Chronic auditory hallucinations in schizophrenic patients: MR analysis of the coincidence between functional and morphologic abnormalities.
OBJECTIVE
To prospectively evaluate if functional magnetic resonance (MR) imaging abnormalities associated with auditory emotional stimuli coexist with focal brain reductions in schizophrenic patients with chronic auditory hallucinations.


METHODS
Institutional review board approval was obtained and all participants gave written informed consent. Twenty-one right-handed male patients with schizophrenia and persistent hallucinations (started to hear hallucinations at a mean age of 23 years +/- 10, with 15 years +/- 8 of mean illness duration) and 10 healthy paired participants (same ethnic group [white], age, and education level [secondary school]) were studied. Functional echo-planar T2*-weighted (after both emotional and neutral auditory stimulation) and morphometric three-dimensional gradient-recalled echo T1-weighted MR images were analyzed using Statistical Parametric Mapping (SPM2) software. Brain activation images were extracted by subtracting those with emotional from nonemotional words. Anatomic differences were explored by optimized voxel-based morphometry. The functional and morphometric MR images were overlaid to depict voxels statistically reported by both techniques. A coincidence map was generated by multiplying the emotional subtracted functional MR and volume decrement morphometric maps. Statistical analysis used the general linear model, Student t tests, random effects analyses, and analysis of covariance with a correction for multiple comparisons following the false discovery rate method.


RESULTS
Large coinciding brain clusters (P < .005) were found in the left and right middle temporal and superior temporal gyri. Smaller coinciding clusters were found in the left posterior and right anterior cingular gyri, left inferior frontal gyrus, and middle occipital gyrus.


CONCLUSIONS
The middle and superior temporal and the cingular gyri are closely related to the abnormal neural network involved in the auditory emotional dysfunction seen in schizophrenic patients.
Martí-Bonmatí
Luis
L
Department of Radiology, Dr Peset University Hospital, Avda Gaspar Aguilar 90, 46017 Valencia, Spain. Luis.Marti@uv.es
Lull
Juan José
JJ
García-Martí
Gracián
G
Aguilar
Eduardo J
EJ
Moratal-Pérez
David
D
Poyatos
Cecilio
C
Robles
Montserrat
M
Sanjuán
Julio
J
D000293:Adolescent; D000328:Adult; D001303:Auditory Cortex / Q000002:abnormalities*; D001931:Brain Mapping / Q000379:methods; D002908:Chronic Disease; D006212:Hallucinations / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D012559:Schizophrenia / Q000503:physiopathology*