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Zanello A, Perez AG, Maksimovic J, Wood S, Sentissi O. Validation and clinical usefulness of the Hamilton Program for Schizophrenia Voices Questionnaire (HPSVQ) among French-speaking voice-hearers. L'ENCEPHALE 2024; 50:300-308. [PMID: 37718200 DOI: 10.1016/j.encep.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 09/19/2023]
Abstract
Auditory verbal hallucinations (AVH), also called voices, are often distressing to individuals experiencing them. Valid and reliable instruments are necessary to document the hearing voices experience across cultures. The Hamilton Program for Schizophrenia Voices Questionnaire (HPSVQ) is becoming a widely used self-administered instrument for assessing characteristics, content and subjective effect of AVH. This study investigates the psychometric characteristics of the HPSVQ French version (HPSVQ FV) in a clinical sample of voice-hearers. The results showed that the HPSVQ yields a global score (HPSVQ-Global) as well as a distress (HPSVQ-Distress) and a severity (HPSVQ-Severity) sub-score having good, acceptable and questionable internal consistency respectively. Significant correlations were found between hallucination severity (BPRS 4.0), distress (PSYRATS-AH), voices acceptance (VAAS-9), anxiety and depression (HADS). However, no significant associations were observed between Suspicion and Unusual Thoughts (BPRS 4.0). At a one-week interval, the temporal stability of the three indices was excellent. Moreover, after a brief cognitive intervention, a significant reduction was observed in all indices. Taken together, the HPSVQ FV demonstrated good construct validity, reliability and sensitivity to change. These findings support the use of the HPSVQ in francophone clinical and research settings. However, the bi-factorial solution of the HPSVQ FV should be further examined in larger samples.
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Affiliation(s)
| | | | | | - Sophie Wood
- HUG Department of Psychiatry, Geneva, Switzerland
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2
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Dollfus S, Letourneur F, Métivier L, Moulier V, Rothärmel M. Self-assessment scale of auditory verbal hallucinations (SAVH): A novel tool for patients with schizophrenia. Schizophr Res 2024; 267:19-23. [PMID: 38513330 DOI: 10.1016/j.schres.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/18/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND A scale for self-assessment of auditory verbal hallucinations (SAVH) was developed for patients, and this study aimed to validate the scale by investigating its psychometric properties. METHODS Forty one patients with schizophrenia or schizoaffective disorders (DSM-5) self-assessed their hallucinations using nine SAVH questions. Each question was scored from 0 to 5, indicating the severity of the symptoms. Patients were also evaluated with the Brief Psychiatric Rating Scale (BPRS), Auditory Hallucination Rating Scale (AHRS), and Birchwood Insight Scale (BIS). The psychometric properties of the SAVH were assessed by the face, internal consistency, construct, convergent and discriminant validities. RESULTS SAVH scores were used to examine the psychometric properties. Cronbach's α and Guttman's Lambda-6 were 0.67 and 0.73 respectively. Significant correlations were observed between SAVH and AHRS total scores, as well as BPRS hallucinatory behavior subscores. No significant correlations were found between total SAVH scores and (i) levels of insight or (ii) negative BPRS subscores. Factor analysis on SAVH revealed three factors accounting for 59.3 % of the variance. Most patients found the questions clear, appropriate, and of adequate length. CONCLUSIONS SAVH demonstrated good psychometric properties, suggesting its utility in assessing auditory verbal hallucinations (AVH). This self-assessment could be valuable in evaluating AVH treatment efficacy, monitoring AVH, and empowering patients.
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Affiliation(s)
- Sonia Dollfus
- Inserm UMR-S 1237 PhIND, Presage team, GIP Cyceron, 14000 Caen, France; Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France; CHU de Caen, Service de Psychiatrie, 14000 Caen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France.
| | - Florian Letourneur
- Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France; CHU de Caen, Service de Psychiatrie, 14000 Caen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France
| | - Lucie Métivier
- Inserm UMR-S 1237 PhIND, Presage team, GIP Cyceron, 14000 Caen, France; Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France
| | - Virginie Moulier
- Centre Hospitalier du Rouvray, Service Hospitalo-Universitaire de Psychiatrie, Centre Thérapeutique d'Excellence, 76300 Sotteville-lès-Rouen, France; Unité de Recherche Clinique (URC), EPS Ville Evrard, Neuilly-sur-Marne, France
| | - Maud Rothärmel
- Inserm UMR-S 1237 PhIND, Presage team, GIP Cyceron, 14000 Caen, France; Centre Hospitalier du Rouvray, Service Hospitalo-Universitaire de Psychiatrie, Centre Thérapeutique d'Excellence, 76300 Sotteville-lès-Rouen, France; Fédération Hospitalo-Universitaire (FHU) A2M2P- CHU, Caen 14000, France
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3
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Aldhafeeri FM. Altered brain responses to emotional auditory stimuli in AVH subjects: an fMRI study. Int J Neurosci 2024; 134:333-340. [PMID: 35849653 DOI: 10.1080/00207454.2022.2102977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 03/07/2022] [Accepted: 06/30/2022] [Indexed: 10/17/2022]
Abstract
Purpose: Auditory verbal hallucinations (AVH) are a frequently occurring phenomenon in which subjects hear verbal sounds in the absence of any external stimuli. The prevalence of auditory hallucinations in schizophrenia has been revealed in many studies. Healthy subjects may also experience auditory hallucinations without accompanying psychological or neurological disorders, and in rare cases they seek clinical assistance for this emotionally disturbing condition. The aim of this study was to investigate the neural basis of emotional disturbance in auditory hallucinating subjects who do not suffer from any psychological or neurological disorder. Materials and Methods: Fourteen subjects suffering from auditory hallucinations and 15 age- and sex-matched healthy controls were recruited in this study. All participants underwent fMRI in two experimental sessions. In the first experimental session, all participants from both groups listened to pleasant auditory stimuli. In the second session, both groups listened to unpleasant auditory stimuli. The auditory stimuli were obtained from the International Affective Digitized Sounds (IADS). Results: Compared with the healthy control group, AVH subjects exhibited significantly increased activation in limbic, auditory, and frontal regions. Conclusion: Current results suggest that AVH may induce functional reorganization in emotion-related brain regions.
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Affiliation(s)
- Faten Mane Aldhafeeri
- Department of Radiology, College of Applied Medical Sciences, University of Hafr Albatin, Hafr Albatin, Saudi Arabia
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Zanello A, Mutanda D, Sentissi O, Hayward M. Coping Strategy Enhancement for Auditory Verbal Hallucinations Within Routine Clinical Practice. J Nerv Ment Dis 2023; 211:79-82. [PMID: 36596290 DOI: 10.1097/nmd.0000000000001589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
ABSTRACT Auditory verbal hallucinations (AVH) are often multiple distressing experiences. Emerging evidence suggests that interventions informed by the principles of cognitive behavioral therapy, such as brief Cognitive Strategy Enhancement (brief-CSE), can reduce the distress related to AVH. The benefits of brief-CSE have been demonstrated for English-speaking patients. This uncontrolled pilot study, conducted in routine clinical practice, evaluated the benefits of brief-CSE within a group of French-speaking AVH hearers. Thirty-two patients were offered the brief-CSE intervention. Self-administered questionnaires were completed pre-post intervention. A significant reduction was observed in AVH distress, with a large effect size, and for more than half of the patients, this reduction was clinically meaningful. AVH severity and anxiety also decreased significantly. This study demonstrates that brief-CSE can be implemented in non-English-speaking routine clinical practice and can reduce several aspects of AVH subjective experience. There is a need to confirm these findings in a larger sample.
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Affiliation(s)
- Adriano Zanello
- HUG Department of Mental Health and Psychiatry, University Hospitals of Geneva, Thônex, Switzerland
| | - Daniel Mutanda
- R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove
| | - Othman Sentissi
- HUG Department of Mental Health and Psychiatry, University Hospitals of Geneva, Thônex, Switzerland
| | - Mark Hayward
- School of Psychology, University of Sussex, Brighton, United Kingdom
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Collins L, Brezina V, Demjén Z, Semino E, Woods A. Corpus linguistics and clinical psychology: Investigating personification in first-person accounts of voice-hearing. INTERNATIONAL JOURNAL OF CORPUS LINGUISTICS 2023; 28:28-59. [PMID: 37090241 PMCID: PMC7614468 DOI: 10.1075/ijcl.21019.col] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Triangulating corpus linguistic approaches with other (linguistic and non-linguistic) approaches enhances "both the rigour of corpus linguistics and its incorporation into all kinds of research" (McEnery & Hardie, 2012:227). Our study investigates an important area of mental health research: the experiences of those who hear voices that others cannot hear, and particularly the ways in which those voices are described as person-like. We apply corpus methods to augment the findings of a qualitative approach to 40 interviews with voice-hearers, whereby each interview was coded as involving 'minimal' or 'complex' personification of voices. Our analysis provides linguistic evidence in support of the qualitative coding of the interviews, but also goes beyond a binary approach by revealing different types and degrees of personification of voices, based on how they are referred to and described by voice-hearers. We relate these findings to concepts that inform therapeutic interventions in clinical psychology.
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Affiliation(s)
- Luke Collins
- Linguistics and English Language, Lancaster University
| | | | | | - Elena Semino
- Linguistics and English Language, Lancaster University
| | - Angela Woods
- Department of English Studies, Durham University
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Johnson JF, Belyk M, Schwartze M, Pinheiro AP, Kotz SA. Hypersensitivity to passive voice hearing in hallucination proneness. Front Hum Neurosci 2022; 16:859731. [PMID: 35966990 PMCID: PMC9366353 DOI: 10.3389/fnhum.2022.859731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/29/2022] [Indexed: 11/21/2022] Open
Abstract
Voices are a complex and rich acoustic signal processed in an extensive cortical brain network. Specialized regions within this network support voice perception and production and may be differentially affected in pathological voice processing. For example, the experience of hallucinating voices has been linked to hyperactivity in temporal and extra-temporal voice areas, possibly extending into regions associated with vocalization. Predominant self-monitoring hypotheses ascribe a primary role of voice production regions to auditory verbal hallucinations (AVH). Alternative postulations view a generalized perceptual salience bias as causal to AVH. These theories are not mutually exclusive as both ascribe the emergence and phenomenology of AVH to unbalanced top-down and bottom-up signal processing. The focus of the current study was to investigate the neurocognitive mechanisms underlying predisposition brain states for emergent hallucinations, detached from the effects of inner speech. Using the temporal voice area (TVA) localizer task, we explored putative hypersalient responses to passively presented sounds in relation to hallucination proneness (HP). Furthermore, to avoid confounds commonly found in in clinical samples, we employed the Launay-Slade Hallucination Scale (LSHS) for the quantification of HP levels in healthy people across an experiential continuum spanning the general population. We report increased activation in the right posterior superior temporal gyrus (pSTG) during the perception of voice features that positively correlates with increased HP scores. In line with prior results, we propose that this right-lateralized pSTG activation might indicate early hypersensitivity to acoustic features coding speaker identity that extends beyond own voice production to perception in healthy participants prone to experience AVH.
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Affiliation(s)
- Joseph F. Johnson
- Department of Neuropsychology and Psychopharmacology, University of Maastricht, Maastricht, Netherlands
| | - Michel Belyk
- Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - Michael Schwartze
- Department of Neuropsychology and Psychopharmacology, University of Maastricht, Maastricht, Netherlands
| | - Ana P. Pinheiro
- Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
| | - Sonja A. Kotz
- Department of Neuropsychology and Psychopharmacology, University of Maastricht, Maastricht, Netherlands
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- *Correspondence: Sonja A. Kotz,
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7
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Volpato E, Cavalera C, Castelnuovo G, Molinari E, Pagnini F. The "common" experience of voice-hearing and its relationship with shame and guilt: a systematic review. BMC Psychiatry 2022; 22:281. [PMID: 35443637 PMCID: PMC9022353 DOI: 10.1186/s12888-022-03902-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite Auditory Verbal Hallucinations (AVHs) having been long associated with mental illness, they represent a common experience also in the non-clinical population, yet do not exhibit distress or need for care. Shame and guilt are emotions related to one's perception of oneself and one's responsibility. As such, they direct our attention to aspects of AVHs that are under-researched and elusive, particularly about the status of voices as others, their social implications and the constitution and conceptualisation of the self. OBJECTIVES This paper aims to provide a systematic review of studies that investigated the relationship between auditory hallucinations, shame, and guilt in people without relevant signs of psychiatric issues. METHODS We searched studies reporting information about voices characteristics, the relationship between voices and hearers, hearer's reactions, and beliefs, paying peculiar attention to shame and guilt issues. Included papers were evaluated for risk of bias. RESULTS Eleven studies that explored the relationship between AVHs, shame and guilt, were extracted. Phenomenological, pragmatic, as well as neuropsychological features of hearing voices in non-clinical populations, allowed us to note a dynamic relationship and the constellation of subjective experiences that can occur. The role of guilt was characterized by few studies and mixed results, while shame was mainly common. CONCLUSIONS Due to the high heterogeneity detected and the scarce sources available, further studies should focus on both the aetiology and the bidirectional relationship between hearing voices, shame, and guilt in non-clinical people. This can be helpful in therapies for non-clinical populations who are distressed by their voices (e.g., psychotherapy), and for whom shame, and guilt may contribute to negative consequences such as isolation, anxiety or future depression. Moreover, it might favour the development and implication of different treatments considering emotion regulation, distress tolerance and interpersonal sensitivity on the clinical populations.
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Affiliation(s)
- E. Volpato
- grid.8142.f0000 0001 0941 3192Present Address: Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123 Milan, Italy ,grid.418563.d0000 0001 1090 9021IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - C. Cavalera
- grid.8142.f0000 0001 0941 3192Present Address: Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123 Milan, Italy
| | - G. Castelnuovo
- grid.8142.f0000 0001 0941 3192Present Address: Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123 Milan, Italy ,grid.418224.90000 0004 1757 9530Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory , Verbania , Italy
| | - E. Molinari
- grid.8142.f0000 0001 0941 3192Present Address: Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123 Milan, Italy ,grid.418224.90000 0004 1757 9530Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - F. Pagnini
- grid.8142.f0000 0001 0941 3192Present Address: Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123 Milan, Italy ,grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
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8
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Chen C, Huang H, Qin X, Zhang L, Rong B, Wang G, Wang H. Reduced inter-hemispheric auditory and memory-related network interactions in patients with schizophrenia experiencing auditory verbal hallucinations. Front Psychiatry 2022; 13:956895. [PMID: 35990049 PMCID: PMC9381966 DOI: 10.3389/fpsyt.2022.956895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Inter-hemispheric disconnection is a primary pathological finding in schizophrenia. However, given the inherent complexity of this disease and its development, it remains unclear as to whether associated inter-hemispheric changes play an important role in auditory verbal hallucination (AVH) development. As such, this study was developed to explore inter-hemispheric connectivity in the context of schizophrenia with AVH while excluding positive symptoms and other factors with the potential to confound these results. METHOD In total, resting-state functional magnetic resonance imaging (fMRI) was used to assess 42 patients with AVH (APG), 26 without AVH (NPG), and 82 normal control (NC) individuals. Inter-hemispheric connectivity in these subjects was then assessed through the use of voxel-mirrored homotopic connectivity (VMHC) and Pearson correlation analyses. RESULT Relative to HC and NPG subjects, APG individuals exhibited a decrease in VMHC in the superior temporal gyrus (STG) extending into Heschl's gyrus, the insula, and the Rolandic operculum as well as in the fusiform gyrus extending into the para-hippocampus (Corrected p < 0.005, cluster size = 52). Among APG individuals, these observed impairments of inter-hemispheric connectivity were negatively correlated with Hoffman auditory hallucination scores. CONCLUSION These results support the schizophrenia hemitropic disconnection hypothesis, and provide novel evidence suggesting that there may be a relationship between reductions in inter-hemispheric connectivity in auditory and memory-related networks and the pathogenesis of AVH in patients with schizophrenia following the exclusion of confounding factors from other positive symptoms.
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Affiliation(s)
- Cheng Chen
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Huan Huang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xucong Qin
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Liang Zhang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Bei Rong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Institute of Neurology and Psychiatry Research, Wuhan, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, China
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Zhuo C, Xiao B, Ji F, Lin X, Jiang D, Tian H, Xu Y, Wang W, Chen C. Patients with first-episode untreated schizophrenia who experience concomitant visual disturbances and auditory hallucinations exhibit co-impairment of the brain and retinas-a pilot study. Brain Imaging Behav 2021; 15:1533-1541. [PMID: 32748321 DOI: 10.1007/s11682-020-00351-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
There are limited structural brain and retina alteration data from schizophrenia patients who experience visual disturbances (VDs) with or without auditory hallucinations (AHs). We compared brain and retina alterations between first-episode untreated schizophrenia patients with VDs (FUSCH-VDs) with versus without AHs, and between patients and healthy controls (HCs)(N = 30/group). VDs, AHs, gray matter volumes (GMVs), and retinal thicknesses were evaluated with the Bonn Scale for Assessment of Basic Symptoms (BSABS) scale, the Auditory Hallucinations Rating Scale (AHRS), magnetic resonance imaging (MRI), and optical coherence tomography (OCT), respectively. Compared to HCs, FUSCH-VDs had reduced GMVs, mainly in dorsal V3/V3A and V5 regions, the fusiform gyrus, and ventral V4 and V8 regions. Most FUSCH-VDs (85.0%; 51/60) had primary visual cortex-retina co-impairments. FUSCH-VDs with AHs had more serious and larger scope GMV reductions than FUSCH-VDs without AHs. FUSCH-VDs with AHs had significant retinal thickness reductions compared to HCs. Primary visual cortex-retina co-impairments were found to be more common, and more pronounced when present, in FUSCH-VDs with AHs than in FUSCH-VDs without AHs. The present findings support the notion that VDs and AHs may have reciprocal deteriorating actions in patients with schizophrenia.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, 272119, Shandong, China. .,Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China. .,Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, 300222, China.
| | - Bo Xiao
- Department of OCT, Tianjin Eye Hospital, Tianjin, 300034, China
| | - Feng Ji
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, 272119, Shandong, China
| | - Xiaodong Lin
- Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China
| | - Deguo Jiang
- Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China
| | - Hongjun Tian
- Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, 300222, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Wenqiang Wang
- Co-collaboration Laboratory of China and Canada, Xiamen Xianyue Hospital and University of Alberta, Xiamen, 361000, Fujian, China
| | - Ce Chen
- Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China.
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Yu H, Ying W, Li G, Lin X, Jiang D, Chen G, Chen S, Sun X, Xu Y, Ye J, Zhuo C. Exploring concomitant neuroimaging and genetic alterations in patients with and patients without auditory verbal hallucinations: A pilot study and mini review. J Int Med Res 2021; 48:300060519884856. [PMID: 32696690 PMCID: PMC7376300 DOI: 10.1177/0300060519884856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective To explore concomitant neuroimaging and genetic alterations in patients with
schizophrenia with or without auditory verbal hallucinations (AVHs), and to
discuss the use of pattern recognition techniques in the development of an
objective index that may improve diagnostic accuracy and treatment outcomes
for schizophrenia. Methods The pilot study included patients with schizophrenia with AVHs (SCH-AVH
group) and without AVHs (SCH-no AVH group). High throughput sequencing (HTS)
was performed to explore RNA networks. Global functional connectivity
density (gFCD) analysis was performed to assess functional connectivity (FC)
alterations of the default mode network (DMN). Quantitative long noncoding
(lnc) RNA and mRNA expression data were related to peak T values of gFCDs
using Pearson’s correlation coefficient analysis. Results Compared with the SCH-no AVH group (n = 5), patients in the
SCH-AVH group (n = 5) exhibited differences in RNA
expression in RNA networks that were related to AVH severity, and displayed
alterations in FC (reflected by gFCD differences) within the DMN (posterior
cingulate and dorsal-medial prefrontal cortex), and in the right parietal
lobe, left occipital lobe, and left temporal lobe. Peak lncRNA expression
values were significantly related to peak gFCD T values within the DMN. Conclusion Among patients with schizophrenia, there are concomitant FC and genetic
expression alterations associated with AVHs. Data from pattern recognition
studies may inform the development of an objective index aimed at improving
early diagnostic accuracy and treatment planning for patients with
schizophrenia with and without AVHs.
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Affiliation(s)
- Haiping Yu
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Wang Ying
- Psychiatric Neuroimaging-Genetic and Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, China
| | - Gang Li
- Department of Psychiatry, Tianshui Third Hospital, Gansu, China
| | - Xiaodong Lin
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Deguo Jiang
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Guangdong Chen
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Suling Chen
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Xiuhai Sun
- Department of Neurology, Zoucheng People's Hospital, Jining Medical University Affiliated Zoucheng Hospital, Shandong, China
| | - Yong Xu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Shanxi, China
| | - Jiaen Ye
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Chuanjun Zhuo
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China.,Psychiatric Neuroimaging-Genetic and Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, China.,Department of Psychiatry, Tianjin Fourth Centre Hospital, Tianjin, China.,Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, School of Mental Health of Jining Medical University, Jining, Shandong, China
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11
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Zhuo C, Xiao B, Chen C, Jiang D, Li G, Ma X, Li R, Wang L, Xu Y, Zhou C, Lin X. Abberant inverted U-shaped brain pattern and trait-related retinal impairment in schizophrenia patients with combined auditory and visual hallucinations: a pilot study. Brain Imaging Behav 2021; 15:738-747. [PMID: 32304019 PMCID: PMC8032576 DOI: 10.1007/s11682-020-00281-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Schizophrenic patients often experience auditory hallucinations (AHs) and visual hallucinations (VHs). However, brain and retinal alterations associated with combined AHs and VHs in schizophrenic patients are unknown. This study aimed o investigate brain and retinal alterations in first episode un-treated schizophrenic patients with combined AHs and VHs (FUSCHAV). FUSCHAV patients (n = 120), divided into four groups according to severity of AH and VH symptoms, were compared to healthy controls (n = 30). Gray matter volume (GMV) and global functional connectivity density (gFCD) were recorded to reflect brain structure and functional alterations. Total retinal thickness was acquired by optical coherence tomography to assess retinal impairment. The majority of FUSCHAV patients (85.8%) demonstrated both GMV reduction and gFCD increases along with retinal thinning compared to healthy controls. The severity of GMV reduction and gFCD increase differed between patient groups, ranked from highest to lowest severity as follows: severe AHs combined with severe VHs (FUSCHSASV, 20 patients), moderate AHs combined with severe VHs (FUSCHMASV, 23 patients), severe AHs combined with moderate VHs (FUSCHSAMV, 28 patients), and moderate AHs combined with moderate VHs (FUSCHMAMV, 26). Retinal impairment was similar among the four FUSCHAV groups. GMV reduction and gFCD increases in the frontal-parietal lobule show an inverted U-shaped pattern among FUSCHAV patients according to AH and VH severity, while retinal impairment remains stable among FUSCHAV groups. These findings indicate a reciprocal deterioration in auditory and visual disturbances among FUSCHAV patients.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry Pattern Recognition, Department of Genetics Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, 272119, Shandong Province, China.
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China.
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory(PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, Tianjin, 300222, China.
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.
- MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
- Department of Psychiatry, Tianjin Medical University, Tianjin, 300074, China.
- Department of Medical Big Data Centre, Shanxi Medical University, Taiyuan, China.
| | - Bo Xiao
- Department of OCT, Tianjin Eye Hospital, Tianjin, 300274, China
| | - Ce Chen
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Gongying Li
- Department of Psychiatry Pattern Recognition, Department of Genetics Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, 272119, Shandong Province, China
| | - Xiaoyan Ma
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory(PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, Tianjin, 300222, China
| | - Ranli Li
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory(PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, Tianjin, 300222, China
| | - Lina Wang
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory(PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, Tianjin, 300222, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Chunhua Zhou
- Department of Pharmacoloy, The First Hospital of Hebei Medical Universtiy, Shijiazhuang, 05000, Hebei Province, China.
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China.
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Kühl M, Lüdtke T, Mehl S, Moritz S. Evaluation of an Internet-based metacognitive training for individuals who hear voices. Schizophr Res 2021; 228:256-259. [PMID: 33493772 DOI: 10.1016/j.schres.2020.12.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 11/30/2020] [Accepted: 12/30/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Marie Kühl
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Thies Lüdtke
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Psychology, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Stephanie Mehl
- Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior (CMBB), Philipps-University, Rudolf-Bultmann-Str. 8, 35039 Marburg, Germany; Department of Health and Social Work, University of Applied Sciences Frankfurt, Frankfurt am Main, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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13
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Common and distinct brain functional alterations in pharmacotherapy treatment-naïve female borderline personality disorder patients with and without auditory verbal hallucinations: a pilot study. Eur Arch Psychiatry Clin Neurosci 2021; 271:1149-1157. [PMID: 32009225 PMCID: PMC8354887 DOI: 10.1007/s00406-020-01102-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 01/21/2020] [Indexed: 02/06/2023]
Abstract
Auditory verbal hallucinations (AVHs) are experienced by approximately 25% of patients with borderline personality disorder (BPD). Despite the high incidence, the pathological features of AVH in BPD remain unclear. This study aimed to investigate whole-brain functional connectivity (FC), as measured by functional connectivity density (FCD), and its relationship with AVH in BPD. 65 pharmacotherapy treatment-naïve female BPD patients (30 with AVH and 35 without AVH), and 35 female healthy controls were investigated. Functional magnetic resonance imaging (fMRI) data were collected to assess whole-brain FC and functional connectivity density mapping (FCDM) was applied to the fMRI data to compute FCD features. Compared to the healthy controls, both BPD groups (BPD-AVH and BPD without AVH) exhibited significantly higher gFCD values in the bilateral prefrontal lobe, bilateral orbital lobule, and bilateral insula, and significantly lower gFCD values in the SMA, right anterior temporal lobule, and the ACC. These altered regions were significantly associated with AVH in the BPD subjects. Moreover, higher gFCD values were observed in the left posterior temporal lobule and posterior frontal lobule. Aberrant alterations also emerged in the left posterior temporal lobule and posterior frontal lobule, mainly in Broca and Wernicke regions. Nevertheless, there was no significant correlation between gFCD values and the severity of AVH as measured by the AVH scores. In summary, we have identified aberrations in the FC and brain metabolism of the aforementioned neural circuits/networks, which may provide new insights into BPD-AVH and facilitate the development of therapeutic approaches for treating AVH in BPD patients.
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14
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Zhuo C, Chen M, Xu Y, Jiang D, Chen C, Ma X, Li R, Sun Y, Li Q, Zhou C, Lin X. Reciprocal deterioration of visual and auditory hallucinations in schizophrenia presents V-shaped cognition impairment and widespread reduction in brain gray matter-A pilot study. J Clin Neurosci 2020; 79:154-159. [PMID: 33070887 DOI: 10.1016/j.jocn.2020.07.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 05/07/2020] [Accepted: 07/19/2020] [Indexed: 10/23/2022]
Abstract
Schizophrenic patients often experience visual hallucinations (VHs) and auditory hallucinations (AHs); however, brain aberrations associated with combined VH and AH in schizophrenic patients remains poorly documented. Changes to the brain and cognition during the first episode of untreated schizophrenic patients (FUSCH) with both VHs and AHs (FUSCHVA) were evaluated. One-hundred and fifty-seven patients were enrolled that had FUSCH (1) with VHs but not AHs (FUSCHV), and (2) with AHs but not VHs (FUSCHA), plus FUSCHVA and healthy controls (n = 30). Gray matter volume (GMV) and MATRICS Consensus Cognitive Battery (MCCB) was measured to reflect impairments to the brain and cognition, respectively. FUSCHVA patients had the severest cognitive impairment for all components of the MCCB, followed by FUSCHV and FUSCHA patients. Compared to healthy patients, FUSCHVA patients had reduced GMV in the occipital, parietal, frontal, and temporal cortex, and increased GMV in the hippocampus and striatum. Compared to FUSCHV patients, FUSCHVA patients had reduced GMV in the occipital cortex and postcentral gyrus, and increased GMV in the posterio-parietal lobe. Compared to patients with FUSCHA, the GMV in patients with FUSCHVV was reduced in the occipital cortex and posterio parietal lobe. In conclusion, visual and auditory hallucinations appear to deteriorate reciprocally in FUSCHVA patients, accompanied with sever cognitive impairments. Compared to AHs, VHs might be accompanied with severe GMV impairment in the brain, especially in the primary visual cortex and higher perception integration cortex (posterio parietal lobe) in patients with FUSCH.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Neuroimage-Genetics Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining 272119, Shandong Province, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan 030001, China; Department of Psychiatric-Neuroimage-Genetics, Wenzhou Seventh People's Hospital, Wenzhou 325000, China; Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, 300222 Tianjin, China; Key labaratory of Real Time of Brain Circuits Tracing For Neurology and Psychiatry, Tianjin Medical University Affiliated Tianjin Forth Centre Hospital, Tianjin Fourth Centre Hospital, Tianjin 300024, China.
| | - Min Chen
- Department of Neuroimage-Genetics Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining 272119, Shandong Province, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Deguo Jiang
- Department of Psychiatric-Neuroimage-Genetics, Wenzhou Seventh People's Hospital, Wenzhou 325000, China
| | - Ce Chen
- Department of Psychiatric-Neuroimage-Genetics, Wenzhou Seventh People's Hospital, Wenzhou 325000, China
| | - Xiaoyan Ma
- Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, 300222 Tianjin, China
| | - Ranli Li
- Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, 300222 Tianjin, China
| | - Yun Sun
- Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, 300222 Tianjin, China
| | - Qianchen Li
- Department of Pharmacoloy, The First Hospital of Hebei Medical University, Shijiazhuang 05000, Hebei Province, China
| | - Chunhua Zhou
- Department of Pharmacoloy, The First Hospital of Hebei Medical University, Shijiazhuang 05000, Hebei Province, China.
| | - Xiaodong Lin
- Department of Pharmacoloy, The First Hospital of Hebei Medical University, Shijiazhuang 05000, Hebei Province, China
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15
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Zhuo C, Wang C, Song X, Xu X, Li G, Lin X, Xu Y, Tian H, Jiang D, Wang W, Zhou C. A unified model of shared brain structural alterations in patients with different mental disorders who experience own-thought auditory verbal hallucinations-A pilot study. Brain Behav 2020; 10:e01614. [PMID: 32304354 PMCID: PMC7303372 DOI: 10.1002/brb3.1614] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/10/2020] [Accepted: 03/15/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To explore shared brain structural alterations in patients diagnosed with mental disorders who experience own-thought auditory verbal hallucinations (OTAVHs). METHODS A cohort of 143 first-diagnosis, nonmedicated patients with OTAVHs was enrolled: 25 with schizophrenia (FUSCH-OTAVH), 20 with major depression disorder (FUMDD-OTAVH), 28 with bipolar disorder (FUBD-OTAVH), 22 patients with posttraumatic stress disorder (FUPTSD-OTAVH), 21 with anxiety disorder (FUAD-OTAVH), and 27 with borderline personality disorder (FUBPD-OTAVH); 25 healthy controls (HCs) participated. The Auditory Hallucinations Rating Scale (AHRS), multiple psychometric scales, voxel-based morphometry (VBM), tract-based spatial statistics (TBSS), and multiple regression were used. RESULTS Compared with HCs, patients had increased occipital cortex, dorsal prefrontal cortex (PFC), and striatum gray matter volumes (GMVs), a reduced insular cortex (IC) GMV, and an impaired frontooccipital fasciculus. The following differences were found versus HCs: FUSCH-OTAVH, reduced PFC and occipital GMVs, increased striatum and thalamus GMVs, impaired arcuate fasciculus, u-shaped bundle, optic tract, and upper longitudinal fasciculus (LF); FUMDD-OTAVH, increased posterior frontotemporal junction and hippocampus GMVs; FUMN-OTAVH, increased posterior frontotemporal junction and parietal cortex GMVs, reduced hippocampus GMV, impaired upper LF; FUPTSD-OTAVH, increased temporal, hippocampus, and nucleus accumbens GMVs; FUBPD-OTAVH, increased frontotemporal junction and hippocampus GMVs, impaired upper/lower LF; and FUAD-OTAVH, increased frontal and temporal cortex, hippocampus GMVs. CONCLUSIONS The present findings provide evidence consistent with a bottom-up and top-down reciprocal action dysfunction hypothesis of AVHs and with the dopamine hypothesis of AVHs. We observed specific features related to OTAVHs in patients with different mental disorders. The findings, though complex, provide clues for further studies of specific mental disorders.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining, China.,The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China.,Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China.,Department of Psychiatry and Neuroimaging Centre, Wenzhou Seventh People's Hospital, Wenzhou, China.,Department of Psychiatry, First Hospital, First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China.,Department of Psychiatric-Neuroimging-Genetics and Comorbidity Labotorary (PNGC_Lab), Tianjin Anding Hospital, Tianjin, China.,Canada and China Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen, China
| | - Chunxiang Wang
- Department of Radiology, MRI Center, Tianjin Children Hospital, Tianjin Medical University Affiliated Tianjin Children Hospital, Tianjin, China
| | - Xueqin Song
- The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China.,Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Xuexin Xu
- Department of Radiology, MRI Center, Tianjin Children Hospital, Tianjin Medical University Affiliated Tianjin Children Hospital, Tianjin, China
| | - Gongying Li
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining, China
| | - Xiaodong Lin
- Department of Psychiatry and Neuroimaging Centre, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Yong Xu
- Department of Psychiatry, First Hospital, First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hongjun Tian
- Department of Psychiatric-Neuroimging-Genetics and Comorbidity Labotorary (PNGC_Lab), Tianjin Anding Hospital, Tianjin, China
| | - Deguo Jiang
- Department of Psychiatry and Neuroimaging Centre, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Wenqiang Wang
- Canada and China Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
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16
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Zhuo C, Xiao B, Chen C, Jiang D, Li G, Ma X, Li R, Wang L, Xu Y, Zhou C, Lin X. Antipsychotic agents deteriorate brain and retinal function in schizophrenia patients with combined auditory and visual hallucinations: A pilot study and secondary follow-up study. Brain Behav 2020; 10:e01611. [PMID: 32285647 PMCID: PMC7303384 DOI: 10.1002/brb3.1611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/13/2020] [Accepted: 03/10/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Schizophrenia patients often experience auditory hallucinations (AHs) and visual hallucinations (VHs). However, the degree and type of brain and retinal alterations associated with combined AHs and VHs in schizophrenia patients remain unknown. There is an urgent need for a study that investigates the trajectory of brain and retinal alterations in patients with first-episode untreated schizophrenia accompanied by combined AHs and VHs (FUSCHAV). METHODS FUSCHAV patients (n = 120), divided into four groups according to AH and VH symptom severity (severe AHs combined with severe VHs [FUSCHSASV, 20 patients]; middle-to-moderate AHs combined with severe VHs [FUSCHMASV, 23 patients]; severe AHs combined with middle-to-moderate VHs [FUSCHSAMV, 28 patients]; and middle-to-moderate AHs combined with middle-to-moderate VHs [FUSCHMAMV, 26 patients]), were compared to healthy controls (n = 30). Gray matter volume (GMV) was adopted for brain structural alteration assessment. Total retinal thickness was adopted as a measure of retinal thickness impairment. RESULTS In the pilot study, the rate of GMV reduction showed an inverted U-shaped pattern across the different FUSCHAV patient groups according to AH and VH severity. The degree of retinal impairment remained stable across the groups. More notably, in the secondary follow-up study, we observed that, after 6 months of treatment with antipsychotic agents, all the GMV reduction-related differences across the different patient groups disappeared, and both GMV and retinal thickness demonstrated a tendency to deteriorate. CONCLUSIONS These findings indicate the need for heightened alertness on brain and retinal impairments in patients with FUSCHAV. Further deteriorations induced by antipsychotic agent treatment should be monitored in clinical practice.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry Pattern Recognition, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China.,Department of Genetics, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China.,Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China.,Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China.,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Bo Xiao
- Department of OCT, Tianjin Eye Hospital, Tianjin, China
| | - Ce Chen
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Gongying Li
- Department of Psychiatry Pattern Recognition, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China.,Department of Genetics, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China
| | - Xiaoyan Ma
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China
| | - Ranli Li
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China
| | - Lina Wang
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
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17
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Zhuo C, Lin X, Wang C, Song X, Xu X, Li G, Xu Y, Tian H, Zhang Y, Wang W, Zhou C. Unified and disease specific alterations to brain structure in patients across six categories of mental disorders who experience own-thought auditory verbal hallucinations: A pilot study. Brain Res Bull 2020; 160:33-39. [PMID: 32298780 DOI: 10.1016/j.brainresbull.2020.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 02/28/2020] [Accepted: 04/04/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To explore the unified and disease specific structural features of the brain in patients spanning six mental disorders who experience own-thought auditory verbal hallucinations (OTAVH). METHODS A pilot study was conducted on 25 patients with schizophrenia (FUSCH-OTAVH), 20 patients with major depression disorder (FUMDD-OTAVH), 28 patients with bipolar disorder (FUBD-OTAVH), 22 patients with posttraumatic stress disorder (FUPTSD-OTAVH), 21 patients with anxiety disorder (FUAD-OTAVH), and 27 patients with borderline personality disorder (FUBPD-OTAVH). Twenty-five healthy controls (HCs) were also recruited. Auditory Hallucinations Rating Scale (AHRS) multiple psychometric scales were adopted to assess the clinical features of voxel-based morphometry (VBM), tract-based spatial statistics (TBSS), and multiple regression in all patients. Common and specific brain features of OTAVH among these mental disorders were investigated. RESULTS Compared to HCs, GMV aberrant pattern across all the six categories patients with OTAVH decreased in the occipital cortex, left parietal lobe, prefrontal cortex (PFC), and insular cortex (IC). Aberrant patterns in white matter (WM) were detected in the corpus callosum and impairment of the fronto-occipital fasciculus. Structural differences in the brain were observed for each mental disorder versus HCs. CONCLUSIONS The unified brain aberrant features of OTAVH across six mental disorders were characterized by decreased GMV and WM impairments in some regions and the specific brain features of each disease were also characterized. In conclusion, this study provides evidence for the structural basis of OTAVH and potential avenues for investigating disease specific brain features of OTAVH.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, 272191, Jining, Shandong Province, China; The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China; Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China; Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, 450000, China; Department of Psychiatry and Neuroimaging Centre, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, China; Department of Psychiatric-Neuroimging-Genetics and Comorbidity Labotorary (PNGC_Lab), Tianjin Anding Hospital, 300300, Tianjin, China; Canada and China Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen, 361000, Fujian Province, China.
| | - Xiaodong Lin
- Department of Psychiatry and Neuroimaging Centre, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China
| | - Chunxiang Wang
- Department of Radiology, MRI Center, Tianjin Children Hospital, Tianjin Medical University Affiliated Tianjin Children Hospital, Tianjin, 300444, China
| | - Xueqin Song
- The First Affiliated Hospital/Zhengzhou University, Zhengzhou, China; Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China; Henan Psychiatric Transformation Research Key Laboratory, Zhengzhou University, Zhengzhou, 450000, China
| | - Xuexin Xu
- Department of Radiology, MRI Center, Tianjin Children Hospital, Tianjin Medical University Affiliated Tianjin Children Hospital, Tianjin, 300444, China
| | - Gongying Li
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, 272191, Jining, Shandong Province, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Hongjun Tian
- Department of Psychiatric-Neuroimging-Genetics and Comorbidity Labotorary (PNGC_Lab), Tianjin Anding Hospital, 300300, Tianjin, China
| | - Yonghui Zhang
- Department of Psychiatric-Neuroimging-Genetics and Comorbidity Labotorary (PNGC_Lab), Tianjin Anding Hospital, 300300, Tianjin, China
| | - Wenqiang Wang
- Canada and China Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen, 361000, Fujian Province, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei Province, China
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18
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Zhuo C, Li G, Chen C, Ji F, Lin X, Jiang D, Tian H, Wang L, Lin X, Ping J. Left cerebral cortex complexity differences in sporadic healthy individuals with auditory verbal hallucinations: A pilot study. Psychiatry Res 2020; 285:112834. [PMID: 32036151 DOI: 10.1016/j.psychres.2020.112834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 11/23/2022]
Abstract
In the present pilot study, we aimed to characterize the brain surface differences between 42 sporadic healthy individuals with AVHs (Hi-AVHs) and 50 healthy individuals without AVHs. The Auditory Hallucinations Rating Scale (AHRS) was used to assess the severity of AVHs, while the gyrification index and fractal dimensions were used to evaluate cerebral cortex complexity. We observed a significant increase of the gyrification index was located in the left superior temporal gyrus, the left temporoparietal junction, the left superior frontal gyrus, and the left parietal lobe. The fractal dimensions had significantly increased in the left Wernicke's area, the left Broca's areas and the left parietal lobe. Our pilot findings indicated gyrification index and fractal dimensions differences were only located in the left hemisphere between the groups of Hi-with and without AVHs. However, these differences did not correlate with the AVHs symptoms, and the non-hallucinating healthy individuals did not demonstrate corresponding reverse changes; hence we cannot postulate that cerebral cortex complexity alterations are related to AVHs. Our pilot study provides a clue for further studies aimed at investigating the brain features of Hi-AVHs.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining 272100, Shandong Province, China; Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou 325000, Zhejiang Province, China; Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab) Tianjin Mental Health Canter, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin 300222, China.
| | - Gongying Li
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining 272100, Shandong Province, China
| | - Ce Chen
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou 325000, Zhejiang Province, China
| | - Feng Ji
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining 272100, Shandong Province, China
| | - Xiao Lin
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou 325000, Zhejiang Province, China
| | - Deguo Jiang
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou 325000, Zhejiang Province, China
| | - Hongjun Tian
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab) Tianjin Mental Health Canter, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin 300222, China
| | - Lina Wang
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab) Tianjin Mental Health Canter, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin 300222, China
| | - Xiaodong Lin
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou 325000, Zhejiang Province, China
| | - Jing Ping
- Department of Psychiatric-Neuroimaging-Genetics Laboratory (PNG_Lab), Wenzhou Seventh People's Hospital, Wenzhou 325000, Zhejiang Province, China
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19
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Kim SH, Hwang SS, Jung HY, Kim Y, Ahn YM, Chung IW, Kim YS. Differences between self-reported and clinician-rated evaluations of 1-year changes in auditory verbal hallucinations among schizophrenia patients. Prog Neuropsychopharmacol Biol Psychiatry 2019; 95:109671. [PMID: 31220520 DOI: 10.1016/j.pnpbp.2019.109671] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/29/2019] [Accepted: 06/17/2019] [Indexed: 12/25/2022]
Abstract
Auditory verbal hallucinations (AVHs) constitute a frequent and distressing symptom of schizophrenia, associated with physical, emotional, and cognitive challenges. Despite their clinical importance, changes in the multiple dimensions of AVHs during treatment have rarely been examined, and subjective views thereof have received minimal attention. Here, we evaluated 87 patients with schizophrenia-related AVHs using the Hamilton Program for Schizophrenia Voices Questionnaire (HPSVQ; a self-report questionnaire) and the Psychotic Symptom Rating Scales-Auditory Hallucination Subscale (PSYRATS-AH; a clinician-rated scale) at baseline and after 6 months and 1 year of treatment. We explored dimensions that changed from the perspectives of both clinicians and patients and the relationships between these perceptions over the year. The test-retest reliabilities of the HPSVQ and PSYRATS-AH were generally fair. Improvements in AVHs were evident over the first 6 months; the PSYRATS-AH revealed a broader range of symptom improvement than did the HPSVQ. The "interference with life" dimension on the HPSVQ was not reduced, but the "disruption to life" score on the PSYRATS-AH was. At both baseline and 6 months, the physical characteristics of AVHs (frequency, duration, and loudness) were significantly correlated with both distress and life interference/disruption; all correlations except that for frequency were reduced at 1 year. The clinician-rated and self-reported personal perspectives on AVHs exhibited both differences and similarities; physical AVH components and subjective distressful experiences changed in different ways in those with chronic, persistent AVHs. The HPSVQ and PSYRATS-AH data were complementary, improving our understanding of the clinical implications of AVHs and subjective patient distress.
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Affiliation(s)
- Se Hyun Kim
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Samuel S Hwang
- Department of Psychology, Chonnam National University, Gwangju, Republic of Korea
| | - Hee Yeon Jung
- Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Yeni Kim
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Yong Min Ahn
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - In Won Chung
- Department of Psychiatry, Dongguk University International Hospital, Dongguk University Medical School, Goyang, Republic of Korea
| | - Yong Sik Kim
- Department of Psychiatry, Dongguk University International Hospital, Dongguk University Medical School, Goyang, Republic of Korea.
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20
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Phenomenology of Voice-Hearing in Psychosis Spectrum Disorders: a Review of Neural Mechanisms. Curr Behav Neurosci Rep 2019. [DOI: 10.1007/s40473-019-00196-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Brain function differences in drug-naïve first-episode auditory verbal hallucination-schizophrenia patients with versus without insight. Chin Med J (Engl) 2019; 132:2199-2205. [PMID: 31478928 PMCID: PMC6797149 DOI: 10.1097/cm9.0000000000000419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Few studies have reported brain function differences in drug-naïve first-episode schizophrenia patients who had auditory verbal hallucinations (AVH) with insight vs. those without insight. This study aimed to investigate brain function differences between drug-naïve first-episode AVH-schizophrenia patients with and without insight. Methods: Forty first-episode drug-naïve AVH-schizophrenia patients with or without insight and 40 healthy controls between December 2016 and December 2018 were recruited in this study. The auditory hallucinations rating scale (AHRS) was used to assess AVH severity, while the insight and treatment attitudes questionnaire was used to distinguish insight. The global functional connectivity density (gFCD) between different groups was compared using a voxel-wise one-way analysis of covariance. The relationship between gFCD and AHRS total scores were analyzed using voxel-wise multiple regression. Results: Finally, 13 first-episode drug-naïve AVH-schizophrenia patients with insight, 15 AVH-schizophrenia patients without insight, and 20 healthy controls were included for analysis. Except for global assessment of functioning scores, there were no significant differences in sociodemographic information between the AVH-schizophrenia and healthy groups (P > 0.05). Compared to the healthy controls, AVH-schizophrenia patients with insight demonstrated a decreased gFCD in the supra-marginal gyrus within the primary auditory cortex, while those without insight demonstrated an increased gFCD in the inferior frontal gyrus and superior temporal gyrus and decreased gFCD in the supplemental motor area. Compared to the AVH-schizophrenia patients with insight, those without insight demonstrated an increased gFCD in the supra-marginal gyrus and posterior superior temporal lobule and a decreased gFCD in the frontal lobe. No significant correlation between gFCD and AVH severity (AHRS total score: r = 0.23, P = 0.590; and frequency: r = 0.42, P = 0.820) was found in both AVH-schizophrenia groups. Conclusions: The gFCD-aberrant brain regions in the AVH-schizophrenia patients without insight were wider compared to those with insight, although the AHRS scores were not significantly different. The AVH-schizophrenia patients without insight had wide functional impairment in the frontal lobule, which may underlie the lack of insight and the abnormal hyperactivity in the inferior frontal gurus and temporal lobe related to the AVH symptoms.
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