title: Putamen-related regional and network functional deficits in first-episode schizophrenia with auditory verbal hallucinations.
abstract: OBJECTIVE
  Auditory verbal hallucinations (AVHs) are one of the cardinal symptoms of schizophrenia (SZ). Cerebral dysfunction may represent pathophysiological underpinnings behind AVHs in SZ. However, regional and network functional deficits for AVHs in SZ remain to be identified.
  
  
  METHODS
  Seventeen medication-naïve first-episode SZ patients with AVHs, 15 without AVHs, and 19 healthy controls (HCs) were studied using resting-state functional magnetic resonance imaging. We compared the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) among these subjects. Areas with both ALFF and ReHo alterations were used as seeds in functional connectivity (FC) analysis. Then we performed correlation analysis between image measures and symptoms and receiver operating characteristic analysis.
  
  
  RESULTS
  One-way analysis of variance showed significant differences of ALFF and ReHo in the bilateral putamen, thereby being used as seeds. SZ patients with AVHs showed decreased ALFF in the left putamen, increased ReHo in the right dorsolateral prefrontal cortex (DLPFC), and increased right putamen-seeded FC with the left DLPFC and Broca's area relative to those without AVHs. Furthermore, the increased strength of the connectivity between the right putamen and left Broca's area correlated with the severity of SZ symptoms. Both patient groups demonstrated hypoconnectivity within frontal/parietal/temporal cortico-striatal-cerebellar networks compared with HCs.
  
  
  CONCLUSIONS
  AVHs in SZ may be caused by abnormal regional function in the putamen and prefrontal cortex, as well as hyperconnectivity between them. The putamen-related regional and network functional deficits may reflect imbalance in neuromodulation of AVHs in SZ. Furthermore, dysconnectivity within cortico-striatal-cerebellar networks might subserve the pathogenesis of SZ.
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Long-Biao
authors.initials: LB
authors.lastname: Cui
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Liu-Xian
authors.initials: LX
authors.lastname: Wang
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Fan
authors.initials: F
authors.lastname: Guo
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Tian
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Yu-Jing
authors.initials: YJ
authors.lastname: Wu
authors.affiliation: Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Li
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Liu
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Yi-Bin
authors.initials: YB
authors.lastname: Xi
authors.affiliation: Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China. Electronic address: xskzhu@fmmu.edu.cn.
authors.forename: Hua-Ning
authors.initials: HN
authors.lastname: Wang
authors.affiliation: Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China. Electronic address: yinhong@fmmu.edu.cn.
authors.forename: Hong
authors.initials: H
authors.lastname: Yin
mesh_terms: D000161:Acoustic Stimulation; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001931:Brain Mapping; D005260:Female; D006212:Hallucinations / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000473:pathology*; D010100:Oxygen / Q000097:blood; D011569:Psychiatric Status Rating Scales; D011699:Putamen / Q000000981:diagnostic imaging*; D012372:ROC Curve; D012559:Schizophrenia / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D013223:Statistics as Topic; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Auditory verbal hallucinations; Data-driven approach; Putamen; Resting-state functional magnetic resonance imaging; Schizophrenia