Neural Signature for Auditory Hallucinations in Schizophrenia: A High-Resolution PET Study with [18F]FDG
Jong-Hoon Kim 1, Young Don Son 2, Jeong-Hee Kim 3, Hyo-Jong Lee 4, Nam-In Kang 5, Gyung Ho Chung 6, 7, Jong-Il Park 6, 8, Yin Cui 6, 8, Woo-Sung Kim 6, 8, Young-Chul Chung 6, 8*
1Department of Psychiatry, Gachon University Gil Medical Center, Gachon University School of Medicine, Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea, 2Department of Biomedical Engineering, Gachon University, Incheon, South Korea, 3Research Institute for Advanced Industrial Technology, Korea University, Sejong, Republic of Korea, 4Department of Computer Science and Engineering & Center for Advanced Image and Information Technology, Chonbuk National University, Jeonju, Korea, 5Department of psychiatry, Maeumsarang Hospital, Wanju, Jeollabuk-do, Korea, 6Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea, 7Department of Radiology, Chonbuk National University Medical School, Jeonju, Korea, 8Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea
Received: January 26, 2018; Revised: April 6, 2018; Accepted: April 23, 2018; Published online: April 23, 2018.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Auditory hallucinations (AHs) are a core symptom of schizophrenia. We investigated the neural signature of AHs by comparing hallucinating patients with schizophrenia with non-hallucinating patients with schizophrenia. We recruited hallucinating patients with schizophrenia meeting the criteria for persistent, prominent, and predominant AHs (n = 10) and non-hallucinating patients with schizophrenia (n = 12). Various clinical assessments were performed incluing Psychotic Symptom Rating Scale for Auditory Hallucinations (PSYRATS-AH). Using [18F]-fluorodeoxyglucose PET (FDG-PET), regional differences in neural activity between the groups were analyzed. The ROI analysis showed significantly lower SUVR in the superior, middle, and inferior frontal gyri, and higher SUVR in the putamen in patients with AHs versus patients without AHs. These findings were confirmed in the voxel-wise analysis. Our findings indicate that hypoactivity in the frontal and cingulate gyri, coupled with hyperactivity in the temporal gyrus and putamen, may contribute to the pathophysiology of AHs.
Keywords: auditory hallucinations, schizophrenia, PET, bottom-up, top-down


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