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Cossette-Roberge H, Li J, Citherlet D, Nguyen DK. Localizing and lateralizing value of auditory phenomena in seizures. Epilepsy Behav 2023; 145:109327. [PMID: 37422934 DOI: 10.1016/j.yebeh.2023.109327] [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: 03/15/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Auditory seizures (AS) are a rare type of focal seizures. AS are classically thought to involve a seizure onset zone (SOZ) in the temporal lobe, but there remain uncertainties about their localizing and lateralizing value. We conducted a narrative literature review with the aim of providing an up-to-date description of the lateralizing and localizing value of AS. METHODS The databases PubMed, Scopus, and Google Scholar were searched for literature on AS in December 2022. All cortical stimulation studies, case reports, and case series were analyzed to assess for auditory phenomena that were suggestive of AS and to evaluate if the lateralization and/or localization of the SOZ could be determined. We classified AS according to their semiology (e.g., simple hallucination versus complex hallucination) and the level of evidence with which the SOZ could be predicted. RESULTS A total of 174 cases comprising 200 AS were analyzed from 70 articles. Across all studies, the SOZ of AS were more often in the left (62%) than in the right (38%) hemisphere. AS heard bilaterally followed this trend. Unilaterally heard AS were more often due to a SOZ in the contralateral hemisphere (74%), although they could also be ipsilateral (26%). The SOZ for AS was not limited to the auditory cortex, nor to the temporal lobe. The areas more frequently involved in the temporal lobe were the superior temporal gyrus (STG) and mesiotemporal structures. Extratemporal locations included parietal, frontal, insular, and rarely occipital structures. CONCLUSION Our review highlighted the complexity of AS and their importance in the identification of the SOZ. Due to the limited data and heterogeneous presentation of AS in the literature, the patterns associated with different AS semiologies warrant further research.
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Affiliation(s)
- Hélène Cossette-Roberge
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Neurology Division, Centre Hospitalier de l'Université de Sherbrooke (CHUS), Sherbrooke, QC, Canada.
| | - Jimmy Li
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Neurology Division, Centre Hospitalier de l'Université de Sherbrooke (CHUS), Sherbrooke, QC, Canada
| | - Daphné Citherlet
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Dang Khoa Nguyen
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Department of Neurosciences, Université de Montréal, Montreal, QC, Canada; Neurology Division, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
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Lu H, Long Q, Chai Y, Shang L, Zhang W, Sun W, Liu X. Auditory verbal hallucination can be evoked by prefrontal epileptic seizure. Epilepsy Behav 2022; 135:108915. [PMID: 36115084 DOI: 10.1016/j.yebeh.2022.108915] [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: 06/17/2022] [Revised: 08/22/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022]
Abstract
Auditory verbal hallucinations (AVHs) have been reported in neocortical temporal epileptic seizures and have been considered highly associated with implication of auditory cortex by epileptic discharges or electrical stimulation. Herein, we report two rare frontal epilepsy cases in which AVHs featured the habitual seizures. The epileptogenic zones of these two patients were localized in the dorsal and orbitomedial prefrontal cortex, respectively by stereoelectroencephalography (SEEG) monitoring. Comparing with the AVHs in schizophrenia, we postulated that the phenomenological similarities between the two sets of AVHs imply homology in mechanisms. Ictal SEEG confirmed that the wide involvement of prefrontal-cingulate-auditory cortical network by low-voltage fast activity corresponded the occurrence with AVHs during frontal epileptic seizures. Electrical stimulation study of one of the two cases highlighted the causal role of prefrontal-cingulate cortex in the emergence of AVHs. Based on our clinical observation, SEEG findings, and electrical cortical stimulation, we supposed that wide implication of prefrontal-cingulate-auditory cortical network during epileptic seizure underlie the emergence of AVHs, and further hypothesized that AVHs could be yielded by transient deficit of self-monitoring for inner speech in focal epileptic seizures.
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Affiliation(s)
- Hongjuan Lu
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Qiting Long
- Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Ying Chai
- Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Li Shang
- Epilepsy Center, Shanghai Deji Hospital, Qingdao University, Shanghai 200126, China
| | - Wei Zhang
- Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
| | - Wei Sun
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing 100053, China.
| | - Xingzhou Liu
- Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
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3
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Kumar S, Nayak DS, Basrur RMR, Vishwanathan LG, Govindappa SKG, Pramod MNB. Auditory aura from the hippocampus - Not all that 'rings' is neocortical temporal lobe epilepsy. Epilepsy Behav Rep 2022; 19:100548. [PMID: 35573059 PMCID: PMC9092987 DOI: 10.1016/j.ebr.2022.100548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/18/2022] [Accepted: 04/22/2022] [Indexed: 10/28/2022] Open
Abstract
Epileptic auras provide the initial clues to identify the probable region of ictal onset. In temporal lobe epilepsies, auras are most commonly experiential or viscerosensory, when they arise from mesial structures. Whereas sensations such as vertigo and auditory hallucinations are more likely to occur from the lateral temporal lobe structures. Auditory auras have been described from the lateral temporal neocortex, Heschl's gyri, frontal operculum and posterior insula. We herein describe a patient with temporal lobe epilepsy with an auditory aura who was localized to have the onset of seizures from the hippocampus using stereotactic EEG (SEEG). Stimulation of the hippocampal contacts also reproduced the habitual auditory aura. Anterior temporal lobectomy with amygdalohippocampectomy resulted in complete seizure freedom for 3 years. This is an initial description of auditory aura elicited from the hippocampus using SEEG.
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Affiliation(s)
- Sujit Kumar
- Department of Neurology, Apollo Hospitals, Seshadripuram, Bangalore, India
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Perez JT, Burneo JG, Macdougall K, McLachlan R, Mirsattari SM, Diosy DC, Hayman-Abello B, Aluwari M, Herrera M, Arevalo M, Suller Marti A. Auditory verbal hallucinations as ictal phenomena in a patient with drug-resistant epilepsy. Clin Neurol Neurosurg 2022; 216:107223. [PMID: 35413637 DOI: 10.1016/j.clineuro.2022.107223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE The presence of verbal auditory hallucinations is often associated with psychotic disorders and rarely is considered as an ictal phenomena. The aim of this paper is to describe the anatomical structures involved in the genesis of this ictal symptom during epileptic seizures and direct cortical stimulation using stereo encephalography (SEEG). METHOD The case is of a 31-year-old right-handed female, bilateral speech representation, schizophrenia and with drug-resistant epilepsy and focal aware sensory seizures characterized by ictal verbal auditory hallucinations. She was implanted with depth electrodes, and she was monitored using SEEG recordings. RESULTS She had focal aware sensory seizures characterized by verbal auditory hallucinations, with the following features: hearing numerous voices (both male and/or female), talking at the same time (not able to distinguish how many). The voices were inside her head, consisted of negative content, and lasted up to two minutes. Some of her focal aware sensory seizures evolved to focal motor seizures and rarely progressed to bilateral tonic clonic seizures. Her neurological examination, her brain MRI and her interictal SPECT were unremarkable. Her PET scan identified mild hypo metabolism over the right temporal and right frontal lobes. Her neuropsychological evaluation showed language laterality undetermined but her functional MRI showed bilateral language representation. On her video-EEG, three seizures were captured with a right posterior temporal onset. A subsequent SEEG showed thirteen typical seizures originating from the posterior temporal neocortical region. The cortical stimulation of the right posterior temporo-parietal neocortical region and right amygdala triggered her typical phenomena, which was multiple voices, inside her head, speaking in the second person, negative content, unable to identify gender, in English, and no side lateralization. CONCLUSION Verbal auditory hallucinations should be analyzed carefully because they can be part of the seizure presentation. Our case supports the localization of these hallucinations in the right posterior neocortical temporal regions.
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Affiliation(s)
- Juan Toro Perez
- Clinical Neurological Science Department, University Hospital - Western University, London, Ontario, Canada; Division of Neurology, Department of Pediatrics, Children's Hospital of Eastern Ontario-University of Ottawa, Ottawa, Ontario, Canada
| | - Jorge G Burneo
- Clinical Neurological Science Department, University Hospital - Western University, London, Ontario, Canada; Neuroepidemiology Unit, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Keith Macdougall
- Clinical Neurological Science Department, University Hospital - Western University, London, Ontario, Canada
| | - Richard McLachlan
- Clinical Neurological Science Department, University Hospital - Western University, London, Ontario, Canada
| | - Seyed M Mirsattari
- Clinical Neurological Science Department, University Hospital - Western University, London, Ontario, Canada
| | - David C Diosy
- Clinical Neurological Science Department, University Hospital - Western University, London, Ontario, Canada
| | - Brent Hayman-Abello
- Clinical Neurological Science Department, University Hospital - Western University, London, Ontario, Canada
| | - Mubarak Aluwari
- Clinical Neurological Science Department, University Hospital - Western University, London, Ontario, Canada
| | - Manuel Herrera
- Clinical Neurological Science Department, University Hospital - Western University, London, Ontario, Canada
| | - Miguel Arevalo
- Clinical Neurological Science Department, University Hospital - Western University, London, Ontario, Canada
| | - Ana Suller Marti
- Clinical Neurological Science Department, University Hospital - Western University, London, Ontario, Canada; Paediatrics Department, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
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Furia A, Licchetta L, Muccioli L, Ferri L, Mostacci B, Mazzoni S, Menghi V, Minardi R, Tinuper P, Bisulli F. Epilepsy With Auditory Features: From Etiology to Treatment. Front Neurol 2022; 12:807939. [PMID: 35153984 PMCID: PMC8829259 DOI: 10.3389/fneur.2021.807939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/31/2021] [Indexed: 01/22/2023] Open
Abstract
Epilepsy with auditory features (EAF) is a focal epilepsy belonging to the focal epileptic syndromes with onset at variable age according to the new ILAE Classification. It is characterized by seizures with auditory aura or receptive aphasia suggesting a lateral temporal lobe involvement of the epileptic discharge. Etiological factors underlying EAF are largely unknown. In the familial cases with an autosomal dominant pattern of inheritance several genes have been involved, among which the first discovered, LGI1, was thought to be predominant. However, increasing evidence now points to a multifactorial etiology, as familial and sporadic EAF share a virtually identical electro-clinical characterization and only a few have a documented genetic etiology. Patients with EAF usually have an unremarkable neurological examination and a good response to antiseizure medications. However, it must be underscored that total remission might be lower than expected and that treatment withdrawal might lead to relapses. Thus, a proper understanding of this condition is in order for better patient treatment and counseling. Further studies are still required to further characterize the many facets of EAF.
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Affiliation(s)
- Alessandro Furia
- Department of Biomedical and NeuroMotor Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Laura Licchetta
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Reference Center for Rare and Complex Epilepsies, Bologna, Italy
| | - Lorenzo Muccioli
- Department of Biomedical and NeuroMotor Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Lorenzo Ferri
- Department of Biomedical and NeuroMotor Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Reference Center for Rare and Complex Epilepsies, Bologna, Italy
| | - Barbara Mostacci
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Reference Center for Rare and Complex Epilepsies, Bologna, Italy
| | - Stefania Mazzoni
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Reference Center for Rare and Complex Epilepsies, Bologna, Italy
| | - Veronica Menghi
- Department of Biomedical and NeuroMotor Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Raffaella Minardi
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Reference Center for Rare and Complex Epilepsies, Bologna, Italy
| | - Paolo Tinuper
- Department of Biomedical and NeuroMotor Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Reference Center for Rare and Complex Epilepsies, Bologna, Italy
| | - Francesca Bisulli
- Department of Biomedical and NeuroMotor Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Reference Center for Rare and Complex Epilepsies, Bologna, Italy
- *Correspondence: Francesca Bisulli
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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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7
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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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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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Coebergh JAF, Lauw RF, Sommer IEC, Blom JD. Musical hallucinations and their relation with epilepsy. J Neurol 2019; 266:1501-1515. [PMID: 30972497 PMCID: PMC6517562 DOI: 10.1007/s00415-019-09289-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/24/2019] [Accepted: 02/26/2019] [Indexed: 02/05/2023]
Abstract
Musical hallucinations are poorly understood phenomena. Their relation with epilepsy was first described over a century ago, but never systematically explored. We, therefore, reviewed the literature, and assessed all descriptions of musical hallucinations attributed to epileptic activity. Our search yielded 191 articles, which together describe 983 unique patients, with 24 detailed descriptions of musical hallucinations related to epilepsy. We also describe six of our own patients. Based on the phenomenological descriptions and neurophysiological data, we distinguish four subgroups of epilepsy-related musical hallucination, comprising auras/ictal, inter-ictal and post-ictal phenomena, and phenomena related to brain stimulation. The case descriptions suggest that musical hallucinations in epilepsy can be conceptualised as lying on a continuum with other auditory hallucinations, including verbal auditory hallucinations, and—notably—tinnitus. To account for the underlying mechanism we propose a Bayesian model involving top-down and bottom-up prediction errors within the auditory network that incorporates findings from EEG and MEG studies. An analysis of phenomenological characteristics, pharmacological triggers, and treatment effects suggests wider ramifications for understanding musical hallucinations. We, therefore, conclude that musical hallucinations in epilepsy open a window to understanding these phenomena in a variety of conditions.
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Affiliation(s)
- J A F Coebergh
- Department of Neurology, Haga Hospital, The Hague, The Netherlands.,Department of Neurology, Ashford and St. Peter's Hospital, Chertsey, UK.,Department of Neurology, St. George's Hospital NHS Foundation Trust, Tooting, London, England, UK
| | - R F Lauw
- Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - I E C Sommer
- Department of Psychiatry, University of Groningen, Groningen, The Netherlands
| | - J D Blom
- Parnassia Psychiatric Institute, The Hague, The Netherlands. .,Department of Psychiatry, University of Groningen, Groningen, The Netherlands. .,Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands.
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10
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Nicastro N, Picard F. Joan of Arc: Sanctity, witchcraft or epilepsy? Epilepsy Behav 2016; 57:247-50. [PMID: 26852074 DOI: 10.1016/j.yebeh.2015.12.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 12/26/2015] [Accepted: 12/28/2015] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The objective of this article is to describe whether Joan of Arc had epilepsy and how that may have influenced her sense of mission and ability to encourage thousands of people to help her to chase the English out of France. METHODS Documentation of her Trial of Condemnation in 1431 provides a description of her episodes of experienced voices and visions. RESULTS From the age of thirteen, Joan of Arc experienced frequent episodes of auditory hallucinations associated with elementary or complex visual hallucinations (e.g., a great light or human faces). These had sudden onset, lasting seconds or minutes at most, and occurred when awake or during sleep, arousing her. Some could be triggered by an auditory stimulus. She had no disorganized thought between the episodes. CONCLUSIONS The semiology of the episodes is very suggestive of epileptic seizures, which have been considered as ecstatic by some authors or as partial epilepsy with auditory features by others, which seems more concordant with the ictal symptoms. The auditory and visual hallucinations could have had a religious content because during her childhood and adolescence, she was brought up in a religious environment, insomuch as this content first undefined only appeared after a few seizures. We can suppose that such hallucinations, without the knowledge of their medical origin, gave her a sense of divine mission, hence, a real strength to try to accomplish the orders she heard during the episodes. Her role during the Hundred Years' War and her narration of her strange episodes led her to be burned for heresy at the age of nineteen, yet rehabilitated 25 years later and to be canonized for her achievements in 1920. This article is part of a Special Issue entitled "Epilepsy, Art, and Creativity".
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Affiliation(s)
- Nicolas Nicastro
- Neurology Department, Geneva University Hospitals, 4 Avenue G. Perret-Gentil, 1205 Geneva, Switzerland.
| | - Fabienne Picard
- Neurology Department, Geneva University Hospitals, 4 Avenue G. Perret-Gentil, 1205 Geneva, Switzerland
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11
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Vreeburg SA, Leijten FSS, Sommer IEC. Auditory hallucinations preceding migraine, differentiation with epileptic origin: A case report. Schizophr Res 2016; 172:222-3. [PMID: 26861903 DOI: 10.1016/j.schres.2016.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 02/02/2016] [Accepted: 02/03/2016] [Indexed: 11/30/2022]
Affiliation(s)
- S A Vreeburg
- Department of Psychiatry, Brain Center Rudolf Magnus, UMCU, Heidelberglaan 100, Utrecht, The Netherlands
| | - F S S Leijten
- Department of Neurology, Brain Center Rudolf Magnus, UMCU, Heidelberglaan 100, Utrecht, The Netherlands
| | - I E C Sommer
- Department of Psychiatry, Brain Center Rudolf Magnus, UMCU, Heidelberglaan 100, Utrecht, The Netherlands.
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12
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Smailes D, Alderson-Day B, Fernyhough C, McCarthy-Jones S, Dodgson G. Tailoring Cognitive Behavioral Therapy to Subtypes of Voice-Hearing. Front Psychol 2015; 6:1933. [PMID: 26733919 PMCID: PMC4685120 DOI: 10.3389/fpsyg.2015.01933] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 12/01/2015] [Indexed: 01/20/2023] Open
Abstract
Cognitive behavioral therapy (CBT) for voice-hearing (i.e., auditory verbal hallucinations; AVH) has, at best, small to moderate effects. One possible reason for this limited efficacy is that current CBT approaches tend to conceptualize voice-hearing as a homogenous experience in terms of the cognitive processes involved in AVH. However, the highly heterogeneous nature of voice-hearing suggests that many different cognitive processes may be involved in the etiology of AVH. These heterogeneous voice-hearing experiences do, however, appear to cluster into a set of subtypes, opening up the possibility of tailoring treatment to the subtype of AVH that a voice-hearer reports. In this paper, we (a) outline our rationale for tailoring CBT to subtypes of voice-hearing, (b) describe CBT for three putative subtypes of AVH (inner speech-based AVH, memory-based AVH, and hypervigilance AVH), and (c) discuss potential limitations and problems with such an approach. We conclude by arguing that tailoring CBT to subtypes of voice-hearing could prove to be a valuable therapeutic development, which may be especially effective when used in early intervention in psychosis services.
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Affiliation(s)
- David Smailes
- Department of Psychology, Durham UniversityDurham, UK; Department of Psychology, Leeds Trinity UniversityLeeds, UK
| | | | | | - Simon McCarthy-Jones
- Department of Psychology, Durham UniversityDurham, UK; Department of Psychiatry, Trinity College DublinDublin, Ireland
| | - Guy Dodgson
- Early Intervention in Psychosis, Northumberland, Tyne and Wear NHS Foundation Trust Ashington, UK
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McCarthy-Jones S, Thomas N, Strauss C, Dodgson G, Jones N, Woods A, Brewin CR, Hayward M, Stephane M, Barton J, Kingdon D, Sommer IE. Better than mermaids and stray dogs? Subtyping auditory verbal hallucinations and its implications for research and practice. Schizophr Bull 2014; 40 Suppl 4:S275-84. [PMID: 24936087 PMCID: PMC4141311 DOI: 10.1093/schbul/sbu018] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 01/24/2014] [Accepted: 01/27/2014] [Indexed: 12/17/2022]
Abstract
The phenomenological diversity of auditory verbal hallucinations (AVH) is not currently accounted for by any model based around a single mechanism. This has led to the proposal that there may be distinct AVH subtypes, which each possess unique (as well as shared) underpinning mechanisms. This could have important implications both for research design and clinical interventions because different subtypes may be responsive to different types of treatment. This article explores how AVH subtypes may be identified at the levels of phenomenology, cognition, neurology, etiology, treatment response, diagnosis, and voice hearer's own interpretations. Five subtypes are proposed; hypervigilance, autobiographical memory (subdivided into dissociative and nondissociative), inner speech (subdivided into obsessional, own thought, and novel), epileptic and deafferentation. We suggest other facets of AVH, including negative content and form (eg, commands), may be best treated as dimensional constructs that vary across subtypes. After considering the limitations and challenges of AVH subtyping, we highlight future research directions, including the need for a subtype assessment tool.
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Affiliation(s)
- Simon McCarthy-Jones
- Department of Cognitive Science, ARC Centre of Excellence in Cognition and Its Disorders, Macquarie University, Sydney, Australia; Department of Psychology, Durham University, Durham, UK;
| | - Neil Thomas
- Brain and Psychological Sciences Centre, Swinburne University, Melbourne, Australia; Monash Alfred Psychiatry Research Centre, Melbourne, Australia
| | - Clara Strauss
- School of Psychology, University of Sussex, Sussex, UK; Sussex Partnership NHS Foundation Trust, Sussex, UK
| | - Guy Dodgson
- Early Intervention in Psychosis, Northumberland, Tyne and Wear NHS FT, Newcastle, UK
| | - Nev Jones
- Department of Psychology, DePaul University, Chicago, IL
| | - Angela Woods
- Centre for Medical Humanities, Durham University, Durham, UK
| | - Chris R Brewin
- Division of Psychology & Language Sciences, University College London, London, UK
| | - Mark Hayward
- School of Psychology, University of Sussex, Sussex, UK; Sussex Partnership NHS Foundation Trust, Sussex, UK
| | - Massoud Stephane
- Department of Psychiatry, Oregon Health and Science University, Portland, OR
| | - Jack Barton
- Department of Psychology, Durham University, Durham, UK
| | - David Kingdon
- Department of Psychiatry, University of Southampton, Southampton, UK
| | - Iris E Sommer
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
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