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Mencarelli L, Torso M, Borghi I, Assogna M, Pezzopane V, Bonnì S, Di Lorenzo F, Santarnecchi E, Giove F, Martorana A, Bozzali M, Ridgway GR, Chance SA, Koch G. Macro and micro structural preservation of grey matter integrity after 24 weeks of rTMS in Alzheimer's disease patients: a pilot study. Alzheimers Res Ther 2024; 16:152. [PMID: 38970141 PMCID: PMC11225141 DOI: 10.1186/s13195-024-01501-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 06/12/2024] [Indexed: 07/07/2024]
Abstract
Alzheimer's Disease (AD) is characterized by structural and functional dysfunction involving the Default Mode Network (DMN), for which the Precuneus (PC) is a key node. We proposed a randomized double-blind pilot study to determine neurobiological changes after 24 weeks of PC-rTMS in patients with mild-to-moderate AD. Sixteen patients were randomly assigned to SHAM or PC-rTMS, and received an intensive 2-weeks course with daily rTMS sessions, followed by a maintenance phase in which rTMS has been applied once a week. Before and after the treatment structural and functional MRIs were collected. Our results showed macro- and micro-structural preservation in PC-rTMS compared to SHAM-rTMS group after 24 weeks of treatment, correlated to an increase of functional connectivity (FC) within the PC in the PC-rTMS group. Even if preliminary, these results trigger the possibility of using PC-rTMS to arrest atrophy progression by manipulating distributed network connectivity patterns.
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Affiliation(s)
- Lucia Mencarelli
- Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, Rome, 00179, Italy
| | - Mario Torso
- Oxford Brain Diagnostics Ltd, New Rd, Oxford, OX1 1BY, UK
| | - Ilaria Borghi
- Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, Rome, 00179, Italy
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Luigi Borsari, 46, Ferrara, 44121, Italy
| | - Martina Assogna
- Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, Rome, 00179, Italy
| | - Valentina Pezzopane
- Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, Rome, 00179, Italy
- Center for Translational Neurophysiology of Speech and Communication, Istituto Italiano di Tecnologia, Via Fossato di Mortara, 19, Ferrara, 44121, Italy
| | - Sonia Bonnì
- Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, Rome, 00179, Italy
| | - Francesco Di Lorenzo
- Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, Rome, 00179, Italy
| | - Emiliano Santarnecchi
- Precision Neuroscience and Neuromodulation Program & Network Control Laboratory, Gordon Center for Medical Imaging, Massachusetts General Hospital & Harvard Medical School, 125 Nashua Street, Boston, MA, 02114- 1107, USA
| | - Federico Giove
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, Rome, 00179, Italy
- MARBILab, Museo Storico della Fisica e Centro Studi e Ricerche Enrico Fermi, Via Panisperna 89 A, Rome, 00184, Italy
| | - Alessandro Martorana
- Department of Systems Medicine, Memory Clinic, University of Tor Vergata, Via Montpellier 1, Rome, 00133, Italy
| | - Marco Bozzali
- Neuroscience Department "Rita Levi Montalcini", University of Turin, Via Cherasco, 15, Turin, 10126, Italy
| | | | | | - Giacomo Koch
- Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Via Ardeatina, 306, Rome, 00179, Italy.
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via Luigi Borsari, 46, Ferrara, 44121, Italy.
- Center for Translational Neurophysiology of Speech and Communication, Istituto Italiano di Tecnologia, Via Fossato di Mortara, 19, Ferrara, 44121, Italy.
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Kim JS, Hong SB, Park KW, Lee ATC. Psychotic Symptoms in Patients With Major Neurological Diseases. J Clin Neurol 2024; 20:153-165. [PMID: 38433485 PMCID: PMC10921039 DOI: 10.3988/jcn.2023.0501] [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: 12/11/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 03/05/2024] Open
Abstract
Neurological diseases often manifest with neuropsychiatric symptoms such as depression, emotional incontinence, anger, apathy and fatigue. In addition, affected patients may also experience psychotic symptoms such as hallucinations and delusions. Various factors contribute to the development of psychotic symptoms, and the mechanisms of psychosis are similar, but still differ among various neurological diseases. Although psychotic symptoms are uncommon, and have been less well investigated, they may annoy patients and their families as well as impair the patients' quality of life and increase the caregiver burden. Therefore, we need to appropriately identify and treat these psychotic symptoms in patients with neurological diseases.
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Affiliation(s)
- Jong S Kim
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
| | - Seung-Bong Hong
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keun-Woo Park
- Department of Neurology, Korea University Anam Hospital, Seoul, Korea
| | - Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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Marino M, Spironelli C, Mantini D, Craven AR, Ersland L, Angrilli A, Hugdahl K. Default mode network alterations underlie auditory verbal hallucinations in schizophrenia. J Psychiatr Res 2022; 155:24-32. [PMID: 35981441 DOI: 10.1016/j.jpsychires.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/08/2022] [Accepted: 08/04/2022] [Indexed: 10/31/2022]
Abstract
Although alterations of the default mode network (DMN) in schizophrenia (SZ) have been largely investigated, less research has been carried out on DMN alterations in different sub-phenotypes of this disorder. The aim of this pilot study was to compare DMN features among SZ patients with and without auditory verbal hallucinations (AVH). Three groups of 17 participants each were considered: patients with hallucinations (AVH-SZ), patients without hallucinations (nAVH-SZ) and age-matched healthy controls (HC). The DMN spatial pattern was similar between the nAVH-SZ and HC, but the comparison between these two groups and the AVH-SZ group revealed alterations in the left Angular Gyrus (lAG) node of the DMN. Using a novel approach based on normalized fractional Amplitude of Low-Frequency Fluctuations (fALFF), the AVH-SZ subgroup showed altered spectral activity in the DMN compared with the other two groups, especially in the lower-frequency bands (0.017-0.04 Hz). Significant positive correlations were found for both SZ groups collapsed, and for the nAVH-SZ group alone between delusional scores (PANSS-P1) and slow fALFF bands of the DMN. Narrowing the analysis to the ROI centered on the lAG, significant correlations were found in the AVH-SZ group for hallucination scores (PANSS-P3) and Slow-5 and Slow-4 (both positive), and Slow-3 (negative) fALFF bands. Our results reveal the central role of the lAG in relation to hallucinations, an important cortical area connecting auditory cortex with several hubs (including frontal linguistic centers) and involved in auditory process monitoring.
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Affiliation(s)
- Marco Marino
- Movement Control and Neuroplasticity Research Group, KU Leuven, Belgium; IRCCS San Camillo Hospital, Venice, Italy.
| | - Chiara Spironelli
- Department of General Psychology, University of Padova, Italy; Padova Neuroscience Center, University of Padova, Italy.
| | - Dante Mantini
- Movement Control and Neuroplasticity Research Group, KU Leuven, Belgium
| | - Alexander R Craven
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway; Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway; Division of Psychiatry and NORMENT Centre of Excellence, Haukeland University Hospital, Bergen, Norway
| | - Lars Ersland
- Department of Clinical Engineering, Haukeland University Hospital, Bergen, Norway
| | - Alessandro Angrilli
- Department of General Psychology, University of Padova, Italy; Padova Neuroscience Center, University of Padova, Italy
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway; Division of Psychiatry and NORMENT Centre of Excellence, Haukeland University Hospital, Bergen, Norway; Department of Radiology, Haukeland University Hospital, Bergen, Norway
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Ahn MH, Alsabbagh N, Lee HJ, Kim HJ, Jung MH, Hong SK. Neurobiological Signatures of Auditory False Perception and Phantom Perception as a Consequence of Sensory Prediction Errors. BIOLOGY 2022; 11:biology11101501. [PMID: 36290405 PMCID: PMC9598671 DOI: 10.3390/biology11101501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
Abstract
In this study, we hypothesized that top-down sensory prediction error due to peripheral hearing loss might influence sensorimotor integration using the efference copy (EC) signals as functional connections between auditory and motor brain areas. Using neurophysiological methods, we demonstrated that the auditory responses to self-generated sound were not suppressed in a group of patients with tinnitus accompanied by significant hearing impairment and in a schizophrenia group. However, the response was attenuated in a group with tinnitus accompanied by mild hearing impairment, similar to a healthy control group. The bias of attentional networks to self-generated sound was also observed in the subjects with tinnitus with significant hearing impairment compared to those with mild hearing impairment and healthy subjects, but it did not reach the notable disintegration found in those in the schizophrenia group. Even though the present study had significant constraints in that we did not include hearing loss subjects without tinnitus, these results might suggest that auditory deafferentation (hearing loss) may influence sensorimotor integration process using EC signals. However, the impaired sensorimotor integration in subjects with tinnitus with significant hearing impairment may have resulted from aberrant auditory signals due to sensory loss, not fundamental deficits in the reafference system, as the auditory attention network to self-generated sound is relatively well preserved in these subjects.
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Affiliation(s)
- Min-Hee Ahn
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
| | - Nour Alsabbagh
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
| | - Hyo-Jeong Lee
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
| | - Hyung-Jong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
| | - Myung-Hun Jung
- Department of Psychiatry, Hallym University College of Medicine, Anyang 14068, Korea
- Correspondence: (M.-H.J.); (S.-K.H.); Tel.: +82-31-380-3849 (S.-K.H.)
| | - Sung-Kwang Hong
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
- Correspondence: (M.-H.J.); (S.-K.H.); Tel.: +82-31-380-3849 (S.-K.H.)
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Jaroszynski C, Amorim-Leite R, Deman P, Perrone-Bertolotti M, Chabert F, Job-Chapron AS, Minotti L, Hoffmann D, David O, Kahane P. Brain mapping of auditory hallucinations and illusions induced by direct intracortical electrical stimulation. Brain Stimul 2022; 15:1077-1087. [PMID: 35952963 DOI: 10.1016/j.brs.2022.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The exact architecture of the human auditory cortex remains a subject of debate, with discrepancies between functional and microstructural studies. In a hierarchical framework for sensory perception, simple sound perception is expected to take place in the primary auditory cortex, while the processing of complex, or more integrated perceptions is proposed to rely on associative and higher-order cortices. OBJECTIVES We hypothesize that auditory symptoms induced by direct electrical stimulation (DES) offer a window into the architecture of the brain networks involved in auditory hallucinations and illusions. The intracranial recordings of these evoked perceptions of varying levels of integration provide the evidence to discuss the theoretical model. METHODS We analyzed SEEG recordings from 50 epileptic patients presenting auditory symptoms induced by DES. First, using the Juelich cytoarchitectonic parcellation, we quantified which regions induced auditory symptoms when stimulated (ROI approach). Then, for each evoked auditory symptom type (illusion or hallucination), we mapped the cortical networks showing concurrent high-frequency activity modulation (HFA approach). RESULTS Although on average, illusions were found more laterally and hallucinations more posteromedially in the temporal lobe, both perceptions were elicited in all levels of the sensory hierarchy, with mixed responses found in the overlap. The spatial range was larger for illusions, both in the ROI and HFA approaches. The limbic system was specific to the hallucinations network, and the inferior parietal lobule was specific to the illusions network. DISCUSSION Our results confirm a network-based organization underlying conscious sound perception, for both simple and complex components. While symptom localization is interesting from an epilepsy semiology perspective, the hallucination-specific modulation of the limbic system is particularly relevant to tinnitus and schizophrenia.
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Affiliation(s)
- Chloé Jaroszynski
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France.
| | - Ricardo Amorim-Leite
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Pierre Deman
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Marcela Perrone-Bertolotti
- Univ. Grenoble Alpes, CNRS, UMR5105, Laboratoire Psychologie et NeuroCognition, LPNC, 38000, Grenoble, France
| | - Florian Chabert
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Anne-Sophie Job-Chapron
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Lorella Minotti
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Dominique Hoffmann
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France
| | - Olivier David
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France; Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France.
| | - Philippe Kahane
- Univ. Grenoble Alpes, CHU Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, GIN, 38000, Grenoble, France.
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Wearne D, Ayalde J, Curtis G, Gopisetty A, Banerjee A, Melvill-Smith P, Orr K, Rajanthiran L, Waters F. Visual phenomenology in schizophrenia and post-traumatic stress disorder: an exploratory study. BJPsych Open 2022; 8:e143. [PMID: 35876067 PMCID: PMC9345685 DOI: 10.1192/bjo.2022.544] [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] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Visual experiences such as hallucinations are commonly reported by people with psychosis, psychological trauma and dissociative states, although questions remain about their similarities and differences. For diagnostic and therapeutic purposes, clinical research must better delineate and compare the characteristics of these experiences in post-traumatic stress disorder (PTSD) and in schizophrenia. AIMS To compare visual phenomena and dissociation in participants with a primary psychotic illness and those with a trauma diagnosis. METHOD A quantitative group design study comparing visual phenomena in three participant groups who also have a history of hearing voices: schizophrenia and no trauma history (n = 19), PTSD with dissociation (n = 17) and comorbid schizophrenia and PTSD (n = 20). Validated clinical measures included the North-East Visual Hallucination Interview, PTSD Symptoms Scale Interview, Clinician Administered Dissociative States Scale, Psychotic Symptoms Rating Scales and Positive and Negative Syndrome Scale. RESULTS There was a remarkable similarity in visual experiences, including rates of complex visual hallucinations, between the three diagnostic groups. There were no significant differences in the severity or components of distress surrounding the visual experiences. Dissociation predicted visual hallucination severity for the comorbid schizophrenia and PTSD group, but not for PTSD or schizophrenia alone. CONCLUSIONS Visual experiences in PTSD can include visual hallucinations that are indistinguishable from those experienced in schizophrenia. Multimodal hallucinations are frequently observed in both schizophrenia and PTSD. A model for visual hallucinations in PTSD is suggested, following two separate neurobiological pathways based on distinct responses to trauma.
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Affiliation(s)
- Deborah Wearne
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Jeremiah Ayalde
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Guy Curtis
- Department of Psychology, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Aarethi Gopisetty
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Amit Banerjee
- Early Psychosis Program Perth, headspace National Youth Mental Health Foundation, Melbourne, Victoria, Australia
| | - Peter Melvill-Smith
- Department of Psychiatry, Western Australia Department of Health, Perth, Western Australia, Australia
| | - Kenneth Orr
- Department of Psychiatry, St John of God Health Care, Perth, Western Australia, Australia
| | - Leon Rajanthiran
- Department of Psychiatry, St John of God Health Care, Perth, Western Australia, Australia
| | - Flavie Waters
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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Moriyama TS, Drukker M, Guloksuz S, Ten Have M, de Graaf R, van Dorsselaer S, Gunther N, Bak M, van Os J. Evidence for an interrelated cluster of Hallucinatory experiences in the general population: an incidence study. Psychol Med 2021; 51:2034-2043. [PMID: 32317030 DOI: 10.1017/s0033291720000793] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although hallucinations have been studied in terms of prevalence and its associations with psychopathology and functional impairment, very little is known about sensory modalities other than auditory (i.e. haptic, visual and olfactory), as well the incidence of hallucinations, factors predicting incidence and subsequent course. METHODS We examined the incidence, course and risk factors of hallucinatory experiences across different modalities in two unique prospective general population cohorts in the same country using similar methodology and with three interview waves, one over the period 1996-1999 (NEMESIS) and one over the period 2007-2015 (NEMESIS-2). RESULTS In NEMESIS-2, the yearly incidence of self-reported visual hallucinations was highest (0.33%), followed by haptic hallucinations (0.31%), auditory hallucinations (0.26%) and olfactory hallucinations (0.23%). Rates in NEMESIS-1 were similar (respectively: 0.35%, 0.26%, 0.23%, 0.22%). The incidence of clinician-confirmed hallucinations was approximately 60% of the self-reported rate. The persistence rate of incident hallucinations was around 20-30%, increasing to 40-50% for prevalent hallucinations. Incident hallucinations in one modality were very strongly associated with occurrence in another modality (median OR = 59) and all modalities were strongly associated with delusional ideation (median OR = 21). Modalities were approximately equally strongly associated with the presence of any mental disorder (median OR = 4), functioning, indicators of help-seeking and established environmental risk factors for psychotic disorder. CONCLUSIONS Hallucinations across different modalities are a clinically relevant feature of non-psychotic disorders and need to be studied in relation to each other and in relation to delusional ideation, as all appear to have a common underlying mechanism.
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Affiliation(s)
- Tais S Moriyama
- Instituto Bairral, Itapira, Brazil
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marjan Drukker
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Magreet Ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Saskia van Dorsselaer
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Nicole Gunther
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Psychology, Open University, Heerlen, The Netherlands
| | - Maarten Bak
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
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Yu H, Ying W, Li G, Lin X, Jiang D, Chen G, Chen S, Sun X, Xu Y, Ye J, Zhuo C. Exploring concomitant neuroimaging and genetic alterations in patients with and patients without auditory verbal hallucinations: A pilot study and mini review. J Int Med Res 2021; 48:300060519884856. [PMID: 32696690 PMCID: PMC7376300 DOI: 10.1177/0300060519884856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective To explore concomitant neuroimaging and genetic alterations in patients with
schizophrenia with or without auditory verbal hallucinations (AVHs), and to
discuss the use of pattern recognition techniques in the development of an
objective index that may improve diagnostic accuracy and treatment outcomes
for schizophrenia. Methods The pilot study included patients with schizophrenia with AVHs (SCH-AVH
group) and without AVHs (SCH-no AVH group). High throughput sequencing (HTS)
was performed to explore RNA networks. Global functional connectivity
density (gFCD) analysis was performed to assess functional connectivity (FC)
alterations of the default mode network (DMN). Quantitative long noncoding
(lnc) RNA and mRNA expression data were related to peak T values of gFCDs
using Pearson’s correlation coefficient analysis. Results Compared with the SCH-no AVH group (n = 5), patients in the
SCH-AVH group (n = 5) exhibited differences in RNA
expression in RNA networks that were related to AVH severity, and displayed
alterations in FC (reflected by gFCD differences) within the DMN (posterior
cingulate and dorsal-medial prefrontal cortex), and in the right parietal
lobe, left occipital lobe, and left temporal lobe. Peak lncRNA expression
values were significantly related to peak gFCD T values within the DMN. Conclusion Among patients with schizophrenia, there are concomitant FC and genetic
expression alterations associated with AVHs. Data from pattern recognition
studies may inform the development of an objective index aimed at improving
early diagnostic accuracy and treatment planning for patients with
schizophrenia with and without AVHs.
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Affiliation(s)
- Haiping Yu
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Wang Ying
- Psychiatric Neuroimaging-Genetic and Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, China
| | - Gang Li
- Department of Psychiatry, Tianshui Third Hospital, Gansu, China
| | - Xiaodong Lin
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Deguo Jiang
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Guangdong Chen
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Suling Chen
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Xiuhai Sun
- Department of Neurology, Zoucheng People's Hospital, Jining Medical University Affiliated Zoucheng Hospital, Shandong, China
| | - Yong Xu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Shanxi, China
| | - Jiaen Ye
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China
| | - Chuanjun Zhuo
- Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, China.,Psychiatric Neuroimaging-Genetic and Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Tianjin, China.,Department of Psychiatry, Tianjin Fourth Centre Hospital, Tianjin, China.,Department of Psychiatric-Neuro-Imaging-Genetics Laboratory, School of Mental Health of Jining Medical University, Jining, Shandong, China
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9
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Spontaneous brain activity underlying auditory hallucinations in the hearing-impaired. Cortex 2021; 136:1-13. [PMID: 33450598 DOI: 10.1016/j.cortex.2020.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/09/2020] [Accepted: 12/05/2020] [Indexed: 11/22/2022]
Abstract
Auditory hallucinations, the perception of a sound without a corresponding source, are common in people with hearing impairment. Two forms can be distinguished: simple (i.e., tinnitus) and complex hallucinations (speech and music). Little is known about the precise mechanisms underlying these types of hallucinations. Here we tested the assumption that spontaneous activity in the auditory pathways, following deafferentation, underlies these hallucinations and is related to their phenomenology. By extracting (fractional) Amplitude of Low Frequency Fluctuation [(f)ALFF] scores from resting state fMRI of 18 hearing impaired patients with complex hallucinations (voices or music), 18 hearing impaired patients with simple hallucinations (tinnitus or murmuring), and 20 controls with normal hearing, we investigated differences in spontaneous brain activity between these groups. Spontaneous activity in the anterior and posterior cingulate cortex of hearing-impaired groups was significantly higher than in the controls. The group with complex hallucinations showed elevated activity in the bilateral temporal cortex including Wernicke's area, while spontaneous activity of the group with simple hallucinations was mainly located in the cerebellum. These results suggest a decrease in error monitoring in both hearing-impaired groups. Spontaneous activity of language-related areas only in complex hallucinations suggests that the manifestation of the spontaneous activity represents the phenomenology of the hallucination. The link between cerebellar activity and simple hallucinations, such as tinnitus, is new and may have consequences for treatment.
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Liu J, Xia M, Wang X, Liao X, He Y. The spatial organization of the chronnectome associates with cortical hierarchy and transcriptional profiles in the human brain. Neuroimage 2020; 222:117296. [PMID: 32828922 DOI: 10.1016/j.neuroimage.2020.117296] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 08/10/2020] [Accepted: 08/18/2020] [Indexed: 02/02/2023] Open
Abstract
The chronnectome of the human brain represents dynamic connectivity patterns of brain networks among interacting regions, but its organization principle and related transcriptional signatures remain unclear. Using task-free fMRI data from the Human Connectome Project (681 participants) and microarray-based gene expression data from the Allen Institute for Brain Science (1791 brain tissue samples from six donors), we conduct a transcriptome-chronnectome association study to investigate the spatial configurations of dynamic brain networks and their linkages with transcriptional profiles. We first classify the dynamic brain networks into four categories of nodes according to their time-varying characteristics in global connectivity and modular switching: the primary sensorimotor regions with large global variations, the paralimbic/limbic regions with frequent modular switching, the frontoparietal cortex with both high global and modular dynamics, and the sensorimotor association cortex with limited dynamics. Such a spatial layout reflects the cortical functional hierarchy, microarchitecture, and primary connectivity gradient spanning from primary to transmodal areas, and the cognitive spectrum from perception to abstract processing. Importantly, the partial least squares regression analysis reveals that the transcriptional profiles could explain 28% of the variation in this spatial layout of network dynamics. The top-related genes in the transcriptional profiles are enriched for potassium ion channel complex and activity and mitochondrial part of the cellular component. These findings highlight the hierarchically spatial arrangement of dynamic brain networks and their coupling with the variation in transcriptional signatures, which provides indispensable implications for the organizational principle and cellular and molecular functions of spontaneous network dynamics.
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Affiliation(s)
- Jin Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing 100875, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Mingrui Xia
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing 100875, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Xindi Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing 100875, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Xuhong Liao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing 100875, China; School of Systems Science, Beijing Normal University, Beijing 100875, China
| | - Yong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing 100875, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China.
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11
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Yang H, Wang M, Wu F, Li Q, Zheng Y, Qin P. Diminished self-monitoring in hallucinations - Aberrant anterior insula connectivity differentiates auditory hallucinations in schizophrenia from subjective tinnitus. Asian J Psychiatr 2020; 52:102056. [PMID: 32417745 DOI: 10.1016/j.ajp.2020.102056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/25/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
Abstract
Auditory hallucinations in schizophrenia (SCZ-AH) and subjective tinnitus (TN) are two conditions that share a superficial resemblance, namely the presence of phantom sounds produced by the brain. A crucial difference between them lies in the self-processing of the phantom signals, which is intact in TN patients but lost in SCZ-AH. Our study sets out to investigate the potential neural mechanisms for this crucial psychotic symptom of SCZ-AH under the framework of self. We gathered resting-state fMRI data from three participant groups: SCZ-AH, TN and healthy controls. Focusing on predefined self-related regions-of-interest, we found that SCZ-AH had reduced degree centrality in the right anterior insula (rAI) compared to both TN and healthy controls. Further functional connectivity analysis showed a reduced connectivity between the rAI and right superior temporal gyrus. Our finding indicates that compromised self-processing in SCZ-AH could be due to aberrant connectivity in rAI, which interacted with the decreased connectivity between rAI and auditory cortex, and jointly contributed to the misattribution of the source of the phantom sound. Our findings provided preliminary evidence for the neural mechanism of self-disorder underlying SCZ-AH, and could provide implications for investigating other modalities of hallucinations in schizophrenia.
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Affiliation(s)
- Haidi Yang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Mingxia Wang
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China; Psychological Applications Research Center, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou, China
| | - Fengchun Wu
- Department of Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Qingwei Li
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China.
| | - Pengmin Qin
- Psychological Applications Research Center, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou, China.
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12
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Sorella S, Lapomarda G, Messina I, Frederickson JJ, Siugzdaite R, Job R, Grecucci A. Testing the expanded continuum hypothesis of schizophrenia and bipolar disorder. Neural and psychological evidence for shared and distinct mechanisms. NEUROIMAGE-CLINICAL 2019; 23:101854. [PMID: 31121524 PMCID: PMC6529770 DOI: 10.1016/j.nicl.2019.101854] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/24/2019] [Accepted: 05/02/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Sara Sorella
- Department of Psychology and Cognitive Science (DiPSCo), University of Trento, Rovereto, Italy.
| | - Gaia Lapomarda
- Department of Psychology and Cognitive Science (DiPSCo), University of Trento, Rovereto, Italy.
| | | | | | - Roma Siugzdaite
- Department of Experimental Psychology, Faculty of Psychological and Pedagogical Sciences, Ghent University, Ghent, Belgium.
| | - Remo Job
- Department of Psychology and Cognitive Science (DiPSCo), University of Trento, Rovereto, Italy.
| | - Alessandro Grecucci
- Department of Psychology and Cognitive Science (DiPSCo), University of Trento, Rovereto, Italy.
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13
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Voss P, Thomas ME, Guercio GD, de Villers-Sidani E. Dysregulation of auditory neuroplasticity in schizophrenia. Schizophr Res 2019; 207:3-11. [PMID: 29703662 DOI: 10.1016/j.schres.2018.04.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/10/2018] [Accepted: 04/13/2018] [Indexed: 12/16/2022]
Abstract
Schizophrenia is a complex brain syndrome characterized by an array of positive symptoms (delusions, hallucinations, disorganized speech), negative symptoms (alogia, apathy, avolition) and cognitive impairments (memory, executive functions). Although investigations of the cognitive deficits in schizophrenia have primarily concentrated on disturbances affecting higher-order cognitive processes, there is an increasing realization that schizophrenia also affects early sensory processing, which might, in fact, play a significant role in the development of higher-order cognitive impairments. Recent evidence suggests that many of these early sensory processing impairments possibly arise from a dysregulation of plasticity regulators in schizophrenia, resulting in either reduced plasticity or excessive unregulated plasticity. The purpose of the present manuscript is to provide a concise overview of how the dysregulation of cortical plasticity mechanisms contributes to schizophrenia symptoms with an emphasis on auditory dysplasticity and to discuss its relevance for treatment outcomes. The idea that plasticity mechanisms are not constrained only within sensitive periods suggests that many functional properties of sensory neurons can be altered throughout the lifetime.
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Affiliation(s)
- Patrice Voss
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada.
| | - Maryse E Thomas
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Gerson D Guercio
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Etienne de Villers-Sidani
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada.
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Dudley R, Aynsworth C, Cheetham R, McCarthy-Jones S, Collerton D. Prevalence and characteristics of multi-modal hallucinations in people with psychosis who experience visual hallucinations. Psychiatry Res 2018; 269:25-30. [PMID: 30145297 DOI: 10.1016/j.psychres.2018.08.032] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 06/25/2018] [Accepted: 08/12/2018] [Indexed: 12/12/2022]
Abstract
Hallucinations can occur in single or multiple sensory modalities. Historically, greater attention has been paid to single sensory modality experiences with a comparative neglect of hallucinations that occur across two or more sensory modalities (multi-modal hallucinations). With growing evidence suggesting that visual hallucinations may be experienced along with other hallucinations, this study aimed to explore multi-modal hallucinations in a sample of people with psychotic disorders who reported visual hallucinations (n = 22). No participants reported just visual hallucinations i.e. all reported related or unrelated auditory hallucinations. Twenty-one participants reported multi-modal hallucinations that were serial in nature, whereby they saw visual hallucinations and heard unrelated auditory hallucinations at other times. Nineteen people out of the twenty two also reported simultaneous multi-modal hallucinations, with the most common being an image that talked to and touched them. Multi-modal related and simultaneous hallucinations appeared to be associated with greater conviction that the experiences were real, and greater distress. Theoretical and clinical implications of multi-modal hallucinations are discussed.
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Affiliation(s)
- Robert Dudley
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom; Early Intervention in Psychosis Service, Northumberland, Tyne and Wear NHS Foundation Trust, Gateshead, United Kingdom.
| | - Charlotte Aynsworth
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom; Early Intervention in Psychosis Service, Northumberland, Tyne and Wear NHS Foundation Trust, Gateshead, United Kingdom
| | - Rea Cheetham
- Early Intervention in Psychosis Service, Northumberland, Tyne and Wear NHS Foundation Trust, Sunderland, United Kingdom
| | | | - Daniel Collerton
- School of Psychology, Newcastle University, Newcastle upon Tyne, United Kingdom; Older People's Psychology Service, Northumberland, Tyne and Wear NHS Foundation Trust, Bensham Hospital, Gateshead, United Kingdom
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15
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daSilva Morgan K, Elder GJ, Ffytche DH, Collerton D, Taylor JP. The utility and application of electrophysiological methods in the study of visual hallucinations. Clin Neurophysiol 2018; 129:2361-2371. [PMID: 30253375 DOI: 10.1016/j.clinph.2018.08.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 07/16/2018] [Accepted: 08/21/2018] [Indexed: 11/24/2022]
Abstract
Visual hallucinations (VH) are a common symptom in multiple clinical and non-clinical populations. Although structural and functional neuroimaging has informed the understanding of VH, temporal resolution is limited. Electrophysiological techniques provide a complementary perspective on dynamic and temporal aspects of neural functioning, offering greater insight into the mechanisms underlying their formation. In this review we examine and critically evaluate the emerging evidence base utilising electrophysiological approaches in the study of VH. Overall, increased visual system excitability, dysfunctional visual processing and network connectivity, and cholinergic dysfunction have been consistently observed in VH-prone pathologies. However, a major limitation is in the lack of robust experimental studies and the reliance on single case reports. We conclude that electrophysiology provides tentative evidence for the contribution of bottom-up, top-down, and network dysfunction in the aetiology of VH, supporting several existing VH models. Furthermore, we discuss how electrophysiology has been directly utilised in specific clinical interventions for VH. Further exploration utilising electrophysiology in combination with, for example, neuroimaging will help better understand VH aetiology while aiding in the development of novel therapeutic interventions for this difficult to treat symptom.
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Affiliation(s)
- Katrina daSilva Morgan
- Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, United Kingdom.
| | - Greg J Elder
- Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, United Kingdom; Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, United Kingdom
| | - Dominic H Ffytche
- Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, United Kingdom
| | - Daniel Collerton
- Northumberland, Tyne and Wear NHS Foundation Trust, Bensham Hospital, Gateshead, NE8 4YL, United Kingdom
| | - John-Paul Taylor
- Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, NE4 5PL, United Kingdom
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16
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Lu Y, Marshall C, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Bearden CE, Mathalon D, Addington J. Perceptual abnormalities in clinical high risk youth and the role of trauma, cannabis use and anxiety. Psychiatry Res 2017; 258:462-468. [PMID: 28886901 PMCID: PMC5915322 DOI: 10.1016/j.psychres.2017.08.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/12/2017] [Accepted: 08/18/2017] [Indexed: 12/21/2022]
Abstract
Recent research suggests that perceptual abnormalities are a group of diverse experiences, which have been associated with trauma, cannabis use, and anxiety. Of the attenuated psychotic symptoms that are present in youth at clinical high risk (CHR) of psychosis, perceptual abnormalities tend to be one of the most frequently endorsed symptoms. However, very few studies have explored perceptual abnormalities and their relationships with the above environmental and affective factors in a CHR sample. Four hundred and forty-one CHR individuals who met criteria for attenuated psychotic symptom syndrome (APSS) determined by the Structured Interview for Psychosis-risk Syndromes (SIPS) were assessed on the content of their perceptual abnormalities, early traumatic experience, cannabis use and self-reported anxiety. Logistic regression analyses suggested that both simple auditory and simple visual perceptual abnormalities were more likely to be reported by CHR who had early traumatic experiences, who are current cannabis users, and who have higher levels of anxiety. Multiple regression analysis revealed that only trauma and anxiety were independent predictors of both simple auditory and simple visual perceptual abnormalities. It is possible that examining subtypes of perceptual abnormalities in CHR leads to an improved understanding of the prevalence of such symptoms.
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Affiliation(s)
- Yun Lu
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Catherine Marshall
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California at San Diego, La Jolla, CA, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
| | | | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Ming T Tsuang
- Department of Psychiatry, University of California at San Diego, La Jolla, CA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Carrie E Bearden
- Department of Psychiatry & Biobehavioral Sciences and Psychology University of California at Los Angeles, Los Angeles, CA, USA
| | - Daniel Mathalon
- Department of Psychiatry, University of California at San Francisco and SFVA Medical Center, San Francisco, CA, USA
| | - Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
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17
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Abstract
A cluster of symptoms including hallucinations characterizes schizophrenia. Hallucinations that occur in more than one modality simultaneously and emanate from a single source are called multimodal hallucinations (MMHs). The occurrence of simultaneous hallucinations as the major manifestations of a psychiatric disorder often was dismissed as factitious disorder or malingering. Conversely, MMHs have been reported in severe mental disorders including schizophrenia. Here, we report MMH in two patients of treatment-resistant schizophrenia and its successful management with clozapine. The significance of MMH on the course, prognosis, and treatment resistance of schizophrenia needs to be elucidated. Further systematic research is needed to address these issues.
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Affiliation(s)
- Vijaya Kumar
- Department of Psychiatry, Vydehi Institute of Medical Sciences and Research Center, Bengaluru, Karnataka, India
| | - Virupakshappa Bagewadi
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Dayanand Sagar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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18
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Lim A, Hoek HW, Deen ML, Blom JD. Prevalence and classification of hallucinations in multiple sensory modalities in schizophrenia spectrum disorders. Schizophr Res 2016; 176:493-499. [PMID: 27349814 DOI: 10.1016/j.schres.2016.06.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 05/08/2016] [Accepted: 06/09/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND Auditory hallucinations are experienced by 60-80% of all patients diagnosed with a schizophrenia spectrum disorder. However, in this patient group, the prevalence of hallucinations in multiple sensory modalities, i.e. multimodal hallucinations (MMHs), is unknown. AIMS To assess the prevalence of MMHs in patients diagnosed with a schizophrenia spectrum disorder, data were analyzed from 750 patients who participated in the Dutch Genetic Risk and Outcome of Psychosis (GROUP) study. METHOD We drew on the section of the CASH (Comprehensive Assessment of Symptoms and History) that probes into the lifetime presence of auditory, visual, somatic/tactile, and olfactory hallucinations. RESULTS A lifetime prevalence of 80% was found in this group for hallucinations in any of these modalities. Within the whole group, 27% of the participants reported unimodal hallucinations and 53% MMHs. There were no significant differences in prevalence rate for Dutch versus migrant participants from Morocco, Turkey, Surinam or the (former) Dutch Antilles. CONCLUSION We conclude that MMHs, rather than auditory hallucinations, are the most frequent perceptual symptom of patients diagnosed with a schizophrenia spectrum disorder. Our data also suggest that hallucinations experienced in a single sensory modality (notably auditory ones) stochastically increase the risk for more sensory modalities to join in. We recommend that future studies take into account all 14 sensory modalities in which hallucinations can be experienced. For this we provide a classification of MMHs that allows characterization of their serial versus simultaneous occurrence and their congruent versus incongruent nature.
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Affiliation(s)
- Anastasia Lim
- Parnassia Psychiatric Institute, The Hague, the Netherlands.
| | - Hans W Hoek
- Parnassia Psychiatric Institute, The Hague, the Netherlands; Department of Psychiatry, University of Groningen, Groningen, the Netherlands; Department of Psychiatric Epidemiology, Columbia University, New York, NY, USA
| | - Mathijs L Deen
- Parnassia Psychiatric Institute, The Hague, the Netherlands; Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Jan Dirk Blom
- Parnassia Psychiatric Institute, The Hague, the Netherlands; Department of Psychiatry, University of Groningen, Groningen, the Netherlands; Institute of Psychology, Leiden University, Leiden, the Netherlands
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19
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Increased risk of psychosis in patients with hearing impairment: Review and meta-analyses. Neurosci Biobehav Rev 2015; 62:1-20. [PMID: 26743858 DOI: 10.1016/j.neubiorev.2015.12.012] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/24/2015] [Accepted: 12/24/2015] [Indexed: 12/12/2022]
Abstract
Several studies suggest hearing impairment as a risk factor for psychosis. Hearing impairment is highly prevalent and potentially reversible, as it can be easily diagnosed and sometimes improved. Insight in the association between hearing impairment and psychosis can therefore contribute to prevention of psychosis. This paper provides meta-analyses of all epidemiologic evidence on the association between hearing impairment and psychosis and summarizes mechanisms that potentially underlie this relationship. Meta-analyses showed an increased risk of hearing impairment on all psychosis outcomes, such as hallucinations (OR 1.40(95%CI 1.18-1.65; n=227,005)), delusions (OR 1.55(95%CI 1.36-1.78; n=250,470)), psychotic symptoms (OR 2.23(95%CI 1.83-2.72; n=229,647) and delirium (OR 2.67(95%CI 2.05-3.48; n=12,432). Early exposure to hearing impairment elevated the risk of later development of schizophrenia (OR 3.15(95%CI 1.25-7.95; n=50,490)). Potential mechanisms underlying this association include loneliness, diminished theory of mind, disturbances of source monitoring and top-down processing and deafferentiation. Early assessment and treatment of hearing impairment in patients with (high risk of) psychosis may be essential in psychosis treatment and prevention.
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Yun JY, Kim SN, Lee TY, Chon MW, Kwon JS. Individualized covariance profile of cortical morphology for auditory hallucinations in first-episode psychosis. Hum Brain Mapp 2015; 37:1051-65. [PMID: 26678706 DOI: 10.1002/hbm.23083] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 10/08/2015] [Accepted: 12/02/2015] [Indexed: 12/29/2022] Open
Abstract
Neocortical phenotype of cortical surface area (CSA) and thickness (CT) are influenced by distinctive genetic factors and undergo differential developmental trajectories, which could be captured using the individualized cortical structural covariance (ISC). Disturbed patterns of neocortical development and maturation underlie the perceptual disturbance of psychosis including auditory hallucination (AH). To demonstrate the utility of selected ISC features as primal biomarker of AH in first-episode psychosis (FEP) subjects experiencing AH (FEP-AH), we employed herein a support vector machine (SVM). A total of 147 subjects (FEP-AH, n = 27; FEP-NAH, n = 24; HC, n = 96) underwent T1 -weighted magnetic resonance imaging at 3T. The FreeSurfer software suite was used for cortical parcellation, with the CSA-ISC and CT-ISC then calculated. The most informative ISCs showing statistical significance (P < 0.001) across every run of leave-one-out group-comparison were aligned according to the absolute value of averaged t-statistics and were packaged into candidate feature sets for classification analysis using the SVM. An optimal feature set comprising three CSA-ISCs, including the intraparietal sulcus, Broca's complex, and the anterior insula, distinguished FEP-AH from FEP-NAH subjects with 83.6% accuracy (sensitivity = 82.8%; specificity = 85.7%). Furthermore, six CT-ISCs encompassing the executive control network and Wernicke's module classified FEP-AH from FEP-NAH subjects with 82.3% accuracy (sensitivity = 79.5%; specificity = 88.6%). Finally, extended sets of ISCs related to the default-mode network distinguished FEP-AH or FEP-NAH from HC subjects with 89.0-93.0% accuracy (sensitivity = 88.4-93.4%; specificity = 89.0-94.1%). This study established a distinctive intermediate phenotype of biological proneness for AH in FEP using CSA-ISCs as well as a state marker of disease progression using CT-ISCs.
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Affiliation(s)
- Je-Yeon Yun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung Nyun Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae Young Lee
- SNU-MRC, Institute of Human Behavioral Medicine, Seoul, Republic of Korea
| | - Myong-Wuk Chon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,SNU-MRC, Institute of Human Behavioral Medicine, Seoul, Republic of Korea.,Department of Brain and Cognitive Sciences, College of Natural Science, Seoul National University, Seoul, Republic of Korea
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21
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Alderson-Day B, McCarthy-Jones S, Fernyhough C. Hearing voices in the resting brain: A review of intrinsic functional connectivity research on auditory verbal hallucinations. Neurosci Biobehav Rev 2015; 55:78-87. [PMID: 25956256 PMCID: PMC5901708 DOI: 10.1016/j.neubiorev.2015.04.016] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 04/16/2015] [Accepted: 04/25/2015] [Indexed: 12/26/2022]
Abstract
Resting state networks (RSNs) are thought to reflect the intrinsic functional connectivity of brain regions. Alterations to RSNs have been proposed to underpin various kinds of psychopathology, including the occurrence of auditory verbal hallucinations (AVH). This review outlines the main hypotheses linking AVH and the resting state, and assesses the evidence for alterations to intrinsic connectivity provided by studies of resting fMRI in AVH. The influence of hallucinations during data acquisition, medication confounds, and movement are also considered. Despite a large variety of analytic methods and designs being deployed, it is possible to conclude that resting connectivity in the left temporal lobe in general and left superior temporal gyrus in particular are disrupted in AVH. There is also preliminary evidence of atypical connectivity in the default mode network and its interaction with other RSNs. Recommendations for future research include the adoption of a common analysis protocol to allow for more overlapping datasets and replication of intrinsic functional connectivity alterations.
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Affiliation(s)
- Ben Alderson-Day
- Department of Psychology, Durham University, Science Laboratories, South Road, Durham DH1 3LE, United Kingdom.
| | - Simon McCarthy-Jones
- Department of Cognitive Science, Australian Hearing Hub, Macquarie University, 16 University Avenue, NSW 2109, Australia
| | - Charles Fernyhough
- Department of Psychology, Durham University, Science Laboratories, South Road, Durham DH1 3LE, United Kingdom
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22
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Fernyhough C, Waters F. Special supplement introduction: hallucinations. Schizophr Bull 2014; 40 Suppl 4:S195-7. [PMID: 24936079 PMCID: PMC4141322 DOI: 10.1093/schbul/sbu043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 02/18/2014] [Accepted: 02/18/2014] [Indexed: 11/13/2022]
Abstract
This Special Supplement presents reports from 11 working groups of the interdisciplinary International Consortium on Hallucination Research meeting in Durham, UK, September 2013. Topics include psychological therapies for auditory hallucinations, culture and hallucinations, hallucinations in children and adolescents, visual hallucinations, interdisciplinary approaches to the phenomenology of auditory verbal hallucinations (AVHs), AVHs in persons without need for care, a multisite study of the PSYRATS instrument, subtypes of AVHs, the Hearing Voices Movement, Research Domain Criteria for hallucinations, and cortical specialization as a route to understanding hallucinations.
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Affiliation(s)
- Charles Fernyhough
- Hearing the Voice, c/o School of Education, Durham University, Durham, UK; Department of Psychology, Durham University, Durham, UK; These authors contributed equally to this work.
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Bentall RP. The search for elusive structure: a promiscuous realist case for researching specific psychotic experiences such as hallucinations. Schizophr Bull 2014; 40 Suppl 4:S198-201. [PMID: 24936080 PMCID: PMC4141316 DOI: 10.1093/schbul/sbu044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Problems in psychiatric classification have impeded research into psychopathology for more than a century. Here, I briefly review several new approaches to solving this problem, including the internalizing-externalizing-psychosis spectra, the 5-factor model of psychotic symptoms, and the more recent network approach. Researchers and clinicians should probably adopt an attitude of promiscuous realism and assume that a single classification system is unlikely to be effective for all purposes, and that different systems will need to be chosen for research into etiology, public mental health research, and clinical activities. Progress in understanding the risk factors and mechanisms that lead to psychopathology is most likely to be achieved by focusing on specific types of experience or symptoms such as hallucinations.
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Affiliation(s)
- Richard P. Bentall
- School of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK,*To whom correspondence should be addressed; School of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool L69 3GL, UK; tel: +44-151-795-5367, e-mail:
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