Abstract
Several cross-sectional functional Magnetic Resonance Imaging (fMRI) studies reported a negative correlation between auditory verbal hallucination (AVH) severity and amplitude of the activations during language tasks. The present study assessed the time course of this correlation and its possible structural underpinnings by combining structural, functional MRI and repetitive Transcranial Magnetic Stimulation (rTMS). Methods: Nine schizophrenia patients with AVH (evaluated with the Auditory Hallucination Rating scale; AHRS) and nine healthy participants underwent two sessions of an fMRI speech listening paradigm. Meanwhile, patients received high frequency (20 Hz) rTMS. Results: Before rTMS, activations were negatively correlated with AHRS in a left posterior superior temporal sulcus (pSTS) cluster, considered henceforward as a functional region of interest (fROI). After rTMS, activations in this fROI no longer correlated with AHRS. This decoupling was explained by a significant decrease of AHRS scores after rTMS that contrasted with a relative stability of cerebral activations. A voxel-based-morphometry analysis evidenced a cluster of the left pSTS where grey matter volume negatively correlated with AHRS before rTMS and positively correlated with activations in the fROI at both sessions. Conclusion: rTMS decreases the severity of AVH leading to modify the functional correlate of AVH underlain by grey matter abnormalities.
Highlights
Auditory verbal hallucinations (AVH) are a frequent and disabling symptom in schizophrenia patients
We recently reported promising results from a pilot study investigating the efficacy of high-frequency (20 Hz) repetitive Transcranial Magnetic Stimulation (rTMS) on refractory auditory verbal hallucination (AVH) in schizophrenia patients [16]
Since several previous studies reported structural correlates of AVH in left temporal areas [18,19,20,21,22,23], we investigated whether grey matter (GM) volume could underlie the functional marker of the propensity to hallucinate
Summary
Auditory verbal hallucinations (AVH) are a frequent and disabling symptom in schizophrenia patients. Some authors endeavored to capture the neural signature of the AVH by asking patients to signal the occurrence of AVH while they were being scanned (for meta-analysis see [2,3,4,5,6,7]) These studies evidenced that brain regions involved in speech processing are activated during AVH. The other approach, that can be complementary to the former, tries to identify functional markers of the propensity to hallucinate either by comparing cerebral activations during a cognitive task between patients with AVH and another population without AVH [3,4] or by uncovering correlations between the severity of the hallucinations and functional neuroimaging data [5,6]
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