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. 2022 Sep 6:13:971105.
doi: 10.3389/fpsyt.2022.971105. eCollection 2022.

The alternations of nucleus accumbent in schizophrenia patients with auditory verbal hallucinations during low-frequency rTMS treatment

Yuanjun Xie  1   2 , Yun Cai  3 , Muzhen Guan  4 , Zhongheng Wang  5 , Zhujing Ma  6 , Peng Fang  7 , Huaning Wang  5
Affiliations

The alternations of nucleus accumbent in schizophrenia patients with auditory verbal hallucinations during low-frequency rTMS treatment

Yuanjun Xie et al. Front Psychiatry. .

Erratum in

Abstract

Low-frequency repetitive transcranial magnetic stimulation (rTMS) has been shown to reduce the severity of auditory verbal hallucinations (AVH) and induce beneficial functional and structural alternations of the brain in schizophrenia patients with AVH. The nucleus accumbens (NAcc) as an important component of the ventral striatum is implicated with the pathology in AVH. However, the induced characteristic patterns of NAcc by low-frequency rTMS in schizophrenia with AVH are seldom explored. We investigated the functional and structural characteristic patterns of NAcc by using seed-based functional connectivity (FC) analysis and gray matter volume (GMV) measurement in schizophrenia patients with AVH during 1 Hz rTMS treatment. Although low-frequency rTMS treatment did not affect the volumetric changes of NAcc, the abnormal FC patterns of NAcc, including increased FC of NAcc with the temporal lobes and decreased FC of NAcc with the frontal cortices in the pretreatment patients compared to healthy controls, were normalized or reversed after treatment. These FC changes were associated with improvements in clinical symptoms and neurocognitive functions. Our findings may extend our understanding of the NAcc in the pathology of schizophrenia with AVH and might be a biomarker of clinical effect for low-frequency rTMS treatment in schizophrenia.

Keywords: auditory verbal hallucination; functional connectivity; gray matter volume; nucleus accumbent; repetitive transcranial magnetic stimulation; schizophrenia.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Nucleus accumbent seed regions of interest are defined by the Anatomical Automatic Labeling (AAL3) atlas (https://www.oxcns.org/aal3.html). Bilateral nucleus accumbent seeds are used in resting-state functional connectivity analysis and gray matter volume measure.
Figure 2
Figure 2
Differences in functional connectivity (FC) between patients at baseline and healthy controls using left nucleus accumbent (A) and right nucleus accumbent (B) seed regions. The warm color indicates an increased FC of seed with the whole brain and the cool color indicates a decreased FC of seed with the whole brain. The color scale is represented by the t-value of statistically significant clusters with the voxel-level statistical threshold of p < 0.05 and a cluster-level threshold of p < 0.05 corrected for the Gaussian random field (size >30).
Figure 3
Figure 3
Differences in functional connectivity (FC) of the nucleus accumbens seeds between patients after treatment and before treatment. The warm color indicates an increased FC of seed with the whole brain and the cool color indicates a decreased FC of seed with the whole brain. The color scale is represented by the t-value of statistically significant clusters with the voxel-level statistical threshold of p < 0.05 and a cluster-level threshold of p < 0.05 corrected for the Gaussian random field (size >30).
Figure 4
Figure 4
Differences in gray matter volume (GMV) of nucleus accumbens between patients (pretreatment and posttreatment) and healthy controls (HC). The pretreatment patients showed significantly decreased GMV in the left nucleus accumbent compared to HC (A). While there were no significant differences in the right nucleus accumbens between patients (pretreatment and posttreatment) and HC (B). *p > 0.05; ns, no significance.
Figure 5
Figure 5
Correlations analysis showed that the changed functional connectivity (FC) value of left nucleus accumbens (NAcc) with the left inferior temporal gyrus (IMG) is negatively correlated with the change of positive symptom score of PNASS (r = −0.545, p = 0.024, False discovery rate correction) (A) and FC value of the right NAcc with the right inferior frontal gyrus (IFG) is positively correlated with the change of verbal memory score (r = 0.526, p = 0.016, False discovery rate correction) (B).
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