title: Visual hallucinations are associated with hyperconnectivity between the amygdala and visual cortex in people with a diagnosis of schizophrenia.
abstract: BACKGROUND
  While auditory verbal hallucinations (AH) are a cardinal symptom of schizophrenia, people with a diagnosis of schizophrenia (SZ) may also experience visual hallucinations (VH). In a retrospective analysis of a large sample of SZ and healthy controls (HC) studied as part of the functional magnetic resonance imaging (fMRI) Biomedical Informatics Research Network (FBIRN), we asked if SZ who endorsed experiencing VH during clinical interviews had greater connectivity between visual cortex and limbic structures than SZ who did not endorse experiencing VH.
  
  
  METHODS
  We analyzed resting state fMRI data from 162 SZ and 178 age- and gender-matched HC. SZ were sorted into groups according to clinical ratings on AH and VH: SZ with VH (VH-SZ; n = 45), SZ with AH but no VH (AH-SZ; n = 50), and SZ with neither AH nor VH (NoH-SZ; n = 67). Our primary analysis was seed based, extracting connectivity between visual cortex and the amygdala (because of its role in fear and negative emotion) and visual cortex and the hippocampus (because of its role in memory).
  
  
  RESULTS
  Compared with the other groups, VH-SZ showed hyperconnectivity between the amygdala and visual cortex, specifically BA18, with no differences in connectivity among the other groups. In a voxel-wise, whole brain analysis comparing VH-SZ with AH-SZ, the amygdala was hyperconnected to left temporal pole and inferior frontal gyrus in VH-SZ, likely due to their more severe thought broadcasting.
  
  
  CONCLUSIONS
  VH-SZ have hyperconnectivity between subcortical areas subserving emotion and cortical areas subserving higher order visual processing, providing biological support for distressing VH in schizophrenia.
authors.affiliation: Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA; Department of Psychiatry, University of California, San Francisco, CA; Judith.Ford@ucsf.edu.
authors.forename: Judith M
authors.initials: JM
authors.lastname: Ford
authors.affiliation: Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA; Department of Psychiatry, University of California, San Francisco, CA;
authors.forename: Vanessa A
authors.initials: VA
authors.lastname: Palzes
authors.affiliation: Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA; Department of Psychiatry, University of California, San Francisco, CA;
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Roach
authors.affiliation: Department of Psychiatry and Human Behavior, University of California, Irvine, CA;
authors.forename: Steven G
authors.initials: SG
authors.lastname: Potkin
authors.affiliation: Department of Psychiatry and Human Behavior, University of California, Irvine, CA;
authors.forename: Theo G M
authors.initials: TG
authors.lastname: van Erp
authors.affiliation: Mind Research Network, Albuquerque, NM; Departments of Psychology and Neuroscience, Georgia State University, Atlanta GA;
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Turner
authors.affiliation: Department of Psychiatry, University of Minnesota, Twin Cities, Minneapolis, MN;
authors.forename: Bryon A
authors.initials: BA
authors.lastname: Mueller
authors.affiliation: Mind Research Network, Albuquerque, NM; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM;
authors.forename: Vincent D
authors.initials: VD
authors.lastname: Calhoun
authors.affiliation: Brain Imaging and Analysis Center, University of North Carolina-Duke University, Durham, NC;
authors.forename: Jim
authors.initials: J
authors.lastname: Voyvodic
authors.affiliation: Brain Imaging and Analysis Center, University of North Carolina-Duke University, Durham, NC; Department of Psychiatry, University of North Carolina, Durham, NC;
authors.forename: Aysenil
authors.initials: A
authors.lastname: Belger
authors.affiliation: Department of Psychiatry, University of New Mexico, Albuquerque, NM;
authors.forename: Juan
authors.initials: J
authors.lastname: Bustillo
authors.affiliation: Department of Psychiatry, University of Iowa, Iowa City, IA;
authors.forename: Jatin G
authors.initials: JG
authors.lastname: Vaidya
authors.affiliation: Department of Psychiatry and Human Behavior, University of California, Irvine, CA;
authors.forename: Adrian
authors.initials: A
authors.lastname: Preda
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA;
authors.forename: Sarah C
authors.initials: SC
authors.lastname: McEwen
authors.affiliation: Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA; Department of Psychiatry, University of California, San Francisco, CA;
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Mathalon
mesh_terms: D000328:Adult; D000679:Amygdala / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D059907:Functional Neuroimaging; D006212:Hallucinations / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000503:physiopathology*; D017397:Prefrontal Cortex / Q000503:physiopathology; D012189:Retrospective Studies; D012559:Schizophrenia / Q000150:complications / Q000503:physiopathology*; D013702:Temporal Lobe / Q000503:physiopathology; D014793:Visual Cortex / Q000503:physiopathology*