Elsevier

Biological Psychiatry

Volume 67, Issue 10, 15 May 2010, Pages 912-918
Biological Psychiatry

Archival Report
Auditory Hallucinations in Schizophrenia Are Associated with Reduced Functional Connectivity of the Temporo-Parietal Area

https://doi.org/10.1016/j.biopsych.2009.11.017Get rights and content

Background

Schizophrenia has been conceptualized as a disorder of integration of neural activity across distributed networks. However, the relationship between specific symptom dimensions and patterns of functional connectivity remains unclear. The current study aimed to investigate the relationship between auditory-verbal hallucinations (AVH), a particularly prevalent and clinically relevant symptom in schizophrenia, and functional connectivity of the temporo-parietal junction (TPJ).

Methods

Resting state functional magnetic resonance imaging scans were obtained from 27 schizophrenia patients with AVH and 27 matched control subjects. We calculated correlations reflecting functional connectivity between a priori defined regions-of-interest and the bilateral TPJ seed regions, comprising the neural network involved in inner speech processes and AVH.

Results

Compared with healthy control subjects, schizophrenia patients showed reduced functional connectivity between left TPJ and the right homotope of Broca. Within the patient group, more severe AVH were associated with reduced neural coupling between left TPJ and bilateral anterior cingulate as well as the bilateral amygdala.

Conclusions

In schizophrenia patients with chronic hallucinations, the left TPJ—a critical node in the speech perception/AVH network—shows reduced functional connectivity with brain areas involved in the attribution of agency, self-referent processing, and attentional control.

Section snippets

Subjects

The study was approved by the Institutional Review Board (University Medical Center Groningen). Twenty-seven patients, meeting DSM-IV criteria for schizophrenia—confirmed by a Schedules for Clinical Assessment in Neuropsychiatry (SCAN) interview (36)—and 27 healthy matched control subjects recruited via advertisement in the local community participated in the study. Detailed clinical and demographical data are presented in Table 1. Before participation, informed consent was obtained. All

Effects of Symptomatology

Analysis of group differences revealed a widespread decrease of functional connectivity with the TPJ in the patients, compared with control subjects. However, the only effect surviving FDR correction was a significantly decreased connectivity between left TPJ and the right homotope of Broca's area in patients compared with control subjects (Z = −2.88; p = .004; Figure 1).

Correlational analyses within the group of hallucinators revealed a negative association between the P3 hallucination item of

Discussion

This study aimed to relate AVH in patients with schizophrenia to patterns of functional connectivity during the resting state. The bilateral TPJ, a critical region in AVH genesis (37), was selected as a seed region; and its connection to other ROIs previously linked to AVH activity and speech perception processes was assessed.

Compared with healthy control subjects, patients showed reduced functional connectivity between the left TPJ and the right hemispheric homotope of Broca's area, which

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