Judith M Ford1, Vanessa A Palzes2, Brian J Roach2, Steven G Potkin3, Theo G M van Erp3, Jessica A Turner4, Bryon A Mueller5, Vincent D Calhoun6, Jim Voyvodic7, Aysenil Belger8, Juan Bustillo9, Jatin G Vaidya10, Adrian Preda3, Sarah C McEwen11, Daniel H Mathalon2. 1. Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA; Department of Psychiatry, University of California, San Francisco, CA; Judith.Ford@ucsf.edu. 2. Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA; Department of Psychiatry, University of California, San Francisco, CA; 3. Department of Psychiatry and Human Behavior, University of California, Irvine, CA; 4. Mind Research Network, Albuquerque, NM; Departments of Psychology and Neuroscience, Georgia State University, Atlanta GA; 5. Department of Psychiatry, University of Minnesota, Twin Cities, Minneapolis, MN; 6. Mind Research Network, Albuquerque, NM; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM; 7. Brain Imaging and Analysis Center, University of North Carolina-Duke University, Durham, NC; 8. Brain Imaging and Analysis Center, University of North Carolina-Duke University, Durham, NC; Department of Psychiatry, University of North Carolina, Durham, NC; 9. Department of Psychiatry, University of New Mexico, Albuquerque, NM; 10. Department of Psychiatry, University of Iowa, Iowa City, IA; 11. Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA;
Abstract
INTRODUCTION: 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.
INTRODUCTION: 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.
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