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Auditory verbal hallucinations: imaging, analysis, and intervention

  • Philipp Homan
  • Jochen Kindler
  • Daniela Hubl
  • Thomas Dierks
Review

Abstract

In this article, we will link neuroimaging, data analysis, and intervention methods in an important psychiatric condition: auditory verbal hallucinations (AVH). The clinical and phenomenological background as well as neurophysiological findings will be covered and discussed with respect to noninvasive brain stimulation. Additionally, methods of noninvasive brain stimulation will be presented as ways to intervene with AVH. Finally, preliminary conclusions and possible future perspectives will be proposed.

Keywords

Schizophrenia Auditory verbal hallucinations Transcranial magnetic stimulation Cerebral blood flow Arterial spin labeling 

Notes

Acknowledgments

This work was supported by the Swiss National Science Foundation (SNSF: 32003B-112578) to TD and (33CM30-124114). We are grateful to A. Federspiel and G. Schroth for providing the MR-ASL sequence. We thank J. J. Wang, A. Federspiel, and K. Jann for providing the ASL subtraction routine. This article is part of the supplement Personalized Psychiatry and Psychotherapy. This supplement was not sponsored by outside commercial interests. It was funded by the German Association for Psychiatry and Psychotherapy (DGPPN).

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Aleman A, Sommer IE, Kahn RS (2007) Efficacy of slow repetitive transcranial magnetic stimulation in the treatment of resistant auditory hallucinations in schizophrenia: a meta-analysis. J Clin Psychiatry 68:416–421PubMedCrossRefGoogle Scholar
  2. 2.
    Antal A, Polania R, Schmidt-Samoa C, Dechent P, Paulus W (2011) Transcranial direct current stimulation over the primary motor cortex during fMRI. Neuroimage 55:590–596PubMedCrossRefGoogle Scholar
  3. 3.
    Bracht T, Heidemeyer K, Koschorke P, Horn H, Razavi N, Wopfner A, Strik W, Walther S (2012) Comparison of objectively measured motor behavior with ratings of the motor behavior domain of the bern psychopathology scale (BPS) in schizophrenia. Psychiatry Res [Epub ahead of print]Google Scholar
  4. 4.
    Brunelin J, Mondino M, Gassab L, Haesebaert F, Gaha L, Suaud-Chagny MF, Saoud M, Mechri A, Poulet E (2012) Examining transcranial direct-current stimulation (tDCS) as a treatment for hallucinations in schizophrenia. Am J Psychiatry. doi: 10.1176/appi.ajp.2012.11071091
  5. 5.
    Dierks T, Linden DE, Jandl M, Formisano E, Goebel R, Lanfermann H, Singer W (1999) Activation of Heschl’s gyrus during auditory hallucinations. Neuron 22:615–621PubMedCrossRefGoogle Scholar
  6. 6.
    Federspiel A, Muller TJ, Horn H, Kiefer C, Strik WK (2006) Comparison of spatial and temporal pattern for fMRI obtained with bold and arterial spin labeling. J Neural Transm 113:1403–1415PubMedCrossRefGoogle Scholar
  7. 7.
    Homan P, Kindler J, Federspiel A, Flury R, Hubl D, Hauf M, Dierks T (2011) Muting the voice: a case of arterial spin labeling-monitored transcranial direct current stimulation treatment of auditory verbal hallucinations. Am J Psychiatry 168:853–854PubMedCrossRefGoogle Scholar
  8. 8.
    Hor K, Taylor M (2010) Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol 24:81–90PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Horn H, Federspiel A, Wirth M, Muller TJ, Wiest R, Wang JJ, Strik W (2009) Structural and metabolic changes in language areas linked to formal thought disorder. Br J Psychiatry 194:130–138PubMedCrossRefGoogle Scholar
  10. 10.
    Huang YZ, Edwards MJ, Rounis E, Bhatia KP, Rothwell JC (2005) Theta burst stimulation of the human motor cortex. Neuron 45:201–206PubMedCrossRefGoogle Scholar
  11. 11.
    Hubl D, Hauf M, van Swam C, Muri R, Dierks T, Strik W (2007) Hearing dysphasic voices. Lancet 370:538PubMedCrossRefGoogle Scholar
  12. 12.
    Hubl D, Koenig T, Strik W, Federspiel A, Kreis R, Boesch C, Maier SE, Schroth G, Lovblad K, Dierks T (2004) Pathways that make voices: white matter changes in auditory hallucinations. Arch Gen Psychiatry 61:658–668PubMedCrossRefGoogle Scholar
  13. 13.
    Hubl D, Koenig T, Strik WK, Garcia LM, Dierks T (2007) Competition for neuronal resources: how hallucinations make themselves heard. Br J Psychiatry 190:57–62PubMedCrossRefGoogle Scholar
  14. 14.
    Kindler J, Hubl D, Strik WK, Dierks T, Koenig T (2011) Resting-state EEG in schizophrenia: auditory verbal hallucinations are related to shortening of specific microstates. Clin Neurophysiol 122:1179–1182PubMedCrossRefGoogle Scholar
  15. 15.
    Kindler J, Schumacher R, Cazzoli D, Gutbrod K, Koenig M, Nyffeler T, Dierks T, Muri RM (2012) Theta burst stimulation over the right Broca’s homologue induces improvement of naming in aphasic patients. Stroke 43:2175–2179Google Scholar
  16. 16.
    Kompus K, Westerhausen R, Hugdahl K (2011) The “paradoxical” engagement of the primary auditory cortex in patients with auditory verbal hallucinations: a meta-analysis of functional neuroimaging studies. Neuropsychologia 49:3361–3369PubMedCrossRefGoogle Scholar
  17. 17.
    McGuire PK, Silbersweig DA, Wright I, Murray RM, David AS, Frackowiak RS, Frith CD (1995) Abnormal monitoring of inner speech: a physiological basis for auditory hallucinations. Lancet 346:596–600PubMedCrossRefGoogle Scholar
  18. 18.
    Nitsche MA, Cohen LG, Wassermann EM, Priori A, Lang N, Antal A, Paulus W, Hummel F, Boggio PS, Fregni F, Pascual-Leone A (2008) Transcranial direct current stimulation: state of the art 2008. Brain stimulation 1:206–223PubMedCrossRefGoogle Scholar
  19. 19.
    Orosz A, Jann K, Wirth M, Wiest R, Dierks T, Federspiel A (2012) Theta burst TMS increases cerebral blood flow in the primary motor cortex during motor performance as assessed by arterial spin labeling (ASL). Neuroimage 61:599–605PubMedCrossRefGoogle Scholar
  20. 20.
    Shergill SS, Murray RM, McGuire PK (1998) Auditory hallucinations: a review of psychological treatments. Schizophr Res 32:137–150PubMedCrossRefGoogle Scholar
  21. 21.
    Slotema CW, Blom JD, de Weijer AD, Diederen KM, Goekoop R, Looijestijn J, Daalman K, Rijkaart AM, Kahn RS, Hoek HW, Sommer IE (2011) Can low-frequency repetitive transcranial magnetic stimulation really relieve medication-resistant auditory verbal hallucinations? Negative results from a large randomized controlled trial. Biol Psychiatry 69:450–456PubMedCrossRefGoogle Scholar
  22. 22.
    Strik W, Dierks T, Hubl D, Horn H (2008) Hallucinations, thought disorders, and the language domain in schizophrenia. Clin EEG Neurosci 39:91–94PubMedCrossRefGoogle Scholar
  23. 23.
    Strik W, Wopfner A, Horn H, Koschorke P, Razavi N, Walther S, Wirtz G (2010) The Bern psychopathology scale for the assessment of system-specific psychotic symptoms. Neuropsychobiology 61:197–209PubMedCrossRefGoogle Scholar
  24. 24.
    van Swam C, Federspiel A, Hubl D, Wiest R, Boesch C, Vermathen P, Kreis R, Strik W, Dierks T (2012) Possible dysregulation of cortical plasticity in auditory verbal hallucinations-a cortical thickness study in schizophrenia. J Psychiatry Res 46:1015–1023Google Scholar
  25. 25.
    Walther S, Federspiel A, Horn H, Razavi N, Wiest R, Dierks T, Strik W, Muller TJ (2011) Alterations of white matter integrity related to motor activity in schizophrenia. Neurobiol Dis 42:276–283PubMedCrossRefGoogle Scholar
  26. 26.
    Walther S, Vanbellingen T, Muri R, Strik W, Bohlhalter S (2012) Impaired pantomime in schizophrenia: association with frontal lobe function. Cortex [Epub ahead of print]Google Scholar
  27. 27.
    Wang Z, Wang J, Connick TJ, Wetmore GS, Detre JA (2005) Continuous ASL (CASL) perfusion MRI with an array coil and parallel imaging at 3T. Magn Reson Med 54:732–737PubMedCrossRefGoogle Scholar
  28. 28.
    Zheng X, Alsop DC, Schlaug G (2011) Effects of transcranial direct current stimulation (tDCS) on human regional cerebral blood flow. Neuroimage 58:26–33PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Philipp Homan
    • 1
  • Jochen Kindler
    • 1
  • Daniela Hubl
    • 1
  • Thomas Dierks
    • 1
  1. 1.Department of Psychiatric Neurophysiology, University Hospital of PsychiatryUniversity of BernBern 60Switzerland

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