Temporal recalibration in schizophrenia: a compensatory timing trap?

Schizophrenia is characterized by widespread neural dysconnectivity and impaired temporal coordination. Despite these pervasive disruptions, patients often maintain coherent perception and sense of agency, particularly during remission. This paradox remains underexplored, as research has mainly focused on symptom emergence rather than the mechanisms supporting preserved conscious experience. We propose a dual-role hypothesis of sensorimotor temporal recalibration, a process of adaptation to temporal asynchronies in sensorimotor integration. Temporal recalibration may serve both as a compensatory mechanism mitigating neural incoherence and, under certain conditions, as a trigger for positive symptoms. We compared clinically stable schizophrenia patients with healthy controls using a visuomotor temporal-order-judgement task following adaptation to sensorimotor asynchronies (0, 150, 300 ms). Patients exhibited significantly greater temporal recalibration than controls. When they experienced asynchrony between their actions and visual outcomes, they adjusted their point of subjective simultaneity more strongly, indicating enhanced adaptation to new temporal relationships. Consequently, after adaptation, patients were more likely to perceive outcomes as occurring before their actions when the adapted asynchrony was transiently reduced, whereas without adaptation they perceived them as following the action. No group differences emerged in just noticeable differences, indicating comparable temporal precision and task difficulty. These findings suggest that patients not only possess an intact recalibration mechanism but may engage it more to counteract neural delays and preserve temporal coherence. Overreliance on this adaptive process, however, may distort the perceived order of actions and outcomes, especially under transient temporal instability in information processing, and contribute to disrupted causality and agency in schizophrenia.