Table 1.
Summary of Included Studies (n = 35)
| Citation | Sample | SZ Age (Mean or Range) | Control Age (Mean or Range) | Methods | Summary of Results | Medication Effect | Symptom Associations |
|---|---|---|---|---|---|---|---|
| Mimicry | |||||||
| Riehle and Lincoln41 |
N = 28 SZ N = 28 HC N = 28 HC confederate |
41.7 (10.7) | 43.0 (12.1) | EMG | No group differences in mimicry. | None | Disorganized symptoms |
| Torregrossa et al12 |
N = 21 SZ N = 23 HC |
47.90 (7.83) | 45.65 (8.17) | EMG | Intact facial mimicry of emotions in SZ despite worse emotion recognition. | None | NA |
| Chechko et al13 |
N = 20 SZ N = 15 HC |
38.04 (10.11) | 39.81 (10.9) | EMG | SZ group was slower to respond with facial mimicry. | NA | None |
| Raffard et al42 |
N = 19 SZ N = 19 HC |
31.9 (9.4) | 30.5 (8.4) | Virtual reality avatar with motion tracking. | No group differences in mimicry. The mimicry condition produced greater rapport between avatar and participants. | None | None |
| Steimer-Krause et al43 |
N = 20 SZ N = 10 other psychopathology N = 50 HC |
19–42 | 19–57 | Observational study | SZ group showed lower facial expressivity although healthy controls also showed lower expressivity when interacting with schizophrenia patients compared to other clinical and nonclinical groups. | NA | NA |
| Varcin et al44 |
N = 25 SZ N = 25 HC |
42.9 (9.43) | 39.2 (10.85) | EMG | SZ group showed atypical pattern of corrugator and zygomaticus muscle activity revealing difficulty in facial mimicry. | None | None |
| Berndl et al45 |
N = 81 SZ N = 78 HC |
35.9 (11.9) | 40.3 (16.9) | Observational study | SZ group showed more errors in mimicry and had difficulty recognizing mimicry expressions in others. | None | None |
| Sestito, et al46 |
N = 15 SZ N = 15 HC |
32.8 (1.69) | 35.80 (2.28) | EMG | SZ group showed less zygomaticus muscle activity during positively valenced stimuli. No differences were found with negatively valenced stimuli. | NA | NA |
| Imitation | |||||||
| Simonsen et al47 |
N = 33 SZ N = 40 HC |
36.7 (10.1) | 39.3 (10.5) | Automatic imitation | SZ group showed enhanced imitation compared to controls after controlling for cognitive, motor, and emotional processes | Imitation was positively correlated with higher medication dosage | None |
| Butler et al40 |
N = 20 high schizotypy N = 20 low schizotypy |
- | 21.62 (5.41) | Automatic imitation | No difference in automatic imitation between high and low schizotypy. | NA | None |
| Thakkar et al48 |
N = 16 SZ N = 16 HC |
40.2 (9.1) | 37.4 (7.0) | Automatic imitation, fMRI | SZ group showed lower activation in the mirror neuron system during imitative vs nonimitative action. | Higher dosage of medication were associated with more normal mirror neuron system activation | NA |
| Dankinas et al49 |
N = 14 SZ N = 15 HC |
37.1 (13.9) | 39.9 (13.5) | Automatic imitation | SZ group were slower in responding to imitative and counter-imitative finger press compared to controls | None | NA |
| Horan et al50 |
N = 23 SZ N = 23 HC |
46.5 (11.1) | 46.7 (6.9) | Automatic imitation, fMRI | No group differences in brain activation for imitation of finger or facial movement. | None | Negative symptoms |
| Matthews et al51 |
N = 14 SZ N = 14 HC |
40.2 (8.6) | 40.0 (10.2) | Automatic imitation | Gesture imitation was impaired in SZ group when imitation depended upon working memory and multiple actions. | None | Negative symptoms |
| Stegmayer et al52 |
N = 45 SZ N = 44 HC |
38.24 (11.37) | 38.77 (13.58) | Test of Upper Limb Apraxia, Voxel based morphometry | SZ group performed worse across imitation and pantomime domains. 13% of patients showed deficits below recommended cutoff for imitation. Pantomime deficits were associated with decreased gray matter in hippocampus, insula, parietal cortex, and superior temporal gyrus. | None | NA |
| Stegmayer et al53 |
N = 14 FEP SZ N = 14 chronic SZ N = 16 HC |
27.2 (8.5) | 28.1 (4.6) | Test of Upper Limb Apraxia | Imitation abilities were lowest in chronic SZ. FEP patients were worse than healthy controls. |
None | NA |
| Viher et al54 |
N = 40 SZ N = 41 HC |
38.61 (9.24) | 38.93 (13.69) | Test of Upper Limb Apraxia, cortical thickness | SZ group with gesture deficits showed reduced cortical thickness in inferior parietal cortex, middle temporal gyrus, inferior frontal gyrus, primary motor, superior parietal cortex, supramarginal gyrus, and insula compared to healthy controls. | None | None |
| Walther et al55 |
N = 46 SZ N = 44 HC |
37.96 (11.17) | 38.77 (13.58) | Test of Upper Limb Apraxia, Tool Use Test, Postural Knowledge task, Test of Nonverbal Intelligence | SZ group showed uniform impaired nonverbal communication across all 4 tasks. Within the SZ group, gesture performance was associated with nonverbal social perception, gesture knowledge and tool use. Motor and cognitive abilities were associated with impaired nonverbal communication. Motor and cognitive abilities partially mediated the association between nonverbal perception and gesture performance. | None | Positive symptoms inversely correlated with nonverbal social perception/gesture performance |
| Walther et al56 | N = 30 SZ | 41.1 (11.95) | - | Test of Upper Limb Apraxia | SZ group was uniformly impaired on both imitative and pantomime gestures. In pantomime gestures, patients were more impaired when performing meaningless gestures. Pantomimed meaningless gestures were correlated with the Frontal Assessment Battery | Gestural deficits correlate with high antipsychotic medication dosage. | NA |
| Walther et al57 |
N = 30 SZ N = 30 HC |
40.2 (-) | 42.2 (-) | Test of Upper Limb Apraxia | 40% of SZ group showed gesture impairment during pantomime and 23% showed impairment with imitation. Impaired pantomime was associated with frontal lobe function. Imitation was associated with catatonia and wrist actigraphy. | Gestural deficits correlate with high antipsychotic medication dosage. | Negative symptoms |
| Lee et al58 |
N = 15 SZ N = 16 HC |
36.7 (8.1) | 36.8 (6.3) | Facial expression imitation, fMRI | SZ group was less expressive for both happiness and sadness than healthy controls. However, poor expressiveness did not result from deficits in emotional recognition. Also, there were increased irrelevant responses when faced with facial/word expressions. | None | Negative symptoms |
| Falkenberg et al59 |
N = 17 SZ N = 17 HC |
28.2 (7.4) | 27.6 (5.4) | Facial expression imitation, EMG | Reaction times were slower in SZ group. SZ group tended to show more incongruence between their increased smiling and negatively valenced facial pictures. | NA | Total symptoms |
| Mazza et al60 | N = 32 SZ | 24.45 (2.14) | - | Emotion and ToM Imitation Training (ETIT) | Social cognition improved following ETIT. | NA | NA |
| Park et al61 |
N = 20 SZ N = 16 HC |
38.6 (10.3) | 37.9 (8.6) | Imitation of hand and facial features | SZ group showed less accurate imitation than healthy controls. | NA | Total BPRS and negative symptoms |
| Schwartz et al62 |
N = 20 SZ N = 10 HC |
46.2 (10.9) | 12.9 (1.9) | Facial imitation of expressed emotion | SZ group was less accurate at imitating facial expressions than healthy controls. | Medication dose was positively associated with impaired imitation of disgust | NA |
| Interpersonal synchrony | |||||||
| Słowiński et al63 | Study 1: N = 30 SZ, N = 29 HC. Study 2: N = 22 SZ, N = 22 HC | 18–58 | 19–49 | Mirror game with iCub Robot | Majority rule classification found that features of synchronized motor activity with computer avatar and iCub robot could be used to predict schizophrenia with 93% accuracy and 100% specificity. | None | NA |
| Raffard et al64 |
N = 45 SZ N = 45 HC N = 90 SZ |
18–61 | 18–56 | Joint action task using a wrist pendulum | When given a pro-social priming prior to pendulum task, SZ group showed greater stability of synchronization. Pro-social priming increased stability of synchronization. Increased synchronization was related to more interpersonal rapport between schizophrenia and healthy comparison subjects. | NA | None |
| Kupper et al65 | N = 27 SZ | - | - | Motion energy analysis | Lower synchrony was associated with the severity of symptoms, social cognition and functioning, self-esteem. | NA | Negative symptoms were inversely associated with imitation of patients towards their partner. Positive symptoms were associated with worse imitation from interactional partners. |
| Del-Monte et al29 |
N = 27 relatives N = 27 HC N = 54 HC confederate |
61.37 (6.48) | 59.74 (6.99) | Joint action task using a wrist pendulum | Relatives of SZ patients showed less coordination during intentional motor synchronization. | NA | None |
| Cohen et al66 |
N = 22 SZ N = 22 HC |
21–45 | 19–46 | Synchronized arm movements with an iCub robot | SZ group showed lower overall synchrony with the robot. Social feedback did not have a facilitatory effect on synchrony. | Antipsychotic medication had an impeding effect on synchrony. | Negative symptoms |
| Lavelle et al67 |
N = 20 SZ N =100 HC |
41.50 (8.64) | 31.10 (9.60) | Video motion capture during a 3-person interaction | SZ group speak less and gesture less. More gestures made by patients was associated with less rapport. | Coordination between participants inversely correlated with antipsychotic medication. | Negative symptoms were associated with less nodding and more gestures when speaking. Patients with more positive symptoms nodded more when listening. Patients’ partners displayed less listener nodding when patients were more symptomatic. |
| Varlet et al68 |
N = 20 SZ 2 separate (N = 20) HC groups |
38.15 (10.19) | 35.60 (14.74) | Joint action task using a wrist pendulum | Intentional coordination is impaired in schizophrenia. Unintentional coordination remains intact. | None | None |
| Galbusera et al69 | N = 16 SZ | 42 (12.7) | - | Motion energy analysis | Interactional synchrony improved following therapy. | NA | Negative symptoms |
| Ellgring et al11 | N = 10 SZ | 17–46 | - | Facial Action Coding System (FACS), gesture, nonverbal behavior, gaze and speech patterns between interactional partners | Both relatives and schizophrenia patients showed lower than expected facial expressivity in speaker roles. | NA | NA |
| Hardin et al70 |
N = 6 SZ N = 6 HC |
20–35 | - | Observational study | HC-HC and HC-SZ showed ability to synchronize legs but SZ-SZ dyads did show any synchronization. Oscillations were only observed in SZ-SZ dyads. Dyads involving SZ showed more imitation behaviors. | NA | NA |
Note: A Pubmed, Web of Science, and Psychinfo database search was performed for studies involving interpersonal coordination and separated into 3 domains: mimicry, imitation, and interactional synchrony. EMG, electromyography; HC, healthy controls; NA, not assessed; None, no association; SZ, patients with schizophrenia. Age range or mean (SD) for patient and comparison groups is provided when possible. A (-) denotes data that are not available.