Aguilar Eduardo Jesús, Sanjuan Julio, García-Martí Gracián, Lull Juan José, Robles Montserrat
Psychiatric Service, Clinic University Hospital, Avda. Blasco Ibáñez 17, 46010 Valencia, Spain.
Eur J Radiol. 2008 Sep;67(3):434-9. doi: 10.1016/j.ejrad.2008.02.046. Epub 2008 Apr 23.
Although many structural and functional abnormalities have been related to schizophrenia, until now, no single biological marker has been of diagnostic clinical utility. One way to obtain more valid findings is to focus on the symptoms instead of the syndrome. Auditory hallucinations (AHs) are one of the most frequent and reliable symptoms of psychosis. We present a review of our main findings, using a multidisciplinary approach, on auditory hallucinations. Firstly, by applying a new auditory emotional paradigm specific for psychosis, we found an enhanced activation of limbic and frontal brain areas in response to emotional words in these patients. Secondly, in a voxel-based morphometric study, we obtained a significant decreased gray matter concentration in the insula (bilateral), superior temporal gyrus (bilateral), and amygdala (left) in patients compared to healthy subjects. This gray matter loss was directly related to the intensity of AH. Thirdly, using a new method for looking at areas of coincidence between gray matter loss and functional activation, large coinciding brain clusters were found in the left and right middle temporal and superior temporal gyri. Finally, we summarized our main findings from our studies of the molecular genetics of auditory hallucinations. Taking these data together, an integrative model to explain the neurobiological basis of this psychotic symptom is presented.
尽管许多结构和功能异常都与精神分裂症有关，但到目前为止，还没有单一的生物学标志物具有诊断临床效用。获得更有效研究结果的一种方法是关注症状而非综合征。幻听（AHs）是精神病最常见且可靠的症状之一。我们采用多学科方法对幻听的主要研究结果进行综述。首先，通过应用一种针对精神病的新型听觉情绪范式，我们发现这些患者在听到情绪性词语时，边缘脑区和额叶脑区的激活增强。其次，在一项基于体素的形态学研究中，与健康受试者相比，我们发现患者双侧脑岛、双侧颞上回和左侧杏仁核的灰质浓度显著降低。这种灰质损失与幻听强度直接相关。第三，使用一种观察灰质损失与功能激活之间重合区域的新方法，在左右颞中回和颞上回发现了大量重合的脑簇。最后，我们总结了幻听分子遗传学研究的主要结果。综合这些数据，提出了一个解释这种精神病症状神经生物学基础的综合模型。
