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Powers A, Angelos P, Bond A, Farina E, Fredericks C, Gandhi J, Greenwald M, Hernandez-Busot G, Hosein G, Kelley M, Mourgues C, Palmer W, Rodriguez-Sanchez J, Seabury R, Toribio S, Vin R, Weleff J, Benrimoh D. A computational account of the development and evolution of psychotic symptoms. ARXIV 2024:arXiv:2404.10954v1. [PMID: 38699166 PMCID: PMC11065053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
The mechanisms of psychotic symptoms like hallucinations and delusions are often investigated in fully-formed illness, well after symptoms emerge. These investigations have yielded key insights, but are not well-positioned to reveal the dynamic forces underlying symptom formation itself. Understanding symptom development over time would allow us to identify steps in the pathophysiological process leading to psychosis, shifting the focus of psychiatric intervention from symptom alleviation to prevention. We propose a model for understanding the emergence of psychotic symptoms within the context of an adaptive, developing neural system. We will make the case for a pathophysiological process that begins with cortical hyperexcitability and bottom-up noise transmission, which engenders inappropriate belief formation via aberrant prediction error signaling. We will argue that this bottom-up noise drives learning about the (im)precision of new incoming sensory information because of diminished signal-to-noise ratio, causing an adaptive relative over-reliance on prior beliefs. This over-reliance on priors predisposes to hallucinations and covaries with hallucination severity. An over-reliance on priors may also lead to increased conviction in the beliefs generated by bottom-up noise and drive movement toward conversion to psychosis. We will identify predictions of our model at each stage, examine evidence to support or refute those predictions, and propose experiments that could falsify or help select between alternative elements of the overall model. Nesting computational abnormalities within longitudinal development allows us to account for hidden dynamics among the mechanisms driving symptom formation and to view established symptomatology as a point of equilibrium among competing biological forces.
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Affiliation(s)
- Albert Powers
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Philip Angelos
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Alexandria Bond
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Emily Farina
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Carolyn Fredericks
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Jay Gandhi
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Maximillian Greenwald
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | | | - Gabriel Hosein
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Megan Kelley
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Catalina Mourgues
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - William Palmer
- Yale University Department of Psychology, New Haven, CT USA
| | | | - Rashina Seabury
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Silmilly Toribio
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Raina Vin
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Jeremy Weleff
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - David Benrimoh
- Department of Psychiatry, McGill University, Montreal, Canada
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Shenyan O, Lisi M, Greenwood JA, Skipper JI, Dekker TM. Visual hallucinations induced by Ganzflicker and Ganzfeld differ in frequency, complexity, and content. Sci Rep 2024; 14:2353. [PMID: 38287084 PMCID: PMC10825158 DOI: 10.1038/s41598-024-52372-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/17/2024] [Indexed: 01/31/2024] Open
Abstract
Visual hallucinations can be phenomenologically divided into those of a simple or complex nature. Both simple and complex hallucinations can occur in pathological and non-pathological states, and can also be induced experimentally by visual stimulation or deprivation-for example using a high-frequency, eyes-open flicker (Ganzflicker) and perceptual deprivation (Ganzfeld). Here we leverage the differences in visual stimulation that these two techniques involve to investigate the role of bottom-up and top-down processes in shifting the complexity of visual hallucinations, and to assess whether these techniques involve a shared underlying hallucinatory mechanism despite their differences. For each technique, we measured the frequency and complexity of the hallucinations produced, utilising button presses, retrospective drawing, interviews, and questionnaires. For both experimental techniques, simple hallucinations were more common than complex hallucinations. Crucially, we found that Ganzflicker was more effective than Ganzfeld at eliciting simple hallucinations, while complex hallucinations remained equivalent across the two conditions. As a result, the likelihood that an experienced hallucination was complex was higher during Ganzfeld. Despite these differences, we found a correlation between the frequency and total time spent hallucinating in Ganzflicker and Ganzfeld conditions, suggesting some shared mechanisms between the two methodologies. We attribute the tendency to experience frequent simple hallucinations in both conditions to a shared low-level core hallucinatory mechanism, such as excitability of visual cortex, potentially amplified in Ganzflicker compared to Ganzfeld due to heightened bottom-up input. The tendency to experience complex hallucinations, in contrast, may be related to top-down processes less affected by visual stimulation.
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Affiliation(s)
- Oris Shenyan
- Experimental Psychology, Division of Psychology and Language Sciences, University College London, London, UK.
- Institute of Ophthalmology, University College London, London, UK.
| | - Matteo Lisi
- Department of Psychology, Royal Holloway University, London, UK
| | - John A Greenwood
- Experimental Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Jeremy I Skipper
- Experimental Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Tessa M Dekker
- Experimental Psychology, Division of Psychology and Language Sciences, University College London, London, UK
- Institute of Ophthalmology, University College London, London, UK
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Tumkaya S, Yücens B, Gündüz M, Maheu M, Berkovitch L. Disruption of consciousness depends on insight in OCD and on positive symptoms in schizophrenia. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.02.571832. [PMID: 38293050 PMCID: PMC10827121 DOI: 10.1101/2024.01.02.571832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Disruption of conscious access contributes to the advent of psychotic symptoms in schizophrenia but could also explain lack of insight in other psychiatric disorders. In this study, we explored how insight and psychotic symptoms related to disruption of consciousness. We explored consciousness in patients with schizophrenia, patients with obsessive-compulsive disorder (OCD) with good vs. poor insight and matched controls. Participants underwent clinical assessments and performed a visual masking task allowing us to measure individual consciousness threshold. We used a principal component analysis to reduce symptom dimensionality and explored how consciousness measures related to symptomatology. We found that clinical dimensions could be well summarized by a restricted set of principal components which also correlated with the extent of consciousness disruption. More specifically, positive symptoms were associated with impaired conscious access in patients with schizophrenia whereas the level of insight delineated two subtypes of OCD patients, those with poor insight who had consciousness impairments similar to patients with schizophrenia, and those with good insight who resemble healthy controls. Our study provides new insights about consciousness disruption in psychiatric disorders, showing that it relates to positive symptoms in schizophrenia and with insight in OCD. In OCD, it revealed a distinct subgroup sharing neuropathological features with schizophrenia. Our findings refine the mapping between symptoms and cognition, paving the way for a better treatment selection.
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Affiliation(s)
- Selim Tumkaya
- Department of Psychiatry, Pamukkale University School of Medicine, Denizli, Turkey
- Department of Neuroscience, Pamukkale University School of Medicine, Denizli, Turkey
| | - Bengü Yücens
- Department of Psychiatry, Pamukkale University School of Medicine, Denizli, Turkey
| | - Muhammet Gündüz
- Department of Psychiatry, Government Hospital of Bolvadin, Bolvadin, Turkey
| | - Maxime Maheu
- Department of Neurophysiology and Pathophysiology, Center for Experimental Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Synaptic Physiology, Centre for Molecular Neurobiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Lucie Berkovitch
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- University Department of Psychiatry, Pôle Hospitalo-Universitaire Psychiatrie Paris 15, Groupe Hospitalier Universitaire Paris, Paris, France
- Saclay CEA Centre, Neurospin, Gif-Sur-Yvette Cedex, France
- Paris Cité University, Paris, France
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Suzuki K, Seth AK, Schwartzman DJ. Modelling phenomenological differences in aetiologically distinct visual hallucinations using deep neural networks. Front Hum Neurosci 2024; 17:1159821. [PMID: 38234594 PMCID: PMC10791985 DOI: 10.3389/fnhum.2023.1159821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 09/11/2023] [Indexed: 01/19/2024] Open
Abstract
Visual hallucinations (VHs) are perceptions of objects or events in the absence of the sensory stimulation that would normally support such perceptions. Although all VHs share this core characteristic, there are substantial phenomenological differences between VHs that have different aetiologies, such as those arising from Neurodegenerative conditions, visual loss, or psychedelic compounds. Here, we examine the potential mechanistic basis of these differences by leveraging recent advances in visualising the learned representations of a coupled classifier and generative deep neural network-an approach we call 'computational (neuro)phenomenology'. Examining three aetiologically distinct populations in which VHs occur-Neurodegenerative conditions (Parkinson's Disease and Lewy Body Dementia), visual loss (Charles Bonnet Syndrome, CBS), and psychedelics-we identified three dimensions relevant to distinguishing these classes of VHs: realism (veridicality), dependence on sensory input (spontaneity), and complexity. By selectively tuning the parameters of the visualisation algorithm to reflect influence along each of these phenomenological dimensions we were able to generate 'synthetic VHs' that were characteristic of the VHs experienced by each aetiology. We verified the validity of this approach experimentally in two studies that examined the phenomenology of VHs in Neurodegenerative and CBS patients, and in people with recent psychedelic experience. These studies confirmed the existence of phenomenological differences across these three dimensions between groups, and crucially, found that the appropriate synthetic VHs were rated as being representative of each group's hallucinatory phenomenology. Together, our findings highlight the phenomenological diversity of VHs associated with distinct causal factors and demonstrate how a neural network model of visual phenomenology can successfully capture the distinctive visual characteristics of hallucinatory experience.
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Affiliation(s)
- Keisuke Suzuki
- Sussex Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
- Department of Informatics, University of Sussex, Brighton, United Kingdom
- Center for Human Nature, Artificial Intelligence and Neuroscience (CHAIN), Hokkaido University, Sapporo, Japan
| | - Anil K. Seth
- Sussex Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
- Department of Informatics, University of Sussex, Brighton, United Kingdom
- Program on Brain, Mind, and Consciousness, Canadian Institute for Advanced Research, Toronto, ON, Canada
| | - David J. Schwartzman
- Sussex Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
- Department of Informatics, University of Sussex, Brighton, United Kingdom
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Schmid FR, Kriegleder MF. Explanatory power by vagueness. Challenges to the strong prior hypothesis on hallucinations exemplified by the Charles-Bonnet-Syndrome. Conscious Cogn 2024; 117:103620. [PMID: 38104388 DOI: 10.1016/j.concog.2023.103620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/30/2023] [Accepted: 12/06/2023] [Indexed: 12/19/2023]
Abstract
Predictive processing models are often ascribed a certain generality in conceptually unifying the relationships between perception, action, and cognition or the potential to posit a 'grand unified theory' of the mind. The limitations of this unification can be seen when these models are applied to specific cognitive phenomena or phenomenal consciousness. Our article discusses these shortcomings for predictive processing models of hallucinations by the example of the Charles-Bonnet-Syndrome. This case study shows that the current predictive processing account omits essential characteristics of stimulus-independent perception in general, which has critical phenomenological implications. We argue that the most popular predictive processing model of hallucinatory conditions - the strong prior hypothesis - fails to fully account for the characteristics of nonveridical perceptual experiences associated with Charles-Bonnet-Syndrome. To fill this explanatory gap, we propose that the strong prior hypothesis needs to include reality monitoring to apply to more than just veridical percepts.
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Affiliation(s)
- Franz Roman Schmid
- Vienna Cognitive Science Hub, University of Vienna, Austria; Vienna Doctoral School in Cognition, Behavior and Neuroscience, University of Vienna, Austria.
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Ćurčić-Blake B, de Vries A, Renken RJ, Marsman JBC, Garrison J, Hugdahl K, Aleman A. Paracingulate Sulcus Length and Cortical Thickness in Schizophrenia Patients With and Without a Lifetime History of Auditory Hallucinations. Schizophr Bull 2023; 49:S48-S57. [PMID: 36840544 PMCID: PMC9960009 DOI: 10.1093/schbul/sbac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND It has been theorized that hallucinations, a common symptom of schizophrenia, are caused by failures in reality monitoring. The paracingulate sulcus (PCS) has been implicated as a brain structure supporting reality monitoring with the absence or shorter length of PCS associated with an occurrence of hallucinations in schizophrenia. The absence or shorter length of PCS has been associated with an occurrence of hallucinations. There are inconsistent findings in the literature regarding the role of the asymmetry of this structure for hallucinations. Here, we investigated the length of the PCS and cortical thickness of surrounding structures in patients with a lifetime history of auditory verbal hallucinations (AVH). DESIGN Seventy-seven patients and twenty-eight healthy controls (HC) underwent an anatomical MRI scan. PCS length and cortical thickness were estimated using Mango brain visualization and FreeSurfer, respectively. Patients with AVH (n = 45) and patients without AVH were compared (n = 32) to the controls. RESULTS PCS length significantly differed between HC and patient groups (F(2,102) = 3.57, P = .032) in the left but not in the right sulcus. We found significantly longer PCS between HC and AVH group but no difference between patient groups. Similarly, we found significant thinning of cortical structures including structures surrounding anterior parts of PCS between HC and patients either in general or per group, but no significant differences were observed between patient groups. CONCLUSIONS PCS length in the left hemisphere is shorter in schizophrenia patients with hallucinations as compared to HC subjects. The patient group without hallucinations was in between those 2 groups. Cortical thickness of neighboring areas of PCS is diminished in patient groups relative to the healthy comparison subjects. The role of lateralization and functional involvement of the PCS region in processes underlying hallucinations, such as reality monitoring, needs further clarification.
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Affiliation(s)
- Branislava Ćurčić-Blake
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annemarie de Vries
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Remco J Renken
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan Bernard C Marsman
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jane Garrison
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Kenneth Hugdahl
- Department of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
- Department of Biological and Medical Psychology, University of Bergen, Norway
| | - André Aleman
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Magnetic Resonance Imaging Center, Shenzhen Key Laboratory of Affective and Social Neuroscience, Center for Brain Disorders and Cognitive Sciences, Shenzhen University, Shenzhen, China
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Lhotka M, Ischebeck A, Helmlinger B, Zaretskaya N. No common factor for illusory percepts, but a link between pareidolia and delusion tendency: A test of predictive coding theory. Front Psychol 2023; 13:1067985. [PMID: 36798645 PMCID: PMC9928206 DOI: 10.3389/fpsyg.2022.1067985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/07/2022] [Indexed: 01/06/2023] Open
Abstract
Predictive coding theory is an influential view of perception and cognition. It proposes that subjective experience of the sensory information results from a comparison between the sensory input and the top-down prediction about this input, the latter being critical for shaping the final perceptual outcome. The theory is able to explain a wide range of phenomena extending from sensory experiences such as visual illusions to complex pathological states such as hallucinations and psychosis. In the current study we aimed at testing the proposed connection between different phenomena explained by the predictive coding theory by measuring the manifestation of top-down predictions at progressing levels of complexity, starting from bistable visual illusions (alternating subjective experience of the same sensory input) and pareidolias (alternative meaningful interpretation of the sensory input) to self-reports of hallucinations and delusional ideations in everyday life. Examining the correlation structure of these measures in 82 adult healthy subjects revealed a positive association between pareidolia proneness and a tendency for delusional ideations, yet without any relationship to bistable illusions. These results show that only a subset of the phenomena that are explained by the predictive coding theory can be attributed to one common underlying factor. Our findings thus support the hierarchical view of predictive processing with independent top-down effects at the sensory and cognitive levels.
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Affiliation(s)
- Magdalena Lhotka
- Department of Cognitive Psychology and Neuroscience, Institute of Psychology, University of Graz, Graz, Austria
| | - Anja Ischebeck
- Department of Cognitive Psychology and Neuroscience, Institute of Psychology, University of Graz, Graz, Austria,BioTechMed-Graz, Graz, Austria
| | - Birgit Helmlinger
- Department of Cognitive Psychology and Neuroscience, Institute of Psychology, University of Graz, Graz, Austria,BioTechMed-Graz, Graz, Austria
| | - Natalia Zaretskaya
- Department of Cognitive Psychology and Neuroscience, Institute of Psychology, University of Graz, Graz, Austria,BioTechMed-Graz, Graz, Austria,*Correspondence: Natalia Zaretskaya, ✉
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Haug E, Øie MG, Svendsen IH, Møller P, Nelson B, Melle I. A seven-year longitudinal study of the association between neurocognitive function and basic self-disorders in schizophrenia. Front Psychol 2023; 14:1124859. [PMID: 36923145 PMCID: PMC10008929 DOI: 10.3389/fpsyg.2023.1124859] [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: 12/15/2022] [Accepted: 02/08/2023] [Indexed: 03/03/2023] Open
Abstract
Introduction Basic self-disorders (SDs) and neurocognitive impairments are fundamental trait-like aspects of schizophrenia spectrum disorders. There has been little research on the association between SDs and neurocognitive impairments in schizophrenia, and no longitudinal studies have investigated if they are related. The aim of this study was to investigate the association between SDs and neurocognitive function in a follow-up study of patients with schizophrenia. Methods SDs and neurocognition were examined in 35 patients with schizophrenia during their first treatment and 7 years later (mean 7.1, SD 0.42). SDs were examined with the Examination of Anomalous Self-Experience (EASE) instrument. The neurocognitive examination included assessments of psychomotor speed, executive- and memory functions. Results Poorer executive functions at baseline were significantly associated with more SDs 7 years later and smaller reductions in SDs over time. There were no significant associations between other neurocognitive functions and SDs. Discussion Executive functions are important for self-regulation, and impairments in these functions in everyday life may have an impact on the development and/or persistence of SDs.
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Affiliation(s)
- Elisabeth Haug
- Department of Acute Psychiatry and Psychosis Treatment, Innlandet Hospital Trust, Brumunddal, Norway
| | - Merete G Øie
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingrid H Svendsen
- Department of Acute Psychiatry and Psychosis Treatment, Innlandet Hospital Trust, Brumunddal, Norway
| | - Paul Møller
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Barnaby Nelson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.,Orygen, Parkville, VIC, Australia
| | - Ingrid Melle
- Norment Centre, University of Oslo, Oslo, Norway.,Norment Centre, Oslo University Hospital, Oslo, Norway
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Tobe M, Nobukawa S, Mizukami K, Kawaguchi M, Higashima M, Tanaka Y, Yamanishi T, Takahashi T. Hub structure in functional network of EEG signals supporting high cognitive functions in older individuals. Front Aging Neurosci 2023; 15:1130428. [PMID: 37139091 PMCID: PMC10149684 DOI: 10.3389/fnagi.2023.1130428] [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: 12/23/2022] [Accepted: 03/15/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Maintaining high cognitive functions is desirable for "wellbeing" in old age and is particularly relevant to a super-aging society. According to their individual cognitive functions, optimal intervention for older individuals facilitates the maintenance of cognitive functions. Cognitive function is a result of whole-brain interactions. These interactions are reflected in several measures in graph theory analysis for the topological characteristics of functional connectivity. Betweenness centrality (BC), which can identify the "hub" node, i.e., the most important node affecting whole-brain network activity, may be appropriate for capturing whole-brain interactions. During the past decade, BC has been applied to capture changes in brain networks related to cognitive deficits arising from pathological conditions. In this study, we hypothesized that the hub structure of functional networks would reflect cognitive function, even in healthy elderly individuals. Method To test this hypothesis, based on the BC value of the functional connectivity obtained using the phase lag index from the electroencephalogram under the eyes closed resting state, we examined the relationship between the BC value and cognitive function measured using the Five Cognitive Functions test total score. Results We found a significant positive correlation of BC with cognitive functioning and a significant enhancement in the BC value of individuals with high cognitive functioning, particularly in the frontal theta network. Discussion The hub structure may reflect the sophisticated integration and transmission of information in whole-brain networks to support high-level cognitive function. Our findings may contribute to the development of biomarkers for assessing cognitive function, enabling optimal interventions for maintaining cognitive function in older individuals.
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Affiliation(s)
- Mayuna Tobe
- Graduate School of Information and Computer Science, Chiba Institute of Technology, Narashino, Japan
| | - Sou Nobukawa
- Graduate School of Information and Computer Science, Chiba Institute of Technology, Narashino, Japan
- Research Center for Mathematical Engineering, Chiba Institute of Technology, Narashino, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- *Correspondence: Sou Nobukawa
| | - Kimiko Mizukami
- Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Megumi Kawaguchi
- Department of Nursing, Faculty of Medical Sciences, University of Fukui, Yoshida, Japan
| | | | | | | | - Tetsuya Takahashi
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Yoshida, Japan
- Uozu Shinkei Sanatorium, Uozu, Japan
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10
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Ortiz de Gortari AB, Diseth Å. Multidimensional assessment of Game Transfer Phenomena: Intrusive cognitions, perceptual distortions, hallucinations and dissociations. Front Psychol 2022; 13:896238. [PMID: 36033066 PMCID: PMC9399741 DOI: 10.3389/fpsyg.2022.896238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/11/2022] [Indexed: 11/21/2022] Open
Abstract
Game Transfer Phenomena (GTP) refers to a cluster of involuntary phenomena related to playing videogames, including sensory and cognitive intrusions, transient changes in perception and self-agency. The Game Transfer Phenomena Scale (GTPS) has been used to measure the frequency of GTP with respect to five factors. The present study aimed to validate an instrument for assessing the multiple dimensions of GTP (GTP-MDS) that helps clarify the distinction between GTP experiences. GTP were contextualized onto the spectrum of intrusive cognitions, perceptual distortions, and dissociations. The relationship between GTP, involuntary phenomena without game content (INVWG) in terms of, e.g., hallucinations and perceptual distortions, and game-biased perceptions (GBPA), as well as the positive and negative impact of GTP and level of distress were also examined. The data were collected using a survey (N = 1,301, male 83.4%, mean age = 28.14). Separate confirmatory factor analyses of the dimensions of "inner intrusions/misperceptions," "outer intrusions/distortions," and "dissociations/mix-ups" produced acceptable fit indices. The findings show that phenomena manifesting as internal experiences are more common, while those manifesting as externalized intrusions are less common. Correlations between the GTP dimensions, INVWG, and GBPA, such as the insertion of game elements in thoughts, perceptions, and dreams, supported convergent validity. The correlations between the GTP dimensions and hours played supported criterion validity. Distress was correlated with outer intrusions and dissociations/mix-ups, but not with inner intrusions. Taken together, these results support the validity and reliability of the proposed assessment of GTP constructs.
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Affiliation(s)
- Angelica B. Ortiz de Gortari
- Faculty of Psychology, Centre for the Science of Learning and Technology, University of Bergen, Bergen, Norway
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology, Speech Therapy and Education Sciences, University of Liège, Liège, Belgium
| | - Åge Diseth
- Faculty of Psychology, University of Bergen, Bergen, Norway
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11
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McGovern HT, Leptourgos P, Hutchinson BT, Corlett PR. Do psychedelics change beliefs? Psychopharmacology (Berl) 2022; 239:1809-1821. [PMID: 35507071 DOI: 10.1007/s00213-022-06153-1] [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] [Received: 02/17/2022] [Accepted: 04/19/2022] [Indexed: 01/29/2023]
Abstract
Renewed interest in psychedelics has reignited the debate about whether and how they change human beliefs. In both the clinical and social-cognitive domains, psychedelic consumption may be accompanied by profound, and sometimes lasting, belief changes. We review these changes and their possible underlying mechanisms. Rather than inducing de novo beliefs, we argue psychedelics may instead change the impact of affect and of others' suggestions on how beliefs are imputed. Critically, we find that baseline beliefs (in the possible effects of psychedelics, for example) might color the acute effects of psychedelics as well as longer-term changes. If we are to harness the apparent potential of psychedelics in the clinic and for human flourishing more generally, these possibilities must be addressed empirically.
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Affiliation(s)
- H T McGovern
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - P Leptourgos
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - B T Hutchinson
- Research School of Psychology, The Australian National University, Canberra, ACT, Australia
| | - P R Corlett
- Department of Psychiatry, Yale University, New Haven, CT, USA.
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12
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Amorim M, Roberto MS, Kotz SA, Pinheiro AP. The perceived salience of vocal emotions is dampened in non-clinical auditory verbal hallucinations. Cogn Neuropsychiatry 2022; 27:169-182. [PMID: 34261424 DOI: 10.1080/13546805.2021.1949972] [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: 01/30/2023]
Abstract
Introduction: Auditory verbal hallucinations (AVH) are a cardinal symptom of schizophrenia but are also reported in the general population without need for psychiatric care. Previous evidence suggests that AVH may reflect an imbalance of prior expectation and sensory information, and that altered salience processing is characteristic of both psychotic and non-clinical voice hearers. However, it remains to be shown how such an imbalance affects the categorisation of vocal emotions in perceptual ambiguity.Methods: Neutral and emotional nonverbal vocalisations were morphed along two continua differing in valence (anger; pleasure), each including 11 morphing steps at intervals of 10%. College students (N = 234) differing in AVH proneness (measured with the Launay-Slade Hallucination Scale) evaluated the emotional quality of the vocalisations.Results: Increased AVH proneness was associated with more frequent categorisation of ambiguous vocalisations as 'neutral', irrespective of valence. Similarly, the perceptual boundary for emotional classification was shifted by AVH proneness: participants needed more emotional information to categorise a voice as emotional.Conclusions: These findings suggest that emotional salience in vocalisations is dampened as a function of increased AVH proneness. This could be related to changes in the acoustic representations of emotions or reflect top-down expectations of less salient information in the social environment.
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Affiliation(s)
- Maria Amorim
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Magda S Roberto
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Sonja A Kotz
- Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, The Netherlands.,Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ana P Pinheiro
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal.,Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, The Netherlands
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13
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McParlin Z, Cerritelli F, Friston KJ, Esteves JE. Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Synchrony. Front Psychol 2022; 13:783694. [PMID: 35250723 PMCID: PMC8892201 DOI: 10.3389/fpsyg.2022.783694] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/19/2022] [Indexed: 12/15/2022] Open
Abstract
Recognizing and aligning individuals' unique adaptive beliefs or "priors" through cooperative communication is critical to establishing a therapeutic relationship and alliance. Using active inference, we present an empirical integrative account of the biobehavioral mechanisms that underwrite therapeutic relationships. A significant mode of establishing cooperative alliances-and potential synchrony relationships-is through ostensive cues generated by repetitive coupling during dynamic touch. Established models speak to the unique role of affectionate touch in developing communication, interpersonal interactions, and a wide variety of therapeutic benefits for patients of all ages; both neurophysiologically and behaviorally. The purpose of this article is to argue for the importance of therapeutic touch in establishing a therapeutic alliance and, ultimately, synchrony between practitioner and patient. We briefly overview the importance and role of therapeutic alliance in prosocial and clinical interactions. We then discuss how cooperative communication and mental state alignment-in intentional communication-are accomplished using active inference. We argue that alignment through active inference facilitates synchrony and communication. The ensuing account is extended to include the role of (C-) tactile afferents in realizing the beneficial effect of therapeutic synchrony. We conclude by proposing a method for synchronizing the effects of touch using the concept of active inference.
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Affiliation(s)
- Zoe McParlin
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
| | - Francesco Cerritelli
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
| | - Karl J. Friston
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, London, United Kingdom
| | - Jorge E. Esteves
- Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy
- Malta ICOM Educational Ltd., Gzira, Malta
- Research Department, University College of Osteopathy, London, United Kingdom
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14
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Dijkstra N, Kok P, Fleming SM. Perceptual reality monitoring: Neural mechanisms dissociating imagination from reality. Neurosci Biobehav Rev 2022; 135:104557. [PMID: 35122782 DOI: 10.1016/j.neubiorev.2022.104557] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 01/12/2022] [Accepted: 01/30/2022] [Indexed: 01/21/2023]
Abstract
There is increasing evidence that imagination relies on similar neural mechanisms as externally triggered perception. This overlap presents a challenge for perceptual reality monitoring: deciding what is real and what is imagined. Here, we explore how perceptual reality monitoring might be implemented in the brain. We first describe sensory and cognitive factors that could dissociate imagery and perception and conclude that no single factor unambiguously signals whether an experience is internally or externally generated. We suggest that reality monitoring is implemented by higher-level cortical circuits that evaluate first-order sensory and cognitive factors to determine the source of sensory signals. According to this interpretation, perceptual reality monitoring shares core computations with metacognition. This multi-level architecture might explain several types of source confusion as well as dissociations between simply knowing whether something is real and actually experiencing it as real. We discuss avenues for future research to further our understanding of perceptual reality monitoring, an endeavour that has important implications for our understanding of clinical symptoms as well as general cognitive function.
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Affiliation(s)
- Nadine Dijkstra
- Wellcome Centre for Human Neuroimaging, University College London, United Kingdom.
| | - Peter Kok
- Wellcome Centre for Human Neuroimaging, University College London, United Kingdom
| | - Stephen M Fleming
- Wellcome Centre for Human Neuroimaging, University College London, United Kingdom; Max Planck UCL Centre for Computational Psychiatry and Aging Research, University College London, United Kingdom; Department of Experimental Psychology, University College London, United Kingdom
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15
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Bachmann T. "Normal" Hallucinations and Attention. Front Neurosci 2021; 15:731600. [PMID: 34557070 PMCID: PMC8452974 DOI: 10.3389/fnins.2021.731600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/06/2021] [Indexed: 12/04/2022] Open
Affiliation(s)
- Talis Bachmann
- School of Law and Institute of Psychology, University of Tartu, Tartu, Estonia
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16
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Mittal VA, Ellman LM, Strauss GP, Walker EF, Corlett PR, Schiffman J, Woods SW, Powers AR, Silverstein SM, Waltz JA, Zinbarg R, Chen S, Williams T, Kenney J, Gold JM. Computerized Assessment of Psychosis Risk. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2021; 6:e210011. [PMID: 34307899 PMCID: PMC8302046 DOI: 10.20900/jpbs.20210011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Early detection and intervention with young people at clinical high risk (CHR) for psychosis is critical for prevention efforts focused on altering the trajectory of psychosis. Early CHR research largely focused on validating clinical interviews for detecting at-risk individuals; however, this approach has limitations related to: (1) specificity (i.e., only 20% of CHR individuals convert to psychosis) and (2) the expertise and training needed to administer these interviews is limited. The purpose of our study is to develop the computerized assessment of psychosis risk (CAPR) battery, consisting of behavioral tasks that require minimal training to administer, can be administered online, and are tied to the neurobiological systems and computational mechanisms implicated in psychosis. The aims of our study are as follows: (1A) to develop a psychosis-risk calculator through the application of machine learning (ML) methods to the measures from the CAPR battery, (1B) evaluate group differences on the risk calculator score and test the hypothesis that the risk calculator score of the CHR group will differ from help-seeking and healthy controls, (1C) evaluate how baseline CAPR battery performance relates to symptomatic outcome two years later (i.e., conversion and symptomatic worsening). These aims will be explored in 500 CHR participants, 500 help-seeking individuals, and 500 healthy controls across the study sites. This project will provide a next-generation CHR battery, tied to illness mechanisms and powered by cutting-edge computational methods that can be used to facilitate the earliest possible detection of psychosis risk.
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Affiliation(s)
- Vijay A. Mittal
- Institutes for Policy Research (IPR) and Innovations in Developmental Sciences (DevSci), Departments of Psychology, Psychiatry, Medical Social Sciences, Northwestern University, Evanston, IL 60208, USA
| | - Lauren M. Ellman
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA
| | - Gregory P. Strauss
- Departments of Psychology and Neuroscience, University of Georgia, Athens, GA 30602, USA
| | - Elaine F. Walker
- Department of Psychology and Program in Neuroscience, Emory University, Atlanta, GA 30322, USA
| | | | - Jason Schiffman
- Department of Psychological Science, 4201 Social and Behavioral Sciences Gateway, University of California, Irvine, CA 92697, USA
| | - Scott W. Woods
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - Albert R. Powers
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - Steven M. Silverstein
- Center for Visual Science, Departments of Psychiatry, Neuroscience and Ophthalmology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - James A. Waltz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
| | - Richard Zinbarg
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA
- The Family Institute at Northwestern University, Evanston, IL 60208, USA
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
| | - Trevor Williams
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA
| | - Joshua Kenney
- Department of Psychiatry, Yale University, New Haven, CT 06519, USA
| | - James M. Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21228, USA
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17
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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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18
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Thakkar KN, Mathalon DH, Ford JM. Reconciling competing mechanisms posited to underlie auditory verbal hallucinations. Philos Trans R Soc Lond B Biol Sci 2021; 376:20190702. [PMID: 33308062 PMCID: PMC7741078 DOI: 10.1098/rstb.2019.0702] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2020] [Indexed: 01/21/2023] Open
Abstract
Perception is not the passive registration of incoming sensory data. Rather, it involves some analysis by synthesis, based on past experiences and context. One adaptive consequence of this arrangement is imagination-the ability to richly simulate sensory experiences, interrogate and manipulate those simulations, in service of action and decision making. In this paper, we will discuss one possible cost of this adaptation, namely hallucinations-perceptions without sensory stimulation, which characterize serious mental illnesses like schizophrenia, but which also occur in neurological illnesses, and-crucially for the present piece-are common also in the non-treatment-seeking population. We will draw upon a framework for imagination that distinguishes voluntary from non-voluntary experiences and explore the extent to which the varieties and features of hallucinations map onto this distinction, with a focus on auditory-verbal hallucinations (AVHs)-colloquially, hearing voices. We will propose that sense of agency for the act of imagining is key to meaningfully dissecting different forms and features of AVHs, and we will outline the neural, cognitive and phenomenological sequelae of this sense. We will conclude that a compelling unifying framework for action, perception and belief-predictive processing-can incorporate observations regarding sense of agency, imagination and hallucination. This article is part of the theme issue 'Offline perception: voluntary and spontaneous perceptual experiences without matching external stimulation'.
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Affiliation(s)
- Katharine N. Thakkar
- Department of Psychology, Michigan State University, East Lansing, MI, USA
- Department of Psychiatry and Behavioral Medicine, Michigan State University, East Lansing, MI, USA
| | - Daniel H. Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA
| | - Judith M. Ford
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA
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19
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Benrimoh D, Sheldon A, Sibarium E, Powers AR. Computational Mechanism for the Effect of Psychosis Community Treatment: A Conceptual Review From Neurobiology to Social Interaction. Front Psychiatry 2021; 12:685390. [PMID: 34385938 PMCID: PMC8353084 DOI: 10.3389/fpsyt.2021.685390] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/18/2021] [Indexed: 11/13/2022] Open
Abstract
The computational underpinnings of positive psychotic symptoms have recently received significant attention. Candidate mechanisms include some combination of maladaptive priors and reduced updating of these priors during perception. A potential benefit of models with such mechanisms is their ability to link multiple levels of explanation, from the neurobiological to the social, allowing us to provide an information processing-based account of how specific alterations in self-self and self-environment interactions result in the experience of positive symptoms. This is key to improving how we understand the experience of psychosis. Moreover, it points us toward more comprehensive avenues for therapeutic research by providing a putative mechanism that could allow for the generation of new treatments from first principles. In order to demonstrate this, our conceptual paper will discuss the application of the insights from previous computational models to an important and complex set of evidence-based clinical interventions with strong social elements, such as coordinated specialty care clinics (CSC) in early psychosis and assertive community treatment (ACT). These interventions may include but also go beyond psychopharmacology, providing, we argue, structure and predictability for patients experiencing psychosis. We develop the argument that this structure and predictability directly counteract the relatively low precision afforded to sensory information in psychosis, while also providing the patient more access to external cognitive resources in the form of providers and the structure of the programs themselves. We discuss how computational models explain the resulting reduction in symptoms, as well as the predictions these models make about potential responses of patients to modifications or to different variations of these interventions. We also link, via the framework of computational models, the patient's experiences and response to interventions to putative neurobiology.
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Affiliation(s)
- David Benrimoh
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Andrew Sheldon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Ely Sibarium
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Albert R Powers
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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20
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Kafadar E, Mittal VA, Strauss GP, Chapman HC, Ellman LM, Bansal S, Gold JM, Alderson-Day B, Evans S, Moffatt J, Silverstein SM, Walker EF, Woods SW, Corlett PR, Powers AR. Modeling perception and behavior in individuals at clinical high risk for psychosis: Support for the predictive processing framework. Schizophr Res 2020; 226:167-175. [PMID: 32593735 PMCID: PMC7774587 DOI: 10.1016/j.schres.2020.04.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 12/16/2022]
Abstract
Early intervention in psychotic spectrum disorders is critical for maximizing key clinical outcomes. While there is some evidence for the utility of intervention during the prodromal phase of the illness, efficacy of interventions is difficult to assess without appropriate risk stratification. This will require biomarkers that robustly help to identify risk level and are also relatively easy to obtain. Recent work highlights the utility of computer-based behavioral tasks for understanding the pathophysiology of psychotic symptoms. Computational modeling of performance on such tasks may be particularly useful because they explicitly and formally link performance and symptom expression. Several recent studies have successfully applied principles of Bayesian inference to understanding the computational underpinnings of hallucinations. Within this framework, hallucinations are seen as arising from an over-weighting of prior beliefs relative to sensory evidence. This view is supported by recently-published data from two tasks: the Conditioned Hallucinations (CH) task, which determines the degree to which participants use expectations in detecting a target tone; and a Sine-Vocoded Speech (SVS) task, in which participants can use prior exposure to speech samples to inform their understanding of degraded speech stimuli. We administered both of these tasks to two samples of participants at clinical high risk for psychosis (CHR; N = 19) and healthy controls (HC; N = 17). CHR participants reported both more conditioned hallucinations and more pre-training SVS detection. In addition, relationships were found between participants' performance on both tasks. On computational modeling of behavior on the CH task, CHR participants demonstrate significantly poorer recognition of task volatility as well as a trend toward higher weighting of priors. A relationship was found between this latter effect and performance on both tasks. Taken together, these results support the assertion that these two tasks may be driven by similar latent factors in perceptual inference, and highlight the potential utility of computationally-based tasks in identifying risk.
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Affiliation(s)
- Eren Kafadar
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Vijay A Mittal
- Northwestern University, Evanston, IL, United States of America
| | | | | | - Lauren M Ellman
- Temple University, Philadelphia, PA, United States of America
| | - Sonia Bansal
- Maryland Psychiatric Research Center, Catonsville, MD, United States of America
| | - James M Gold
- Maryland Psychiatric Research Center, Catonsville, MD, United States of America
| | | | | | | | | | | | - Scott W Woods
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States of America
| | - Philip R Corlett
- 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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21
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Mourgues C, Negreira AM, Quagan B, Mercan NE, Niles H, Kafadar E, Bien C, Kamal F, Powers AR. Development of Voluntary Control Over Voice-Hearing Experiences: Evidence From Treatment-Seeking and Non-Treatment-Seeking Voice-Hearers. SCHIZOPHRENIA BULLETIN OPEN 2020; 1:sgaa052. [PMID: 33196043 PMCID: PMC7643545 DOI: 10.1093/schizbullopen/sgaa052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Voluntary control over voice-hearing experiences is one of the most consistent predictors of functioning among voice-hearers. However, control over voice-hearing experiences is likely to be more nuanced and variable than may be appreciated through coarse clinician-rated measures, which provide little information about how control is conceptualized and developed. We aimed to identify key factors in the evolution of control over voice-hearing experiences in treatment-seeking (N = 7) and non-treatment-seeking (N = 8) voice-hearers. Treatment-seeking voice-hearers were drawn from local chapters of the Connecticut Hearing Voices Network, and non-treatment-seeking voice-hearers were recruited from local spiritually oriented organizations. Both groups participated in a clinical assessment, and a semi-structured interview meant to explore the types of control exhibited and how it is fostered. Using Grounded Theory, we identified that participants from both groups exerted direct and indirect control over their voice-hearing experiences. Participants that developed a spiritual explanatory framework were more likely to exert direct control over the voice-hearing experiences than those that developed a pathologizing framework. Importantly, despite clear differences in explanatory framework and distress because of their experiences, both groups underwent similar trajectories to develop control and acceptance over their voice-hearing experiences. Understanding these factors will be critical in transforming control over voice-hearing experiences from a phenomenological observation to an actionable route for clinical intervention.
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Affiliation(s)
- Catalina Mourgues
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Alyson M Negreira
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Brittany Quagan
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | | | - Halsey Niles
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT.,Yale University School of Medicine, New Haven, CT
| | | | - Claire Bien
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Faria Kamal
- Department of Psychiatry, Columbia University, New York, NY
| | - Albert R Powers
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT.,Yale University School of Medicine, New Haven, CT.,Department of Psychology, Yale University, New Haven, CT
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22
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Leptourgos P, Corlett PR. Embodied Predictions, Agency, and Psychosis. Front Big Data 2020; 3:27. [PMID: 33693400 PMCID: PMC7931869 DOI: 10.3389/fdata.2020.00027] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/14/2020] [Indexed: 01/11/2023] Open
Abstract
Psychotic symptoms, i.e., hallucinations and delusions, involve gross departures from conscious apprehension of consensual reality; respectively, perceiving and believing things that, according to same culture peers, do not obtain. In schizophrenia, those experiences are often related to abnormal sense of control over one's own actions, often expressed as a distorted sense of agency (i.e., passivity symptoms). Cognitive and computational neuroscience have furnished an account of these experiences and beliefs in terms of the brain's generative model of the world, which underwrites inferences to the best explanation of current and future states, in order to behave adaptively. Inference then involves a reliability-based trade off of predictions and prediction errors, and psychotic symptoms may arise as departures from this inference process, either an over- or under-weighting of priors relative to prediction errors. Surprisingly, there is empirical evidence in favor of both positions. Relatedly, there is evidence for both an enhanced and a diminished sense of agency in schizophrenia. How can this be? We argue that there is more than one generative model in the brain, and that ego- and allo-centric models operate in tandem. In brief, ego-centric models implement corollary discharge signals that cancel out the effects of self-generated actions while allo-centric models compare several hypothesis regarding the causes of sensory inputs (including the self among the potential causes). The two parallel hierarchies give rise to different levels of agency, with ego-centric models subserving "feelings of agency" and allo-centric predictions giving rise to "judgements of agency." Those two components are weighted according to their reliability and combined, generating a higher-level "sense of agency." We suggest that in schizophrenia a failure of corollary discharges to suppress self-generated inputs results in the absence of a "feeling of agency" and in a compensatory enhancement of allo-centric priors, which might underlie hallucinations, delusions of control but also, under certain circumstances, the enhancement of "judgments of agency." We discuss the consequences of such a model, and potential courses of action that could lead to its falsification.
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Affiliation(s)
| | - Philip R. Corlett
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT, United States
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23
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Lyndon S, Corlett P. Hallucinations in posttraumatic stress disorder: Insights from predictive coding. JOURNAL OF ABNORMAL PSYCHOLOGY 2020; 129:534-543. [PMID: 32437205 PMCID: PMC10658640 DOI: 10.1037/abn0000531] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Although hallucinations are not one of the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) criteria for posttraumatic stress disorder (PTSD), they are increasingly documented in PTSD. They are noted in the absence of clear delusions, formal thought disorganization, disorganized speech, or behavior, ruling out a comorbid psychotic disorder like schizophrenia as a better explanation for these hallucinations. Hallucinations in both PTSD and schizophrenia share phenomenological features. We propose that hallucinations in PTSD, like those in schizophrenia, might be explained in terms of aberrant predictive coding, specifically the misapplication of strong prior beliefs that vitiate perceptual inference. This approach highlights the broader relationship between trauma and psychosis. Under predictive coding, the nervous system organizes past sensory data into an internal model of the world. Under stress, the brain prioritizes speed over accurate encoding. However, memories for traumatic experiences are typically strongly consolidated, to avoid similar experiences in future. In PTSD, this could lead to a world model comprised of inaccurate but overly precise prior beliefs, that can be triggered by stimuli tangentially related to the index trauma, resulting in hallucinations. Crucially, this evidence accumulation depends upon the relative precision of prior beliefs and sensory evidence (supplied in the form of prediction errors). Our basic argument is that stressful situations induce belief updating, in terms of precise prior beliefs, that are difficult to undo. These unduly precise, trauma-related beliefs then constitute perceptual hypotheses, memories, or narratives that bias subsequent experience. This prior bias may be so severe that sensory evidence is effectively ignored; that is, treated as very imprecise, in relation to prior beliefs. Such an account may lead to cognitive therapies for hallucinations aimed at strong prior beliefs, and the exciting prospect of combining such therapies with drugs that modulate neuroplasticity and enhance the adaptive consolidation of more appropriate priors. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- S. Lyndon
- Yale University, Department of Psychiatry, Connecticut Mental Health Center, 34 Park Street, New Haven, CT, USA, 06511
| | - P.R. Corlett
- Yale University, Department of Psychiatry, Connecticut Mental Health Center, 34 Park Street, New Haven, CT, USA, 06511
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Weilnhammer V, Röd L, Eckert AL, Stuke H, Heinz A, Sterzer P. Psychotic Experiences in Schizophrenia and Sensitivity to Sensory Evidence. Schizophr Bull 2020; 46:927-936. [PMID: 32090246 PMCID: PMC7345814 DOI: 10.1093/schbul/sbaa003] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Perceptual inference depends on an optimal integration of current sensory evidence with prior beliefs about the environment. Alterations of this process have been related to the emergence of positive symptoms in schizophrenia. However, it has remained unclear whether delusions and hallucinations arise from an increased or decreased weighting of prior beliefs relative to sensory evidence. To investigate the relation of this prior-to-likelihood ratio to positive symptoms in schizophrenia, we devised a novel experimental paradigm which gradually manipulates perceptually ambiguous visual stimuli by disambiguating stimulus information. As a proxy for likelihood precision, we assessed the sensitivity of individual participants to sensory evidence. As a surrogate for the precision of prior beliefs in perceptual stability, we measured phase duration in ambiguity. Relative to healthy controls, patients with schizophrenia showed a stronger increment in congruent perceptual states for increasing levels of disambiguating stimulus evidence. Sensitivity to sensory evidence correlated positively with the individual patients' severity of perceptual anomalies and hallucinations. Moreover, the severity of such experiences correlated negatively with phase duration. Our results indicate that perceptual anomalies and hallucinations are associated with a shift of perceptual inference toward sensory evidence and away from prior beliefs. This reduced prior-to-likelihood ratio in sensory processing may contribute to the phenomenon of aberrant salience, which has been suggested to give rise to the false inferences underlying psychotic experiences.
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Affiliation(s)
- Veith Weilnhammer
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Lukas Röd
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anna-Lena Eckert
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Heiner Stuke
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Philipp Sterzer
- Department of Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Charité Universitätsmedizin Berlin, Berlin, Germany
- Einstein Center for Neurosciences Berlin, Charite Universitatsmedizin Berlin, Berlin, Germany
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25
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Walpola IC, Muller AJ, Hall JM, Andrews-Hanna JR, Irish M, Lewis SJ, Shine JM, O'Callaghan C. Mind-wandering in Parkinson's disease hallucinations reflects primary visual and default network coupling. Cortex 2020; 125:233-245. [DOI: 10.1016/j.cortex.2019.12.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/26/2019] [Accepted: 12/22/2019] [Indexed: 11/25/2022]
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Vasil J, Badcock PB, Constant A, Friston K, Ramstead MJD. A World Unto Itself: Human Communication as Active Inference. Front Psychol 2020; 11:417. [PMID: 32269536 PMCID: PMC7109408 DOI: 10.3389/fpsyg.2020.00417] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 02/24/2020] [Indexed: 01/12/2023] Open
Abstract
Recent theoretical work in developmental psychology suggests that humans are predisposed to align their mental states with those of other individuals. One way this manifests is in cooperative communication; that is, intentional communication aimed at aligning individuals' mental states with respect to events in their shared environment. This idea has received strong empirical support. The purpose of this paper is to extend this account by proposing an integrative model of the biobehavioral dynamics of cooperative communication. Our formulation is based on active inference. Active inference suggests that action-perception cycles operate to minimize uncertainty and optimize an individual's internal model of the world. We propose that humans are characterized by an evolved adaptive prior belief that their mental states are aligned with, or similar to, those of conspecifics (i.e., that 'we are the same sort of creature, inhabiting the same sort of niche'). The use of cooperative communication emerges as the principal means to gather evidence for this belief, allowing for the development of a shared narrative that is used to disambiguate interactants' (hidden and inferred) mental states. Thus, by using cooperative communication, individuals effectively attune to a hermeneutic niche composed, in part, of others' mental states; and, reciprocally, attune the niche to their own ends via epistemic niche construction. This means that niche construction enables features of the niche to encode precise, reliable cues about the deontic or shared value of certain action policies (e.g., the utility of using communicative constructions to disambiguate mental states, given expectations about shared prior beliefs). In turn, the alignment of mental states (prior beliefs) enables the emergence of a novel, contextualizing scale of cultural dynamics that encompasses the actions and mental states of the ensemble of interactants and their shared environment. The dynamics of this contextualizing layer of cultural organization feedback, across scales, to constrain the variability of the prior expectations of the individuals who constitute it. Our theory additionally builds upon the active inference literature by introducing a new set of neurobiologically plausible computational hypotheses for cooperative communication. We conclude with directions for future research.
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Affiliation(s)
- Jared Vasil
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | - Paul B. Badcock
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
- Orygen, Melbourne, VIC, Australia
| | - Axel Constant
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- Culture, Mind, and Brain Program, McGill University, Montreal, QC, Canada
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
| | - Karl Friston
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
| | - Maxwell J. D. Ramstead
- Culture, Mind, and Brain Program, McGill University, Montreal, QC, Canada
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, QC, Canada
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27
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Smailes D, Burdis E, Gregoriou C, Fenton B, Dudley R. Pareidolia-proneness, reality discrimination errors, and visual hallucination-like experiences in a non-clinical sample. Cogn Neuropsychiatry 2020; 25:113-125. [PMID: 31810425 DOI: 10.1080/13546805.2019.1700789] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: It has been proposed that hallucinations occur because of problems with reality discrimination (when internal, self-generated cognitions are misattributed to an external, non-self source) and because of elevated levels of top-down processing. In this study, we examined whether visual reality discrimination abilities and elevated top-down processing (assessed via face pareidolia-proneness) were associated with how often non-clinical participants report visual hallucination-like experiences.Methods: Participants (N = 82, mean age = 23.12 years) completed a visual reality discrimination task and a face pareidolia task, as well as self-report measures of schizotypy and of the frequency of visual hallucination-like experiences.Results: Regression analysis demonstrated that the number of false alarms made on the visual reality discrimination task and the number of hits made on the face pareidolia task were independent predictors of the frequency of visual hallucination-like experiences. Correlations between performance on the tasks and levels of schizotypy were not statistically significant.Conclusions: These findings suggest that weaker visual reality discrimination abilities and elevated levels of top-down processing are associated with visual hallucination-proneness and are discussed in terms of the idea that clinical visual hallucinations and non-clinical visual hallucination-like experiences share similar cognitive mechanisms.
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Affiliation(s)
- David Smailes
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK.,Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Emma Burdis
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | | | - Bryony Fenton
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
| | - Rob Dudley
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Gateshead, UK
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28
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Sinapayen L, Masumori A, Ikegami T. Reactive, Proactive, and Inductive Agents: An Evolutionary Path for Biological and Artificial Spiking Networks. Front Comput Neurosci 2020; 13:88. [PMID: 32038209 PMCID: PMC6987297 DOI: 10.3389/fncom.2019.00088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022] Open
Abstract
Complex environments provide structured yet variable sensory inputs. To best exploit information from these environments, organisms must evolve the ability to anticipate consequences of new stimuli, and act on these predictions. We propose an evolutionary path for neural networks, leading an organism from reactive behavior to simple proactive behavior and from simple proactive behavior to induction-based behavior. Based on earlier in-vitro and in-silico experiments, we define the conditions necessary in a network with spike-timing dependent plasticity for the organism to go from reactive to proactive behavior. Our results support the existence of specific evolutionary steps and four conditions necessary for embodied neural networks to evolve predictive and inductive abilities from an initial reactive strategy.
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Affiliation(s)
- Lana Sinapayen
- Sony Computer Science Laboratories, Inc., Tokyo, Japan.,Earth-Life Science Institute, Tokyo Institute of Technology, Tokyo, Japan
| | - Atsushi Masumori
- Department of General Systems Studies, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Takashi Ikegami
- Department of General Systems Studies, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
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29
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de Boer JN, Linszen MMJ, de Vries J, Schutte MJL, Begemann MJH, Heringa SM, Bohlken MM, Hugdahl K, Aleman A, Wijnen FNK, Sommer IEC. Auditory hallucinations, top-down processing and language perception: a general population study. Psychol Med 2019; 49:2772-2780. [PMID: 30606279 PMCID: PMC6877468 DOI: 10.1017/s003329171800380x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 11/13/2018] [Accepted: 11/21/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Studies investigating the underlying mechanisms of hallucinations in patients with schizophrenia suggest that an imbalance in top-down expectations v. bottom-up processing underlies these errors in perception. This study evaluates this hypothesis by testing if individuals drawn from the general population who have had auditory hallucinations (AH) have more misperceptions in auditory language perception than those who have never hallucinated. METHODS We used an online survey to determine the presence of hallucinations. Participants filled out the Questionnaire for Psychotic Experiences and participated in an auditory verbal recognition task to assess both correct perceptions (hits) and misperceptions (false alarms). A hearing test was performed to screen for hearing problems. RESULTS A total of 5115 individuals from the general Dutch population participated in this study. Participants who reported AH in the week preceding the test had a higher false alarm rate in their auditory perception compared with those without such (recent) experiences. The more recent the AH were experienced, the more mistakes participants made. While the presence of verbal AH (AVH) was predictive for false alarm rate in auditory language perception, the presence of non-verbal or visual hallucinations were not. CONCLUSIONS The presence of AVH predicted false alarm rate in auditory language perception, whereas the presence of non-verbal auditory or visual hallucinations was not, suggesting that enhanced top-down processing does not transfer across modalities. More false alarms were observed in participants who reported more recent AVHs. This is in line with models of enhanced influence of top-down expectations in persons who hallucinate.
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Affiliation(s)
- J. N. de Boer
- Department of Psychiatry, University Medical Center Utrecht, Utrecht University & Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - M. M. J. Linszen
- Department of Neuroscience and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - J. de Vries
- Department of Psychiatry, University Medical Center Utrecht, Utrecht University & Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - M. J. L. Schutte
- Department of Neuroscience and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M. J. H. Begemann
- Department of Neuroscience and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - S. M. Heringa
- Department of Psychiatry, University Medical Center Utrecht, Utrecht University & Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - M. M. Bohlken
- Department of Psychiatry, University Medical Center Utrecht, Utrecht University & Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - K. Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - A. Aleman
- Department of Neuroscience and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - F. N. K. Wijnen
- Utrecht University, Utrecht Institute of Linguistics OTS, Utrecht, The Netherlands
| | - I. E. C. Sommer
- Department of Neuroscience and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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30
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Fernyhough C. Modality-general and modality-specific processes in hallucinations. Psychol Med 2019; 49:2639-2645. [PMID: 31530334 PMCID: PMC6877466 DOI: 10.1017/s0033291719002496] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 08/12/2019] [Accepted: 08/27/2019] [Indexed: 02/07/2023]
Abstract
There is a growing recognition in psychosis research of the importance of hallucinations in modalities other than the auditory. This has focused attention on cognitive and neural processes that might be shared by, and which might contribute distinctly to, hallucinations in different modalities. In this article, I address some issues around the modality-generality of cognitive and neural processes in hallucinations, including the role of perceptual and reality-monitoring systems, top-down and bottom-up processes in relation to the psychological and neural substrates of hallucinations, and the phenomenon of simultaneous multimodal hallucinations of the same entity. I suggest that a functional systems approach, inspired by some neglected aspects of the writings of A. R. Luria, can help us to understand patterns of hallucinatory experience across modalities and across clinical and non-clinical groups. Understanding the interplay between modality-general and modality-specific processes may bear fruit for improved diagnosis and therapeutic approaches to dealing with distressing hallucinations.
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31
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Dijkstra N, Hinne M, Bosch SE, van Gerven MAJ. Between-subject variability in the influence of mental imagery on conscious perception. Sci Rep 2019; 9:15658. [PMID: 31666592 PMCID: PMC6821778 DOI: 10.1038/s41598-019-52072-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 10/08/2019] [Indexed: 11/24/2022] Open
Abstract
Mental imagery and visual perception rely on similar neural mechanisms, but the function of this overlap remains unclear. One idea is that imagery can influence perception. Previous research has shown that imagining a stimulus prior to binocular presentation of rivalling stimuli increases the chance of perceiving the imagined stimulus. In this study we investigated how this effect interacts with bottom-up sensory input by comparing psychometric response curves for congruent and incongruent imagery in humans. A Bayesian hierarchical model was used, allowing us to simultaneously study group-level effects as well as effects for individual participants. We found strong effects of both imagery as well as its interaction with sensory evidence within individual participants. However, the direction of these effects were highly variable between individuals, leading to weak effects at the group level. This highlights the heterogeneity of conscious perception and emphasizes the need for individualized investigation of such complex cognitive processes.
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Affiliation(s)
- N Dijkstra
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
| | - M Hinne
- University of Amsterdam, Amsterdam, The Netherlands
| | - S E Bosch
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - M A J van Gerven
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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32
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Niles HF, Walsh BC, Woods SW, Powers AR. Does hallucination perceptual modality impact psychosis risk? Acta Psychiatr Scand 2019; 140:360-370. [PMID: 31355420 PMCID: PMC6752971 DOI: 10.1111/acps.13078] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Subthreshold perceptual abnormalities are commonly used to identify individuals at clinical high risk (CHR) for developing a psychotic disorder. Predictive validity for modality-specific perceptual abnormality severity on psychosis risk is unknown. METHODS We examined prospectively collected data from 164 individuals age 12-35 meeting criteria for CHR followed for 6-24 months or until conversion to psychosis. Using intake interview notes, baseline perceptual abnormality scores were split into auditory, visual, somatic/tactile, and olfactory/gustatory components, and auditory scores were further split into those for verbal vs non-verbal content. Relationships between perceptual abnormality characteristics and conversion were assessed with Cox proportional hazards regression and logistic regression. RESULTS Unusual thought content and paranoia were predictive of conversion, but no modality-specific perceptual abnormality score predicted conversion status or days to conversion. However, when auditory perceptual abnormalities were further categorized as verbal vs non-verbal, the severity of verbal experiences was predictive of conversion to psychosis (P = 0.007). CONCLUSIONS Perceptual abnormality scores failed to meaningfully predict conversion to psychosis in either direction in this CHR sample. However, verbal auditory experiences may identify a group of CHR individuals at elevated risk of conversion. Further exploration of the relationship between phenomenological aspects of perceptual abnormalities and conversion risk is warranted.
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Affiliation(s)
- Halsey F. Niles
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Barbara C. Walsh
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Scott W. Woods
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Albert R. Powers
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
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Zarkali A, Adams RA, Psarras S, Leyland LA, Rees G, Weil RS. Increased weighting on prior knowledge in Lewy body-associated visual hallucinations. Brain Commun 2019; 1:fcz007. [PMID: 31886459 PMCID: PMC6924538 DOI: 10.1093/braincomms/fcz007] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/03/2019] [Accepted: 07/26/2019] [Indexed: 01/25/2023] Open
Abstract
Hallucinations are a common and distressing feature of many psychiatric and neurodegenerative conditions. In Lewy body disease, visual hallucinations are a defining feature, associated with worse outcomes; yet their mechanisms remain unclear and treatment options are limited. Here, we show that hallucinations in Lewy body disease are associated with altered integration of top-down predictions with incoming sensory evidence, specifically with an increased relative weighting of prior knowledge. We tested 37 individuals with Lewy body disease, 17 habitual hallucinators and 20 without hallucinations, and 20 age-matched healthy individuals. We employed an image-based learning paradigm to test whether people with Lewy body disease and visual hallucinations show higher dependence on prior knowledge. We used two-tone images that are difficult to disambiguate without any prior information but generate a strong percept when information is provided. We measured discrimination sensitivity before and after this information was provided. We observed that in people with Lewy body disease who experience hallucinations, there was greater improvement in discrimination sensitivity after information was provided, compared to non-hallucinators and controls. This suggests that people with Lewy body disease and hallucinations place higher relative weighting on prior knowledge than those who do not hallucinate. Importantly, increased severity of visual hallucinations was associated with an increased effect of prior knowledge. Together these findings suggest that visual hallucinations in Lewy body disease are linked to a shift towards top-down influences on perception and away from sensory evidence, perhaps due to an increase in sensory noise. This provides important mechanistic insights to how hallucinations develop in Lewy body disease, with potential for revealing new therapeutic targets.
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Affiliation(s)
- Angeliki Zarkali
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, UK,Correspondence to: Angeliki Zarkali Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, UK E-mail:
| | - Rick A Adams
- Max Planck Centre for Computational Psychiatry and Aging Research, University College London, 10-12 Russell Square, London WC1B 5EH, UK,Department of Computer Science, University College London, Gower Street, London WC1E 6BT, UK
| | - Stamatios Psarras
- Space Syntax Laboratory, University College London, 14 Upper Woburn Place, London WC1H 0NN, UK
| | - Louise-Ann Leyland
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, UK
| | - Geraint Rees
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London WC1N 3AR, UK,Welcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London WC1N 3AR, UK
| | - Rimona S Weil
- Dementia Research Centre, University College London, 8-11 Queen Square, London WC1N 3AR, UK,Welcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London WC1N 3AR, UK
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34
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Kantrowitz JT, Sehatpour P, Avissar M, Horga G, Gwak A, Hoptman MJ, Beggel O, Girgis RR, Vail B, Silipo G, Carlson M, Javitt DC. Significant improvement in treatment resistant auditory verbal hallucinations after 5 days of double-blind, randomized, sham controlled, fronto-temporal, transcranial direct current stimulation (tDCS): A replication/extension study. Brain Stimul 2019; 12:981-991. [PMID: 30922713 PMCID: PMC9896410 DOI: 10.1016/j.brs.2019.03.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/12/2019] [Accepted: 03/04/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is a potentially novel treatment for antipsychotic-resistant auditory verbal hallucinations (AVH) in schizophrenia. Nevertheless, results have been mixed across studies. METHODS 89 schizophrenia/schizoaffective subjects (active: 47; Sham: 42) were randomized to five days of twice-daily 20-min active tDCS vs. sham treatments across two recruitment sites. AVH severity was assessed using the Auditory Hallucination Rating Scale (AHRS) total score. To assess target engagement, MRI was obtained in a sub sample. RESULTS We observed a statistically significant, moderate effect-size change in AHRS total score across one-week and one-month favoring active treatment following covariation for baseline symptoms and antipsychotic dose (p = 0.036; d = 0.48). Greatest change was observed on the AHRS loudness item (p = 0.003; d = 0.69). In exploratory analyses, greatest effects on AHRS were observed in patients with lower cognitive symptoms (d = 0.61). In target engagement analysis, suprathreshold mean field-strength (>0.2 V/m) was seen within language-sensitive regions. However, off-target field-strength, which correlated significantly with less robust clinical response, was observed in anterior regions. CONCLUSIONS This is the largest study of tDCS for persistent AVH conducted to date. We replicate previous reports of significant therapeutic benefit, but only if medication dosage is considered, with patients receiving lowest medication dosage showing greatest effect. Response was also greatest in patients with lowest levels of cognitive symptoms. Overall, these findings support continued development of tDCS for persistent AVH, but also suggest that response may be influenced by specific patient and treatment characteristics. CLINICALTRIALS.GOV: NCT01898299.
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Affiliation(s)
- Joshua T Kantrowitz
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, 10962, USA; Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, USA; Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, 10032, USA.
| | - Pejman Sehatpour
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, 10962, USA; Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, USA; Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Michael Avissar
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, USA; Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Guillermo Horga
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, USA; Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Anna Gwak
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, USA; Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Mathew J Hoptman
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, 10962, USA; Department of Psychiatry, NYU School of Medicine, New York, NY, 10016, USA
| | - Odeta Beggel
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, 10962, USA
| | - Ragy R Girgis
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, USA; Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Blair Vail
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, USA; Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Gail Silipo
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, 10962, USA
| | - Marlene Carlson
- Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, USA; Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Daniel C Javitt
- Schizophrenia Research Center, Nathan Kline Institute, Orangeburg, NY, 10962, USA; Division of Experimental Therapeutics, Department of Psychiatry, Columbia University, USA; Division of Experimental Therapeutics, Department of Psychiatry, New York State Psychiatric Institute, New York, NY, 10032, USA
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Corlett PR. Factor one, familiarity and frontal cortex: a challenge to the two-factor theory of delusions. Cogn Neuropsychiatry 2019; 24:165-177. [PMID: 31010382 PMCID: PMC6686846 DOI: 10.1080/13546805.2019.1606706] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Two-factor theory suggests delusions require two neuropsychological impairments, one in perception (which furnishes content), and a second in belief evaluation (that augers formation and maintenance). Capgras delusion; the belief that one's loved one has been replaced by an imposter, then entails two independent processes; first a lack of skin conductance response to familiar faces so the loved one feels different. This has been demonstrated in four patients with damage to the ventromedial prefrontal cortex (vmPFC) but who do not have delusions. Thus two-factor theorists demand a second factor: a change in belief evaluation, which is associated with damage to the right dorsolateral prefrontal cortex (rDLPFC). METHODS Literature review of foundational and related papers on the cognitive neuropsychology of delusions, perception and belief. RESULTS The four vmPFC patients appear together in another publication, uncited by two-factor theorists, in which the full extent of their damage is documented. These four cases not only lack skin responses to familiar faces, but lack responses to salient psychological stimuli more generally, which challenges factor one. They also have damage outside vmPFC, including damage to rDLPFC, which challenges factor two. CONCLUSION Two-factor theory is found lacking and should be reappraised.
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Affiliation(s)
- Philip R. Corlett
- Department of Psychiatry, Yale University, School of Medicine. New Haven, CT, USA,Corresponding author.
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Alderson-Day B, Smailes D, Moffatt J, Mitrenga K, Moseley P, Fernyhough C. Intentional inhibition but not source memory is related to hallucination-proneness and intrusive thoughts in a university sample. Cortex 2019; 113:267-278. [PMID: 30716609 PMCID: PMC6459394 DOI: 10.1016/j.cortex.2018.12.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/01/2018] [Accepted: 12/19/2018] [Indexed: 11/29/2022]
Abstract
Proneness to unusual perceptual states - such as auditory or visual hallucinations - has been proposed to exist on a continuum in the general population, but whether there is a cognitive basis for such a continuum remains unclear. Intentional cognitive inhibition (the ability to wilfully control thoughts and memories) is one mechanism that has been linked to auditory hallucination susceptibility, but most evidence to date has been drawn from clinical samples only. Moreover, such a link has yet to be demonstrated over and above relations to other cognitive skills (source monitoring) and cognitive states (intrusive thoughts) that often correlate with both inhibition and hallucinations. The present study deployed two tests of intentional inhibition ability - the Inhibition of Currently Irrelevant Memories (ICIM) task and Directed Forgetting (DF) task - and one test of source monitoring (a source memory task) to examine how cognitive task performance relates to self-reported i) auditory hallucination-proneness and ii) susceptibility to intrusive thoughts in a non-clinical student sample (N = 76). Hierarchical regression analyses were used to assess the independent and combined contributions of task performance to proneness scores. ICIM performance but not DF or source memory scores were significantly related to both hallucination-proneness and intrusive thoughts. Further analysis suggested that intrusive thoughts may mediate the link between intentional inhibition skills and auditory hallucination-proneness, suggesting a potential pathway from inhibition to perception via intrusions in cognition. The implications for studying cognitive mechanisms of hallucination and their role in "continuum" views of psychosis-like experiences are discussed.
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Affiliation(s)
| | - David Smailes
- Department of Psychology, University of Northumbria, Newcastle-Upon-Tyne, UK
| | - Jamie Moffatt
- Department of Psychology, Durham University, Durham, UK; School of Psychology, University of Sussex, Falmer, UK
| | - Kaja Mitrenga
- Department of Psychology, Durham University, Durham, UK
| | - Peter Moseley
- Department of Psychology, Durham University, Durham, UK; Department of Psychology, University of Central Lancashire, Preston, UK
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Hall JM, O’Callaghan C, Muller AJ, Ehgoetz Martens KA, Phillips JR, Moustafa AA, Lewis SJG, Shine JM. Changes in structural network topology correlate with severity of hallucinatory behavior in Parkinson's disease. Netw Neurosci 2019; 3:521-538. [PMID: 30984905 PMCID: PMC6444885 DOI: 10.1162/netn_a_00078] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 12/21/2018] [Indexed: 12/13/2022] Open
Abstract
Inefficient integration between bottom-up visual input and higher order visual processing regions is implicated in visual hallucinations in Parkinson's disease (PD). Here, we investigated white matter contributions to this perceptual imbalance hypothesis. Twenty-nine PD patients were assessed for hallucinatory behavior. Hallucination severity was correlated to connectivity strength of the network using the network-based statistic approach. The results showed that hallucination severity was associated with reduced connectivity within a subnetwork that included the majority of the diverse club. This network showed overall greater between-module scores compared with nodes not associated with hallucination severity. Reduced between-module connectivity in the lateral occipital cortex, insula, and pars orbitalis and decreased within-module connectivity in the prefrontal, somatosensory, and primary visual cortices were associated with hallucination severity. Conversely, hallucination severity was associated with increased between- and within-module connectivity in the orbitofrontal and temporal cortex, as well as regions comprising the dorsal attentional and default mode network. These results suggest that hallucination severity is associated with marked alterations in structural network topology with changes in participation along the perceptual hierarchy. This may result in the inefficient transfer of information that gives rise to hallucinations in PD.
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Affiliation(s)
- Julie M. Hall
- School of Social Sciences and Psychology, Western Sydney University, Milperra, NSW, Australia
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - Claire O’Callaghan
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Alana J. Muller
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | | | - Joseph R. Phillips
- School of Social Sciences and Psychology, Western Sydney University, Milperra, NSW, Australia
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - Ahmed A. Moustafa
- School of Social Sciences and Psychology, Western Sydney University, Milperra, NSW, Australia
- MARCS Institute, Western Sydney University, Milperra, NSW, Australia
| | - Simon J. G. Lewis
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - James M. Shine
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
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Perceptual phenomena in destructured sensory fields: Probing the brain’s intrinsic functional architectures. Neurosci Biobehav Rev 2019; 98:265-286. [DOI: 10.1016/j.neubiorev.2019.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 01/13/2019] [Accepted: 01/14/2019] [Indexed: 12/20/2022]
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Fleming LM, Javitt DC, Carter CS, Kantrowitz JT, Girgis RR, Kegeles LS, Ragland JD, Maddock RJ, Lesh TA, Tanase C, Robinson J, Potter WZ, Carlson M, Wall MM, Choo TH, Grinband J, Lieberman J, Krystal JH, Corlett PR. A multicenter study of ketamine effects on functional connectivity: Large scale network relationships, hubs and symptom mechanisms. NEUROIMAGE-CLINICAL 2019; 22:101739. [PMID: 30852397 PMCID: PMC6411494 DOI: 10.1016/j.nicl.2019.101739] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/24/2019] [Accepted: 02/27/2019] [Indexed: 12/14/2022]
Abstract
Ketamine is an uncompetitive N-methyl-d-aspartate (NMDA) glutamate receptor antagonist. It induces effects in healthy individuals that mimic symptoms associated with schizophrenia. We sought to root these experiences in altered brain function, specifically aberrant resting state functional connectivity (rsfMRI). In the present study, we acquired rsfMRI data under ketamine and placebo in a between-subjects design and analyzed seed-based measures of rsfMRI using large-scale networks, dorsolateral prefrontal cortex (DLPFC) and sub-nuclei of the thalamus. We found ketamine-induced alterations in rsfMRI connectivity similar to those seen in patients with schizophrenia, some changes that may be more comparable to early stages of schizophrenia, and other connectivity signatures seen in patients that ketamine did not recreate. We do not find any circuits from our regions of interest that correlates with positive symptoms of schizophrenia in our sample, although we find that DLPFC connectivity with ACC does correlate with a mood measure. These results provide support for ketamine's use as a model of certain biomarkers of schizophrenia, particularly for early or at-risk patients. Ketamine altered connectivity in default mode network, thalamus and DLPFC at rest. Similar patterns of altered connectivity are seen with ketamine as in psychotic patients. Mood symptoms correlated with DLPFC connectivity with ACC and frontal orbital cortex.
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Affiliation(s)
- Leah M Fleming
- Department of Psychiatry, Yale University, New Haven, CT, United States of America; Interdepartmental Neuroscience Program, Yale University, New Haven, CT, United States of America
| | - Daniel C Javitt
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America; Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, NY, United States of America
| | - Cameron S Carter
- Department of Psychiatry, University of California, Davis, United States of America
| | - Joshua T Kantrowitz
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America; Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, NY, United States of America
| | - Ragy R Girgis
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - Lawrence S Kegeles
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - John D Ragland
- Department of Psychiatry, University of California, Davis, United States of America
| | - Richard J Maddock
- Department of Psychiatry, University of California, Davis, United States of America
| | - Tyler A Lesh
- Department of Psychiatry, University of California, Davis, United States of America
| | - Costin Tanase
- Department of Psychiatry, University of California, Davis, United States of America
| | - James Robinson
- Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, NY, United States of America
| | - William Z Potter
- National Institute of Mental Health, Rockville, MD, United States of America
| | - Marlene Carlson
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - Melanie M Wall
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America; National Institute of Mental Health, Rockville, MD, United States of America
| | - Tse-Hwei Choo
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - Jack Grinband
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - Jeffrey Lieberman
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, United States of America
| | - John H Krystal
- Department of Psychiatry, Yale University, New Haven, CT, United States of America
| | - Philip R Corlett
- Department of Psychiatry, Yale University, New Haven, CT, United States of America.
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Corlett PR, Horga G, Fletcher PC, Alderson-Day B, Schmack K, Powers AR. Hallucinations and Strong Priors. Trends Cogn Sci 2019; 23:114-127. [PMID: 30583945 PMCID: PMC6368358 DOI: 10.1016/j.tics.2018.12.001] [Citation(s) in RCA: 242] [Impact Index Per Article: 48.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/01/2018] [Accepted: 12/04/2018] [Indexed: 01/25/2023]
Abstract
Hallucinations, perceptions in the absence of objectively identifiable stimuli, illustrate the constructive nature of perception. Here, we highlight the role of prior beliefs as a critical elicitor of hallucinations. Recent empirical work from independent laboratories shows strong, overly precise priors can engender hallucinations in healthy subjects and that individuals who hallucinate in the real world are more susceptible to these laboratory phenomena. We consider these observations in light of work demonstrating apparently weak, or imprecise, priors in psychosis. Appreciating the interactions within and between hierarchies of inference can reconcile this apparent disconnect. Data from neural networks, human behavior, and neuroimaging support this contention. This work underlines the continuum from normal to aberrant perception, encouraging a more empathic approach to clinical hallucinations.
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Affiliation(s)
| | - Guillermo Horga
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Paul C Fletcher
- Department of Psychiatry, University of Cambridge, Cambridge, UK; The Cambridgeshire and Peteborough NHS Foundation Trust, Elizabeth House, Fulbourn Hospital, Cambridge, UK
| | | | | | - Albert R Powers
- Department of Psychiatry, Yale University, New Haven, CT, USA
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Rollins CP, Garrison JR, Simons JS, Rowe JB, O'Callaghan C, Murray GK, Suckling J. Meta-analytic Evidence for the Plurality of Mechanisms in Transdiagnostic Structural MRI Studies of Hallucination Status. EClinicalMedicine 2019; 8:57-71. [PMID: 31193632 PMCID: PMC6537703 DOI: 10.1016/j.eclinm.2019.01.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/15/2019] [Accepted: 01/27/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Hallucinations are transmodal and transdiagnostic phenomena, occurring across sensory modalities and presenting in psychiatric, neurodegenerative, neurological, and non-clinical populations. Despite their cross-category occurrence, little empirical work has directly compared between-group neural correlates of hallucinations. METHODS We performed whole-brain voxelwise meta-analyses of hallucination status across diagnoses using anisotropic effect-size seed-based d mapping (AES-SDM), and conducted a comprehensive systematic review in PubMed and Web of Science until May 2018 on other structural correlates of hallucinations, including cortical thickness and gyrification. FINDINGS 3214 abstracts were identified. Patients with psychiatric disorders and hallucinations (eight studies) exhibited reduced gray matter (GM) in the left insula, right inferior frontal gyrus, left anterior cingulate/paracingulate gyrus, left middle temporal gyrus, and increased in the bilateral fusiform gyrus, while patients with neurodegenerative disorders with hallucinations (eight studies) showed GM decreases in the left lingual gyrus, right supramarginal gyrus/parietal operculum, left parahippocampal gyrus, left fusiform gyrus, right thalamus, and right lateral occipital gyrus. Group differences between psychiatric and neurodegenerative hallucination meta-analyses were formally confirmed using Monte Carlo randomizations to determine statistical significance, and a jackknife sensitivity analysis established the reproducibility of results across nearly all study combinations. For other structural measures (28 studies), the most consistent findings associated with hallucination status were reduced cortical thickness in temporal gyri in schizophrenia and altered hippocampal volume in Parkinson's disease and dementia. Additionally, increased severity of hallucinations in schizophrenia correlated with GM reductions within the left superior temporal gyrus, right middle temporal gyrus, bilateral supramarginal and angular gyri. INTERPRETATION Distinct patterns of neuroanatomical alteration characterize hallucination status in patients with psychiatric and neurodegenerative diseases, suggesting a plurality of anatomical signatures. This approach has implications for treatment, theoretical frameworks, and generates refutable predictions for hallucinations in other diseases and their occurrence within the general population. FUNDING None.
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Affiliation(s)
- Colleen P.E. Rollins
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Corresponding author at: Department of Psychiatry, University of Cambridge, Cambridge CB2 0SP, UK
| | - Jane R. Garrison
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Jon S. Simons
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - James B. Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Supekar K, Cai W, Krishnadas R, Palaniyappan L, Menon V. Dysregulated Brain Dynamics in a Triple-Network Saliency Model of Schizophrenia and Its Relation to Psychosis. Biol Psychiatry 2019; 85:60-69. [PMID: 30177256 DOI: 10.1016/j.biopsych.2018.07.020] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 07/08/2018] [Accepted: 07/09/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Schizophrenia is a highly disabling psychiatric disorder characterized by a range of positive "psychosis" symptoms. However, the neurobiology of psychosis and associated systems-level disruptions in the brain remain poorly understood. Here, we test an aberrant saliency model of psychosis, which posits that dysregulated dynamic cross-network interactions among the salience network (SN), central executive network, and default mode network contribute to positive symptoms in patients with schizophrenia. METHODS Using task-free functional magnetic resonance imaging data from two independent cohorts, we examined 1) dynamic time-varying cross-network interactions among the SN, central executive network, and default mode network in 130 patients with schizophrenia versus well-matched control subjects; 2) accuracy of a saliency model-based classifier for distinguishing dynamic brain network interactions in patients versus control subjects; and 3) the relation between SN-centered network dynamics and clinical symptoms. RESULTS In both cohorts, we found that dynamic SN-centered cross-network interactions were significantly reduced, less persistent, and more variable in patients with schizophrenia compared with control subjects. Multivariate classification analysis identified dynamic SN-centered cross-network interaction patterns as factors that distinguish patients from control subjects, with accuracies of 78% and 80% in the two cohorts, respectively. Crucially, in both cohorts, dynamic time-varying measures of SN-centered cross-network interactions were correlated with positive, but not negative, symptoms. CONCLUSIONS Aberrations in time-varying engagement of the SN with the central executive network and default mode network is a clinically relevant neurobiological signature of psychosis in schizophrenia. Our findings provide strong evidence for dysregulated brain dynamics in a triple-network saliency model of schizophrenia and inform theoretically motivated systems neuroscience approaches for characterizing aberrant brain dynamics associated with psychosis.
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Affiliation(s)
- Kaustubh Supekar
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
| | - Weidong Cai
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Rajeev Krishnadas
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Sackler Institute of Psychobiological Research, University of Glasgow, United Kingdom
| | - Lena Palaniyappan
- Department of Psychiatry and Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada
| | - Vinod Menon
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, California; Stanford Neurosciences Institute, Stanford University School of Medicine, Stanford, California.
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43
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Sterzer P, Adams RA, Fletcher P, Frith C, Lawrie SM, Muckli L, Petrovic P, Uhlhaas P, Voss M, Corlett PR. The Predictive Coding Account of Psychosis. Biol Psychiatry 2018; 84:634-643. [PMID: 30007575 PMCID: PMC6169400 DOI: 10.1016/j.biopsych.2018.05.015] [Citation(s) in RCA: 375] [Impact Index Per Article: 62.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 01/12/2023]
Abstract
Fueled by developments in computational neuroscience, there has been increasing interest in the underlying neurocomputational mechanisms of psychosis. One successful approach involves predictive coding and Bayesian inference. Here, inferences regarding the current state of the world are made by combining prior beliefs with incoming sensory signals. Mismatches between prior beliefs and incoming signals constitute prediction errors that drive new learning. Psychosis has been suggested to result from a decreased precision in the encoding of prior beliefs relative to the sensory data, thereby garnering maladaptive inferences. Here, we review the current evidence for aberrant predictive coding and discuss challenges for this canonical predictive coding account of psychosis. For example, hallucinations and delusions may relate to distinct alterations in predictive coding, despite their common co-occurrence. More broadly, some studies implicate weakened prior beliefs in psychosis, and others find stronger priors. These challenges might be answered with a more nuanced view of predictive coding. Different priors may be specified for different sensory modalities and their integration, and deficits in each modality need not be uniform. Furthermore, hierarchical organization may be critical. Altered processes at lower levels of a hierarchy need not be linearly related to processes at higher levels (and vice versa). Finally, canonical theories do not highlight active inference-the process through which the effects of our actions on our sensations are anticipated and minimized. It is possible that conflicting findings might be reconciled by considering these complexities, portending a framework for psychosis more equipped to deal with its many manifestations.
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Affiliation(s)
- Philipp Sterzer
- Department of Psychiatry, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Rick A Adams
- Division of Psychiatry, University College London, London, United Kingdom
| | - Paul Fletcher
- Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom; Wellcome-MRC Behavioral and Clinical Neuroscience Institute, Cambridge and Peterborough Foundation Trust, Cambridge, United Kingdom
| | - Chris Frith
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom
| | - Stephen M Lawrie
- Center for Clinical and Brain Sciences, Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, United Kingdom
| | - Lars Muckli
- Centre for Cognitive Neuroimaging, Institute of Neuroscience & Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Predrag Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Peter Uhlhaas
- Centre for Cognitive Neuroimaging, Institute of Neuroscience & Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Martin Voss
- Department of Psychiatry and Psychotherapy, Charité University Medicine and St. Hedwig Hospital, Berlin Center for Advanced Neuroimaging, Humboldt University Berlin, Berlin, Germany
| | - Philip R Corlett
- Department of Psychiatry, Yale University, New Haven, Connecticut.
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Powers A, Bien C, Corlett P. Aligning Computational Psychiatry With the Hearing Voices Movement: Hearing Their Voices. JAMA Psychiatry 2018; 75:640-641. [PMID: 29801029 PMCID: PMC6129977 DOI: 10.1001/jamapsychiatry.2018.0509] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- A.R. Powers
- Yale University, Department of Psychiatry, Connecticut Mental Health Center, 34 Park St., New Haven, CT 06519,Correspondence should be addressed to
| | - C. Bien
- The Connection, Inc., 48 Howe Street, New Haven, CT 06511
| | - P.R. Corlett
- Yale University, Department of Psychiatry, Connecticut Mental Health Center, 34 Park St., New Haven, CT 06519
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Limanowski J, Friston K. 'Seeing the Dark': Grounding Phenomenal Transparency and Opacity in Precision Estimation for Active Inference. Front Psychol 2018; 9:643. [PMID: 29780343 PMCID: PMC5945877 DOI: 10.3389/fpsyg.2018.00643] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 04/16/2018] [Indexed: 01/14/2023] Open
Abstract
One of the central claims of the Self-model Theory of Subjectivity is that the experience of being someone – even in a minimal form – arises through a transparent phenomenal self-model, which itself can in principle be reduced to brain processes. Here, we consider whether it is possible to distinguish between phenomenally transparent and opaque states in terms of active inference. We propose a relationship of phenomenal opacity to expected uncertainty or precision; i.e., the capacity for introspective attention and implicit mental action. Thus we associate introspective attention with the deployment of ‘precision’ that may render the perceptual evidence (for action) opaque, while treating transparency as a necessary aspect of beliefs about action, i.e., ‘what I am’ doing. We conclude by proposing how we may have to nuance our conception of minimal phenomenal selfhood and agency in light of this active inference conception of transparency-opacity.
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Affiliation(s)
- Jakub Limanowski
- The Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, United Kingdom
| | - Karl Friston
- The Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, United Kingdom
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46
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Targeted neural network interventions for auditory hallucinations: Can TMS inform DBS? Schizophr Res 2018; 195:455-462. [PMID: 28969932 PMCID: PMC8141945 DOI: 10.1016/j.schres.2017.09.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/30/2017] [Accepted: 09/14/2017] [Indexed: 12/30/2022]
Abstract
The debilitating and refractory nature of auditory hallucinations (AH) in schizophrenia and other psychiatric disorders has stimulated investigations into neuromodulatory interventions that target the aberrant neural networks associated with them. Internal or invasive forms of brain stimulation such as deep brain stimulation (DBS) are currently being explored for treatment-refractory schizophrenia. The process of developing and implementing DBS is limited by symptom clustering within psychiatric constructs as well as a scarcity of causal tools with which to predict response, refine targeting or guide clinical decisions. Transcranial magnetic stimulation (TMS), an external or non-invasive form of brain stimulation, has shown some promise as a therapeutic intervention for AH but remains relatively underutilized as an investigational probe of clinically relevant neural networks. In this editorial, we propose that TMS has the potential to inform DBS by adding individualized causal evidence to an evaluation processes otherwise devoid of it in patients. Although there are significant limitations and safety concerns regarding DBS, the combination of TMS with computational modeling of neuroimaging and neurophysiological data could provide critical insights into more robust and adaptable network modulation.
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Cassidy CM, Balsam PD, Weinstein JJ, Rosengard RJ, Slifstein M, Daw ND, Abi-Dargham A, Horga G. A Perceptual Inference Mechanism for Hallucinations Linked to Striatal Dopamine. Curr Biol 2018; 28:503-514.e4. [PMID: 29398218 PMCID: PMC5820222 DOI: 10.1016/j.cub.2017.12.059] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/23/2017] [Accepted: 12/29/2017] [Indexed: 12/14/2022]
Abstract
Hallucinations, a cardinal feature of psychotic disorders such as schizophrenia, are known to depend on excessive striatal dopamine. However, an underlying cognitive mechanism linking dopamine dysregulation and the experience of hallucinatory percepts remains elusive. Bayesian models explain perception as an optimal combination of prior expectations and new sensory evidence, where perceptual distortions such as illusions and hallucinations may occur if prior expectations are afforded excessive weight. Such excessive weight of prior expectations, in turn, could stem from a gain-control process controlled by neuromodulators such as dopamine. To test for such a dopamine-dependent gain-control mechanism of hallucinations, we studied unmedicated patients with schizophrenia with varying degrees of hallucination severity and healthy individuals using molecular imaging with a pharmacological manipulation of dopamine, structural imaging, and a novel task designed to measure illusory changes in the perceived duration of auditory stimuli under different levels of uncertainty. Hallucinations correlated with a perceptual bias, reflecting disproportional gain on expectations under uncertainty. This bias could be pharmacologically induced by amphetamine, strongly correlated with striatal dopamine release, and related to cortical volume of the dorsal anterior cingulate, a brain region involved in tracking environmental uncertainty. These findings outline a novel dopamine-dependent mechanism for perceptual modulation in physiological conditions and further suggest that this mechanism may confer vulnerability to hallucinations in hyper-dopaminergic states underlying psychosis.
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Affiliation(s)
- Clifford M Cassidy
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; The Royal's Institute of Mental Health Research, University of Ottawa, 1145 Carling Avenue, Ottawa, ON K1Z 7K4, Canada
| | - Peter D Balsam
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychology, Columbia University, 3009 Broadway, New York, NY 10027, USA
| | - Jodi J Weinstein
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, Stony Brook University, 100 Nicholls Road, Stony Brook, NY 11794, USA
| | - Rachel J Rosengard
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - Mark Slifstein
- Department of Psychiatry, Stony Brook University, 100 Nicholls Road, Stony Brook, NY 11794, USA
| | - Nathaniel D Daw
- Department of Psychology, Princeton University, South Drive, Princeton, NJ 08540, USA
| | - Anissa Abi-Dargham
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, Stony Brook University, 100 Nicholls Road, Stony Brook, NY 11794, USA
| | - Guillermo Horga
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, NY 10032, USA.
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48
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Okruszek Ł, Piejka A, Wysokiński A, Szczepocka E, Manera V. The second agent effect: Interpersonal predictive coding in people with schizophrenia. Soc Neurosci 2017; 14:208-213. [DOI: 10.1080/17470919.2017.1415969] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Łukasz Okruszek
- Clinical Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | | | - Adam Wysokiński
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Łódź, Łódź, Poland
| | - Ewa Szczepocka
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Łódź, Łódź, Poland
| | - Valeria Manera
- Spatio-Temporal Activity Recognition Systems Research team, INRIA, Sophia Antipolis, France
- Cognition Behavior Technologies (CoBTeK), Université Côte d’Azur, Nice, France
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49
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Alderson-Day B, Lima CF, Evans S, Krishnan S, Shanmugalingam P, Fernyhough C, Scott SK. Distinct processing of ambiguous speech in people with non-clinical auditory verbal hallucinations. Brain 2017; 140:2475-2489. [PMID: 29050393 DOI: 10.1093/brain/awx206] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 06/29/2017] [Indexed: 01/17/2023] Open
Abstract
Auditory verbal hallucinations (hearing voices) are typically associated with psychosis, but a minority of the general population also experience them frequently and without distress. Such 'non-clinical' experiences offer a rare and unique opportunity to study hallucinations apart from confounding clinical factors, thus allowing for the identification of symptom-specific mechanisms. Recent theories propose that hallucinations result from an imbalance of prior expectation and sensory information, but whether such an imbalance also influences auditory-perceptual processes remains unknown. We examine for the first time the cortical processing of ambiguous speech in people without psychosis who regularly hear voices. Twelve non-clinical voice-hearers and 17 matched controls completed a functional magnetic resonance imaging scan while passively listening to degraded speech ('sine-wave' speech), that was either potentially intelligible or unintelligible. Voice-hearers reported recognizing the presence of speech in the stimuli before controls, and before being explicitly informed of its intelligibility. Across both groups, intelligible sine-wave speech engaged a typical left-lateralized speech processing network. Notably, however, voice-hearers showed stronger intelligibility responses than controls in the dorsal anterior cingulate cortex and in the superior frontal gyrus. This suggests an enhanced involvement of attention and sensorimotor processes, selectively when speech was potentially intelligible. Altogether, these behavioural and neural findings indicate that people with hallucinatory experiences show distinct responses to meaningful auditory stimuli. A greater weighting towards prior knowledge and expectation might cause non-veridical auditory sensations in these individuals, but it might also spontaneously facilitate perceptual processing where such knowledge is required. This has implications for the understanding of hallucinations in clinical and non-clinical populations, and is consistent with current 'predictive processing' theories of psychosis.
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Affiliation(s)
- Ben Alderson-Day
- Department of Psychology, Durham University, Science Laboratories, South Road, Durham, DH1 3LE, UK
| | - César F Lima
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK.,Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal
| | - Samuel Evans
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK.,Department of Psychology, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - Saloni Krishnan
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK.,Department of Experimental Psychology, University of Oxford, S Parks Rd, Oxford OX1 3UD, UK
| | - Pradheep Shanmugalingam
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK
| | - Charles Fernyhough
- Department of Psychology, Durham University, Science Laboratories, South Road, Durham, DH1 3LE, UK
| | - Sophie K Scott
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK
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50
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Disrupted cholinergic modulation can underlie abnormal gamma rhythms in schizophrenia and auditory hallucination. J Comput Neurosci 2017; 43:173-187. [PMID: 29047010 DOI: 10.1007/s10827-017-0666-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 10/07/2017] [Accepted: 10/10/2017] [Indexed: 01/06/2023]
Abstract
The pathophysiology of auditory hallucination, a common symptom of schizophrenia, has yet been understood, but during auditory hallucination, primary auditory cortex (A1) shows paradoxical responses. When auditory stimuli are absent, A1 becomes hyperactive, while A1 responses to auditory stimuli are reduced. Such activation pattern of A1 responses during auditory hallucination is consistent with aberrant gamma rhythms in schizophrenia observed during auditory tasks, raising the possibility that the pathology underlying abnormal gamma rhythms can account for auditory hallucination. Moreover, A1 receives top-down signals in the gamma frequency band from an adjacent association area (Par2), and cholinergic modulation regulates interactions between A1 and Par2. In this study, we utilized a computational model of A1 to ask if disrupted cholinergic modulation could underlie abnormal gamma rhythms in schizophrenia. Furthermore, based on our simulation results, we propose potential pathology by which A1 can directly contribute to auditory hallucination.
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