Temporal Recalibration in Schizophrenia: A Compensatory Timing Trap?

BackgroundSchizophrenia is characterised by widespread neural dysconnectivity and impaired temporal coordination. Despite these pervasive disruptions, patients can maintain coherent perception and functional behaviour, particularly during remission. This paradox is underexplored in the literature, which has primarily focused on symptom emergence. We propose a dual-role hypothesis of sensorimotor temporal recalibration, a process known for adapting to temporal discrepancies in sensorimotor integration. We hypothesise that temporal recalibration may serve both as a compensatory mechanism mitigating neural incoherence and as a trigger for positive symptoms. MethodTo investigate its compensatory role, we compared 20 clinically stable schizophrenia patients to 20 matched healthy controls using a visuomotor temporal order judgement task following adaptation to varying sensorimotor asynchronies (0, 150 and 300 ms). ResultsOur findings revealed that patients with schizophrenia exhibited significantly greater temporal recalibration compared to controls. Across participants, recalibration was stronger for longer delays. No group differences were observed in just noticeable differences (JNDs) suggesting comparable task difficulty and temporal precision. ConclusionsThese findings suggest that patients not only have an intact temporal recalibration mechanism but also may engage it more to counteract neural delays and preserve temporal coherence. We further propose that overreliance on this adaptive mechanism may paradoxically contribute to symptom emergence under conditions of temporal instability by distorting the perceived order of actions and their sensory consequences. This dual-role hypothesis offers a novel perspective for understanding how the same temporal mechanism can sustain perceptual coherence, yet under certain conditions, contribute to the breakdown of causality and agency, which underlie control delusions and hallucinations.