Inhibition of return in schizophrenic patients: Impaired reorientation, facilitation by stimuli, or both? An eye-movement based study.

This study aimed to explore the mechanisms underlying impaired inhibition of return (IOR) in schizophrenia (SZ) patients, using a cue-target paradigm with eye-tracking experiments. Forty-four SZ patients and thirty healthy controls (HC) completed symptom assessments, single-cue, and double-cue eye-tracking tasks. Hidden Markov Models (HMM) were employed to analyze gaze trajectories on emotional faces. In the single-cue task, SZ patients showed a cue facilitation effect at 300 ms (t = -3.572, P = 0.001) and 600 ms (t = -3.539, P = 0.001). In the double-cue task, they exhibited an IOR effect at 300 ms (t = 2.905, P = 0.006), 600 ms (t = 2.588, P = 0.013), and 800 ms (t = 2.972, P = 0.006). Analysis using HMM revealed two distinct attention patterns among all subjects: Group 1 (local fixation, t = 7.257, P < 0.001, d = 1.21) and Group 2 (global fixation, t = 11.85, P < 0.001, d = 1.92). Additionally, attention patterns were significantly correlated with information processing speed (r = -0.310, P = 0.049) and working memory (r = -0.320, P = 0.041). The study concludes that impaired IOR in SZ results from a combination of masked facilitation effects and reorientation impairments, providing valuable evidence for enhancing the treatment of SZ.