Neuroimaging auditory verbal hallucinations in schizophrenia patient and healthy populations
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A description of the experience
Psychol Med. 2019 Feb 20:1-10. doi: 10.1017/S0033291719000205. [Epub ahead of print]
Neuroimaging auditory verbal hallucinations in schizophrenia patient and healthy populations.
Di Biase MA1, Zhang F2, Lyall A1, Kubicki M1, Mandl RCW3, Sommer IE4, Pasternak O1.
1Department of Psychiatry,Brigham and Women's Hospital, Harvard Medical School,Boston, Massachusetts,USA.
2Department of Radiology,Brigham and Women's Hospital, Harvard Medical School,Boston, Massachusetts,USA.
3Department of Psychiatry,UMC Utrecht Brain Center,Utrecht,The Netherlands.
4Department of Neuroscience,Rijksuniversiteit Groningen (RUG), University Medical Center Groningen,Antonie Deusinglaan 2 Groningen,The Netherlands.
Auditory verbal hallucinations (AVH) are a cardinal feature of schizophrenia, but they can also appear in otherwise healthy individuals. Imaging studies implicate language networks in the generation of AVH; however, it remains unclear if alterations reflect biologic substrates of AVH, irrespective of diagnostic status, age, or illness-related factors. We applied multimodal imaging to identify AVH-specific pathology, evidenced by overlapping gray or white matter deficits between schizophrenia patients and healthy voice-hearers.
Diffusion-weighted and T1-weighted magnetic resonance images were acquired in 35 schizophrenia patients with AVH (SCZ-AVH), 32 healthy voice-hearers (H-AVH), and 40 age- and sex-matched controls without AVH. White matter fractional anisotropy (FA) and gray matter thickness (GMT) were computed for each region comprising ICBM-DTI and Desikan-Killiany atlases, respectively. Regions were tested for significant alterations affecting both SCZ-AVH and H-AVH groups, relative to controls.
Compared with controls, the SCZ-AVH showed widespread FA and GMT reductions; but no significant differences emerged between H-AVH and control groups. While no overlapping pathology appeared in the overall study groups, younger (<40 years) H-AVH and SCZ-AVH subjects displayed overlapping FA deficits across four regions (p < 0.05): the genu and splenium of the corpus callosum, as well as the anterior limbs of the internal capsule. Analyzing these regions with free-water imaging ascribed overlapping FA abnormalities to tissue-specific anisotropy changes.
We identified white matter pathology associated with the presence of AVH, independent of diagnostic status. However, commonalities were constrained to younger and more homogenous groups, after reducing pathologic variance associated with advancing age and chronicity effects.
Age; chronicity; cortical thickness; diffusion MRI; free-water; gray matter thickness; psychosis; symptom dimensions; tissue-specific fractional anisotropy