Evidence of altered cortical and amygdala activation during social decision-making in schizophrenia.

Impaired social cognition is a frequently observed and disabling characteristic of schizophrenia. An important aspect of social cognition involves making social decisions about others. The present study investigates whether brain activity related to social decision-making differs between patients with schizophrenia and healthy controls. Twelve patients with schizophrenia and 21 control subjects participated in the study. Behavioral performance and brain activity were assessed during a task that involved judging the trustworthiness of faces. We performed region-of-interest-based analyses, which revealed that patients with schizophrenia display specific increases and reductions in activation of the medial orbitofrontal cortex, amygdala and the right insula during social decision-making, areas that play key roles in the network that underlies social decisions. These findings suggest that the impairments in social cognition that are often observed in schizophrenia are, at least in part, related to altered brain activity in these areas.