Deciphering the neural signatures of auditory hallucinations in early-onset schizophrenia: A topological brain...

Early-onset schizophrenia (EOS) is a rare and severe subtype of schizophrenia, characterized by auditory hallucinations (AH). However, studies on AH in EOS are significantly fewer than in adult schizophrenia, and the underlying mechanisms remain unclear.

We studied 81 first-episode, drug-naïve EOS patients, grouped by the severity of AH, and compared them with 32 healthy controls. We analyzed the topological properties of the brain's functional network. Using nodes with distinct topological properties as regions of interest (ROI), we examined the correlation between ROI-based functional connectivity and AH scores.

The resting-state brain functional network of EOS patients exhibited small-world network properties (sparsity = 0.05-0.34). Significant differences in degree centrality (DC) and nodal efficiency (NE) were found in the left superior temporal gyrus (STG) (false discovery rate-corrected P [P_FDR] < 0.05). Post hoc multiple comparisons revealed that in DC, there were no significant differences between the non-AH group and the mild AH group, but significant differences were observed among the other groups (P_FDR < 0.05). In NE, no significant differences were found between the non-AH group and both the mild and severe AH groups, while significant differences were observed among the other groups (P_FDR < 0.05). Changes in functional connectivity between the left STG and the left cingulate gyrus (CG) were significantly correlated with AH scores (r = 0.316, P_FDR = 0.0303).

This study implicates dysfunctional circuitry between the left superior temporal gyrus and the left cingulate gyrus in the neurobiology of auditory hallucinations in EOS.