition in schizophrenia. Front Psychiatry 2021; 12: 633717.
[http://dx.doi.org/10.3389/fpsyt.2021.633717] [PMID: 34017272]
[30]
Berkovitch L, Del Cul A, Maheu M, Dehaene S. Impaired conscious access and abnormal attentional amplification in schizophrenia. Neuroimage Clin 2018; 18: 835-48.
[http://dx.doi.org/10.1016/j.nicl.2018.03.010] [PMID: 29876269]
[31]
Dzafic I, Larsen KM, Darke H, et al. Stronger top-down and weaker bottom-up frontotemporal connections during sensory learning are associated with severity of psychotic phenomena. Schizophr Bull 2021; 47(4): 1039-47.
[http://dx.doi.org/10.1093/schbul/sbaa188] [PMID: 33404057]
[32]
Javitt DC. When doors of perception close: Bottom-up models of disrupted cognition in schizophrenia. Annu Rev Clin Psychol 2009; 5(1): 249-75.
[http://dx.doi.org/10.1146/annurev.clinpsy.032408.153502] [PMID: 19327031]
[33]
Vlcek P, Bob P. Schizophrenia, bipolar disorder and pre-attentional inhibitory deficits. Neuropsychiatr Dis Treat 2022; 18: 821-7.
[http://dx.doi.org/10.2147/NDT.S352157] [PMID: 35422621]