BRAIN WORK

By Anastasia Toufexis

IN A QUIET, DARKENED HOSPITAL ROOM, a 25-year-old man with paranoid schizophrenia lies on a table, his eyes closed, listening to the "voice" that has plagued him for more than two years. The voice is relentless, speaking once every 10 seconds or so. "Don't act stupid," it says in a demeaning tone. "Dirty rotten bastard." Each time the man hears the voice, he clicks a button. Scientists, meanwhile, are monitoring his brain activity. Using a special imaging technique called PET scanning, they take series of pictures every 10 minutes. Later, by matching the timing of the button clicks with the snapshots--744 in all--they get what is, in effect, a photo album of active hallucinations.

That experiment, repeated with five other patients, has now yielded dramatic results that not only open a window on the workings of the diseased mind but may eventually lead to better treatments. In an article published last week in Nature, a team of U.S. and British researchers report that they have pinpointed brain circuits that seem to control the auditory and visual hallucinations of schizophrenia. "We've identified the areas that are responsible for the brain creating its own reality," says neurologist David Silbersweig at New York Hospital-Cornell Medical Center. "This may help us tailor the medications."

The new research suggests that hallucinations are jointly generated by the brain's deep structures that regulate thinking and emotions and surface regions that process sights and sounds. Silbersweig says that by integrating fleeting voices and visions with emotions, the schizophrenic brain may give these simulacra an acute sense of reality. The findings cast doubt on one theory: that hallucinating patients are actually talking to themselves. The brain scans found activity in the areas responsible for hearing, but not in those involved in speech.

--Reported by Jenifer Mattos/New York

With reporting by JENIFER MATTOS/NEW YORK