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The neural basis of auditory hallucinations (AH) in patients with schizophrenia is poorly characterized. Functional imaging studies investigate either the "state" dimension (i.e., the measurement of changes in brain area activation at the precise moment of AH onset) or the "trait" dimension (i.e., the neural correlates of the propensity to hallucinate). A corollary of AH (particularly acoustic-verbal) is the activation of brain regions involved in the auditory perception of speech (auditory cortex). One theory is that patients with schizophrenia with AH may have a deficit in processing their internal speech (i.e., external attribution to internal verbal content). However, there is little clinical data on the specific role of the mesencephalic region of the inferior colliculi (IC) in the formation of these symptoms. Preliminary research has shown intense expression of dopamine D2 receptors, particularly on glutamatergic neurons in mouse ICs. Thus, ICs receive numerous inhibitory dopaminergic inputs, likely involved in signal optimization and modulation. The study authors hypothesize that AHs are the result of a defect in signal inhibition by the IC, which lose their function as perceptual filters.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patient Group (SCZ+/AH+) | Experimental | schizophrenic patients experiencing auditory hallucinations |
|
| Control Group (SCZ+/AH-) | Experimental | schizophrenic patients without hallucinations |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Unenhanced brain MRI | Other | Unenhanced brain MRI in five sequences: 1) T1-weighted anatomical sequences 2) Resting-state functional sequences 3) Task-based functional sequence 4) Structural sequence using Diffusion Tensor Imaging (DTI) 5) Routine magnetic resonance spectroscopy sequence |
| Measure | Description | Time Frame |
|---|---|---|
| Resting state of functional connectivity of the inferior colliculi region with other regions of the auditory network between groups | Measured by MRI | Day 0 |
| Default mode network patterns between groups | Measured by MRI | Day 0 |
| Measure | Description | Time Frame |
|---|---|---|
| Neuronal activation in the ICs during exposure to auditory stimuli between groups | Difference in the blood-oxygen level dependent (BOLD) signal measured by functional MRI during an auditory stimulus exposure paradigm in the IC region | Day 0 |
| Per-auditory activation in other brain areas between groups |
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Inclusion Criteria:
Specific inclusion criteria for the group (SCZ+/HA+) • Patient with a PANSS score (question P3 regarding hallucinations) ≥ 4 (corresponds to PANSS (P3) 4, 5, 6, and 7 patients) AND having experienced hallucinations in the past 15 days.
Specific inclusion criteria for the control group
• Patient with a PANSS score (question P3 regarding hallucinations) = 1) AND having not experienced any hallucinations in the past 15 days.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Martin Pastre | Contact | 06 95 55 68 80 | matinpastre@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Martin Pastre | CHU de Nimes | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Nîmes, Hôpital Universitaire Carémeau | Recruiting | Nîmes | 30029 | France |
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| ID | Term |
|---|---|
| D012559 | Schizophrenia |
| D006212 | Hallucinations |
| ID | Term |
|---|---|
| D019967 | Schizophrenia Spectrum and Other Psychotic Disorders |
| D001523 | Mental Disorders |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
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|
Difference in the BOLD signal measured by functional MRI in other brain areas |
| Day 0 |
| IC metabolite composition between the groups | Difference in the peak magnetic resonance spectrometry (sMRI) signal | Day 0 |
| Structural connectivity via white matter between ICs and other auditory network structures between groups | Difference in structural connectivity using DTI (diffusion tensor imaging, anisotropy fraction calculation, mean diffusivity, and tractography) from the ICs | Day 0 |
| Correlation between BOLD signal and psychopathological symptoms | Measured by Positive and Negative Syndrome Scale (PANSS), providing a negative symptomatology score ranging from 7 to 49, and a general psychopathology score ranging from 16 to 112, with a total score ranging from 30 to 210. | Day 0 |
| Correlation between BOLD signal and severity of delusions and hallucinations | Measured by Psychotic Symptom Rating Scale (PSYRATS), an 11-item scale where each symptom is rated from 0 to 4 depending on the intensity | Day 0 |
| Correlation between BOLD signal and doses of antipsychotic treatment | Antipsychotic doses calculated by olanzapine equivalent method | Day 0 |
| Difference in perauditory activation and functional connectivity (resting-state) in SCZ+ HA+ patients who hallucinated during the procedure and those who did not | Measured via post-hoc task-based, BOLD signal state hallucination analysis | Day 0 |
| Correlation between BOLD signal and dissociation symptoms | Measured by Dissociative Experience Scale (DES) | Day 0 |
| Correlation between BOLD signal and severity of somatoform manifestations of dissociation | Measured by Somatoform Dissociation Questionnaire (SDQ) | Day 0 |
| Correlation between BOLD signal and clinically assessed states of dissociation | Measured by Clinician Administered Dissociative States Scale (CADSS), a 5-point Likert scale | Day 0 |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |