Auditory hallucinations in first-episode psychosis: A voxel-based morphometry study

Area of Science:

• Neuroscience
• Psychiatry
• Neuroimaging

Background:

• Auditory hallucinations (AH) are a key symptom of psychosis, but their underlying brain abnormalities are debated.
• Previous research on gray matter (GM) changes in psychosis is inconsistent, often due to factors like illness duration.
• Limited studies have investigated structural brain changes in first-episode psychosis (FEP) specifically concerning AH.

Purpose of the Study:

• To investigate structural gray matter (GM) abnormalities in patients with first-episode psychosis (FEP).
• To examine if these GM changes correlate with the intensity of general psychotic symptoms and auditory hallucinations (AH).
• To validate findings in a larger, more homogeneous sample than prior studies.

Main Methods:

• Voxel-based morphometry (VBM) using magnetic resonance imaging (MRI).
• Analyzed 215 FEP patients (93 with AH, 122 without AH) and 177 healthy controls.
• Assessed patients using the Positive and Negative Syndrome Scale (PANSS).

Main Results:

• FEP patients showed reduced GM concentrations in temporal, frontal, cingulate, and insular regions compared to controls.
• No significant GM differences were observed between FEP patients with and without AH.
• Overall PANSS scores negatively correlated with GM reductions in FEP patients.
• No correlation found between AH severity and GM volumes.

Conclusions:

• Gray matter reductions in FEP patients indicate early-stage alterations, correlating with overall illness severity.
• These GM reductions were not associated with the presence or severity of auditory hallucinations.
• Findings suggest that while GM changes are present early in psychosis, they may not be directly linked to AH.