Abstract
Purpose To investigate auditory verbal hallucination (AVH)-specific patterns of brain activity within the resting-state networks (RSNs) that have been proposed to underpin the neural mechanisms of schizophrenia (SZ). Materials and Methods This cross-sectional study was approved by the local ethics committee, and written informed consent was obtained from all participants prospectively recruited. Independent component analysis was used to investigate RSNs in 17 patients with first-episode untreated SZ with AVHs, 15 patients with SZ without AVHs, and 19 healthy control subjects who underwent resting-state functional magnetic resonance imaging. Dual regression was implemented to perform between-group analysis. Regional brain function was then explored within RSNs by using the amplitude of low-frequency fluctuation. Two-sample t tests were used to compare regional brain function between the two patient groups, and Pearson correlation analysis was used to characterize the relationship between imaging findings and severity of AVHs. Receiver operating characteristic analysis was used to evaluate the diagnostic performance of these brain function measures. Results Independent component analysis demonstrated symptom-specific abnormal disrupted coactivation within the auditory, default mode, executive, motor, and frontoparietal networks and was pronounced in the auditory cortex, supramarginal gyrus, insula, putamen, dorsolateral prefrontal cortex, angular gyrus, precuneus, and thalamus (P < .05 with false discovery rate correction). Amplitude of low-frequency fluctuation analysis demonstrated similar patterns within these RSNs (P < .05 with false discovery rate correction). Furthermore, a positive correlation between the degree of coactivation within the motor network and the severity of AVHs was observed in patients with SZ with AVHs (r = 0.67, P = .003). The area under the receiver operating characteristic curve was 0.76-0.90 for all RSNs. Conclusion These findings indicate that dysfunctional brain regions are involved in auditory processing, language production and monitoring, and sensory information filtering in patients with SZ with AVHs, which may be helpful in furthering the understanding of pathophysiological correlates of AVHs in SZ. Online supplemental material is available for this article.
Highlights
The area under the receiver operating characteristic curve was 0.76–0.90 for all resting-state networks (RSNs). These findings indicate that dysfunctional brain regions are involved in auditory processing, language production and monitoring, and sensory information filtering in patients with SZ with auditory verbal hallucination (AVH), which may be helpful in furthering the understanding of pathophysiological correlates of AVHs in SZ
The following exclusion criteria applied to all groups: (a) presence of another axis I psychiatric disorder; (b) history of antipsychotic treatment, repetitive transcranial magnetic stimulation, transcranial direct current stimulation (tDCS), or behavioral therapy; (c) history of clinically significant neurological or systematic illness; (d) diagnosis of substance abuse in the prior 30 days or substance dependence in the prior 6 months; (e) pregnancy or magnetic resonance (MR) imaging contraindications, including cardiac pacemakers and other metallic implants; and (f) head motion of more than 2.5 mm or 3.0° during resting-state functional MR imaging detected with Data Processing Assistant for Resting-State fMRI Advanced Edition software version 3.1 [19]
We explored the patterns of RSNs by using independent component analysis (ICA) and amplitude of low-frequency fluctuation (ALFF) within each RSN to validate ICA findings in patients with first-episode untreated SZ with AVHs
Summary
Results: Conclusion: To investigate auditory verbal hallucination (AVH)–specific patterns of brain activity within the resting-state networks (RSNs) that have been proposed to underpin the neural mechanisms of schizophrenia (SZ). This cross-sectional study was approved by the local ethics committee, and written informed consent was obtained from all participants prospectively recruited. Advances in Knowledge nn With independent component analysis and dual regression, our findings indicate mainly increased brain activity in regions that involve auditory processing, language production and monitoring, and sensory information filtering in auditory verbal hallucinations (AVHs) in schizophrenia (SZ) (P , .05 with false discovery rate correction), creating a predisposition toward false perceptual inference.
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