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Cerebellar Contributions to Persistent Auditory Verbal Hallucinations in Patients with Schizophrenia

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Abstract

There is growing evidence that the cerebellum plays a crucial role in the pathophysiology of schizophrenia symptoms. Despite increasing evidence for cerebellar involvement in affective, attentive, and cognitive functions including language processing and perception, investigations of cerebellar contributions to auditory verbal hallucinations (AVH) in schizophrenia are lacking. Using structural magnetic resonance imaging at 3T, we investigated the data of 20 patients with schizophrenia and 14 matched healthy controls. Ten patients were classified as having chronic and treatment resistant AVH (pAVH), whereas the remaining ten patients either never had AVH in the past or were in full remission with regard to AVH (nAVH). Employing cerebellum-optimized segmentation techniques, i.e., the Spatially Unbiased Infratentorial Template (SUIT) toolbox, we investigated cerebellar gray matter volume (GMV) differences among the pAVH, nAVH, and a healthy control group, the magnitude of their expression between these groups and the relationship between GMV and schizophrenia symptom load. Lower GMV in pAVH patients compared to controls was found in lobules VIIb and VIIIa. Additionally, lower GMV in pAVH compared to nAVH patients was found in lobule VIIIa. A negative relationship between VIIIa GMV and overall positive symptoms was detected. Correlations with AVH-specific psychometric scores were not significant. This study shows that there are structural changes in the cognitive regions of the cerebellum that are linked to a clinical phenotype presenting with persistent positive symptoms such as AVH. The results suggest that the cerebellum and its associated neural circuits do play a role in the emergence of positive symptoms in schizophrenia, but probably not exclusively in AVH symptom expression.

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Acknowledgements

This work was supported by a research grant from the University of Ulm, Germany (principal investigator R.C.W.). The authors thank all participants and their families for their time and interest in this study. The authors are grateful to Miriam Ott and Petra Neumann for their assistance with data collection.

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Authors and Affiliations

  1. Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Vosstrasse 4, 69115, Heidelberg, Germany

    Maximilian Cierpka, Nadine D. Wolf, Katharina M. Kubera, Mike M. Schmitgen & Robert Christian Wolf

  2. Department of Psychiatry and Psychotherapy, Clinical Center Christophsbad, Göp**en, Germany

    Nenad Vasic

  3. Department of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskliniken Schwaben, Donauwörth, Germany

    Karel Frasch

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  1. Maximilian Cierpka
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  2. Nadine D. Wolf
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  7. Robert Christian Wolf
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Correspondence to Robert Christian Wolf.

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The study was approved by the Research Ethics Committee of Ulm University and was performed in accordance with ethical standards laid down in the Declaration of Helsinki.

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Written informed consent was obtained from all participants after a complete description of the study.

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The authors declare that they have no conflicts of interest.

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Fig. 1

Plot of significant correlations between lobule VIIIa GMV parameter estimates and clinical scores. a PANSS-P scores. b BPRS-THD scores. (JPEG 40 kb)

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Cierpka, M., Wolf, N.D., Kubera, K.M. et al. Cerebellar Contributions to Persistent Auditory Verbal Hallucinations in Patients with Schizophrenia. Cerebellum 16, 964–972 (2017). https://doi.org/10.1007/s12311-017-0874-5

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