Fan Z, Lv KY, Zhang J, Wang TT, Liu XH, Wang WL, Zhou ZH, Zhou HL. Neurobiological mechanisms and clinical implications of scene perception impairment in schizophrenia. World J Psychiatry 2026; 16(8): 120370 [DOI: 10.5498/wjp.120370]
Corresponding Author of This Article
Zhen-He Zhou, MD, PhD, Chief Physician, Professor, Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, No. 156 Qianrong Road, Wuxi 214151, Jiangsu Province, China. zhouzh@jiangnan.edu.cn
Research Domain of This Article
Psychiatry
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review-article
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Fan Z, Lv KY, Zhang J, Wang TT, Liu XH, Wang WL, Zhou ZH, Zhou HL. Neurobiological mechanisms and clinical implications of scene perception impairment in schizophrenia. World J Psychiatry 2026; 16(8): 120370 [DOI: 10.5498/wjp.120370]
Zheng Fan, Jing Zhang, Tian-Tian Wang, Xiao-Hong Liu, Wen-Liang Wang, Zhen-He Zhou, Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi 214151, Jiangsu Province, China
Ke-Ying Lv, Department of Psychiatry, Wuxi Mental Health Center, Wannan Medical College Graduate Training Unit, Wuxi 214151, Jiangsu Province, China
Hong-Liang Zhou, Department of Psychology, The Affiliated Hospital of Jiangnan University, Wuxi 214151, Jiangsu Province, China
Co-first authors: Zheng Fan and Ke-Ying Lv.
Co-corresponding authors: Zhen-He Zhou and Hong-Liang Zhou.
Author contributions: Zhou ZH and Zhou HL designed the study and contributed equally as co-corresponding authors; Fan Z and Lv KY collected and organized the literature, drafted and revised the manuscript and contributed equally as co-first authors; Zhang J, Wang TT, Liu XH, and Wang WL assisted with literature collection and manuscript revision; and all authors contributed to the manuscript revision and approved the final version of the manuscript.
AI contribution statement: In the course of preparing this manuscript, we utilized ChatGPT to enhance the linguistic quality. Following the application of this tool, we conducted a thorough review and made necessary edits to the content, assuming full responsibility for the publication’s final version.
Supported by Wuxi Taihu Talent Project, No. WXTTP 2021.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Zhen-He Zhou, MD, PhD, Chief Physician, Professor, Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, No. 156 Qianrong Road, Wuxi 214151, Jiangsu Province, China. zhouzh@jiangnan.edu.cn
Received: February 26, 2026 Revised: April 27, 2026 Accepted: June 15, 2026 Published online: August 19, 2026 Processing time: 142 Days and 20 Hours
Abstract
As more recognition has been given to scene perception impairments in schizophrenia as a manifestation of abnormal sensorimotor function leading to subsequent social and cognitive decline. Synthesise the findings of event-related potential, functional magnetic resonance imaging (MRI) scanning, structural MRI, and molecular neuroscience techniques. A meta-analysis demonstrated that there was a moderate-to-large decrease in the visual mismatch negativity (g = -0.63), indicating impairments of the automatic prediction-error signal; while abnormal N170 and late positive potentials suggested deficits spreading from early visual analysis to face-selective and socio-affective processing. The structures of the MRIs showed changes in gyrolithogenesis and others to support an objective measurement system for structural-functional relationship. At the mechanical level, N-methyl-D-aspartate receptor hypo-function, parvalbumin interneuron dysfunction, gamma-band disordering, and glial-related neuro-inflammation all affect predictive coding and obtain control together. In practice, these malformations may provide a reason for the inconsistency in the formation of social scenes among some patients when registering partial visual information. Accordingly, we propose that scenes of perception should not be regarded merely as minor visual issues but rather as a clinically significant system-level objective. Visual remediation, neuro-modulatory, ecological evaluation, biomarker-guided intervention have emerged as particularly relevant, but long-term and mechanisms-supported clinical studies are lacking.
Core Tip: Scene perception impairment in schizophrenia is best understood as a multilevel disturbance that begins with early sensory prediction deficits and unfolds through visual-stream dysfunction, network dysconnectivity, and clinically relevant failures in social-scene interpretation. This review incorporates structural magnetic resonance imaging findings, expands the analysis of effective connectivity and feedforward-feedback abnormalities, links molecular evidence across gene, cell, circuit, and computational levels, and sharpens the discussion of translational implications. Taken together, the literature suggests that scene perception may offer a practical bridge between basic visual neuroscience and real-world functional outcomes.
