Cortical Activations During Auditory Verbal Hallucinations in Schizophrenia: A Coordinate-Based Meta-Analysis
Cortical Activations During Auditory Verbal Hallucinations in Schizophrenia: A Coordinate-Based Meta-Analysis
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DOI：
10.1176/appi.ajp.2010.09101522
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发表时间：
2011-01-01
影响因子：
17.7
通讯作者：
Thomas, Pierre
中科院分区：
文献类型：
--
作者：
Jardri, Renaud;Pouchet, Alexandre;Thomas, Pierre
目的：听觉言语幻觉（AVH）是精神分裂症的严重失能症状。尽管越来越多的兴趣在AVH的功能探索，现有的研究结果仍然难以整合，因为它们相当大的变化。作者的目的是进行一个强大的定量审查现有的功能数据，以阐明一致的模式出现AVH和定向新的病理生理模型的hallucinations.Method：10正电子发射断层扫描或功能磁共振成像研究后，系统评价的荟萃分析。共有68例精神分裂症谱系障碍患者在扫描过程中出现AVH。根据随机效应激活似然估计算法，提取并计算在源研究中报告为显著的129个病灶的立体定位坐标，以估计与研究中AVH最一致相关的大脑位置（聚类范围阈值：200 mm（3））。患有AVH的患者在双侧神经网络中表现出显著增加的激活可能性，包括布罗卡区（激活似然估计=1.84x10（-3）），前额叶（1.78x10（-3）），中央前回（1.46x10（-3）），额盖（1.29 × 10（-3）），颞中回和上级回（1.59x10（-3）），顶下小叶（1.33x10（-3）），海马/海马旁区（1.90x10（-3））.结论：这项荟萃分析表明，经历AVH与参与语音生成和语音感知的额颞区活动增加有关，而且还位于内侧颞叶内，这是一个与言语记忆有关的结构。这些发现支持AVH的模型，其中异常皮层激活出现在一个分布式网络中，涉及大脑结构中不同层次的复杂性。考虑了未来的关键方向。
Objective: Auditory verbal hallucinations (AVHs) constitute severe, incapacitating symptoms of schizophrenia. Despite increasing interest in the functional exploration of AVHs, the available findings remain difficult to integrate because of their considerable variability. The authors' aim was to perform a robust quantitative review of existing functional data in order to elucidate consistent patterns observed during the emergence of AVHs and to orient new pathophysiological models of hallucinations.Method: Ten positron emission tomography or functional magnetic resonance imaging studies were selected for the meta-analysis after systematic review. A total of 68 patients with schizophrenia spectrum disorders experiencing AVHs during scanning were included. According to a random-effects activation likelihood estimation algorithm, stereotaxic coordinates of 129 foci, reported as significant in the source studies, were extracted and computed to estimate the brain locations most consistently associated with AVHs across studies (cluster-extent threshold: 200 mm(3)).Results: Patients experiencing AVHs demonstrated significantly increased activation likelihoods in a bilateral neural network, including the Broca's area (activation likelihood estimation=1.84x10(-3)), anterior insula (1.78x10(-3)), precentral gyrus (1.46x10(-3)), frontal operculum (1.29x10(-3)), middle and superior temporal gyri (1.59x10(-3)), inferior parietal lobule (1.33x10(-3)), and hippocampus/parahippocampal region (1.90x10(-3)).Conclusions: This meta-analysis demonstrated that experiencing AVHs is associated with increased activity in fronto-temporal areas involved in speech generation and speech perception, but also within the medial temporal lobe, a structure notably involved in verbal memory. Such findings support a model for AVHs in which aberrant cortical activations emerge within a distributed network involved at different levels of complexity in the brain architecture. Critical future directions are considered.