| Summary: | Background: Theory of Mind (ToM) is an ability to infer the mental state of others, which plays an important role during social events. Previous studies have shown that ToM deficits exist frequently in schizophrenia, which may result from abnormal activity in brain regions related to sociality. However, the interactions between brain regions during ToM processing in schizophrenia are still unclear. Therefore, in this study, we investigated functional connectivity during ToM processing in patients with schizophrenia, using functional magnetic resonance imaging (fMRI). Methods: A total of 36 patients with schizophrenia and 33 healthy controls were recruited to complete a ToM task from the Human Connectome Project (HCP) during fMRI scanning. Psychophysiological interaction (PPI) analysis was applied to explore functional connectivity. Results: Patients with schizophrenia were less accurate than healthy controls in judging social stimuli from non-social stimuli (Z = 2.31, <i>p</i> = 0.021), and displayed increased activity in the right inferior frontal gyrus and increased functional connectivity between the bilateral middle temporal gyrus and the ipsilateral parahippocampal gyrus during ToM processing (AlphaSim corrected <i>p</i> < 0.05). Conclusions: Here, we showed that the brain regions related to sociality interact more with the parahippocampal gyrus in patients with schizophrenia during ToM processing, which may reflect a possible compensatory pathway of ToM deficits in schizophrenia. Our study provides a new idea for ToM deficits in schizophrenia, which could be helpful to better understand social cognition of schizophrenia.
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