S78. TIME PREDICTION AND SENSE OF SELF: LACK OF FLEXIBILITY IN PATIENTS WITH SCHIZOPHRENIA
Authors: Giersch Anne , Martin Brice , van der Burg Erik 
Published: May 2020

Abstract

Background
The sense of time continuity appears to be disturbed in pathologies like schizophrenia, associated with a disruption of the sense of self, and of the feeling of being immersed in the world. Prediction mechanisms have been proposed to be involved in the sense of time continuity by helping to relate discontinuous events, and our previous studies have suggested that these mechanisms may occur even at the millisecond level. Such mechanisms would be involved in our ability to interact with the outer world, by helping to follow events accurately in both space and time. We explored prediction mechanisms and attention shifts based on recently experienced sequences of visual information (sequential effects).

Methods
26 patients with schizophrenia and 20 matched controls were included in asynchrony discrimination tasks, and assessments of minimal self disorders with the EASE. On each trial, two stimuli are displayed with varying stimulus onset asynchronies (SOA). Subjects decide whether the stimuli are simultaneous or asynchronous and give manual responses. Sequential effects were explored further in several groups of 15 healthy participants.

Results
The main finding in controls is a strong accuracy advantage for different- as compared to same-order trials, but only when trial t is with an SOA slightly larger than trial t-1 (advantage of 16% in accuracy), or equivalent (advantage of 10% in accuracy). An advantage for same-vs. different-order trials is observed only when the SOA on the previous trial is large and visible. In patients, there is no advantage for same-order trials. There is a clear advantage for different-order trials (advantage of 16% in accuracy), but this effect disappears, contrary to controls, when SOAs are equivalent on successive trials (1% difference in accuracy). The impairment in the trial-to-trial effects in patients correlates with minimal self disorders (the EASE).

Discussion
Further investigations in healthy participants suggest that the sequential effects can be explained in terms of prediction of stimulus sequences from trial to trial, which are accompanied by an attention shift. The first stimulus triggers the onset of the sequence, and attention is then covertly shifted in space and time according to the previous trial, in order to attend to the second stimulus. This explains the advantage for different-order trials: when order is reversed on the present trial, attention ends up in the location of the first stimulus of the present sequence. This first stimulus is perceived as isolated on the screen if the second stimulus occurs later than on the previous trial, thus facilitating the detection of an asynchrony. The asynchrony is then obvious, explaining the large amplitude of the effect. The fact that the effect extends to the condition in which SOAs are equivalent on successive trials suggests that participants shift their attention in advance, as if anticipating the location of the second stimulus. This is impaired in patients, who replay sequences of events, but do not anticipate the successive events flexibly. This would impair their immersion in the world, where events rarely happen twice at the same time exactly.