People with schizophrenia cannot hear false notes in music as well as healthy people do, and often cannot make out important tones that convey meaning in speech, U.S. researchers reported on Thursday.

They now want to see if their findings could lead to new ways to treat the disease, either with drugs, therapy or both.

“People have been assuming that patients are experiencing the world normally and not processing the information correctly,” Dr. Daniel Javitt, a psychiatrist and neuroscientist at the New York University School of Medicine in Orangeburg, New York, said in a telephone interview.

“We show they are not experiencing the world normally. They don’t read social cues. They can’t read facial expressions. They can’t tell by tone of voice what emotion a person is showing.”

Their tests on 19 adults with schizophrenia and 19 similar people without the condition showed clear differences, both when assessed using quizzes and looking inside the brain using magnetic resonance imaging, or MRI.

“They can’t use pitch - they just don’t hear those pitch changes. Not only do they not get emotion, they don’t get whether it is a question or a statement. And what we show in the paper is that these sensory abnormalities are driven by structures in the brain, in the connections between the brain stem and the auditory cortex,” Javitt said.

Javitt said the findings, published in the March issue of the American Journal of Psychiatry, might help explain why people with schizophrenia often have poor social skills even before they begin to show symptoms of the disease.

“If we could detect it early and start remediating and start having patients practice, we could hopefully preserve and restore these pathways,” Javitt said.

Schizophrenia occurs in about 1 percent of the population everywhere. It is far more common in men than in women and is usually diagnosed in late adolescence or early adulthood.

But some studies have shown that when the school records of adults with schizophrenia are examined, they showed poor social skills early on.

“They do tend to have been the most socially disturbed,” Javitt said.

His study may help explain it.

“In our behavioral battery, we did a range of tests including the distorted tunes test. You take a common tune and change a note to see if people can tell you if the note has been changed,” Javitt said.

“Then we did another test where we played recorded voices from actors that express different emotions and we asked people to identify the different emotions. We showed that people who had the worst musical abilities were the ones that did worst on the emotions test.”

Javitt wants to find out if there is data on whether professional musicians might be protected from schizophrenia, and would like to see if musical training might be protective.

Another important study would be to see how schizophrenia affects people who speak languages in which tone is even more important than it is in English, such as Chinese or Vietnamese.

Schizophrenia affects 3.2 million Americans. It is characterized by hallucinations, delusions and disordered thinking. While antipsychotic drugs can help, they do not cure the mental illness and cause unpleasant side-effects, including sometimes dangerous weight gain.