Neural mechanisms underlying visual and auditory processing impairments in schizophrenia: insight into the etiology and implications for tailoring preventive and therapeutic interventions.

Schizophrenia is a complex and devastating neuropsychiatric disorder with an unknown etiology. Patients with schizophrenia have a high prevalence of visual disturbances, commonly accompanied by auditory impairments. In recent review articles, the perceptual deficits of visual and auditory sensory processing have been downplayed. However, visual and auditory impairments are associated with hallucinations, which is characteristic of schizophrenia across all cultures. Despite decades of research, the common neural mechanisms underlying hallucinations remain largely unknown. In recent years, neuroimaging technologies have empowered researchers to investigate the underlying neural mechanisms. In this review article, we performed a literature search of studies that assessed visual and auditory processing impairments, along with their relationship to visual disturbances and auditory hallucinations, in schizophrenia. We proposed that the pulvinar may play a critical role. In addition, disrupted visual and auditory projections from the pulvinar to the visual and auditory cortices could be shared pathways in relation to visual disturbances and auditory hallucinations in schizophrenia. Our findings suggest that early visual and auditory processing deficits may occur before the onset of the initial psychotic episode, including hallucinations, and the full manifestation of schizophrenia. Furthermore, we discussed the directions for future studies. Our findings from this review offer unique insights into the distinct underlying neural mechanisms of schizophrenia, which may help develop tailored preventive and therapeutic interventions in the future.