Department of Psychiatry, Yale University School of Medicine, Yale-New Haven Psychiatric Hospital, 184 Liberty Street LV108, New Haven, CT 06519, USA.
Biol Psychiatry. 2011 Mar 1;69(5):407-14. doi: 10.1016/j.biopsych.2010.09.050. Epub 2010 Dec 8.
Higher levels of inter-region functional coordination can facilitate emergence of neural activity as conscious percepts. We consequently tested the hypothesis that auditory/verbal hallucinations (AVHs) arise from elevated functional coordination within a speech processing network.
Functional coordination was indexed with functional connectivity (FC) computed from functional magnetic resonance imaging data. Thirty-two patients with schizophrenia reporting AVHs, 24 similarly diagnosed patients without hallucinations, and 23 healthy control subjects were studied. FC was seeded from a bilateral Wernicke's region delineated according to activation detected during AVHs in a prior study.
Wernicke's-seeded FC with Brodmann area 45/46 of the left inferior frontal gyrus (IFG) was significantly greater for hallucinating patients compared with nonhallucinating patients but not compared with healthy control subjects. In contrast, Wernicke's-seeded FC with a large subcortical region that included the thalamus, midbrain, and putamen was significantly greater for the combined patient group compared with healthy control subjects after false discovery rate correction, but not when comparing the two patient groups. Within that subcortical domain, the putamen demonstrated significantly greater FC relative to a secondary left IFG seed region when hallucinators were compared with nonhallucinating patients. A follow-up analysis found that FC summed along a loop linking the Wernicke's and IFG seed regions and the putamen was robustly greater for hallucinating patients compared with nonhallucinating patients and healthy control subjects.
These findings suggest that higher levels of functional coordination intrinsic to a corticostriatal loop comprise a causal factor leading to AVHs in schizophrenia.
更高水平的区域间功能协调可以促进作为有意识知觉的神经活动的出现。因此，我们测试了这样一个假设，即听觉/言语幻觉（AVH）是由言语处理网络内的功能协调升高引起的。
功能协调通过功能磁共振成像数据计算的功能连接（FC）来索引。研究了 32 名报告有 AVH 的精神分裂症患者、24 名具有相似诊断但无幻觉的患者和 23 名健康对照者。FC 是从双侧韦尼克区引出的，根据先前研究中在 AVH 期间检测到的激活来界定韦尼克区。
与无幻觉患者相比，左侧额下回（IFG）的布罗德曼区 45/46 的韦尼克种子功能连接（FC）对于有幻觉的患者明显更大，但与健康对照组相比则不然。相比之下，经过假发现率校正后，韦尼克种子与包括丘脑、中脑和壳核在内的大皮质下区域的 FC 在合并患者组与健康对照组之间显著更高，但在比较两组患者时则不然。在那个皮质下区域中，当与无幻觉患者相比时，壳核相对于第二个左侧 IFG 种子区域显示出更大的 FC。一项后续分析发现，沿着连接韦尼克和 IFG 种子区域以及壳核的环路求和的 FC 在有幻觉的患者中与无幻觉的患者和健康对照组相比明显更高。
这些发现表明，皮质纹状体环内固有更高水平的功能协调构成了导致精神分裂症 AVH 的因果因素。
