Abstract Background Schizophrenia is a severe psychiatric disorder characterized by cognitive deficits as well as positive and negative symptoms. It is considered a disorder of widespread network dysconnectivity, including aberrant connectivity between the thalamus and the visual pathway. However, the relationships between the thalamus and various regions of the dorsal and ventral visual pathways in schizophrenia, and how the thalamus affects interactions among these visual regions, remain unclear. Methods Resting-state functional magnetic resonance imaging, task-state functional magnetic resonance imaging, and diffusion tensor imaging data were acquired to examine the neural activity within the thalamus and the visual pathway, along with the relationships between them (i.e., functional connectivity, structural connectivity, and structure-function coupling). We also correlated the altered imaging parameters with clinical characteristics. Furthermore, based on previous molecular imaging in healthy controls, we explored the spatial associations between altered imaging parameters and receptors/transporters distributions. Results We found significantly decreased neural activity and widespread altered thalamo-visual pathway connectivity in both dorsal and ventral pathways in schizophrenia patients. Moreover, schizophrenia patients exhibited altered mediation effects within the thalamo–dorsal visual pathway, involving MT, V1, V2, and V3. Abnormal neural activity and connectivity were related to disease duration and positive symptoms severity. Altered neural activity of MT was correlated with the density of multiple neurotransmitters. Conclusions Our findings further expand our understanding of thalamo-visual pathway dysconnectivity and primary information-processing deficits in schizophrenia, which may be related to clinical symptoms. Our findings may provide more potential insights for non-invasive intervention treatments.
Hou et al. (2026) studied this question.