Clin Psychopharmacol Neurosci 2018; 16(3): 324-332  
Neural Signature for Auditory Hallucinations in Schizophrenia: A High-Resolution Positron Emission Tomography Study with Fludeoxyglucose (18F)
Jong-Hoon Kim1,2, Young Don Son3, Jeong-Hee Kim4, Hyo-Jong Lee5, Nam-In Kang6, Gyung Ho Chung7,8, Jong-Il Park7,9, Yin Cui7,9, Woo-Sung Kim7,9, Young-Chul Chung7,9
1Department of Psychiatry, Gachon University Gil Medical Center, Gachon University School of Medicine, 2Neuroscience Research Institute, 3Department of Biomedical Engineering, Gachon University, Incheon, 4Research Institute for Advanced Industrial Technology, Korea University, Sejong, 5Department of Computer Science and Engineering & Center for Advanced Image and Information Technology, Chonbuk National University, Jeonju, 6Department of Psychiatry, Maeumsarang Hospital, Wanju, 7Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Departments of 8Radiology and 9Psychiatry, Chonbuk National University Medical School, Jeonju, Korea
Correspondence to: Young-Chul Chung, MD, PhD
Department of Psychiatry, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea
Tel: +82-63-250-2185, Fax: +82-63-275-3157
E-mail: chungyc@jbnu.ac.kr
ORCID: https://orcid.org/0000-0001-9491-1822
Received: January 26, 2018; Revised: April 6, 2018; Accepted: April 23, 2018; Published online: August 31, 2018.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Objective: 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.
Methods: 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. Using fludeoxyglucose (18F) positron emission tomography, regional differences in neural activity between the groups were analyzed.
Results: The regions of interest analysis showed significantly lower standardized uptake value ratio (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.
Conclusion: 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; Positron-emission tomography; Bottom-up; Top-down.


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