Spatial and Temporal Mapping of Neural Activity Associated with Auditory Hallucinations

B.R. Lennox, S. Bert, G. Park, P.B. Jones, and P.G. Morris, Lancet, 1999, 353, 644.

Summary: This study examined a 26-year-old, right-handed male that had been suffering from paranoid schizophrenia for 8 years. The patient pressed a button at the onset of a hallucination, and magnetic resonance imaging (MRI) was used to scan his brain, showing the areas of activity during his hallucinations. Results showed that activation first appeared in the right middle temporal gyrus and then extended to a wider area of the right superior temporal and left superior temporal gyri (where the hallucination is “heard”), right middle and inferior frontal gyri, right anterior cingulate, and right cuncus.

Abstract: Auditory hallucinations are a common and distressing symptom of psychosis. The underlying pathophysiology is poorly understood. It is hypothesised that they arise from areas of auditory cortex subserving language. New functional imaging techniques can further our understanding, as they are well suited to exploring episodic phenomena. However, the unpredictable timing of hallucinations, along with the level of disturbance in the patients, make direct-observation methodologically difficult. Many investigators therefore use more indirect approaches, with consequent variability of results. We report a case of a male subject with schizophrenia who experienced a stable pattern of hallucinations such that we were able to take images of repeated episodes of hallucination and demonstrate the functional anatomy and time course of his psychotic phenomena.