Differences in functional connectivity density among subtypes of schizophrenic auditory hallucination


This study aimed to investigate alterations in brain function among different subtypes of auditory hallucinations (AH) in drug-naïve first episode schizophrenia patients. We recruited 20 patients with drug-naïve first episode schizophrenia who had constant commanding and commenting auditory verbal hallucinations (CCCAVH), 15 drug-naïve first episode schizophrenia patients who had nonverbal auditory hallucinations (NVAH), and 20 healthy controls to participate in this study. We used global functional connectivity density (gFCD) and one-way analysis of covariance to characterize differences in brain function between the two patient groups. Statistical significance was set at P < 0.05. As compared to controls, schizophrenia patients with CCCAVH demonstrated increased gFCD in the right Broca’s area, bilateral superior temporal gyri, hippocampus, bilateral insula, and anterior cingulate gyri, and decreased gFCD in the left temporoparietal junction (family-wise error [FEW] correct, P < 0.05). Schizophrenia patients with NVAH demonstrated increased gFCD in the bilateral superior temporal gyri and most of the components of the default mode network (DMN), and decreased gFCD in components of the executive control network (FWE correct, P < 0.05). We found that schizophrenia patients with CCCAVH and NVAH have distinct functional brain patterns. The features observed in patients with CCCAVH are consistent with the “inner speech” hypothesis of AH. Features of patients with NVAH suggest hyperactivity of the superior temporal gyrus and DMN, and hypoactivity of the prefrontal lobe.

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This work was supported by grants from the National Natural Science Foundation of China (81871052 to C.Z., 81801679 and 81571319 to Y.X.), the Key Projects of the Natural Science Foundation of Tianjin, China (17JCZDJC35700 to C.Z.), the Tianjin Health Bureau Foundation (2014KR02 to C.Z.), the National Key Research and Development Program of China (2016YFC1307004 to Y.X.), the Shanxi Science and Technology Innovation Training Team’s Multidisciplinary Team for Cognitive Impairment (201705D131027 to Y.X.), Zhejiang Public Welfare Fund Project (LGF18H090002 to D.J), Tianjin Anding Hospital Outstanding Award rewarding 300000¥ to C.Z., and the key project of Wenzhou Science and Technology Bureau (ZS2017011 to X.L).

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All authors listed have made a substantial, direct, and intellectual contribution to the work, and approved it for publication.

Correspondence to Chuanjun Zhuo or Chunhua Zhou or Xiao Lin.

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This study was approved by the Ethics Committee of Wenzhou Seventh People’s Hospital (No. ZS2017011), Tianjin Anding Hospital (No. TJMH-Cohort Study-004) and Jining Medical University (No. JM-Senior Professor Project-001). All procedures were in accordance with the ethics standards of the institutional and national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethics standards.

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Zhuo, C., Li, G., Ji, F. et al. Differences in functional connectivity density among subtypes of schizophrenic auditory hallucination. Brain Imaging and Behavior (2020) doi:10.1007/s11682-019-00210-8

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  • Auditory verbal hallucination
  • gFCD
  • Inner speech hypothesis
  • Unstable DMN hypothesis