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Neuroimaging auditory verbal hallucinations in schizophrenia patient and healthy populations

Published online by Cambridge University Press:  14 February 2019

Maria Angelique Di Biase Open the ORCID record for Maria Angelique Di Biase [Opens in a new window] ,
Fan Zhang ,
Amanda Lyall ,
Marek Kubicki ,
René C. W. Mandl ,
Iris E. Sommer  and
Ofer Pasternak
Maria Angelique Di Biase*
Affiliation:
Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Fan Zhang
Affiliation:
Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Amanda Lyall
Affiliation:
Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Marek Kubicki
Affiliation:
Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
René C. W. Mandl
Affiliation:
Department of Psychiatry, UMC Utrecht Brain Center, Utrecht, The Netherlands CNSR, Mental Health Center Glostrup, Glostrup, Denmark
Iris E. Sommer
Affiliation:
Department of Neuroscience, Rijksuniversiteit Groningen (RUG), University Medical Center Groningen, Antonie Deusinglaan 2 Groningen, The Netherlands
Ofer Pasternak
Affiliation:
Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
*
Author for correspondence: Maria Angelique Di Biase, E-mail: mdibiase1@bwh.harvard.edu
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Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Agechronicitycortical thicknessdiffusion MRIfree-watergray matter thicknesspsychosissymptom dimensionstissue-specific fractional anisotropy
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 3 , February 2020 , pp. 403 - 412
Copyright
Copyright © Cambridge University Press 2019

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Footnotes

*

These authors contributed equally and share senior authorship

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