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Bell A, Toh WL, Allen P, Cella M, Jardri R, Larøi F, Moseley P, Rossell SL. Examining the relationships between cognition and auditory hallucinations: A systematic review. Aust N Z J Psychiatry 2024; 58:467-497. [PMID: 38470085 PMCID: PMC11128145 DOI: 10.1177/00048674241235849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
OBJECTIVE Auditory hallucinations (hearing voices) have been associated with a range of altered cognitive functions, pertaining to signal detection, source-monitoring, memory, inhibition and language processes. Yet, empirical results are inconsistent. Despite this, several theoretical models of auditory hallucinations persist, alongside increasing emphasis on the utility of a multidimensional framework. Thus, clarification of current evidence across the broad scope of proposed mechanisms is warranted. METHOD A systematic search of the Web of Science, PubMed and Scopus databases was conducted. Records were screened to confirm the use of an objective behavioural cognitive task, and valid measurement of hallucinations specific to the auditory modality. RESULTS Auditory hallucinations were primarily associated with difficulties in perceptual decision-making (i.e. reduced sensitivity/accuracy for signal-noise discrimination; liberal responding to ambiguity), source-monitoring (i.e. self-other and temporal context confusion), working memory and language function (i.e. reduced verbal fluency). Mixed or limited support was observed for perceptual feature discrimination, imagery vividness/illusion susceptibility, source-monitoring for stimulus form and spatial context, recognition and recall memory, executive functions (e.g. attention, inhibition), emotion processing and language comprehension/hemispheric organisation. CONCLUSIONS Findings were considered within predictive coding and self-monitoring frameworks. Of concern was the portion of studies which - despite offering auditory-hallucination-specific aims and inferences - employed modality-general measures, and/or diagnostic-based contrasts with psychologically healthy individuals. This review highlights disparities within the literature between theoretical conceptualisations of auditory hallucinations and the body of rigorous empirical evidence supporting such inferences. Future cognitive investigations, beyond the schizophrenia-spectrum, which explicitly define and measure the timeframe and sensory modality of hallucinations, are recommended.
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Affiliation(s)
- Adrienne Bell
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Wei Lin Toh
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
- Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia
- Department of Psychology, Alfred Health, Melbourne, VIC, Australia
| | - Paul Allen
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Matteo Cella
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Renaud Jardri
- University of Lille, INSERM U-1172, Plasticity and Subjectivity Team, Lille Neuroscience and Cognition Research Centre, Fontan Hospital, CHU Lille, Lille, France
| | - Frank Larøi
- Department of Psychology, University of Oslo, Oslo, Norway
- Psychology and Neuroscience of Cognition Research Unit, University of Liege, Liege, Belgium
| | - Peter Moseley
- Department of Psychology, Northumbria University, Newcastle-Upon-Tyne, UK
| | - Susan L Rossell
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
- Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia
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2
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Rossell S. Understanding and treating body dysmorphic disorder. Psychiatry Res 2023; 319:114980. [PMID: 36470162 DOI: 10.1016/j.psychres.2022.114980] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
Body dysmorphic disorder (BDD) is a mental disorder that involves a distressing preoccupation with a perceived defect in physical appearance, associated with excessive or repetitive behaviours or mental acts aimed at camouflaging, checking or 'improving' the perceived area of concern. BDD is relatively common, affecting at least 2% of the population world-wide, yet is poorly understood. Professor Susan Rossell has produced a substantial body of influential research, which has improved our understanding of BDD. This includes a more comprehensive understanding of the phenomenology, neurocognition and neurobiology, as well as significant treatment advances. This work will be reviewed in this commentary.
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Affiliation(s)
- Susan Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia.
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AĞDANLI O, TOPUZOGLU A, KARABAY N, ALPTEKİN K. Corpus Callosum Volume in Patients with First-Episode Psychosis. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.789999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Onur AĞDANLI
- Sağlık Bakanlığı, İzmir Katip Çelebi Üniverstesi Atatürk Eğitim Araştırma Hastanesi, Psikiyatri Kliniği
| | - Ahmet TOPUZOGLU
- MARMARA ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, HALK SAĞLIĞI ANABİLİM DALI
| | - Nuri KARABAY
- Dokuz Eylül Üniversitesi Tıp Fakültesi Dahili Bilimler, Radyoloji Anabilim Dalı
| | - Köksal ALPTEKİN
- DOKUZ EYLÜL ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, RUH SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI
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4
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Oestreich LKL, Randeniya R, Garrido MI. Auditory prediction errors and auditory white matter microstructure associated with psychotic-like experiences in healthy individuals. Brain Struct Funct 2019; 224:3277-3289. [PMID: 31686202 DOI: 10.1007/s00429-019-01972-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 10/17/2019] [Indexed: 12/23/2022]
Abstract
Our sensory systems actively predict sensory information based on previously learnt patterns, which are continuously updated with information from the actual sensory input via prediction errors. Individuals with schizophrenia consistently show reduced auditory prediction errors as well as altered fractional anisotropy (indicative of white matter changes) in the arcuate fasciculus and the auditory interhemispheric pathway, both of which are auditory white matter pathways associated with prediction errors. However, it is not clear if healthy individuals with psychotic-like experiences exhibit similar deficits. Participants underwent electroencephalography (EEG) recordings while listening to a classical two-tone duration deviant oddball paradigm (n = 103) and a stochastic oddball paradigm (n = 89). A subset of participants (n = 89) also underwent diffusion-weighted magnetic resonance imaging (MRI). Fractional anisotropy (FA), was extracted from the arcuate fasciculi and the auditory interhemispheric pathway. While prediction errors evoked by the classical oddball paradigm failed to reveal significant effects, the stochastic oddball paradigm elicited significant clusters at the typical mismatch negativity time window. Furthermore, we observed that FA of the arcuate fasciculi and auditory interhemispheric pathway significantly improved predictive models of psychotic-like experiences in healthy individuals over and above predictions made by auditory prediction error responses alone. Specifically, we observed that decreasing FA in the auditory interhemispheric pathway and reducing ability to learn stochastic irregularities are associated with increasing CAPE + scores. To the extent that these associations have previously been reported in patients with schizophrenia, the findings from this study suggest that both, auditory prediction errors and white matter changes in the auditory interhemispheric pathway, may have the potential to be translated into early screening markers for psychosis.
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Affiliation(s)
- L K L Oestreich
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia. .,Centre for Advanced Imaging, The University of Queensland, Brisbane, Australia. .,Royal Brisbane and Women's Hospital, Brisbane, Australia.
| | - R Randeniya
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia.,ARC Centre for Integrative Brain Function, Clayton, Australia
| | - M I Garrido
- Centre for Advanced Imaging, The University of Queensland, Brisbane, Australia.,Queensland Brain Institute, The University of Queensland, Brisbane, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.,ARC Centre for Integrative Brain Function, Clayton, Australia
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5
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Rollins CP, Garrison JR, Simons JS, Rowe JB, O'Callaghan C, Murray GK, Suckling J. Meta-analytic Evidence for the Plurality of Mechanisms in Transdiagnostic Structural MRI Studies of Hallucination Status. EClinicalMedicine 2019; 8:57-71. [PMID: 31193632 PMCID: PMC6537703 DOI: 10.1016/j.eclinm.2019.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/15/2019] [Accepted: 01/27/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Hallucinations are transmodal and transdiagnostic phenomena, occurring across sensory modalities and presenting in psychiatric, neurodegenerative, neurological, and non-clinical populations. Despite their cross-category occurrence, little empirical work has directly compared between-group neural correlates of hallucinations. METHODS We performed whole-brain voxelwise meta-analyses of hallucination status across diagnoses using anisotropic effect-size seed-based d mapping (AES-SDM), and conducted a comprehensive systematic review in PubMed and Web of Science until May 2018 on other structural correlates of hallucinations, including cortical thickness and gyrification. FINDINGS 3214 abstracts were identified. Patients with psychiatric disorders and hallucinations (eight studies) exhibited reduced gray matter (GM) in the left insula, right inferior frontal gyrus, left anterior cingulate/paracingulate gyrus, left middle temporal gyrus, and increased in the bilateral fusiform gyrus, while patients with neurodegenerative disorders with hallucinations (eight studies) showed GM decreases in the left lingual gyrus, right supramarginal gyrus/parietal operculum, left parahippocampal gyrus, left fusiform gyrus, right thalamus, and right lateral occipital gyrus. Group differences between psychiatric and neurodegenerative hallucination meta-analyses were formally confirmed using Monte Carlo randomizations to determine statistical significance, and a jackknife sensitivity analysis established the reproducibility of results across nearly all study combinations. For other structural measures (28 studies), the most consistent findings associated with hallucination status were reduced cortical thickness in temporal gyri in schizophrenia and altered hippocampal volume in Parkinson's disease and dementia. Additionally, increased severity of hallucinations in schizophrenia correlated with GM reductions within the left superior temporal gyrus, right middle temporal gyrus, bilateral supramarginal and angular gyri. INTERPRETATION Distinct patterns of neuroanatomical alteration characterize hallucination status in patients with psychiatric and neurodegenerative diseases, suggesting a plurality of anatomical signatures. This approach has implications for treatment, theoretical frameworks, and generates refutable predictions for hallucinations in other diseases and their occurrence within the general population. FUNDING None.
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Affiliation(s)
- Colleen P.E. Rollins
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Corresponding author at: Department of Psychiatry, University of Cambridge, Cambridge CB2 0SP, UK
| | - Jane R. Garrison
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Jon S. Simons
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - James B. Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Kuo SS, Pogue-Geile MF. Variation in fourteen brain structure volumes in schizophrenia: A comprehensive meta-analysis of 246 studies. Neurosci Biobehav Rev 2019; 98:85-94. [PMID: 30615934 DOI: 10.1016/j.neubiorev.2018.12.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 11/21/2018] [Accepted: 12/31/2018] [Indexed: 12/24/2022]
Abstract
Despite hundreds of structural MRI studies documenting smaller brain volumes on average in schizophrenia compared to controls, little attention has been paid to group differences in the variability of brain volumes. Examination of variability may help interpret mean group differences in brain volumes and aid in better understanding the heterogeneity of schizophrenia. Variability in 246 MRI studies was meta-analyzed for 13 structures that have shown medium to large mean effect sizes (Cohen's d≥0.4): intracranial volume, total brain volume, lateral ventricles, third ventricle, total gray matter, frontal gray matter, prefrontal gray matter, temporal gray matter, superior temporal gyrus gray matter, planum temporale, hippocampus, fusiform gyrus, insula; and a control structure, caudate nucleus. No significant differences in variability in cortical/subcortical volumes were detected in schizophrenia relative to controls. In contrast, increased variability was found in schizophrenia compared to controls for intracranial and especially lateral and third ventricle volumes. These findings highlight the need for more attention to ventricles and detailed analyses of brain volume distributions to better elucidate the pathophysiology of schizophrenia.
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Affiliation(s)
- Susan S Kuo
- Department of Psychology, University of Pittsburgh, 4209 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA.
| | - Michael F Pogue-Geile
- Department of Psychology, University of Pittsburgh, 4209 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA; Department of Psychology and Department of Psychiatry, University of Pittsburgh, 4207 Sennott Square, 210 South Bouquet St., Pittsburgh PA 15260, USA.
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7
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Moschopoulos NP, Nimatoudis I, Kaprinis S, Iliadou V. Behavioral assessment of auditory processing deficits in schizophrenia: Literature review and suggestions for future research. Scand J Psychol 2018; 60:116-127. [DOI: 10.1111/sjop.12514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/12/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Nikolaos P. Moschopoulos
- Clinical Psychoacoustics Lab; 3rd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Ioannis Nimatoudis
- Clinical Psychoacoustics Lab; 3rd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Stergios Kaprinis
- 2nd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Vasiliki Iliadou
- Clinical Psychoacoustics Lab; 3rd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
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8
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Taghipour M, Ghaffarpasand F. Corpus Callosotomy for Drug-Resistant Schizophrenia; Novel Treatment Based on Pathophysiology. World Neurosurg 2018; 116:483-484. [PMID: 30049036 DOI: 10.1016/j.wneu.2018.04.113] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 04/17/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Mousa Taghipour
- Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
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9
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Tréhout M, Leroux E, Delcroix N, Dollfus S. Relationships between corpus callosum and language lateralization in patients with schizophrenia and bipolar disorders. Bipolar Disord 2017; 19:496-504. [PMID: 28834020 DOI: 10.1111/bdi.12526] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/01/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The question of whether there is a continuum or a dichotomy among patients with schizophrenia (SZ) and bipolar disorders (BD) has not been clearly resolved and remains a challenge. Thus, the identification of specific biomarkers of these disorders might be helpful. The present study investigated the volume of the corpus callosum (CC) and functional lateralization for language as potential biomarkers and their relationships in SZ and BD. METHODS The study included 20 patients with SZ, 20 patients with BD and 40 healthy controls (HC). A functional lateralization index (FLI) was computed for each participant within the language comprehension network. For each participant, the volume of the total CC and those of three subregions were extracted. These variables and their anatomo-functional relationships were investigated. RESULTS In comparison to HC, SZ patients presented a decreased leftward lateralization for language, whereas this was not found in BD patients. However, as compared to SZ patients and HC, BD patients showed a reduction in CC volume associated with a lower leftward lateralization for language. CONCLUSIONS Our study revealed that SZ patients displayed a reduction of the leftward functional lateralization for language; however, no reduction of CC volume was observed, whereas BD patients presented a decreased volume of the CC associated with a lower leftward asymmetry for language. The results of our study detected distinct anomalies in both SZ and BD that may be considered as specific biomarkers of these disorders related to neurodevelopmental models.
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Affiliation(s)
- Maxime Tréhout
- Service de Psychiatrie, CHU de Caen, Caen, France.,Normandie Univ, UNICAEN, UFR de médecine (Medical School), Caen, France.,Normandie Univ, UNICAEN, ISTS, Caen, France
| | | | | | - Sonia Dollfus
- Service de Psychiatrie, CHU de Caen, Caen, France.,Normandie Univ, UNICAEN, UFR de médecine (Medical School), Caen, France.,Normandie Univ, UNICAEN, ISTS, Caen, France
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10
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Steinmann S, Leicht G, Mulert C. Interhemispheric auditory connectivity: structure and function related to auditory verbal hallucinations. Front Hum Neurosci 2014; 8:55. [PMID: 24574995 PMCID: PMC3920068 DOI: 10.3389/fnhum.2014.00055] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 01/23/2014] [Indexed: 02/06/2023] Open
Abstract
Auditory verbal hallucinations (AVH) are one of the most common and most distressing symptoms of schizophrenia. Despite fundamental research, the underlying neurocognitive and neurobiological mechanisms are still a matter of debate. Previous studies suggested that “hearing voices” is associated with a number of factors including local deficits in the left auditory cortex and a disturbed connectivity of frontal and temporoparietal language-related areas. In addition, it is hypothesized that the interhemispheric pathways connecting right and left auditory cortices might be involved in the pathogenesis of AVH. Findings based on Diffusion-Tensor-Imaging (DTI) measurements revealed a remarkable interindividual variability in size and shape of the interhemispheric auditory pathways. Interestingly, schizophrenia patients suffering from AVH exhibited increased fractional anisotropy (FA) in the interhemispheric fibers than non-hallucinating patients. Thus, higher FA-values indicate an increased severity of AVH. Moreover, a dichotic listening (DL) task showed that the interindividual variability in the interhemispheric auditory pathways was reflected in the behavioral outcome: stronger pathways supported a better information transfer and consequently improved speech perception. This detection indicates a specific structure-function relationship, which seems to be interindividually variable. This review focuses on recent findings concerning the structure-function relationship of the interhemispheric pathways in controls, hallucinating and non-hallucinating schizophrenia patients and concludes that changes in the structural and functional connectivity of auditory areas are involved in the pathophysiology of AVH.
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Affiliation(s)
- Saskia Steinmann
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Gregor Leicht
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Christoph Mulert
- Psychiatry Neuroimaging Branch, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf Hamburg, Germany
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11
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van Tol MJ, van der Meer L, Bruggeman R, Modinos G, Knegtering H, Aleman A. Voxel-based gray and white matter morphometry correlates of hallucinations in schizophrenia: The superior temporal gyrus does not stand alone. Neuroimage Clin 2013; 4:249-57. [PMID: 25061563 PMCID: PMC4107370 DOI: 10.1016/j.nicl.2013.12.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 12/19/2013] [Accepted: 12/20/2013] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Auditory verbal hallucinations (AVH) in schizophrenia (SZ) have been proposed to result from abnormal local, interregional and interhemispheric integration of brain signals in regions involved in language production and perception. This abnormal functional integration may find its base in morphological abnormalities. Structurally, AVHs have been frequently linked to abnormal morphology of the superior temporal gyrus (STG), but only a few studies investigated the relation of hallucination presence with both whole-brain gray matter (GM) and white matter (WM) morphometry. METHODS Using a unified voxel-based morphometry-DARTEL approach, we investigated correlates of AVH presence in 51 schizophrenia patients (20 non-hallucinating [SZ -], 31 hallucinating [SZ +]), and included 51 age and sex matched healthy participants. Effects are reported at p < .05 FWE corrected. RESULTS Patients showed lower GM volume of the left STG than controls, irrespective of AVH presence. In addition, SZ + showed lower GM volume of the left inferior frontal and right parahippocampal gyrus, and higher WM volume of the left postcentral and superior parietal lobule than controls. Finally, volume of the putamen was lower in SZ + compared to SZ -. No effects on corpus callosum morphometry were observed. Delusion severity, general positive and negative symptomatology illness duration, and medication status could not explain the results. DISCUSSION Results suggest that STG GM abnormalities underlie the general susceptibility to experience psychotic symptoms and that additional abnormalities in a network of medial temporal, ventrolateral, putaminal, and parietal regions related to verbal memory and speech production may specifically increase the likelihood of experiencing AVH. Future studies should clarify the meaning of morphometry abnormalities for functional interregional communication.
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Affiliation(s)
- Marie-José van Tol
- University of Groningen, University Medical Center Groningen, Neuroimaging Center, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands
| | - Lisette van der Meer
- University of Groningen, University Medical Center Groningen, Neuroimaging Center, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands
- Lentis Institution for Mental Health Care, Department of Rehabilitation, PO Box 128, 9470 AC Zuidlaren, The Netherlands
| | - Richard Bruggeman
- University Medical Center Groningen, Department of Psychiatry, Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - Gemma Modinos
- Institute of Psychiatry, King's College London, Department of Psychosis Studies, 16 De Crespigny Park, London SE5 8AF, UK
| | - Henderikus Knegtering
- Lentis Institution for Mental Health Care, Groningen and Lentis Institution for Mental Health Care, Department of Rehabilitation, Postbus 128, 9470 AC Zuidlaren, The Netherlands
| | - André Aleman
- University of Groningen, University Medical Center Groningen, Neuroimaging Center, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands
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12
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Auditory hallucinations and reduced language lateralization in schizophrenia: a meta-analysis of dichotic listening studies. J Int Neuropsychol Soc 2013; 19:410-8. [PMID: 23332000 DOI: 10.1017/s1355617712001476] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Reduced left-hemispheric language lateralization has been proposed to be a trait marker for schizophrenia, but the empirical evidence is ambiguous. Recent studies suggest that auditory hallucinations are critical for whether a patient shows reduced language lateralization. Therefore, the aim of the study was to statistically integrate studies investigating language lateralization in schizophrenia patients using dichotic listening. To this end, two meta-analyses were conducted, one comparing schizophrenia patients with healthy controls (n = 1407), the other comparing schizophrenia patients experiencing auditory hallucinations with non-hallucinating controls (n = 407). Schizophrenia patients showed weaker language lateralization than healthy controls but the effect size was small (g = -0.26). When patients with auditory hallucinations were compared to non-hallucinating controls, the effect size was substantially larger (g = -0.45). These effect sizes suggest that reduced language lateralization is a weak trait marker for schizophrenia as such and a strong trait marker for the experience of auditory hallucinations within the schizophrenia population.
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13
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Whitford TJ, Savadjiev P, Kubicki M, O'Donnell LJ, Terry DP, Bouix S, Westin CF, Schneiderman JS, Bobrow L, Rausch AC, Niznikiewicz M, Nestor PG, Pantelis C, Wood SJ, McCarley RW, Shenton ME. Fiber geometry in the corpus callosum in schizophrenia: evidence for transcallosal misconnection. Schizophr Res 2011; 132:69-74. [PMID: 21831601 PMCID: PMC3172336 DOI: 10.1016/j.schres.2011.07.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 07/05/2011] [Accepted: 07/09/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND Structural abnormalities in the callosal fibers connecting the heteromodal association areas of the prefrontal and temporoparietal cortices bilaterally have been suggested to play a role in the etiology of schizophrenia. AIMS To investigate for geometric abnormalities in these callosal fibers in schizophrenia patients by using a novel Diffusion-Tensor Imaging (DTI) metric of fiber geometry named Shape-Normalized Dispersion (SHD). METHODS DTIs (3T, 51 gradient directions, 1.7mm isotropic voxels) were acquired from 26 schizophrenia patients and 23 matched healthy controls. The prefrontal and temporoparietal fibers of the corpus callosum were extracted by means of whole-brain tractography, and their mean SHD calculated. RESULTS The schizophrenia patients exhibited subnormal levels of SHD in the prefrontal callosal fibers when controlling for between-group differences in Fractional Anisotropy. Reduced SHD could reflect either irregularly turbulent or inhomogeneously distributed fiber trajectories in the corpus callosum. CONCLUSIONS The results suggest that the transcallosal misconnectivity thought to be associated with schizophrenia could reflect abnormalities in fiber geometry. These abnormalities in fiber geometry could potentially be underpinned by neurodevelopmental irregularities.
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Affiliation(s)
- Thomas J. Whitford
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA,Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Heath, Melbourne, VIC, Australia, Corresponding Author: Thomas J. Whitford, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston St, Boston, MA, 02215, USA, Phone: +1 617 525 1059, Fax: +1 617 525 6150,
| | - Peter Savadjiev
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA,Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs (VA) Boston Healthcare System, Harvard Medical School Brockton, MA, USA
| | - Lauren J. O'Donnell
- Laboratory of Mathematics in Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA,Golby Laboratory, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Douglas P. Terry
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA,Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs (VA) Boston Healthcare System, Harvard Medical School Brockton, MA, USA
| | - Carl-Fredrik Westin
- Laboratory of Mathematics in Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jason S. Schneiderman
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Laurel Bobrow
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrew C. Rausch
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Margaret Niznikiewicz
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs (VA) Boston Healthcare System, Harvard Medical School Brockton, MA, USA
| | - Paul G. Nestor
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs (VA) Boston Healthcare System, Harvard Medical School Brockton, MA, USA,College of Liberal Arts, University of Massachusetts – Boston, Boston, MA, USA
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Heath, Melbourne, VIC, Australia
| | - Stephen J. Wood
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Heath, Melbourne, VIC, Australia
| | - Robert W. McCarley
- Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs (VA) Boston Healthcare System, Harvard Medical School Brockton, MA, USA
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA,Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs (VA) Boston Healthcare System, Harvard Medical School Brockton, MA, USA
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Francis A, Bhojraj TS, Prasad K, Kulkarni S, Montrose D, Eack S, Keshavan MS. Abnormalities of the corpus callosum in non-psychotic high-risk offspring of schizophrenia patients. Psychiatry Res 2011; 191:9-15. [PMID: 21145214 PMCID: PMC3124091 DOI: 10.1016/j.pscychresns.2010.09.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 08/06/2010] [Accepted: 09/14/2010] [Indexed: 01/10/2023]
Abstract
Alterations in the structure of the corpus callosum (CC) have been observed in schizophrenia. Offspring of schizophrenia parents have 10-15 times higher risk for developing schizophrenia. We examined CC volume in offspring at genetic high-risk (HR) subjects. Since the sub-regions of the CC are topographically mapped to cortical brain regions, we hypothesized that HR subjects may show a decrement in total volume and differential volume decreases in sub-regions of the CC. The offspring of schizophrenia parents (HR; n=70; 36 males) and healthy volunteers with no family or personal history of psychotic disorders (healthy controls (HC); n=73; 37 males) matched for age, gender and education were selected for the study. Magnetic resonance images were collected using a GE 1.5 T scanner and processed using FreeSurfer image analysis software. The CC was divided into five neuroanatomically based partitions. The volume of total CC and the five sub-regions were measured blind to clinical information. With covariation for intracranial volume, HR subjects had significantly reduced total CC, more prominently observed in the anterior splenium. An age-related increase in CC volume was found in the anterior and posterior splenium of healthy controls but not in HR subjects. The volume reduction was greater in male than female HR subjects. The volume reduction in the CC may reflect a reduction in axonal fibers crossing the hemispheres and/or myelination between the left and right temporo-parietal cortices. The absence of an age-related volume increase suggests an abnormal developmental trajectory that may underlie susceptibility to schizophrenia.
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Affiliation(s)
- A. Francis
- Beth Israel Deaconess Medical Center, Boston, MA, Harvard Medical School, Boston, MA
| | - TS Bhojraj
- Beth Israel Deaconess Medical Center, Boston, MA, Harvard Medical School, Boston, MA
| | - K Prasad
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - S Kulkarni
- Beth Israel Deaconess Medical Center, Boston, MA, Harvard Medical School, Boston, MA
| | - D Montrose
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - S Eack
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - MS Keshavan
- Beth Israel Deaconess Medical Center, Boston, MA, Harvard Medical School, Boston, MA, University of Pittsburgh Medical Center, Pittsburgh, PA
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15
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Chaim TM, Schaufelberger MS, Ferreira LK, Duran FLS, Ayres AM, Scazufca M, Menezes PR, Amaro E, Leite CC, Murray RM, McGuire PK, Rushe TM, Busatto GF. Volume reduction of the corpus callosum and its relationship with deficits in interhemispheric transfer of information in recent-onset psychosis. Psychiatry Res 2010; 184:1-9. [PMID: 20817487 DOI: 10.1016/j.pscychresns.2010.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2009] [Revised: 04/26/2010] [Accepted: 06/08/2010] [Indexed: 01/11/2023]
Abstract
The present study aimed to investigate the presence of corpus callosum (CC) volume deficits in a population-based recent-onset psychosis (ROP) sample, and whether CC volume relates to interhemispheric communication deficits. For this purpose, we used voxel-based morphometry comparisons of magnetic resonance imaging data between ROP (n =122) and healthy control (n = 94) subjects. Subgroups (38 ROP and 39 controls) were investigated for correlations between CC volumes and performance on the Crossed Finger Localization Test (CFLT). Significant CC volume reductions in ROP subjects versus controls emerged after excluding substance misuse and non-right-handedness. CC reductions retained significance in the schizophrenia subgroup but not in affective psychoses subjects. There were significant positive correlations between CC volumes and CFLT scores in ROP subjects, specifically in subtasks involving interhemispheric communication. From these results, we can conclude that CC volume reductions are present in association with ROP. The relationship between such deficits and CFLT performance suggests that interhemispheric communication impairments are directly linked to CC abnormalities in ROP.
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Affiliation(s)
- Tiffany M Chaim
- Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
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16
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Gavrilescu M, Rossell S, Stuart GW, Shea TL, Innes-Brown H, Henshall K, McKay C, Sergejew AA, Copolov D, Egan GF. Reduced connectivity of the auditory cortex in patients with auditory hallucinations: a resting state functional magnetic resonance imaging study. Psychol Med 2010; 40:1149-1158. [PMID: 19891811 DOI: 10.1017/s0033291709991632] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Previous research has reported auditory processing deficits that are specific to schizophrenia patients with a history of auditory hallucinations (AH). One explanation for these findings is that there are abnormalities in the interhemispheric connectivity of auditory cortex pathways in AH patients; as yet this explanation has not been experimentally investigated. We assessed the interhemispheric connectivity of both primary (A1) and secondary (A2) auditory cortices in n=13 AH patients, n=13 schizophrenia patients without auditory hallucinations (non-AH) and n=16 healthy controls using functional connectivity measures from functional magnetic resonance imaging (fMRI) data. METHOD Functional connectivity was estimated from resting state fMRI data using regions of interest defined for each participant based on functional activation maps in response to passive listening to words. Additionally, stimulus-induced responses were regressed out of the stimulus data and the functional connectivity was estimated for the same regions to investigate the reliability of the estimates. RESULTS AH patients had significantly reduced interhemispheric connectivity in both A1 and A2 when compared with non-AH patients and healthy controls. The latter two groups did not show any differences in functional connectivity. Further, this pattern of findings was similar across the two datasets, indicating the reliability of our estimates. CONCLUSIONS These data have identified a trait deficit specific to AH patients. Since this deficit was characterized within both A1 and A2 it is expected to result in the disruption of multiple auditory functions, for example, the integration of basic auditory information between hemispheres (via A1) and higher-order language processing abilities (via A2).
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Affiliation(s)
- M Gavrilescu
- Howard Florey Institute, Florey Neuroscience Institutes, Florey Neuroscience Institutes, University of Melbourne, Parkville, 3010, Victoria, Australia.
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17
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Kubicki M, Styner M, Bouix S, Gerig G, Markant D, Smith K, Kikinis R, McCarley R, Shenton M. Reduced interhemispheric connectivity in schizophrenia-tractography based segmentation of the corpus callosum. Schizophr Res 2008; 106:125-31. [PMID: 18829262 PMCID: PMC2630535 DOI: 10.1016/j.schres.2008.08.027] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 08/11/2008] [Accepted: 08/14/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND A reduction in interhemispheric connectivity is thought to contribute to the etiology of schizophrenia. Diffusion Tensor Imaging (DTI) measures the diffusion of water and can be used to describe the integrity of the corpus callosum white matter tracts, thereby providing information concerning possible interhemispheric connectivity abnormalities. Previous DTI studies in schizophrenia are inconsistent in reporting decreased Fractional Anisotropy (FA), a measure of anisotropic diffusion, within different portions of the corpus callosum. Moreover, none of these studies has investigated corpus callosum systematically, using anatomical subdivisions. METHODS DTI and structural MRI scans were obtained from 32 chronic schizophrenic subjects and 42 controls. Corpus callosum cross sectional area and its probabilistic subdivisions were determined automatically from structural MRI scans using a model based deformable contour segmentation. These subdivisions employ a previously generated probabilistic subdivision atlas, based on fiber tractography and anatomical lobe subdivision. The structural scan was then co-registered with the DTI scan and the anatomical corpus callosum subdivisions were propagated to the associated FA map. RESULTS Results revealed decreased FA within parts of the corpus interconnecting frontal regions in schizophrenia compared with controls, but no significant changes for callosal fibers interconnecting parietal and temporo-occipital brain regions. In addition, integrity of the anterior corpus was statistically significantly correlated with negative as well as positive symptoms, while posterior measures correlated with positive symptoms only. CONCLUSIONS This study provides quantitative evidence for a reduction of interhemispheric brain connectivity in schizophrenia, involving corpus callosum, and further points to frontal connections as possibly disrupted in schizophrenia.
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Affiliation(s)
- M. Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Clinical Neuroscience Division, Laboratory of Neuroscience, Boston VA Healthcare System-Brockton Division, Department of Psychiatry, Harvard Medical School, Brockton, MA
| | - M. Styner
- Departments of Computer Science and Psychiatry, University of North Carolina, Chapel Hill, NC
| | - S. Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School
| | - G. Gerig
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT
| | - D. Markant
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School
| | - K. Smith
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School
| | - R. Kikinis
- Surgical Planning Laboratory, MRI Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - R.W. McCarley
- Clinical Neuroscience Division, Laboratory of Neuroscience, Boston VA Healthcare System-Brockton Division, Department of Psychiatry, Harvard Medical School, Brockton, MA
| | - M.E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Clinical Neuroscience Division, Laboratory of Neuroscience, Boston VA Healthcare System-Brockton Division, Department of Psychiatry, Harvard Medical School, Brockton, MA, Surgical Planning Laboratory, MRI Division, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
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18
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John JP, Shakeel K. M, Jain S. Corpus callosal area differences and gender dimorphism in neuroleptic-naïve, recent-onset schizophrenia and healthy control subjects. Schizophr Res 2008; 103:11-21. [PMID: 18585006 PMCID: PMC2605782 DOI: 10.1016/j.schres.2008.04.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Revised: 04/21/2008] [Accepted: 04/28/2008] [Indexed: 10/21/2022]
Abstract
The study of corpus callosal morphometry is important to unravel the underlying connectivity disturbance in schizophrenia. We studied the corpus callosal area in schizophrenia subjects compared to healthy subjects, while controlling for several confounders that could affect morphometric measures of the corpus callosum (CC). Areas of the whole CC and its sub-regions obtained by two geometric partitioning schemes were studied in 23 right-handed neuroleptic-naïve, recent-onset, schizophrenia patients and compared with 23 right-handed age-, sex- and education-matched healthy subjects. The patients did not differ from controls in whole CC area. On tripartite division of the CC, the area of the anterior sub-region was significantly higher in patients compared to controls. On radial division into 5 sub-regions, the anterior truncus area was significantly higher in patients compared to controls. There was a significant effect of gender (F>M) on the area measures; however there was no significant diagnosis()gender effect. Age, age of onset, duration of illness and psychopathology ratings did not show any significant correlations with whole CC area and area of CC sub-regions. The finding of increased area of the anterior truncus that possibly comprises white fibres connecting the temporal association cortices could be indicative of an "abnormal functional hyperconnection" involving these regions in positive symptom schizophrenia. Additionally, the finding of females having larger areas of the whole CC and of the anterior and middle sub-regions could reflect a "normal hyperconnection" underlying increased ambilaterality in females.
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Affiliation(s)
- John P John
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
| | - Mohammed Shakeel K.
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore
| | - Sanjeev Jain
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore
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19
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Meta-analysis of magnetic resonance imaging studies of the corpus callosum in schizophrenia. Schizophr Res 2008; 101:124-32. [PMID: 18289833 DOI: 10.1016/j.schres.2008.01.005] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Revised: 12/26/2007] [Accepted: 01/04/2008] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The corpus callosum plays a pivotal role in inter-hemispheric transfer and integration of information. Magnetic resonance studies have reported callosal abnormalities in schizophrenia but findings have been inconsistent. Uncertainty has persisted despite a meta-analytic evaluation of this structure several years ago. We set out to perform a further meta-analysis with the addition of the numerous reports published on the subject to test the hypothesis that the corpus callosum is abnormal in schizophrenia. METHOD A systematic search was carried out to identify suitable magnetic resonance studies which reported callosal areas in schizophrenia compared to controls. Results from the retrieved studies were compared in a meta-analysis whilst the influence of biological and clinical variables on effect size was ascertained with meta-regression analysis. RESULTS Twenty-eight studies were identified. Corpus callosum area was reduced in schizophrenia in comparison to healthy volunteers. This effect was larger in first episode patients. Similarly, heterogeneity detected among the studies was associated with course of illness indicating that chronic subjects with schizophrenia showed larger callosal areas. There was no evidence of publication bias. CONCLUSIONS This study confirms the presence of reduced callosal areas in schizophrenia. The effect is of a larger magnitude at first presentation and less so in subjects with a chronic course generally medicated with antipsychotics.
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20
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Toulopoulou T, Chua SE, Lam I, Cheung V, Murray RM, David AS. Evidence of normal hearing laterality in familial schizophrenic patients and their relatives. Am J Med Genet B Neuropsychiatr Genet 2008; 147B:73-6. [PMID: 17722025 DOI: 10.1002/ajmg.b.30587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Dichotic listening (DL) has been used as a tool to investigate possible left cerebral dysfunction in schizophrenia. However, the wide range of DL tests (e.g., words, emotions, sentences) as well as patient groups ("heterogeneity") has introduced several confounders. Assessing relatives of patients with schizophrenia may overcome some of these problems, and may be more useful in determining if loss of functional cerebral laterality in schizophrenia is a state or a trait phenomenon. The fused consonant-vowel DL test was administered to 114 subjects: 20 individuals with familial schizophrenia, 42 of their healthy relatives, and 52 healthy volunteers. We did this to investigate whether the normal language processing asymmetry-a right ear advantage (REA)-is present, and whether it could serve as a marker for genetic liability. General performance accuracy level was lower in schizophrenia patients and their relatives but the expected REA was present in all groups. Adjusting for age, accuracy, and obligate status made no difference. In conclusion, familial schizophrenic patients and their relatives have normal REA and hearing laterality on the fused DL test.
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Affiliation(s)
- Timothea Toulopoulou
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
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21
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García-Martí G, Aguilar EJ, Lull JJ, Martí-Bonmatí L, Escartí MJ, Manjón JV, Moratal D, Robles M, Sanjuán J. Schizophrenia with auditory hallucinations: a voxel-based morphometry study. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:72-80. [PMID: 17716795 DOI: 10.1016/j.pnpbp.2007.07.014] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2006] [Revised: 07/11/2007] [Accepted: 07/11/2007] [Indexed: 11/29/2022]
Abstract
Many studies have shown widespread but subtle pathological changes in gray matter in patients with schizophrenia. Some of these studies have related specific alterations to the genesis of auditory hallucinations, particularly in the left superior temporal gyrus, but none has analysed the relationship between morphometric data and a specific scale for auditory hallucinations. The present study aims to define the presence and characteristics of structural abnormalities in relation with the intensity and phenomenology of auditory hallucinations by means of magnetic resonance voxel-based morphometry (MR-VBM) method applied on a highly homogeneous group of 18 persistent hallucinatory patients meeting DSM-IV criteria for schizophrenia compared to 19 healthy matched controls. Patients were evaluated using the PSYRATS scale for auditory hallucinations. Reductions of gray matter concentration in patients to controls were observed in bilateral insula, bilateral superior temporal gyri and left amygdala. In addition, specific relationships between left inferior frontal and right postcentral gyri reductions and the severity of auditory hallucinations were observed. All these areas might be implicated in the genesis and/or persistence of auditory hallucinations through specific mechanisms. Precise morphological abnormalities may help to define reliable MR-VBM biomarkers for the genesis and persistence of auditory hallucinations.
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Affiliation(s)
- Gracián García-Martí
- Bioengineering, Electronic and Telemedicine Group, Polytechnic University of Valencia, Camino de Vera, s/n, ES-46022 Valencia, Spain.
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22
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Allen P, Larøi F, McGuire PK, Aleman A. The hallucinating brain: A review of structural and functional neuroimaging studies of hallucinations. Neurosci Biobehav Rev 2008; 32:175-91. [PMID: 17884165 DOI: 10.1016/j.neubiorev.2007.07.012] [Citation(s) in RCA: 347] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2007] [Revised: 07/20/2007] [Accepted: 07/26/2007] [Indexed: 12/13/2022]
Abstract
Hallucinations remains one of the most intriguing phenomena in psychopathology. In the past two decades the advent of neuroimaging techniques have allowed researchers to investigate what is happening in the brain of those who experience hallucinations. In this article we review both structural and functional neuroimaging studies of patients with auditory and visual hallucinations as well as a small number of studies that have assessed cognitive processes associated with hallucinations in healthy volunteers. The current literature suggests that in addition to secondary (and occasionally primary) sensory cortices, dysfunction in prefrontal premotor, cingulate, subcortical and cerebellar regions also seem to contribute to hallucinatory experiences. Based on the findings of these studies we tentatively propose a neurocognitive model in which both bottom-up and top-down processes interact to produce these erroneous percepts. Finally, directions for future work are discussed.
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Affiliation(s)
- Paul Allen
- Kings College London, Department of Psychological Medicine and Psychiatry, Institute of Psychiatry, London, UK.
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23
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Rotarska-Jagiela A, Schönmeyer R, Oertel V, Haenschel C, Vogeley K, Linden DEJ. The corpus callosum in schizophrenia-volume and connectivity changes affect specific regions. Neuroimage 2007; 39:1522-32. [PMID: 18096406 DOI: 10.1016/j.neuroimage.2007.10.063] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Revised: 10/17/2007] [Accepted: 10/31/2007] [Indexed: 11/29/2022] Open
Abstract
The corpus callosum (CC) is of great interest for pathophysiological models of schizophrenia. Volume and structural integrity of the CC have been examined by volumetric and diffusion tensor imaging (DTI) studies, but results were not consistent across methods or studies. A possible explanation may be varying methodologies and accuracy of measurements based on a single slice or small regions of interest. In addition, none of the studies examined volume and diffusion values in the same group of patients, and thus the relationship between these anatomical measures is not clear. We used an automatic algorithm to segment seven midline slices of the CC from DTI images. We compared volume and the DTI measures fractional anisotropy (FA) and mean diffusivity (MD) in the CC and its subdivisions in the schizophrenia patients and matched controls. Patients had decreased volume, decreased FA and increased MD of the whole CC. The important novel finding is, however, that not all regions were equally affected by anatomical changes. The results emphasize the importance of using different methods in evaluation of white matter (WM) in schizophrenia to avoid false negative findings. In addition, the measures were highly correlated with each other, implying a common pathological process influencing FA, MD and volume of the CC. Although we cannot rule out other mechanisms affecting volume, FA and MD, converging evidence from cytoarchitectonic and genetic studies suggests that WM changes observed in schizophrenia may involve disintegration of healthy, functional axons and strengthening of aberrant connections resulting in increased severity of clinical symptoms.
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Affiliation(s)
- Anna Rotarska-Jagiela
- Department of Psychiatry, Neurophysiology and Neuroimaging Lab, Johann Wolfgang Goethe University, Frankfurt/Main, Germany.
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24
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Abstract
Inter- and intra-hemispheric connectivity disturbances have been suggested to play a major role in schizophrenia. To this extent, diffusion weighted imaging (DWI) is a relatively new technique examining subtle white matter microstructure organization. DWI studies in schizophrenia strongly suggest that white matter communication is disrupted. This supports the hypothesis that there is a cortico-cortical and transcallosal altered connectivity in schizophrenia, which may be relevant for the pathophysiology and the cognitive disturbances of the disorder. Future longitudinal diffusion and functional imaging studies targeting brain communication together with genetic investigations should further characterize white matter pathology in schizophrenia and its relevance for the development of the illness.
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Affiliation(s)
- Paolo Brambilla
- Department of Pathology and Clinical and Experimental Medicine, Section of Psychiatry, University of Udine, Scientific Institute IRCCS E. Medea, Via Colugna 50, 33100 Udine, Italy.
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25
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Kanaan RAA, Kim JS, Kaufmann WE, Pearlson GD, Barker GJ, McGuire PK. Diffusion tensor imaging in schizophrenia. Biol Psychiatry 2005; 58:921-9. [PMID: 16043134 DOI: 10.1016/j.biopsych.2005.05.015] [Citation(s) in RCA: 229] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2005] [Revised: 05/02/2005] [Accepted: 05/04/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) is a relatively new neuroimaging technique that can be used to examine the microstructure of white matter in vivo. A systematic review of DTI studies in schizophrenia was undertaken to test the hypothesis that DTI can detect white matter differences between schizophrenia patients and normal control subjects. METHODS EMBASE, PubMed, Medline, and PsychInfo were searched online and key journals were searched manually for studies comparing anisotropy (a measure of white matter integrity) between patients and control subjects. Nineteen articles were systematically reviewed. RESULTS Though 16 studies found differences, methodological and data differences prevented a meta-analysis. Fourteen studies found reduced anisotropy in patients; two studies found only a loss of normal asymmetry. The region of investigation varied across studies, however, and when the same region (for example, the cingulum) was examined in different studies, as many failed to find a difference as found one. These inconsistencies may be the result of small sample sizes and differences in methodology. CONCLUSIONS Diffusion tensor imaging has yet to provide consistent findings of white matter abnormalities in schizophrenia. Its potential as a means of examining anatomical connectivity may be realized with the study of larger, more homogenous groups of subjects and with ongoing improvements in image analysis.
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Affiliation(s)
- Richard A A Kanaan
- Section of Neuroimaging, Institute of Psychiatry, London, United Kingdom.
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26
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Rossell SL, Boundy CL. Are auditory-verbal hallucinations associated with auditory affective processing deficits? Schizophr Res 2005; 78:95-106. [PMID: 16005614 DOI: 10.1016/j.schres.2005.06.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2005] [Revised: 05/30/2005] [Accepted: 06/01/2005] [Indexed: 11/22/2022]
Abstract
We investigated whether the presence of auditory-verbal hallucinations (AVH) was associated with impaired auditory affect perception. Controls, schizophrenia patients with a history of AVH (AVH) or with no history of AVH (NAVH) completed four perceptual auditory affect tasks. The tasks used either non-verbal/non-semantic or verbal/semantic stimuli. AVH patients showed significant impairments on a non-verbal task requiring the recognition of environmental sounds, this was particularly so for the affective stimuli and not the neutral valance stimuli. Thus, confirming auditory affect deficits in AVH patients. AVH patients also showed reduced right ear performance on a dichotic listening task. Conversely, both patient groups showed impairments on auditory affect tasks that used verbal/semantic stimuli; as these tasks require proficient semantic processing we speculated that significant semantic impairments in schizophrenia masked the additional auditory affect deficits present in the AVH group. The overall results support the notion that patients with AVH have increased liability for auditory affect perception deficits.
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Affiliation(s)
- Susan L Rossell
- Macquarie Centre for Cognitive Science (MACCS), Macquarie University, Sydney, NSW 2109, Australia.
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27
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Goghari VM, Lang DJ, Flynn SW, Mackay AL, Honer WG. Smaller corpus callosum subregions containing motor fibers in schizophrenia. Schizophr Res 2005; 73:59-68. [PMID: 15567078 DOI: 10.1016/j.schres.2004.08.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2004] [Revised: 08/23/2004] [Accepted: 08/31/2004] [Indexed: 10/26/2022]
Abstract
Neuropsychological and neurophysiological studies provide evidence for abnormal interhemispheric communication in schizophrenia. These abnormalities may have a substrate in structural irregularities of the corpus callosum. This study investigated schizophrenia patients (n=27) and healthy comparison subjects (n=31). Global and regional measurements of the corpus callosum were acquired from one midsagittal SPGR slice. Eight subregions were approximately matched to fiber pathways from cortical regions. Overall effects of diagnosis [Wilks' Lambda F(8,46)=2.45, p=0.03] and diagnosis by age interaction [Wilks' Lambda F(8,46)=2.58, p=0.02] were found in a MANCOVA of the eight functionally specific subregions. Specifically, chronic schizophrenia was associated with a smaller rostral body [lower by 6.9%, F(1,53)=9.70, p=0.003] and anterior midbody [lower by 9.7%, F(1,53)=4.89, p=0.03] subregions. The rostral body and anterior midbody subregions of the corpus callosum primarily have premotor, supplementary motor, and motor cortical fibers transversing through them. Functional abnormalities of the associated cortical regions are reported in schizophrenia. These novel findings suggest that structural abnormalities of the corpus callosum exist in schizophrenia, with perhaps the motor-specific subregions affected more than others. Structural differences in the corpus callosum may be a substrate for interhemispheric functional dysconnectivity in schizophrenia.
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Affiliation(s)
- Vina M Goghari
- Centre for Complex Disorders, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
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28
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Shin SE, Lee JS, Kang MH, Kim CE, Bae JN, Jung G. Segmented volumes of cerebrum and cerebellum in first episode schizophrenia with auditory hallucinations. Psychiatry Res 2005; 138:33-42. [PMID: 15708299 DOI: 10.1016/j.pscychresns.2004.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2003] [Revised: 11/14/2004] [Accepted: 11/19/2004] [Indexed: 11/16/2022]
Abstract
The volumes of cerebral and cerebellar regions were measured in first episode schizophrenic patients with (n = 17) and without (n = 8) auditory hallucinations. Magnetic resonance images of cerebral and cerebellar regions were segmented into gray and white fractions using an algorithm for semiautomated fuzzy tissue segmentation. They were defined by using the semiautomated Talairach atlas-based parcellation method. Patients with auditory hallucinations showed larger temporal white matter, frontal gray matter, and temporal gray matter volumes than patients without auditory hallucinations. These findings suggest that auditory hallucinations in schizophrenic patients may be associated with neuropathological abnormalities in frontal and temporal brain regions.
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Affiliation(s)
- Sang-Eun Shin
- Department of Psychiatry, Inchon Christian Hospital, 237, Yul Mok-Dong, Choong-Ku, Inchon, South Korea
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29
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Abstract
INTRODUCTION The cognitive neuropsychiatric approach to auditory verbal hallucinations (AVHs) attempts to explain the phenomena in cognitive or information-processing terms and ultimately their brain bases. METHODS A narrative review of the literature and an overview of this special issue of Cognitive Neuropsychiatry. RESULTS First, an operational definition of AVHs is offered. Next, clues to etiology are derived from a detailed consideration of the clinical phenomenology of "voices", their form and content. Functional and structural neuroimaging studies suggest the importance of left-side language areas in the generation/perception of AVHs. CONCLUSIONS Existing cognitive neuropsychiatric models provide a useful framework for the understanding of AVHs. However, data need to be applied more specifically to these models so that they may be refined.
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Affiliation(s)
- Anthony S David
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, London, UK.
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30
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Hulshoff Pol HE, Schnack HG, Mandl RCW, Cahn W, Collins DL, Evans AC, Kahn RS. Focal white matter density changes in schizophrenia: reduced inter-hemispheric connectivity. Neuroimage 2004; 21:27-35. [PMID: 14741639 DOI: 10.1016/j.neuroimage.2003.09.026] [Citation(s) in RCA: 133] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Gray matter changes have been demonstrated in several regions in schizophrenia. Particularly, the frontal and temporal cortices and amygdala-hippocampal region have been found decreased in volume and density in magnetic resonance imaging (MRI) studies. These abnormalities may reflect an aberrant neuronal network in schizophrenia, suggesting that white matter fibers connecting these regions may also be affected. However, it is unclear if particular white matter areas are (progressively) affected in schizophrenia and if these are related to the gray matter changes. Focal white matter changes in schizophrenia were studied in whole brain magnetic resonance images acquired from 159 patients with schizophrenia or schizophreniform disorder and 158 healthy comparison subjects using voxel-based morphometry. White matter density changes in the patients with schizophrenia were correlated to gray matter density changes and to illness severity. In the patients with schizophrenia, significant decreases in white matter density were found in the genu and truncus of the corpus callosum in the left and right hemisphere, in the right anterior internal capsule and in the right anterior commissure. No interactions between diagnosis and age were found. Increased illness severity was correlated with low density of the corpus callosum and anterior commissure. Decreased corpus callosum density correlated with decreased density of thalamus, lateral inferior frontal and insular gray matter in patients and controls and with decreased density of medial orbitofrontal and superior temporal gyri in patients. Decreased internal capsule and anterior commissure density correlated with increased caudate, and globus pallidus density in patients and controls. These findings suggest aberrant inter-hemispheric connectivity of anterior cortical and sub-cortical brain regions in schizophrenia, reflecting decreased hemispheric specialisation in schizophrenia.
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Affiliation(s)
- Hilleke E Hulshoff Pol
- Neuroscience Division, A01.126, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands.
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31
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Abstract
The Zeitgeist favors an interpretation of schizophrenia as a condition of abnormal connectivity of cortical neurons, particularly in the prefrontal and temporal cortex. The available evidence points to reduced connectivity, a possible consequence of excessive synaptic pruning in development. A decreased thalamic input to the cerebral cortex appears likely, and developmental studies predict that this decrease should entail a secondary loss of both long- and short-range cortico-cortical connections, including connections between the hemispheres. Indeed, morphological, electrophysiological and neuropsychological studies over the last two decades suggest that the callosal connections are altered in schizophrenics. However, the alterations are subtle and sometimes inconsistent across studies, and need to be investigated further with new methodologies.
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Affiliation(s)
- G M Innocenti
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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