Tuning in to the voices: a multisite FMRI study of auditory hallucinations.
BACKGROUND
Auditory hallucinations or voices are experienced by 75% of people diagnosed with schizophrenia. We presumed that auditory cortex of schizophrenia patients who experience hallucinations is tonically "tuned" to internal auditory channels, at the cost of processing external sounds, both speech and nonspeech. Accordingly, we predicted that patients who hallucinate would show less auditory cortical activation to external acoustic stimuli than patients who did not.


METHODS
At 9 Functional Imaging Biomedical Informatics Research Network (FBIRN) sites, whole-brain images from 106 patients and 111 healthy comparison subjects were collected while subjects performed an auditory target detection task. Data were processed with the FBIRN processing stream. A region of interest analysis extracted activation values from primary (BA41) and secondary auditory cortex (BA42), auditory association cortex (BA22), and middle temporal gyrus (BA21). Patients were sorted into hallucinators (n = 66) and nonhallucinators (n = 40) based on symptom ratings done during the previous week.


RESULTS
Hallucinators had less activation to probe tones in left primary auditory cortex (BA41) than nonhallucinators. This effect was not seen on the right.


CONCLUSIONS
Although "voices" are the anticipated sensory experience, it appears that even primary auditory cortex is "turned on" and "tuned in" to process internal acoustic information at the cost of processing external sounds. Although this study was not designed to probe cortical competition for auditory resources, we were able to take advantage of the data and find significant effects, perhaps because of the power afforded by such a large sample.
Ford
Judith M
JM
Yale University, West Haven, CT, USA. judith.ford@yale.edu
Roach
Brian J
BJ
Jorgensen
Kasper W
KW
Turner
Jessica A
JA
Brown
Gregory G
GG
Notestine
Randy
R
Bischoff-Grethe
Amanda
A
Greve
Douglas
D
Wible
Cynthia
C
Lauriello
John
J
Belger
Aysenil
A
Mueller
Bryon A
BA
Calhoun
Vincent
V
Preda
Adrian
A
Keator
David
D
O'Leary
Daniel S
DS
Lim
Kelvin O
KO
Glover
Gary
G
Potkin
Steven G
SG
Mathalon
Daniel H
DH
D000328:Adult; D001303:Auditory Cortex / Q000503:physiopathology; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006212:Hallucinations / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012720:Severity of Illness Index