Irony comprehension and context processing in schizophrenia during remission – A functional MRI study

• We examined the neural correlates of irony understanding in schizophrenic patients.
• Schizophrenic patients had significantly poorer performance in irony tasks.
• Patients showed abnormal brain activation patterns during the irony tasks.
• Linguistic help reduced patients’ difficulties to integrate contextual cues.
• Linguistic help evoked similar brain activities in schizophrenic and healthy groups.

Schizophrenic patients have Theory of Mind (ToM) deficits even during remission, but it is yet unknown whether this could be influenced. We examined the neural correlates of irony understanding in schizophrenic patients, as an indicator of ToM capacity, and evaluated how linguistic help inserted into the context phase could affect irony comprehension. Schizophrenic patients in remission and healthy controls were subjected to event-related functional MRI scanning while performing irony, ‘irony with linguistic help’, and control tasks. Patients understood irony significantly worse than healthy controls. The patients showed stronger brain activity in the parietal and frontal areas in the early phase of irony task, however the healthy controls exhibited higher activation in frontal, temporal and parietal regions in the latter phase of the irony task. Interestingly the linguistic help not only improved the patients’ ToM performance, but it also evoked similar activation pattern to healthy controls.