Functional imaging localization of complex organic hallucinations

Autor:	Michael Duchowny, George M. Ibrahim, Philip LaPlante, Nolan Altman, Byron Bernal, Magno R. Guillen, John Ragheb, Americo Padilla
Rok vydání:	2019
Předmět:	Male Psychosis medicine.medical_specialty Adolescent Hallucinations genetic structures Audiology behavioral disciplines and activities 050105 experimental psychology 03 medical and health sciences 0302 clinical medicine Arts and Humanities (miscellaneous) Fasciculus medicine Humans 0501 psychology and cognitive sciences Electrocorticography biology medicine.diagnostic_test Brain Neoplasms business.industry Functional Neuroimaging 05 social sciences Brain Electroencephalography medicine.disease biology.organism_classification Magnetic Resonance Imaging Visual Hallucination Functional imaging Treatment Outcome Mood nervous system Frontal lobe Neurology (clinical) business psychological phenomena and processes 030217 neurology & neurosurgery Tractography
Zdroj:	Neurocase. 25:91-97
ISSN:	1465-3656 1355-4794
DOI:	10.1080/13554794.2019.1611866
Popis:	Background: fMRI of mental phenomena is quite difficult to perform because lack of patient's cooperation or because the symptoms are stable. In some exceptional cases, however, fMRI and DTI are capable to provide insights on the anatomy of organic hallucinations. Methods: In this report we describe a 14-year-old boy with a left fronto-dorsal tumor who experienced chronic complex brief, frequent and repetitive complex visual and auditory hallucinations. His clinical picture included multiple and severe social and mood problems. During a presurgical fMRI mapping the patient complained of having the visual and auditory hallucinations. A block-design FMRI paradigm was obtained from the event timecourse. Deterministic DTI of the brain was obtained seeding the lesion as ROI. The patient underwent surgery and electrocorticography of the lesional area. Results: The fMRI of the hallucinations showed activation in the left inferior frontal gyrus (IFG) and the peri-lesional area. The tractography of the tumor revealed structural aberrant connectivity to occipital and temporal areas in addition to the expected connectivity with the IFG via the aslant fasciculus and homotopic contralateral areas. Intraoperative EEG demonstrated epileptic discharges in the tumor and neighboring areas. After resection, the patient's hallucinations stopped completely. He regained his normal social life and recover his normal mood. He remained asymptomatic for 90 days. Afterwards, hallucinations reappeared but with less intensity. Conclusions: To our knowledge, this is the first reported case of combined functional and structural connectivity imaging demonstrating brain regions participating in a network involved in the generation of complex auditory and visual hallucinations.
Databáze:	OpenAIRE
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