Abberant inverted U-shaped brain pattern and trait-related retinal impairment in schizophrenia patients with combined auditory and visual hallucinations: a pilot study

Abstract

Schizophrenic patients often experience auditory hallucinations (AHs) and visual hallucinations (VHs). However, brain and retinal alterations associated with combined AHs and VHs in schizophrenic patients are unknown. This study aimed o investigate brain and retinal alterations in first episode untreated schizophrenic patients with combined AHs and VHs (FUSCHAV). FUSCHAV patients (n = 120), divided into four groups according to severity of AH and VH symptoms, were compared to healthy controls (n = 30). Gray matter volume (GMV) and global functional connectivity density (gFCD) were recorded to reflect brain structure and functional alterations. Total retinal thickness was acquired by optical coherence tomography to assess retinal impairment. The majority of FUSCHAV patients (85.8%) demonstrated both GMV reduction and gFCD increases along with retinal thinning compared to healthy controls. The severity of GMV reduction and gFCD increase differed between patient groups, ranked from highest to lowest severity as follows: severe AHs combined with severe VHs (FUSCHSASV, 20 patients), moderate AHs combined with severe VHs (FUSCHMASV, 23 patients), severe AHs combined with moderate VHs (FUSCHSAMV, 28 patients), and moderate AHs combined with moderate VHs (FUSCHMAMV, 26). Retinal impairment was similar among the four FUSCHAV groups. GMV reduction and gFCD increases in the frontal-parietal lobule show an inverted U-shaped pattern among FUSCHAV patients according to AH and VH severity, while retinal impairment remains stable among FUSCHAV groups. These findings indicate a reciprocal deterioration in auditory and visual disturbances among FUSCHAV patients.

Brain imaging features in schizophrenia with co‐occurring auditory verbal hallucinations and depressive symptoms—Implication for novel therapeutic strategies to alleviate the reciprocal deterioration

“…This will help develop comprehensive treatment strategies, such as antipsychotic and brain stimulation therapies (e.g., neural feedback techniques, rTMS, tDCS, AVATAR), to normalize the brain alterations associated with AVHs and depressive symptoms (Bohlken et al., 2017). Hence, in agreement with previous studies, we have shown that functional alterations in first‐episode schizophrenia patients with AVHs have an “inverted U‐shaped” pattern, in which network connectivity is initially increased, followed by a reduction in connectivity (Zhuo, Xiao, et al, 2020).…”

The Phenomenology and Neurobiology of Visual Distortions and Hallucinations in Schizophrenia: An Update

“…In Parkinson's disease, one study demonstrated a relationship between RNFL thinning and VH ( 153), but a second study found no evidence for such a link (154). A recent study in schizophrenia (155,156) indicated that four separate samples of patients with both auditory and visual hallucinations of at least moderate severity were characterized by significant macula and RNFL thinning relative to a control group. The lack of a control group of patients with auditory hallucinations only and/or no hallucinations precludes a definitive conclusion regarding specific relationships with VH, however.…”

Investigation of Light Parameters on Image Quality and Optical Coherence Tomography

“…When the time difference is zero, the reflectance is maximum and it is called constructive interference. is means the monochromatic signal intensity fringes are in phase only for zero time [23][24][25][26][27][28].…”