# (2) Auditory Verbal Hallucinations in Borderline Personality Disorder ###### tags: `Presentation` `results` `ViBE` --- # Recap... ##### - n = 29, fMRI scan, pressed button when AVH occured. Measured thoughts, quality and quantity of AVH and brain activity (BOLD) ----  ###### - Longer mean AVH length associated with greater anxiety and more intrusive thoughts. ----  ###### - Nothing in the data indicates that location of AVH (inside/outisde the head) has any bearing on the associated negative outcomes --- ## What's going on in the brain during AVH?  ----  --- # Connectivity Patterns ##### - 9 minute resting state data used in seed-based functional connectivity analysis ---- ##### Seeds: The 3 task clusters (ACC, rA1, rPCG) 1.  2.  3.  ##### Covariates: AVH Length, AVH location, AVH symptom score ---- # AVH Length #### The longer the hallucination the greater the FC between ACC; ##### & left A1, left Wernicke's Area,  ##### Precuneus cortex & PCC  ---- # AVH Symptom #### The less severe patients' voice hearing (BSIS-V) the greater the FC between ACC; ##### & Insular  ---- # AVH Location #### The more 'outside the head' a hallucination is the greater the FC between ACC; ##### & post central gyrus, pars operculum (left 2nd ss cortex), IPL, frontal pole left and right  ---- #### The more 'outside the head' a hallucination is the greater FC between rA1; ##### & paracingulate gyrus, orbitofrontal cortex, left somatosensory cortex  --- # To summarise... ### 1. The experience of an AVH is underpinned by activity in ACC, right auditory cortices, rPCG. ##### The fact that we see activity in primary and secondary auditory cortices suggests the experience of an AVH is neurally similar to _actually_ hearing an external stimuli. ##### The implications of this may be powerful - adds validity to BPD patients' claims which are often seen as disengeneous. ---- ### 2. Length of hallucination is associated with the increased FC between ACC, language and transmodal cortices. ##### - As AVH are verbal (not visual), it makes sense that the neural substrates of AVHs (ACC) are acting more in concert with langauge regions as AVH duration extends and the becomes more dialogic in nature. ##### - Supports previous literature which highlights the importance of language networks in AVH. (Curcic-Blake et al, 2017) ##### -The role of transmodal cortices (PCC, precuneus) here may be supporting the stimulus-independent nature of AVHs. ---- ### 3. AVH symptom score is associated with FC between ACC and Insular. ##### - Coordinated activity with the insular may be important for labelling thoughts and feelings as self-produced. ##### Insular (one of the) neural substrates for self-awareness (Craig, 2009) and an important region for integrating extroceptive and interoceptive signals (Critchley & Harrison, 2013). ##### e.g. body ownership during rubber hand illusion (Tsakiris, Hesse, Boy, Haggard, & Fink, 2007); denial of paralysis and somatoparaphrenia (Vallar & Ronchi, 2008). ---- ### 4. AVH Location assoicted with FC differences between ACC, rA1 and many other regions. #### This is depsite the fact that behaviourally, AVH location had no correlates. ---- # Questions?