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Deviations in cortex sulcation associated with visual hallucinations in schizophrenia

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Abstract

Hallucinations, and auditory hallucinations (AH) in particular, constitute the most typical and disabling schizophrenia symptoms. Although visual hallucinations (VH) have been largely neglected in psychiatric disorders, a recent review reported a 27% mean prevalence of VH in schizophrenia patients. The pathophysiology underlying VH in schizophrenia remains elusive. Several schizophrenia studies reported a significant effect of age on VH; therefore, we tested the hypothesis that the neurodevelopmental model of schizophrenia may explain VH occurrence. We analyzed cortex sulcation, a marker of brain development, in healthy controls (HCs) and two subgroups of carefully selected schizophrenia patients suffering from hallucinations: patients with only AH (that is, patients who never reported VH) and patients with audio–visual hallucinations (A+VH). Different cortical sulcation and left–right sulcal asymmetry were found between A+VH and AH patients, with decreased sulcation in both A+VH and AH patients in comparison with the HCs. Although a specific association between VH and neurodegenerative mechanisms, for example, in Body-Lewy Dementia or Parkinson’s Disease, has previously been reported in the literature, the current study provides the first neuroimaging evidence of an association between VH and neurodevelopmental mechanisms.

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Acknowledgements

This study was supported by the GDR CNRS—3557 ‘Institut de Recherche en Psychiatrie’ as well as by grants from the ERANET-NEURON program (AUSZ_EUCan), the Programme Hospitalier de Recherche Clinique (PHRC Multimodhal), the Pierre Houriez foundation (hosted by the Fondation de France), the Pierre Deniker foundation and the NRJ foundation.

Author Contributions

All the authors designed the study; AA, PT, JB, RJ recruited the participants; JB & RJ acquired the MRI data; AC, AA, RJ performed the analyses; All the authors contributed to the manuscript writing.

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Correspondence to A Cachia.

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Cachia, A., Amad, A., Brunelin, J. et al. Deviations in cortex sulcation associated with visual hallucinations in schizophrenia. Mol Psychiatry 20, 1101–1107 (2015). https://doi.org/10.1038/mp.2014.140

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