Malevolent Voices in Schizophrenia. Amygdala Resting State Functional Connectivity Based on Emotional Valence of Auditory Hallucinations.

The present study explored functional connectivity of the laterobasal amygdala in a group of schizophrenia patients and healthy control subjects during rest to investigate underlying neural correlates of emotion processing related to auditory hallucinations. Beliefs About the Voices Questionnaire was used to separate hallucinating patients into a group with malevolent voices, and a group with benevolent voices to investigate neural correlates of the voices emotional valence. Patients with auditory hallucinations (N = 20), non-hallucinating patients (N = 25), and healthy controls (N = 54) underwent a resting-state fMRI scan. Functional connectivity analysis of the laterobasal amygdala was conducted to investigate differences between hallucinating patients and control groups. A second analysis was conducted to compare patients with malevolent voices and benevolent voices. Results show that hallucinating patients have different resting state functional connectivity of the laterobasal amygdala, compared with non- hallucinating patients and healthy controls. These areas include the paracingulate gyrus, anterior cingulate cortex, inferior frontal gyrus, temporal pole, inferior parietal lobule and precuneus. The hallucinating patients with malevolent voices have decreased resting state functional connectivity between the laterobasal amygdala and the medial prefrontal cortex, compared to hallucinating patients with benevolent voices. There was also a gender effect, where women experienced more malevolent and omnipotent voices compared to men. Women also experienced more depression, anxiety, general psychopathology and negative symptoms. The results suggest that intrinsic activation of regions involved with emotion processing are different depending on symptoms in schizophrenia