Salisbury Dean F, Seebold Dylan, Longenecker Julia M, Coffman Brian A, Yeh Fang-Chen
Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Schizophr Res. 2024 Mar;265:4-13. doi: 10.1016/j.schres.2023.06.001. Epub 2023 Jun 14.
Auditory hallucinations (AH) are a debilitating symptom in psychosis, impacting cognition and real world functioning. Recent thought conceptualizes AH as a consequence of long-range brain communication dysfunction, or circuitopathy, within the auditory sensory/perceptual, language, and cognitive control systems. Recently we showed in first-episode psychosis (FEP) that, despite overall intact white matter integrity in the cortical-cortical and cortical-subcortical language tracts and the callosal tracts connecting auditory cortices, the severity of AH correlated inversely with white matter integrity. However, that hypothesis-driven isolation of specific tracts likely missed important white matter concomitants of AH. In this report, we used a whole-brain data-driven dimensional approach using correlational tractography to associate AH severity with white matter integrity in a sample of 175 individuals. Diffusion Spectrum Imaging (DSI) was used to image diffusion distribution. Quantitative Anisotropy (QA) in three tracts was greater with increased AH severity (FDR < 0.001) and QA in three tracts was lower with increased AH severity (FDR < 0.01). White matter tracts showing associations between QA and AH were generally associated with frontal-parietal-temporal connectivity (tracts with known relevance for cognitive control and the language system), in the cingulum bundle, and in prefrontal inter-hemispheric connectivity. The results of this whole brain data-driven analysis suggest that subtle white matter alterations connecting frontal, parietal, and temporal lobes in the service of sensory-perceptual, language/semantic, and cognitive control processes impact the expression of auditory hallucination in FEP. Disentangling the distributed neural circuits involved in AH should help to develop novel interventions, such as non-invasive brain stimulation.
幻听（AH）是精神病中的一种使人衰弱的症状，会影响认知和现实世界的功能。最近的观点将幻听概念化为听觉感觉/感知、语言和认知控制系统内远程脑通讯功能障碍或神经回路病变的结果。最近我们在首发精神病（FEP）中发现，尽管皮质-皮质和皮质-皮质下语言束以及连接听觉皮质的胼胝体束中的白质完整性总体完好，但幻听的严重程度与白质完整性呈负相关。然而，那种由假设驱动的特定束的分离可能遗漏了幻听重要的白质伴随情况。在本报告中，我们使用了一种全脑数据驱动的维度方法，通过相关纤维束成像将175名个体样本中幻听的严重程度与白质完整性相关联。扩散光谱成像（DSI）用于对扩散分布进行成像。随着幻听严重程度增加，三条纤维束中的定量各向异性（QA）更高（错误发现率<0.001），而随着幻听严重程度增加，另外三条纤维束中的QA更低（错误发现率<0.01）。显示QA与幻听之间存在关联的白质纤维束通常与额顶颞连接性（对认知控制和语言系统具有已知相关性的纤维束）、扣带束以及前额叶半球间连接性有关。这种全脑数据驱动分析的结果表明，服务于感觉-感知、语言/语义和认知控制过程的连接额叶、顶叶和颞叶的细微白质改变会影响首发精神病中幻听的表现。解开与幻听相关的分布式神经回路应有助于开发新的干预措施，如非侵入性脑刺激。
