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Mapping auditory hallucinations in schizophrenia using functional magnetic resonance imaging.
S S Shergill1, M J Brammer, S C Williams
1Wellcome Clinical Fellow, Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom. s.shergill@iop.kcl.ac.uk
Archives of General Psychiatry
|November 14, 2000
Summary
Auditory verbal hallucinations in schizophrenia involve brain activity in multiple regions, including the frontal, temporal, and cingulate cortex. This study used advanced neuroimaging to map these neural correlates without patient signaling.
Area of Science:
- Neuroimaging
- Psychiatry
- Cognitive Neuroscience
Background:
- Auditory verbal hallucinations are a key symptom of schizophrenia.
- Previous functional neuroimaging studies yielded inconsistent results.
- Inconsistent findings may stem from small sample sizes and patient signaling.
Purpose of the Study:
- To investigate neural activity during auditory hallucinations using a novel fMRI method.
- To overcome limitations of previous studies by not requiring active signaling.
- To identify brain regions associated with spontaneous auditory hallucinations.
Main Methods:
- Examined 6 schizophrenia patients experiencing auditory hallucinations.
- Utilized functional magnetic resonance imaging (fMRI) to measure spontaneous neural activity.
- Acquired approximately 50 scans per subject at unpredictable intervals, followed by immediate self-report of hallucination status.
Main Results:
- Auditory hallucinations correlated with bilateral activation in the inferior frontal/insular, anterior cingulate, and temporal cortex.
- Significant activation was also observed in the right thalamus, right inferior colliculus, and left hippocampus/parahippocampal cortex.
- These activations were statistically significant (P<.0001).
Conclusions:
- Auditory hallucinations appear to be mediated by a distributed network of cortical and subcortical brain areas.
- The identified network provides a more comprehensive understanding of the neural basis of these hallucinations.
- This approach may reconcile discrepancies in previous neuroimaging findings.