Differential brain glucose metabolic patterns in antipsychotic-naïve first-episode schizophrenia with and without auditory verbal hallucinations.
BACKGROUND
Auditory verbal hallucinations (AVHs) are a core symptom of schizophrenia. Previous reports on neural activity patterns associated with AVHs are inconsistent, arguably owing to the lack of an adequate control group (i.e., patients with similar characteristics but without AVHs) and neglect of the potential confounding effects of medication.


METHODS
The current study was conducted in a homogeneous group of patients with schizophrenia to assess whether the presence or absence of AVHs was associated with differential regional cerebral glucose metabolic patterns. We investigated differences between patients with commenting AVHs and patients without AVHs among a group of dextral antipsychotic-naive inpatients with acute first-episode schizophrenia examined with [(18)F]fluoro-deoxyglucose positron emission tomography (FDG-PET) at rest. Univariate and multivariate approaches were used to establish between-group differences.


RESULTS
We included 9 patients with AVHs and 7 patients without AVHs in this study. Patients experiencing AVHs during FDG uptake had significantly higher metabolic rates in the left superior and middle temporal cortices, bilateral superior medial frontal cortex and left caudate nucleus (cluster level p < 0.005, family wise error-corrected, and bootstrap ratio > 3.3, respectively). Additionally, the multivariate method identified hippocampal-parahippocampal, cerebellar and parietal relative hypoactivity during AVHs in both hemispheres (bootstrap ratio < -3.3).


CONCLUSIONS
The FDG-PET imaging technique does not provide information regarding the temporal course of neural activity. The limited sample size may have increased the risk of false-negative findings.


CONCLUSIONS
Our results indicate that AVHs in patients with schizophrenia may be mediated by an alteration of neural pathways responsible for normal language function. Our findings also point to the potential role of the dominant caudate nucleus and the parahippocampal gyri in the pathophysiology of AVHs. We discuss the relevance of phenomenology-based grouping in the study of AVHs.
Clinic Schizophrenia Program, Psychiatry Department, Hospital Clinic of Barcelona, Barcelona, Spain. guillermo.horga@gmail.com
Guillermo
G
Horga
Eduard
E
Parellada
Francisco
F
Lomeña
Emilio
E
Fernández-Egea
Anna
A
Mané
Mireia
M
Font
Carles
C
Falcón
Anna B
AB
Konova
Javier
J
Pavia
Domènec
D
Ros
Miguel
M
Bernardo
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D059907:Functional Neuroimaging / Q000379:methods / Q000523:psychology; D005947:Glucose / Q000378:metabolism*; D006212:Hallucinations / Q000150:complications / Q000378:metabolism*; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism*
D019788:Fluorodeoxyglucose F18; D005947:Glucose
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