目的:研究精神分裂症听觉言语幻觉(AVH)的神经基础的神经影像学研究产生了不同的结果,这可以通过网络本地化来协调。我们试图检查精神分裂症中AVH状态和AVH特征脑改变是否位于共同或不同的网络。
方法:我们最初在48项以前的研究中报道了精神分裂症患者的AVH状态和AVH特征脑改变。通过将这些受影响的大脑位置与大规模发现和验证静息状态功能磁共振成像数据集整合,然后,我们利用新的功能连接网络映射来构建AVH状态和AVH特性功能失调网络。
结果:精神分裂症中神经解剖学上异质性AVH状态和AVH特征的脑改变位于不同和特定的网络中。AVH状态功能失调网络由一组广泛分布的大脑区域组成,主要涉及听觉,显著性,基底神经节,语言,和感觉运动网络。相反,AVH特征功能失调网络表现为主要涉及尾状回和额下回的限制脑区模式。此外,与有效治疗AVH的神经调节目标相一致的AVH状态功能障碍网络,表明可能的临床相关性。
结论:除了将先前的AVH研究中看似不可重复的神经影像学结果统一起来,我们的研究结果表明,从网络的角度来看,精神分裂症患者存在不同的AVH状态和特征的神经机制,更广泛地说,这可能为未来AVH的神经调节治疗提供依据.
OBJECTIVE: Neuroimaging studies investigating the neural substrates of auditory verbal hallucinations (AVH) in schizophrenia have yielded mixed results, which may be reconciled by network localization. We sought to examine whether AVH-state and AVH-trait brain alterations in schizophrenia localize to common or distinct networks.
METHODS: We initially identified AVH-state and AVH-trait brain alterations in schizophrenia reported in 48 previous studies. By integrating these affected brain locations with large-scale discovery and validation resting-state functional magnetic resonance imaging datasets, we then leveraged novel functional connectivity network mapping to construct AVH-state and AVH-trait dysfunctional networks.
RESULTS: The neuroanatomically heterogeneous AVH-state and AVH-trait brain alterations in schizophrenia localized to distinct and specific networks. The AVH-state dysfunctional network comprised a broadly distributed set of brain regions mainly involving the auditory, salience, basal ganglia, language, and sensorimotor networks. Contrastingly, the AVH-trait dysfunctional network manifested as a pattern of circumscribed brain regions principally implicating the caudate and inferior frontal gyrus. Additionally, the AVH-state dysfunctional network aligned with the neuromodulation targets for effective treatment of AVH, indicating possible clinical relevance.
CONCLUSIONS: Apart from unifying the seemingly irreproducible neuroimaging results across prior AVH studies, our findings suggest different neural mechanisms underlying AVH state and trait in schizophrenia from a network perspective and more broadly may inform future neuromodulation treatment for AVH.