Effective stimulation sites and networks for substantia nigra pars reticulata deep brain stimulation for auditory verbal hallucinations in schizophrenia.
7 affiliations
- 1Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- 2Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
- 3Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
- 4Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA.
- 5Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
- 6Department of Radiology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
- 7Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA. [email protected].
Abstract
Deep brain stimulation (DBS) of the substantia nigra pars reticulata (SNpr) is under investigation for managing auditory-verbal hallucinations (AVH) in treatment-resistant schizophrenia (TR-SZ). We assessed acute AVH suppression during initial SNpr-DBS programming in three TR-SZ patients and mapped associated brain network engagement using normative connectomes. One-month post-implantation, monopolar stimulation at each electrode contact was evaluated for its effect on AVH severity. Volumes of tissue activation (VTA) were integrated with normative structural and functional connectivity data to generate individualized network maps. Among 86 VTAs, stimulation volumes associated with greatest AVH relief localized to left anterior-dorsal and right posterior-ventral SNpr. Greater AVH suppression correlated with structural connectivity to sensorimotor cortex and inferior frontal gyral subregions, and functional connectivity to the insula, orbitofrontal cortex, and dorsolateral prefrontal cortex, regions that fit salience attribution, value/belief updating, and top-down control of source/reality monitoring deficits reported in schizophrenia. These preliminary results highlight specific SNpr subregions and circuits linked to acute symptom reduction, supporting the potential of network-targeted DBS for TR-SZ.
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BibTeX
@article{kim2026effective,
title = {{Effective stimulation sites and networks for substantia nigra pars reticulata deep brain stimulation for auditory verbal hallucinations in schizophrenia.}},
author = {Min Jae Kim and Ankur Butala and Yousef Salimpour and Akira Sawa and Martijn Figee and Ki Sueng Choi and Anruo Shen and David Schretlen and Kelly A Mills and Nicola Cascella},
journal = {Translational psychiatry},
year = {2026},
month = jul,
doi = {10.1038/s41398-026-04298-7},
url = {https://europepmc.org/article/MED/42897143},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Effective stimulation sites and networks for substantia nigra pars reticulata deep brain stimulation for auditory verbal hallucinations in schizophrenia.
AU - Min Jae Kim
AU - Ankur Butala
AU - Yousef Salimpour
AU - Akira Sawa
AU - Martijn Figee
AU - Ki Sueng Choi
AU - Anruo Shen
AU - David Schretlen
AU - Kelly A Mills
AU - Nicola Cascella
PY - 2026
DA - 2026/07/01
JO - Translational psychiatry
DO - 10.1038/s41398-026-04298-7
UR - https://europepmc.org/article/MED/42897143
AB - Deep brain stimulation (DBS) of the substantia nigra pars reticulata (SNpr) is under investigation for managing auditory-verbal hallucinations (AVH) in treatment-resistant schizophrenia (TR-SZ). We assessed acute AVH suppression during initial SNpr-DBS programming in three TR-SZ patients and mapped associated brain network engagement using normative connectomes. One-month post-implantation, monopolar stimulation at each electrode contact was evaluated for its effect on AVH severity. Volumes of tissue activation (VTA) were integrated with normative structural and functional connectivity data to generate individualized network maps. Among 86 VTAs, stimulation volumes associated with greatest AVH relief localized to left anterior-dorsal and right posterior-ventral SNpr. Greater AVH suppression correlated with structural connectivity to sensorimotor cortex and inferior frontal gyral subregions, and functional connectivity to the insula, orbitofrontal cortex, and dorsolateral prefrontal cortex, regions that fit salience attribution, value/belief updating, and top-down control of source/reality monitoring deficits reported in schizophrenia. These preliminary results highlight specific SNpr subregions and circuits linked to acute symptom reduction, supporting the potential of network-targeted DBS for TR-SZ.
SN - 2158-3188
ER -