Abstract
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.
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Acknowledgements
We extend our gratitude to the participant and his family. We also thank Ms. Yukiko Lema for her suggestions for formatting the figures and her role in research management.Dr. Sawa reports having received research funding from the National Institutes of Health Grant (No. P50MH136297). Dr. Cascella reports having received research funding from the National Institutes of Health Grant (No. U01 MH130625).
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Y.S., W.A., K.M., and N.C. contributed substantially to the conception and design of the study. A.S., Y.S., M.F., N.C., and A.B. contributed to data analysis and interpretation. W.A., K.M., and N.C. were responsible for data acquisition. A.S., W.A., K.M., A.B., M.F., M.J.K., M.B., and N.C. drafted the manuscript or revised it critically for important intellectual content. All authors approved the final version of the manuscript. N.C. agreed to be accountable for all aspects of the work, ensuring that questions related to accuracy or integrity were appropriately investigated and resolved.
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W.S.A. reports having received royalty from Globus Medical, and he is a compensated consultant for Iota Biosciences. All other authors report no biomedical financial interests or potential conflicts of interest.
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Shen, A., Salimpour, Y., Butala, A. et al. Substantia nigra pars reticulata involvement in auditory hallucinations of treatment-resistant schizophrenia: a deep brain stimulation case report. Schizophr (2026). https://doi.org/10.1038/s41537-026-00732-3
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DOI: https://doi.org/10.1038/s41537-026-00732-3
