Background

Auditory hallucinations are prevalent across the major psychotic disorders, but their underlying mechanism is poorly understood. Limited prior work supports a hypothesis of altered auditory/language brain systems. To more definitively assess this, we examined whether alterations in resting state connectivity of auditory and language cortices are associated with hallucination severity in a large sample of individuals in the schizo-bipolar spectrum.

Methods

Whole brain resting state connectivity of auditory and language cortex (primary auditory cortex, unimodal auditory association cortex, Wernicke’s area [speech and heteromodal association cortex] and Broca’s area [speech production motor]) was evaluated for 243 subjects with schizophrenia, schizoaffective, or bipolar disorder with psychosis and 186 healthy controls from the Bipolar Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study. Regression analyses were conducted to evaluate whether resting state connectivity of auditory and language cortex was a significant predictor of current overall hallucination severity (information about specific modality of hallucinations experienced was not available).

Results

Increased connectivity between lower and higher order regions of left temporal-parietal auditory/language processing cortex was associated with worse hallucination severity for all psychosis patients. Additionally, within bipolar subjects, increased interhemispheric connectivity between higher order temporal-parietal auditory/language regions was related to greater hallucination severity. When patients were categorized by B-SNIP biomarker-based Biotype groups, interhemispheric connectivity between left auditory association cortex and right core auditory cortex was related to greater hallucination severity for Biotype 1 patients. Exploratory analyses resulted in different patterns of connectivity of auditory/language cortex in patients and controls, unrelated to current hallucination severity.

Conclusions

Although the findings cannot be precisely attributed to auditory hallucination severity or possible differences in such experiences between groups, increased connectivity among the left hemisphere auditory and receptive language cortex may represent a significant factor contributing to hallucination severity across psychotic disorders, and additional subgroup specific connectivity alterations may also be present.

中文翻译：

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静息状态的听觉语言皮层连通性与精神病性疾病的临床和生物学亚型的幻觉有关。

背景

听觉幻觉在主要的精神病性疾病中普遍存在，但对其潜在机制了解甚少。有限的先前工作支持了听觉/语言大脑系统改变的假设。为了更明确地评估这一点，我们检查了在精神分裂双极性谱图中的大量个体中，听觉和语言皮层的静息状态连通性变化是否与幻觉严重度相关。

方法

评估了243位精神分裂症，精神分裂症或双极型受试者的听觉和语言皮层（主要听觉皮层，单峰听觉联想皮层，Wernicke区域[语音和异模式联想皮层]和Broca区域[语音产生运动]）的全脑静息状态连通性。双相精神分裂症中级表型网络（B-SNIP）的研究中，发现了精神病性疾病和186名健康对照。进行回归分析以评估听觉和语言皮层的静息状态连通性是否是当前总体幻觉严重性的重要预测因子（尚无有关所经历的幻觉具体方式的信息）。

结果

所有精神病患者的左颞顶听觉/语言加工皮层的低阶和高阶区域之间的连通性增加与幻觉的严重程度有关。另外，在双相受试者中，高阶颞顶听觉/语言区域之间的半球间连通性增加与更大的幻觉严重度有关。当按基于B-SNIP生物标记物的生物型组对患者进行分类时，对于生物型1型患者，左听觉联想皮层和右核心听觉皮层之间的半球连接性与更大的幻觉严重度相关。探索性分析导致患者和对照中听觉/语言皮层连通性的不同模式，与当前的幻觉严重性无关。

结论

尽管这些发现不能精确地归因于听觉幻觉的严重程度或各组之间这种经历的可能差异，但左半球听觉和接受语言皮层之间的连通性增加可能是导致精神病患者幻觉严重性的重要因素，以及其他亚组特异性连通性改变也可能存在。