INSERM UMR 894, Centre de Psychiatrie & Neurosciences, Paris, France.
Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Mol Psychiatry. 2015 Sep;20(9):1101-7. doi: 10.1038/mp.2014.140. Epub 2014 Oct 28.
Hallucinations, and auditory hallucinations (AH) in particular, constitute the most typical and disabling schizophrenia symptoms. Although visual hallucinations (VH) have been largely neglected in psychiatric disorders, a recent review reported a 27% mean prevalence of VH in schizophrenia patients. The pathophysiology underlying VH in schizophrenia remains elusive. Several schizophrenia studies reported a significant effect of age on VH; therefore, we tested the hypothesis that the neurodevelopmental model of schizophrenia may explain VH occurrence. We analyzed cortex sulcation, a marker of brain development, in healthy controls (HCs) and two subgroups of carefully selected schizophrenia patients suffering from hallucinations: patients with only AH (that is, patients who never reported VH) and patients with audio-visual hallucinations (A+VH). Different cortical sulcation and left-right sulcal asymmetry were found between A+VH and AH patients, with decreased sulcation in both A+VH and AH patients in comparison with the HCs. Although a specific association between VH and neurodegenerative mechanisms, for example, in Body-Lewy Dementia or Parkinson's Disease, has previously been reported in the literature, the current study provides the first neuroimaging evidence of an association between VH and neurodevelopmental mechanisms.
幻觉，特别是听觉幻觉 (AH)，构成了最典型和最具致残性的精神分裂症症状。尽管视觉幻觉 (VH) 在精神障碍中被广泛忽视，但最近的一项综述报告称，精神分裂症患者中 VH 的平均患病率为 27%。精神分裂症中 VH 的病理生理学仍然难以捉摸。几项精神分裂症研究报告称，年龄对 VH 有显著影响；因此，我们检验了这样一个假设，即精神分裂症的神经发育模型可以解释 VH 的发生。我们分析了健康对照组 (HCs) 和两组精心挑选的精神分裂症患者的脑回沟，这两组患者都有幻觉：只有 AH 的患者（即从未报告过 VH 的患者）和有视听幻觉的患者 (A+VH)。与 HCs 相比，A+VH 和 AH 患者之间存在不同的脑回沟和左右脑回沟不对称，A+VH 和 AH 患者的脑回沟均减少。尽管以前的文献已经报道了 VH 与神经退行性机制之间的特定关联，例如在路易体痴呆或帕金森病中，但目前的研究提供了 VH 与神经发育机制之间关联的第一个神经影像学证据。
