Structural brain abnormalities in schizophrenia patients with a history and presence of auditory verbal hallucination

Abstract

Although many studies have demonstrated structural brain abnormalities associated with auditory verbal hallucinations (AVH) in schizophrenia, the results remain inconsistent because of the small sample sizes and the reliability of clinical interviews. We compared brain morphometries in 204 participants, including 58 schizophrenia patients with a history of AVH (AVH + ), 29 without a history of AVH (AVH−), and 117 healthy controls (HCs) based on a detailed inspection of medical records. We further divided the AVH+ group into 37 patients with and 21 patients without hallucinations at the time of the MRI scans (AVH++ and AVH+−, respectively) via clinical interviews to explore the morphological differences according to the persistence of AVH. The AVH + group had a smaller surface area in the left caudal middle frontal gyrus (F = 7.28, FDR-corrected p = 0.0008) and precentral gyrus (F = 7.68, FDR-corrected p = 0.0006) compared to the AVH− group. The AVH+ patients had a smaller surface area in the left insula (F = 7.06, FDR-corrected p = 0.001) and a smaller subcortical volume in the bilateral hippocampus (right: F = 13.34, FDR-corrected p = 0.00003; left: F = 6.80, FDR-corrected p = 0.001) compared to the HC group. Of these significantly altered areas, the AVH++ group showed significantly smaller bilateral hippocampal volumes compared to the AVH+− group, and a smaller surface area in the left precentral gyrus and caudal middle frontal gyrus compared to the AVH- group. Our findings highlighted the distinct pattern of structural alteration between the history and presence of AVH in schizophrenia, and the importance of integrating multiple criteria to elucidate the neuroanatomical mechanisms.

Investigating the lateralisation of experimentally induced auditory verbal hallucinations

“…These findings indicate a reduced left-hemisphere lateralisation for language perception, which has been associated with greater AVH severity (Hugdahl et al, 2012), mediated by impaired functional and structural interhemispheric auditory connectivity (Steinmann et al, 2019). Such AVH severity, in turn, has been linked to asymmetric structural abnormalities, including reduced grey matter volume in the left insula (Romeo and Spironelli, 2022), and a smaller surface area in this area of the brain in actively hallucinating schizophrenia participants compared to healthy controls (Sone et al, 2022).…”

Auditory hallucinations of Buddhist chanting as an initial symptom of mild cognitive impairment with Lewy bodies

“…In cases of deafness or compromise of the pontine inhibitory pathways over these musical memory circuits, anomalous disinhibition of these circuits and liberation of this type of memory in the form of musical auditory hallucinations may occur 4 . A recent report suggested that patients with schizophrenia who exhibited verbal auditory hallucinations had significantly smaller bilateral hippocampal volumes and smaller surface areas in the left superior frontal cortex and caudal middle frontal gyrus 5 . While functional changes in the occipital lobe have been noted in DLB, atrophy of the medial temporal lobe, especially the hippocampus, has been observed in some cases 6 .…”

“…4 A recent report suggested that patients with schizophrenia who exhibited verbal auditory hallucinations had significantly smaller bilateral hippocampal volumes and smaller surface areas in the left superior frontal cortex and caudal middle frontal gyrus. 5 While functional changes in the occipital lobe have been noted in DLB, atrophy of the medial temporal lobe, especially the hippocampus, has been observed in some cases. 6 A previous study showed that in patients with DLB and visual hallucinations, there were significant decreases in the left inferior parietal lobule, left superior temporal gyrus, and right primary visual cortex, while with auditory hallucinations, there were significant increases in the right middle occipital and right inferior occipital gyri as observed by brain perfusion single-photon emission computed tomography.…”

Characterization of dynamic patterns of human fetal to neonatal brain asymmetry with deformation-based morphometry

“…On a morphological level, post-mortem studies in humans provide evidence for cytoarchitectonic asymmetries (Galaburda, Sanides, and Geschwind 1978) and macroscopic asymmetries such as the ‘Yakovlevian-Torque’ can be observed by pure visual inspection. From the clinical perspective, there is emerging evidence for the association of altered or disrupted hemispheric asymmetry in neurological disorders and neuropsychological conditions (Postema et al 2019; Sone et al 2022; Lubben et al 2021).…”