Abnormal brain response during the auditory emotional processing in schizophrenic patients with chronic auditory hallucinations

Objective: Few neuroimaging studies have been conducted regarding clinical associations between auditory hallucinations (AHs) and affective disturbances in patients with schizophrenia. This study aimed to elucidate the neurobiological basis of emotional disturbances in schizophrenic patients with persisting AHs. Methods: Using functional magnetic resonance imaging (fMRI), the cortical responsiveness during the processing of laughing and crying sounds was measured and compared between 14 hallucinating schizophrenic patients, 14 nonhallucinating schizophrenic patients and 28 normal controls. Results: The hallucinating patients showed differential neural activities in various areas including the amygdala, the hippocampus, the cingulate, the prefrontal cortex, and the parietal cortex, compared with the nonhallucinating patients and the normal controls. In particular, compared with the nonhallucinators, the hallucinators revealed reduced activation in the left amygdala and the bilateral hippocampus during the processing of crying sounds. Conclusion: Our findings suggest that the persistence of AHs in schizophrenia may induce functional disturbances of the emotion-related interconnected neural networks, including reduced responsiveness in the amygdala and hippocampus to negative stimuli.