Cortical folding abnormalities in schizophrenia patients with resistant auditory hallucinations

Gray matter volume and functional abnormalities have been reported in language-related cortex in schizophrenia patients with auditory hallucinations. Such abnormalities might denote abnormal cortical folding development, which can now be investigated using gyrification measures. Anatomic magnetic resonance images (MRIs) were obtained from 30 schizophrenia patients screened for resistant auditory hallucinations and 28 control subjects. We searched for overall gyrification abnormalities in the whole cortex as well as localized abnormalities in language-related cortex, assuming that gyrification is associated with brain sulcation. A fully automated method was applied to MRIs to extract, label and measure the sulcus area in the whole cortex. Gyrification was assessed using both global and local sulcal indices, respectively the ratio between total sulcal area, or area of each labeled sulcus, and outer cortex area. For both hemispheres, the patients had a lower global sulcal index. The local sulcal index decrease was not homogeneous across the whole cortex. It was more significant in the superior temporal sulcus bilaterally, in the left middle frontal sulcus and in the diagonal branch of left sylvian fissure (Broca's area). Findings suggest abnormalities in cortical gyrification in these patients. Sulcal abnormalities in language-related cortex might underlie these patients' particular vulnerability to hallucinations.