Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Hefei National Laboratory for Physical Sciences at Microscale, School of Life Science, University of Science and Technology of China, Hefei 230027, China.
Schizophr Bull. 2022 Nov 18;48(6):1336-1343. doi: 10.1093/schbul/sbab142.
The thalamus is known to be impaired in schizophrenia patients with auditory verbal hallucinations (AVHs). Abnormal filtering function of the thalamus has been found in schizophrenia patients with AVHs. However, a whole-structure approach has commonly been adopted when investigating thalamic dysconnectivity in patients with AVHs, and it remains unclear which thalamic nucleus is the critical structure underlying AVHs. Here, we investigated voxel-wise resting-state functional connectivity (rsFC) of the thalamic nucleus in drug-naïve patients with first-episode schizophrenia (FES) with AVHs. In addition, dynamic causal modeling was applied to compute effective connectivity and estimate causal relationships that could explain aberrant rsFC. Compared with the FES patients without AVH (NAVH) and normal controls, patients with AVHs had weaker rsFC of the bilateral medial pulvinar (PuM) nucleus-cerebellum. Moreover, compared with the normal control group, the AVH and NAVH groups had significantly stronger rsFC of the bilateral PuM nucleus-cerebral cortex, as well as weaker rsFC of the right medial geniculate nucleus-cerebral cortex. Compared with the NAVH and normal control groups, dynamic causal modeling revealed significantly stronger effective connectivity from the left PuM nucleus to the right inferior frontal gyrus in the AVH group. These findings indicate that the critical structure in the thalamus underlying AVHs is the PuM nucleus, and provide direct evidence that the cerebello-thalamo-cortical circuit is associated with AVHs.
丘脑在有听觉言语幻觉（AVH）的精神分裂症患者中已知受损。在有 AVH 的精神分裂症患者中发现了丘脑异常滤波功能。然而，在研究有 AVH 的患者的丘脑连接异常时，通常采用整体结构方法，并且尚不清楚哪个丘脑核是 AVH 的关键结构。在这里，我们研究了有 AVH 的初发精神分裂症（FES）患者的丘脑核体素水平静息态功能连接（rsFC）。此外，还应用了动态因果建模来计算有效连接并估计可以解释异常 rsFC 的因果关系。与无 AVH（NAVH）的 FES 患者和正常对照组相比，有 AVH 的患者双侧内侧丘觉核（PuM）-小脑的 rsFC 较弱。此外，与正常对照组相比，AVH 组和 NAVH 组双侧 PuM 核-大脑皮质的 rsFC 明显增强，而右内侧膝状体-大脑皮质的 rsFC 较弱。与 NAVH 组和正常对照组相比，动态因果建模显示 AVH 组左侧 PuM 核到右侧额下回的有效连接明显增强。这些发现表明，丘脑在 AVH 中的关键结构是 PuM 核，并提供了小脑-丘脑-皮质回路与 AVH 相关的直接证据。
