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Chen J, Wei Y, Xue K, Han S, Li W, Zhou B, Cheng J. Abnormal effective connectivity of reward network in first-episode schizophrenia with auditory verbal hallucinations. J Psychiatr Res 2024; 171:207-214. [PMID: 38309210 DOI: 10.1016/j.jpsychires.2024.01.023] [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: 07/06/2023] [Revised: 12/02/2023] [Accepted: 01/15/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVE Auditory verbal hallucinations (AVHs) in schizophrenia is proved to be associated with dysfunction of mesolimbic-cortical circuits, especially during abnormal salient and internal verbal resource monitoring processing procedures. However, the information flow among areas involved in coordinated interaction implicated the pathophysiology of AVHs remains unclear. METHODS We used spectral dynamic causal modeling (DCM) to quantify connections among eight critical hubs of reward network in 86 first-episode drug-naïve schizophrenia patients with AVHs (AVH), 93 patients without AVHs (NAVH), and 88 matched normal controls (NC) using resting-state functional magnetic resonance imaging. Group-level connection coefficients, between-group differences and correlation analysis between image measures and symptoms were performed. RESULT DCM revealed weaker effective connectivity (EC) from right ventral striatum (RVS) to ventral tegmental area (VTA) in AVH compared to NAVH. AVH showed stronger EC from left anterior insula (AI) to RVS, stronger EC from RVS to anterior cingulate cortex (ACC), and stronger EC from VTA to posterior cingulate cortex (PCC) compared to NC. The correlation analysis results were mostly visible in the negative correlation between EC from right AI to ACC and positive sub-score, P1 sub-score, and P3 sub-score of PNASS in group-level. CONCLUSION These findings suggest that neural causal interactions between the reward network associated with AVHs are disrupted, expanding the evidence for potential neurobiological mechanisms of AVHs. Particularly, dopamine-dependent salience attribution and top-down monitoring impairments and compensatory effects of enhanced excitatory afferents to ACC, which may provide evidence for a therapeutic target based on direct in vivo of AVHs in schizophrenia.
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Affiliation(s)
- Jingli Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China; Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, 450052, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China; Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, 450052, China
| | - Kangkang Xue
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China; Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, 450052, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China; Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, 450052, China
| | - Wenbin Li
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China; Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, 450052, China
| | - Bingqian Zhou
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China; Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, 450052, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China; Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, 450052, China.
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Lerosier B, Simon G, Takerkart S, Auzias G, Dollfus S. Sulcal pits of the superior temporal sulcus in schizophrenia patients with auditory verbal hallucinations. AIMS Neurosci 2024; 11:25-38. [PMID: 38617038 PMCID: PMC11007407 DOI: 10.3934/neuroscience.2024002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 04/16/2024] Open
Abstract
Auditory verbal hallucinations (AVHs) are among the most common and disabling symptoms of schizophrenia. They involve the superior temporal sulcus (STS), which is associated with language processing; specific STS patterns may reflect vulnerability to auditory hallucinations in schizophrenia. STS sulcal pits are the deepest points of the folds in this region and were investigated here as an anatomical landmark of AVHs. This study included 53 patients diagnosed with schizophrenia and past or present AVHs, as well as 100 healthy control volunteers. All participants underwent a 3-T magnetic resonance imaging T1 brain scan, and sulcal pit differences were compared between the two groups. Compared with controls, patients with AVHs had a significantly different distributions for the number of sulcal pits in the left STS, indicating a less complex morphological pattern. The association of STS sulcal morphology with AVH suggests an early neurodevelopmental process in the pathophysiology of schizophrenia with AVHs.
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Affiliation(s)
| | - Gregory Simon
- Normandie Univ, UNICAEN, ISTS, EA 7466, 14000 Caen, France
| | - Sylvain Takerkart
- Aix Marseille Univ, CNRS, INT, Institut de Neurosciences de la Timone, Marseille, France
| | - Guillaume Auzias
- Aix Marseille Univ, CNRS, INT, Institut de Neurosciences de la Timone, Marseille, France
| | - Sonia Dollfus
- Normandie Univ, UNICAEN, ISTS, EA 7466, 14000 Caen, France
- CHU de Caen, Service de Psychiatrie, 14000 Caen, France
- Normandie Univ, UNICAEN, UFR santé, 14000 Caen, France
- Fédération Hospitalo-Universitaire (FHU-AMP), Normandie Univ, UNICAEN, UFR santé, 14000 Caen, France
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3
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Luttenbacher I, Phillips A, Kazemi R, Hadipour AL, Sanghvi I, Martinez J, Adamson MM. Transdiagnostic role of glutamate and white matter damage in neuropsychiatric disorders: A Systematic Review. J Psychiatr Res 2022; 147:324-348. [PMID: 35151030 DOI: 10.1016/j.jpsychires.2021.12.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/08/2021] [Accepted: 12/19/2021] [Indexed: 12/09/2022]
Abstract
Neuropsychiatric disorders including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ) have been considered distinct categories of diseases despite their overlapping characteristics and symptomatology. We aimed to provide an in-depth review elucidating the role of glutamate/Glx and white matter (WM) abnormalities in these disorders from a transdiagnostic perspective. The PubMed online database was searched for studies published between 2010 and 2021. After careful screening, 401 studies were included. The findings point to decreased levels of glutamate in the Anterior Cingulate Cortex in both SZ and BD, whereas Glx is elevated in the Hippocampus in SZ and MDD. With regard to WM abnormalities, the Corpus Callosum and superior Longitudinal Fascicle were the most consistently identified brain regions showing decreased fractional anisotropy (FA) across all the reviewed disorders, except GAD. Additionally, the Uncinate Fasciculus displayed decreased FA in all disorders, except OCD. Decreased FA was also found in the inferior Longitudinal Fasciculus, inferior Fronto-Occipital Fasciculus, Thalamic Radiation, and Corona Radiata in SZ, BD, and MDD. Decreased FA in the Fornix and Corticospinal Tract were found in BD and SZ patients. The Cingulum and Anterior Limb of Internal Capsule exhibited decreased FA in MDD and SZ patients. The results suggest a gradual increase in severity from GAD to SZ defined by the number of brain regions with WM abnormality which may be partially caused by abnormal glutamate levels. WM damage could thus be considered a potential marker of some of the main neuropsychiatric disorders.
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Affiliation(s)
- Ines Luttenbacher
- Department of Social & Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands; Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Angela Phillips
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Reza Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
| | - Abed L Hadipour
- Department of Cognitive Sciences, University of Messina, Messina, Italy
| | - Isha Sanghvi
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neuroscience, University of Southern California, Los Angeles, CA, USA
| | - Julian Martinez
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Palo Alto University, Palo Alto, CA, USA
| | - Maheen M Adamson
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA; Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
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Shao X, Liao Y, Gu L, Chen W, Tang J. The Etiology of Auditory Hallucinations in Schizophrenia: From Multidimensional Levels. Front Neurosci 2021; 15:755870. [PMID: 34858129 PMCID: PMC8632545 DOI: 10.3389/fnins.2021.755870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/14/2021] [Indexed: 11/25/2022] Open
Abstract
Enormous efforts have been made to unveil the etiology of auditory hallucinations (AHs), and multiple genetic and neural factors have already been shown to have their own roles. Previous studies have shown that AHs in schizophrenia vary from those in other disorders, suggesting that they have unique features and possibly distinguishable mechanisms worthy of further investigation. In this review, we intend to offer a comprehensive summary of current findings related to AHs in schizophrenia from aspects of genetics and transcriptome, neurophysiology (neurometabolic and electroencephalogram studies), and neuroimaging (structural and functional magnetic resonance imaging studies and transcriptome–neuroimaging association study). Main findings include gene polymorphisms, glutamate level change, electroencephalographic alterations, and abnormalities of white matter fasciculi, cortical structure, and cerebral activities, especially in multiple regions, including auditory and language networks. More solid and comparable research is needed to replicate and integrate ongoing findings from multidimensional levels.
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Affiliation(s)
- Xu Shao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Gu
- RIKEN AIP, Tokyo, Japan.,Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Wei Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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5
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A review of functional and structural neuroimaging studies to investigate the inner speech model of auditory verbal hallucinations in schizophrenia. Transl Psychiatry 2021; 11:582. [PMID: 34764242 PMCID: PMC8585980 DOI: 10.1038/s41398-021-01670-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 08/14/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022] Open
Abstract
Although the pathophysiology of auditory verbal hallucinations remains uncertain, the inner speech model remains a prominent theory. A systematic review and meta-analyses of both functional and structural neuroimaging studies were performed to investigate the inner speech model. Of the 417 papers retrieved, 26 met the inclusion criteria. Meta-analyses found the left insula to be significantly active during auditory verbal hallucinations and to have a significantly reduced grey matter volume in hallucinators. Dysfunction of the left insula may contribute to the misattribution of inner speech due to its suggested roles in both inner speech production and the salience network. No significant activity was found at Broca's area or Heschl's gyrus during auditory verbal hallucinations. Furthermore, no structural abnormalities were found at these sites or in the arcuate fasciculi. Overall, evidence was found to both support and oppose the inner speech model. Further research should particularly include a systematic review of task-based trait studies with a focus on inner speech production and self-referential processing, and analyses of additional language-related white matter tracts.
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6
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Wang Z, Wang H, Mwansisya TE, Sheng Y, Shan B, Liu Z, Xue Z, Chen X. The integrity of the white matter in first-episode schizophrenia patients with auditory verbal hallucinations: An atlas-based DTI analysis. Psychiatry Res Neuroimaging 2021; 315:111328. [PMID: 34260985 DOI: 10.1016/j.pscychresns.2021.111328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 05/31/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022]
Abstract
Auditory verbal hallucination (AVH) is one of the most remarkable symptoms of schizophrenia, with great impact on patients' lives and unclear pathogenesis. Neuroimaging studies have indicated that the development of AVHs is associated with white matter alteration, however, there are still inconsistencies in specific findings across previous investigations. The present study aimed to investigate the characteristics of the microstructural integrity of white matter (WM) in first-episode schizophrenia patients who experience auditory hallucinations. Atlas-based Diffusion Tensor Imaging (DTI) analysis was performed to evaluate the white matter integrity in 37 first-episode schizophrenia patients with AVH, 60 schizophrenia patients without AVH, and 50 healthy controls. Compared with the healthy controls group, AVH showed decreased mean fractional anisotropy (FA) in the genu and body of corpus callosum, right posterior corona radiata, left superior corona radiata, left external capsule, right superior fronto-occipital fasciculus, and higher mean diffusivity (MD) in genu of corpus callosum and left fornix and stria terminalis; whereas the nAVH group showed a much more significant reduction of FA and increased MD in broader brain regions. In addition, a significant positive correlation between FA and the severity of AVHs was observed in right posterior corona radiate. These observations collectively demonstrated that a certain degree of preserved fronto-temporal and interhemispheric connectivity in the early stage of schizophrenia might be associated with the brain capability to generate AVHs.
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Affiliation(s)
- Zhiyu Wang
- School of Public Health, Central South University, Changsha, China; Department of Communicable Disease Prevention and Management, Centers for Disease Control and Prevention(CDC) of Changsha City, Changsha, China
| | - Hui Wang
- Department of Geriatrics, The First Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
| | | | - Yaoyao Sheng
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Baoci Shan
- Key Laboratory of Nuclear Analysis, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
| | - Zhening Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China; Hunan Key Laboratory of Psychiatry and Mental Health, National Technology Institute of Psychiatry, Changsha, China; Institute of Mental Health, Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhimin Xue
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China; Hunan Key Laboratory of Psychiatry and Mental Health, National Technology Institute of Psychiatry, Changsha, China; Institute of Mental Health, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xudong Chen
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China; Hunan Key Laboratory of Psychiatry and Mental Health, National Technology Institute of Psychiatry, Changsha, China; Institute of Mental Health, Second Xiangya Hospital, Central South University, Changsha, China.
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7
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Adamczyk P, Jáni M, Ligeza TS, Płonka O, Błądziński P, Wyczesany M. On the Role of Bilateral Brain Hypofunction and Abnormal Lateralization of Cortical Information Flow as Neural Underpinnings of Conventional Metaphor Processing Impairment in Schizophrenia: An fMRI and EEG Study. Brain Topogr 2021; 34:537-554. [PMID: 33973137 PMCID: PMC8195899 DOI: 10.1007/s10548-021-00849-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 05/05/2021] [Indexed: 01/05/2023]
Abstract
Figurative language processing (e.g. metaphors) is commonly impaired in schizophrenia. In the present study, we investigated the neural activity and propagation of information within neural circuits related to the figurative speech, as a neural substrate of impaired conventional metaphor processing in schizophrenia. The study included 30 schizophrenia outpatients and 30 healthy controls, all of whom were assessed with a functional Magnetic Resonance Imaging (fMRI) and electroencephalography (EEG) punchline-based metaphor comprehension task including literal (neutral), figurative (metaphorical) and nonsense (absurd) endings. The blood oxygenation level-dependent signal was recorded with 3T MRI scanner and direction and strength of cortical information flow in the time course of task processing was estimated with a 64-channel EEG input for directed transfer function. The presented results revealed that the behavioral manifestation of impaired figurative language in schizophrenia is related to the hypofunction in the bilateral fronto-temporo-parietal brain regions (fMRI) and various differences in effective connectivity in the fronto-temporo-parietal circuit (EEG). Schizophrenia outpatients showed an abnormal pattern of connectivity during metaphor processing which was related to bilateral (but more pronounced at the left hemisphere) hypoactivation of the brain. Moreover, we found reversed lateralization patterns, i.e. a rightward-shifted pattern during metaphor processing in schizophrenia compared to the control group. In conclusion, the presented findings revealed that the impairment of the conventional metaphor processing in schizophrenia is related to the bilateral brain hypofunction, which supports the evidence on reversed lateralization of the language neural network and the existence of compensatory recruitment of alternative neural circuits in schizophrenia.
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Affiliation(s)
- Przemysław Adamczyk
- Institute of Psychology, Jagiellonian University, Ingardena 6, 30-060, Kraków, Poland.
| | - Martin Jáni
- Institute of Psychology, Jagiellonian University, Ingardena 6, 30-060, Kraków, Poland.,Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Tomasz S Ligeza
- Institute of Psychology, Jagiellonian University, Ingardena 6, 30-060, Kraków, Poland
| | - Olga Płonka
- Institute of Psychology, Jagiellonian University, Ingardena 6, 30-060, Kraków, Poland
| | - Piotr Błądziński
- Community Psychiatry and Psychosis Research Center, Chair of Psychiatry, Medical College, Jagiellonian University, Kraków, Poland
| | - Miroslaw Wyczesany
- Institute of Psychology, Jagiellonian University, Ingardena 6, 30-060, Kraków, Poland
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8
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Pawełczyk A, Łojek E, Żurner N, Gawłowska-Sawosz M, Gębski P, Pawełczyk T. The correlation between white matter integrity and pragmatic language processing in first episode schizophrenia. Brain Imaging Behav 2021; 15:1068-1084. [PMID: 32710335 PMCID: PMC8032571 DOI: 10.1007/s11682-020-00314-6] [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: 01/13/2023]
Abstract
Objective: Higher-order language disturbances could be the result of white matter tract abnormalities. The study explores the relationship between white matter and pragmatic skills in first-episode schizophrenia. Methods: Thirty-four first-episode patients with schizophrenia and 32 healthy subjects participated in a pragmatic language and Diffusion Tensor Imaging study, where fractional anisotropy of the arcuate fasciculus, corpus callosum and cingulum was correlated with the Polish version of the Right Hemisphere Language Battery. Results: The patients showed reduced fractional anisotropy in the right arcuate fasciculus, left anterior cingulum bundle and left forceps minor. Among the first episode patients, reduced understanding of written metaphors correlated with reduced fractional anisotropy of left forceps minor, and greater explanation of written and picture metaphors correlated with reduced fractional anisotropy of the left anterior cingulum. Conclusions: The white matter dysfunctions may underlie the pragmatic language impairment in schizophrenia. Our results shed further light on the functional neuroanatomical basis of pragmatic language use by patients with schizophrenia.
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Affiliation(s)
- Agnieszka Pawełczyk
- Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland.
| | | | - Natalia Żurner
- Adolescent Ward, Central Clinical Hospital of Medical University of Łódź, Łódź, Poland
| | | | - Piotr Gębski
- Scanlab Diagnostyka Medyczna Księży Młyn, Medical Examination Centre, Medical University of Łódź, Łódź, Poland
| | - Tomasz Pawełczyk
- Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland
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Zhuo C, Fang T, Chen C, Chen M, Sun Y, Ma X, Li R, Tian H, Ping J. Brain imaging features in schizophrenia with co-occurring auditory verbal hallucinations and depressive symptoms-Implication for novel therapeutic strategies to alleviate the reciprocal deterioration. Brain Behav 2021; 11:e01991. [PMID: 33305913 PMCID: PMC7882177 DOI: 10.1002/brb3.1991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Auditory verbal hallucinations (AVHs) and depressive symptoms are highly prevalent in schizophrenia, and recent progress has been made in understanding the reciprocal deterioration of both symptoms through structural and functional brain imaging studies. To date, there is limited literature on this topic. In this review, we synthesized the recent literature on the neuroimaging features of schizophrenia patients with concurrent AVHs and depressive symptoms. METHODS A literature search was conducted with the major databases using the keywords, mainly including schizophrenia, AVHs, depression, neuropsychiatric disorders, brain imaging, and magnetic resonance imaging. RESULTS The existing studies have shown that AVHs and depressive symptoms reciprocally deteriorate in patients with schizophrenia, which has challenged the conventional treatment of the disease. Interestingly, repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) therapies have emerged as two efficacious brain stimulation treatments that can normalize the brain regions associated with the symptoms, as shown through functional and structural brain imaging studies. In light of these important findings, there is an urgent need to conduct in-depth neuronal mechanistic studies to identify targets for stimulation therapy. CONCLUSIONS These new findings may elucidate the pathological mechanisms underlying schizophrenia with concurrent AVHs and depressive symptoms. Furthermore, this review has important clinical implications for developing novel therapeutic strategies to alleviate the reciprocal deterioration AVHs and depressive symptoms of schizophrenia patients.
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Affiliation(s)
- Chuanjun Zhuo
- Key Laboratory of Real Time Brain Circuits Tracing of Neurology and Psychiatry (RTBNB_Lab)Tianjin Fourth Center HospitalTianjin Medical Affiliated Tianjin Fourth Central HospitalNankai University Affiliated Tianjin Fourth Center HospitalTianjinChina
- Department of PsychiatryWenzhou Seventh People’s HospitalWenzhouChina
- Psychiatric‐Neuroimaging‐Genetics‐Comorbidity (PNGC) LaboratoryTianjin Mental Health CenterTianjin Anding HospitalNankai University Affiliated Anding HospitalTianjinChina
| | - Tao Fang
- Key Laboratory of Real Time Brain Circuits Tracing of Neurology and Psychiatry (RTBNB_Lab)Tianjin Fourth Center HospitalTianjin Medical Affiliated Tianjin Fourth Central HospitalNankai University Affiliated Tianjin Fourth Center HospitalTianjinChina
| | - Ce Chen
- Department of PsychiatryWenzhou Seventh People’s HospitalWenzhouChina
| | - Min Chen
- Department of PsychiatrySchool of Mental HealthyJining Medical UniversityJiningChina
| | - Yun Sun
- Psychiatric‐Neuroimaging‐Genetics‐Comorbidity (PNGC) LaboratoryTianjin Mental Health CenterTianjin Anding HospitalNankai University Affiliated Anding HospitalTianjinChina
| | - Xiaoyan Ma
- Psychiatric‐Neuroimaging‐Genetics‐Comorbidity (PNGC) LaboratoryTianjin Mental Health CenterTianjin Anding HospitalNankai University Affiliated Anding HospitalTianjinChina
| | - Ranli Li
- Psychiatric‐Neuroimaging‐Genetics‐Comorbidity (PNGC) LaboratoryTianjin Mental Health CenterTianjin Anding HospitalNankai University Affiliated Anding HospitalTianjinChina
| | - Hongjun Tian
- Key Laboratory of Real Time Brain Circuits Tracing of Neurology and Psychiatry (RTBNB_Lab)Tianjin Fourth Center HospitalTianjin Medical Affiliated Tianjin Fourth Central HospitalNankai University Affiliated Tianjin Fourth Center HospitalTianjinChina
| | - Jing Ping
- Department of PsychiatryWenzhou Seventh People’s HospitalWenzhouChina
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Beresniewicz J, Craven AR, Hugdahl K, Løberg EM, Kroken RA, Johnsen E, Grüner R. White Matter Microstructural Differences between Hallucinating and Non-Hallucinating Schizophrenia Spectrum Patients. Diagnostics (Basel) 2021; 11:139. [PMID: 33477803 PMCID: PMC7832406 DOI: 10.3390/diagnostics11010139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/07/2021] [Accepted: 01/15/2021] [Indexed: 01/14/2023] Open
Abstract
The relation between auditory verbal hallucinations (AVH) and white matter has been studied, but results are still inconsistent. This inconsistency may be related to having only a single time-point of AVH assessment in many studies, not capturing that AVH severity fluctuates over time. In the current study, AVH fluctuations were captured by utilizing a longitudinal design and using repeated (Positive and Negative Symptoms Scale) PANSS questionnaire interviews over a 12 month period. We used a Magnetic Resonance Diffusion Tensor Imaging (MR DTI) sequence and tract-based spatial statistics (TBSS) to explore white matter differences between two subtypes of schizophrenia patients; 44 hallucinating (AVH+) and 13 non-hallucinating (AVH-), compared to 13 AVH- matched controls and 44 AVH+ matched controls. Additionally, we tested for hemispheric fractional anisotropy (FA) asymmetry between the groups. Significant widespread FA-value reduction was found in the AVH+ group in comparison to the AVH- group. Although not significant, the extracted FA-values for the control group were in between the two patient groups, for all clusters. We also found a significant difference in FA-asymmetry between the AVH+ and AVH- groups in two clusters, with significantly higher leftward asymmetry in the AVH- group. The current findings suggest a possible qualitative difference in white matter integrity between AVH+ and AVH- patients. Strengths and limitations of the study are discussed.
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Affiliation(s)
- Justyna Beresniewicz
- Department of Biological and Medical Psychology, University of Bergen, 5009 Bergen, Norway; (A.R.C.); (K.H.)
- NORMENT Center of Excellence, Haukeland University Hospital, 5021 Bergen, Norway; (E.-M.L.); (R.A.K.); (E.J.)
- Mohn Medical Imaging and Visualization Center, Haukeland University Hospital, 5021 Bergen, Norway;
| | - Alexander R. Craven
- Department of Biological and Medical Psychology, University of Bergen, 5009 Bergen, Norway; (A.R.C.); (K.H.)
- NORMENT Center of Excellence, Haukeland University Hospital, 5021 Bergen, Norway; (E.-M.L.); (R.A.K.); (E.J.)
- Department of Clinical Engineering, Haukeland University Hospital, 5021 Bergen, Norway
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, 5009 Bergen, Norway; (A.R.C.); (K.H.)
- Division of Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Radiology, Haukeland University Hospital, 5021 Bergen, Norway
| | - Else-Marie Løberg
- NORMENT Center of Excellence, Haukeland University Hospital, 5021 Bergen, Norway; (E.-M.L.); (R.A.K.); (E.J.)
- Division of Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Addiction Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Psychology, University of Bergen, 5009 Bergen, Norway
| | - Rune Andreas Kroken
- NORMENT Center of Excellence, Haukeland University Hospital, 5021 Bergen, Norway; (E.-M.L.); (R.A.K.); (E.J.)
- Division of Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Medicine, University of Bergen, 5009 Bergen, Norway
| | - Erik Johnsen
- NORMENT Center of Excellence, Haukeland University Hospital, 5021 Bergen, Norway; (E.-M.L.); (R.A.K.); (E.J.)
- Division of Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Medicine, University of Bergen, 5009 Bergen, Norway
| | - Renate Grüner
- Mohn Medical Imaging and Visualization Center, Haukeland University Hospital, 5021 Bergen, Norway;
- Department of Radiology, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Physics and Technology, University of Bergen, 5009 Bergen, Norway
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11
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Schoorl J, Barbu MC, Shen X, Harris MR, Adams MJ, Whalley HC, Lawrie SM. Grey and white matter associations of psychotic-like experiences in a general population sample (UK Biobank). Transl Psychiatry 2021; 11:21. [PMID: 33414383 PMCID: PMC7791107 DOI: 10.1038/s41398-020-01131-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/10/2020] [Accepted: 11/23/2020] [Indexed: 01/29/2023] Open
Abstract
There has been a substantial amount of research reporting the neuroanatomical associations of psychotic symptoms in people with schizophrenia. Comparatively little attention has been paid to the neuroimaging correlates of subclinical psychotic symptoms, so-called "psychotic-like experiences" (PLEs), within large healthy populations. PLEs are relatively common in the general population (7-13%), can be distressing and negatively affect health. This study therefore examined gray and white matter associations of four different PLEs (auditory or visual PLEs, and delusional ideas about conspiracies or communications) in subjects of the UK Biobank study with neuroimaging data (N = 21,390, mean age = 63 years). We tested for associations between any PLE (N = 768) and individual PLEs with gray and white matter brain structures, controlling for sex, age, intracranial volume, scanning site, and position in the scanner. Individuals that reported having experienced auditory hallucinations (N = 272) were found to have smaller volumes of the caudate, putamen, and accumbens (β = -0.115-0.134, pcorrected = 0.048-0.036), and reduced temporal lobe volume (β = -0.017, pcorrected = 0.047) compared to those that did not. People who indicated that they had ever believed in unreal conspiracies (N = 111) had a larger volume of the left amygdala (β = 0.023, pcorrected = 0.038). Individuals that reported a history of visual PLEs (N = 435) were found to have reduced white matter microstructure of the forceps major (β = -0.029, pcorrected = 0.009), an effect that was more marked in participants who reported PLEs as distressing. These associations were not accounted for by diagnoses of psychotic or depressive illness, nor the known risk factors for psychotic symptoms of childhood adversity or cannabis use. These findings suggest altered regional gray matter volumes and white matter microstructure in association with PLEs in the general population. They further suggest that these alterations may appear more frequently with the presentation of different psychotic symptoms in the absence of clinically diagnosed psychotic disorders.
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Affiliation(s)
- Julie Schoorl
- Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, UK
| | - Miruna C Barbu
- Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, UK
| | - Xueyi Shen
- Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, UK
| | - Mat R Harris
- Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, UK
| | - Mark J Adams
- Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, UK
| | - Heather C Whalley
- Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, UK
| | - Stephen M Lawrie
- Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, Edinburgh, EH10 5HF, UK.
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12
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Altamura M, Prete G, Elia A, Angelini E, Padalino FA, Bellomo A, Tommasi L, Fairfield B. Do patients with hallucinations imagine speech right? Neuropsychologia 2020; 146:107567. [PMID: 32698031 DOI: 10.1016/j.neuropsychologia.2020.107567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023]
Abstract
A direct relationship between auditory verbal hallucinations (AVHs) and decreased left-hemispheric lateralization in speech perception has been often described, although it has not been conclusively proven. The specific lateralization of AVHs has been poorly explored. However, patients with verbal hallucinations show a weak Right Ear Advantage (REA) in verbal perception compared to non AVHs listeners suggesting that left-hemispheric language area are involved in AVHs. In the present study, 29 schizophrenia patients with AVHs, 31 patients with psychotic bipolar disorder who experienced frequent AVHs, 27 patients with schizophrenia who had never experienced AVHs and 57 healthy controls were required to imagine hearing a voice in one ear alone. In line with previous evidence healthy controls confirmed the expected REA for auditory imagery, and the same REA was also found in non-hallucinator patients. However, in line with our hypothesis, patients with schizophrenia and psychotic bipolar disorder with AVHs showed no lateral bias. Results extend the relationship between abnormal asymmetry for verbal stimuli and AVHs to verbal imagery, suggesting that atypical verbal imagery may reflect a disruption of inter-hemispheric connectivity between areas implicated in the generation and monitoring of verbal imagery and may be predictive of a predisposition for AVHs. Results also indicate that the relationship between AVHs and hemispheric lateralization for auditory verbal imagery is not specific to schizophrenia but may extend to other disorders as well.
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Affiliation(s)
- Mario Altamura
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Giulia Prete
- Department of Psychological, Health and Territorial Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Antonella Elia
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Eleonora Angelini
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Flavia A Padalino
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy
| | - Luca Tommasi
- Department of Psychological, Health and Territorial Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Beth Fairfield
- Department of Psychological, Health and Territorial Sciences, University of Chieti-Pescara, Chieti, Italy.
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13
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Lin X, Li G, Ji F, Cheng L, Chen G, Zhang W, Su Z, Zhang Z, Wang W, Zhou C, Xu Y, Zhuo C. A typical antipsychotic treatment induced gradually expanding white matter alterations in healthy individuals with persistent auditory verbal hallucinations-an artificially controlled pilot study. Int J Neurosci 2020; 131:536-543. [PMID: 32354294 DOI: 10.1080/00207454.2020.1750387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to explore the effects of atypical antipsychotics (AaPs) on brain white matter (WM) tracts in healthy individuals with auditory verbal hallucinations (Hi-AVHs). METHODS We analyzed neuroimaging, AVH symptoms, and cognitive assessment data obtained from 39 Hi-AVHs who reported being distressed by persistent AVHs and volunteered to receive AaP treatment. We used tract-based spatial statistics (TBSS) and t tests to explore AaP pharmacotherapy effects on AVH symptoms and brain WM alterations in Hi-AVH subjects. RESULTS TBSS and t tests revealed WM alterations after AaP treatment, relative to pretreatment observations. Although AaPs alleviated AVH symptoms, WM alterations in these subjects expanded over 8 months of AaP treatment, encompassing most major WM tracts by the end of the observation period, including the corpus callosum, arcuate fasciculus, cortico-spinal tracts, anterior commissure, and posterior commissure. CONCLUSIONS The worsening of AaP-associated WM alterations observed in this study suggest that AaPs may not be a good choice for the treatment of Hi-AVHs despite their ability to alleviate AVHs.
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Affiliation(s)
- Xiaodong Lin
- Department of Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Gongying Li
- Department of Psychiatry, Institute of Mental Health, Jining University, Jining, China
| | - Feng Ji
- Department of Psychiatry, Institute of Mental Health, Jining University, Jining, China
| | - Langlang Cheng
- Department of Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Guangdong Chen
- Department of Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Wei Zhang
- Department of Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Zhonghua Su
- Department of Psychiatry, Institute of Mental Health, Jining University, Jining, China
| | - Zhenqing Zhang
- China-Canada Collaborated Institute of Biological Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Wenqiang Wang
- China-Canada Collaborated Institute of Biological Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Chunhua Zhou
- Department of Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yong Xu
- Department of Psychiatry, MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Chuanjun Zhuo
- Department of Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, China.,Department of Psychiatry, Institute of Mental Health, Jining University, Jining, China.,China-Canada Collaborated Institute of Biological Psychiatry, Xiamen Xianyue Hospital, Xiamen, China.,Department of Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC-lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Ading Hospital, China, Tianjin China
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14
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The role of functional and structural interhemispheric auditory connectivity for language lateralization - A combined EEG and DTI study. Sci Rep 2018; 8:15428. [PMID: 30337548 PMCID: PMC6194074 DOI: 10.1038/s41598-018-33586-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/01/2018] [Indexed: 12/17/2022] Open
Abstract
Interhemispheric connectivity between auditory areas is highly relevant for normal auditory perception and alterations are a major factor for the development of auditory verbal hallucinations. Surprisingly, there is no combined EEG-DTI study directly addressing the role of functional and structural connectivity in the same group of subjects. Accordingly, nothing is known about the relationship between functional connectivity such as gamma-band synchrony, structural integrity of the interhemispheric auditory pathways (IAPs) and language lateralization as well as whether the gamma-band synchrony is configured on the backbone of IAPs. By applying multimodal imaging of 64-channel EEG and DTI tractography, we investigated in 27 healthy volunteers the functional gamma-band synchrony between either bilateral primary or secondary auditory cortices from eLORETA source-estimation during dichotic listening, as well as the correspondent IAPs from which fractional anisotropy (FA) values were extracted. Correlation and regression analyses revealed highest values for gamma-band synchrony, followed by FA for secondary auditory cortices, which were both significantly related to a reduced language lateralization. There was no such association between the white-matter microstructure and gamma-band synchrony, suggesting that structural connectivity might also be relevant for other (minor) aspects of information transfer in addition to gamma-band synchrony, which are not detected in the present coupling analyses. The combination of multimodal EEG-DTI imaging provides converging evidence of neural correlates by showing that both stronger pathways and increased gamma-band synchrony within one cohort of subjects are related to a reduced leftward-lateralization for language.
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15
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Lian N, Lv H, Guo W, Shen Y, Wu R, Liu Y, Zhu F, Hu M, Ou J, Zhao J. A comparative study of magnetic resonance imaging on the gray matter and resting-state function in prodromal and first-episode schizophrenia. Am J Med Genet B Neuropsychiatr Genet 2018; 177:537-545. [PMID: 30105860 DOI: 10.1002/ajmg.b.32644] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 12/06/2017] [Accepted: 04/16/2018] [Indexed: 12/11/2022]
Abstract
It is very difficult to predict the future development possibility of schizophrenia through the clinical symptoms of the high-risk cases. Therefore, how to determine the possibility of developing into schizophrenia individuals before the onset of the diseases are particularly important. The study investigated cerebral gray matter volume differences and resting-state functional connections among patients with psychosis risk syndrome (PRS), patients with first-episode schizophrenic (FES), and healthy controls (HC), aiming to provide scientific clinical evidence for schizophrenia early identification and intervention. A total of 19 PRS patients, 18 FES patients, and 29 HC were recruited. Gray matter volume and amplitude of low-frequency fluctuation (fALFF) during resting-state functional studies were measured. Comparison of gray matter volumes showed that PRS and FES groups had common reduced gray matter volume in the right caudate. PRS and FES patients showed altered connectivity mainly in the semantic processing-related brain areas. fALFF analysis found that PRF and FES patients had significant differences in fALFF values of the brain region mainly located in the subcortical network, visual recognition network, and auditory network. In addition, PRF individuals had a higher fALFF value and a lower fALFF value in the anterior wedge of the cerebral network than the HC group. Gray matter volume loss between related brain areas might appear prior to illness onset. Similar fALFF values occurred in PRS and FES groups indicated that multiple brain regions of neuronal activity abnormalities and unconventional neural network mechanism have been existed in PRS patients.
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Affiliation(s)
- Nan Lian
- Department of Psychiatry, First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hailong Lv
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Wenbing Guo
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Yidong Shen
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Renlong Wu
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Yong Liu
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Furong Zhu
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Maorong Hu
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Jianjun Ou
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Jingping Zhao
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
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16
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Alterations in interhemispheric gamma-band connectivity are related to the emergence of auditory verbal hallucinations in healthy subjects during NMDA-receptor blockade. Neuropsychopharmacology 2018; 43:1608-1615. [PMID: 29453445 PMCID: PMC5983549 DOI: 10.1038/s41386-018-0014-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 12/19/2017] [Accepted: 01/05/2018] [Indexed: 02/06/2023]
Abstract
Auditory verbal hallucinations (AVH) are a common positive symptom of schizophrenia. Excitatory-to-inhibitory (E/I) imbalance related to disturbed N-methyl-D-aspartate receptor (NMDAR) functioning has been suggested as a possible mechanism underlying altered connectivity and AVH in schizophrenia. The current study examined the effects of ketamine, a NMDAR antagonist, on glutamate-related mechanisms underlying interhemispheric gamma-band connectivity, conscious auditory perception during dichotic listening (DL), and the emergence of auditory verbal distortions and hallucinations (AVD/AVH) in healthy volunteers. In a single-blind, pseudo-randomized, placebo-controlled crossover design, nineteen male, right-handed volunteers were measured using 64 channel electroencephalography (EEG). Psychopathology was assessed with the PANSS interview and the 5D-ASC questionnaire, including a subscale to detect auditory alterations with regard to AVD/AVH (AUA-AVD/AVH). Interhemispheric connectivity analysis was performed using eLORETA source estimation and lagged phase synchronization (LPS) in the gamma-band range (30-100 Hz). Ketamine induced positive symptoms such as hallucinations in a subgroup of healthy subjects. In addition, interhemispheric gamma-band connectivity was found to be altered under ketamine compared to placebo, and subjects with AUA-AVD/AVH under ketamine showed significantly higher interhemispheric gamma-band connectivity than subjects without AUA-AVD/AVH. These findings demonstrate a relationship between NMDAR functioning, interhemispheric connectivity in the gamma-band frequency range between bilateral auditory cortices and the emergence of AVD/AVH in healthy subjects. The result is in accordance with the interhemispheric miscommunication hypothesis of AVH and argues for a possible role of glutamate in AVH in schizophrenia.
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17
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Steinmann S, Leicht G, Andreou C, Polomac N, Mulert C. Auditory verbal hallucinations related to altered long-range synchrony of gamma-band oscillations. Sci Rep 2017; 7:8401. [PMID: 28827744 PMCID: PMC5566404 DOI: 10.1038/s41598-017-09253-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 07/25/2017] [Indexed: 11/09/2022] Open
Abstract
Our understanding of the neural correlates of auditory-verbal-hallucinations (AVH) has substantially increased during the last few years, but is far from sufficient. One current hypothesis, the interhemispheric miscommunication theory, is based on findings from fMRI, DTI and EEG, but there is only limited evidence so far concerning underlying functional coupling mechanisms. Here we report a 64-channel EEG study using lagged phase synchronization analysis and eLORETA source estimation to examine the functional connectivity between bilateral auditory cortices in the gamma-band in 26 schizophrenia patients (13 with and 13 without AVH) and 26 matched healthy controls (HC) while performing a dichotic listening task. We found a significantly reduced right-ear-advantage (REA) in AVH but not in non-AVH patients compared to HC. The major finding was significantly stronger gamma-band connectivity between bilateral auditory cortices during conscious perception of left (versus right) ear syllables in patients with AVH compared to HC and patients without AVH. A significant positive correlation was found between this connectivity alteration and the AVH symptom score in schizophrenia patients. These findings provide further support for the interhemispheric miscommunication hypothesis of AVH pathophysiology by indicating that aberrant gamma-band coupling between auditory cortices is related to the emergence of AVH in schizophrenia.
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Affiliation(s)
- Saskia Steinmann
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Gregor Leicht
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christina Andreou
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nenad Polomac
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Mulert
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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