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Abalo-Rodríguez I, Santos-Mayo A, Moratti S. Pavlovian conditioning-induced hallucinations reduce MMN amplitudes for duration but not frequency deviants. Schizophr Res 2023; 256:63-71. [PMID: 37156071 DOI: 10.1016/j.schres.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/12/2023] [Accepted: 04/30/2023] [Indexed: 05/10/2023]
Abstract
The mismatch negativity (MMN) is an evoked potential that indexes auditory regularity violations. Since the 90's, a reduced amplitude of this brain activity in patients with schizophrenia has been consistently reported. Recently, this alteration has been related to the presence of auditory hallucinations (AHs) rather than the schizophrenia diagnostic per se. However, making this attribution is rather problematic due to the high heterogeneity of symptoms in schizophrenia. In an attempt to isolate the AHs influence on the MMN amplitude from other cofounding variables, we artificially induced AHs in a non-clinical population by Pavlovian conditioning. Before and after conditioning, volunteers (N = 31) participated in an oddball paradigm that elicited an MMN. Two different types of deviants were presented: a frequency and a duration deviant, as the MMN alteration seems to be especially present in schizophrenia with the latter type of deviant. Hence, this pre-post design allowed us to compare whether experiencing conditioning-induced AHs exert any influence on MMN amplitudes. Our results show that duration-deviant related MMN reductions significantly correlate with the number of AHs experienced. Moreover, we found a significant correlation between AHs proneness (measured with the Launay-Slade Hallucination Extended Scale) and the number of AHs experienced during the paradigm. In sum, our study shows that AHs can be conditioned and exert similar effects on MMN modulation in healthy participants as has been reported for patients with schizophrenia. Thus, conditioning paradigms offer the possibility to study the association between hallucinations and MMN reductions without the confounding variables present in schizophrenia patients.
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Affiliation(s)
- Inés Abalo-Rodríguez
- Department of Experimental Psychology, Complutense University of Madrid, Spain; Center of Cognitive and Computational Neuroscience, Complutense University of Madrid, Spain
| | - Alejandro Santos-Mayo
- Department of Experimental Psychology, Complutense University of Madrid, Spain; Center of Cognitive and Computational Neuroscience, Complutense University of Madrid, Spain
| | - Stephan Moratti
- Department of Experimental Psychology, Complutense University of Madrid, Spain; Center of Cognitive and Computational Neuroscience, Complutense University of Madrid, Spain.
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2
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Dondé C, Kantrowitz JT, Medalia A, Saperstein AM, Balla A, Sehatpour P, Martinez A, O'Connell MN, Javitt DC. Early auditory processing dysfunction in schizophrenia: Mechanisms and implications. Neurosci Biobehav Rev 2023; 148:105098. [PMID: 36796472 PMCID: PMC10106448 DOI: 10.1016/j.neubiorev.2023.105098] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/16/2023]
Abstract
Schizophrenia is a major mental disorder that affects approximately 1% of the population worldwide. Cognitive deficits are a key feature of the disorder and a primary cause of long-term disability. Over the past decades, significant literature has accumulated demonstrating impairments in early auditory perceptual processes in schizophrenia. In this review, we first describe early auditory dysfunction in schizophrenia from both a behavioral and neurophysiological perspective and examine their interrelationship with both higher order cognitive constructs and social cognitive processes. Then, we provide insights into underlying pathological processes, especially in relationship to glutamatergic and N-methyl-D-aspartate receptor (NMDAR) dysfunction models. Finally, we discuss the utility of early auditory measures as both treatment targets for precision intervention and as translational biomarkers for etiological investigation. Altogether, this review points out the crucial role of early auditory deficits in the pathophysiology of schizophrenia, in addition to major implications for early intervention and auditory-targeted approaches.
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Affiliation(s)
- Clément Dondé
- Univ. Grenoble Alpes, F-38000 Grenoble, France; INSERM, U1216, F-38000 Grenoble, France; Psychiatry Department, CHU Grenoble Alpes, F-38000 Grenoble, France; Psychiatry Department, CH Alpes-Isère, F-38000 Saint-Egrève, France.
| | - Joshua T Kantrowitz
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States; Schizophrenia Research Center, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States
| | - Alice Medalia
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY 10032, United States
| | - Alice M Saperstein
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY 10032, United States
| | - Andrea Balla
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
| | - Pejman Sehatpour
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Antigona Martinez
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Monica N O'Connell
- Translational Neuroscience Division, Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States
| | - Daniel C Javitt
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, United States; Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY, United States.
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Soler-Vidal J, Fuentes-Claramonte P, Salgado-Pineda P, Ramiro N, García-León MÁ, Torres ML, Arévalo A, Guerrero-Pedraza A, Munuera J, Sarró S, Salvador R, Hinzen W, McKenna P, Pomarol-Clotet E. Brain correlates of speech perception in schizophrenia patients with and without auditory hallucinations. PLoS One 2022; 17:e0276975. [PMID: 36525414 PMCID: PMC9757556 DOI: 10.1371/journal.pone.0276975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 10/18/2022] [Indexed: 12/23/2022] Open
Abstract
The experience of auditory verbal hallucinations (AVH, "hearing voices") in schizophrenia has been found to be associated with reduced auditory cortex activation during perception of real auditory stimuli like tones and speech. We re-examined this finding using 46 patients with schizophrenia (23 with frequent AVH and 23 hallucination-free), who underwent fMRI scanning while they heard words, sentences and reversed speech. Twenty-five matched healthy controls were also examined. Perception of words, sentences and reversed speech all elicited activation of the bilateral superior temporal cortex, the inferior and lateral prefrontal cortex, the inferior parietal cortex and the supplementary motor area in the patients and the healthy controls. During the sentence and reversed speech conditions, the schizophrenia patients as a group showed reduced activation in the left primary auditory cortex (Heschl's gyrus) relative to the healthy controls. No differences were found between the patients with and without hallucinations in any condition. This study therefore fails to support previous findings that experience of AVH attenuates speech-perception-related brain activations in the auditory cortex. At the same time, it suggests that schizophrenia patients, regardless of presence of AVH, show reduced activation in the primary auditory cortex during speech perception, a finding which could reflect an early information processing deficit in the disorder.
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Affiliation(s)
- Joan Soler-Vidal
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Benito Menni Complex Asistencial en Salut Mental, Sant Boi de Llobregat, Spain
| | - Paola Fuentes-Claramonte
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
| | - Pilar Salgado-Pineda
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
| | | | - María Ángeles García-León
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
| | | | | | | | - Josep Munuera
- Diagnostic Imaging and Image Guided Therapy, Institut de Recerca Sant Joan de Déu, Santa Rosa 39–57, Esplugues de Llobregat, Spain
- Diagnostic Imaging Department, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu 2, Barcelona, Spain
- Hospital de Sant Joan de Déu, Barcelona, Spain
| | - Salvador Sarró
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
| | - Raymond Salvador
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
| | - Wolfram Hinzen
- Universitat Pompeu Fabra, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Peter McKenna
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
- * E-mail:
| | - Edith Pomarol-Clotet
- FIDMAG Hermanas Hospitalarias Research Foundation, Sant Boi de Llobregat, Spain
- CIBERSAM (G15), Barcelona, Spain
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Francis AM, Parks A, Choueiry J, El-Marj N, Impey D, Knott VJ, Fisher DJ. Sensory gating in tobacco-naïve cannabis users is unaffected by acute nicotine administration. Psychopharmacology (Berl) 2022; 239:1279-1288. [PMID: 33932162 DOI: 10.1007/s00213-021-05843-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/29/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Long-term cannabis use has been associated with the appearance of psychotic symptoms and schizophrenia-like cognitive impairments; however these studies may be confounded by concomitant use of tobacco by cannabis users. We aimed to determine if previously observed cannabis-associated deficits in sensory gating would be seen in cannabis users with no history of tobacco use, as evidenced by changes in the P50, N100, and P200 event-related potentials. A secondary objective of this study was to examine the effects of acute nicotine administration on cannabis users with no tobacco use history. METHODS Three components (P50, N100, P200) of the mid-latency auditory-evoked response (MLAER) were elicited by a paired-stimulus paradigm in 43 healthy, non-tobacco smoking male volunteers between the ages of 18-30. Cannabis users (CU, n = 20) were administered nicotine (6 mg) and placebo gum within a randomized, double-blind design. Non-cannabis users (NU, n = 23) did not receive nicotine. RESULTS Between-group sensory gating effects were only observed for the N100, with CUs exhibiting a smaller N100 to S1 of the paired stimulus paradigm, in addition to reduced dN100 (indicating poorer gating). Results revealed no significant sensory gating differences with acute administration of nicotine compared to placebo cannabis conditions. CONCLUSIONS These findings suggest a relationship between gating impairment and cannabis use; however, acute nicotine administration nicotine does not appear to impact sensory gating function.
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Affiliation(s)
- Ashley M Francis
- Department of Psychology, Saint Mary's University, Halifax, NS, Canada
| | - Andrea Parks
- Department of Biomedical Science, University of Ottawa, Ottawa, ON, Canada
| | - Joëlle Choueiry
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Nicole El-Marj
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Danielle Impey
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Verner J Knott
- Department of Biomedical Science, University of Ottawa, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Derek J Fisher
- Department of Psychology, Saint Mary's University, Halifax, NS, Canada.
- School of Psychology, University of Ottawa, Ottawa, ON, Canada.
- Department of Psychology, Mount Saint Vincent University, 166 Bedford Hwy, Halifax, NS, B3M 2J6, Canada.
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5
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Mi L, Wang L, Li X, She S, Li H, Huang H, Zhang J, Liu Y, Zhao J, Ning Y, Zheng Y. Reduction of phonetic mismatch negativity may depict illness course and predict functional outcomes in schizophrenia. J Psychiatr Res 2021; 137:290-297. [PMID: 33735719 DOI: 10.1016/j.jpsychires.2021.02.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/05/2021] [Accepted: 02/26/2021] [Indexed: 01/16/2023]
Abstract
Schizophrenia (SZ) is characterized by a series of cognitive impairments, including automatic processing impairment of basic auditory information, indexed by mismatch negativity (MMN). Existing studies mainly focus on MMN induced by deviant of single acoustic features, and relatively few studies have focused on complex acoustic stimuli, especially speech-induced MMN. Many cognitive impairments in SZ are related to speech function. Thus, the present study aimed to examine the reduction of phonetic MMN in SZ as a potential biomarker and its relationship with illness course and functional outcomes. Electroencephalogram (EEG) signals were recorded from 32 SZ and 32 healthy controls (HC) in a double oddball paradigm, with /da/ as the standard stimulus and /ba/ and /du/ as the deviant stimuli. MMN was computed for vowel and consonant deviants separately. Clinical symptoms were assessed using the Positive and Negative Symptom Rating Scale (PANSS). Illness duration and illness relapse were acquired by combining clinical interviews and electronic medical records. Functional outcomes were assessed using the Global Assessment of Functioning scale (GAF). Compared with HC, SZ showed lower amplitudes of phonetic MMN, especially for vowel deviants. In addition, the MMN amplitude of the vowel deviant was significantly correlated with illness duration, illness relapse, and functional outcomes among patients with SZ. These findings indicate that the pre-attentive automatic phonetic processing of SZ was impaired for both consonants and vowels, while the vowel processing deficit may be the key speech processing deficit in SZ, which could depict the illness course and predict the functional outcomes.
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Affiliation(s)
- Lin Mi
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Le Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Xuanzi Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Shenglin She
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Haijing Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Huiyan Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Jinfang Zhang
- School of Psychology, South China Normal University, Guangzhou, 510631, China
| | - Yi Liu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China
| | - Jingping Zhao
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
| | - Yingjun Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, 510370, China.
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6
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Choueiry J, Blais CM, Shah D, Smith D, Fisher D, Illivitsky V, Knott V. CDP-choline and galantamine, a personalized α7 nicotinic acetylcholine receptor targeted treatment for the modulation of speech MMN indexed deviance detection in healthy volunteers: a pilot study. Psychopharmacology (Berl) 2020; 237:3665-3687. [PMID: 32851421 DOI: 10.1007/s00213-020-05646-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023]
Abstract
RATIONALE The combination of CDP-choline, an α7 nicotinic acetylcholine receptor (α7 nAChR) agonist, with galantamine, a positive allosteric modulator of nAChRs, is believed to counter the fast desensitization rate of the α7 nAChRs and may be of interest for schizophrenia (SCZ) patients. Beyond the positive and negative clinical symptoms, deficits in early auditory prediction-error processes are also observed in SCZ. Regularity violations activate these mechanisms that are indexed by electroencephalography-derived mismatch negativity (MMN) event-related potentials (ERPs) in response to auditory deviance. OBJECTIVES/METHODS This pilot study in thirty-three healthy humans assessed the effects of an optimized α7 nAChR strategy combining CDP-choline (500 mg) with galantamine (16 mg) on speech-elicited MMN amplitude and latency measures. The randomized, double-blinded, placebo-controlled, and counterbalanced design with a baseline stratification method allowed for assessment of individual response differences. RESULTS Increases in MMN generation mediated by the acute CDP-choline/galantamine treatment in individuals with low baseline MMN amplitude for frequency, intensity, duration, and vowel deviants were revealed. CONCLUSIONS These results, observed primarily at temporal recording sites overlying the auditory cortex, implicate α7 nAChRs in the enhancement of speech deviance detection and warrant further examination with respect to dysfunctional auditory deviance processing in individuals with SCZ.
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Affiliation(s)
- Joelle Choueiry
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, 1145 Carling Ave, Ottawa, ON, K1Z 7K4, Canada.
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada.
- Department of Psychology, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.
| | - Crystal M Blais
- Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | - Dhrasti Shah
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Smith
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
- Department of Psychology, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Derek Fisher
- Department of Psychology, Faculty of Social Sciences, Mount Saint Vincent University, Halifax, NS, Canada
| | - Vadim Illivitsky
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Verner Knott
- Department of Neuroscience, Faculty of Medicine, University of Ottawa, 1145 Carling Ave, Ottawa, ON, K1Z 7K4, Canada
- Department of Psychiatry, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
- Department of Psychology, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
- Institute of Cognitive Science, Carleton University, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
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7
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Hirano S, Spencer KM, Onitsuka T, Hirano Y. Language-Related Neurophysiological Deficits in Schizophrenia. Clin EEG Neurosci 2020; 51:222-233. [PMID: 31741393 DOI: 10.1177/1550059419886686] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Schizophrenia is a severe psychiatric disorder that affects all aspects of one's life with several cognitive and social dysfunctions. However, there is still no objective and universal index for diagnosis and treatment of this disease. Many researchers have studied language processing in schizophrenia since most of the patients show symptoms related to language processing, such as thought disorder, auditory verbal hallucinations, or delusions. Electroencephalography (EEG) and magnetoencephalography (MEG) with millisecond order high temporal resolution, have been applied to reveal the abnormalities in language processing in schizophrenia. The aims of this review are (a) to provide an overview of recent findings in language processing in schizophrenia with EEG and MEG using neurophysiological indices, providing insights into underlying language related pathophysiological deficits in this disease and (b) to emphasize the advantage of EEG and MEG in research on language processing in schizophrenia.
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Affiliation(s)
- Shogo Hirano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Higashiku, Fukuoka, Japan.,Neural Dynamics Laboratory, Research Service, VA Boston Healthcare System, and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kevin M Spencer
- Neural Dynamics Laboratory, Research Service, VA Boston Healthcare System, and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Toshiaki Onitsuka
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Higashiku, Fukuoka, Japan
| | - Yoji Hirano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Higashiku, Fukuoka, Japan.,Neural Dynamics Laboratory, Research Service, VA Boston Healthcare System, and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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8
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Knott V, Wright N, Shah D, Baddeley A, Bowers H, de la Salle S, Labelle A. Change in the Neural Response to Auditory Deviance Following Cognitive Therapy for Hallucinations in Patients With Schizophrenia. Front Psychiatry 2020; 11:555. [PMID: 32595542 PMCID: PMC7304235 DOI: 10.3389/fpsyt.2020.00555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/01/2020] [Indexed: 12/28/2022] Open
Abstract
Adjunctive psychotherapeutic approaches recommended for patients with schizophrenia (SZ) who are fully or partially resistant to pharmacotherapy have rarely utilized biomarkers to enhance the understanding of treatment-effective mechanisms. As SZ patients with persistent auditory verbal hallucinations (AVH) frequently evidence reduced neural responsiveness to external auditory stimulation, which may impact cognitive and functional outcomes, this study examined the effects of cognitive behavioral therapy for voices (CBTv) on clinical and AVH symptoms and the sensory processing of auditory deviants as measured with the electroencephalographically derived mismatch negativity (MMN) response. Twenty-four patients with SZ and AVH were randomly assigned to group CBTv treatment or a treatment as usual (TAU) condition. Patients in the group CBTv condition received treatment for 5 months while the matched control patients received TAU for the same period, followed by 5 months of group CBTv. Assessments were conducted at baseline and at the end of treatment. Although not showing consistent changes in the frequency of AVHs, CBTv (vs. TAU) improved patients' appraisal (p = 0.001) of and behavioral/emotional responses to AVHs, and increased both MMN generation (p = 0.001) and auditory cortex current density (p = 0.002) in response to tone pitch deviants. Improvements in AVH symptoms were correlated with change in pitch deviant MMN and current density in left primary auditory cortex. These findings of improved auditory information processing and symptom-response attributable to CBTv suggest potential clinical and functional benefits of psychotherapeutical approaches for patients with persistent AVHs.
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Affiliation(s)
- Verner Knott
- School of Psychology, University of Ottawa, Ottawa, ON, Canada.,Clinical Neuroelectrophysiology and Cognitive Research Laboratory, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.,Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Nicola Wright
- Schizophrenia Program, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Dhrasti Shah
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Ashley Baddeley
- Clinical Neuroelectrophysiology and Cognitive Research Laboratory, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Hayley Bowers
- Schizophrenia Program, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Sara de la Salle
- School of Psychology, University of Ottawa, Ottawa, ON, Canada.,Clinical Neuroelectrophysiology and Cognitive Research Laboratory, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Alain Labelle
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.,Schizophrenia Program, The Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
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9
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Francis AM, Knott VJ, Labelle A, Fisher DJ. Interaction of Background Noise and Auditory Hallucinations on Phonemic Mismatch Negativity (MMN) and P3a Processing in Schizophrenia. Front Psychiatry 2020; 11:540738. [PMID: 33093834 PMCID: PMC7523538 DOI: 10.3389/fpsyt.2020.540738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 08/17/2020] [Indexed: 12/21/2022] Open
Abstract
UNLABELLED Auditory hallucinations (AHs) are among the cardinal symptoms of schizophrenia (SZ). During the presence of AHs aberrant activity of auditory cortices have been observed, including hyperactivation during AHs alone and hypoactivation when AHs are accompanied by a concurrent external auditory competitor. Mismatch negativity (MMN) and P3a are common ERPs of interest within the study of SZ as they are robustly reduced in the chronic phase of the illness. The present study aimed to explore whether background noise altered the auditory MMN and P3a in those with SZ and treatment-resistant AHs. METHODS MMN and P3a were assessed in 12 hallucinating patients (HPs), 11 non-hallucinating patients (NPs) and 9 healthy controls (HCs) within an auditory oddball paradigm. Standard (P = 0.85) and deviant (P = 0.15) stimuli were presented during three noise conditions: silence (SL), traffic noise (TN), and wide-band white noise (WN). RESULTS HPs showed significantly greater deficits in MMN amplitude relative to NPs in all background noise conditions, though predominantly at central electrodes. Conversely, both NPs and HPs exhibited significant deficits in P3a amplitude relative to HCs under the SL condition only. SIGNIFICANCE These findings suggest that the presence of AHs may specifically impair the MMN, while the P3a appears to be more generally impaired in SZ. That MMN amplitudes are specifically reduced for HPs during background noise conditions suggests HPs may have a harder time detecting changes in phonemic sounds during situations with external traffic or "real-world" noise compared to NPs.
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Affiliation(s)
- Ashley M Francis
- Department of Psychology, Saint Mary's University, Halifax, NS, Canada
| | - Verner J Knott
- Royal Ottawa Mental Health Centre, Ottawa, ON, Canada.,Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Alain Labelle
- Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Derek J Fisher
- Department of Psychology, Saint Mary's University, Halifax, NS, Canada.,Royal Ottawa Mental Health Centre, Ottawa, ON, Canada.,Department of Psychology, Carleton University, Ottawa, ON, Canada.,Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
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10
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Haigh SM, Laher RM, Murphy TK, Coffman BA, Ward KL, Leiter-McBeth JR, Holt LL, Salisbury DF. Normal categorical perception to syllable-like stimuli in long term and in first episode schizophrenia. Schizophr Res 2019; 208:124-132. [PMID: 30982643 PMCID: PMC6607915 DOI: 10.1016/j.schres.2019.03.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 10/27/2022]
Abstract
Schizophrenia is associated with deficits in language processing that are evident even at first-episode. However, there is debate as to how early in the processing stream the linguistic deficits appear. We measured categorical processing of artificial syllables that varied in voice-onset time (VOT), and how sensory biasing impacts categorical perception. VOT varied in 5 ms increments from 0 ms (strong /ba/) to 40 ms (strong /pa/). Participants chose whether a syllable sounded more like /ba/ or /pa/. Twenty-two individuals with long-term schizophrenia (Sz) were compared to 21 controls (HCSz), and 17 individuals at their first-episode of schizophrenia (FE) were compared to 19 controls (HCFE). There were three conditions: equiprobable - each syllable had an equal probability of being presented; /ba/-biased - 0 ms VOT (strong /ba/) presented 70% of the time; /pa/-biased - 40 ms VOT (strong /pa/) presented 70% of the time. All groups showed categorical perception and category shifts during biased conditions. Sz and FE were statistically indistinguishable from controls in the point of categorical shift, slope of their response function, and the VOT needed to reliably perceive /pa/. Together, this suggests intact ability to map acoustic stimuli to phonetic categories when based on timing differences in voiced information, both early and late in the disease.
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Affiliation(s)
- Sarah M Haigh
- Department of Psychiatry, University of Pittsburgh, Suite 420, 3501 Forbes Avenue, Pittsburgh, PA 15213, USA; Department of Psychology and Center for Integrative Neuroscience, University of Nevada, Reno, Mack Social Science, 1664 N Virginia Street, Reno, NA, 89557, USA
| | - Rebecca M Laher
- Department of Psychiatry, University of Pittsburgh, Suite 420, 3501 Forbes Avenue, Pittsburgh, PA 15213, USA
| | - Timothy K Murphy
- Department of Psychiatry, University of Pittsburgh, Suite 420, 3501 Forbes Avenue, Pittsburgh, PA 15213, USA; Department of Psychology, Carnegie Mellon University, Baker Hall, 5000 Forbes Avenue, Pittsburgh, PA 15213, USA
| | - Brian A Coffman
- Department of Psychiatry, University of Pittsburgh, Suite 420, 3501 Forbes Avenue, Pittsburgh, PA 15213, USA
| | - Kayla L Ward
- Department of Psychiatry, University of Pittsburgh, Suite 420, 3501 Forbes Avenue, Pittsburgh, PA 15213, USA
| | - Justin R Leiter-McBeth
- Department of Psychiatry, University of Pittsburgh, Suite 420, 3501 Forbes Avenue, Pittsburgh, PA 15213, USA
| | - Lori L Holt
- Department of Psychology, Carnegie Mellon University, Baker Hall, 5000 Forbes Avenue, Pittsburgh, PA 15213, USA
| | - Dean F Salisbury
- Department of Psychiatry, University of Pittsburgh, Suite 420, 3501 Forbes Avenue, Pittsburgh, PA 15213, USA.
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11
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Fisher DJ, Rudolph ED, Ells EML, Knott VJ, Labelle A, Tibbo PG. Mismatch negativity-indexed auditory change detection of speech sounds in early and chronic schizophrenia. Psychiatry Res Neuroimaging 2019; 287:1-9. [PMID: 30933744 DOI: 10.1016/j.pscychresns.2019.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 03/11/2019] [Accepted: 03/19/2019] [Indexed: 11/27/2022]
Abstract
Auditory change detection, as indexed by the EEG-derived mismatch negativity, has been demonstrated to be dysfunctional in chronic schizophrenia using both pure-tone and speech (phoneme) sounds. It is unclear, however, whether reduced MMN amplitudes to speech sound deviants are observed within the first 5 years of the illness. The present study investigated MMNs elicited by across-vowel (phoneme) change in early schizophrenia (ESZ; Experiment 1) as well as chronic schizophrenia (CSZ; Experiment 2). In both experiments, clinical and control participants were presented the Finnish phoneme /e/ (standard; P = .90) and the Finnish phoneme /ö/ (deviant; P = .10) within an oddball paradigm. In experiment 2 we report significantly reduced MMN amplitudes in CSZ relative to HCs, but no differences were found when comparing ESZ and HC in experiment 1. Additionally, in our clinical samples, MMN amplitudes were correlated with symptom scores. These findings suggest that early detection of phonetic change may be impaired in chronic schizophrenia, but not early in the progression of the illness. As MMN reductions only emerged in patients with a longer course of illness, and appeared to change with symptom severity, this suggests a dynamic change in the early auditory processing of language over time in schizophrenia.
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Affiliation(s)
- Derek J Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; The Royal's Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Psychology, Saint Mary's University, Halifax, Nova Scotia, Canada.
| | - Erica D Rudolph
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; Department of Psychology, Saint Mary's University, Halifax, Nova Scotia, Canada
| | - Emma M L Ells
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Verner J Knott
- The Royal's Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Alain Labelle
- The Royal's Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Early Psychosis Program, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
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12
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de la Salle S, Shah D, Choueiry J, Bowers H, McIntosh J, Ilivitsky V, Knott V. NMDA Receptor Antagonist Effects on Speech-Related Mismatch Negativity and Its Underlying Oscillatory and Source Activity in Healthy Humans. Front Pharmacol 2019; 10:455. [PMID: 31139075 PMCID: PMC6517681 DOI: 10.3389/fphar.2019.00455] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 04/11/2019] [Indexed: 11/18/2022] Open
Abstract
Background: Previous studies in schizophrenia have consistently shown that deficits in the generation of the auditory mismatch negativity (MMN) – a pre-attentive, event-related potential (ERP) typically elicited by changes to simple sound features – are linked to N-methyl-D-aspartate (NMDA) receptor hypofunction. Concomitant with extensive language dysfunction in schizophrenia, patients also exhibit MMN deficits to changes in speech but their relationship to NMDA-mediated neurotransmission is not clear. Accordingly, our study aimed to investigate speech MMNs in healthy humans and their underlying electrophysiological mechanisms in response to NMDA antagonist treatment. We also evaluated the relationship between baseline MMN/electrocortical activity and emergent schizophrenia-like symptoms associated with NMDA receptor blockade. Methods: In a sample of 18 healthy volunteers, a multi-feature Finnish language paradigm incorporating changes in syllables, vowels and consonant stimuli was used to assess the acute effects of the NMDA receptor antagonist ketamine and placebo on the MMN. Further, measures of underlying neural activity, including evoked theta power, theta phase locking and source-localized current density in cortical regions of interest were assessed. Subjective symptoms were assessed with the Clinician Administered Dissociative States Scale (CADSS). Results: Participants exhibited significant ketamine-induced increases in psychosis-like symptoms and depending on temporal or frontal recording region, co-occurred with reductions in MMN generation in response to syllable frequency/intensity, vowel duration, across vowel and consonant deviants. MMN attenuation was associated with decreases in evoked theta power, theta phase locking and diminished current density in auditory and inferior frontal (language-related cortical) regions. Baseline (placebo) MMN and underlying electrophysiological features associated with the processing of changes in syllable intensity correlated with the degree of psychotomimetic response to ketamine. Conclusion: Ketamine-induced impairments in healthy human speech MMNs and their underlying electrocortical mechanisms closely resemble those observed in schizophrenia and support a model of dysfunctional NMDA receptor-mediated neurotransmission of language processing deficits in schizophrenia.
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Affiliation(s)
| | - Dhrasti Shah
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Joelle Choueiry
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Hayley Bowers
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Judy McIntosh
- The Royal's Institute of Mental Health Research, Ottawa, ON, Canada
| | | | - Verner Knott
- School of Psychology, University of Ottawa, Ottawa, ON, Canada.,Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada.,The Royal's Institute of Mental Health Research, Ottawa, ON, Canada.,Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
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13
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Iino H, Ohta K, Hara K, Miyajima M, Hara M, Matsushima E, Matsuura M. Vowel-speech versus pure-tone processing in healthy subjects. Neurosci Res 2018; 137:43-48. [PMID: 29630919 DOI: 10.1016/j.neures.2018.03.002] [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: 08/29/2017] [Revised: 02/22/2018] [Accepted: 03/09/2018] [Indexed: 11/26/2022]
Abstract
To investigate the characteristics of speech perception, we evaluated the differences in mismatch negativity (MMN) between vowel change and frequency change. Additionally, we examined the effects of gender, age, and educational length on MMN. Forty healthy adults (21 females), who were native Japanese speakers, participated in the study. A Japanese vowel-speech pair (standard/a/vs. deviant/o/) and a pure-tone pair (standard 1000 Hz vs. deviant 1050 Hz) were constructed. MMN elicited by vowel-speech sounds was larger and earlier compared with pure-tone sounds. Larger and earlier MMNs for vowel-speech sounds than for pure-tone sounds suggest different processing of linguistically relevant information at the early stage in the auditory cortex. In conclusion, the factors influencing on MMN are different between vowel-speech sounds and pure-tone sounds.
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Affiliation(s)
- Hiroko Iino
- Biofunctional Informatics, Biomedical Laboratory Sciences, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8510, Japan; Department of Clinical Laboratory, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Katsuya Ohta
- Biofunctional Informatics, Biomedical Laboratory Sciences, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8510, Japan; Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8510, Japan; Onda-daini Hospital, 302 Kanegasaku, Matsudo-shi, Chiba 270-2251, Japan
| | - Keiko Hara
- Biofunctional Informatics, Biomedical Laboratory Sciences, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8510, Japan; Hara Clinic, 1-1 Urahuna-cho Minami-ku, Yokohama-shi, Kanagawa 232-0024, Japan
| | - Miho Miyajima
- Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8510, Japan
| | - Minoru Hara
- Hara Clinic, 1-1 Urahuna-cho Minami-ku, Yokohama-shi, Kanagawa 232-0024, Japan
| | - Eisuke Matsushima
- Section of Liaison Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8510, Japan
| | - Masato Matsuura
- Biofunctional Informatics, Biomedical Laboratory Sciences, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima Bunkyo-ku, Tokyo 113-8510, Japan
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14
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Goldsmith DR, Crooks CL, Walker EF, Cotes RO. An Update on Promising Biomarkers in Schizophrenia. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2018; 16:153-163. [PMID: 31975910 DOI: 10.1176/appi.focus.20170046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Given the heterogeneity of symptoms in patients with schizophrenia and current treatment limitations, biomarkers may play an important role in diagnosis, subtype stratification, and the assessment of treatment response. Though many potential biomarkers have been studied, we have chosen to focus on some of the most promising and potentially clinically relevant biomarkers to review herein. These include markers of inflammation, neuroimaging biomarkers, brain-derived neurotrophic factor, genetic/epigenetic markers, and speech analysis. This will provide a broad overview of putative biomarkers that could become clinically relevant in the future, though none currently appear ready to assist the clinician in identifying cases of schizophrenia, subtypes of the disorder, treatment choice, or response. Nonetheless, some biomarkers, such as C-reactive protein (CRP), may be useful at identifying individuals who may be more highly inflamed, which could drive treatment choice. Though checking CRP is not a standard of practice, this is one example of how biomarkers may drive treatment decisions in the future, supporting precision medicine. Similarly, technological advances may one day allow clinicians to detect changes in speech patterns, which could represent a noninvasive, clinically useful tool in the future. We conclude the review by highlighting two important potential clinical uses for biomarkers in schizophrenia: the identification of individuals who may convert from clinical high risk and the stratification of patients via different biomarkers that may supersede clinical diagnosis. Given the enormous burden of illness of schizophrenia, the search for clinically relevant biomarkers is of great importance to improve the lives of patients with the disorder.
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Affiliation(s)
- David R Goldsmith
- Dr. Goldsmith, Dr. Crooks, and Dr. Cotes are with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia. Dr. Crooks is also with the Electronic Systems Laboratory, Georgia Tech Research Institute, Atlanta. Dr. Walker is with the Department of Psychology, Emory University
| | - Courtney L Crooks
- Dr. Goldsmith, Dr. Crooks, and Dr. Cotes are with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia. Dr. Crooks is also with the Electronic Systems Laboratory, Georgia Tech Research Institute, Atlanta. Dr. Walker is with the Department of Psychology, Emory University
| | - Elaine F Walker
- Dr. Goldsmith, Dr. Crooks, and Dr. Cotes are with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia. Dr. Crooks is also with the Electronic Systems Laboratory, Georgia Tech Research Institute, Atlanta. Dr. Walker is with the Department of Psychology, Emory University
| | - Robert O Cotes
- Dr. Goldsmith, Dr. Crooks, and Dr. Cotes are with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia. Dr. Crooks is also with the Electronic Systems Laboratory, Georgia Tech Research Institute, Atlanta. Dr. Walker is with the Department of Psychology, Emory University
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15
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Upthegrove R, Broome MR, Caldwell K, Ives J, Oyebode F, Wood SJ. Understanding auditory verbal hallucinations: a systematic review of current evidence. Acta Psychiatr Scand 2016; 133:352-67. [PMID: 26661730 DOI: 10.1111/acps.12531] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Auditory verbal hallucinations (AVHs) are core features of psychotic illness and remain significant in predicting poor outcome and risk. There has been a wide range of approaches to understanding these experiences. METHOD A systematic literature review summarizing different methods of investigation and their results; phenomenology, descriptive psychopathology, psychological, cognitive neurobiology, and neuroimaging. RESULTS A number of 764 papers and texts were screened and 113 reviewed. Phenomenological studies are comparably few in number, and psychopathology remains based on concepts defined in the early 20th century. Psychological models focus on voice content and emotional reaction, and suggest a continuum of AVHs from normal experience. Neuropsychological models include AVHs as misattribution of inner speech, whilst functional neuroimaging studies focus on the spontaneous activity and connectivity of auditory networks. CONCLUSION There has been a large growth in research on AVHs in recent decades dominated by neurobiological and neuroimaging studies. Future research should include focus on phenomenological aspects and AVHs change over the course of developing illness. Integration between branches of enquiry is needed, and the risk is that without this, models are proposed and investigated that bear scant relevance to the symptom itself.
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Affiliation(s)
- R Upthegrove
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - M R Broome
- Department of Psychiatry, University of Oxford, Oxford, UK.,Warneford Hospital, Oxford Health NHS Foundation Trust, Oxford, UK
| | - K Caldwell
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - J Ives
- Medicine, Ethics, Society and History, The University of Birmingham, Birmingham, UK
| | - F Oyebode
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - S J Wood
- School of Psychology, University of Birmingham, Birmingham, UK.,Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Melbourne, Vic., Australia
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16
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Brown M, Kuperberg GR. A Hierarchical Generative Framework of Language Processing: Linking Language Perception, Interpretation, and Production Abnormalities in Schizophrenia. Front Hum Neurosci 2015; 9:643. [PMID: 26640435 PMCID: PMC4661240 DOI: 10.3389/fnhum.2015.00643] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 11/12/2015] [Indexed: 12/27/2022] Open
Abstract
Language and thought dysfunction are central to the schizophrenia syndrome. They are evident in the major symptoms of psychosis itself, particularly as disorganized language output (positive thought disorder) and auditory verbal hallucinations (AVHs), and they also manifest as abnormalities in both high-level semantic and contextual processing and low-level perception. However, the literatures characterizing these abnormalities have largely been separate and have sometimes provided mutually exclusive accounts of aberrant language in schizophrenia. In this review, we propose that recent generative probabilistic frameworks of language processing can provide crucial insights that link these four lines of research. We first outline neural and cognitive evidence that real-time language comprehension and production normally involve internal generative circuits that propagate probabilistic predictions to perceptual cortices - predictions that are incrementally updated based on prediction error signals as new inputs are encountered. We then explain how disruptions to these circuits may compromise communicative abilities in schizophrenia by reducing the efficiency and robustness of both high-level language processing and low-level speech perception. We also argue that such disruptions may contribute to the phenomenology of thought-disordered speech and false perceptual inferences in the language system (i.e., AVHs). This perspective suggests a number of productive avenues for future research that may elucidate not only the mechanisms of language abnormalities in schizophrenia, but also promising directions for cognitive rehabilitation.
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Affiliation(s)
- Meredith Brown
- Department of Psychiatry–Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, CharlestownMA, USA
- Department of Psychology, Tufts University, MedfordMA, USA
| | - Gina R. Kuperberg
- Department of Psychiatry–Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, CharlestownMA, USA
- Department of Psychology, Tufts University, MedfordMA, USA
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17
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Ford JM, Palzes VA, Roach BJ, Potkin SG, van Erp TGM, Turner JA, Mueller BA, Calhoun VD, Voyvodic J, Belger A, Bustillo J, Vaidya JG, Preda A, McEwen SC, Mathalon DH. Visual hallucinations are associated with hyperconnectivity between the amygdala and visual cortex in people with a diagnosis of schizophrenia. Schizophr Bull 2015; 41:223-32. [PMID: 24619536 PMCID: PMC4266287 DOI: 10.1093/schbul/sbu031] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION While auditory verbal hallucinations (AH) are a cardinal symptom of schizophrenia, people with a diagnosis of schizophrenia (SZ) may also experience visual hallucinations (VH). In a retrospective analysis of a large sample of SZ and healthy controls (HC) studied as part of the functional magnetic resonance imaging (fMRI) Biomedical Informatics Research Network (FBIRN), we asked if SZ who endorsed experiencing VH during clinical interviews had greater connectivity between visual cortex and limbic structures than SZ who did not endorse experiencing VH. METHODS We analyzed resting state fMRI data from 162 SZ and 178 age- and gender-matched HC. SZ were sorted into groups according to clinical ratings on AH and VH: SZ with VH (VH-SZ; n = 45), SZ with AH but no VH (AH-SZ; n = 50), and SZ with neither AH nor VH (NoH-SZ; n = 67). Our primary analysis was seed based, extracting connectivity between visual cortex and the amygdala (because of its role in fear and negative emotion) and visual cortex and the hippocampus (because of its role in memory). RESULTS Compared with the other groups, VH-SZ showed hyperconnectivity between the amygdala and visual cortex, specifically BA18, with no differences in connectivity among the other groups. In a voxel-wise, whole brain analysis comparing VH-SZ with AH-SZ, the amygdala was hyperconnected to left temporal pole and inferior frontal gyrus in VH-SZ, likely due to their more severe thought broadcasting. CONCLUSIONS VH-SZ have hyperconnectivity between subcortical areas subserving emotion and cortical areas subserving higher order visual processing, providing biological support for distressing VH in schizophrenia.
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Affiliation(s)
- Judith M. Ford
- Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, CA;,*To whom correspondence should be addressed; Psychiatry Service (116D), San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121, US; tel: 415-221-4810, ext. 4187, fax: 415-750-6622, e-mail:
| | - Vanessa A. Palzes
- Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, CA
| | - Brian J. Roach
- Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, CA
| | - Steven G. Potkin
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA
| | - Theo G. M. van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA
| | - Jessica A. Turner
- Mind Research Network, Albuquerque, NM;,Departments of Psychology and Neuroscience, Georgia State University, Atlanta GA
| | - Bryon A. Mueller
- Department of Psychiatry, University of Minnesota, Twin Cities, Minneapolis, MN
| | - Vincent D. Calhoun
- Mind Research Network, Albuquerque, NM;,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM
| | - Jim Voyvodic
- Brain Imaging and Analysis Center, University of North Carolina-Duke University, Durham, NC
| | - Aysenil Belger
- Brain Imaging and Analysis Center, University of North Carolina-Duke University, Durham, NC;,Department of Psychiatry, University of North Carolina, Durham, NC
| | - Juan Bustillo
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | | | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA
| | - Sarah C. McEwen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | | | - Daniel H. Mathalon
- Psychiatry Service, San Francisco VA Medical Center, San Francisco, CA;,Department of Psychiatry, University of California, San Francisco, CA
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Fisher DJ, Smith DM, Labelle A, Knott VJ. Attenuation of mismatch negativity (MMN) and novelty P300 in schizophrenia patients with auditory hallucinations experiencing acute exacerbation of illness. Biol Psychol 2014; 100:43-9. [PMID: 24865523 DOI: 10.1016/j.biopsycho.2014.05.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 05/14/2014] [Accepted: 05/15/2014] [Indexed: 10/25/2022]
Abstract
This study examined measures of early auditory feature analysis, including the mismatch negativity (MMN) and novelty P300 (NP3) in schizophrenia patients (SZ) with persistent auditory hallucinations (AH) during an acute psychotic episode requiring hospitalisation. Neuroelectric activity was recorded in 10 SZ patients and 13 healthy controls (HC) during a passive auditory oddball task including novel environmental sounds. MMN/NP3 amplitudes and latencies were compared between groups and were correlated with trait (PSYRATS) and state measures of AH severity as well as clinical symptom ratings in SZs.SZ patients (vs. HCs) exhibited reduced MMN amplitudes to both rare deviant and novel stimuli, as well as reduced NP3 amplitudes. Additionally, while novelty MMN amplitudes were correlated with measures of hallucinatory trait, NP3 amplitudes were correlated with measures of hallucinatory state. Therefore, in acutely ill SZ patients, individual components of the auditory novelty detection mechanism may be differentially sensitive to varying aspects of AHs.
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Affiliation(s)
- Derek J Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada.
| | - Dylan M Smith
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Alain Labelle
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada
| | - Verner J Knott
- University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada; Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Hallucinations and negative symptoms differentially revealed by frontal and temporal responses to speech in schizophrenia. Schizophr Res 2014; 155:39-44. [PMID: 24703528 DOI: 10.1016/j.schres.2014.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 03/10/2014] [Accepted: 03/10/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Auditory verbal hallucinations (AVH) in schizophrenia may arise because of aberrant speech perception. We used an electroencephalography method to examine the neural processes underlying speech perception in schizophrenic patients with hallucinations. METHODS Cortical event-related potentials (ERPs) were analyzed topographically (scalp potential and scalp current density (SCD) mapping) in response to the vowel /a/ using a passive paradigm in 26 patients with schizophrenia. RESULTS From the SCD distribution of the P1 peak, we showed that, whereas the hallucination score (PSYRATS) was negatively correlated with the amplitude of the frontal currents, the PANSS negative symptom score was negatively correlated with the amplitude of the temporal currents in patients with schizophrenia. CONCLUSIONS These results provide evidence that AVH and negative symptoms are associated with abnormal early processing of speech. Whereas AVH are related to decreased early frontal activation, negative symptoms are associated with a reduced early temporal response.
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Galderisi S, Vignapiano A, Mucci A, Boutros NN. Physiological correlates of positive symptoms in schizophrenia. Curr Top Behav Neurosci 2014; 21:103-28. [PMID: 24920446 DOI: 10.1007/7854_2014_322] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Patients with schizophrenia have been hypothesized to have a functional impairment in filtering irrelevant sensory information, which may result in positive symptoms such as hallucinations or delusions. Many evidences suggest that abnormalities in the event-related brain potentials (ERPs), resting state electroencephalography (EEG) and synchronized oscillatory activity of neurons may reflect core pathophysiological mechanisms of schizophrenia. Abnormalities in amplitude and latency of the ERPs reflecting aberrations in gating and difficulties in the detection of changes in auditory stimuli, as well as defects in stimuli evaluation and integration of information are common in patients with schizophrenia. This chapter highlights the findings of electrophysiological studies in schizophrenia dealing with early sensory perception and attention, automatic sensory detection of stimuli changes and cognitive evaluation and integration of information, relevant to the pathophysiological mechanisms underpinning hallucinations and delusions. Results of electrophysiological studies investigating the neural correlates of positive symptoms suggest aberrant intrinsic organization of functional brain networks.
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Affiliation(s)
- Silvana Galderisi
- Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138, Naples, NA, Italy,
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Todd J, Harms L, Schall U, Michie PT. Mismatch negativity: translating the potential. Front Psychiatry 2013; 4:171. [PMID: 24391602 PMCID: PMC3866657 DOI: 10.3389/fpsyt.2013.00171] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 12/04/2013] [Indexed: 02/05/2023] Open
Abstract
The mismatch negativity (MMN) component of the auditory event-related potential has become a valuable tool in cognitive neuroscience. Its reduced size in persons with schizophrenia is of unknown origin but theories proposed include links to problems in experience-dependent plasticity reliant on N-methyl-d-aspartate glutamate receptors. In this review we address the utility of this tool in revealing the nature and time course of problems in perceptual inference in this illness together with its potential for use in translational research testing animal models of schizophrenia-related phenotypes. Specifically, we review the reasons for interest in MMN in schizophrenia, issues pertaining to the measurement of MMN, its use as a vulnerability index for the development of schizophrenia, the pharmacological sensitivity of MMN and the progress in developing animal models of MMN. Within this process we highlight the challenges posed by knowledge gaps pertaining to the tool and the pharmacology of the underlying system.
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Affiliation(s)
- Juanita Todd
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Callaghan, NSW, Australia
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Lauren Harms
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Callaghan, NSW, Australia
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Ulrich Schall
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Callaghan, NSW, Australia
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Patricia T. Michie
- School of Psychology, University of Newcastle, Callaghan, NSW, Australia
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Callaghan, NSW, Australia
- Schizophrenia Research Institute, Darlinghurst, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
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Iliadou V(V, Apalla K, Kaprinis S, Nimatoudis I, Kaprinis G, Iacovides A. Is Central Auditory Processing Disorder Present in Psychosis? Am J Audiol 2013; 22:201-208. [DOI: 10.1044/1059-0889(2013/12-0073)] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Purpose
The scope of this study was to trace central auditory processing issues in patients with first-episode psychosis using a psychoacoustic test battery approach.
Method
Patients (
n
= 17) and volunteer control subjects (
n
= 17) with no personal or family history of schizophrenia were included in the study on the basis of normal hearing sensitivity. The authors implemented a central auditory processing battery consisting of monaural and binaural tests with verbal and nonverbal stimuli.
Results
Perceptual deficits in both nonverbal and verbal auditory stimuli are reported in this study, with temporal central auditory processing deficits and a mean left-ear advantage documented in the patient group.
Conclusion
This study points to the possibility of the existence of central auditory processing deficits in first-episode psychosis leading to schizophrenia. Audiologists should be aware of the psychiatric research pointing to enhanced verbal memory as a result of auditory training, linking bottom-up remediation with top-down improvement.
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de Lacy N, King BH. Revisiting the relationship between autism and schizophrenia: toward an integrated neurobiology. Annu Rev Clin Psychol 2013; 9:555-87. [PMID: 23537488 DOI: 10.1146/annurev-clinpsy-050212-185627] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Schizophrenia and autism have been linked since their earliest descriptions. Both are disorders of cerebral specialization originating in the embryonic period. Genetic, molecular, and cytologic research highlights a variety of shared contributory mechanisms that may lead to patterns of abnormal connectivity arising from altered development and topology. Overt behavioral pathology likely emerges during or after neurosensitive periods in which resource demands overwhelm system resources and the individual's ability to compensate using interregional activation fails. We are at the threshold of being able to chart autism and schizophrenia from the inside out. In so doing, the door is opened to the consideration of new therapeutics that are developed based upon molecular, synaptic, and systems targets common to both disorders.
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Affiliation(s)
- Nina de Lacy
- University of Washington and Seattle Children's Hospital, Seattle, Washington 98195, USA
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Smith DM, Grant B, Fisher DJ, Borracci G, Labelle A, Knott VJ. Auditory verbal hallucinations in schizophrenia correlate with P50 gating. Clin Neurophysiol 2013; 124:1329-35. [DOI: 10.1016/j.clinph.2013.02.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 01/31/2013] [Accepted: 02/05/2013] [Indexed: 11/16/2022]
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25
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Knott V, Shah D, Millar A, McIntosh J, Fisher D, Blais C, Ilivitsky V. Nicotine, Auditory Sensory Memory, and sustained Attention in a Human Ketamine Model of Schizophrenia: Moderating Influence of a Hallucinatory Trait. Front Pharmacol 2012; 3:172. [PMID: 23060793 PMCID: PMC3460347 DOI: 10.3389/fphar.2012.00172] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 09/04/2012] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The procognitive actions of the nicotinic acetylcholine receptor (nAChR) agonist nicotine are believed, in part, to motivate the excessive cigarette smoking in schizophrenia, a disorder associated with deficits in multiple cognitive domains, including low-level auditory sensory processes and higher-order attention-dependent operations. OBJECTIVES As N-methyl-d-aspartate receptor (NMDAR) hypofunction has been shown to contribute to these cognitive impairments, the primary aims of this healthy volunteer study were to: (a) to shed light on the separate and interactive roles of nAChR and NMDAR systems in the modulation of auditory sensory memory (and sustained attention), as indexed by the auditory event-related brain potential - mismatch negativity (MMN), and (b) to examine how these effects are moderated by a predisposition to auditory hallucinations/delusions (HD). METHODS In a randomized, double-blind, placebo-controlled design involving a low intravenous dose of ketamine (0.04 mg/kg) and a 4 mg dose of nicotine gum, MMN, and performance on a rapid visual information processing (RVIP) task of sustained attention were examined in 24 healthy controls psychometrically stratified as being lower (L-HD, n = 12) or higher (H-HD) for HD propensity. RESULTS Ketamine significantly slowed MMN, and reduced MMN in H-HD, with amplitude attenuation being blocked by the co-administration of nicotine. Nicotine significantly enhanced response speed [reaction time (RT)] and accuracy (increased % hits and d' and reduced false alarms) on the RVIP, with improved performance accuracy being prevented when nicotine was administered with ketamine. Both % hits and d', as well as RT were poorer in H-HD (vs. L-HD) and while hit rate and d' was increased by nicotine in H-HD, RT was slowed by ketamine in L-HD. CONCLUSIONS Nicotine alleviated ketamine-induced sensory memory impairment and improved attention, particularly in individuals prone to HD.
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Affiliation(s)
- Verner Knott
- Institute of Mental Health Research, University of OttawaOttawa, ON, Canada
- Neuroscience Program, Department of Cellular and Molecular Medicine, University of OttawaOttawa, ON, Canada
- School of Psychology, University of OttawaOttawa, ON, Canada
- Institute of Cognitive Science, Carleton UniversityOttawa, ON, Canada
- Royal Ottawa Mental Health CentreOttawa, ON, Canada
| | - Dhrasti Shah
- School of Psychology, University of OttawaOttawa, ON, Canada
| | - Anne Millar
- Neuroscience Program, Department of Cellular and Molecular Medicine, University of OttawaOttawa, ON, Canada
| | - Judy McIntosh
- Institute of Mental Health Research, University of OttawaOttawa, ON, Canada
| | - Derek Fisher
- Department of Psychology, Mount Saint Vincent UniversityHalifax, NS, Canada
| | - Crystal Blais
- Institute of Cognitive Science, Carleton UniversityOttawa, ON, Canada
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26
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Fisher DJ, Labelle A, Knott VJ. Alterations of mismatch negativity (MMN) in schizophrenia patients with auditory hallucinations experiencing acute exacerbation of illness. Schizophr Res 2012; 139:237-45. [PMID: 22727705 DOI: 10.1016/j.schres.2012.06.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 06/01/2012] [Accepted: 06/04/2012] [Indexed: 11/19/2022]
Abstract
Auditory verbal hallucinations (AHs), or hearing 'voices', are one of the hallmark symptoms of patients with schizophrenia. The primary objective of this study was to compare hallucinating schizophrenia patients with respect to differences in deviance detection, as indexed by the auditory mismatch negativity (MMN). Patients were recruited during an acute psychotic episode requiring hospitalization, during which time symptoms of psychosis, including auditory hallucinations, are likely to be at their most severe. MMNs to duration, frequency, gap, intensity and location deviants (as elicited by the 'optimal' multi-feature paradigm) were recorded in 12 acutely ill schizophrenia patients (SZ) with persistent AHs and 15 matched healthy controls (HC). Electrical activity was recorded from 32 scalp electrodes. MMN amplitudes and latencies for each deviant were compared between groups and were correlated with trait (PSYRATS) and state measures of AH severity and Positive and Negative Syndrome Scale (PANSS) ratings in SZs. There were significant group differences for duration, gap, intensity and location MMN amplitudes, such that SZs exhibited reduced MMNs compared to HCs. Additionally, gap MMN amplitudes were correlated with measures of hallucinatory state and frequency of AHs, while location MMN was correlated with perceived location of AHs. In summary, this study corroborates previous research reporting a robust duration MMN deficit in schizophrenia, as well as reporting gap, intensity and location MMN deficits in acutely ill schizophrenia patients with persistent AHs. Additionally, MMN amplitudes were correlated with state and trait measures of AHs. These findings offer further support to previous work suggesting that the presence of auditory hallucinations may make a significant contribution to the widely reported MMN deficits in schizophrenia.
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Affiliation(s)
- Derek J Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
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Ford JM, Dierks T, Fisher DJ, Herrmann CS, Hubl D, Kindler J, Koenig T, Mathalon DH, Spencer KM, Strik W, van Lutterveld R. Neurophysiological studies of auditory verbal hallucinations. Schizophr Bull 2012; 38:715-23. [PMID: 22368236 PMCID: PMC3406526 DOI: 10.1093/schbul/sbs009] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We discuss 3 neurophysiological approaches to study auditory verbal hallucinations (AVH). First, we describe "state" (or symptom capture) studies where periods with and without hallucinations are compared "within" a patient. These studies take 2 forms: passive studies, where brain activity during these states is compared, and probe studies, where brain responses to sounds during these states are compared. EEG (electroencephalography) and MEG (magnetoencephalography) data point to frontal and temporal lobe activity, the latter resulting in competition with external sounds for auditory resources. Second, we discuss "trait" studies where EEG and MEG responses to sounds are recorded from patients who hallucinate and those who do not. They suggest a tendency to hallucinate is associated with competition for auditory processing resources. Third, we discuss studies addressing possible mechanisms of AVH, including spontaneous neural activity, abnormal self-monitoring, and dysfunctional interregional communication. While most studies show differences in EEG and MEG responses between patients and controls, far fewer show symptom relationships. We conclude that efforts to understand the pathophysiology of AVH using EEG and MEG have been hindered by poor anatomical resolution of the EEG and MEG measures, poor assessment of symptoms, poor understanding of the phenomenon, poor models of the phenomenon, decoupling of the symptoms from the neurophysiology due to medications and comorbidites, and the possibility that the schizophrenia diagnosis breeds truer than the symptoms it comprises. These problems are common to studies of other psychiatric symptoms and should be considered when attempting to understand the basic neural mechanisms responsible for them.
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Affiliation(s)
- Judith M. Ford
- Psychiatry Service, San Francisco Veterans Affairs Medical Center, Department of Psychiatry, University of California, San Francisco, CA,To whom correspondence should be addressed; San Francisco Veterans Affairs Medical Center, 116D, 4150 Clement Street, San Francisco, CA 94121, US; tel: 415-221-4810, ext 4187, fax: 415-750-6622, e-mail:
| | - Thomas Dierks
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Derek J. Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada,Neuroelectrophysiology Unit, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Christoph S. Herrmann
- Department of Experimental Psychology, Carl von Ossietzky University, Oldenburg, Germany
| | - Daniela Hubl
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Jochen Kindler
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Thomas Koenig
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Daniel H. Mathalon
- Psychiatry Service, San Francisco Veterans Affairs Medical Center, Department of Psychiatry, University of California, San Francisco, CA
| | - Kevin M. Spencer
- Research Service, Veterans Affairs Boston Healthcare System and Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Werner Strik
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Remko van Lutterveld
- Department of Psychiatry, University Medical Center, Utrecht, the Netherlands,Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, Utrecht, the Netherlands
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28
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Fisher DJ, Grant B, Smith DM, Borracci G, Labelle A, Knott VJ. Nicotine and the hallucinating brain: effects on mismatch negativity (MMN) in schizophrenia. Psychiatry Res 2012; 196:181-7. [PMID: 22425471 DOI: 10.1016/j.psychres.2012.01.026] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 01/23/2012] [Accepted: 01/25/2012] [Indexed: 10/28/2022]
Abstract
Elevated smoking rates have been noted in schizophrenia, and it has been hypothetically attributed to nicotine's ameliorating abnormal brain processes in this illness. There is some preliminary evidence that nicotine may alter pre-attentive auditory change detection, as indexed by the EEG-derived mismatch negativity (MMN), but no previous study has examined what role auditory verbal hallucinations (AVH) may have on these effects. The objective of this study was to examine MMN-indexed acoustic change detection in schizophrenia (SZ) following nicotine administration and elucidate its association with AVH. Using a modified multi-feature paradigm, MMNs to duration, frequency and intensity deviants were recorded in 12 schizophrenia outpatients (SZ) with persistent AVHs following nicotine (6mg) and placebo administration. Electrical activity was recorded from 32 scalp electrodes; MMN amplitudes and latencies for each deviant were compared between treatments and were correlated with trait (PSYRATS) and state measures of AVH severity and Positive and Negative Syndrome Scale (PANSS) ratings. Nicotine administration resulted in a shortened latency for intensity MMN. Additionally, nicotine-related change in MMN amplitude was correlated with nicotine-related change in subjective measures of hallucinatory state. In summary, nicotine did not affect MMN amplitudes in schizophrenia patients with persistent AVHs, however this study reports accelerated auditory change detection to intensity deviants with nicotine in this group. Additionally, nicotine appeared to induce a generalized activation of the auditory cortex in schizophrenia, resulting in a concurrent increase in intensity MMN amplitude and subjective clarity of AVHs.
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Affiliation(s)
- Derek J Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
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29
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The mismatch negativity (MMN)--a unique window to disturbed central auditory processing in ageing and different clinical conditions. Clin Neurophysiol 2011; 123:424-58. [PMID: 22169062 DOI: 10.1016/j.clinph.2011.09.020] [Citation(s) in RCA: 268] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 09/16/2011] [Accepted: 09/20/2011] [Indexed: 12/14/2022]
Abstract
In this article, we review clinical research using the mismatch negativity (MMN), a change-detection response of the brain elicited even in the absence of attention or behavioural task. In these studies, the MMN was usually elicited by employing occasional frequency, duration or speech-sound changes in repetitive background stimulation while the patient was reading or watching videos. It was found that in a large number of different neuropsychiatric, neurological and neurodevelopmental disorders, as well as in normal ageing, the MMN amplitude was attenuated and peak latency prolonged. Besides indexing decreased discrimination accuracy, these effects may also reflect, depending on the specific stimulus paradigm used, decreased sensory-memory duration, abnormal perception or attention control or, most importantly, cognitive decline. In fact, MMN deficiency appears to index cognitive decline irrespective of the specific symptomatologies and aetiologies of the different disorders involved.
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30
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Fisher DJ, Grant B, Smith DM, Borracci G, Labelle A, Knott VJ. Effects of auditory hallucinations on the mismatch negativity (MMN) in schizophrenia as measured by a modified 'optimal' multi-feature paradigm. Int J Psychophysiol 2011; 81:245-51. [PMID: 21749905 DOI: 10.1016/j.ijpsycho.2011.06.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Revised: 06/24/2011] [Accepted: 06/27/2011] [Indexed: 10/18/2022]
Abstract
UNLABELLED The recently developed Optimal-3 multi-feature MMN paradigm, a shortened version of the 'optimal' multi-feature MMN paradigm, allows for the focused recording of the most widely reported MMN deviants (frequency, duration, intensity) within an efficient and time-saving paradigm. The objective of this study was to examine MMN acoustic change detection in schizophrenia (SZ), and elucidate its association with auditory verbal hallucinations (AH), using the Optimal-3. METHODS MMN to duration, frequency and intensity deviants were recorded in 12 SZ outpatients (SZs) with persistent AHs and 12 matched healthy controls (HC). Electrical activity was recorded from 32 scalp electrodes; MMN amplitudes and latencies for each deviant were compared between groups and were correlated with trait (PSYRATS) and state measures of AH severity and Positive and Negative Syndrome Scale (PANSS) ratings in SZs. RESULTS SZs showed a significantly smaller duration MMN compared to HCs. Furthermore, in SZs attenuated duration MMN amplitudes were correlated with increased PSYRATS scores, as well as increased PANSS positive symptom, hallucination item and general psychoticism ratings, while attenuated intensity MMN amplitudes were correlated with increased PSYRATS scores. CONCLUSIONS This is the first study to examine MMN in SZ within the modified (Optimal-3) multi-feature MMN paradigm. This study corroborates previous research reporting a robust duration MMN deficit in SZ and supports previous findings suggesting that AHs may contribute to MMN deficits in SZ.
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Affiliation(s)
- Derek J Fisher
- Department of Psychology/Institute of Neuroscience, Carleton University, Ottawa, Ontario, Canada.
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31
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Naatanen R, Kujala T, Kreegipuu K, Carlson S, Escera C, Baldeweg T, Ponton C. The mismatch negativity: an index of cognitive decline in neuropsychiatric and neurological diseases and in ageing. Brain 2011; 134:3435-53. [DOI: 10.1093/brain/awr064] [Citation(s) in RCA: 159] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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32
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How can the brain's resting state activity generate hallucinations? A 'resting state hypothesis' of auditory verbal hallucinations. Schizophr Res 2011; 127:202-14. [PMID: 21146961 DOI: 10.1016/j.schres.2010.11.009] [Citation(s) in RCA: 146] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 09/16/2010] [Accepted: 11/08/2010] [Indexed: 11/20/2022]
Abstract
While several hypotheses about the neural mechanisms underlying auditory verbal hallucinations (AVH) have been suggested, the exact role of the recently highlighted intrinsic resting state activity of the brain remains unclear. Based on recent findings, we therefore developed what we call the 'resting state hypotheses' of AVH. Our hypothesis suggest that AVH may be traced back to abnormally elevated resting state activity in auditory cortex itself, abnormal modulation of the auditory cortex by anterior cortical midline regions as part of the default-mode network, and neural confusion between auditory cortical resting state changes and stimulus-induced activity. We discuss evidence in favour of our 'resting state hypothesis' and show its correspondence with phenomenological accounts.
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33
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van Lutterveld R, Sommer IEC, Ford JM. The neurophysiology of auditory hallucinations - a historical and contemporary review. Front Psychiatry 2011; 2:28. [PMID: 21629768 PMCID: PMC3099363 DOI: 10.3389/fpsyt.2011.00028] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 05/04/2011] [Indexed: 11/13/2022] Open
Abstract
Electroencephalography and magnetoencephalography are two techniques that distinguish themselves from other neuroimaging methodologies through their ability to directly measure brain-related activity and their high temporal resolution. A large body of research has applied these techniques to study auditory hallucinations. Across a variety of approaches, the left superior temporal cortex is consistently reported to be involved in this symptom. Moreover, there is increasing evidence that a failure in corollary discharge, i.e., a neural signal originating in frontal speech areas that indicates to sensory areas that forthcoming thought is self-generated, may underlie the experience of auditory hallucinations.
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Takei Y, Kumano S, Maki Y, Hattori S, Kawakubo Y, Kasai K, Fukuda M, Mikuni M. Preattentive dysfunction in bipolar disorder: a MEG study using auditory mismatch negativity. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:903-12. [PMID: 20417242 DOI: 10.1016/j.pnpbp.2010.04.014] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 03/26/2010] [Accepted: 04/15/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Neuropsychological studies have demonstrated that cognitive dysfunction represents pathophysiological mechanisms underlying bipolar disorder. However, information processing deficits in bipolar disorder have not often been examined electrophysiologically. Here, we examined preattentive processing and sensory information processing using mismatch field (MMNm) and P1m components, respectively, using magnetoencephalography. METHODS Ten patients with bipolar disorder and 20 healthy volunteers participated in the study. The participants were presented with auditory stimuli sequences comprising standard and deviant stimuli. MMNm was elicited in response to changes in duration and frequency of pure-tone stimuli and a vowel across-category change. RESULTS The magnetic global field power of MMNm in the right hemisphere under the pure-tone condition was significantly delayed in patients with bipolar disorder compared to healthy volunteers, and that of P1m did not differ between the two groups. The MMNm dipole in the left hemisphere was located inferior in patients with bipolar disorder than in healthy volunteers. This finding did not correlate with clinical symptoms. CONCLUSIONS Information processing at the preattentive level is impaired in patients with bipolar disorder irrespective of clinical symptoms, and this dysfunction is not due to sensory level dysfunction. The quality of preattentive information processing impairment is different between patients with bipolar disorder and patients with major depressive disorder, as shown by the MMNm latency and power differences.
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Affiliation(s)
- Yuichi Takei
- Department of Psychiatry and Human Behavior, Gunma University Graduate School of Medicine, Japan
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35
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Sorokin A, Alku P, Kujala T. Change and novelty detection in speech and non-speech sound streams. Brain Res 2010; 1327:77-90. [DOI: 10.1016/j.brainres.2010.02.052] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Revised: 01/30/2010] [Accepted: 02/18/2010] [Indexed: 10/19/2022]
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