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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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Salisbury DF, Seebold D, Longenecker JM, Coffman BA, Yeh FC. White matter tracts differentially associated with auditory hallucinations in first-episode psychosis: A correlational tractography diffusion spectrum imaging study. Schizophr Res 2024; 265:4-13. [PMID: 37321880 PMCID: PMC10719419 DOI: 10.1016/j.schres.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/17/2023]
Abstract
Auditory hallucinations (AH) are a debilitating symptom in psychosis, impacting cognition and real world functioning. Recent thought conceptualizes AH as a consequence of long-range brain communication dysfunction, or circuitopathy, within the auditory sensory/perceptual, language, and cognitive control systems. Recently we showed in first-episode psychosis (FEP) that, despite overall intact white matter integrity in the cortical-cortical and cortical-subcortical language tracts and the callosal tracts connecting auditory cortices, the severity of AH correlated inversely with white matter integrity. However, that hypothesis-driven isolation of specific tracts likely missed important white matter concomitants of AH. In this report, we used a whole-brain data-driven dimensional approach using correlational tractography to associate AH severity with white matter integrity in a sample of 175 individuals. Diffusion Spectrum Imaging (DSI) was used to image diffusion distribution. Quantitative Anisotropy (QA) in three tracts was greater with increased AH severity (FDR < 0.001) and QA in three tracts was lower with increased AH severity (FDR < 0.01). White matter tracts showing associations between QA and AH were generally associated with frontal-parietal-temporal connectivity (tracts with known relevance for cognitive control and the language system), in the cingulum bundle, and in prefrontal inter-hemispheric connectivity. The results of this whole brain data-driven analysis suggest that subtle white matter alterations connecting frontal, parietal, and temporal lobes in the service of sensory-perceptual, language/semantic, and cognitive control processes impact the expression of auditory hallucination in FEP. Disentangling the distributed neural circuits involved in AH should help to develop novel interventions, such as non-invasive brain stimulation.
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Affiliation(s)
- Dean F Salisbury
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Dylan Seebold
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Julia M Longenecker
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; VISN 4 Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Brian A Coffman
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Fang-Chen Yeh
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Mo F, Zhao H, Li Y, Cai H, Song Y, Wang R, Yu Y, Zhu J. Network Localization of State and Trait of Auditory Verbal Hallucinations in Schizophrenia. Schizophr Bull 2024:sbae020. [PMID: 38401526 DOI: 10.1093/schbul/sbae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
BACKGROUND AND HYPOTHESIS Neuroimaging studies investigating the neural substrates of auditory verbal hallucinations (AVH) in schizophrenia have yielded mixed results, which may be reconciled by network localization. We sought to examine whether AVH-state and AVH-trait brain alterations in schizophrenia localize to common or distinct networks. STUDY DESIGN We initially identified AVH-state and AVH-trait brain alterations in schizophrenia reported in 48 previous studies. By integrating these affected brain locations with large-scale discovery and validation resting-state functional magnetic resonance imaging datasets, we then leveraged novel functional connectivity network mapping to construct AVH-state and AVH-trait dysfunctional networks. STUDY RESULTS The neuroanatomically heterogeneous AVH-state and AVH-trait brain alterations in schizophrenia localized to distinct and specific networks. The AVH-state dysfunctional network comprised a broadly distributed set of brain regions mainly involving the auditory, salience, basal ganglia, language, and sensorimotor networks. Contrastingly, the AVH-trait dysfunctional network manifested as a pattern of circumscribed brain regions principally implicating the caudate and inferior frontal gyrus. Additionally, the AVH-state dysfunctional network aligned with the neuromodulation targets for effective treatment of AVH, indicating possible clinical relevance. CONCLUSIONS Apart from unifying the seemingly irreproducible neuroimaging results across prior AVH studies, our findings suggest different neural mechanisms underlying AVH state and trait in schizophrenia from a network perspective and more broadly may inform future neuromodulation treatment for AVH.
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Affiliation(s)
- Fan Mo
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Han Zhao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Yifan Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Huanhuan Cai
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Yang Song
- Department of Pain, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Rui Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
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Panikratova YR, Lebedeva IS, Akhutina TV, Tikhonov DV, Kaleda VG, Vlasova RM. Executive control of language in schizophrenia patients with history of auditory verbal hallucinations: A neuropsychological and resting-state fMRI study. Schizophr Res 2023; 262:201-210. [PMID: 37923596 DOI: 10.1016/j.schres.2023.10.026] [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: 03/03/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND As demonstrated by a plethora of studies, compromised executive functions (EF) and language are implicated in mechanisms of auditory verbal hallucinations (AVH), but the contribution of their interaction to AVH remains unclear. We hypothesized that schizophrenia patients with history of AVH (AVHh+) vs. without history of AVH (AVHh-) have a specific deficit of executive control of language and alterations in functional connectivity (FC) between the brain regions involved in EF and language, and these neuropsychological and neurophysiological traits are associated with each other. METHODS To explore the executive control of language and its contribution to AVH, we used an integrative approach involving analysis of neuropsychological and resting-state fMRI data of 34 AVHh+, 16 AVHh-, and 40 healthy controls. We identified the neuropsychological and FC measures that differentiated between AVHh+, AVHh-, and HC, and tested the associations between them. RESULTS AVHh+ were characterized by decreased category and phonological verbal fluency, utterance length, productivity in the planning tasks, and poorer retelling. AVHh+ had decreased FC between the left inferior frontal gyrus and the anterior cingulate cortex. Productivity in category verbal fluency was associated with the FC between these regions. CONCLUSIONS Poor executive control of word retrieval and deficient programming of sentence and narrative related to more general deficits of planning may be the neuropsychological traits specific for AVHh+. A neurophysiological trait specific for AVHh+ may be a decreased FC between regions involved in language production and differentiation between alien- vs. self-generated speech and between language production vs. comprehension.
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Affiliation(s)
- Yana R Panikratova
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, 115522, 34 Kashirskoye shosse, Moscow, Russia.
| | - Irina S Lebedeva
- Laboratory of Neuroimaging and Multimodal Analysis, Mental Health Research Center, 115522, 34 Kashirskoye shosse, Moscow, Russia
| | - Tatiana V Akhutina
- Laboratory of Neuropsychology, Faculty of Psychology, Lomonosov Moscow State University, 125009, 11/9 Mokhovaya street, Moscow, Russia
| | - Denis V Tikhonov
- Department of Youth Psychiatry, Mental Health Research Center, 115522, 34 Kashirskoye shosse, Moscow, Russia
| | - Vasilii G Kaleda
- Department of Youth Psychiatry, Mental Health Research Center, 115522, 34 Kashirskoye shosse, Moscow, Russia
| | - Roza M Vlasova
- Department of Psychiatry, University of North Carolina, 101 Manning Dr # 1, Chapel Hill, NC 27514, United States of America
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Conring F, Gangl N, Derome M, Wiest R, Federspiel A, Walther S, Stegmayer K. Associations of resting-state perfusion and auditory verbal hallucinations with and without emotional content in schizophrenia. Neuroimage Clin 2023; 40:103527. [PMID: 37871539 PMCID: PMC10598456 DOI: 10.1016/j.nicl.2023.103527] [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: 07/07/2023] [Revised: 09/21/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
Auditory Verbal Hallucinations (AVH) are highly prevalent in patients with schizophrenia. AVH with high emotional content lead to particularly poor functional outcome. Increasing evidence shows that AVH are associated with alterations in structure and function in language and memory related brain regions. However, neural correlates of AVH with emotional content remain unclear. In our study (n = 91), we related resting-state cerebral perfusion to AVH and emotional content, comparing four groups: patients with AVH with emotional content (n = 13), without emotional content (n = 14), without hallucinations (n = 20) and healthy controls (n = 44). Patients with AVH and emotional content presented with increased perfusion within the amygdala and the ventromedial and dorsomedial prefrontal cortex (vmPFC/ dmPFC) compared to patients with AVH without emotional content. In addition, patients with any AVH showed hyperperfusion within the anterior cingulate gyrus, the vmPFC/dmPFC, the right hippocampus, and the left pre- and postcentral gyrus compared to patients without AVH. Our results indicate metabolic alterations in brain areas critical for the processing of emotions as key for the pathophysiology of AVH with emotional content. Particularly, hyperperfusion of the amygdala may reflect and even trigger emotional content of AVH, while hyperperfusion of the vmPFC/dmPFC cluster may indicate insufficient top-down amygdala regulation in patients with schizophrenia.
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Affiliation(s)
- Frauke Conring
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Nicole Gangl
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Melodie Derome
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katharina Stegmayer
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Mizutani R, Saiga R, Yamamoto Y, Uesugi M, Takeuchi A, Uesugi K, Terada Y, Suzuki Y, De Andrade V, De Carlo F, Takekoshi S, Inomoto C, Nakamura N, Torii Y, Kushima I, Iritani S, Ozaki N, Oshima K, Itokawa M, Arai M. Structural aging of human neurons is opposite of the changes in schizophrenia. PLoS One 2023; 18:e0287646. [PMID: 37352288 PMCID: PMC10289376 DOI: 10.1371/journal.pone.0287646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/11/2023] [Indexed: 06/25/2023] Open
Abstract
Human mentality develops with age and is altered in psychiatric disorders, though their underlying mechanism is unknown. In this study, we analyzed nanometer-scale three-dimensional structures of brain tissues of the anterior cingulate cortex from eight schizophrenia and eight control cases. The distribution profiles of neurite curvature of the control cases showed a trend depending on their age, resulting in an age-correlated decrease in the standard deviation of neurite curvature (Pearson's r = -0.80, p = 0.018). In contrast to the control cases, the schizophrenia cases deviate upward from this correlation, exhibiting a 60% higher neurite curvature compared with the controls (p = 7.8 × 10-4). The neurite curvature also showed a correlation with a hallucination score (Pearson's r = 0.80, p = 1.8 × 10-4), indicating that neurite structure is relevant to brain function. This report is based on our 3D analysis of human brain tissues over a decade and is unprecedented in terms of the number of cases. We suggest that neurite curvature plays a pivotal role in brain aging and can be used as a hallmark to exploit a novel treatment of schizophrenia.
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Affiliation(s)
- Ryuta Mizutani
- Department of Bioengineering, Tokai University, Hiratsuka, Kanagawa, Japan
| | - Rino Saiga
- Department of Bioengineering, Tokai University, Hiratsuka, Kanagawa, Japan
| | - Yoshiro Yamamoto
- Department of Mathematics, Tokai University, Hiratsuka, Kanagawa, Japan
| | - Masayuki Uesugi
- Japan Synchrotron Radiation Research Institute (JASRI/SPring-8), Sayo, Hyogo, Japan
| | - Akihisa Takeuchi
- Japan Synchrotron Radiation Research Institute (JASRI/SPring-8), Sayo, Hyogo, Japan
| | - Kentaro Uesugi
- Japan Synchrotron Radiation Research Institute (JASRI/SPring-8), Sayo, Hyogo, Japan
| | - Yasuko Terada
- Japan Synchrotron Radiation Research Institute (JASRI/SPring-8), Sayo, Hyogo, Japan
| | - Yoshio Suzuki
- Photon Factory, High Energy Accelerator Research Organization KEK, Tsukuba, Ibaraki, Japan
| | - Vincent De Andrade
- Advanced Photon Source, Argonne National Laboratory, Lemont, IL, United States of America
| | - Francesco De Carlo
- Advanced Photon Source, Argonne National Laboratory, Lemont, IL, United States of America
| | - Susumu Takekoshi
- Department of Cell Biology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Chie Inomoto
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Youta Torii
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Itaru Kushima
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Medical Genomics Center, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Shuji Iritani
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kenichi Oshima
- Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
- Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - Masanari Itokawa
- Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
- Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
| | - Makoto Arai
- Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
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Impact of low-frequency repetitive transcranial magnetic stimulation on functional network connectivity in schizophrenia patients with auditory verbal hallucinations. Psychiatry Res 2023; 320:114974. [PMID: 36587467 DOI: 10.1016/j.psychres.2022.114974] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/10/2022] [Accepted: 11/19/2022] [Indexed: 11/22/2022]
Abstract
Auditory verbal hallucinations (AVH) are a key symptom of schizophrenia. Low-frequency repetitive transcranial magnetic stimulation (rTMS) has shown potential in the treatment of AVH. However, the underlying neural mechanismof rTMS in the treatment of AVH remains largely unknown. In this study, we used a static and dynamic functional network connectivity approach to investigate the connectivity changes among the brain functional networks in schizophrenia patients with AVH receiving 1 Hz rTMS treatment. The static functional network connectivity (sFNC) analysis revealed that patients at baseline had significantly decreased connectivity between the default mode network (DMN) and language network (LAN), and within the executive control network (ECN) as well as within the auditory network (AUD) compared to controls. However, the abnormal network connectivity patterns were normalized or restored after rTMS treatment in patients, instead of increased connectivity between the ECN and LAN, as well as within the AUD. Moreover, the dynamic functional network connectivity (dFNC) analysis showed that the patients at baseline spent more time in this state that was characterized by strongly negative connectivity between the ENC and AUD, as well as within the AUD relative to controls. While after rTMS treatment, the patients showed a higher occurrence rate in this state that was characterized by strongly positive connectivity among the LAN, DMN, and ENC, as well as within the ECN. In addition, the altered static and dynamic connectivity properties were associated with reduced severity of clinical symptoms. Both sFNC and dFNC analyses provided complementary information and suggested that low-frequency rTMS treatment could induce intrinsic functional network alternations and contribute to improvements in clinical symptoms in patients with AVH.
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Gornerova N, Brunovsky M, Klirova M, Novak T, Zaytseva Y, Koprivova J, Bravermanova A, Horacek J. The effect of low-frequency rTMS on auditory hallucinations, EEG source localization and functional connectivity in schizophrenia. Neurosci Lett 2023; 794:136977. [PMID: 36427815 DOI: 10.1016/j.neulet.2022.136977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 11/12/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) diminishes auditory hallucinations (AHs). The aims of our study were a) to assess the efficacy of LF-rTMS in a randomized, sham-controlled double-blind alignment, b) to identify the electrophysiological changes accompanying the LF-rTMS, and c) to identify the influence of LF-rTMS on brain functional connectivity (FC). METHODS Nineteen schizophrenia patients with antipsychotic-resistant AHs were randomized to either active (n = 10) or sham (n = 9) LF-rTMS administered over the left temporo-parietal region for ten days. The clinical effect was assessed by the Auditory Hallucination Rating Scale (AHRS). The localization of the differences in electrical activity was identified by standardized low resolution brain electromagnetic tomography (sLORETA) and FC was measured by lagged phase synchronization. RESULTS AHRS scores were significantly improved for patients receiving active rTMS compared to the sham (median reduction: 40 % vs 12 %; p = 0.01). sLORETA revealed a decrease of alpha-2, beta-1,-2 bands in the left hemisphere in the active group. Active rTMS led to a decrease of the lagged phase connectivity in beta bands originating in areas close to the site of stimulation, and to a prevailing increase of alpha-2 FC. No significant differences in current density or FC were observed in the sham group. LIMITATIONS Limitations to our study included the small group sizes, and the disability of LORETA to assess subcortical neuronal activity. CONCLUSIONS LF-rTMS attenuated AHs and induced a decrease of higher frequency bands on the left hemisphere. The FC changes support the assumption that LF-rTMS is linked to the modulation of cortico-cortical coupling.
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Affiliation(s)
- Natalie Gornerova
- National Institute of Mental Health, Czech Republic; Third Medical Faculty of Charles University, Prague, Czech Republic.
| | - Martin Brunovsky
- National Institute of Mental Health, Czech Republic; Third Medical Faculty of Charles University, Prague, Czech Republic
| | - Monika Klirova
- National Institute of Mental Health, Czech Republic; Third Medical Faculty of Charles University, Prague, Czech Republic
| | - Tomas Novak
- National Institute of Mental Health, Czech Republic; Third Medical Faculty of Charles University, Prague, Czech Republic
| | - Yuliya Zaytseva
- National Institute of Mental Health, Czech Republic; Third Medical Faculty of Charles University, Prague, Czech Republic
| | - Jana Koprivova
- National Institute of Mental Health, Czech Republic; Third Medical Faculty of Charles University, Prague, Czech Republic
| | | | - Jiri Horacek
- National Institute of Mental Health, Czech Republic; Third Medical Faculty of Charles University, Prague, Czech Republic
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Soler-Vidal J, Fuentes-Claramonte P, Salgado-Pineda P, Ramiro N, García-León MÁ, Torres ML, Arévalo A, Guerrero-Pedraza A, Munuera J, Sarró S, Salvador R, Hinzen W, McKenna P, Pomarol-Clotet E. Brain correlates of speech perception in schizophrenia patients with and without auditory hallucinations. PLoS One 2022; 17:e0276975. [PMID: 36525414 PMCID: PMC9757556 DOI: 10.1371/journal.pone.0276975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 10/18/2022] [Indexed: 12/23/2022] Open
Abstract
The experience of auditory verbal hallucinations (AVH, "hearing voices") in schizophrenia has been found to be associated with reduced auditory cortex activation during perception of real auditory stimuli like tones and speech. We re-examined this finding using 46 patients with schizophrenia (23 with frequent AVH and 23 hallucination-free), who underwent fMRI scanning while they heard words, sentences and reversed speech. Twenty-five matched healthy controls were also examined. Perception of words, sentences and reversed speech all elicited activation of the bilateral superior temporal cortex, the inferior and lateral prefrontal cortex, the inferior parietal cortex and the supplementary motor area in the patients and the healthy controls. During the sentence and reversed speech conditions, the schizophrenia patients as a group showed reduced activation in the left primary auditory cortex (Heschl's gyrus) relative to the healthy controls. No differences were found between the patients with and without hallucinations in any condition. This study therefore fails to support previous findings that experience of AVH attenuates speech-perception-related brain activations in the auditory cortex. At the same time, it suggests that schizophrenia patients, regardless of presence of AVH, show reduced activation in the primary auditory cortex during speech perception, a finding which could reflect an early information processing deficit in the disorder.
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Affiliation(s)
- Joan Soler-Vidal
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Benito Menni Complex Asistencial en Salut Mental, Sant Boi de Llobregat, Spain
| | - Paola Fuentes-Claramonte
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
| | - Pilar Salgado-Pineda
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
| | | | - María Ángeles García-León
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
| | | | | | | | - Josep Munuera
- Diagnostic Imaging and Image Guided Therapy, Institut de Recerca Sant Joan de Déu, Santa Rosa 39–57, Esplugues de Llobregat, Spain
- Diagnostic Imaging Department, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, Barcelona, Spain
- Hospital de Sant Joan de Déu, Barcelona, Spain
| | - Salvador Sarró
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
| | - Raymond Salvador
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
| | - Wolfram Hinzen
- Universitat Pompeu Fabra, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Peter McKenna
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
- * E-mail:
| | - Edith Pomarol-Clotet
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
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10
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Chang X, Zhao W, Kang J, Xiang S, Xie C, Corona-Hernández H, Palaniyappan L, Feng J. Language abnormalities in schizophrenia: binding core symptoms through contemporary empirical evidence. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:95. [PMID: 36371445 PMCID: PMC9653408 DOI: 10.1038/s41537-022-00308-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Both the ability to speak and to infer complex linguistic messages from sounds have been claimed as uniquely human phenomena. In schizophrenia, formal thought disorder (FTD) and auditory verbal hallucinations (AVHs) are manifestations respectively relating to concrete disruptions of those abilities. From an evolutionary perspective, Crow (1997) proposed that "schizophrenia is the price that Homo sapiens pays for the faculty of language". Epidemiological and experimental evidence points to an overlap between FTD and AVHs, yet a thorough investigation examining their shared neural mechanism in schizophrenia is lacking. In this review, we synthesize observations from three key domains. First, neuroanatomical evidence indicates substantial shared abnormalities in language-processing regions between FTD and AVHs, even in the early phases of schizophrenia. Second, neurochemical studies point to a glutamate-related dysfunction in these language-processing brain regions, contributing to verbal production deficits. Third, genetic findings further show how genes that overlap between schizophrenia and language disorders influence neurodevelopment and neurotransmission. We argue that these observations converge into the possibility that a glutamatergic dysfunction in language-processing brain regions might be a shared neural basis of both FTD and AVHs. Investigations of language pathology in schizophrenia could facilitate the development of diagnostic tools and treatments, so we call for multilevel confirmatory analyses focused on modulations of the language network as a therapeutic goal in schizophrenia.
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Affiliation(s)
- Xiao Chang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
- Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Wei Zhao
- MOE-LCSM, School of Mathematics and Statistics, Hunan Normal University, Changsha, PR China
| | - Jujiao Kang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
- Shanghai Center for Mathematical Sciences, Shanghai, China
| | - Shitong Xiang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Chao Xie
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Hugo Corona-Hernández
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada.
- Lawson Health Research Institute, London, Ontario, Canada.
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China.
- MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
- Zhangjiang Fudan International Innovation Center, Shanghai, China.
- Shanghai Center for Mathematical Sciences, Shanghai, China.
- Department of Computer Science, University of Warwick, Coventry, UK.
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11
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Billig AJ, Lad M, Sedley W, Griffiths TD. The hearing hippocampus. Prog Neurobiol 2022; 218:102326. [PMID: 35870677 PMCID: PMC10510040 DOI: 10.1016/j.pneurobio.2022.102326] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/08/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
Abstract
The hippocampus has a well-established role in spatial and episodic memory but a broader function has been proposed including aspects of perception and relational processing. Neural bases of sound analysis have been described in the pathway to auditory cortex, but wider networks supporting auditory cognition are still being established. We review what is known about the role of the hippocampus in processing auditory information, and how the hippocampus itself is shaped by sound. In examining imaging, recording, and lesion studies in species from rodents to humans, we uncover a hierarchy of hippocampal responses to sound including during passive exposure, active listening, and the learning of associations between sounds and other stimuli. We describe how the hippocampus' connectivity and computational architecture allow it to track and manipulate auditory information - whether in the form of speech, music, or environmental, emotional, or phantom sounds. Functional and structural correlates of auditory experience are also identified. The extent of auditory-hippocampal interactions is consistent with the view that the hippocampus makes broad contributions to perception and cognition, beyond spatial and episodic memory. More deeply understanding these interactions may unlock applications including entraining hippocampal rhythms to support cognition, and intervening in links between hearing loss and dementia.
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Affiliation(s)
| | - Meher Lad
- Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - William Sedley
- Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Timothy D Griffiths
- Biosciences Institute, Newcastle University Medical School, Newcastle upon Tyne, UK; Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK; Human Brain Research Laboratory, Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, USA
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12
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Sharaev M, Malashenkova I, Maslennikova A, Zakharova N, Bernstein A, Burnaev E, Mamedova G, Krynskiy S, Ogurtsov D, Kondrateva E, Druzhinina P, Zubrikhina M, Arkhipov A, Strelets V, Ushakov V. Diagnosis of Schizophrenia Based on the Data of Various Modalities: Biomarkers and Machine Learning Techniques (Review). Sovrem Tekhnologii Med 2022; 14:53-75. [PMID: 37181835 PMCID: PMC10171060 DOI: 10.17691/stm2022.14.5.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Indexed: 05/16/2023] Open
Abstract
Schizophrenia is a socially significant mental disorder resulting frequently in severe forms of disability. Diagnosis, choice of treatment tactics, and rehabilitation in clinical psychiatry are mainly based on the assessment of behavioral patterns, socio-demographic data, and other investigations such as clinical observations and neuropsychological testing including examination of patients by the psychiatrist, self-reports, and questionnaires. In many respects, these data are subjective and therefore a large number of works have appeared in recent years devoted to the search for objective characteristics (indices, biomarkers) of the processes going on in the human body and reflected in the behavioral and psychoneurological patterns of patients. Such biomarkers are based on the results of instrumental and laboratory studies (neuroimaging, electro-physiological, biochemical, immunological, genetic, and others) and are successfully being used in neurosciences for understanding the mechanisms of the emergence and development of nervous system pathologies. Presently, with the advent of new effective neuroimaging, laboratory, and other methods of investigation and also with the development of modern methods of data analysis, machine learning, and artificial intelligence, a great number of scientific and clinical studies is being conducted devoted to the search for the markers which have diagnostic and prognostic value and may be used in clinical practice to objectivize the processes of establishing and clarifying the diagnosis, choosing and optimizing treatment and rehabilitation tactics, predicting the course and outcome of the disease. This review presents the analysis of the works which describe the correlates between the diagnosis of schizophrenia, established by health professionals, various manifestations of the psychiatric disorder (its subtype, variant of the course, severity degree, observed symptoms, etc.), and objectively measured characteristics/quantitative indicators (anatomical, functional, immunological, genetic, and others) obtained during instrumental and laboratory examinations of patients. A considerable part of these works has been devoted to correlates/biomarkers of schizophrenia based on the data of structural and functional (at rest and under cognitive load) MRI, EEG, tractography, and immunological data. The found correlates/biomarkers reflect anatomic disorders in the specific brain regions, impairment of functional activity of brain regions and their interconnections, specific microstructure of the brain white matter and the levels of connectivity between the tracts of various structures, alterations of electrical activity in various parts of the brain in different EEG spectral ranges, as well as changes in the innate and adaptive links of immunity. Current methods of data analysis and machine learning to search for schizophrenia biomarkers using the data of diverse modalities and their application during building and interpretation of predictive diagnostic models of schizophrenia have been considered in the present review.
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Affiliation(s)
- M.G. Sharaev
- Senior Researcher; Skolkovo Institute of Science and Technology (Skoltech), Territory of Skolkovo Innovation Center, Bldg 1, 30 Bolshoy Boulevard, Moscow, 121205, Russia; Department Senior Researcher; N.A. Alekseyev Psychiatric Clinical Hospital No.1, 2 Zagorodnoye Shosse, Moscow, 117152, Russia
- Corresponding author: Maksim G. Sharaev, e-mail:
| | - I.K. Malashenkova
- Head of the Laboratory of Molecular Immunology and Virology; National Research Center “Kurchatov Institute”, 1 Akademika Kurchatova Square, Moscow, 123182, Russia; Senior Researcher, Laboratory of Clinical Immunology; Federal Research and Clinical Center of Physical-Chemical Medicine, Federal Medical Biological Agency of Russia, 1A Malaya Pirogovskaya St., Moscow, 119435, Russia
| | - A.V. Maslennikova
- Researcher, Laboratory of Human Higher Nervous Activity; Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5A Butlerova St., Moscow, 117485, Russia
| | - N.V. Zakharova
- Head of the Laboratory for Fundamental Research Methods, Research Clinical Center of Neuropsychiatry; N.A. Alekseyev Psychiatric Clinical Hospital No.1, 2 Zagorodnoye Shosse, Moscow, 117152, Russia
| | - A.V. Bernstein
- Professor, Professor of the Center of Applied Artificial Intelligence; Skolkovo Institute of Science and Technology (Skoltech), Territory of Skolkovo Innovation Center, Bldg 1, 30 Bolshoy Boulevard, Moscow, 121205, Russia
| | - E.V. Burnaev
- Associate Professor, Professor of the Center of Applied Artificial Intelligence; Skolkovo Institute of Science and Technology (Skoltech), Territory of Skolkovo Innovation Center, Bldg 1, 30 Bolshoy Boulevard, Moscow, 121205, Russia
| | - G.S. Mamedova
- Junior Researcher, Laboratory for Fundamental Research Methods, Research Clinical Center of Neuropsychiatry; N.A. Alekseyev Psychiatric Clinical Hospital No.1, 2 Zagorodnoye Shosse, Moscow, 117152, Russia
| | - S.A. Krynskiy
- Researcher, Laboratory of Molecular Immunology and Virology; National Research Center “Kurchatov Institute”, 1 Akademika Kurchatova Square, Moscow, 123182, Russia
| | - D.P. Ogurtsov
- Researcher, Laboratory of Molecular Immunology and Virology; National Research Center “Kurchatov Institute”, 1 Akademika Kurchatova Square, Moscow, 123182, Russia
| | - E.A. Kondrateva
- PhD Student; Skolkovo Institute of Science and Technology (Skoltech), Territory of Skolkovo Innovation Center, Bldg 1, 30 Bolshoy Boulevard, Moscow, 121205, Russia
| | - P.V. Druzhinina
- PhD Student; Skolkovo Institute of Science and Technology (Skoltech), Territory of Skolkovo Innovation Center, Bldg 1, 30 Bolshoy Boulevard, Moscow, 121205, Russia
| | - M.O. Zubrikhina
- PhD Student; Skolkovo Institute of Science and Technology (Skoltech), Territory of Skolkovo Innovation Center, Bldg 1, 30 Bolshoy Boulevard, Moscow, 121205, Russia
| | - A.Yu. Arkhipov
- Researcher, Laboratory of Human Higher Nervous Activity; Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5A Butlerova St., Moscow, 117485, Russia
| | - V.B. Strelets
- Chief Researcher, Laboratory of Human Higher Nervous Activity; Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5A Butlerova St., Moscow, 117485, Russia
| | - V.L. Ushakov
- Associate Professor, Chief Researcher, Institute for Advanced Brain Research; Lomonosov Moscow State University, 27/1 Lomonosov Avenue, Moscow, 119192, Russia; Head of the Department; N.A. Alekseyev Psychiatric Clinical Hospital No.1, 2 Zagorodnoye Shosse, Moscow, 117152, Russia; Senior Researcher; National Research Nuclear University MEPhI, 31 Kashirskoye Shosse, Moscow, 115409, Russia
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13
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Xie Y, Cai Y, Guan M, Wang Z, Ma Z, Fang P, Wang H. The alternations of nucleus accumbent in schizophrenia patients with auditory verbal hallucinations during low-frequency rTMS treatment. Front Psychiatry 2022; 13:971105. [PMID: 36147981 PMCID: PMC9485869 DOI: 10.3389/fpsyt.2022.971105] [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: 06/16/2022] [Accepted: 08/16/2022] [Indexed: 01/24/2023] Open
Abstract
Low-frequency repetitive transcranial magnetic stimulation (rTMS) has been shown to reduce the severity of auditory verbal hallucinations (AVH) and induce beneficial functional and structural alternations of the brain in schizophrenia patients with AVH. The nucleus accumbens (NAcc) as an important component of the ventral striatum is implicated with the pathology in AVH. However, the induced characteristic patterns of NAcc by low-frequency rTMS in schizophrenia with AVH are seldom explored. We investigated the functional and structural characteristic patterns of NAcc by using seed-based functional connectivity (FC) analysis and gray matter volume (GMV) measurement in schizophrenia patients with AVH during 1 Hz rTMS treatment. Although low-frequency rTMS treatment did not affect the volumetric changes of NAcc, the abnormal FC patterns of NAcc, including increased FC of NAcc with the temporal lobes and decreased FC of NAcc with the frontal cortices in the pretreatment patients compared to healthy controls, were normalized or reversed after treatment. These FC changes were associated with improvements in clinical symptoms and neurocognitive functions. Our findings may extend our understanding of the NAcc in the pathology of schizophrenia with AVH and might be a biomarker of clinical effect for low-frequency rTMS treatment in schizophrenia.
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Affiliation(s)
- Yuanjun Xie
- School of Education, Xinyang College, Xinyang, China.,Department of Radiology, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Yun Cai
- Department of Neurodevelopment Psychology, School of Psychology, Army Medical University, Chongqing, China
| | - Muzhen Guan
- Department of Mental Health, Xi'an Medical University, Xi'an, China
| | - Zhongheng Wang
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Zhujing Ma
- Department of Clinical Psychology, Air Force Medical University, Xi'an, China
| | - Peng Fang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, Air Force Medical University, Xi'an, China
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14
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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: 17] [Impact Index Per Article: 5.7] [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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15
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Demro C, Mueller BA, Kent JS, Burton PC, Olman CA, Schallmo MP, Lim KO, Sponheim SR. The psychosis human connectome project: An overview. Neuroimage 2021; 241:118439. [PMID: 34339830 PMCID: PMC8542422 DOI: 10.1016/j.neuroimage.2021.118439] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/25/2021] [Accepted: 07/21/2021] [Indexed: 01/05/2023] Open
Abstract
Investigations within the Human Connectome Project have expanded to include studies focusing on brain disorders. This paper describes one of the investigations focused on psychotic psychopathology: The psychosis Human Connectome Project (P-HCP). The data collected as part of this project were multimodal and derived from clinical assessments of psychopathology, cognitive assessments, instrument-based motor assessments, blood specimens, and magnetic resonance imaging (MRI) data. The dataset will be made publicly available through the NIMH Data Archive. In this report we provide specific information on how the sample of participants was obtained and characterized and describe the experimental tasks and procedures used to probe neural functions involved in psychotic disorders that may also mark genetic liability for psychotic psychopathology. Our goal in this paper is to outline the data acquisition process so that researchers intending to use these publicly available data can plan their analyses. MRI data described in this paper are limited to data acquired at 3 Tesla. A companion paper describes the study's 7 Tesla image acquisition protocol in detail, which is focused on visual perceptual functions in psychotic psychopathology.
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Affiliation(s)
- Caroline Demro
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States; Department of Psychology, University of Minnesota, Minneapolis, MN, United State
| | - Bryon A Mueller
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Jerillyn S Kent
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Philip C Burton
- College of Liberal Arts, University of Minnesota, Minneapolis, MN, United State
| | - Cheryl A Olman
- Department of Psychology, University of Minnesota, Minneapolis, MN, United State
| | - Michael-Paul Schallmo
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States; Minneapolis Veterans Affairs Medical Center, 1 Veterans Drive, Minneapolis, MN 55417, United State
| | - Scott R Sponheim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States; Department of Psychology, University of Minnesota, Minneapolis, MN, United State; Minneapolis Veterans Affairs Medical Center, 1 Veterans Drive, Minneapolis, MN 55417, United State.
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16
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Fuentes-Claramonte P, Soler-Vidal J, Salgado-Pineda P, García-León MÁ, Ramiro N, Santo-Angles A, Llanos Torres M, Tristany J, Guerrero-Pedraza A, Munuera J, Sarró S, Salvador R, Hinzen W, McKenna PJ, Pomarol-Clotet E. Auditory hallucinations activate language and verbal short-term memory, but not auditory, brain regions. Sci Rep 2021; 11:18890. [PMID: 34556714 PMCID: PMC8460641 DOI: 10.1038/s41598-021-98269-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/31/2021] [Indexed: 11/12/2022] Open
Abstract
Auditory verbal hallucinations (AVH, ‘hearing voices’) are an important symptom of schizophrenia but their biological basis is not well understood. One longstanding approach proposes that they are perceptual in nature, specifically that they reflect spontaneous abnormal neuronal activity in the auditory cortex, perhaps with additional ‘top down’ cognitive influences. Functional imaging studies employing the symptom capture technique—where activity when patients experience AVH is compared to times when they do not—have had mixed findings as to whether the auditory cortex is activated. Here, using a novel variant of the symptom capture technique, we show that the experience of AVH does not induce auditory cortex activation, even while real speech does, something that effectively rules out all theories that propose a perceptual component to AVH. Instead, we find that the experience of AVH activates language regions and/or regions that are engaged during verbal short-term memory.
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Affiliation(s)
- Paola Fuentes-Claramonte
- FIDMAG Hermanas Hospitalarias Research Foundation, C/. Dr. Antoni Pujadas 38, 08830, Sant Boi de Llobregat, Barcelona, Spain.,CIBERSAM, Madrid, Spain
| | - Joan Soler-Vidal
- FIDMAG Hermanas Hospitalarias Research Foundation, C/. Dr. Antoni Pujadas 38, 08830, Sant Boi de Llobregat, Barcelona, Spain.,CIBERSAM, Madrid, Spain.,Universitat de Barcelona, Barcelona, Spain.,Benito Menni Complex Asistencial en Salut Mental, Sant Boi de Llobregat, Spain
| | - Pilar Salgado-Pineda
- FIDMAG Hermanas Hospitalarias Research Foundation, C/. Dr. Antoni Pujadas 38, 08830, Sant Boi de Llobregat, Barcelona, Spain.,CIBERSAM, Madrid, Spain
| | - María Ángeles García-León
- FIDMAG Hermanas Hospitalarias Research Foundation, C/. Dr. Antoni Pujadas 38, 08830, Sant Boi de Llobregat, Barcelona, Spain.,CIBERSAM, Madrid, Spain
| | | | - Aniol Santo-Angles
- FIDMAG Hermanas Hospitalarias Research Foundation, C/. Dr. Antoni Pujadas 38, 08830, Sant Boi de Llobregat, Barcelona, Spain
| | | | | | | | | | - Salvador Sarró
- FIDMAG Hermanas Hospitalarias Research Foundation, C/. Dr. Antoni Pujadas 38, 08830, Sant Boi de Llobregat, Barcelona, Spain.,CIBERSAM, Madrid, Spain
| | - Raymond Salvador
- FIDMAG Hermanas Hospitalarias Research Foundation, C/. Dr. Antoni Pujadas 38, 08830, Sant Boi de Llobregat, Barcelona, Spain.,CIBERSAM, Madrid, Spain
| | - Wolfram Hinzen
- ICREA (Institució Catalana de Recerca i Estudis Avançats), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Peter J McKenna
- FIDMAG Hermanas Hospitalarias Research Foundation, C/. Dr. Antoni Pujadas 38, 08830, Sant Boi de Llobregat, Barcelona, Spain. .,CIBERSAM, Madrid, Spain.
| | - Edith Pomarol-Clotet
- FIDMAG Hermanas Hospitalarias Research Foundation, C/. Dr. Antoni Pujadas 38, 08830, Sant Boi de Llobregat, Barcelona, Spain.,CIBERSAM, Madrid, Spain
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17
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Kim DJ, Jassar H, Lim M, Nascimento TD, DaSilva AF. Dopaminergic Regulation of Reward System Connectivity Underpins Pain and Emotional Suffering in Migraine. J Pain Res 2021; 14:631-643. [PMID: 33727857 PMCID: PMC7955762 DOI: 10.2147/jpr.s296540] [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: 12/10/2020] [Accepted: 02/17/2021] [Indexed: 12/31/2022] Open
Abstract
Purpose It has been suggested that reward system dysfunction may account for emotion and pain suffering in migraine. However, there is a lack of evidence whether the altered reward system connectivity is directly associated with clinical manifestations, including negative affect and ictal pain severity and, at the molecular level, the dopamine (DA) D2/D3 receptors (D2/3Rs) signaling implicated in encoding motivational and emotional cues. Patients and Methods We acquired resting-state functional MRI from interictal episodic migraine (EM) patients and age-matched healthy controls, as well as positron emission tomography (PET) with [11C]raclopride, a selective radiotracer for DA D2/3Rs, from a subset of these participants. The nucleus accumbens (NAc) was seeded to measure functional connectivity (FC) and DA D2/3Rs availability based on its essential involvement in pain-related aversive/reward functions. Associations of the brain measures with positive/negative affect and ictal pain severity were also assessed. Results Compared with controls, the EM group showed weaker right NAc connectivity with areas implicated in pain and emotional regulation, such as the amygdala, rostral anterior cingulate cortex, hippocampus, and thalamus; but showed stronger left NAc connectivity with the dorsolateral prefrontal cortex and lingual gyrus. Moreover, among the altered NAc connectivities, only right NAc-amygdala connectivity was inversely correlated with DA D2/3Rs availability in migraine patients (diagnostic group-by-D2/3Rs interaction p < 0.007). At a clinical level, such weaker NAc-amygdala connectivity was associated with lower interictal positive affect and greater ictal pain severity over the head and facial extension area (pain area and intensity number summation, PAINS). Conclusion Together, our findings suggest that altered reward system connectivity, specifically between the NAc and amygdala, might be affected by endogenous DA D2/3Rs signaling, and such process might be a neural mechanism that underlies emotional and pain suffering in episodic migraineurs.
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Affiliation(s)
- Dajung J Kim
- Headache and Orofacial Pain Effort (H.O.P.E.), Biologic and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Hassan Jassar
- Headache and Orofacial Pain Effort (H.O.P.E.), Biologic and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Manyoel Lim
- Headache and Orofacial Pain Effort (H.O.P.E.), Biologic and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Thiago D Nascimento
- Headache and Orofacial Pain Effort (H.O.P.E.), Biologic and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Alexandre F DaSilva
- Headache and Orofacial Pain Effort (H.O.P.E.), Biologic and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
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18
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Curtis MT, Coffman BA, Salisbury DF. Parahippocampal area three gray matter is reduced in first-episode schizophrenia spectrum: Discovery and replication samples. Hum Brain Mapp 2020; 42:724-736. [PMID: 33219733 PMCID: PMC7814759 DOI: 10.1002/hbm.25256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/02/2020] [Accepted: 10/07/2020] [Indexed: 12/27/2022] Open
Abstract
Early course schizophrenia is associated with reduced gray matter. The specific structures affected first and how deficits impact symptoms and cognition remain unresolved. We used the Human Connectome Project multimodal parcellation (HCP‐MMP) to precisely identify cortical areas and investigate thickness abnormalities in discovery and replication samples of first‐episode schizophrenia spectrum individuals (FESz). In the discovery sample, T1w scans were acquired from 31 FESz and 31 matched healthy controls (HC). Thickness was calculated for 360 regions in Freesurfer. In the replication sample, high‐resolution T1w, T2w, and BOLD‐rest scans were acquired from 23 FESz and 32 HC and processed with HCP protocols. Thickness was calculated for regions significant in the discovery sample. After FDR correction (q < .05), left and right parahippocampal area 3 (PHA3) were significantly thinner in FESz. In the replication sample, bilateral PHA3 were again thinner in FESz (q < .05). Exploratory correlation analyses revealed left PHA3 was positively associated with hallucinations and right PHA3 was positively associated with processing speed, working memory, and verbal learning. The novel use of the HCP‐MMP in two independent FESz samples revealed thinner bilateral PHA3, suggesting this byway between cortical and limbic processing is a critical site of pathology near the emergence of psychosis.
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Affiliation(s)
- Mark T Curtis
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Brian A Coffman
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Dean F Salisbury
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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19
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Rollins CPE, Garrison JR, Arribas M, Seyedsalehi A, Li Z, Chan RCK, Yang J, Wang D, Liò P, Yan C, Yi ZH, Cachia A, Upthegrove R, Deakin B, Simons JS, Murray GK, Suckling J. Evidence in cortical folding patterns for prenatal predispositions to hallucinations in schizophrenia. Transl Psychiatry 2020; 10:387. [PMID: 33159044 PMCID: PMC7648757 DOI: 10.1038/s41398-020-01075-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 09/30/2020] [Accepted: 10/22/2020] [Indexed: 12/26/2022] Open
Abstract
All perception is a construction of the brain from sensory input. Our first perceptions begin during gestation, making fetal brain development fundamental to how we experience a diverse world. Hallucinations are percepts without origin in physical reality that occur in health and disease. Despite longstanding research on the brain structures supporting hallucinations and on perinatal contributions to the pathophysiology of schizophrenia, what links these two distinct lines of research remains unclear. Sulcal patterns derived from structural magnetic resonance (MR) images can provide a proxy in adulthood for early brain development. We studied two independent datasets of patients with schizophrenia who underwent clinical assessment and 3T MR imaging from the United Kingdom and Shanghai, China (n = 181 combined) and 63 healthy controls from Shanghai. Participants were stratified into those with (n = 79 UK; n = 22 Shanghai) and without (n = 43 UK; n = 37 Shanghai) hallucinations from the PANSS P3 scores for hallucinatory behaviour. We quantified the length, depth, and asymmetry indices of the paracingulate and superior temporal sulci (PCS, STS), which have previously been associated with hallucinations in schizophrenia, and constructed cortical folding covariance matrices organized by large-scale functional networks. In both ethnic groups, we demonstrated a significantly shorter left PCS in patients with hallucinations compared to those without, and to healthy controls. Reduced PCS length and STS depth corresponded to focal deviations in their geometry and to significantly increased covariance within and between areas of the salience and auditory networks. The discovery of neurodevelopmental alterations contributing to hallucinations establishes testable models for these enigmatic, sometimes highly distressing, perceptions and provides mechanistic insight into the pathological consequences of prenatal origins.
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Affiliation(s)
- Colleen P. E. Rollins
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Jane R. Garrison
- grid.5335.00000000121885934Department of Psychology, University of Cambridge, Cambridge, UK
| | - Maite Arribas
- grid.5335.00000000121885934Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK ,grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Aida Seyedsalehi
- grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK ,grid.450563.10000 0004 0412 9303Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Zhi Li
- grid.9227.e0000000119573309Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Raymond C. K. Chan
- grid.9227.e0000000119573309Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Junwei Yang
- grid.5335.00000000121885934Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
| | - Duo Wang
- grid.5335.00000000121885934Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
| | - Pietro Liò
- grid.5335.00000000121885934Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
| | - Chao Yan
- grid.22069.3f0000 0004 0369 6365Key Laboratory of Brain Functional Genomics (MOE & STCSM), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Zheng-hui Yi
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Arnaud Cachia
- Université de Paris, LaPsyDÉ, CNRS, F-75005 Paris, France ,Université de Paris, IPNP, INSERM, F-75005 Paris, France
| | - Rachel Upthegrove
- grid.6572.60000 0004 1936 7486Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Bill Deakin
- grid.5379.80000000121662407Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
| | - Jon S. Simons
- grid.5335.00000000121885934Department of Psychology, University of Cambridge, Cambridge, UK
| | - Graham K. Murray
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK ,grid.450563.10000 0004 0412 9303Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - John Suckling
- grid.5335.00000000121885934Department of Psychiatry, University of Cambridge, Cambridge, UK
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20
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Pinheiro AP, Schwartze M, Kotz SA. Cerebellar circuitry and auditory verbal hallucinations: An integrative synthesis and perspective. Neurosci Biobehav Rev 2020; 118:485-503. [DOI: 10.1016/j.neubiorev.2020.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/30/2020] [Accepted: 08/07/2020] [Indexed: 02/06/2023]
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21
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Hua M, Peng Y, Zhou Y, Qin W, Yu C, Liang M. Disrupted pathways from limbic areas to thalamus in schizophrenia highlighted by whole-brain resting-state effective connectivity analysis. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109837. [PMID: 31830509 DOI: 10.1016/j.pnpbp.2019.109837] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/22/2019] [Accepted: 12/06/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Numerous neuroimaging studies have revealed that schizophrenia was characterized by wide-spread dysconnection among brain regions during rest measured by functional connectivity (FC). In contrast with FC, effective connectivity (EC) provides information about directionality of brain connections and is thus valuable in mechanistic investigation of schizophrenic brain. However, a systematic characterization of whole-brain resting-state EC (rsEC) and how it captures different information compared with resting-state FC (rsFC) in schizophrenia are still lacking. AIMS To systematically characterize the abnormalities of rsEC, compared with rsFC, in schizophrenia, and to test its discriminative power as a neuroimaging marker for schizophrenia diagnosis. METHOD Whole-brain rsEC and rsFC networks were constructed using resting-state fMRI data and compared between 103 patients with schizophrenia and 110 healthy participants. Pattern classifications between patients and controls based on whole-brain rsEC and rsFC were further performed using multivariate pattern analysis. RESULTS We identified 17 rsEC significantly disrupted (mostly decreased) in patients, among which all were associated with the thalamus and 15 were from limbic areas (including hippocampus, parahippocampus and cingulate cortex) to the thalamus. In contrast, abnormal rsFC were widely distributed in the whole brain. The classification accuracies for distinguishing patients and controls using whole-brain rsEC and rsFC patterns were 78.6% and 82.7%, respectively, and was further improved to 84.5% when combining rsEC and rsFC. CONCLUSIONS Schizophrenia is featured by disrupted 'limbic areas-to-thalamus' rsEC, in contrast with diffusively altered rsFC. Moreover, both rsEC and rsFC contain valuable and complementary information which may be used as diagnostic markers for schizophrenia.
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Affiliation(s)
- Minghui Hua
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Yanmin Peng
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Yuan Zhou
- CAS Key Laboratory of Behavioral Science and Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Chunshui Yu
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China; Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Meng Liang
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China.
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22
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Gao J, Zhang D, Wang L, Wang W, Fan Y, Tang M, Zhang X, Lei X, Wang Y, Yang J, Zhang X. Altered Effective Connectivity in Schizophrenic Patients With Auditory Verbal Hallucinations: A Resting-State fMRI Study With Granger Causality Analysis. Front Psychiatry 2020; 11:575. [PMID: 32670108 PMCID: PMC7327618 DOI: 10.3389/fpsyt.2020.00575] [Citation(s) in RCA: 2] [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: 03/31/2020] [Accepted: 06/05/2020] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Auditory verbal hallucinations (AVH) are among the most common and prominent symptoms of schizophrenia. Although abnormal functional connectivity associated with AVH has been reported in multiple regions, the changes in information flow remain unclear. In this study, we aimed to elucidate causal influences related to AVH in key regions of auditory, language, and memory networks, by using Granger causality analysis (GCA). PATIENTS AND METHODS Eighteen patients with schizophrenia with AVH and eighteen matched patients without AVH who received resting-state fMRI scans were enrolled in the study. The bilateral superior temporal gyrus (STG), Broca's area, Wernicke's area, putamen, and hippocampus were selected as regions of interest. RESULTS Granger causality (GC) increased from Broca's area to the left STG, and decreased from the right homolog of Wernicke's area to the right homolog of Broca's area, and from the right STG to the right hippocampus in the AVH group compared with the non-AVH group. Correlation analysis showed that the normalized GC ratios from the left STG to Broca's area, from the left STG to the right homolog of Broca's area, and from the right STG to the right homolog of Broca's area were negatively correlated with severity of AVH, and the normalized GC ratios from Broca's area to the left hippocampus and from Broca's area to the right STG were positively correlated with severity of AVH. CONCLUSION Our findings indicate a causal influence of pivotal regions involving the auditory, language, and memory networks in schizophrenia with AVH, which provide a deeper understanding of the neural mechanisms underlying AVH.
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Affiliation(s)
- Jie Gao
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Dongsheng Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Lei Wang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wei Wang
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yajuan Fan
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Min Tang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xin Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Xiaoyan Lei
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Yarong Wang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jian Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoling Zhang
- Department of MRI, Shaanxi Provincial People's Hospital, Xi'an, China
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23
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Zhuo C, Jiang D, Liu C, Lin X, Li J, Chen G, Xie Z, Xu Z, Zhou C, Zhu J. Understanding auditory verbal hallucinations in healthy individuals and individuals with psychiatric disorders. Psychiatry Res 2019; 274:213-219. [PMID: 30807972 DOI: 10.1016/j.psychres.2019.02.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/17/2019] [Accepted: 02/17/2019] [Indexed: 01/09/2023]
Abstract
Auditory verbal hallucinations(AVHs) are psychiatric manifestations that are common in patients with psychiatric disorders and can occur in healthy individuals. This review summarizes the existing literature on the phenomenological features of auditory verbal hallucinations, imaging findings, and interventions, focusing on patients with schizophrenia who experience auditory verbal hallucinations, in addition to patients with borderline personality disorder, bipolar disorder, major depressive disorder, and posttraumatic stress disorder, as well as healthy individuals. The phenomenological features of AVHs vary in different psychiatric disorders, and the symptoms are associated with changes in specific brain structures and disturbances in brain function, blood flow, and metabolism. Interventions for auditory verbal hallucinations include antipsychotic drugs, neurostimulation, and cognitive behavioral therapy.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China; Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China; Department of Psychiatric-Neuroimaging-Genetics and comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, 300222, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Chuanxin Liu
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Jie Li
- Department of Psychiatric-Neuroimaging-Genetics and comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, 300222, China
| | - Guangdong Chen
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China
| | - Zuoliang Xie
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China
| | - ZhangJi Xu
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China
| | - Chunhua Zhou
- Department of Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, 050000, China
| | - Jingjing Zhu
- Department of Psychiatry, Institute of Mental Health, Jining Medical University, Shandong, Jining, 272191, China
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24
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Neurofeedback of core language network nodes modulates connectivity with the default-mode network: A double-blind fMRI neurofeedback study on auditory verbal hallucinations. Neuroimage 2019; 189:533-542. [DOI: 10.1016/j.neuroimage.2019.01.058] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 12/16/2018] [Accepted: 01/21/2019] [Indexed: 12/11/2022] Open
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25
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Rollins CP, Garrison JR, Simons JS, Rowe JB, O'Callaghan C, Murray GK, Suckling J. Meta-analytic Evidence for the Plurality of Mechanisms in Transdiagnostic Structural MRI Studies of Hallucination Status. EClinicalMedicine 2019; 8:57-71. [PMID: 31193632 PMCID: PMC6537703 DOI: 10.1016/j.eclinm.2019.01.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/15/2019] [Accepted: 01/27/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Hallucinations are transmodal and transdiagnostic phenomena, occurring across sensory modalities and presenting in psychiatric, neurodegenerative, neurological, and non-clinical populations. Despite their cross-category occurrence, little empirical work has directly compared between-group neural correlates of hallucinations. METHODS We performed whole-brain voxelwise meta-analyses of hallucination status across diagnoses using anisotropic effect-size seed-based d mapping (AES-SDM), and conducted a comprehensive systematic review in PubMed and Web of Science until May 2018 on other structural correlates of hallucinations, including cortical thickness and gyrification. FINDINGS 3214 abstracts were identified. Patients with psychiatric disorders and hallucinations (eight studies) exhibited reduced gray matter (GM) in the left insula, right inferior frontal gyrus, left anterior cingulate/paracingulate gyrus, left middle temporal gyrus, and increased in the bilateral fusiform gyrus, while patients with neurodegenerative disorders with hallucinations (eight studies) showed GM decreases in the left lingual gyrus, right supramarginal gyrus/parietal operculum, left parahippocampal gyrus, left fusiform gyrus, right thalamus, and right lateral occipital gyrus. Group differences between psychiatric and neurodegenerative hallucination meta-analyses were formally confirmed using Monte Carlo randomizations to determine statistical significance, and a jackknife sensitivity analysis established the reproducibility of results across nearly all study combinations. For other structural measures (28 studies), the most consistent findings associated with hallucination status were reduced cortical thickness in temporal gyri in schizophrenia and altered hippocampal volume in Parkinson's disease and dementia. Additionally, increased severity of hallucinations in schizophrenia correlated with GM reductions within the left superior temporal gyrus, right middle temporal gyrus, bilateral supramarginal and angular gyri. INTERPRETATION Distinct patterns of neuroanatomical alteration characterize hallucination status in patients with psychiatric and neurodegenerative diseases, suggesting a plurality of anatomical signatures. This approach has implications for treatment, theoretical frameworks, and generates refutable predictions for hallucinations in other diseases and their occurrence within the general population. FUNDING None.
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Affiliation(s)
- Colleen P.E. Rollins
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Corresponding author at: Department of Psychiatry, University of Cambridge, Cambridge CB2 0SP, UK
| | - Jane R. Garrison
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Jon S. Simons
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - James B. Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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26
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Humpston CS, Adams RA, Benrimoh D, Broome MR, Corlett PR, Gerrans P, Horga G, Parr T, Pienkos E, Powers AR, Raballo A, Rosen C, Linden DEJ. From Computation to the First-Person: Auditory-Verbal Hallucinations and Delusions of Thought Interference in Schizophrenia-Spectrum Psychoses. Schizophr Bull 2019; 45:S56-S66. [PMID: 30715542 PMCID: PMC6357975 DOI: 10.1093/schbul/sby073] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Schizophrenia-spectrum psychoses are highly complex and heterogeneous disorders that necessitate multiple lines of scientific inquiry and levels of explanation. In recent years, both computational and phenomenological approaches to the understanding of mental illness have received much interest, and significant progress has been made in both fields. However, there has been relatively little progress bridging investigations in these seemingly disparate fields. In this conceptual review and collaborative project from the 4th Meeting of the International Consortium on Hallucination Research, we aim to facilitate the beginning of such dialogue between fields and put forward the argument that computational psychiatry and phenomenology can in fact inform each other, rather than being viewed as isolated or even incompatible approaches. We begin with an overview of phenomenological observations on the interrelationships between auditory-verbal hallucinations (AVH) and delusional thoughts in general, before moving on to review several theoretical frameworks and empirical findings in the computational modeling of AVH. We then relate the computational models to the phenomenological accounts, with a special focus on AVH and delusions that involve the senses of agency and ownership of thought (delusions of thought interference). Finally, we offer some tentative directions for future research, emphasizing the importance of a mutual understanding between separate lines of inquiry.
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Affiliation(s)
- Clara S Humpston
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom,School of Psychology, Cardiff University, Cardiff, United Kingdom,To whom correspondence should be addressed;Department of Psychological Medicine (PO72), Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Denmark Hill, LondonSE5 8AF, United Kingdom; tel: +44 (0) 20 7848 0088, fax: +44 (0) 20 7848 0298, e-mail:
| | - Rick A Adams
- Division of Psychiatry, University College London, London, United Kingdom
| | - David Benrimoh
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Matthew R Broome
- Institute for Mental Health, School of Psychology, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom,Department of Psychiatry,Medical Sciences Division, University of Oxford, Oxford, United Kingdom,Faculty of Philosophy, Humanities Division, University of Oxford, Oxford, United Kingdom
| | | | - Philip Gerrans
- Department of Philosophy, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Thomas Parr
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom
| | - Elizabeth Pienkos
- Graduate Institute of ProfessionalPsychology, University of Hartford, West Hartford, CT
| | | | - Andrea Raballo
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Department of Medicine, Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, Italy
| | - Cherise Rosen
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
| | - David E J Linden
- School of Psychology, Cardiff University, Cardiff, United Kingdom,Division of Psychological Medicine and Clinical Neuroscience, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, United Kingdom
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27
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Iwashiro N, Takano Y, Natsubori T, Aoki Y, Yahata N, Gonoi W, Kunimatsu A, Abe O, Kasai K, Yamasue H. Aberrant attentive and inattentive brain activity to auditory negative words, and its relation to persecutory delusion in patients with schizophrenia. Neuropsychiatr Dis Treat 2019; 15:491-502. [PMID: 30858706 PMCID: PMC6387602 DOI: 10.2147/ndt.s194353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Previous research has suggested that deficits in emotion recognition are involved in the pathogenesis of persecutory delusion in schizophrenia. Although disruption in auditory and language processing is crucial in the pathophysiology of schizophrenia, the neural basis for the deficits in emotion recognition of auditorily presented language stimuli and its relation to persecutory delusion have not yet been clarified. PATIENTS AND METHODS The current functional magnetic resonance imaging study used a dichotic listening task for 15 patients with schizophrenia and 23 healthy controls matched for age, sex, parental socioeconomic background, handedness, dexterous ear, and intelligence quotient. The participants completed a word recognition task on the attended side in which a word with emotionally valenced content (negative/neutral) was presented to one ear and a different neutral word was presented to the other ear. Participants selectively attended to either ear. RESULTS The whole brain analysis detected the aberrant neural activity in the right inferior frontal gyrus in the patients with schizophrenia compared to that in the controls (P<0.05, false discovery rate-corrected). Brain activity in the right pars triangularis of the inferior frontal gyrus was significantly reduced when negatively valenced words were presented to the right ear, whereas the activity of the same region was significantly enhanced when these words were presented to the left ear, irrespective of the attended ear, in the participants with schizophrenia compared to the controls. Furthermore, this diminished brain response to auditorily presented negatively valenced words significantly correlated with severe positive symptoms (r=-0.67, P=0.006) and delusional behavior (r=-0.62, P=0.014) in the patients with schizophrenia. CONCLUSION The present results indicate that the significantly impaired brain activity in response to auditorily presented negatively valenced words in the right pars triangularis of the inferior frontal gyrus is associated with the pathogenesis of positive symptoms such as persecutory delusion.
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Affiliation(s)
- Norichika Iwashiro
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan,
| | - Yosuke Takano
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan,
| | - Tatsunobu Natsubori
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan,
| | - Yuta Aoki
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan,
| | - Noriaki Yahata
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan, .,Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba-city, Chiba, Japan
| | - Wataru Gonoi
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Akira Kunimatsu
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan,
| | - Hidenori Yamasue
- Department of Psychiatry, Hamamatsu University School of Medicine, Higashi-ku, Hamamatsu City, Japan,
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28
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Raij TT, Riekki TJJ, Rikandi E, Mäntylä T, Kieseppä T, Suvisaari J. Activation of the motivation-related ventral striatum during delusional experience. Transl Psychiatry 2018; 8:283. [PMID: 30563960 PMCID: PMC6298954 DOI: 10.1038/s41398-018-0347-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 11/10/2018] [Accepted: 11/25/2018] [Indexed: 11/30/2022] Open
Abstract
Delusion is the most characteristic symptom of psychosis, occurring in almost all first-episode psychosis patients. The motivational salience hypothesis suggests delusion to originate from the experience of abnormal motivational salience. Whether the motivation-related brain circuitries are activated during the actual delusional experience remains, however, unknown. We used a forced-choice answering tree at random intervals during functional magnetic resonance imaging to capture delusional and non-delusional spontaneous experiences in patients with first-episode psychosis (n = 31) or clinical high-risk state (n = 7). The motivation-related brain regions were identified by an automated meta-analysis of 149 studies. Thirteen first-episode patients reported both delusional and non-delusional spontaneous experiences. In these patients, delusional experiences were related to stronger activation of the ventral striatum in both hemispheres. This activation overlapped with the most strongly motivation-related brain regions. These findings provide an empirical link between the actual delusional experience and the motivational salience hypothesis. Further use and development of the present methods in localizing the neurobiological basis of the most characteristic symptoms may be useful in the search for etiopathogenic pathways that result in psychotic disorders.
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Affiliation(s)
- Tuukka T. Raij
- 0000 0000 9950 5666grid.15485.3dDepartment of Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland ,0000000108389418grid.5373.2Department of Neuroscience and Biomedical Engineering and Advanced Magnetic Imaging Center, Aalto University School of Science, Espoo, Finland
| | - Tapani J. J. Riekki
- 0000 0004 0410 2071grid.7737.4Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Eva Rikandi
- 0000000108389418grid.5373.2Department of Neuroscience and Biomedical Engineering and Advanced Magnetic Imaging Center, Aalto University School of Science, Espoo, Finland ,0000 0004 0410 2071grid.7737.4Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland ,0000 0001 1013 0499grid.14758.3fMental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Mäntylä
- 0000000108389418grid.5373.2Department of Neuroscience and Biomedical Engineering and Advanced Magnetic Imaging Center, Aalto University School of Science, Espoo, Finland ,0000 0004 0410 2071grid.7737.4Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland ,0000 0001 1013 0499grid.14758.3fMental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Tuula Kieseppä
- 0000 0000 9950 5666grid.15485.3dDepartment of Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland ,0000 0001 1013 0499grid.14758.3fMental Health Unit, National Institute for Health and Welfare, Helsinki, Finland ,0000 0004 0410 2071grid.7737.4Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Jaana Suvisaari
- 0000 0001 1013 0499grid.14758.3fMental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
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Benrimoh D, Parr T, Vincent P, Adams RA, Friston K. Active Inference and Auditory Hallucinations. COMPUTATIONAL PSYCHIATRY (CAMBRIDGE, MASS.) 2018; 2:183-204. [PMID: 30627670 PMCID: PMC6317754 DOI: 10.1162/cpsy_a_00022] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/03/2018] [Indexed: 01/27/2023]
Abstract
Auditory verbal hallucinations (AVH) are often distressing symptoms of several neuropsychiatric conditions, including schizophrenia. Using a Markov decision process formulation of active inference, we develop a novel model of AVH as false (positive) inference. Active inference treats perception as a process of hypothesis testing, in which sensory data are used to disambiguate between alternative hypotheses about the world. Crucially, this depends upon a delicate balance between prior beliefs about unobserved (hidden) variables and the sensations they cause. A false inference that a voice is present, even in the absence of auditory sensations, suggests that prior beliefs dominate perceptual inference. Here we consider the computational mechanisms that could cause this imbalance in perception. Through simulation, we show that the content of (and confidence in) prior beliefs depends on beliefs about policies (here sequences of listening and talking) and on beliefs about the reliability of sensory data. We demonstrate several ways in which hallucinatory percepts could occur when an agent expects to hear a voice in the presence of imprecise sensory data. This model expresses, in formal terms, alternative computational mechanisms that underwrite AVH and, speculatively, can be mapped onto neurobiological changes associated with schizophrenia. The interaction of action and perception is important in modeling AVH, given that speech is a fundamentally enactive and interactive process-and that hallucinators often actively engage with their voices.
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Affiliation(s)
| | - Thomas Parr
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
| | - Peter Vincent
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
| | - Rick A. Adams
- Division of Psychiatry, University College London, London, UK,Institute of Cognitive Neuroscience, University College London, London, UK
| | - Karl Friston
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
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Benrimoh D, Parr T, Vincent P, Adams RA, Friston K. Active Inference and Auditory Hallucinations. COMPUTATIONAL PSYCHIATRY (CAMBRIDGE, MASS.) 2018. [PMID: 30627670 DOI: 10.1162/cpsy˙a˙00022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Auditory verbal hallucinations (AVH) are often distressing symptoms of several neuropsychiatric conditions, including schizophrenia. Using a Markov decision process formulation of active inference, we develop a novel model of AVH as false (positive) inference. Active inference treats perception as a process of hypothesis testing, in which sensory data are used to disambiguate between alternative hypotheses about the world. Crucially, this depends upon a delicate balance between prior beliefs about unobserved (hidden) variables and the sensations they cause. A false inference that a voice is present, even in the absence of auditory sensations, suggests that prior beliefs dominate perceptual inference. Here we consider the computational mechanisms that could cause this imbalance in perception. Through simulation, we show that the content of (and confidence in) prior beliefs depends on beliefs about policies (here sequences of listening and talking) and on beliefs about the reliability of sensory data. We demonstrate several ways in which hallucinatory percepts could occur when an agent expects to hear a voice in the presence of imprecise sensory data. This model expresses, in formal terms, alternative computational mechanisms that underwrite AVH and, speculatively, can be mapped onto neurobiological changes associated with schizophrenia. The interaction of action and perception is important in modeling AVH, given that speech is a fundamentally enactive and interactive process-and that hallucinators often actively engage with their voices.
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Affiliation(s)
- David Benrimoh
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
| | - Thomas Parr
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
| | - Peter Vincent
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
| | - Rick A Adams
- Division of Psychiatry, University College London, London, UK
| | - Karl Friston
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, UK
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Orlov ND, Giampietro V, O’Daly O, Lam SL, Barker GJ, Rubia K, McGuire P, Shergill SS, Allen P. Real-time fMRI neurofeedback to down-regulate superior temporal gyrus activity in patients with schizophrenia and auditory hallucinations: a proof-of-concept study. Transl Psychiatry 2018; 8:46. [PMID: 29430009 PMCID: PMC5865171 DOI: 10.1038/s41398-017-0067-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/18/2017] [Accepted: 10/26/2017] [Indexed: 02/07/2023] Open
Abstract
Neurocognitive models and previous neuroimaging work posit that auditory verbal hallucinations (AVH) arise due to increased activity in speech-sensitive regions of the left posterior superior temporal gyrus (STG). Here, we examined if patients with schizophrenia (SCZ) and AVH could be trained to down-regulate STG activity using real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF). We also examined the effects of rtfMRI-NF training on functional connectivity between the STG and other speech and language regions. Twelve patients with SCZ and treatment-refractory AVH were recruited to participate in the study and were trained to down-regulate STG activity using rtfMRI-NF, over four MRI scanner visits during a 2-week training period. STG activity and functional connectivity were compared pre- and post-training. Patients successfully learnt to down-regulate activity in their left STG over the rtfMRI-NF training. Post- training, patients showed increased functional connectivity between the left STG, the left inferior prefrontal gyrus (IFG) and the inferior parietal gyrus. The post-training increase in functional connectivity between the left STG and IFG was associated with a reduction in AVH symptoms over the training period. The speech-sensitive region of the left STG is a suitable target region for rtfMRI-NF in patients with SCZ and treatment-refractory AVH. Successful down-regulation of left STG activity can increase functional connectivity between speech motor and perception regions. These findings suggest that patients with AVH have the ability to alter activity and connectivity in speech and language regions, and raise the possibility that rtfMRI-NF training could present a novel therapeutic intervention in SCZ.
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Affiliation(s)
- Natasza D. Orlov
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,0000 0001 0468 7274grid.35349.38Department of Psychology, University of Roehampton, London, UK
| | - Vincent Giampietro
- 0000 0001 2322 6764grid.13097.3cDepartment of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Owen O’Daly
- 0000 0001 2322 6764grid.13097.3cDepartment of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sheut-Ling Lam
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,0000 0001 2322 6764grid.13097.3cDepartment of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Gareth J. Barker
- 0000 0001 2322 6764grid.13097.3cDepartment of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Katya Rubia
- 0000 0001 2322 6764grid.13097.3cDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Philip McGuire
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sukhwinder S. Shergill
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Paul Allen
- 0000 0001 2322 6764grid.13097.3cDepartment of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,0000 0001 0468 7274grid.35349.38Department of Psychology, University of Roehampton, London, UK ,Combined Universities Brain Imaging Centre (CUBIC), London, UK
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Nishiyama K, Suzuki H, Harasawa T, Suzuki N, Kurimoto E, Kawai T, Maruyama M, Komatsu H, Sakuma K, Shimizu Y, Shimojo M. FTBMT, a Novel and Selective GPR52 Agonist, Demonstrates Antipsychotic-Like and Procognitive Effects in Rodents, Revealing a Potential Therapeutic Agent for Schizophrenia. J Pharmacol Exp Ther 2017; 363:253-264. [PMID: 28851764 DOI: 10.1124/jpet.117.242925] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 08/23/2017] [Indexed: 01/23/2023] Open
Abstract
GPR52 is a Gs-coupled G protein-coupled receptor that is predominantly expressed in the striatum and nucleus accumbens (NAc) and was recently proposed as a potential therapeutic target for schizophrenia. In the current study, we investigated the in vitro and in vivo pharmacologic activities of a novel GPR52 agonist, 4-(3-(3-fluoro-5-(trifluoromethyl)benzyl)-5-methyl-1H-1,2,4-triazol-1-yl)-2-methylbenzamide (FTBMT). FTBMT functioned as a selective GPR52 agonist in vitro and in vivo, as demonstrated by the activation of Camp signaling in striatal neurons. FTBMT inhibited MK-801-induced hyperactivity, an animal model for acute psychosis, without causing catalepsy in mice. The c-fos expression also revealed that FTBMT preferentially induced neuronal activation in the shell of the Nac compared with the striatum, thereby supporting its antipsychotic-like activity with less catalepsy. Furthermore, FTBMT improved recognition memory in a novel object-recognition test and attenuated MK-801-induced working memory deficits in a radial arm maze test in rats. These recognitive effects were supported by the results of FTBMT-induced c-fos expression in the brain regions related to cognition, including the medial prefrontal cortex, entorhinal cortex, and hippocampus. Taken together, these findings suggest that FTBMT shows antipsychotic and recognitive properties without causing catalepsy in rodents. Given its unique pharmacologic profile, which differs from that of current antipsychotics, FTBMT may provide a new therapeutic option for the treatment of positive and cognitive symptoms of schizophrenia.
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Affiliation(s)
- Keiji Nishiyama
- CNS Drug Discovery Unit, Research (K.N., H.S., T.H., N.S., E.K., T.K., M.M., H.K., Y.S., M.S.) and Regenerative Medicine Unit (K.S.), Takeda Pharmaceutical Company Limited, Fujisawa, Japan
| | - Hirobumi Suzuki
- CNS Drug Discovery Unit, Research (K.N., H.S., T.H., N.S., E.K., T.K., M.M., H.K., Y.S., M.S.) and Regenerative Medicine Unit (K.S.), Takeda Pharmaceutical Company Limited, Fujisawa, Japan
| | - Toshiya Harasawa
- CNS Drug Discovery Unit, Research (K.N., H.S., T.H., N.S., E.K., T.K., M.M., H.K., Y.S., M.S.) and Regenerative Medicine Unit (K.S.), Takeda Pharmaceutical Company Limited, Fujisawa, Japan
| | - Noriko Suzuki
- CNS Drug Discovery Unit, Research (K.N., H.S., T.H., N.S., E.K., T.K., M.M., H.K., Y.S., M.S.) and Regenerative Medicine Unit (K.S.), Takeda Pharmaceutical Company Limited, Fujisawa, Japan
| | - Emi Kurimoto
- CNS Drug Discovery Unit, Research (K.N., H.S., T.H., N.S., E.K., T.K., M.M., H.K., Y.S., M.S.) and Regenerative Medicine Unit (K.S.), Takeda Pharmaceutical Company Limited, Fujisawa, Japan
| | - Takayuki Kawai
- CNS Drug Discovery Unit, Research (K.N., H.S., T.H., N.S., E.K., T.K., M.M., H.K., Y.S., M.S.) and Regenerative Medicine Unit (K.S.), Takeda Pharmaceutical Company Limited, Fujisawa, Japan
| | - Minoru Maruyama
- CNS Drug Discovery Unit, Research (K.N., H.S., T.H., N.S., E.K., T.K., M.M., H.K., Y.S., M.S.) and Regenerative Medicine Unit (K.S.), Takeda Pharmaceutical Company Limited, Fujisawa, Japan
| | - Hidetoshi Komatsu
- CNS Drug Discovery Unit, Research (K.N., H.S., T.H., N.S., E.K., T.K., M.M., H.K., Y.S., M.S.) and Regenerative Medicine Unit (K.S.), Takeda Pharmaceutical Company Limited, Fujisawa, Japan
| | - Kensuke Sakuma
- CNS Drug Discovery Unit, Research (K.N., H.S., T.H., N.S., E.K., T.K., M.M., H.K., Y.S., M.S.) and Regenerative Medicine Unit (K.S.), Takeda Pharmaceutical Company Limited, Fujisawa, Japan
| | - Yuji Shimizu
- CNS Drug Discovery Unit, Research (K.N., H.S., T.H., N.S., E.K., T.K., M.M., H.K., Y.S., M.S.) and Regenerative Medicine Unit (K.S.), Takeda Pharmaceutical Company Limited, Fujisawa, Japan
| | - Masato Shimojo
- CNS Drug Discovery Unit, Research (K.N., H.S., T.H., N.S., E.K., T.K., M.M., H.K., Y.S., M.S.) and Regenerative Medicine Unit (K.S.), Takeda Pharmaceutical Company Limited, Fujisawa, Japan
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Li P, Fan TT, Zhao RJ, Han Y, Shi L, Sun HQ, Chen SJ, Shi J, Lin X, Lu L. Altered Brain Network Connectivity as a Potential Endophenotype of Schizophrenia. Sci Rep 2017; 7:5483. [PMID: 28710394 PMCID: PMC5511161 DOI: 10.1038/s41598-017-05774-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 06/02/2017] [Indexed: 01/04/2023] Open
Abstract
Abnormal functional brain connectivity could be considered an endophenotype of psychosis in schizophrenia. Identifying candidate endophenotypes may serve as a tool for elucidating its biological and neural mechanisms. The present study investigated the similarities and differences of features of brain network connectivity between patients and their first-degree relatives. Independent component analysis was conducted on imaging data collected from 34 healthy controls, 33 schizophrenia patients, and 30 unaffected first-degree relatives. The correlation between functional connectivity with neurocognitive performance and clinical symptoms were calculated. Abnormalities of between-network connectivity largely overlapped in patients and first-degree relatives, but the extent of such abnormalities was relatively minor in relatives. Negative connectivity between language networks and executive control networks was impaired in schizophrenia patients and their first-degree relatives, and this decreased connectivity was correlated with performance in language processing. Similar impairments were found in high-visual network and executive network coupling, and this decreased connection was correlated with the severity of positive symptoms in patients. The results indicated that abnormal functional connectivity within and between perceptual systems (i.e., high-visual and language) and executive control networks was related to the generic risk of schizophrenia, which makes it a potential endophenotype for schizophrenia.
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Affiliation(s)
- Peng Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Teng-Teng Fan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Rong-Jiang Zhao
- Department of Alcohol and Drug Dependence, Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China
| | - Ying Han
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing, 100191, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing, 100191, China
| | - Hong-Qiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Si-Jing Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing, 100191, China
| | - Xiao Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871, China.
- National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing, 100191, China.
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Nelson BG, Bassett DS, Camchong J, Bullmore ET, Lim KO. Comparison of large-scale human brain functional and anatomical networks in schizophrenia. NEUROIMAGE-CLINICAL 2017; 15:439-448. [PMID: 28616384 PMCID: PMC5459352 DOI: 10.1016/j.nicl.2017.05.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/27/2017] [Accepted: 05/13/2017] [Indexed: 01/04/2023]
Abstract
Schizophrenia is a disease with disruptions in thought, emotion, and behavior. The dysconnectivity hypothesis suggests these disruptions are due to aberrant brain connectivity. Many studies have identified connectivity differences but few have been able to unify gray and white matter findings into one model. Here we develop an extension of the Network-Based Statistic (NBS) called NBSm (Multimodal Network-based statistic) to compare functional and anatomical networks in schizophrenia. Structural, resting functional, and diffusion magnetic resonance imaging data were collected from 29 chronic patients with schizophrenia and 29 healthy controls. Images were preprocessed, and average time courses were extracted for 90 regions of interest (ROI). Functional connectivity matrices were estimated by pairwise correlations between wavelet coefficients of ROI time series. Following diffusion tractography, anatomical connectivity matrices were estimated by white matter streamline counts between each pair of ROIs. Global and regional strength were calculated for each modality. NBSm was used to find significant overlap between functional and anatomical components that distinguished health from schizophrenia. Global strength was decreased in patients in both functional and anatomical networks. Regional strength was decreased in all regions in functional networks and only one region in anatomical networks. NBSm identified a distinguishing functional component consisting of 46 nodes with 113 links (p < 0.001), a distinguishing anatomical component with 47 nodes and 50 links (p = 0.002), and a distinguishing intermodal component with 26 nodes (p < 0.001). NBSm is a powerful technique for understanding network-based group differences present in both anatomical and functional data. In light of the dysconnectivity hypothesis, these results provide compelling evidence for the presence of significant overlapping anatomical and functional disruption in people with schizophrenia. A novel method for the unified analysis of functional and anatomical networks in schizophrenia is proposed. The methodology extends existing networkbased analyses to test brain network differences across imaging modalities. A fundamental disrupted network was found in those with schizophrenia when compared to healthy, agematched controls.
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Affiliation(s)
- Brent G Nelson
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA.
| | - Danielle S Bassett
- Department of Physics, University of California, Santa Barbara, CA 93106, USA; Sage Center for the Study of the Mind, University of California, Santa Barbara, CA 93106, USA; Department of Bioengineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jazmin Camchong
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA
| | - Edward T Bullmore
- Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK; GlaxoSmithKline R&D, Cambridge, UK
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA
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Ćurčić-Blake B, Ford JM, Hubl D, Orlov ND, Sommer IE, Waters F, Allen P, Jardri R, Woodruff PW, David O, Mulert C, Woodward TS, Aleman A. Interaction of language, auditory and memory brain networks in auditory verbal hallucinations. Prog Neurobiol 2016; 148:1-20. [PMID: 27890810 PMCID: PMC5240789 DOI: 10.1016/j.pneurobio.2016.11.002] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 10/04/2016] [Accepted: 11/20/2016] [Indexed: 12/22/2022]
Abstract
The language, auditory and memory/limbic networks are of particular relevance for auditory verbal hallucinations. An increased interaction among the auditory-language and striatal brain regions occurs while patients hallucinate. Fronto-temporal connections are often altered in AVH individuals, but there is no consensus regarding increase or decrease. Connections of the interhemispheric auditory pathway are stronger for first episode patients, but they are weaker in chronic patients. The majority of studies support hybrid AVH hypotheses in which all three networks and the striatal network are involved.
Auditory verbal hallucinations (AVH) occur in psychotic disorders, but also as a symptom of other conditions and even in healthy people. Several current theories on the origin of AVH converge, with neuroimaging studies suggesting that the language, auditory and memory/limbic networks are of particular relevance. However, reconciliation of these theories with experimental evidence is missing. We review 50 studies investigating functional (EEG and fMRI) and anatomic (diffusion tensor imaging) connectivity in these networks, and explore the evidence supporting abnormal connectivity in these networks associated with AVH. We distinguish between functional connectivity during an actual hallucination experience (symptom capture) and functional connectivity during either the resting state or a task comparing individuals who hallucinate with those who do not (symptom association studies). Symptom capture studies clearly reveal a pattern of increased coupling among the auditory, language and striatal regions. Anatomical and symptom association functional studies suggest that the interhemispheric connectivity between posterior auditory regions may depend on the phase of illness, with increases in non-psychotic individuals and first episode patients and decreases in chronic patients. Leading hypotheses involving concepts as unstable memories, source monitoring, top-down attention, and hybrid models of hallucinations are supported in part by the published connectivity data, although several caveats and inconsistencies remain. Specifically, possible changes in fronto-temporal connectivity are still under debate. Precise hypotheses concerning the directionality of connections deduced from current theoretical approaches should be tested using experimental approaches that allow for discrimination of competing hypotheses.
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Affiliation(s)
- Branislava Ćurčić-Blake
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Judith M Ford
- University of California and Veterans Affairs Medical Center, San Francisco, United States
| | - Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Switzerland
| | - Natasza D Orlov
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Iris E Sommer
- Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
| | - Flavie Waters
- Graylands Hospital, North Metro Health Service Mental Health, The University of Western Australia, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia Graylands Hospital, Australia
| | - Paul Allen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Department of Psychology, University of Roehampton, London, United Kingdom
| | - Renaud Jardri
- University of Lille, CNRS UMR9193, SCA-Lab & CHU Lille, Fontan Hospital (CURE), Lille, France
| | - Peter W Woodruff
- Department of Neuroscience, The University of Sheffield, United Kingdom
| | - Olivier David
- University of Grenoble Alpes, Inserm, U1216, Grenoble Institute of Neuroscience, Grenoble, France
| | - Christoph Mulert
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, Hamburg, Germany
| | - Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, Canada; BC Mental Health and Addiction Research Institute, Vancouver, Canada
| | - André Aleman
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Zmigrod L, Garrison JR, Carr J, Simons JS. The neural mechanisms of hallucinations: A quantitative meta-analysis of neuroimaging studies. Neurosci Biobehav Rev 2016; 69:113-23. [PMID: 27473935 DOI: 10.1016/j.neubiorev.2016.05.037] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 05/20/2016] [Accepted: 05/20/2016] [Indexed: 12/19/2022]
Abstract
Activation likelihood estimation meta-analysis of functional neuroimaging data was used to investigate the neural mechanisms underlying auditory-verbal and visual hallucinations (AVHs and VHs). Consistent activation across studies during AVHs, but not VHs, in Wernicke's and Broca's areas is consistent with involvement of speech and language processes in the experience of hearing voices when none are present. Similarly, greater activity in auditory cortex during AVHs and in visual cortex during VHs supports models proposing over-stimulation of sensory cortices in the generation of these perceptual anomalies. Activation across studies in the medial temporal lobe highlights a role for memory intrusions in the provision of content for AVHs, whereas insula activation may relate to the involvement of awareness and self-representation. Finally, activation in the paracingulate region of medial prefrontal cortex during AVHs is consistent with models implicating reality monitoring impairment in the misattribution of self-generated information as externally perceived. In the light of the results, the need for unified theoretical frameworks that account for the full range of hallucinatory experiences is discussed.
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Affiliation(s)
- Leor Zmigrod
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, UK
| | - Jane R Garrison
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, UK
| | - Joseph Carr
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, UK
| | - Jon S Simons
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, UK.
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37
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Connors MH, Robidoux S, Langdon R, Coltheart M. Beliefs about hearing voices. Conscious Cogn 2016; 43:89-101. [DOI: 10.1016/j.concog.2016.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 03/17/2016] [Accepted: 05/06/2016] [Indexed: 10/21/2022]
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Upthegrove R, Broome MR, Caldwell K, Ives J, Oyebode F, Wood SJ. Understanding auditory verbal hallucinations: a systematic review of current evidence. Acta Psychiatr Scand 2016; 133:352-67. [PMID: 26661730 DOI: 10.1111/acps.12531] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Auditory verbal hallucinations (AVHs) are core features of psychotic illness and remain significant in predicting poor outcome and risk. There has been a wide range of approaches to understanding these experiences. METHOD A systematic literature review summarizing different methods of investigation and their results; phenomenology, descriptive psychopathology, psychological, cognitive neurobiology, and neuroimaging. RESULTS A number of 764 papers and texts were screened and 113 reviewed. Phenomenological studies are comparably few in number, and psychopathology remains based on concepts defined in the early 20th century. Psychological models focus on voice content and emotional reaction, and suggest a continuum of AVHs from normal experience. Neuropsychological models include AVHs as misattribution of inner speech, whilst functional neuroimaging studies focus on the spontaneous activity and connectivity of auditory networks. CONCLUSION There has been a large growth in research on AVHs in recent decades dominated by neurobiological and neuroimaging studies. Future research should include focus on phenomenological aspects and AVHs change over the course of developing illness. Integration between branches of enquiry is needed, and the risk is that without this, models are proposed and investigated that bear scant relevance to the symptom itself.
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Affiliation(s)
- R Upthegrove
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - M R Broome
- Department of Psychiatry, University of Oxford, Oxford, UK.,Warneford Hospital, Oxford Health NHS Foundation Trust, Oxford, UK
| | - K Caldwell
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - J Ives
- Medicine, Ethics, Society and History, The University of Birmingham, Birmingham, UK
| | - F Oyebode
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - S J Wood
- School of Psychology, University of Birmingham, Birmingham, UK.,Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Melbourne, Vic., Australia
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Association between impaired brain activity and volume at the sub-region of Broca's area in ultra-high risk and first-episode schizophrenia: A multi-modal neuroimaging study. Schizophr Res 2016; 172:9-15. [PMID: 26873807 DOI: 10.1016/j.schres.2016.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 01/31/2016] [Accepted: 02/03/2016] [Indexed: 11/24/2022]
Abstract
Recent studies have suggested that functional abnormalities in Broca's area, which is important in language production (speech and thoughts before speech), play an important role in the pathophysiology of schizophrenia. While multi-modal approaches have proved useful in revealing the specific pathophysiology of psychosis, the association of functional abnormalities with gray matter volume (GMV) here in subjects with an ultra-high risk (UHR) of schizophrenia, those with first-episode schizophrenia (FES), and healthy controls has yet to be clarified. Therefore, the relationship between cortical activity measured using functional near-infrared spectroscopy (fNIRS) during a verbal fluency task, and GMV in the Broca's area assessed using a manual tracing in magnetic resonance imaging (MRI), which considers individual structural variation, was examined for 57 subjects (23 UHR/18 FES/16 controls). The UHR and FES group showed significantly reduced brain activity compared to control group in the left pars triangularis (PT) (P=.036, .003, respectively). Furthermore in the FES group, the reduced brain activity significantly positively correlated with the volume in the left PT (B=0.29, P=.027), while significant negative association was evident for all subjects (B=-0.18, P=.010). This correlation remained significant after adjusting for antipsychotics dosage, and voxel-wise analysis could not detect any significant correlation between impaired cortical activity and volume. The significant relationship between neural activity and GMV in the left PT may reflect a specific pathophysiology related to the onset of schizophrenia.
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Mondino M, Jardri R, Suaud-Chagny MF, Saoud M, Poulet E, Brunelin J. Effects of Fronto-Temporal Transcranial Direct Current Stimulation on Auditory Verbal Hallucinations and Resting-State Functional Connectivity of the Left Temporo-Parietal Junction in Patients With Schizophrenia. Schizophr Bull 2016; 42:318-26. [PMID: 26303936 PMCID: PMC4753593 DOI: 10.1093/schbul/sbv114] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Auditory verbal hallucinations (AVH) in patients with schizophrenia are associated with abnormal hyperactivity in the left temporo-parietal junction (TPJ) and abnormal connectivity between frontal and temporal areas. Recent findings suggest that fronto-temporal transcranial Direct Current stimulation (tDCS) with the cathode placed over the left TPJ and the anode over the left prefrontal cortex can alleviate treatment-resistant AVH in patients with schizophrenia. However, brain correlates of the AVH reduction are unclear. Here, we investigated the effect of tDCS on the resting-state functional connectivity (rs-FC) of the left TPJ. Twenty-three patients with schizophrenia and treatment-resistant AVH were randomly allocated to receive 10 sessions of active (2 mA, 20 min) or sham tDCS (2 sessions/d for 5 d). We compared the rs-FC of the left TPJ between patients before and after they received active or sham tDCS. Relative to sham tDCS, active tDCS significantly reduced AVH as well as the negative symptoms. Active tDCS also reduced rs-FC of the left TPJ with the left anterior insula and the right inferior frontal gyrus and increased rs-FC of the left TPJ with the left angular gyrus, the left dorsolateral prefrontal cortex and the precuneus. The reduction of AVH severity was correlated with the reduction of the rs-FC between the left TPJ and the left anterior insula. These findings suggest that the reduction of AVH induced by tDCS is associated with a modulation of the rs-FC within an AVH-related brain network, including brain areas involved in inner speech production and monitoring.
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Affiliation(s)
- Marine Mondino
- EA4615, Université de Lyon & CH Le Vinatier, F-69678 Bron, France
| | - Renaud Jardri
- Laboratoire de Sciences Cognitives & Affectives (SCA-Lab), UMR CNRS 9193, Université de Lille & CURE, Hôpital Fontan, CHRU de Lille, F-59000, Lille, France
| | | | - Mohamed Saoud
- EA4615, Université de Lyon & CH Le Vinatier, F-69678 Bron, France
| | - Emmanuel Poulet
- EA4615, Université de Lyon & CH Le Vinatier, F-69678 Bron, France
| | - Jérôme Brunelin
- EA4615, Université de Lyon & CH Le Vinatier, F-69678 Bron, France;
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Kubera KM, Barth A, Hirjak D, Thomann PA, Wolf RC. Noninvasive brain stimulation for the treatment of auditory verbal hallucinations in schizophrenia: methods, effects and challenges. Front Syst Neurosci 2015; 9:131. [PMID: 26528145 PMCID: PMC4601083 DOI: 10.3389/fnsys.2015.00131] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 09/07/2015] [Indexed: 12/12/2022] Open
Abstract
This mini-review focuses on noninvasive brain stimulation techniques as an augmentation method for the treatment of persistent auditory verbal hallucinations (AVH) in patients with schizophrenia. Paradigmatically, we place emphasis on transcranial magnetic stimulation (TMS). We specifically discuss rationales of stimulation and consider methodological questions together with issues of phenotypic diversity in individuals with drug-refractory and persistent AVH. Eventually, we provide a brief outlook for future investigations and treatment directions. Taken together, current evidence suggests TMS as a promising method in the treatment of AVH. Low-frequency stimulation of the superior temporal cortex (STC) may reduce symptom severity and frequency. Yet clinical effects are of relatively short duration and effect sizes appear to decrease over time along with publication of larger trials. Apart from considering other innovative stimulation techniques, such as transcranial Direct Current Stimulation (tDCS), and optimizing stimulation protocols, treatment of AVH using noninvasive brain stimulation will essentially rely on accurate identification of potential responders and non-responders for these treatment modalities. In this regard, future studies will need to consider distinct phenotypic presentations of AVH in patients with schizophrenia, together with the putative functional neurocircuitry underlying these phenotypes.
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Affiliation(s)
- Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Anja Barth
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Dusan Hirjak
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Philipp A Thomann
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Robert C Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, University of Heidelberg Heidelberg, Germany ; Department of Psychiatry, Psychotherapy and Psychosomatics, Saarland University Homburg, Germany
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Iwatani J, Ishida T, Donishi T, Ukai S, Shinosaki K, Terada M, Kaneoke Y. Use of T1-weighted/T2-weighted magnetic resonance ratio images to elucidate changes in the schizophrenic brain. Brain Behav 2015; 5:e00399. [PMID: 26516617 PMCID: PMC4614056 DOI: 10.1002/brb3.399] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/27/2015] [Accepted: 08/23/2015] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION One leading hypothesis suggests that schizophrenia (SZ) is a neurodevelopmental disorder caused by genetic defects in association with environmental risk factors that affect synapse and myelin formation. Recent magnetic resonance imaging (MRI) studies of SZ brain showed both gray matter (GM) reduction and white matter (WM) fractional anisotropy reduction. In this study, we used T1-weighted (T1w)/T2-weighted (T2w) MRI ratio images, which increase myelin-related signal contrast and reduce receiver-coil bias. METHODS We measured T1w/T2w ratio image signal intensity in 29 patients with SZ and 33 healthy controls (HCs), and then compared them against bias-corrected T1w images. RESULTS Mean T1w/T2w ratio signal intensity values across all SZ GM and WM voxels were significantly lower than those for the HC values (analysis of covariance with age, gender, handedness, and premorbid intelligence quotient as nuisance covariates). SZ mean WM T1w/T2w ratio values were related to Global Assessment of Functioning (GAF) scores and were inversely related to the positive psychotic symptoms of the Positive and Negative Syndrome Scale. Voxel-based analysis revealed significantly lower T1w/T2w ratio image signal intensity values in the right ventral putamen in SZ GM. T1w image intensities did not differ between the SZ and HC groups. CONCLUSIONS T1-weighted/T2-weighted ratio imaging increased the detectability of SZ pathological changes. Reduced SZ brain signal intensity is likely due to diminished myelin content; therefore, mapping myelin-related SZ brain changes using T1w/T2w ratio images may be useful for studies of SZ brain abnormalities.
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Affiliation(s)
- Jun Iwatani
- Department of Neuropsychiatry Graduate School of Wakayama Medical University 811-1 Kimiidera Wakayama 641-8509 Japan
| | - Takuya Ishida
- Department of Neuropsychiatry Graduate School of Wakayama Medical University 811-1 Kimiidera Wakayama 641-8509 Japan ; Department of System Neurophysiology Graduate School of Wakayama Medical University 811-1 Kimiidera Wakayama 641-8509 Japan
| | - Tomohiro Donishi
- Department of System Neurophysiology Graduate School of Wakayama Medical University 811-1 Kimiidera Wakayama 641-8509 Japan
| | - Satoshi Ukai
- Department of Neuropsychiatry Graduate School of Wakayama Medical University 811-1 Kimiidera Wakayama 641-8509 Japan
| | - Kazuhiro Shinosaki
- Department of Neuropsychiatry Graduate School of Wakayama Medical University 811-1 Kimiidera Wakayama 641-8509 Japan
| | - Masaki Terada
- Wakayama-Minami Radiology Clinic 870-2 Kimiidera Wakayama 641-0012 Japan
| | - Yoshiki Kaneoke
- Department of System Neurophysiology Graduate School of Wakayama Medical University 811-1 Kimiidera Wakayama 641-8509 Japan
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Perez DL, Pan H, Weisholtz DS, Root JC, Tuescher O, Fischer DB, Butler T, Vago DR, Isenberg N, Epstein J, Landa Y, Smith TE, Savitz AJ, Silbersweig DA, Stern E. Altered threat and safety neural processing linked to persecutory delusions in schizophrenia: a two-task fMRI study. Psychiatry Res 2015; 233. [PMID: 26208746 PMCID: PMC5003172 DOI: 10.1016/j.pscychresns.2015.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Persecutory delusions are a clinically important symptom in schizophrenia associated with social avoidance and increased violence. Few studies have investigated the neurobiology of persecutory delusions, which is a prerequisite for developing novel treatments. The aim of this two-paradigm functional magnetic resonance imaging (fMRI) study is to characterize social "real world" and linguistic threat brain activations linked to persecutory delusions in schizophrenia (n=26) using instructed-fear/safety and emotional word paradigms. Instructed-fear/safety activations correlated to persecutory delusion severity demonstrated significant increased lateral orbitofrontal cortex and visual association cortex activations for the instructed-fear vs. safety and instructed-fear vs. baseline contrasts; decreased lateral orbitofrontal cortex and ventral occipital-temporal cortex activations were observed for the instructed-safety stimuli vs. baseline contrast. The salience network also showed divergent fear and safety cued activations correlated to persecutory delusions. Emotional word paradigm analyses showed positive correlations between persecutory delusion severity and left-lateralized linguistic and hippocampal-parahippocampal activations for the threat vs. neutral word contrast. Visual word form area activations correlated positively with persecutory delusions for both threat and neutral word vs. baseline contrasts. This study links persecutory delusions to enhanced neural processing of threatening stimuli and decreased processing of safety cues, and helps elucidate systems-level activations associated with persecutory delusions in schizophrenia.
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Affiliation(s)
- David L. Perez
- Functional Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Department of Psychiatry, Chestnut Hill, MA, USA
| | - Hong Pan
- Functional Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Department of Psychiatry, Chestnut Hill, MA, USA,Brigham and Women’s Hospital, Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Daniel S. Weisholtz
- Functional Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Department of Psychiatry, Chestnut Hill, MA, USA,Brigham and Women’s Hospital, Department of Neurology, Boston, MA, USA
| | - James C. Root
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY, USA
| | - Oliver Tuescher
- University Medical Center Freiburg, Department of Neurology, Freiburg im Breisgau, Germany,University Medical Centre Mainz, Department of Psychiatry and Psychotherapy, Mainz, Germany
| | - David B. Fischer
- Functional Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Department of Psychiatry, Chestnut Hill, MA, USA
| | - Tracy Butler
- Langone Medical Center, New York University School of Medicine, New York, NY, USA
| | - David R. Vago
- Functional Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Department of Psychiatry, Chestnut Hill, MA, USA
| | - Nancy Isenberg
- Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA, USA
| | - Jane Epstein
- Functional Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Department of Psychiatry, Chestnut Hill, MA, USA
| | - Yulia Landa
- Weill Cornell Medical Center, Department of Psychiatry, New York, NY, USA
| | - Thomas E. Smith
- New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Adam J. Savitz
- Weill Cornell Medical Center, Department of Psychiatry, New York, NY, USA
| | - David A. Silbersweig
- Functional Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Department of Psychiatry, Chestnut Hill, MA, USA,Brigham and Women’s Hospital, Department of Neurology, Boston, MA, USA
| | - Emily Stern
- Functional Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Department of Psychiatry, 824 Boylston Street, Chestnut Hill, MA 02467, USA; Brigham and Women's Hospital, Department of Radiology, Harvard Medical School, Boston, MA, USA.
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Chang X, Xi YB, Cui LB, Wang HN, Sun JB, Zhu YQ, Huang P, Collin G, Liu K, Xi M, Qi S, Tan QR, Miao DM, Yin H. Distinct inter-hemispheric dysconnectivity in schizophrenia patients with and without auditory verbal hallucinations. Sci Rep 2015; 5:11218. [PMID: 26053998 PMCID: PMC4459220 DOI: 10.1038/srep11218] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 05/19/2015] [Indexed: 01/26/2023] Open
Abstract
Evidence from behavioral, electrophysiological and diffusion-weighted imaging studies suggest that schizophrenia patients suffer from deficiencies in bilateral brain communication, and this disruption may be related to the occurrence of auditory verbal hallucinations (AVH). To increase our understanding of aberrant inter-hemispheric communication in relation to AVH, we recruited two groups of first-episode schizophrenia patients: one group with AVH (N = 18 AVH patients) and one without hallucinations (N = 18 Non-AVH patients), and 20 healthy controls. All participants received T1 structural imaging and resting-state fMRI scanning. We adopted a newly developed index, voxel-mirrored homotopic connectivity (VMHC), to quantitatively describe bilateral functional connectivity. The whole-brain VMHC measure was compared among the three groups and correlation analyses were conducted between symptomology scores and neurological measures. Our findings suggest all patients shared abnormalities in parahippocampus and striatum. Aberrant bilateral connectivity of default mode network (DMN), inferior frontal gyrus and cerebellum only showed in AVH patients, whereas aberrances in superior temporal gyrus and precentral gyrus were specific to Non-AVH patients. Meanwhile, inter-hemispheric connectivity of DMN correlated with patients' symptomatology scores. This study corroborates that schizophrenia is characterized by inter-hemispheric dysconnectivity, and suggests the localization of such abnormalities may be crucial to whether auditory verbal hallucinations develop.
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Affiliation(s)
- Xiao Chang
- Department of Medical Psychology, The Fourth Military Medical University, Xi’an, Shaanxi Province, 710032, P.R. China
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Yi-Bin Xi
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi Province, 710032, P.R. China
| | - Long-Biao Cui
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi Province, 710032, P.R. China
| | - Hua-Ning Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi Province, 710032, P.R. China
| | - Jin-Bo Sun
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, Shaanxi Province, 710126, P.R. China
| | - Yuan-Qiang Zhu
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, Shaanxi Province, 710126, P.R. China
| | - Peng Huang
- Department of Medical Psychology, The Fourth Military Medical University, Xi’an, Shaanxi Province, 710032, P.R. China
| | - Guusje Collin
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Kang Liu
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi Province, 710032, P.R. China
| | - Min Xi
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi Province, 710032, P.R. China
| | - Shun Qi
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi Province, 710032, P.R. China
| | - Qing-Rong Tan
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi Province, 710032, P.R. China
| | - Dan-Min Miao
- Department of Medical Psychology, The Fourth Military Medical University, Xi’an, Shaanxi Province, 710032, P.R. China
| | - Hong Yin
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi Province, 710032, P.R. China
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Zhou Y, Fan L, Qiu C, Jiang T. Prefrontal cortex and the dysconnectivity hypothesis of schizophrenia. Neurosci Bull 2015; 31:207-19. [PMID: 25761914 DOI: 10.1007/s12264-014-1502-8] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 11/20/2014] [Indexed: 12/15/2022] Open
Abstract
Schizophrenia is hypothesized to arise from disrupted brain connectivity. This "dysconnectivity hypothesis" has generated interest in discovering whether there is anatomical and functional dysconnectivity between the prefrontal cortex (PFC) and other brain regions, and how this dysconnectivity is linked to the impaired cognitive functions and aberrant behaviors of schizophrenia. Critical advances in neuroimaging technologies, including diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI), make it possible to explore these issues. DTI affords the possibility to explore anatomical connectivity in the human brain in vivo and fMRI can be used to make inferences about functional connections between brain regions. In this review, we present major advances in the understanding of PFC anatomical and functional dysconnectivity and their implications in schizophrenia. We then briefly discuss future prospects that need to be explored in order to move beyond simple mapping of connectivity changes to elucidate the neuronal mechanisms underlying schizophrenia.
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Affiliation(s)
- Yuan Zhou
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China
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46
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Rolland B, Amad A, Poulet E, Bordet R, Vignaud A, Bation R, Delmaire C, Thomas P, Cottencin O, Jardri R. Resting-state functional connectivity of the nucleus accumbens in auditory and visual hallucinations in schizophrenia. Schizophr Bull 2015; 41:291-9. [PMID: 25053649 PMCID: PMC4266295 DOI: 10.1093/schbul/sbu097] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Both auditory hallucinations (AH) and visual hallucinations may occur in schizophrenia. One of the main hypotheses underlying their occurrence involves the increased activity of the mesolimbic pathway, which links the ventral tegmental area (VTA) and the nucleus accumbens (NAcc). However, the precise contribution of the mesolimbic pathway in hallucinations across various sensory modalities has not yet been explored. We compared the resting-state functional connectivity (rs-FC) of the NAcc among 16 schizophrenia patients with pure AH, 15 with both visuoauditory hallucinations (VAH), and 14 without hallucinations (NoH). A between-group comparison was performed using random-effects ANCOVA (rs-FC of the bilateral NAcc as the dependent variable, groups as the between-subjects factor, age and Positive and Negative Syndrome Scale scores as covariates; q(false discovery rate [FDR]) < .05). Compared to the NoH group, the AH group exhibited significantly enhanced NAcc rs-FC with the left temporal superior gyrus, the cingulate gyri, and the VTA, whereas the VAH group, compared to the AH group, exhibited significantly enhanced NAcc rs-FC with the bilateral insula, putamen, parahippocampal gyri, and VTA. The strength in rs-FC between the NAcc and the VTA appeared to be positively associated with the presence of hallucinations, but the NAcc FC patterns changed with the complexity of these experiences (ie, 0, 1, or 2 sensory modalities), rather than with severity. This might support the aberrant salience hypothesis of schizophrenia. Moreover, these findings suggest that future clinical and neurobiological studies of hallucinations should evaluate not only the global severity of symptoms but also their sensorial features.
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Affiliation(s)
| | - Ali Amad
- LNFP, EA4559, Université Lille Nord de France, Lille, France;,Department of Psychiatry, Pediatric Psychiatry and Addiction Medicine, CHU Lille, Lille, France
| | - Emmanuel Poulet
- Institut Fédératif des Neurosciences de Lyon, EA 4166, CH le Vinatier, University Lyon 1, Lyon, France
| | - Régis Bordet
- Department of Pharmacology, EA1046, Université Lille Nord de France, Lille, France
| | | | - Rémy Bation
- Équipe d’Accueil 4615, Université Lyon 1, Bron, France
| | - Christine Delmaire
- LNFP, EA4559, Université Lille Nord de France, Lille, France;,Department of Neuroradiology, CHU Lille, Lille, France
| | - Pierre Thomas
- LNFP, EA4559, Université Lille Nord de France, Lille, France;,Department of Psychiatry, Pediatric Psychiatry and Addiction Medicine, CHU Lille, Lille, France
| | - Olivier Cottencin
- LNFP, EA4559, Université Lille Nord de France, Lille, France;,Department of Psychiatry, Pediatric Psychiatry and Addiction Medicine, CHU Lille, Lille, France
| | - Renaud Jardri
- LNFP, EA4559, Université Lille Nord de France, Lille, France; Department of Psychiatry, Pediatric Psychiatry and Addiction Medicine, CHU Lille, Lille, France; Service de Psychiatrie de l'enfant et de l'adolescent, Hôpital Fontan, Lille Cedex, France
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Zheng L, Chai H, Yu S, Xu Y, Chen W, Wang W. EEG theta power and coherence to octave illusion in first-episode paranoid schizophrenia with auditory hallucinations. Psychopathology 2015; 48:36-46. [PMID: 25359515 DOI: 10.1159/000366104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 07/19/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND The exact mechanism behind auditory hallucinations in schizophrenia remains unknown. A corollary discharge dysfunction hypothesis has been put forward, but it requires further confirmation. Electroencephalography (EEG) of the Deutsch octave illusion might offer more insight, by demonstrating an abnormal cerebral activation similar to that under auditory hallucinations in schizophrenic patients. METHODS We invited 23 first-episode schizophrenic patients with auditory hallucinations and 23 healthy participants to listen to silence and two sound sequences, which consisted of alternating 400- and 800-Hz tones. EEG spectral power and coherence values of different frequency bands, including theta rhythm (3.5-7.5 Hz), were computed using 32 scalp electrodes. Task-related spectral power changes and task-related coherence differences were also calculated. Clinical characteristics of patients were rated using the Positive and Negative Syndrome Scale. RESULTS After both sequences of octave illusion, the task-related theta power change values of frontal and temporal areas were significantly lower, and the task-related theta coherence difference values of intrahemispheric frontal-temporal areas were significantly higher in schizophrenic patients than in healthy participants. Moreover, the task-related power change values in both hemispheres were negatively correlated and the task-related coherence difference values in the right hemisphere were positively correlated with the hallucination score in schizophrenic patients. LIMITATIONS We only tested the Deutsch octave illusion in primary schizophrenic patients with acute first episode. Further studies might adopt other illusions or employ other forms of schizophrenia. CONCLUSION Our results showed a lower activation but higher connection within frontal and temporal areas in schizophrenic patients under octave illusion. This suggests an oversynchronized but weak frontal area to exert an action to the ipsilateral temporal area, which supports the corollary discharge dysfunction hypothesis.
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Affiliation(s)
- Leilei Zheng
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
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48
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Northoff G. Are Auditory Hallucinations Related to the Brain's Resting State Activity? A 'Neurophenomenal Resting State Hypothesis'. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2014; 12:189-95. [PMID: 25598821 PMCID: PMC4293163 DOI: 10.9758/cpn.2014.12.3.189] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 06/19/2014] [Accepted: 06/23/2014] [Indexed: 11/23/2022]
Abstract
While several hypotheses about the neural mechanisms underlying auditory verbal hallucinations (AVH) have been suggested, the exact role of the recently highlighted intrinsic resting state activity of the brain remains unclear. Based on recent findings, we therefore developed what we call the 'resting state hypotheses' of AVH. Our hypothesis suggest that AVH may be traced back to abnormally elevated resting state activity in auditory cortex itself, abnormal modulation of the auditory cortex by anterior cortical midline regions as part of the default-mode network, and neural confusion between auditory cortical resting state changes and stimulus-induced activity. We discuss evidence in favour of our 'resting state hypothesis' and show its correspondence with phenomenal, i.e., subjective-experiential features as explored in phenomenological accounts. Therefore I speak of a 'neurophenomenal resting state hypothesis' of auditory hallucinations in schizophrenia.
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Affiliation(s)
- Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada. ; Taipei Medical University, Graduate Institute of Humanities in Medicine, Taipei, Taiwan. ; Taipei Medical University-Shuang Ho Hospital, Brain and Consciousness Research Center, New Taipei City, Taiwan. ; National Chengchi University, Research Center for Mind, Brain and Learning, Taipei, Taiwan. ; National Chengchi University, Department of Psychology, Taipei, Taiwan. ; Centre for Cognition and Brain Disorders (CBBD), Normal University Hangzhou, Hangzhou, China
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49
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Guo Q, Tang Y, Li H, Zhang T, Li J, Sheng J, Liu D, Li C, Wang J. Both volumetry and functional connectivity of Heschl's gyrus are associated with auditory P300 in first episode schizophrenia. Schizophr Res 2014; 160:57-66. [PMID: 25458859 DOI: 10.1016/j.schres.2014.10.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 09/11/2014] [Accepted: 10/07/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Reduced gray matter volume in left superior temporal gyrus (STG) is considered to be associated with auditory P300 amplitude in schizophrenia. Little is known about possible pathological circuits regarding sub-regions of STG that contribute to auditory P300 abnormality in schizophrenia. The current study investigated gray matter volume in STG and functional connectivity of Heschl's gyrus in first-episode schizophrenia (FESZ), as well as their correlations with P300 amplitude. METHODS Nineteen FESZ patients and 19 healthy controls contributed MRI scans. Eighteen patients and 17 controls underwent auditory P300 test within 1 week after MRI scanning. STG structural abnormalities were analyzed using voxel-based morphometry (VBM) analysis. Bilateral Heschl's gyri (HG) were selected as seeds for FC analysis in resting MRI data. Correlations of P300 amplitude with gray matter alterations in STG and HG-based FC were analyzed using Pearson correlation analysis within each group. RESULTS Compared to healthy controls, FESZ patients showed reduced gray matter in left STG and P300 amplitude. Gray matter volume of left Heschl's gyrus was positively correlated with P300 amplitude in FESZ patients. HG-based FC of resting fMRI was decreased in the inferior frontal gyrus (IFG), medial frontal gyrus (MFG), anterior cingulate cortex (ACC), and left temporal pole, whereas the same metric was increased in the lingual gyrus, precuneus and cerebellar tonsil among FESZ patients. FC between bilateral HG and precuneus was inversely correlated with P300 amplitude among healthy controls, and was absent among FES patients. CONCLUSIONS The findings point towards both decreased volume of Heschl's gyrus and its altered functional pathways may contribute to auditory P300 abnormality in schizophrenia.
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Affiliation(s)
- Qian Guo
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Yingying Tang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Hui Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Tianhong Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Jianqi Li
- Department of Physics, East China Normal University, Shanghai 200062, China
| | - Jianhua Sheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Dengtang Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Chunbo Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China.
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50
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Woods A, Jones N, Bernini M, Callard F, Alderson-Day B, Badcock JC, Bell V, Cook CCH, Csordas T, Humpston C, Krueger J, Larøi F, McCarthy-Jones S, Moseley P, Powell H, Raballo A, Smailes D, Fernyhough C. Interdisciplinary approaches to the phenomenology of auditory verbal hallucinations. Schizophr Bull 2014; 40 Suppl 4:S246-54. [PMID: 24903416 PMCID: PMC4141308 DOI: 10.1093/schbul/sbu003] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 01/08/2014] [Accepted: 01/10/2014] [Indexed: 11/14/2022]
Abstract
Despite the recent proliferation of scientific, clinical, and narrative accounts of auditory verbal hallucinations (AVHs), the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucinatory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowledge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate methodologies to analyze a wider range of first-person accounts of AVH at 3 contextual levels: (1) cultural, social, and historical; (2) experiential; and (3) biographical. We go on to show that there are significant potential benefits for voice hearers, clinicians, and researchers. These include (1) informing the development and refinement of subtypes of hallucinations within and across diagnostic categories; (2) "front-loading" research in cognitive neuroscience; and (3) suggesting new possibilities for therapeutic intervention. In conclusion, we argue that an interdisciplinary approach to the phenomenology of AVH can nourish the ethical core of scientific enquiry by challenging its interpretive paradigms, and offer voice hearers richer, potentially more empowering ways to make sense of their experiences.
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Affiliation(s)
- Angela Woods
- Centre for Medical Humanities, School of Medicine, Pharmacy and Health, Durham University, Durham, UK;
| | - Nev Jones
- Lived Experience Research Network, Chicago, IL
| | - Marco Bernini
- Department of English Studies, Durham University, Durham, UK
| | - Felicity Callard
- Centre for Medical Humanities, Department of Geography, Durham University, Durham, UK
| | | | - Johanna C Badcock
- School of Psychology, University of Western Australia, Crawley, Australia
| | - Vaughan Bell
- Institute of Psychiatry, Psychosis Studies, King's College London, London, UK
| | - Chris C H Cook
- Department of Theology and Religion, Durham University, Durham, UK
| | - Thomas Csordas
- Department of Anthropology, University of California San Diego, San Diego, CA
| | - Clara Humpston
- Institute of Psychiatry, Psychosis Studies, King's College London, London, UK
| | - Joel Krueger
- Department of Sociology, Philosophy and Anthropology, University of Exeter, Exeter, UK
| | - Frank Larøi
- Department of Psychology: Cognition and Behaviour, University of Liège, Liège, Belgium
| | - Simon McCarthy-Jones
- ARC Centre of Excellence in Cognitions and Its Disorders, Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Peter Moseley
- Department of Psychology, Durham University, Durham, UK
| | - Hilary Powell
- Centre for Medical Humanities, Department of English Studies, Durham University, Durham, UK
| | - Andrea Raballo
- Department of Mental Health and Pathological Addiction, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - David Smailes
- Department of Psychology, Durham University, Durham, UK
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