Altered language–salience network connectivity in schizophrenia and differential associations with emotion regulation

Introduction: Emotion regulation is a key domain of social cognition, and its impairment contributes to poor psychosocial functioning in schizophrenia (SZ). The “Managing Emotions” (ME) branch of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) is widely used to assess this ability, yet its neural correlates remain unclear. Methods: We examined resting-state functional connectivity (rsFC) associated with MSCEIT-ME performance in 56 patients with schizophrenia and 56 healthy controls matched for age, sex, and years of education. Seed-based correlation analyses focused on three large-scale networks previously implicated in emotion regulation: the salience network (SN), the language network (LN), and the ventral attention network (VAN). Between-group differences and brain–behavior relationships were tested while controlling for IQ scores on the Wechsler Abbreviated Scale of Intelligence (WASI). False discovery rate Benjamini-Yekutieli (FDR-BY) correction was applied to all analyses. Results: Patients with SZ scored significantly lower on the MSCEIT-ME compared to healthy subjects (HCs). Moreover, SZ patients exhibited reduced left-lateralized rsFC between SN and LN regions relative to HCs. These findings indicate altered language–salience connectivity in schizophrenia and show that, while connectivity is associated with emotion regulation ability in healthy individuals, no significant brain–behavior association was detected in patients. Therefore, the neural mechanisms underlying emotion regulation deficits in schizophrenia remain to be clarified. Conclusion: Schizophrenia was characterized by altered left-lateralized language–salience connectivity. However, because no significant brain–behavior associations were found in patients, the neural basis of emotion-regulation deficits in schizophrenia remains unresolved, highlighting the need for network-level investigations in larger samples.