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Wynn JK, Green MF. An EEG-Based Neuroplastic Approach to Predictive Coding in People With Schizophrenia or Traumatic Brain Injury. Clin EEG Neurosci 2024:15500594241252897. [PMID: 38711326 DOI: 10.1177/15500594241252897] [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] [Indexed: 05/08/2024]
Abstract
Despite different etiologies, people with schizophrenia (SCZ) or with traumatic brain injury (TBI) both show aberrant neuroplasticity. One neuroplastic mechanism that may be affected is prediction error coding. We used a roving mismatch negativity (rMMN) paradigm which uses different lengths of standard tone trains and is optimized to assess predictive coding. Twenty-five SCZ, 22 TBI (mild to moderate), and 25 healthy controls were assessed. We used a frequency-deviant rMMN in which the number of standards preceding the deviant was either 2, 6, or 36. We evaluated repetition positivity to the standard tone immediately preceding a deviant tone (repetition positivity [RP], to assess formation of the memory trace), deviant negativity to the deviant stimulus (deviant negativity [DN], which reflects signaling of a prediction error), and the difference wave between the 2 (the MMN). We found that SCZ showed reduced DN and MMN compared with healthy controls and with people with mild to moderate TBI. We did not detect impairments in any index (RP, DN, or MMN) in people with TBI compared to controls. Our findings suggest that prediction error coding assessed with rMMN is aberrant in SCZ but intact in TBI, though there is a suggestion that severity of head injury results in poorer prediction error coding.
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Affiliation(s)
- Jonathan K Wynn
- Center on Enhancement of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Michael F Green
- Center on Enhancement of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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Mo F, Zhao H, Li Y, Cai H, Song Y, Wang R, Yu Y, Zhu J. Network Localization of State and Trait of Auditory Verbal Hallucinations in Schizophrenia. Schizophr Bull 2024:sbae020. [PMID: 38401526 DOI: 10.1093/schbul/sbae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2024]
Abstract
BACKGROUND AND HYPOTHESIS Neuroimaging studies investigating the neural substrates of auditory verbal hallucinations (AVH) in schizophrenia have yielded mixed results, which may be reconciled by network localization. We sought to examine whether AVH-state and AVH-trait brain alterations in schizophrenia localize to common or distinct networks. STUDY DESIGN We initially identified AVH-state and AVH-trait brain alterations in schizophrenia reported in 48 previous studies. By integrating these affected brain locations with large-scale discovery and validation resting-state functional magnetic resonance imaging datasets, we then leveraged novel functional connectivity network mapping to construct AVH-state and AVH-trait dysfunctional networks. STUDY RESULTS The neuroanatomically heterogeneous AVH-state and AVH-trait brain alterations in schizophrenia localized to distinct and specific networks. The AVH-state dysfunctional network comprised a broadly distributed set of brain regions mainly involving the auditory, salience, basal ganglia, language, and sensorimotor networks. Contrastingly, the AVH-trait dysfunctional network manifested as a pattern of circumscribed brain regions principally implicating the caudate and inferior frontal gyrus. Additionally, the AVH-state dysfunctional network aligned with the neuromodulation targets for effective treatment of AVH, indicating possible clinical relevance. CONCLUSIONS Apart from unifying the seemingly irreproducible neuroimaging results across prior AVH studies, our findings suggest different neural mechanisms underlying AVH state and trait in schizophrenia from a network perspective and more broadly may inform future neuromodulation treatment for AVH.
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Affiliation(s)
- Fan Mo
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Han Zhao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Yifan Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Huanhuan Cai
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Yang Song
- Department of Pain, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Rui Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Anhui Province, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Anhui Provincial Key Laboratory for Brain Bank Construction and Resource Utilization, Hefei, China
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Anhøj S, Ebdrup B, Nielsen MØ, Antonsen P, Glenthøj B, Rostrup E. Functional Connectivity Between Auditory and Medial Temporal Lobe Networks in Antipsychotic-Naïve Patients With First-Episode Schizophrenia Predicts the Effects of Dopamine Antagonism on Auditory Verbal Hallucinations. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:308-316. [PMID: 38298804 PMCID: PMC10829637 DOI: 10.1016/j.bpsgos.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 02/02/2024] Open
Abstract
Background Understanding how antipsychotic medication ameliorates auditory verbal hallucinations (AVHs) through modulation of brain circuitry is pivotal for understanding the pathophysiology of psychosis and for predicting treatment response. Methods This case-control study included examinations at baseline and at follow-up after 6 weeks. Initially, antipsychotic-naïve patients with first-episode schizophrenia who were experiencing AVHs were recruited together with healthy control participants. Antipsychotic treatment with the relatively selective D2 receptor antagonist amisulpride was administered as monotherapy. Functional connectivity measured by resting-state functional magnetic resonance imaging between networks of interest was used to study the effects of D2 blockade on brain circuitry and predict clinical treatment response. Hallucinations were rated with the Positive and Negative Syndrome Scale. Results Thirty-two patients experiencing AVHs and 34 healthy control participants were scanned at baseline. Twenty-two patients and 34 healthy control participants were rescanned at follow-up. Connectivity between the auditory network and the medial temporal lobe network was increased in patients at baseline (p = .002) and normalized within 6 weeks of D2 blockade (p = .018). At baseline, the connectivity between these networks was positively correlated with ratings of hallucinations (t = 2.67, p = .013). Moreover, baseline connectivity between the auditory network and the medial temporal lobe network predicted reduction in hallucinations (t = 2.34, p = .032). Conclusions Functional connectivity between the auditory network and the medial temporal lobe predicted response to initial antipsychotic treatment. These findings demonstrate that connectivity between networks involved in auditory processing, internal monitoring, and memory is associated with the clinical effect of dopamine antagonism.
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Affiliation(s)
- Simon Anhøj
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
| | - Bjørn Ebdrup
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Ødegaard Nielsen
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Patrick Antonsen
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
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Donaldson KR, Jonas K, Foti D, Larsen EM, Mohanty A, Kotov R. Mismatch negativity and clinical trajectories in psychotic disorders: Five-year stability and predictive utility. Psychol Med 2023; 53:5818-5828. [PMID: 36226640 PMCID: PMC10782876 DOI: 10.1017/s0033291722003075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Mismatch negativity (MMN) amplitude is reduced in psychotic disorders and associated with symptoms and functioning. Due to these robust associations, it is often considered a biomarker for psychotic illness. The relationship between MMN and clinical outcomes has been examined well in early onset psychotic illness; however, its stability and predictive utility in chronic samples are not clear. METHOD We examined the five-year stability of MMN amplitude over two timepoints in individuals with established psychotic disorders (cases; N = 132) and never-psychotic participants (NP; N = 170), as well as longitudinal associations with clinical symptoms and functioning. RESULTS MMN amplitude exhibited good temporal stability (cases, r = 0.53; never-psychotic, r = 0.52). In cases, structural equation models revealed MMN amplitude to be a significant predictor of worsening auditory hallucinations (β = 0.19), everyday functioning (β = -0.13), and illness severity (β = -0.12) at follow-up. Meanwhile, initial IQ (β = -0.24), negative symptoms (β = 0.23), and illness severity (β = -0.16) were significant predictors of worsening MMN amplitude five years later. CONCLUSIONS These results imply that MMN measures a neural deficit that is reasonably stable up to five years. Results support disordered cognition and negative symptoms as preceding reduced MMN, which then may operate as a mechanism driving reductions in everyday functioning and the worsening of auditory hallucinations in chronic psychotic disorders. This pattern may inform models of illness course, clarifying the relationships amongst biological mechanisms of predictive processing and clinical deficits in chronic psychosis and allowing us to better understand the mechanisms driving such impairments over time.
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Affiliation(s)
| | | | - Dan Foti
- Purdue University, Department of Psychological Sciences
| | | | | | - Roman Kotov
- Stony Brook Medicine, Department of Psychiatry
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Chhabra H, Selvaraj S, Sreeraj VS, Damodharan D, Shivakumar V, Kumar V, Narayanaswamy JC, Venkatasubramanian G. Functional near-infrared spectroscopy in schizophrenia patients with auditory verbal hallucinations: Preliminary observations. Asian J Psychiatr 2022; 73:103127. [PMID: 35430497 DOI: 10.1016/j.ajp.2022.103127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 04/07/2022] [Indexed: 11/02/2022]
Abstract
Auditory Signal Detection (ASD) theory postulates that auditory verbal hallucinations (AVH) result from an aberrant association of meaningful connection to abstract noises. In this study, schizophrenia (SZ) patients with persistent AVH (N = 17) and matched controls (N = 25) performed an ASD task with concurrent functional near-infrared spectroscopy recording targetting the left dorsolateral prefrontal cortex (L-DLPFC) and left temporoparietal junction (L-TPJ). During the task, discriminability index had a significant negative correlation, and early deoxyhemoglobin (HbR) latency at L-TPJ positively correlated with AVH scores. Also, patients had significantly lower discriminability, early HbR latency at L-TPJ, and delayed latency at L-DLPFC. This finding suggests the presence of ASD abnormalities and impaired auditory processing in SZ patients with AVH supporting ASD-based pathogenesis.
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Affiliation(s)
- Harleen Chhabra
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Sowmya Selvaraj
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Vanteemar S Sreeraj
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Dinakaran Damodharan
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Venkataram Shivakumar
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Vijay Kumar
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Janardhanan C Narayanaswamy
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
| | - Ganesan Venkatasubramanian
- Center for Psychophysics, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India.
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Xue K, Chen J, Wei Y, Chen Y, Han S, Wang C, Zhang Y, Song X, Cheng J. Altered dynamic functional connectivity of auditory cortex and medial geniculate nucleus in first-episode, drug-naïve schizophrenia patients with and without auditory verbal hallucinations. Front Psychiatry 2022; 13:963634. [PMID: 36159925 PMCID: PMC9489854 DOI: 10.3389/fpsyt.2022.963634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/18/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVE As a key feature of schizophrenia, auditory verbal hallucination (AVH) is causing concern. Altered dynamic functional connectivity (dFC) patterns involving in auditory related regions were rarely reported in schizophrenia patients with AVH. The goal of this research was to find out the dFC abnormalities of auditory related regions in first-episode, drug-naïve schizophrenia patients with and without AVH using resting state functional magnetic resonance imaging (rs-fMRI). METHODS A total of 107 schizophrenia patients with AVH, 85 schizophrenia patients without AVH (NAVH) underwent rs-fMRI examinations, and 104 healthy controls (HC) were matched. Seed-based dFC of the primary auditory cortex (Heschl's gyrus, HES), auditory association cortex (AAC, including Brodmann's areas 22 and 42), and medial geniculate nucleus (MGN) was conducted to build a whole-brain dFC diagram, then inter group comparison and correlation analysis were performed. RESULTS In comparison to the NAVH and HC groups, the AVH group showed increased dFC from left ACC to the right middle temporal gyrus and right middle occipital gyrus, decreased dFC from left HES to the left superior occipital gyrus, left cuneus gyrus, left precuneus gyrus, decreased dFC from right HES to the posterior cingulate gyrus, and decreased dFC from left MGN to the bilateral calcarine gyrus, bilateral cuneus gyrus, bilateral lingual gyrus. The Auditory Hallucination Rating Scale (AHRS) was significantly positively correlated with the dFC values of cluster 1 (bilateral calcarine gyrus, cuneus gyrus, lingual gyrus, superior occipital gyrus, precuneus gyrus, and posterior cingulate gyrus) using left AAC seed, cluster 2 (right middle temporal gyrus and right middle occipital gyrus) using left AAC seed, cluster 1 (bilateral calcarine gyrus, cuneus gyrus, lingual gyrus, superior occipital gyrus, precuneus gyrus and posterior cingulate gyrus) using right AAC seed and cluster 2 (posterior cingulate gyrus) using right HES seed in the AVH group. In both AVH and NAVH groups, a significantly negative correlation is also found between the dFC values of cluster 2 (posterior cingulate gyrus) using the right HES seed and the PANSS negative sub-scores. CONCLUSIONS The present findings demonstrate that schizophrenia patients with AVH showed multiple abnormal dFC regions using auditory related cortex and nucleus as seeds, particularly involving the occipital lobe, default mode network (DMN), and middle temporal lobe, implying that the different dFC patterns of auditory related areas could provide a neurological mechanism of AVH in schizophrenia.
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Affiliation(s)
- Kangkang Xue
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingli Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Caihong Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Shao X, Liao Y, Gu L, Chen W, Tang J. The Etiology of Auditory Hallucinations in Schizophrenia: From Multidimensional Levels. Front Neurosci 2021; 15:755870. [PMID: 34858129 PMCID: PMC8632545 DOI: 10.3389/fnins.2021.755870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/14/2021] [Indexed: 11/25/2022] Open
Abstract
Enormous efforts have been made to unveil the etiology of auditory hallucinations (AHs), and multiple genetic and neural factors have already been shown to have their own roles. Previous studies have shown that AHs in schizophrenia vary from those in other disorders, suggesting that they have unique features and possibly distinguishable mechanisms worthy of further investigation. In this review, we intend to offer a comprehensive summary of current findings related to AHs in schizophrenia from aspects of genetics and transcriptome, neurophysiology (neurometabolic and electroencephalogram studies), and neuroimaging (structural and functional magnetic resonance imaging studies and transcriptome–neuroimaging association study). Main findings include gene polymorphisms, glutamate level change, electroencephalographic alterations, and abnormalities of white matter fasciculi, cortical structure, and cerebral activities, especially in multiple regions, including auditory and language networks. More solid and comparable research is needed to replicate and integrate ongoing findings from multidimensional levels.
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Affiliation(s)
- Xu Shao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Gu
- RIKEN AIP, Tokyo, Japan.,Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Wei Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Musiek FE, Morris S, Ichiba K, Clark L, Davidson AJ. Auditory Hallucinations: An Audiological Horizon? J Am Acad Audiol 2021; 32:195-210. [PMID: 34062609 DOI: 10.1055/s-0041-1722989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Interesting data and theories have emerged regarding auditory hallucinations (AHs) in patients with schizophrenia. The possibility that these patients may have changes in the anatomy of the auditory cortex and/or subcortical structures of the central auditory nervous system and present with deficits on audiological tests is important information to the audiology community. However, it seems clear that, in general, audiologists are not sufficiently aware of these findings. PURPOSE There are two main purposes of this article: (1) to educate audiologists about AHs related to schizophrenia and related issues, and (2) to encourage audiologists and hearing scientists to become involved in the evaluation and research of AHs. This fascinating disorder is one in which audiologists/hearing scientists are well suited to make a significant contribution. RESEARCH DESIGN A review and synthesis of the literature was conducted. Relevant literature was identified through PubMed, Google Scholar, as well as independent book chapters and article searches. Keywords driving the searches were AHs, auditory illusions, verbal and musical hallucinations, schizophrenia, and central auditory disorders. Given the currency of the topic, the information collected was primarily between 1990 and 2020. STUDY SAMPLE The review is organized around categorization, prevalence, models, mechanisms, anatomy, pathophysiology, and audiological correlates related to AHs. DATA COLLECTION AND ANALYSIS Searches were conducted using well-known search engines and manual searches by each author. This information on AHs was then analyzed collectively by the authors for useful background and relevance, as well as important for the field of audiology. RESULTS Several anatomical, physiological, and functional imaging studies have shown compromise of the auditory cortex in those with schizophrenia and AHs. Potentially related to this, are studies that demonstrated sub-par performance on behavioral audiologic measures for this unique clinical population. These findings align well with the kind of hearing disorder for which audiologists are well-trained to make significant contributions. CONCLUSION Neurobiological and audiological evidence is accumulating on patients with schizophrenia and AH potentially rendering it as both an auditory and psychiatric disorder. Audiologists should consider expanding their horizon and playing a role in the clinical investigation of this disorder.
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Affiliation(s)
- Frank E Musiek
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, Arizona
| | - Sarah Morris
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, Arizona
| | - Kayla Ichiba
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, Arizona
| | - Liza Clark
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, Arizona
| | - Alyssa J Davidson
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
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9
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Orepic P, Rognini G, Kannape OA, Faivre N, Blanke O. Sensorimotor conflicts induce somatic passivity and louden quiet voices in healthy listeners. Schizophr Res 2021; 231:170-177. [PMID: 33866262 DOI: 10.1016/j.schres.2021.03.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 02/09/2021] [Accepted: 03/28/2021] [Indexed: 02/08/2023]
Abstract
Sensorimotor conflicts are known to alter the perception of accompanying sensory signals, and deficits in sensory attenuation have been observed in schizophrenia. In the auditory domain, self-generated tones or voices (compared to tones or voices presented passively or with temporal delays) have been associated with changes in loudness perception and attenuated neural responses. It has been argued that for sensory signals to be attenuated, predicted and sensory consequences must have a consistent spatiotemporal relationship, between button presses and reafferent signals, via predictive sensory signaling, a process altered in schizophrenia. Here, we investigated auditory sensory attenuation for a series of morphed voices while healthy participants applied sensorimotor stimulations that had no spatiotemporal relationship to the voice stimuli and that have been shown to induce mild psychosis-like phenomena. In two independent groups of participants, we report a loudening of silent voices and found this effect only during maximal sensorimotor conflicts (versus several control conditions). Importantly, conflicting sensorimotor stimulation also induced a mild psychosis-like state in the form of somatic passivity and participants who experienced stronger passivity lacked the sensorimotor loudening effect. We argue that this conflict-related sensorimotor loudness amplification may represent a reduction of auditory self-attenuation that is lacking in participants experiencing a concomitant mild psychosis-like state. We interpret our results within the framework of the comparator model of sensorimotor control, and discuss the implications of our findings regarding passivity experiences and hallucinations in schizophrenia.
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Affiliation(s)
- Pavo Orepic
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics and Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Switzerland
| | - Giulio Rognini
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics and Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Switzerland
| | - Oliver Alan Kannape
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics and Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Switzerland
| | - Nathan Faivre
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LPNC, 38000 Grenoble, France
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Center for Neuroprosthetics and Brain Mind Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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Cheng CH, Chang CC, Chao YP, Lu H, Peng SW, Wang PN. Altered mismatch response precedes gray matter atrophy in subjective cognitive decline. Psychophysiology 2021; 58:e13820. [PMID: 33792049 DOI: 10.1111/psyp.13820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 02/03/2023]
Abstract
The cross-sectional identification of subjective cognitive decline (SCD) in cognitively normal adults is particularly important for the early effective prevention or intervention of the future development of mild cognitive impairments (MCI) or Alzheimer's disease (AD). A pre-attentive neurophysiological signal that reflects the brain's ability to detect the changes of the environment is called mismatch negativity (MMN) or its magnetic counterpart (MMNm). It has been shown that patients with MCI or AD demonstrate reduced MMN/MMNm responses, while the exact profile of MMN/MMNm in SCD is substantially unknown. We applied magnetoencephalographic recordings to interrogate MMNm activities in healthy controls (HC, n = 29) and individuals with SCD (n = 26). Furthermore, we analyzed gray matter (GM) volumes in the MMNm-related regions through voxel-based morphometry and performed apolipoprotein E4 (APOE4) genotyping for all the participants. Our results showed that there were no significant differences in GM volume and proportions of APOE4 carriers between HC and SCD groups. However, individuals with SCD exhibited weakened z-corrected MMNm responses in the left inferior parietal lobule and right inferior frontal gyrus (IFG) as compared to HC. Based on the regions showing significant between-group differences, z-corrected MMNm amplitudes of the right IFG significantly correlated with the memory performance among the SCD participants. Our data suggest that neurophysiological changes of the brain, as indexed by MMNm, precede structural atrophy in the individuals with SCD compared to those without SCD.
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Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan.,Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chiung-Chih Chang
- Department of Neurology and Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Ping Chao
- Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan.,Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hsinjie Lu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan.,Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan
| | - Shih-Wei Peng
- Division of General Neurology, Department of Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Pei-Ning Wang
- Division of General Neurology, Department of Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Neurology, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.,Brain Research Center, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
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11
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Hsieh MH, Chien YL, Gau SSF. Mismatch negativity and P3a in drug-naive adults with attention-deficit hyperactivity disorder. Psychol Med 2021; 52:1-11. [PMID: 33706818 PMCID: PMC9772912 DOI: 10.1017/s0033291720005516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/15/2020] [Accepted: 01/04/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Individuals with attention-deficit hyperactivity disorder (ADHD) often display over-response to stimuli that are irrelevant to the ongoing task, and their attentional abilities disproportionately worsen in the presence of competing stimuli. Auditory event-related potentials (ERPs) such as mismatch negativity (MMN) and P3a using the passive oddball paradigm have been studied in children and adolescents with ADHD. Still, there is no such data for adults with ADHD. This study aimed to compare the MMN and P3a and their clinical and neurocognitive correlations between drug-naive adults with ADHD and control adults. METHODS We recruited 52 adults with ADHD (26.5 ± 6.2 years), and 62 age-matched controls (25.6 ± 5.6 years). They received the psychiatric interviews, auditory ERP, the Conners' continuous performance test (CCPT), and the Cambridge gambling test (CGT). They also completed the questionnaires about ADHD symptoms and real-world executive functions. MMN and P3a were assessed during a passive duration-deviant auditory oddball paradigm from the midline electrodes Cz. RESULTS Adults with ADHD demonstrated smaller Cz MMN amplitude, more severe ADHD symptoms, poorer attention profiles (CCPT), and a wide range of executive dysfunctions than controls. As for the correlates, Cz peak amplitude of MMN correlated with inattention symptoms, executive dysfunctions, attentional vigilance (CCPT), and decision-making (CGT) in ADHD adults but only with decision-making in controls. CONCLUSIONS Our findings that smaller amplitude of MMN and its differential associated pattern with inattention, real-world executive dysfunction, and decision-making, in drug-naive adults with ADHD from adult controls, provide evidence to support the potential electrophysiological biomarker for adult ADHD.
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Affiliation(s)
- Ming H. Hsieh
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, and Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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12
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Common and distinct brain functional alterations in pharmacotherapy treatment-naïve female borderline personality disorder patients with and without auditory verbal hallucinations: a pilot study. Eur Arch Psychiatry Clin Neurosci 2021; 271:1149-1157. [PMID: 32009225 PMCID: PMC8354887 DOI: 10.1007/s00406-020-01102-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 01/21/2020] [Indexed: 02/06/2023]
Abstract
Auditory verbal hallucinations (AVHs) are experienced by approximately 25% of patients with borderline personality disorder (BPD). Despite the high incidence, the pathological features of AVH in BPD remain unclear. This study aimed to investigate whole-brain functional connectivity (FC), as measured by functional connectivity density (FCD), and its relationship with AVH in BPD. 65 pharmacotherapy treatment-naïve female BPD patients (30 with AVH and 35 without AVH), and 35 female healthy controls were investigated. Functional magnetic resonance imaging (fMRI) data were collected to assess whole-brain FC and functional connectivity density mapping (FCDM) was applied to the fMRI data to compute FCD features. Compared to the healthy controls, both BPD groups (BPD-AVH and BPD without AVH) exhibited significantly higher gFCD values in the bilateral prefrontal lobe, bilateral orbital lobule, and bilateral insula, and significantly lower gFCD values in the SMA, right anterior temporal lobule, and the ACC. These altered regions were significantly associated with AVH in the BPD subjects. Moreover, higher gFCD values were observed in the left posterior temporal lobule and posterior frontal lobule. Aberrant alterations also emerged in the left posterior temporal lobule and posterior frontal lobule, mainly in Broca and Wernicke regions. Nevertheless, there was no significant correlation between gFCD values and the severity of AVH as measured by the AVH scores. In summary, we have identified aberrations in the FC and brain metabolism of the aforementioned neural circuits/networks, which may provide new insights into BPD-AVH and facilitate the development of therapeutic approaches for treating AVH in BPD patients.
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13
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Pinheiro AP, Schwartze M, Kotz SA. Cerebellar circuitry and auditory verbal hallucinations: An integrative synthesis and perspective. Neurosci Biobehav Rev 2020; 118:485-503. [DOI: 10.1016/j.neubiorev.2020.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/30/2020] [Accepted: 08/07/2020] [Indexed: 02/06/2023]
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14
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Chen C, Wang GH, Wu SH, Zou JL, Zhou Y, Wang HL. Abnormal Local Activity and Functional Dysconnectivity in Patients with Schizophrenia Having Auditory Verbal Hallucinations. Curr Med Sci 2020; 40:979-984. [PMID: 33123911 DOI: 10.1007/s11596-020-2271-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 08/03/2020] [Indexed: 11/25/2022]
Abstract
Auditory verbal hallucination (AVH) is emphasized as a pathological hallmark of schizophrenia. Neuroimaging studies provide evidence linking AVH to overlapping functional abnormalities in distributed networks. However, no clear conclusion has still been reached. This study aimed to further explore the brain activity of patients with schizophrenia having AVH from both local activity (LA) and functional connectivity (FC) insights, while excluding confounding factors from other positive symptoms. A total of 42 patients with AVH (AVH patients group, APG), 26 without AVH (non-AVH patients group, NPG), and 82 normal controls (NC) underwent resting-state functional magnetic resonance imaging (fMRI). LA measures, including regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuations (fALFF), and FC measures were evaluated to understand the neuroimaging mechanism of AVH. APG showed increased ReHo and fALFF in the bilateral putamen (Put) compared with NPG and NC. FC analysis (using bilateral putamen as seeds) revealed that all patients showed abnormal FC of multiple resting-state network regions, including the anterior and post cingulate cortex, middle frontal gyrus, inferior parietal gyrus, and left angular gyrus. Interestingly, APG showed significantly decreased FC of insula extending to the superior temporal gyrus and inferior frontal gyrus compared with NPG and NC. The present findings suggested a significant correlation of abnormal LA and dysfunctional putamen-auditory cortical connectivity with the neuropathological mechanism of AVH, providing evidence for the functional disconnection hypothesis of schizophrenia.
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Affiliation(s)
- Cheng Chen
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Gao-Hua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
- Hubei Institute of Neurology and Psychiatry Research, Wuhan, 430060, China
| | - Shi-Hao Wu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Ji-Lin Zou
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yuan Zhou
- Institute of Psychology, CAS Key Laboratory of Behavioral Science, Beijing, 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Hui-Ling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
- Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan, 430071, China.
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15
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Shinn AK, Wolff JD, Hwang M, Lebois LAM, Robinson MA, Winternitz SR, Öngür D, Ressler KJ, Kaufman ML. Assessing Voice Hearing in Trauma Spectrum Disorders: A Comparison of Two Measures and a Review of the Literature. Front Psychiatry 2020; 10:1011. [PMID: 32153431 PMCID: PMC7050446 DOI: 10.3389/fpsyt.2019.01011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 12/20/2019] [Indexed: 11/13/2022] Open
Abstract
Voice hearing (VH) can occur in trauma spectrum disorders (TSD) such as posttraumatic stress disorder (PTSD) and dissociative disorders. However, previous estimates of VH among individuals with TSD vary widely. In this study, we sought to better characterize the rate and phenomenology of VH in a sample of 70 women with TSD related to childhood abuse who were receiving care in a specialized trauma program. We compared the rate of VH within our sample using two different measures: 1) the auditory hallucination (AH) item in the Structured Clinical Interview for DSM-IV-TR (SCID), and 2) the thirteen questions involving VH in the Multidimensional Inventory of Dissociation (MID), a self-report questionnaire that comprehensively assesses pathological dissociation. We found that 45.7% of our sample met threshold for SCID AH, while 91.4% met criteria for MID VH. Receiver operating characteristics (ROC) analyses showed that while SCID AH and MID VH items have greater than chance agreement, the strength of agreement is only moderate, suggesting that SCID and MID VH items measure related but not identical constructs. Thirty-two patients met criteria for both SCID AH and at least one MID VH item ("unequivocal VH"), 32 for at least one MID VH item but not SCID AH ("ambiguous VH"), and 6 met criteria for neither ("unequivocal non-VH"). Relative to the ambiguous VH group, the unequivocal VH group had higher dissociation scores for child voices, and higher mean frequencies for child voices and Schneiderian voices. Our findings suggest that VH in women with TSD related to childhood abuse is common, but that the rate of VH depends on how the question is asked. We review prior studies examining AH and/or VH in TSD, focusing on the measures used to ascertain these experiences, and conclude that our two estimates are consistent with previous studies that used comparable instruments and patient samples. Our results add to growing evidence that VH-an experience typically considered psychotic or psychotic-like-is not equivalent to having a psychotic disorder. Instruments that assess VH apart from psychotic disorders and that capture their multidimensional nature may improve identification of VH, especially among patients with non-psychotic disorders.
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Affiliation(s)
- Ann K. Shinn
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Jonathan D. Wolff
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Dissociative Disorders and Trauma Research Program, McLean Hospital, Belmont, MA, United States
| | - Melissa Hwang
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States
| | - Lauren A. M. Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Dissociative Disorders and Trauma Research Program, McLean Hospital, Belmont, MA, United States
- Neurobiology of Fear Laboratory, McLean Hospital, Belmont, MA, United States
| | - Mathew A. Robinson
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Dissociative Disorders and Trauma Research Program, McLean Hospital, Belmont, MA, United States
| | - Sherry R. Winternitz
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Dissociative Disorders and Trauma Research Program, McLean Hospital, Belmont, MA, United States
| | - Dost Öngür
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Neurobiology of Fear Laboratory, McLean Hospital, Belmont, MA, United States
| | - Milissa L. Kaufman
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Dissociative Disorders and Trauma Research Program, McLean Hospital, Belmont, MA, United States
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16
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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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17
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McCleery A, Mathalon DH, Wynn JK, Roach BJ, Hellemann GS, Marder SR, Green MF. Parsing components of auditory predictive coding in schizophrenia using a roving standard mismatch negativity paradigm. Psychol Med 2019; 49:1195-1206. [PMID: 30642411 PMCID: PMC6499668 DOI: 10.1017/s0033291718004087] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Mismatch negativity (MMN) is an event-related potential (ERP) component reflecting auditory predictive coding. Repeated standard tones evoke increasing positivity ('repetition positivity'; RP), reflecting strengthening of the standard's memory trace and the prediction it will recur. Likewise, deviant tones preceded by more standard repetitions evoke greater negativity ('deviant negativity'; DN), reflecting stronger prediction error signaling. These memory trace effects are also evident in MMN difference wave. Here, we assess group differences and test-retest reliability of these indices in schizophrenia patients (SZ) and healthy controls (HC). METHODS Electroencephalography was recorded twice, 2 weeks apart, from 43 SZ and 30 HC, during a roving standard paradigm. We examined ERPs to the third, eighth, and 33rd standards (RP), immediately subsequent deviants (DN), and the corresponding MMN. Memory trace effects were assessed by comparing amplitudes associated with the three standard repetition trains. RESULTS Compared with controls, SZ showed reduced MMNs and DNs, but normal RPs. Both groups showed memory trace effects for RP, MMN, and DN, with a trend for attenuated DNs in SZ. Intraclass correlations obtained via this paradigm indicated good-to-moderate reliabilities for overall MMN, DN and RP, but moderate to poor reliabilities for components associated with short, intermediate, and long standard trains, and poor reliability of their memory trace effects. CONCLUSION MMN deficits in SZ reflected attenuated prediction error signaling (DN), with relatively intact predictive code formation (RP) and memory trace effects. This roving standard MMN paradigm requires additional development/validation to obtain suitable levels of reliability for use in clinical trials.
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Affiliation(s)
- Amanda McCleery
- Semel Institute for Neuroscience and Human Behavior, UCLA
- Veterans Affairs Greater Los Angeles Healthcare System
| | - Daniel H. Mathalon
- Veterans Affairs San Francisco Healthcare System
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco
| | - Jonathan K. Wynn
- Semel Institute for Neuroscience and Human Behavior, UCLA
- Veterans Affairs Greater Los Angeles Healthcare System
| | | | - Gerhard S. Hellemann
- Semel Institute for Neuroscience and Human Behavior, UCLA
- Veterans Affairs Greater Los Angeles Healthcare System
| | - Stephen R. Marder
- Semel Institute for Neuroscience and Human Behavior, UCLA
- Veterans Affairs Greater Los Angeles Healthcare System
| | - Michael F. Green
- Semel Institute for Neuroscience and Human Behavior, UCLA
- Veterans Affairs Greater Los Angeles Healthcare System
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18
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Voss P, Thomas ME, Guercio GD, de Villers-Sidani E. Dysregulation of auditory neuroplasticity in schizophrenia. Schizophr Res 2019; 207:3-11. [PMID: 29703662 DOI: 10.1016/j.schres.2018.04.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/10/2018] [Accepted: 04/13/2018] [Indexed: 12/16/2022]
Abstract
Schizophrenia is a complex brain syndrome characterized by an array of positive symptoms (delusions, hallucinations, disorganized speech), negative symptoms (alogia, apathy, avolition) and cognitive impairments (memory, executive functions). Although investigations of the cognitive deficits in schizophrenia have primarily concentrated on disturbances affecting higher-order cognitive processes, there is an increasing realization that schizophrenia also affects early sensory processing, which might, in fact, play a significant role in the development of higher-order cognitive impairments. Recent evidence suggests that many of these early sensory processing impairments possibly arise from a dysregulation of plasticity regulators in schizophrenia, resulting in either reduced plasticity or excessive unregulated plasticity. The purpose of the present manuscript is to provide a concise overview of how the dysregulation of cortical plasticity mechanisms contributes to schizophrenia symptoms with an emphasis on auditory dysplasticity and to discuss its relevance for treatment outcomes. The idea that plasticity mechanisms are not constrained only within sensitive periods suggests that many functional properties of sensory neurons can be altered throughout the lifetime.
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Affiliation(s)
- Patrice Voss
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada.
| | - Maryse E Thomas
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Gerson D Guercio
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada
| | - Etienne de Villers-Sidani
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada.
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19
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Rollins CP, Garrison JR, Simons JS, Rowe JB, O'Callaghan C, Murray GK, Suckling J. Meta-analytic Evidence for the Plurality of Mechanisms in Transdiagnostic Structural MRI Studies of Hallucination Status. EClinicalMedicine 2019; 8:57-71. [PMID: 31193632 PMCID: PMC6537703 DOI: 10.1016/j.eclinm.2019.01.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/15/2019] [Accepted: 01/27/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Hallucinations are transmodal and transdiagnostic phenomena, occurring across sensory modalities and presenting in psychiatric, neurodegenerative, neurological, and non-clinical populations. Despite their cross-category occurrence, little empirical work has directly compared between-group neural correlates of hallucinations. METHODS We performed whole-brain voxelwise meta-analyses of hallucination status across diagnoses using anisotropic effect-size seed-based d mapping (AES-SDM), and conducted a comprehensive systematic review in PubMed and Web of Science until May 2018 on other structural correlates of hallucinations, including cortical thickness and gyrification. FINDINGS 3214 abstracts were identified. Patients with psychiatric disorders and hallucinations (eight studies) exhibited reduced gray matter (GM) in the left insula, right inferior frontal gyrus, left anterior cingulate/paracingulate gyrus, left middle temporal gyrus, and increased in the bilateral fusiform gyrus, while patients with neurodegenerative disorders with hallucinations (eight studies) showed GM decreases in the left lingual gyrus, right supramarginal gyrus/parietal operculum, left parahippocampal gyrus, left fusiform gyrus, right thalamus, and right lateral occipital gyrus. Group differences between psychiatric and neurodegenerative hallucination meta-analyses were formally confirmed using Monte Carlo randomizations to determine statistical significance, and a jackknife sensitivity analysis established the reproducibility of results across nearly all study combinations. For other structural measures (28 studies), the most consistent findings associated with hallucination status were reduced cortical thickness in temporal gyri in schizophrenia and altered hippocampal volume in Parkinson's disease and dementia. Additionally, increased severity of hallucinations in schizophrenia correlated with GM reductions within the left superior temporal gyrus, right middle temporal gyrus, bilateral supramarginal and angular gyri. INTERPRETATION Distinct patterns of neuroanatomical alteration characterize hallucination status in patients with psychiatric and neurodegenerative diseases, suggesting a plurality of anatomical signatures. This approach has implications for treatment, theoretical frameworks, and generates refutable predictions for hallucinations in other diseases and their occurrence within the general population. FUNDING None.
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Affiliation(s)
- Colleen P.E. Rollins
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Corresponding author at: Department of Psychiatry, University of Cambridge, Cambridge CB2 0SP, UK
| | - Jane R. Garrison
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Jon S. Simons
- Department of Psychology and Behavioural & Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - James B. Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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20
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Sterzer P, Adams RA, Fletcher P, Frith C, Lawrie SM, Muckli L, Petrovic P, Uhlhaas P, Voss M, Corlett PR. The Predictive Coding Account of Psychosis. Biol Psychiatry 2018; 84:634-643. [PMID: 30007575 PMCID: PMC6169400 DOI: 10.1016/j.biopsych.2018.05.015] [Citation(s) in RCA: 378] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 01/12/2023]
Abstract
Fueled by developments in computational neuroscience, there has been increasing interest in the underlying neurocomputational mechanisms of psychosis. One successful approach involves predictive coding and Bayesian inference. Here, inferences regarding the current state of the world are made by combining prior beliefs with incoming sensory signals. Mismatches between prior beliefs and incoming signals constitute prediction errors that drive new learning. Psychosis has been suggested to result from a decreased precision in the encoding of prior beliefs relative to the sensory data, thereby garnering maladaptive inferences. Here, we review the current evidence for aberrant predictive coding and discuss challenges for this canonical predictive coding account of psychosis. For example, hallucinations and delusions may relate to distinct alterations in predictive coding, despite their common co-occurrence. More broadly, some studies implicate weakened prior beliefs in psychosis, and others find stronger priors. These challenges might be answered with a more nuanced view of predictive coding. Different priors may be specified for different sensory modalities and their integration, and deficits in each modality need not be uniform. Furthermore, hierarchical organization may be critical. Altered processes at lower levels of a hierarchy need not be linearly related to processes at higher levels (and vice versa). Finally, canonical theories do not highlight active inference-the process through which the effects of our actions on our sensations are anticipated and minimized. It is possible that conflicting findings might be reconciled by considering these complexities, portending a framework for psychosis more equipped to deal with its many manifestations.
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Affiliation(s)
- Philipp Sterzer
- Department of Psychiatry, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Rick A Adams
- Division of Psychiatry, University College London, London, United Kingdom
| | - Paul Fletcher
- Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom; Wellcome-MRC Behavioral and Clinical Neuroscience Institute, Cambridge and Peterborough Foundation Trust, Cambridge, United Kingdom
| | - Chris Frith
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom
| | - Stephen M Lawrie
- Center for Clinical and Brain Sciences, Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, United Kingdom
| | - Lars Muckli
- Centre for Cognitive Neuroimaging, Institute of Neuroscience & Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Predrag Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Peter Uhlhaas
- Centre for Cognitive Neuroimaging, Institute of Neuroscience & Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Martin Voss
- Department of Psychiatry and Psychotherapy, Charité University Medicine and St. Hedwig Hospital, Berlin Center for Advanced Neuroimaging, Humboldt University Berlin, Berlin, Germany
| | - Philip R Corlett
- Department of Psychiatry, Yale University, New Haven, Connecticut.
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21
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McCleery A, Wynn JK, Mathalon DH, Roach BJ, Green MF. Hallucinations, neuroplasticity, and prediction errors in schizophrenia. Scand J Psychol 2018; 59:41-48. [PMID: 29356009 PMCID: PMC5969574 DOI: 10.1111/sjop.12413] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/26/2017] [Indexed: 01/09/2023]
Abstract
Auditory hallucinations, a hallmark symptom of psychosis, are experienced by most people with a diagnosis of schizophrenia at some point in their illness. Auditory hallucinations can be understood as a failure in predictive coding, whereby abnormalities in sensory/perceptual processing combine with biased cognitive processes to result in a dampening of normal prediction error signaling. In this paper, we used a roving mismatch negativity (MMN) paradigm to optimize evaluation of prediction error signaling and short-term neuroplasticity in 30 people with schizophrenia (n = 16 with and n = 14 without recent auditory hallucinations) and 20 healthy comparison participants. The recent hallucinations group exhibited an abnormal roving MMN profile [F(2,27) = 3.98, p = 0.03], significantly reduced prediction error signaling [t(28) = -2.25, p = 0.03], and a trend for diminished short-term neuroplasticity [t(28) = 1.80, p = 0.08]. There were no statistically significant differences between the healthy comparison group and the combined schizophrenia group on any of the roving MMN indices. These findings are consistent with a predictive coding account of hallucinations in schizophrenia, which posits reduced prediction error signaling in those who are prone to hallucinations. These results also suggest that plasticity-mediated formation and online updating of predictive coding models may also be disrupted in individuals with recent hallucinations.
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Affiliation(s)
- Amanda McCleery
- University of California, Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
- Veterans Affairs Greater Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
| | - Jonathan K. Wynn
- University of California, Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
- Veterans Affairs Greater Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
| | - Daniel H. Mathalon
- Veterans Affairs San Francisco Healthcare System, University of California, San Francisco
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco
| | - Brian J. Roach
- Veterans Affairs San Francisco Healthcare System, University of California, San Francisco
| | - Michael F. Green
- University of California, Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
- Veterans Affairs Greater Los Angeles, Veterans Integrated Service Network 22 Mental Illness Research, Education, and Clinical Center
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22
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Chhabra H, Sowmya S, Sreeraj VS, Kalmady SV, Shivakumar V, Amaresha AC, Narayanaswamy JC, Venkatasubramanian G. Auditory false perception in schizophrenia: Development and validation of auditory signal detection task. Asian J Psychiatr 2016; 24:23-27. [PMID: 27931901 DOI: 10.1016/j.ajp.2016.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/13/2016] [Accepted: 08/13/2016] [Indexed: 01/30/2023]
Abstract
Auditory hallucinations constitute an important symptom component in 70-80% of schizophrenia patients. These hallucinations are proposed to occur due to an imbalance between perceptual expectation and external input, resulting in attachment of meaning to abstract noises; signal detection theory has been proposed to explain these phenomena. In this study, we describe the development of an auditory signal detection task using a carefully chosen set of English words that could be tested successfully in schizophrenia patients coming from varying linguistic, cultural and social backgrounds. Schizophrenia patients with significant auditory hallucinations (N=15) and healthy controls (N=15) performed the auditory signal detection task wherein they were instructed to differentiate between a 5-s burst of plain white noise and voiced-noise. The analysis showed that false alarms (p=0.02), discriminability index (p=0.001) and decision bias (p=0.004) were significantly different between the two groups. There was a significant negative correlation between false alarm rate and decision bias. These findings extend further support for impaired perceptual expectation system in schizophrenia patients.
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Affiliation(s)
- Harleen Chhabra
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Selvaraj Sowmya
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Vanteemar S Sreeraj
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sunil V Kalmady
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Venkataram Shivakumar
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Anekal C Amaresha
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Janardhanan C Narayanaswamy
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ganesan Venkatasubramanian
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India.
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23
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Ćurčić-Blake B, Ford JM, Hubl D, Orlov ND, Sommer IE, Waters F, Allen P, Jardri R, Woodruff PW, David O, Mulert C, Woodward TS, Aleman A. Interaction of language, auditory and memory brain networks in auditory verbal hallucinations. Prog Neurobiol 2016; 148:1-20. [PMID: 27890810 PMCID: PMC5240789 DOI: 10.1016/j.pneurobio.2016.11.002] [Citation(s) in RCA: 142] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 10/04/2016] [Accepted: 11/20/2016] [Indexed: 12/22/2022]
Abstract
The language, auditory and memory/limbic networks are of particular relevance for auditory verbal hallucinations. An increased interaction among the auditory-language and striatal brain regions occurs while patients hallucinate. Fronto-temporal connections are often altered in AVH individuals, but there is no consensus regarding increase or decrease. Connections of the interhemispheric auditory pathway are stronger for first episode patients, but they are weaker in chronic patients. The majority of studies support hybrid AVH hypotheses in which all three networks and the striatal network are involved.
Auditory verbal hallucinations (AVH) occur in psychotic disorders, but also as a symptom of other conditions and even in healthy people. Several current theories on the origin of AVH converge, with neuroimaging studies suggesting that the language, auditory and memory/limbic networks are of particular relevance. However, reconciliation of these theories with experimental evidence is missing. We review 50 studies investigating functional (EEG and fMRI) and anatomic (diffusion tensor imaging) connectivity in these networks, and explore the evidence supporting abnormal connectivity in these networks associated with AVH. We distinguish between functional connectivity during an actual hallucination experience (symptom capture) and functional connectivity during either the resting state or a task comparing individuals who hallucinate with those who do not (symptom association studies). Symptom capture studies clearly reveal a pattern of increased coupling among the auditory, language and striatal regions. Anatomical and symptom association functional studies suggest that the interhemispheric connectivity between posterior auditory regions may depend on the phase of illness, with increases in non-psychotic individuals and first episode patients and decreases in chronic patients. Leading hypotheses involving concepts as unstable memories, source monitoring, top-down attention, and hybrid models of hallucinations are supported in part by the published connectivity data, although several caveats and inconsistencies remain. Specifically, possible changes in fronto-temporal connectivity are still under debate. Precise hypotheses concerning the directionality of connections deduced from current theoretical approaches should be tested using experimental approaches that allow for discrimination of competing hypotheses.
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Affiliation(s)
- Branislava Ćurčić-Blake
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - Judith M Ford
- University of California and Veterans Affairs Medical Center, San Francisco, United States
| | - Daniela Hubl
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Switzerland
| | - Natasza D Orlov
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Iris E Sommer
- Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
| | - Flavie Waters
- Graylands Hospital, North Metro Health Service Mental Health, The University of Western Australia, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia Graylands Hospital, Australia
| | - Paul Allen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; Department of Psychology, University of Roehampton, London, United Kingdom
| | - Renaud Jardri
- University of Lille, CNRS UMR9193, SCA-Lab & CHU Lille, Fontan Hospital (CURE), Lille, France
| | - Peter W Woodruff
- Department of Neuroscience, The University of Sheffield, United Kingdom
| | - Olivier David
- University of Grenoble Alpes, Inserm, U1216, Grenoble Institute of Neuroscience, Grenoble, France
| | - Christoph Mulert
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Psychiatry Neuroimaging Branch, Hamburg, Germany
| | - Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, Canada; BC Mental Health and Addiction Research Institute, Vancouver, Canada
| | - André Aleman
- Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Jardri R, Hugdahl K, Hughes M, Brunelin J, Waters F, Alderson-Day B, Smailes D, Sterzer P, Corlett PR, Leptourgos P, Debbané M, Cachia A, Denève S. Are Hallucinations Due to an Imbalance Between Excitatory and Inhibitory Influences on the Brain? Schizophr Bull 2016; 42:1124-34. [PMID: 27261492 PMCID: PMC4988749 DOI: 10.1093/schbul/sbw075] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This review from the International Consortium on Hallucinations Research intends to question the pertinence of the excitatory-to-inhibitory (E/I) imbalance hypothesis as a model for hallucinations. A large number of studies suggest that subtle impairments of the E/I balance are involved in neurological and psychiatric conditions, such as schizophrenia. Emerging evidence also points to a role of the E/I balance in maintaining stable perceptual representations, suggesting it may be a plausible model for hallucinations. In support, hallucinations have been linked to inhibitory deficits as shown with impairment of gamma-aminobutyric acid transmission, N-methyl-d-aspartate receptor plasticity, reductions in gamma-frequency oscillations, hyperactivity in sensory cortices, and cognitive inhibition deficits. However, the mechanisms by which E/I dysfunctions at the cellular level might relate to clinical symptoms and cognitive deficits remain unclear. Given recent data advances in the field of clinical neuroscience, it is now possible to conduct a synthesis of available data specifically related to hallucinations. These findings are integrated with the latest computational frameworks of hallucinations, and recommendations for future research are provided.
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Affiliation(s)
- Renaud Jardri
- Univ Lille, CNRS UMR 9193, SCALab (psyCHIC Team) & CHU Lille, Psychiatry Department (CURE), Lille, France;
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen; Department of Radiology, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Matthew Hughes
- Brain & Psychological Sciences Centre, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Jérôme Brunelin
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Université Laval, Québec City, Québec, Canada; Université Lyon 1, INSERM U1028 & CNRS 5292, Lyon Neuroscience Research Centre (ΨR2 Team), Centre Hospitalier Le Vinatier, Lyon, France
| | - Flavie Waters
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, and Clinical Research Centre, Graylands Health Campus, North Metropolitan Area Health Service Mental Health, Perth, Western Australia, Australia
| | | | - Dave Smailes
- School of Health and Social Sciences, Leeds Trinity University, Leeds, UK
| | - Philipp Sterzer
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universtätsmedizin Berlin, Berlin, Germany
| | - Philip R Corlett
- Department of Psychiatry, Yale University, Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT
| | - Pantelis Leptourgos
- Group for Neural Theory, INSERM U960, Institute of Cognitive Studies, École Normale Supérieure, Paris, France
| | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Arnaud Cachia
- Laboratoire de Psychologie du Développement et de l'Éducation de l'Enfant, UMR 8240, CNRS & Université Paris-Descartes (Sorbonne-Paris-Cité), Paris, France
| | - Sophie Denève
- Group for Neural Theory, INSERM U960, Institute of Cognitive Studies, École Normale Supérieure, Paris, France
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Pinheiro AP, Rezaii N, Rauber A, Niznikiewicz M. Is this my voice or yours? The role of emotion and acoustic quality in self-other voice discrimination in schizophrenia. Cogn Neuropsychiatry 2016; 21:335-353. [PMID: 27454152 DOI: 10.1080/13546805.2016.1208611] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Impairments in self-other voice discrimination have been consistently reported in schizophrenia, and associated with the severity of auditory verbal hallucinations (AVHs). This study probed the interactions between voice identity, voice acoustic quality, and semantic valence in a self-other voice discrimination task in schizophrenia patients compared with healthy subjects. The relationship between voice identity discrimination and AVH severity was also explored. METHODS Seventeen chronic schizophrenia patients and 19 healthy controls were asked to read aloud a list of adjectives characterised by emotional or neutral content. Participants' voice was recorded in the first session. In the behavioural task, 840 spoken words differing in identity (self/non-self), acoustic quality (undistorted/distorted), and semantic valence (negative/positive/neutral) were presented. Participants indicated if the words were spoken in their own voice, another person's voice, or were unsure. RESULTS Patients were less accurate than controls in the recognition of self-generated speech with negative content only. Impaired recognition of negative self-generated speech was associated with AVH severity ("voices conversing"). CONCLUSIONS These results suggest that abnormalities in higher order processes (evaluation of the salience of a speech stimulus) modulate impaired self-other voice discrimination in schizophrenia. Abnormal processing of negative self-generated speech may play a role in the experience of AVH.
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Affiliation(s)
- Ana P Pinheiro
- a Laboratory of Neuroscience, Department of Psychiatry , Harvard Medical School, & Veterans Affairs Boston Healthcare System, Brockton V.A. Medical Center Psychiatry , Brockton , MA , USA.,b Neuropsychophysiology Laboratory, CIPsi , School of Psychology, University of Minho , Braga , Portugal.,c Faculty of Psychology , University of Lisbon , Lisbon , Portugal
| | - Neguine Rezaii
- a Laboratory of Neuroscience, Department of Psychiatry , Harvard Medical School, & Veterans Affairs Boston Healthcare System, Brockton V.A. Medical Center Psychiatry , Brockton , MA , USA
| | - Andréia Rauber
- d Computational Linguistics Department , University of Tübingen , Tübingen , Germany
| | - Margaret Niznikiewicz
- a Laboratory of Neuroscience, Department of Psychiatry , Harvard Medical School, & Veterans Affairs Boston Healthcare System, Brockton V.A. Medical Center Psychiatry , Brockton , MA , USA
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26
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Thoma RJ, Chaze C, Lewine JD, Calhoun VD, Clark VP, Bustillo J, Houck J, Ford J, Bigelow R, Wilhelmi C, Stephen JM, Turner JA. Functional MRI Evaluation of Multiple Neural Networks Underlying Auditory Verbal Hallucinations in Schizophrenia Spectrum Disorders. Front Psychiatry 2016; 7:39. [PMID: 27065889 PMCID: PMC4810075 DOI: 10.3389/fpsyt.2016.00039] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/29/2016] [Indexed: 11/13/2022] Open
Abstract
Functional MRI studies have identified a distributed set of brain activations to be associated with auditory verbal hallucinations (AVH). However, very little is known about how activated brain regions may be linked together into AVH-generating networks. Fifteen volunteers with schizophrenia or schizoaffective disorder pressed buttons to indicate onset and offset of AVH during fMRI scanning. When a general linear model was used to compare blood oxygenation level dependence signals during periods in which subjects indicated that they were versus were not experiencing AVH ("AVH-on" versus "AVH-off"), it revealed AVH-related activity in bilateral inferior frontal and superior temporal regions; the right middle temporal gyrus; and the left insula, supramarginal gyrus, inferior parietal lobule, and extranuclear white matter. In an effort to identify AVH-related networks, the raw data were also processed using independent component analyses (ICAs). Four ICA components were spatially consistent with an a priori network framework based upon published meta-analyses of imaging correlates of AVH. Of these four components, only a network involving bilateral auditory cortices and posterior receptive language areas was significantly and positively correlated to the pattern of AVH-on versus AVH-off. The ICA also identified two additional networks (occipital-temporal and medial prefrontal), not fully matching the meta-analysis framework, but nevertheless containing nodes reported as active in some studies of AVH. Both networks showed significant AVH-related profiles, but both were most active during AVH-off periods. Overall, the data suggest that AVH generation requires specific and selective activation of auditory cortical and posterior language regions, perhaps coupled to a release of indirect influence by occipital and medial frontal structures.
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Affiliation(s)
- Robert J Thoma
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA; The Mind Research Network and the Lovelace Family of Companies, Albuquerque, NM, USA
| | - Charlotte Chaze
- The Mind Research Network and the Lovelace Family of Companies , Albuquerque, NM , USA
| | - Jeffrey David Lewine
- The Mind Research Network and the Lovelace Family of Companies, Albuquerque, NM, USA; Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Vince D Calhoun
- The Mind Research Network and the Lovelace Family of Companies, Albuquerque, NM, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, USA
| | - Vincent P Clark
- The Mind Research Network and the Lovelace Family of Companies, Albuquerque, NM, USA; Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Juan Bustillo
- Department of Psychiatry, University of New Mexico , Albuquerque, NM , USA
| | - Jon Houck
- The Mind Research Network and the Lovelace Family of Companies, Albuquerque, NM, USA; Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Judith Ford
- Department of Psychiatry, University of California San Francisco School of Medicine , San Francisco, CA , USA
| | - Rose Bigelow
- Department of Psychiatry, University of New Mexico , Albuquerque, NM , USA
| | - Corbin Wilhelmi
- The Mind Research Network and the Lovelace Family of Companies , Albuquerque, NM , USA
| | - Julia M Stephen
- The Mind Research Network and the Lovelace Family of Companies , Albuquerque, NM , USA
| | - Jessica A Turner
- The Mind Research Network and the Lovelace Family of Companies, Albuquerque, NM, USA; Department of Psychology, Georgia State University, Atlanta, GA, USA
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27
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Badcock JC. A Neuropsychological Approach to Auditory Verbal Hallucinations and Thought Insertion - Grounded in Normal Voice Perception. ACTA ACUST UNITED AC 2015; 7:631-652. [PMID: 27617046 PMCID: PMC4995233 DOI: 10.1007/s13164-015-0270-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A neuropsychological perspective on auditory verbal hallucinations (AVH) links key phenomenological features of the experience, such as voice location and identity, to functionally separable pathways in normal human audition. Although this auditory processing stream (APS) framework has proven valuable for integrating research on phenomenology with cognitive and neural accounts of hallucinatory experiences, it has not yet been applied to other symptoms presumed to be closely related to AVH – such as thought insertion (TI). In this paper, I propose that an APS framework offers a useful way of thinking about the experience of TI as well as AVH, providing a common conceptual framework for both. I argue that previous self-monitoring theories struggle to account for both the differences and similarities in the characteristic features of AVH and TI, which can be readily accommodated within an APS framework. Furthermore, the APS framework can be integrated with predictive processing accounts of psychotic symptoms; makes predictions about potential sites of prediction error signals; and may offer a template for understanding a range of other symptoms beyond AVH and TI.
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Affiliation(s)
- Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, 6009 Western Australia
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28
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Chyzhyk D, Graña M, Öngür D, Shinn AK. Discrimination of schizophrenia auditory hallucinators by machine learning of resting-state functional MRI. Int J Neural Syst 2015; 25:1550007. [PMID: 25753600 DOI: 10.1142/s0129065715500070] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Auditory hallucinations (AH) are a symptom that is most often associated with schizophrenia, but patients with other neuropsychiatric conditions, and even a small percentage of healthy individuals, may also experience AH. Elucidating the neural mechanisms underlying AH in schizophrenia may offer insight into the pathophysiology associated with AH more broadly across multiple neuropsychiatric disease conditions. In this paper, we address the problem of classifying schizophrenia patients with and without a history of AH, and healthy control (HC) subjects. To this end, we performed feature extraction from resting state functional magnetic resonance imaging (rsfMRI) data and applied machine learning classifiers, testing two kinds of neuroimaging features: (a) functional connectivity (FC) measures computed by lattice auto-associative memories (LAAM), and (b) local activity (LA) measures, including regional homogeneity (ReHo) and fractional amplitude of low frequency fluctuations (fALFF). We show that it is possible to perform classification within each pair of subject groups with high accuracy. Discrimination between patients with and without lifetime AH was highest, while discrimination between schizophrenia patients and HC participants was worst, suggesting that classification according to the symptom dimension of AH may be more valid than discrimination on the basis of traditional diagnostic categories. FC measures seeded in right Heschl's gyrus (RHG) consistently showed stronger discriminative power than those seeded in left Heschl's gyrus (LHG), a finding that appears to support AH models focusing on right hemisphere abnormalities. The cortical brain localizations derived from the features with strong classification performance are consistent with proposed AH models, and include left inferior frontal gyrus (IFG), parahippocampal gyri, the cingulate cortex, as well as several temporal and prefrontal cortical brain regions. Overall, the observed findings suggest that computational intelligence approaches can provide robust tools for uncovering subtleties in complex neuroimaging data, and have the potential to advance the search for more neuroscience-based criteria for classifying mental illness in psychiatry research.
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Affiliation(s)
- Darya Chyzhyk
- Computational Intelligence Group, Universidad del Pais Vasco (UPV/EHU), San Sebastian 20018, Spain
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29
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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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McCarthy-Jones S, Trauer T, Mackinnon A, Sims E, Thomas N, Copolov DL. A new phenomenological survey of auditory hallucinations: evidence for subtypes and implications for theory and practice. Schizophr Bull 2014; 40:231-5. [PMID: 23267192 PMCID: PMC3885292 DOI: 10.1093/schbul/sbs156] [Citation(s) in RCA: 179] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A comprehensive understanding of the phenomenology of auditory hallucinations (AHs) is essential for developing accurate models of their causes. Yet, only 1 detailed study of the phenomenology of AHs with a sample size of N ≥ 100 has been published. The potential for overreliance on these findings, coupled with a lack of phenomenological research into many aspects of AHs relevant to contemporary neurocognitive models and the proposed (but largely untested) existence of AH subtypes, necessitates further research in this area. We undertook the most comprehensive phenomenological study of AHs to date in a psychiatric population (N = 199; 81% people diagnosed with schizophrenia), using a structured interview schedule. Previous phenomenological findings were only partially replicated. New findings included that 39% of participants reported that their voices seemed in some way to be replays of memories of previous conversations they had experienced; 45% reported that the general theme or content of what the voices said was always the same; and 55% said new voices had the same content/theme as previous voices. Cluster analysis, by variable, suggested the existence of 4 AH subtypes. We propose that there are likely to be different neurocognitive processes underpinning these experiences, necessitating revised AH models.
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Affiliation(s)
- Simon McCarthy-Jones
- To whom correspondence should be addressed; ARC Centre of Excellence in Cognition and Its Disorders, Department of Cognitive Science, Macquarie University, Balaclava Road, North Ryde, NSW 2109, Australia; tel: +61 2 9850 8669, fax: +61 2 9850 6059, e-mail:
| | - Tom Trauer
- School of Psychology and Psychiatry, Monash University, Melbourne, Australia;,Department of Psychiatry, The University of Melbourne, Melbourne, Australia;,St Vincent’s Hospital, Mental Health Service, Melbourne, Australia
| | - Andrew Mackinnon
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Eliza Sims
- Victoria Harbour Medical Centre, Docklands, Victoria 3008, Australia
| | - Neil Thomas
- Monash Alfred Psychiatry Research Centre, The Alfred, Melbourne, Australia;,Faculty of Life and Social Sciences, Swinburne University, Melbourne, Australia
| | - David L. Copolov
- School of Psychology and Psychiatry, Monash University, Melbourne, Australia
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Sedley W, Cunningham MO. Do cortical gamma oscillations promote or suppress perception? An under-asked question with an over-assumed answer. Front Hum Neurosci 2013; 7:595. [PMID: 24065913 PMCID: PMC3778316 DOI: 10.3389/fnhum.2013.00595] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 09/03/2013] [Indexed: 01/04/2023] Open
Abstract
Cortical gamma oscillations occur alongside perceptual processes, and in proportion to perceptual salience. They have a number of properties that make them ideal candidates to explain perception, including incorporating synchronized discharges of neural assemblies, and their emergence over a fast timescale consistent with that of perception. These observations have led to widespread assumptions that gamma oscillations' role is to cause or facilitate conscious perception (i.e., a "positive" role). While the majority of the human literature on gamma oscillations is consistent with this interpretation, many or most of these studies could equally be interpreted as showing a suppressive or inhibitory (i.e., "negative") role. For example, presenting a stimulus and recording a response of increased gamma oscillations would only suggest a role for gamma oscillations in the representation of that stimulus, and would not specify what that role were; if gamma oscillations were inhibitory, then they would become selectively activated in response to the stimulus they acted to inhibit. In this review, we consider two classes of gamma oscillations: "broadband" and "narrowband," which have very different properties (and likely roles). We first discuss studies on gamma oscillations that are non-discriminatory, with respect to the role of gamma oscillations, followed by studies that specifically support specifically a positive or negative role. These include work on perception in healthy individuals, and in the pathological contexts of phantom perception and epilepsy. Reference is based as much as possible on magnetoencephalography (MEG) and electroencephalography (EEG) studies, but we also consider evidence from invasive recordings in humans and other animals. Attempts are made to reconcile findings within a common framework. We conclude with a summary of the pertinent questions that remain unanswered, and suggest how future studies might address these.
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Affiliation(s)
- William Sedley
- Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University Medical School Newcastle Upon Tyne, UK
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32
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Hoskin R, Hunter MD, Woodruff PWR. The effect of psychological stress and expectation on auditory perception: A signal detection analysis. Br J Psychol 2013; 105:524-46. [PMID: 25280122 DOI: 10.1111/bjop.12048] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 07/18/2013] [Indexed: 11/26/2022]
Abstract
Both psychological stress and predictive signals relating to expected sensory input are believed to influence perception, an influence which, when disrupted, may contribute to the generation of auditory hallucinations. The effect of stress and semantic expectation on auditory perception was therefore examined in healthy participants using an auditory signal detection task requiring the detection of speech from within white noise. Trait anxiety was found to predict the extent to which stress influenced response bias, resulting in more anxious participants adopting a more liberal criterion, and therefore experiencing more false positives, when under stress. While semantic expectation was found to increase sensitivity, its presence also generated a shift in response bias towards reporting a signal, suggesting that the erroneous perception of speech became more likely. These findings provide a potential cognitive mechanism that may explain the impact of stress on hallucination-proneness, by suggesting that stress has the tendency to alter response bias in highly anxious individuals. These results also provide support for the idea that top-down processes such as those relating to semantic expectation may contribute to the generation of auditory hallucinations.
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Affiliation(s)
- Robert Hoskin
- Sheffield Cognition and Neuroimaging Lab (SCANLAB), Academic Clinical Psychiatry, Department of Neuroscience, Faculty of Medicine, Dentistry & Health, Longley Centre, University of Sheffield, UK
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Nazimek JM, Hunter MD, Hoskin R, Wilkinson I, Woodruff PW. Neural basis of auditory expectation within temporal cortex. Neuropsychologia 2013; 51:2245-50. [PMID: 23933483 DOI: 10.1016/j.neuropsychologia.2013.07.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Revised: 07/08/2013] [Accepted: 07/24/2013] [Indexed: 10/26/2022]
Abstract
Predictive coding frameworks of perception propose that neural networks form predictions of expected input and generate prediction errors when the external input does not match expectation. We therefore investigated the processing of unexpected sounds and silence in the auditory cortex using fMRI. Unexpected sounds, when compared to expected sounds, evoked greater activation in large areas of the left temporal and insular cortices. Additionally the left middle temporal gyrus exhibited greater activation to unexpected events in general, whether sounds or silence, when compared to the corresponding expected events. These findings support predictive coding models of perception, which suggest that regions of the temporal cortex function to integrate sensory information with predictive signals during auditory perception.
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Affiliation(s)
- J M Nazimek
- Sheffield Cognition and Neuroimaging Laboratory (SCANlab), Academic Clinical Psychiatry, Department of Neuroscience, Faculty of Medicine, Dentistry and Health, University of Sheffield, Yorkshire, UK.
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