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Salisbury DF, Seebold D, Longenecker JM, Coffman BA, Yeh FC. White matter tracts differentially associated with auditory hallucinations in first-episode psychosis: A correlational tractography diffusion spectrum imaging study. Schizophr Res 2024; 265:4-13. [PMID: 37321880 PMCID: PMC10719419 DOI: 10.1016/j.schres.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/17/2023]
Abstract
Auditory hallucinations (AH) are a debilitating symptom in psychosis, impacting cognition and real world functioning. Recent thought conceptualizes AH as a consequence of long-range brain communication dysfunction, or circuitopathy, within the auditory sensory/perceptual, language, and cognitive control systems. Recently we showed in first-episode psychosis (FEP) that, despite overall intact white matter integrity in the cortical-cortical and cortical-subcortical language tracts and the callosal tracts connecting auditory cortices, the severity of AH correlated inversely with white matter integrity. However, that hypothesis-driven isolation of specific tracts likely missed important white matter concomitants of AH. In this report, we used a whole-brain data-driven dimensional approach using correlational tractography to associate AH severity with white matter integrity in a sample of 175 individuals. Diffusion Spectrum Imaging (DSI) was used to image diffusion distribution. Quantitative Anisotropy (QA) in three tracts was greater with increased AH severity (FDR < 0.001) and QA in three tracts was lower with increased AH severity (FDR < 0.01). White matter tracts showing associations between QA and AH were generally associated with frontal-parietal-temporal connectivity (tracts with known relevance for cognitive control and the language system), in the cingulum bundle, and in prefrontal inter-hemispheric connectivity. The results of this whole brain data-driven analysis suggest that subtle white matter alterations connecting frontal, parietal, and temporal lobes in the service of sensory-perceptual, language/semantic, and cognitive control processes impact the expression of auditory hallucination in FEP. Disentangling the distributed neural circuits involved in AH should help to develop novel interventions, such as non-invasive brain stimulation.
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Affiliation(s)
- Dean F Salisbury
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Dylan Seebold
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Julia M Longenecker
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; VISN 4 Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Brian A Coffman
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Fang-Chen Yeh
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Richards SE, Hughes ME, Woodward TS, Rossell SL, Carruthers SP. External speech processing and auditory verbal hallucinations: A systematic review of functional neuroimaging studies. Neurosci Biobehav Rev 2021; 131:663-687. [PMID: 34517037 DOI: 10.1016/j.neubiorev.2021.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 12/23/2022]
Abstract
It has been documented that individuals who hear auditory verbal hallucinations (AVH) exhibit diminished capabilities in processing external speech. While functional neuroimaging studies have attempted to characterise the cortical regions and networks facilitating these deficits in a bid to understand AVH, considerable methodological heterogeneity has prevented a consensus being reached. The current systematic review investigated the neurobiological underpinnings of external speech processing deficits in voice-hearers in 38 studies published between January 1990 to June 2020. AVH-specific deviations in the activity and lateralisation of the temporal auditory regions were apparent when processing speech sounds, words and sentences. During active or affective listening tasks, functional connectivity changes arose within the language, limbic and default mode networks. However, poor study quality and lack of replicable results plague the field. A detailed list of recommendations has been provided to improve the quality of future research on this topic.
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Affiliation(s)
- Sophie E Richards
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, VIC, 3122, Australia.
| | - Matthew E Hughes
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, VIC, 3122, Australia
| | - Todd S Woodward
- Department of Psychiatry, University of British Colombia, Vancouver, BC, Canada; BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, VIC, 3122, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Sean P Carruthers
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, VIC, 3122, Australia
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Zhuo C, Xiao B, Ji F, Lin X, Jiang D, Tian H, Xu Y, Wang W, Chen C. Patients with first-episode untreated schizophrenia who experience concomitant visual disturbances and auditory hallucinations exhibit co-impairment of the brain and retinas-a pilot study. Brain Imaging Behav 2021; 15:1533-1541. [PMID: 32748321 DOI: 10.1007/s11682-020-00351-1] [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] [Indexed: 02/02/2023]
Abstract
There are limited structural brain and retina alteration data from schizophrenia patients who experience visual disturbances (VDs) with or without auditory hallucinations (AHs). We compared brain and retina alterations between first-episode untreated schizophrenia patients with VDs (FUSCH-VDs) with versus without AHs, and between patients and healthy controls (HCs)(N = 30/group). VDs, AHs, gray matter volumes (GMVs), and retinal thicknesses were evaluated with the Bonn Scale for Assessment of Basic Symptoms (BSABS) scale, the Auditory Hallucinations Rating Scale (AHRS), magnetic resonance imaging (MRI), and optical coherence tomography (OCT), respectively. Compared to HCs, FUSCH-VDs had reduced GMVs, mainly in dorsal V3/V3A and V5 regions, the fusiform gyrus, and ventral V4 and V8 regions. Most FUSCH-VDs (85.0%; 51/60) had primary visual cortex-retina co-impairments. FUSCH-VDs with AHs had more serious and larger scope GMV reductions than FUSCH-VDs without AHs. FUSCH-VDs with AHs had significant retinal thickness reductions compared to HCs. Primary visual cortex-retina co-impairments were found to be more common, and more pronounced when present, in FUSCH-VDs with AHs than in FUSCH-VDs without AHs. The present findings support the notion that VDs and AHs may have reciprocal deteriorating actions in patients with schizophrenia.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, 272119, Shandong, China. .,Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China. .,Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, 300222, China.
| | - Bo Xiao
- Department of OCT, Tianjin Eye Hospital, Tianjin, 300034, China
| | - Feng Ji
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, 272119, Shandong, China
| | - Xiaodong Lin
- Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China
| | - Deguo Jiang
- Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China
| | - Hongjun Tian
- Psychiatric-Neuroimaging-Genetics-Comorbidity Laboratory, Tianjin Mental Health Centre, Tianjin Anding Hospital, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin, 300222, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, China
| | - Wenqiang Wang
- Co-collaboration Laboratory of China and Canada, Xiamen Xianyue Hospital and University of Alberta, Xiamen, 361000, Fujian, China
| | - Ce Chen
- Psychiatric-Neuroimaging-Genetics Laboratory, Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang, 325000, China.
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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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Stephane M. The Self, Agency and Spatial Externalizations of Inner Verbal Thoughts, and Auditory Verbal Hallucinations. Front Psychiatry 2019; 10:668. [PMID: 31607965 PMCID: PMC6768100 DOI: 10.3389/fpsyt.2019.00668] [Citation(s) in RCA: 10] [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: 03/20/2019] [Accepted: 08/19/2019] [Indexed: 12/02/2022] Open
Abstract
Aim: Auditory Verbal Hallucinations (AVH) are experienced as the "voices" of others (O-AVH) or self (S-AVH) in internal space/inside the head (IS-AVH) or external space (ES-AVH), and are considered to result from agency and spatial externalizations of inner speech. Both types of externalizations are conflated, and the relationship between these externalizations and AVH experiences is unclear. In this paper, I investigate the relationship between cognitive agency and spatial externalizations and between these externalizations and the types of AVH experience. Method: Twenty-five patients with history of AVH and 24 matched healthy controls performed agency and spatial distinction tasks: distinction between self-generated (read) (S) sentences and other-generated (O) sentences, and between sentences read silently (experienced in internal space, IS) and sentences read aloud (experienced in external space, ES). Regression analyses between misattribution biases (S-O vs. IS-ES, and O-S vs. ES-IS) were obtained. t tests were used to compare misattribution biases between AVH subtypes (S-AVH vs. O-AVH, and IS-AVH vs. ES-AVH). Results: Regressions suggest that agency distinction is independent from spatial distinction in both groups. O-AVH and S-AVH subgroups differed only with respect to S-O bias, and IS-AVH and ES-AVH subgroups differed only with respect to IS-ES bias. Conclusion: These results suggest that agency and spatial externalizations of inner speech are independent at phenomenological and cognitive and levels; and that these externalizations are co-related across levels. I discuss the implications of these findings in the wider context of research on AVH and on the experience of self.
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Affiliation(s)
- Massoud Stephane
- Department of Psychiatry and Behavioral Sciences, Indiana University Purdue University Indianapolis, IU Health Neuroscience Center, Indianapolis, IN, United States
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