title: Brain metabolism during hallucination-like auditory stimulation in schizophrenia.
abstract: Auditory verbal hallucinations (AVH) in schizophrenia are typically characterized by rich emotional content. Despite the prominent role of emotion in regulating normal perception, the neural interface between emotion-processing regions such as the amygdala and auditory regions involved in perception remains relatively unexplored in AVH. Here, we studied brain metabolism using FDG-PET in 9 remitted patients with schizophrenia that previously reported severe AVH during an acute psychotic episode and 8 matched healthy controls. Participants were scanned twice: (1) at rest and (2) during the perception of aversive auditory stimuli mimicking the content of AVH. Compared to controls, remitted patients showed an exaggerated response to the AVH-like stimuli in limbic and paralimbic regions, including the left amygdala. Furthermore, patients displayed abnormally strong connections between the amygdala and auditory regions of the cortex and thalamus, along with abnormally weak connections between the amygdala and medial prefrontal cortex. These results suggest that abnormal modulation of the auditory cortex by limbic-thalamic structures might be involved in the pathophysiology of AVH and may potentially account for the emotional features that characterize hallucinatory percepts in schizophrenia.
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, New York, United States of America ; Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain ; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Horga
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, and the Cambridgeshire and Peterborough NHS Foundation Trust, Huntingdon, United Kingdom ; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Fernández-Egea
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ; Centre Forum, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Mané
authors.affiliation: Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Font
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, New York, United States of America.
authors.forename: Kelly C
authors.initials: KC
authors.lastname: Schatz
authors.affiliation: GIB-UB. CIBER-BBN, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Falcon
authors.affiliation: Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain ; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Lomeña
authors.affiliation: Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain ; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain ; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Bernardo
authors.affiliation: Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain ; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain ; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Eduard
authors.initials: E
authors.lastname: Parellada
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D001303:Auditory Cortex / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D001931:Brain Mapping; D016022:Case-Control Studies; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006212:Hallucinations / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography; D012074:Remission Induction; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology; D012565:Schizophrenic Psychology; D013788:Thalamus / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology
chemical_list: D005947:Glucose