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Kowalski J, Dąbkowska M, Aleksandrowicz A, Jarkiewicz M, Larøi F, Gawęda Ł. Associations of Cognitive Expectancies With Auditory Hallucinations and Hallucinatory-Like Experiences in Patients With Schizophrenia. Schizophr Bull 2024:sbae115. [PMID: 38982879 DOI: 10.1093/schbul/sbae115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
BACKGROUND Various neurocognitive models explore perceptual distortions and hallucinations in schizophrenia and the general population. A variant of predictive coding account suggests that strong priors, like cognitive expectancy, may influence perception. This study examines if stronger cognitive expectancies result in more auditory false percepts in clinical and healthy control groups, investigates group differences, and explores the association between false percepts and hallucinations. STUDY DESIGN Patients diagnosed with schizophrenia with current auditory hallucinations (n = 51) and without hallucinations (n = 66) and healthy controls (n = 51) underwent the False Perception Task under various expectancy conditions. All groups were examined for the presence and severity of hallucinations or hallucinatory-like experiences. STUDY RESULTS We observed a main effect of condition across all groups, ie, the stronger the cognitive expectancy, the greater the ratio of auditory false percepts. However, there was no group effect for the ratio of auditory false percepts. Despite modest pairwise correlations in the hallucinating group, the ratio of auditory false percepts was not predicted by levels of hallucinations and hallucinatory-like experiences in a linear mixed model. CONCLUSIONS The current study demonstrates that strong priors in the form of cognitive expectancies affect perception and play a role in perceptual disturbances. There is also a tentative possibility that overreliance on strong priors may be associated with hallucinations in currently hallucinating subjects. Possible, avoidable confounding factors are discussed in detail.
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Affiliation(s)
- Joachim Kowalski
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Małgorzata Dąbkowska
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Adrianna Aleksandrowicz
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Michał Jarkiewicz
- Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Frank Larøi
- Department of Psychology, University of Oslo, Oslo, Norway
- Psychology and Neuroscience of Cognition Research Unit, Department of Psychology, University of Liège, Liège, Belgium
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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Bell A, Toh WL, Allen P, Cella M, Jardri R, Larøi F, Moseley P, Rossell SL. Examining the relationships between cognition and auditory hallucinations: A systematic review. Aust N Z J Psychiatry 2024; 58:467-497. [PMID: 38470085 PMCID: PMC11128145 DOI: 10.1177/00048674241235849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
OBJECTIVE Auditory hallucinations (hearing voices) have been associated with a range of altered cognitive functions, pertaining to signal detection, source-monitoring, memory, inhibition and language processes. Yet, empirical results are inconsistent. Despite this, several theoretical models of auditory hallucinations persist, alongside increasing emphasis on the utility of a multidimensional framework. Thus, clarification of current evidence across the broad scope of proposed mechanisms is warranted. METHOD A systematic search of the Web of Science, PubMed and Scopus databases was conducted. Records were screened to confirm the use of an objective behavioural cognitive task, and valid measurement of hallucinations specific to the auditory modality. RESULTS Auditory hallucinations were primarily associated with difficulties in perceptual decision-making (i.e. reduced sensitivity/accuracy for signal-noise discrimination; liberal responding to ambiguity), source-monitoring (i.e. self-other and temporal context confusion), working memory and language function (i.e. reduced verbal fluency). Mixed or limited support was observed for perceptual feature discrimination, imagery vividness/illusion susceptibility, source-monitoring for stimulus form and spatial context, recognition and recall memory, executive functions (e.g. attention, inhibition), emotion processing and language comprehension/hemispheric organisation. CONCLUSIONS Findings were considered within predictive coding and self-monitoring frameworks. Of concern was the portion of studies which - despite offering auditory-hallucination-specific aims and inferences - employed modality-general measures, and/or diagnostic-based contrasts with psychologically healthy individuals. This review highlights disparities within the literature between theoretical conceptualisations of auditory hallucinations and the body of rigorous empirical evidence supporting such inferences. Future cognitive investigations, beyond the schizophrenia-spectrum, which explicitly define and measure the timeframe and sensory modality of hallucinations, are recommended.
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Affiliation(s)
- Adrienne Bell
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Wei Lin Toh
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
- Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia
- Department of Psychology, Alfred Health, Melbourne, VIC, Australia
| | - Paul Allen
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Matteo Cella
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Renaud Jardri
- University of Lille, INSERM U-1172, Plasticity and Subjectivity Team, Lille Neuroscience and Cognition Research Centre, Fontan Hospital, CHU Lille, Lille, France
| | - Frank Larøi
- Department of Psychology, University of Oslo, Oslo, Norway
- Psychology and Neuroscience of Cognition Research Unit, University of Liege, Liege, Belgium
| | - Peter Moseley
- Department of Psychology, Northumbria University, Newcastle-Upon-Tyne, UK
| | - Susan L Rossell
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
- Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia
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Aleksandrowicz A, Kowalski J, Stefaniak I, Elert K, Gawęda Ł. Cognitive correlates of auditory hallucinations in schizophrenia spectrum disorders. Psychiatry Res 2023; 327:115372. [PMID: 37619509 DOI: 10.1016/j.psychres.2023.115372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/09/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023]
Abstract
Auditory hallucinations (AHs) are one of the central symptoms of schizophrenia spectrum disorders (SSD). Current cognitive models of AH implicate source monitoring, top-down processes, and inhibitory control. However, research combining these processes is limited. Our study aimed to examine how source monitoring bias, top-down processes, and inhibitory control contribute to AHs in individuals with SSD. Eighty seven patients (aged 18-45 years) with SSD were included in the analyses. Participants completed cognitive tasks assessing source monitoring (Action Memory Task), top-down processes (False Perception Task; FPT), and inhibitory control (Auditory Go/NoGo task). AH was positively associated with response bias on the FPT. Correlations between AH and the other cognitive tasks were nonsignificant. Source monitoring errors correlated positively with response bias measures and negatively with Hits on the FPT. PANSS total score was positively correlated with source monitoring bias and False Alarms on the Go/NoGo task. The severity of disorganized symptoms was related to Source Monitoring Errors and False Alarms in the Go/NoGo task. Negative symptoms were associated with Hits and False Alarms in the Go/NoGo task. Future studies are necessary to further elucidate the relationships between different cognitive processes that may be related to clinical symptoms of psychosis.
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Affiliation(s)
- Adrianna Aleksandrowicz
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
| | - Joachim Kowalski
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Izabela Stefaniak
- First Department of Psychiatry Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland
| | - Katarzyna Elert
- First Department of Psychiatry Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
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Mak O, Couth S, Plack CJ, Kotz SA, Yao B. Investigating the lateralisation of experimentally induced auditory verbal hallucinations. Front Neurosci 2023; 17:1193402. [PMID: 37483346 PMCID: PMC10359906 DOI: 10.3389/fnins.2023.1193402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/16/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Auditory verbal hallucinations (AVHs), or hearing non-existent voices, are a common symptom in psychosis. Recent research suggests that AVHs are also experienced by neurotypical individuals. Individuals with schizophrenia experiencing AVHs and neurotypicals who are highly prone to hallucinate both produce false positive responses in auditory signal detection. These findings suggest that voice-hearing may lie on a continuum with similar mechanisms underlying AVHs in both populations. Methods The current study used a monaural auditory stimulus in a signal detection task to test to what extent experimentally induced verbal hallucinations are (1) left-lateralised (i.e., more likely to occur when presented to the right ear compared to the left ear due to the left-hemisphere dominance for language processing), and (2) predicted by self-reported hallucination proneness and auditory imagery tendencies. In a conditioning task, fifty neurotypical participants associated a negative word on-screen with the same word being played via headphones through successive simultaneous audio-visual presentations. A signal detection task followed where participants were presented with a target word on-screen and indicated whether they heard the word being played concurrently amongst white noise. Results Results showed that Pavlovian audio-visual conditioning reliably elicited a significant number of false positives (FPs). However, FP rates, perceptual sensitivities, and response biases did not differ between either ear. They were neither predicted by hallucination proneness nor auditory imagery. Discussion The results show that experimentally induced FPs in neurotypicals are not left-lateralised, adding further weight to the argument that lateralisation may not be a defining feature of hallucinations in clinical or non-clinical populations. The findings also support the idea that AVHs may be a continuous phenomenon that varies in severity and frequency across the population. Studying induced AVHs in neurotypicals may help identify the underlying cognitive and neural mechanisms contributing to AVHs in individuals with psychotic disorders.
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Affiliation(s)
- Olivia Mak
- Division of Human Communication, Development & Hearing, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Samuel Couth
- Division of Human Communication, Development & Hearing, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Christopher J. Plack
- Division of Human Communication, Development & Hearing, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
| | - Sonja A. Kotz
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Bo Yao
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
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5
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Phantom phone signals and other hallucinatory-like experiences: Investigation of similarities and differences. Psychiatry Res 2023; 319:114964. [PMID: 36463722 DOI: 10.1016/j.psychres.2022.114964] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/25/2022] [Accepted: 11/17/2022] [Indexed: 11/21/2022]
Abstract
Phantom Phone Signals (PPS) and other hallucinatory-like experiences (HLEs) are perceptual anomalies that are commonly reported in the general population. Both phenomena concern the same sensory modality, but PPS are restricted to smartphone use. The current study aimed to assess similarities and differences between these types of anomalies in relation to general psychopathology, metacognitive beliefs about perception, smartphone dependence, and susceptibility to top-down influences on perception. We analyzed data from a Polish community sample (N = 236, aged 18-69). We used questions pertaining to PPS, a questionnaire pertaining to HLEs (Multi-Modality Unusual Sensory Experiences Questionnaire), and other variables of interest (Symptom Checklist-27-plus, Mobile Phone Problematic Use Scale, and the Beliefs about Perception Questionnaire). Additionally, a false-perception task manipulating cognitive expectancy (i.e., a visual cue associated with auditory stimuli vs. no visual cue) was devised to measure top-down influences on perception. Regression analyses showed that only top-down beliefs about perception predicted both PPS and HLEs. Smartphone dependency proved to be a stronger predictor of PPS than other measured variables, whereas for HLEs, general psychopathology was the strongest predictor. Current results suggest that despite sharing some mechanisms, PPS and HLEs may have independent underlying factors.
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Chhabra H, Selvaraj S, Sreeraj VS, Damodharan D, Shivakumar V, Kumar V, Narayanaswamy JC, Venkatasubramanian G. Functional near-infrared spectroscopy in schizophrenia patients with auditory verbal hallucinations: Preliminary observations. Asian J Psychiatr 2022; 73:103127. [PMID: 35430497 DOI: 10.1016/j.ajp.2022.103127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 04/07/2022] [Indexed: 11/02/2022]
Abstract
Auditory Signal Detection (ASD) theory postulates that auditory verbal hallucinations (AVH) result from an aberrant association of meaningful connection to abstract noises. In this study, schizophrenia (SZ) patients with persistent AVH (N = 17) and matched controls (N = 25) performed an ASD task with concurrent functional near-infrared spectroscopy recording targetting the left dorsolateral prefrontal cortex (L-DLPFC) and left temporoparietal junction (L-TPJ). During the task, discriminability index had a significant negative correlation, and early deoxyhemoglobin (HbR) latency at L-TPJ positively correlated with AVH scores. Also, patients had significantly lower discriminability, early HbR latency at L-TPJ, and delayed latency at L-DLPFC. This finding suggests the presence of ASD abnormalities and impaired auditory processing in SZ patients with AVH supporting ASD-based pathogenesis.
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Affiliation(s)
- Harleen Chhabra
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Sowmya Selvaraj
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Vanteemar S Sreeraj
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Dinakaran Damodharan
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Venkataram Shivakumar
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Vijay Kumar
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Janardhanan C Narayanaswamy
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Ganesan Venkatasubramanian
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India.
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7
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Laloyaux J, Hirnstein M, Specht K, Giersch A, Larøi F. Eliciting false auditory perceptions using speech frequencies and semantic priming: a signal detection approach. Cogn Neuropsychiatry 2022; 27:255-272. [PMID: 35118930 DOI: 10.1080/13546805.2022.2031945] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Individuals experiencing auditory hallucinations (AH) tend to perceive voices when exposed to random noise. However, the factors driving this tendency remain unclear. The present study examined the interaction of a top-down (expectations) and bottom-up (type of noise) process to better understand the mechanisms that underlie AH. METHODS Fifty-two healthy individuals (29 with high proneness and 23 with low proneness to AH) completed a signal detection task, in which they listened to pre-recorded sentences. The last word was either masked by noise or only noise was presented without the word. Two types of noise existed (speech-related versus speech-unrelated frequencies) and words were characterised by either high or low levels of semantic expectation. RESULTS Participants with high proneness to AH showed a more liberal decision bias (i.e., they were more likely to report having heard a word) and poorer discrimination ability as compared to participants with low proneness to AH - but only when the word was masked by speech-related noises and the level of expectation was high. Further, the more liberal decision bias correlated negatively with the tendency to experience AH. CONCLUSION This novel paradigm demonstrated an interaction between top-down (level of expectation) and bottom-up (type of noise) processes, supporting current theoretical models of AH.
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Affiliation(s)
- Julien Laloyaux
- Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
| | - Marco Hirnstein
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,NORMENT - Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Oslo, Norway
| | - Karsten Specht
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,Mohn Medical and Imaging Visualization Centre, Haukeland University Hospital, Bergen, Norway.,Department of Education, UiT/The Arctic University of Norway, Tromsø, Norway
| | - Anne Giersch
- University of Strasbourg, INSERM U1114 NCPS, Strasbourg, France.,Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France
| | - Frank Larøi
- Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium.,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.,NORMENT - Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Oslo, Norway
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8
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Sheldon AD, Kafadar E, Fisher V, Greenwald MS, Aitken F, Negreira AM, Woods SW, Powers AR. Perceptual pathways to hallucinogenesis. Schizophr Res 2022; 245:77-89. [PMID: 35216865 PMCID: PMC9232894 DOI: 10.1016/j.schres.2022.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 12/22/2022]
Abstract
Recent advances in computational psychiatry have provided unique insights into the neural and cognitive underpinnings of psychotic symptoms. In particular, a host of new data has demonstrated the utility of computational frameworks for understanding how hallucinations might arise from alterations in typical perceptual processing. Of particular promise are models based in Bayesian inference that link hallucinatory perceptual experiences to latent states that may drive them. In this piece, we move beyond these findings to ask: how and why do these latent states arise, and how might we take advantage of heterogeneity in that process to develop precision approaches to the treatment of hallucinations? We leverage specific models of Bayesian inference to discuss components that might lead to the development of hallucinations. Using the unifying power of our model, we attempt to place disparate findings in the study of psychotic symptoms within a common framework. Finally, we suggest directions for future elaboration of these models in the service of a more refined psychiatric nosology based on predictable, testable, and ultimately treatable information processing derangements.
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Affiliation(s)
- Andrew D Sheldon
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Eren Kafadar
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Victoria Fisher
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Maximillian S Greenwald
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Fraser Aitken
- School of Biomedical and Imaging Sciences, Kings College, London, UK
| | | | - Scott W Woods
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Albert R Powers
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America.
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Chinchani AM, Menon M, Roes M, Hwang H, Allen P, Bell V, Bless J, Bortolon C, Cella M, Fernyhough C, Garrison J, Kozáková E, Larøi F, Moffatt J, Say N, Suzuki M, Toh WL, Zaytseva Y, Rossell SL, Moseley P, Woodward TS. Item-specific overlap between hallucinatory experiences and cognition in the general population: A three-step multivariate analysis of international multi-site data. Cortex 2021; 145:131-144. [PMID: 34717270 DOI: 10.1016/j.cortex.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/01/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022]
Abstract
Hallucinatory experiences (HEs) can be pronounced in psychosis, but similar experiences also occur in nonclinical populations. Cognitive mechanisms hypothesized to underpin HEs include dysfunctional source monitoring, heightened signal detection, and impaired attentional processes. Using data from an international multisite study on non-clinical participants (N = 419), we described the overlap between two sets of variables - one measuring cognition and the other HEs - at the level of individual items. We used a three-step method to extract and examine item-specific signal, which is typically obscured when summary scores are analyzed using traditional methodologies. The three-step method involved: (1) constraining variance in cognition variables to that which is predictable from HE variables, followed by dimension reduction, (2) determining reliable HE items using split-halves and permutation tests, and (3) selecting cognition items for interpretation using a leave-one-out procedure followed by repetition of Steps 1 and 2. The results showed that the overlap between HEs and cognition variables can be conceptualized as bi-dimensional, with two distinct mechanisms emerging as candidates for separate pathways to the development of HEs: HEs involving perceptual distortions on one hand (including voices), underpinned by a low threshold for signal detection in cognition, and HEs involving sensory overload on the other hand, underpinned by reduced laterality in cognition. We propose that these two dimensions of HEs involving distortions/liberal signal detection, and sensation overload/reduced laterality may map onto psychosis-spectrum and dissociation-spectrum anomalous experiences, respectively.
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Affiliation(s)
- Abhijit M Chinchani
- BC Mental Health and Substance Use Services, Vancouver, UK; Department of Bioinformatics, University of British Columbia, Vancouver, UK
| | - Mahesh Menon
- Department of Psychiatry, University of British Columbia, Vancouver, UK
| | - Meighen Roes
- BC Mental Health and Substance Use Services, Vancouver, UK; Department of Psychology, University of British Columbia, Vancouver, UK
| | - Heungsun Hwang
- Department of Psychology, McGill University, Montreal, UK
| | - Paul Allen
- Department of Psychology, University of Roehampton, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Vaughan Bell
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Josef Bless
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Catherine Bortolon
- Univ. Grenoble Alpes, Laboratoire Inter-universitaire de Psychologie, University Grenoble Alpes, Grenoble, France
| | - Matteo Cella
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London & Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK
| | | | - Jane Garrison
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Eva Kozáková
- Department of Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czech Republic; Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | - Frank Larøi
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway; Psychology and Neuroscience of Cognition Research Unit, University of Liege, Liege, Belgium; NORMENT-Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Oslo, Norway
| | - Jamie Moffatt
- School of Psychology, University of Sussex, Falmer, UK
| | - Nicolas Say
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | - Mimi Suzuki
- Division of Psychiatry, University College London, London, UK
| | - Wei Lin Toh
- Cognitive Neuropsychiatry Lab, Centre for Mental Health, Swinburne University, Melbourne, Australia
| | - Yuliya Zaytseva
- Department of Applied Neurosciences and Brain Imaging, National Institute of Mental Health, Klecany, Czech Republic; Department of Psychiatry and Medical Psychology, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Susan L Rossell
- Cognitive Neuropsychiatry Lab, Centre for Mental Health, Swinburne University, Melbourne, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Peter Moseley
- Department of Psychology, Northumbria University, Newcastle-Upon Tyne, UK
| | - Todd S Woodward
- BC Mental Health and Substance Use Services, Vancouver, UK; Department of Bioinformatics, University of British Columbia, Vancouver, UK; Department of Psychiatry, University of British Columbia, Vancouver, UK.
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10
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Anderson A, Hartley S, Bucci S. A Systematic Review of the experimental induction of auditory perceptual experiences. J Behav Ther Exp Psychiatry 2021; 71:101635. [PMID: 33348277 DOI: 10.1016/j.jbtep.2020.101635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 11/16/2020] [Accepted: 12/07/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Voice-hearing exists on a continuum and research studies have utilised experimental paradigms in an attempt to induce unusual auditory experiences in clinical and non-clinical samples. The aim of the current review was to systematically identify, review and appraise voice-hearing induction paradigms in order to guide researchers. METHODS Five databases were searched for studies in which an experimental manipulation was used with the aim of inducing an auditory experience akin to voice-hearing. Papers were assessed for quality and the voice-hearing paradigms critically appraised. RESULTS Forty-nine studies, included in 41 papers, were reviewed. Studies were organised into five groups based on the type of voice-hearing paradigm used: sensory deprivation/limitation; hallucination suggestion; combined suggestion and ambiguous stimulus; signal detection and voice detection tasks; and auditory discrimination/transformation. Signal and voice detection tasks were found to be the most robust paradigms. The quality of paradigms was assessed, and their strengths and limitations evaluated, including evidence in relation to their utility, ecological validity and usability. LIMITATIONS The current review excluded case studies, grey literature and studies which were not written in the English language, and as such voice-hearing paradigms may have been missed. CONCLUSIONS Voice-hearing paradigms vary in their ecological validity and experimental robustness. A challenge for future research is to develop a paradigm in which internally generated material can be attributed externally in a way that more closely represents inner speech and the experience of voice-hearing.
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Affiliation(s)
- Amanda Anderson
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Samantha Hartley
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom; Pennine Care NHS Foundation Trust, United Kingdom.
| | - Sandra Bucci
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
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11
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Faramarzi M, Kasten FH, Altaş G, Aleman A, Ćurčić-Blake B, Herrmann CS. Similar EEG Activity Patterns During Experimentally-Induced Auditory Illusions and Veridical Perceptions. Front Neurosci 2021; 15:602437. [PMID: 33867913 PMCID: PMC8047478 DOI: 10.3389/fnins.2021.602437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/12/2021] [Indexed: 12/31/2022] Open
Abstract
Hallucinations and illusions are two instances of perceptual experiences illustrating how perception might diverge from external sensory stimulations and be generated or altered based on internal brain states. The occurrence of these phenomena is not constrained to patient populations. Similar experiences can be elicited in healthy subjects by means of suitable experimental procedures. Studying the neural mechanisms underlying these experiences not only has the potential to expand our understanding of the brain's perceptual machinery but also of how it might get impaired. In the current study, we employed an auditory signal detection task to induce auditory illusions by presenting speech snippets at near detection threshold intensity embedded in noise. We investigated the neural correlates of auditory false perceptions by examining the EEG activity preceding the responses in speech absent (false alarm, FA) trials and comparing them to speech present (hit) trials. The results of the comparison of event-related potentials (ERPs) in the activation period vs. baseline revealed the presence of an early negativity (EN) and a late positivity (LP) similar in both hits and FAs, which were absent in misses, correct rejections (CR) and control button presses (BPs). We postulate that the EN and the LP might represent the auditory awareness negativity (AAN) and centro-parietal positivity (CPP) or P300, respectively. The event-related spectral perturbations (ERSPs) exhibited a common power enhancement in low frequencies (<4 Hz) in hits and FAs. The low-frequency power enhancement has been frequently shown to be accompanied with P300 as well as separately being a marker of perceptual awareness, referred to as slow cortical potentials (SCP). Furthermore, the comparison of hits vs. FAs showed a significantly higher LP amplitude and low frequency power in hits compared to FAs. Generally, the observed patterns in the present results resembled some of the major neural correlates associated with perceptual awareness in previous studies. Our findings provide evidence that the neural correlates associated with conscious perception, can be elicited in similar ways in both presence and absence of externally presented sensory stimuli. The present findings did not reveal any pre-stimulus alpha and beta modulations distinguishing conscious vs. unconscious perceptions.
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Affiliation(s)
- Maryam Faramarzi
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Florian H. Kasten
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
- Neuroimaging Unit, European Medical School, Carl von Ossietzky University, Oldenburg, Germany
| | - Gamze Altaş
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
| | - André Aleman
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Branislava Ćurčić-Blake
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Christoph S. Herrmann
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
- Neuroimaging Unit, European Medical School, Carl von Ossietzky University, Oldenburg, Germany
- Research Center Neurosensory Science, Carl von Ossietzky University, Oldenburg, Germany
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Auditory signal detection in schizophrenia: Correlates with auditory verbal hallucinations & effect of single session transcranial direct current stimulation (tDCS). Psychiatry Res 2021; 297:113704. [PMID: 33453498 DOI: 10.1016/j.psychres.2021.113704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/31/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Transcranial Direct Current Stimulation (tDCS) has been beneficial for treating auditory verbal hallucinations (AVH) in schizophrenia (SZ). Aberrant auditory signal detection (ASD) is one of the pathogenetic mechanisms for AVH. We investigated the correlates of ASD with AVH and the impact of single-session tDCS on ASD in SZ patients. METHODS The ASD performance in SZ patients was compared with matched healthy controls (HC) (N = 24). Subsequently, the effect of single-session tDCS on ASD in SZ patients (N = 24) with AVH was examined in a randomized, double-blind, sham-controlled, cross-over design. The true and sham tDCS were administered (anode at the left dorsolateral prefrontal cortex and cathode at the left temporoparietal junction) on two different days. ASD task was performed before and after each session of tDCS. RESULTS Auditory hallucination rating scores correlated significantly with false alarm rate, discriminability index, and response bias. SZ patients had a significantly lesser discriminability index in ASD than HC. Single-session tDCS (true versus sham) did not have any significant effect on ASD in SZ patients. CONCLUSION The study findings support the pathogenetic role of ASD in AVH in SZ. Lack of effect on ASD following single-session tDCS suggests the need for multi-session studies in the future.
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Gawęda Ł, Moritz S. The role of expectancies and emotional load in false auditory perceptions among patients with schizophrenia spectrum disorders. Eur Arch Psychiatry Clin Neurosci 2021; 271:713-722. [PMID: 31493150 PMCID: PMC8119254 DOI: 10.1007/s00406-019-01065-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 08/29/2019] [Indexed: 11/25/2022]
Abstract
Cognitive models suggest that top-down and emotional processes increase false perceptions in schizophrenia spectrum disorders (SSD). However, little is still known about the interaction of these processes in false auditory perceptions. The present study aimed at investigating the specific as well as joint impacts of expectancies and emotional load on false auditory perceptions in SSD. Thirty-three patients with SSD and 33 matched healthy controls were assessed with a false perception task. Participants were asked to detect a target stimulus (a word) in a white noise background (the word was present in 60% of the cases and absent in 40%). Conditions varied in terms of the level of expectancy (1. no cue prior to the stimulus, 2. semantic priming, 3. semantic priming accompanied by a video of a man's mouth spelling out the word). The words used were neutral or emotionally negative. Symptom severity was assessed with the Positive and Negative Syndrome Scale. Higher expectancy significantly increased the likelihood of false auditory perceptions only among the patients with SSD (the group x expectancy condition interaction was significant), which was unrelated to general cognitive performance. Emotional load had no impact on false auditory perceptions in either group. Patients made more false auditory perceptions with high confidence than controls did. False auditory perceptions were significantly correlated with the severity of positive symptoms and disorganization, but not with other dimensions. Perception in SSD seems to be susceptible to top-down processes, increasing the likelihood of high-confidence false auditory perceptions.
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Affiliation(s)
- Łukasz Gawęda
- Psychopathology and Early Intervention Lab II, Department of Psychiatry, The Medical University of Warsaw, Ul. Kondratowicza 8, 03-242, Warsaw, Poland.
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Laloyaux J, De Keyser F, Pinchard A, Della Libera C, Larøi F. Testing a model of auditory hallucinations: the role of negative emotions and cognitive resources. Cogn Neuropsychiatry 2019; 24:256-274. [PMID: 31188062 DOI: 10.1080/13546805.2019.1629895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Models of auditory hallucinations (AH) state that AH arise through an interaction between negative emotions and limited available cognitive resources. However, this hypothesis has never been directly tested. Methods: A two-by-two factorial design was used to examine the effect of emotions (neutral VS negative) and available cognitive resources (high VS low) on the elicitation of false alarms in an auditory signal detection paradigm. One hundred and seventy four healthy participants were assigned to one of the four experimental conditions. While participants were listening to white noise, their emotional state was manipulated using affective pictures and the level of available cognitive resources was manipulated using a visual N-back task. Results: Results revealed significant interaction effects between emotions and cognitive resources on the number of false alarms. In particular, participants with fewer available cognitive resources and at the same time who were in a negative emotional state, tended to hear significantly more false alarms. In addition, the degree of certitude was significantly correlated with a higher degree of hallucination proneness. Conclusions: Such results are in agreement with models of AH and they provide new data for the understanding of the emotional and cognitive mechanisms that underpin AH.
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Affiliation(s)
- Julien Laloyaux
- a Department of Biological and Medical Psychology, University of Bergen , Bergen , Norway.,b NORMENT - Norwegian Center for Mental Disorders Research, University of Oslo , Oslo , Norway.,c Psychology and Neuroscience of Cognition Research Unit, University of Liège , Liège , Belgium
| | - Freya De Keyser
- d Faculty of Psychology and Educational Sciences, Department Of Experimental Psychology, University of Ghent , Ghent , Belgium
| | - Antoine Pinchard
- c Psychology and Neuroscience of Cognition Research Unit, University of Liège , Liège , Belgium
| | - Clara Della Libera
- c Psychology and Neuroscience of Cognition Research Unit, University of Liège , Liège , Belgium
| | - Frank Larøi
- a Department of Biological and Medical Psychology, University of Bergen , Bergen , Norway.,b NORMENT - Norwegian Center for Mental Disorders Research, University of Oslo , Oslo , Norway.,c Psychology and Neuroscience of Cognition Research Unit, University of Liège , Liège , Belgium
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Goldsmith DR, Crooks CL, Walker EF, Cotes RO. An Update on Promising Biomarkers in Schizophrenia. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2018; 16:153-163. [PMID: 31975910 DOI: 10.1176/appi.focus.20170046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Given the heterogeneity of symptoms in patients with schizophrenia and current treatment limitations, biomarkers may play an important role in diagnosis, subtype stratification, and the assessment of treatment response. Though many potential biomarkers have been studied, we have chosen to focus on some of the most promising and potentially clinically relevant biomarkers to review herein. These include markers of inflammation, neuroimaging biomarkers, brain-derived neurotrophic factor, genetic/epigenetic markers, and speech analysis. This will provide a broad overview of putative biomarkers that could become clinically relevant in the future, though none currently appear ready to assist the clinician in identifying cases of schizophrenia, subtypes of the disorder, treatment choice, or response. Nonetheless, some biomarkers, such as C-reactive protein (CRP), may be useful at identifying individuals who may be more highly inflamed, which could drive treatment choice. Though checking CRP is not a standard of practice, this is one example of how biomarkers may drive treatment decisions in the future, supporting precision medicine. Similarly, technological advances may one day allow clinicians to detect changes in speech patterns, which could represent a noninvasive, clinically useful tool in the future. We conclude the review by highlighting two important potential clinical uses for biomarkers in schizophrenia: the identification of individuals who may convert from clinical high risk and the stratification of patients via different biomarkers that may supersede clinical diagnosis. Given the enormous burden of illness of schizophrenia, the search for clinically relevant biomarkers is of great importance to improve the lives of patients with the disorder.
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Affiliation(s)
- David R Goldsmith
- Dr. Goldsmith, Dr. Crooks, and Dr. Cotes are with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia. Dr. Crooks is also with the Electronic Systems Laboratory, Georgia Tech Research Institute, Atlanta. Dr. Walker is with the Department of Psychology, Emory University
| | - Courtney L Crooks
- Dr. Goldsmith, Dr. Crooks, and Dr. Cotes are with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia. Dr. Crooks is also with the Electronic Systems Laboratory, Georgia Tech Research Institute, Atlanta. Dr. Walker is with the Department of Psychology, Emory University
| | - Elaine F Walker
- Dr. Goldsmith, Dr. Crooks, and Dr. Cotes are with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia. Dr. Crooks is also with the Electronic Systems Laboratory, Georgia Tech Research Institute, Atlanta. Dr. Walker is with the Department of Psychology, Emory University
| | - Robert O Cotes
- Dr. Goldsmith, Dr. Crooks, and Dr. Cotes are with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia. Dr. Crooks is also with the Electronic Systems Laboratory, Georgia Tech Research Institute, Atlanta. Dr. Walker is with the Department of Psychology, Emory University
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Taylor ST, Chhabra H, Sreeraj VS, Shivakumar V, Kalmady SV, Venkatasubramanian G. Neural Effects of Transcranial Direct Current Stimulation in Schizophrenia: A Case Study using Functional Near-infrared Spectroscopy. Indian J Psychol Med 2017; 39:691-694. [PMID: 29200573 PMCID: PMC5688904 DOI: 10.4103/ijpsym.ijpsym_238_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Schizophrenia is a severe neuropsychiatric disorder characterized by delusions, hallucinations, behavioral symptoms, and cognitive deficits. Roughly, 70%-80% of schizophrenia patients experience auditory verbal hallucinations (AVHs), with 25%-30% demonstrating resistance to conventional antipsychotic medications. Studies suggest a promising role for add-on transcranial direct current stimulation (tDCS) in the treatment of medication-refractory AVHs. The mechanisms through which tDCS could be therapeutic in such cases are unclear, but possibly involve neuroplastic effects. In recent years, functional near-infrared spectroscopy (fNIRS) has been used successfully to study tDCS-induced neuroplastic changes. In a double-blind, sham-controlled design, we applied fNIRS to measure task-dependent cerebral blood flow (CBF) changes as a surrogate outcome of single session tDCS-induced effects on neuroplasticity in a schizophrenia patient with persistent auditory hallucinations. The observations are discussed in this case report.
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Affiliation(s)
- S Trevor Taylor
- Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, USA
| | - Harleen Chhabra
- Department of Psychiatry and Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vanteemar S Sreeraj
- Department of Psychiatry and Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Venkataram Shivakumar
- Department of Psychiatry and Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sunil V Kalmady
- Department of Psychiatry and Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry and Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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