Journal
SCHIZOPHRENIA BULLETIN
Volume 37, Issue 1, Pages 212-221Publisher
OXFORD UNIV PRESS
DOI: 10.1093/schbul/sbp081
Keywords
hallucinations; spatial location; brain anatomy; MRI; schizophrenia; where pathway; temporoparietal junction
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Funding
- National Agency for Research [PSYMARKER/APV05137LSA]
- FRM Fondation (Fondation pour la Recherche Medicale)
- Commissariat a l'Energie Atomique and Assistance Publique Hopitaux de Paris (AP-HP/CEA)
- AP-HP/INSERM
- INSERM
- FRM Foundation
- Finnish Cultural Foundation
- Sigrid Juselius Foundation, Finland
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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.
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