Theory of mind skills are disrupted in schizophrenia. However, various theory of mind tasks measure different neurocognitive domains. This multimodal neuroimaging study aimed to investigate the neuroanatomical correlates of mental state decoding and reasoning components of theory of mind in schizophrenia and healthy controls (HCs) using T1-weighted and diffusion-weighted (DTI) magnetic resonance imaging (MRI). Sixty-two patients with schizophrenia and 34 HCs were included. The Reading the Mind in the Eyes (RMET) and Hinting tests were used to evaluate mental state decoding and reasoning, respectively. Correlations between social cognition and cortical parameters (thickness, volume, surface area), or DTI scalars (fractional anisotropy, axial diffusivity, radial diffusivity) were cluster-based corrected for multiple comparisons. In schizophrenia, RMET scores showed positive correlations in 3 clusters, including left insula thickness, right superior-temporal thickness, left superior-temporal-sulcus volume, and DTI analysis revealed that fractional anisotropy showed positive correlations in 3 clusters, including right inferior-fronto-occipital fasciculus, left forceps-major, left inferior-fronto-occipital fasciculus. In schizophrenia, Hinting test scores showed positive correlations in 3 clusters in T1-weighted MRI, including left superior-temporal-sulcus volume, left superior-temporal-sulcus surface area, left pars-orbitalis volume. In conclusion, this study provided evidence for the involvement of particular cortical regions and white matter tracts in mental state decoding and reasoning.

精神分裂症患者的心理理论技能受到破坏。然而，各种心理理论任务测量不同的神经认知领域。这项多模态神经影像研究旨在使用 T1 加权和扩散加权 (DTI) 磁共振成像 (MRI) 来研究精神分裂症和健康对照组 (HC) 的精神状态解码和心理理论推理成分的神经解剖学相关性。包括 62 名精神分裂症患者和 34 名 HC。眼中读心（RMET）和暗示测试分别用于评估心理状态解码和推理。社会认知和皮质参数（厚度、体积、表面积）或 DTI 标量（分数各向异性、轴向扩散率、径向扩散率）之间的相关性进行基于聚类的校正，以进行多重比较。在精神分裂症中，RMET 评分在 3 个簇中显示正相关，包括左侧岛叶厚度、右侧颞上厚度、左侧颞上沟体积，DTI 分析显示分数各向异性在 3 个簇中显示正相关，包括右侧额下叶-枕叶束、左钳大束、左额下枕叶束。在精神分裂症中，T1加权MRI中Hinting测试分数显示3组呈正相关，包括左侧颞上沟体积、左侧颞上沟表面积、左侧眼眶部体积。总之，这项研究为特定皮质区域和白质束参与精神状态解码和推理提供了证据。