Substantia nigra pars reticulata involvement in auditory hallucinations of treatment-resistant schizophrenia: a deep brain stimulation case report

One-third of schizophrenia patients exhibit treatment resistance, underscoring the need for mechanism-based interventions. We report that deep brain stimulation of the substantia nigra pars reticulata has acutely alleviated persistent auditory hallucinations by 64% in a treatment-resistant schizophrenia patient. Deep brain stimulation normalized hallucination-correlated elevation of intraoperative electrocortical theta–gamma phase–amplitude coupling at language-related cortical areas. These findings suggest aberrant cortical synchronization may be involved in the generation of verbal hallucinations and highlight subcortical modulation as a potential therapeutic strategy.