Lateral interactions in the visual cortex of patients with schizophrenia and bipolar disorder
Open accessAbstract
BACKGROUND: Schizophrenia is associated with perceptual organization deficits and abnormal neuronal connectivity has been described in early visual areas. The purpose of this study was to investigate the functional integrity of lateral connections in early visual areas of patients with schizophrenia and type I bipolar disorder with a history of psychosis. METHOD: Twenty-four out-patients with schizophrenia, 22 out-patients with bipolar disorder, and 20 healthy control subjects participated in the study. Using a computer-assisted psychophysical test, contrast thresholds were measured for centrally presented target stimuli (Gabor patches), which were surrounded by two collinear flankers. Target-to-flanker distances were 0, 1, 2, 3, 4, 6, 9 and 122. Psychophysical measures were contrast threshold changes at each target-to-flanker distance compared with baseline thresholds determined for isolated targets with no flankers. Clinical measures included IQ, positive, negative, and depressive symptoms. Results. In patients with schizophrenia, flankers did not facilitate contrast detection for target stimuli at 2-6 lambda distances compared to controls [effect size (Cohen's d): 1.25-1.42]. The inhibitory effect of flankers (0 and 1lambda) and contrast thresholds in the absence of flankers were spared. Patients with bipolar disorder did not differ from the controls. Medicated and non-medicated patients displayed similar performances. Positive and negative symptoms and depression did not correlate with contrast threshold values. CONCLUSIONS: Excitatory lateral connections in early visual cortex are specifically impaired in patients with schizophrenia, which may contribute to perceptual disorders such as unclear seeing, partial or skewed sight, disrupted rectilinearity, and abnormal figure-ground segregation.
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Patients with schizophrenia do not exhibit a difference in flank facilitation, suggesting a failure in ability to integrate the collinear flankers.
“Patients with schizophrenia do not exhibit such a difference, suggesting a failure in ability to integrate the collinear flankers (53).”
From Visual perception and its impairment in schizophrenia (2008) · cites this paper as [53]
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Cited by
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Visual perception and its impairment in schizophrenia
Butler, P. D., Silverstein, S. M., & Dakin, S. C. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.03.023 · Cited by 472 · see citing works
Silverstein, S. M., & Keane, B. P. (2011) · Schizophrenia Bulletin · doi:10.1093/schbul/sbr052 · Cited by 284 · see citing works
“facilitation and this did not depend on medication status.(26,28) The deficit cannot be blamed on insufficient attention, because the patients performed the same as controls on a secondary task that required making use of the collinear flankers.”
BackgroundWeakened center-surround interactions in visual motion processing in schizophrenia
Tadin, D., Kim, J., Doop, M. L., Gibson, C., Lappin, J. S., Blake, R., & Park, S. (2006) · The Journal of Neuroscience · doi:10.1523/jneurosci.2592-06.2006 · Cited by 182 · see citing works
“Moreover, Keri and colleagues found that weakening of contextual interactions in schizophrenia was correlated with negative symptom severity in one study (Keri et al., 2005b), but not in two related investigations (Must et al., 2004; Keri et al., 2005a).”
BackgroundResultInfluentialSilverstein, S. M., & Rosen, R. B. (2015) · Schizophrenia Research Cognition · doi:10.1016/j.scog.2015.03.004 · Cited by 183 · see citing works
“…in contrast sensitivity (Kelemen et al., 2013; Kiss et al., 2010); various excitatory and inhibitory functions (Kaplan and Lubow, 2011; Keri et al., 2005a; Robol et al., 2013) including those involved in masking (Green et al., 2011) and surround suppression (Tibber et al., 2013); and…”
Visual Perception Disturbances in Schizophrenia: A Unified Model
Silverstein, S. M. (2016) · Nebraska Symposium on Motivation/The Nebraska symposium on motivation · doi:10.1007/978-3-319-30596-7_4 · Cited by 144 · see citing works
Diminished Orientation-Specific Surround Suppression of Visual Processing in Schizophrenia
Yoon, J. H., Rokem, A., Silver, M. A., Minzenberg, M., Ursu, S., Ragland, J. D., & Carter, C. S. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbp064 · Cited by 114 · see citing works
On the functions, mechanisms, and malfunctions of intracortical contextual modulation
Phillips, W. A., Clark, A., & Silverstein, S. M. (2015) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2015.02.010 · Cited by 93 · see citing works
“Compared to controls, patients demonstrate reduced facilitatory effects of collinear flankers on detection of a target at short target-flanker distances (Kéri et al., 2005).”
Silverstein, S. M., & Keane, B. P. (2011) · Schizophrenia Bulletin · doi:10.1093/schbul/sbr053 · Cited by 77 · see citing works
Phillips, W. A., & Silverstein, S. M. (2013) · Frontiers in Psychology · doi:10.3389/fpsyg.2013.00307 · Cited by 75 · see citing works
Schallmo, M., Sponheim, S. R., & Olman, C. A. (2015) · Psychological Medicine · doi:10.1017/s0033291715001439 · Cited by 62 · see citing works
“Our observation of a moderate deficit in surround suppression in BP might reflect an impairment in visual context processing shared among patients with SZ and BP (but see also Chen et al. 2005; Kéri et al. 2005).”
An event-related potential examination of contour integration deficits in schizophrenia
Butler, P. D., Abeles, I. Y., Silverstein, S. M., Dias, E. C., Weiskopf, N. G., Calderone, D., & Sehatpour, P. (2013) · Frontiers in Psychology · doi:10.3389/fpsyg.2013.00132 · Cited by 62 · see citing works
“There is also some, albeit more inconsistent, evidence for bottom-up contributions to perceptual integration deficits in schizophrenia from studies of contour linking over short distances (Spencer et al., 2003; Keri et al., 2005).”
ResultEnhanced mental imagery and intact perceptual organization in schizotypal personality disorder
Maróthi, R., & Kéri, S. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.11.015 · Cited by 58 · see citing works
“6 The procedure was described in our previous studies (Keri, 2015; Keri et al., 2005; Must et al., 2004).”
InfluentialSelf-citationVisual Population Receptive Fields in People with Schizophrenia Have Reduced Inhibitory Surrounds
Anderson, E. J., Tibber, M. S., Schwarzkopf, D. S., Shergill, S. S., Fernández-Egea, E., Rees, G. E., & Dakin, S. C. (2016) · Journal of Neuroscience · doi:10.1523/jneurosci.3620-15.2016 · Cited by 56 · see citing works
“These results, and related findings that patients with SZ exhibit abnormal flanker facilitation (Must et al., 2004; Kéri et al., 2005), have been taken to indicate weaker interactions between orientation detectors, most likely mediated by abnormal horizontal connectivity in V1.”
Yoon, J. H., Sheremata, S., Rokem, A., & Silver, M. A. (2013) · Frontiers in Psychology · doi:10.3389/fpsyg.2013.00681 · Cited by 57 · see citing works
“…abundantly documented in schizophrenia using a wide variety of paradigms (Silverstein et al., 1996, 2013; Must et al., 2004; Dakin et al., 2005; Kéri et al., 2005; Tadin et al., 2006; Uhlhaas et al., 2006b; Chen et al., 2008b; Yoon et al., 2009; Schallmo et al., 2013; Tibber et al., 2013; Yang…”
BackgroundAtypical Lateral Connectivity: A Neural Basis for Altered Visuospatial Processing in Autism
Kéïta, L., Mottron, L., Dawson, M., & Bertone, A. (2011) · Biological Psychiatry · doi:10.1016/j.biopsych.2011.07.031 · Cited by 53 · see citing works
van de Ven, V. G., Rotarska-Jagiela, A., Oertel‐Knöchel, V., & Linden, D. E. J. (2017) · NeuroImage Clinical · doi:10.1016/j.nicl.2017.04.012 · Cited by 52 · see citing works
Serrano‐Pedraza, I., Romero‐Ferreiro, V., Read, J. C. A., Diéguez-Risco, T., Bagney, A., Caballero-González, M., Rodríguez-Torresano, J., & Rodríguez–Jiménez, R. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.01431 · Cited by 48 · see citing works
“Thus, the hypofunction of the NMDA receptors could potentially explain results where a reduced facilitation was found (Must et al., 2004; Kéri et al., 2005).”
BackgroundMethodInfluentialPerceptual organization by proximity and similarity in schizophrenia
Kurylo, D. D., Pasternak, R., Silipo, G., Javitt, D. C., & Butler, P. D. (2007) · Schizophrenia Research · doi:10.1016/j.schres.2007.07.001 · Cited by 46 · see citing works
The Shine-Through Masking Paradigm Is a Potential Endophenotype of Schizophrenia
Chkonia, E. D., Roinishvili, M., Makhatadze, N., Tsverava, L., Stroux, A., Neumann, K., Herzog, M. H., & Brand, A. (2010) · PLoS ONE · doi:10.1371/journal.pone.0014268 · Cited by 47 · see citing works
“In our study, unmasked vernier durations were not significantly longer in relatives of patients compared to controls (however, [31,32] used much longer VDs).”
BackgroundAbnormal contextual modulation of visual contour detection in patients with schizophrenia
Schallmo, M.-P., Sponheim, S. R., & Olman, C. A. (2013) · PLoS ONE · doi:10.1371/journal.pone.0068090 · Cited by 41 · see citing works
“One explanation for our pattern of results is that schizophrenia leads to an overall impairment in contour integration, in agreement with previous reports [8–13,35–39].”
ResultVisual context processing in bipolar disorder: a comparison with schizophrenia
Yang, E., Tadin, D., Glasser, D. M., Wook Hong, S., Blake, R., & Park, S. (2013) · Frontiers in Psychology · doi:10.3389/fpsyg.2013.00569 · Cited by 38 · see citing works
“In the visual perceptual domain, SZ and BD patients perform differently on tasks measuring photoreceptor sensitivity (Balogh et al., 2008), motion discrimination (Chen et al., 2006), and notably, contrast sensitivity modulation by collinear flanking stimuli (Kéri et al., 2005).”
Kelemen, O., Kovács, T., & Kéri, S. (2013) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2013.06.017 · Cited by 34 · see citing works
Self-citationKeane, B. P., Silverstein, S. M., Wang, Y., Roché, M. W., & Papathomas, T. V. (2016) · Schizophrenia Research · doi:10.1016/j.schres.2016.06.015 · Cited by 34 · see citing works
“The rationale is that the DII-relevant positive symptoms are present but muted in bipolar disorder and that other types of visual processing abnormalities in schizophrenia are reduced or absent in bipolar disorder (Jahshan et al., 2014; Kéri et al., 2005a; Yang et al., 2013).”
Individual Differences in Local and Global Perceptual Organization
de‐Wit, L., & Wagemans, J. P. (2014) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199686858.013.028 · Cited by 32 · see citing works
Dima, D., de Jong, S., Breen, G. D., & Frangou, S. (2016) · NeuroImage Clinical · doi:10.1016/j.nicl.2016.10.022 · Cited by 32 · see citing works
“These findings add to the growing evidence of visual information processing abnormalities in patients with BD observed in visual backward masking (McClure, 1999), vernier acuity (Kéri et al., 2005), motion discrimination (Chen et al.”
Silverstein, S. M., Demmin, D. L., & Bednar, J. A. (2017) · Computational Psychiatry · doi:10.1162/cpsy_a_00005 · Cited by 26 · see citing works
Perceptual organization in schizophrenia: Plasticity and state-related change
Silverstein, S. M., & Keane, B. P. (2009) · Learning & Perception · doi:10.1556/lp.1.2009.2.111 · Cited by 28 · see citing works
“, 2000, 2009), and evidence that basic contour linking is impaired (Kéri et al., 2005; Must et al., 2004) even when attention is normal (Keri et al.”
Multiple forms of contour grouping deficits in schizophrenia: What is the role of spatial frequency?
Keane, B. P., Erlikhman, G., Kästner, S., Paterno, D., & Silverstein, S. M. (2014) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2014.10.031 · Cited by 26 · see citing works
“Because prior collinear facilitation studies in schizophrenia did not include subjects with a schizoaffective diagnosis (Kéri et al., 2009; Kéri et al., 2005a; Kéri et al., 2005b; Must et al., 2004), we re-ran the same analyses without this subgroup of patients.”
BackgroundMethodInfluentialVisual system assessment for predicting a transition to psychosis
Diamond, A., Silverstein, S. M., & Keane, B. P. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-02111-9 · Cited by 25 · see citing works
“The facilitation impairment arises among SZ patients with intact attention, intact contrast sensitivity, and 12-week medication washout periods [45, 46].”
BackgroundKeane, B. P., Kästner, S., Paterno, D., & Silverstein, S. M. (2014) · Psychonomic Bulletin & Review · doi:10.3758/s13423-014-0647-9 · Cited by 24 · see citing works
“We opted to present the stimulus on every trial rather than use a two-interval forced choice, since qualitatively the same results arise in the two cases (Kéri et al., 2005) , and since the former allows for a shorter experiment .”
Collinear contextual suppression in schizophrenic patients
Schütze, C., Bongard, I., Marbach, S., Brand, A., & Herzog, M. H. (2007) · Psychiatry Research · doi:10.1016/j.psychres.2006.03.021 · Cited by 22 · see citing works
“Several studies have shown that visual contextual processing and perceptual organization are diminished in schizophrenic patients (e.g. Place and Gilmore, 1980; Silverstein et al., 1996, 2000; Goodarzi et al., 2000; Parnas et al., 2001; Phillips and Silverstein, 2003; Must et al., 2004; Keri et al., 2005).”
BackgroundBressan, P., & Krämer, P. (2013) · Frontiers in Psychology · doi:10.3389/fpsyg.2013.00343 · Cited by 21 · see citing works
Rheenen, T. E. V., Joshua, N. R., Castle, D. J., et al. (2017) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617716001211 · Cited by 21 · see citing works
Altered perception of apparent motion in schizophrenia spectrum disorder
Tschacher, W., Dubouloz, P., Meier, R., & Junghan, U. (2008) · Psychiatry Research · doi:10.1016/j.psychres.2007.04.005 · Cited by 19 · see citing works
“A majority of studies showed impairments of perceptual organization in schizophrenia (Brand et al., 2005; Kéri et al., 2005; Silverstein and Uhlhaas, 2004; Uhlhaas and Silverstein, 2003, 2005), indicating that many persons with schizophrenia appear to have deficient gestalt perception.”
BackgroundAttentional modulation of perceptual organisation in schizophrenia
Kéri, S., Kelemen, O., & Benedek, G. (2009) · Cognitive Neuropsychiatry · doi:10.1080/13546800902757936 · Cited by 19 · see citing works
“Recently, we investigated the basic components of perceptual organisation in schizophrenia, that is, the interactions among three small luminance-contrast gratings, called Gabor patches ( Figure 1 ) (Keri, Kelemen, Benedek, & Janka, 2005 ; Keri, Kiss, Kelemen, Benedek, & Janka, 2005; Must, Janka, Benedek, & Keri, 2004…”
Self-citationDevelopment and Evaluation of a Visual Remediation Intervention for People with Schizophrenia
Seitz, A. R., Ahmed, A. O., Thompson, J. L., D.Butler, P., Silverstein, S. M., Gara, M. A., & Zemon, V. M. (2020) · Journal of Psychiatry and Brain Science · doi:10.20900/jpbs.20200017 · Cited by 16 · see citing works
Contextual suppression and protection in schizophrenic patients
Roinishvili, M., Chkonia, E. D., Brand, A., & Herzog, M. H. (2008) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-007-0780-9 · Cited by 14 · see citing works
“On the other hand, there is clear evidence that contextual facilitation is deteriorated [12, 23 ] and patients need clearly longer SOAs in our paradigm.”
BackgroundInfluentialKeane, B. P., Paterno, D., Crespo, L. P., Kästner, S., & Silverstein, S. M. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.112636 · Cited by 10 · see citing works
Schallmo, M., Sponheim, S. R., & Olman, C. A. (2013) · PLoS ONE · doi:10.1371/annotation/f082ec4d-419c-43ce-ae50-e05107539bf3 · Cited by 8 · see citing works
A neural model of modified excitation/inhibition and feedback levels in schizophrenia
Zhu, J., Zikopoulos, B., & Yazdanbakhsh, A. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1199690 · Cited by 8 · see citing works
Seeing is remembering: Do deficits in closure affect visual memory recognition in schizophrenia?
Brodeur, M. B., Pelletier, M., & Lepage, M. (2008) · Cognitive Neuropsychiatry · doi:10.1080/13546800802341047 · Cited by 6 · see citing works
“This finding goes against several assumptions pointing toward a low-level deficit (Kéri et al., 2005; Must et al., 2004) accompanied with reduced brain activity reflecting these processes (Doniger, Foxe, Murray, Higgins, & Javitt, 2002; Spencer et al.”
BackgroundResultInfluentialPitting temporal against spatial integration in schizophrenic patients
Herzog, M. H., & Brand, A. (2009) · Psychiatry Research · doi:10.1016/j.psychres.2008.03.020 · Cited by 5 · see citing works
“Particularly, contextual spatial interactions between elements in the gratings seem to be intact in our paradigm whereas deficient contextual processing was reported before (e.g. Place and Gilmore, 1980; Silverstein et al., 1996, 2000; Goodarzi et al., 2000; Parnas et al., 2001; Phillips and Silverstein, 2003; Must et…”
BackgroundDissecting perception and memory-driven imagery by boosting GABA-ergic neurotransmission
Kéri, S. (2014) · Vision Research · doi:10.1016/j.visres.2014.10.030 · Cited by 5 · see citing works
“We previously modified the procedure of Polat and Sagi (1993) to fit for patient populations (Kéri et al., 2005a, 2005b; Must et al., 2004).”
MethodSelf-citationJayakumar, S., Ahmed, A. O., Butler, P. D., Silverstein, S. M., Thompson, J. L., & Seitz, A. R. (2024) · Vision Research · doi:10.1016/j.visres.2024.108394 · Cited by 5 · see citing works
“However, an alternative explanation could be the weakened long-range horizontal connections in both striate and extrastriate visual areas (Butler et al., 2008; Keane et al., 2012; K ´ eri et al., 2005).”
BackgroundKeane, B. P., Silverstein, S. M., Papathomas, T. V., & Krekelberg, B. (2024) · PLoS ONE · doi:10.1371/journal.pone.0310678 · Cited by 6 · see citing works
Wang, L.-L., Li, G., Yan, C., Wang, Y., Gao, Y., Wang, Y., Lui, S. S. Y., Li, J., & Chan, R. C. K. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad116 · Cited by 5 · see citing works
Thakkar, K. N., Silverstein, S. M., Fattal, J., Bao, J. Y., Slate, R., Roberts, D., & Brascamp, J. W. (2024) · Schizophrenia Research · doi:10.1016/j.schres.2023.12.029 · Cited by 2 · see citing works
Speed of perceptual grouping in acquired brain injury
Kurylo, D. D., Larkin, G. B., Waxman, R., & Bukhari, F. (2014) · Experimental Brain Research · doi:10.1007/s00221-014-3970-5 · Cited by 1 · see citing works
Center-surround processing in psychosisPreprint
Montoya, S. A., Moser, H. R., Kamath, R. S., Chong, L. S., Grant, A., Marjańska, M., Sponheim, S. R., Engel, S. A., Olman, C. A., & Schallmo, M. (2025) · medRxiv · doi:10.1101/2025.08.15.25333221 · Cited by 1 · see citing works
An fMRI investigation of perceptual impairments on the DS-CPT in Schizophrenia patients.
Force, R. B. (2010) · University of Minnesota Digital Conservancy (University of Minnesota)
Kanani, M., Goodarzi, M. A., & Taghavi, M. R. (2022) · Psychiatry Research Communications · doi:10.1016/j.psycom.2022.100061
Center-Surround Processing in Psychosis
Montoya, S. A., Moser, H. R., Kamath, R. S., Chong, L. S., Grant, A., Marjańska, M., Sponheim, S. R., Engel, S. A., Olman, C. A., & Schallmo, M. (2026) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2026.03.016 · Cited by 1 · see citing works
- Authors
- KÉRI, S., KELEMEN, O., BENEDEK, G., & JANKA, Z.
- Affiliations
- University of Szeged (HU)
- ORCID
- KÉRI, SZABOLCS
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2005-02-07
- Volume
- 35
- Issue
- 7
- Pages
- 1043-1051
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2003742768
- Cited by
- 52
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2020: 1 · 2019: 1 · 2017: 4 · 2016: 4 · 2015: 3 · 2014: 6 · 2013: 8
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- SZTE Publicatio Repozitórium (University of Szeged) (acceptedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Visual perception and processing mechanisms
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Keywords
- schizophrenia, bipolar disorder, lateral interactions, early visual cortex, contrast detection, flanker effect, perceptual organization, figure-ground segregation, antipsychotic drugs, positive and negative symptoms, depression
- MeSH terms
- Adult, Aged, Bipolar Disorder, Female, Humans, Functional Laterality, Male, Middle Aged, Perceptual Disorders, Schizophrenia, Task Performance and Analysis, Visual Cortex, Visual Perception, Case-Control Studies
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