Abnormal Effective Connectivity in the Brain is Involved in Auditory Verbal Hallucinations in Schizophrenia

• Published in: Neuroscience bulletin Vol. 33; no. 3; pp. 281 - 291
• Main Authors: Li, Baojuan, Cui, Long-Biao, Xi, Yi-Bin, Friston, Karl J., Guo, Fan, Wang, Hua-Ning, Zhang, Lin-Chuan, Bai, Yuan-Han, Tan, Qing-Rong, Yin, Hong, Lu, Hongbing
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.06.2017; Springer
• Subjects: Adult; Anatomy; Anesthesiology; Auditory Cortex - diagnostic imaging; Auditory Cortex - physiopathology; Biomedical and Life Sciences; Biomedicine; Broca Area - diagnostic imaging; Broca Area - physiopathology; Computational linguistics; Connectome - methods; Hallucinations - diagnostic imaging; Hallucinations - etiology; Hallucinations - physiopathology; Hallucinations and illusions; Hippocampus - diagnostic imaging; Hippocampus - physiopathology; Human Physiology; Humans; Language processing; Magnetic Resonance Imaging; Models, Theoretical; Natural language interfaces; Neurology; Neurosciences; Original; Original Article; Pain Medicine; Prefrontal Cortex - diagnostic imaging; Prefrontal Cortex - physiopathology; Schizophrenia; Schizophrenia - complications; Schizophrenia - diagnostic imaging; Schizophrenia - physiopathology; Speech Perception - physiology; Thalamus - diagnostic imaging; Thalamus - physiopathology; 丘脑; 功能磁共振成像; 异常; 精神分裂症; 诊断价值; 语言处理; 连接强度; 额叶皮层; Schizophrenia; Stochastic dynamic causal modeling; Auditory verbal hallucinations; Effective connectivity
• DOI: 10.1007/s12264-017-0101-x
• ISSN: 1673-7067

Information flow among auditory and language processing-related regions implicated in the pathophysiology of auditory verbal hallucinations（AVHs） in schizophrenia（SZ） remains unclear. In this study, we used stochastic dynamic causal modeling（s DCM） to quantify connections among the left dorsolateral prefrontal cortex（inner speech monitoring）, auditory cortex（auditory processing）, hippocampus（memory retrieval）, thalamus（information filtering）, and Broca＇s area（language production） in 17 first-episode drug-na？¨ve SZ patients with AVHs, 15 without AVHs, and 19 healthy controls using resting-state functional magnetic resonance imaging.Finally, we performed receiver operating characteristic（ROC） analysis and correlation analysis between image measures and symptoms. s DCM revealed an increasedsensitivity of auditory cortex to its thalamic afferents and a decrease in hippocampal sensitivity to auditory inputs in SZ patients with AVHs. The area under the ROC curve showed the diagnostic value of these two connections to distinguish SZ patients with AVHs from those without AVHs. Furthermore, we found a positive correlation between the strength of the connectivity from Broca＇s area to the auditory cortex and the severity of AVHs. These findings demonstrate, for the first time, augmented AVHspecific excitatory afferents from the thalamus to the auditory cortex in SZ patients, resulting in auditory perception without external auditory stimuli. Our results provide insights into the neural mechanisms underlying AVHs in SZ. This thalamic-auditory cortical-hippocampal dysconnectivity may also serve as a diagnostic biomarker of AVHs in SZ and a therapeutic target based on direct in vivo evidence.