title: "Where do auditory hallucinations come from?"--a brain morphometry study of schizophrenia patients with inner or outer space hallucinations.
abstract: Auditory verbal hallucinations are a cardinal symptom of schizophrenia. Bleuler and Kraepelin distinguished 2 main classes of hallucinations: hallucinations heard outside the head (outer space, or external, hallucinations) and hallucinations heard inside the head (inner space, or internal, hallucinations). This distinction has been confirmed by recent phenomenological studies that identified 3 independent dimensions in auditory hallucinations: language complexity, self-other misattribution, and spatial location. Brain imaging studies in schizophrenia patients with auditory hallucinations have already investigated language complexity and self-other misattribution, but the neural substrate of hallucination spatial location remains unknown. Magnetic resonance images of 45 right-handed patients with schizophrenia and persistent auditory hallucinations and 20 healthy right-handed subjects were acquired. Two homogeneous subgroups of patients were defined based on the hallucination spatial location: patients with only outer space hallucinations (N=12) and patients with only inner space hallucinations (N=15). Between-group differences were then assessed using 2 complementary brain morphometry approaches: voxel-based morphometry and sulcus-based morphometry. Convergent anatomical differences were detected between the patient subgroups in the right temporoparietal junction (rTPJ). In comparison to healthy subjects, opposite deviations in white matter volumes and sulcus displacements were found in patients with inner space hallucination and patients with outer space hallucination. The current results indicate that spatial location of auditory hallucinations is associated with the rTPJ anatomy, a key region of the "where" auditory pathway. The detected tilt in the sulcal junction suggests deviations during early brain maturation, when the superior temporal sulcus and its anterior terminal branch appear and merge.
authors: INSERM, U797 Research Unit, Neuroimaging and Psychiatry, IFR49, Orsay, France.
authors: Marion
authors: M
authors: Plaze
authors: Marie-Laure
authors: ML
authors: Paillère-Martinot
authors: Jani
authors: J
authors: Penttilä
authors: Dominique
authors: D
authors: Januel
authors: Renaud
authors: R
authors: de Beaurepaire
authors: Franck
authors: F
authors: Bellivier
authors: Jamila
authors: J
authors: Andoh
authors: André
authors: A
authors: Galinowski
authors: Thierry
authors: T
authors: Gallarda
authors: Eric
authors: E
authors: Artiges
authors: Jean-Pierre
authors: JP
authors: Olié
authors: Jean-François
authors: JF
authors: Mangin
authors: Jean-Luc
authors: JL
authors: Martinot
authors: Arnaud
authors: A
authors: Cachia
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D005260:Female; D007839:Functional Laterality; D006212:Hallucinations / Q000145:classification / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000473:pathology; D010296:Parietal Lobe / Q000473:pathology; D012559:Schizophrenia / Q000473:pathology*; D012565:Schizophrenic Psychology; D013702:Temporal Lobe / Q000473:pathology