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Honcamp H, Schwartze M, Amorim M, Linden DEJ, Pinheiro AP, Kotz SA. Revisiting alpha resting state dynamics underlying hallucinatory vulnerability: Insights from Hidden semi-Markov Modeling. J Neurosci Methods 2024; 407:110138. [PMID: 38648892 DOI: 10.1016/j.jneumeth.2024.110138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/22/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Resting state (RS) brain activity is inherently non-stationary. Hidden semi-Markov Models (HsMM) can characterize continuous RS data as a sequence of recurring and distinct brain states along with their spatio-temporal dynamics. NEW METHOD Recent explorations suggest that HsMM state dynamics in the alpha frequency band link to auditory hallucination proneness (HP) in non-clinical individuals. The present study aimed to replicate these findings to elucidate robust neural correlates of hallucinatory vulnerability. Specifically, we aimed to investigate the reproducibility of HsMM states across different data sets and within-data set variants as well as the replicability of the association between alpha brain state dynamics and HP. RESULTS We found that most brain states are reproducible in different data sets, confirming that the HsMM characterized robust and generalizable EEG RS dynamics on a sub-second timescale. Brain state topographies and temporal dynamics of different within-data set variants showed substantial similarities and were robust against reduced data length and number of electrodes. However, the association with HP was not directly reproducible across data sets. COMPARISON WITH EXISTING METHODS The HsMM optimally leverages the high temporal resolution of EEG data and overcomes time-domain restrictions of other state allocation methods. CONCLUSION The results indicate that the sensitivity of brain state dynamics to capture individual variability in HP may depend on the data recording characteristics and individual variability in RS cognition, such as mind wandering. Future studies should consider that the order in which eyes-open and eyes-closed RS data are acquired directly influences an individual's attentional state and generation of spontaneous thoughts, and thereby might mediate the link to hallucinatory vulnerability.
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Affiliation(s)
- Hanna Honcamp
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands.
| | - Michael Schwartze
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands
| | - Maria Amorim
- Centro de Investigação em Ciência Psicológica, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - David E J Linden
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Ana P Pinheiro
- Centro de Investigação em Ciência Psicológica, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Sonja A Kotz
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands
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2
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Payne B, Addlesee A, Rieser V, McGettigan C. Self-ownership, not self-production, modulates bias and agency over a synthesised voice. Cognition 2024; 248:105804. [PMID: 38678806 DOI: 10.1016/j.cognition.2024.105804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 04/08/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
Voices are fundamentally social stimuli, and their importance to the self may be underpinned by how far they can be used to express the self and achieve communicative goals. This paper examines how self-bias and agency over a synthesised voice is altered when that voice is used to represent the self in social interaction. To enable participants to use a new voice, a novel two-player game was created, in which participants communicated online using a text-to-speech (TTS) synthesised voice. We then measured self-bias and sense of agency attributed to this synthesised voice, comparing participants who had used their new voice to interact with another person (n = 44) to a control group of participants (n = 44) who had been only briefly exposed to the voices. We predicted that the new, synthesised self-voice would be more perceptually prioritised after it had been self-produced. Further, that participants' sense of agency over the voice would be increased, if they had experienced self-producing the voice, relative to those who only owned it. Contrary to the hypothesis, the results indicated that both experimental participants and control participants similarly prioritised the new synthesised voice and experienced a similar degree of agency over it, relative to voices owned by others. Critically then, being able to produce the new voice in a social interaction did not modulate bias towards it nor participant's sense of agency over it. These results suggest that merely having ownership over a new voice may be sufficient to generate a perceptual bias and a sense of agency over it.
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Affiliation(s)
- Bryony Payne
- Department of Speech, Hearing and Phonetic Sciences, University College London, United Kingdom; Department of Psychology, King's College London, United Kingdom.
| | - Angus Addlesee
- School of Mathematical and Computer Sciences, Heriot-Watt University, United Kingdom
| | - Verena Rieser
- School of Mathematical and Computer Sciences, Heriot-Watt University, United Kingdom
| | - Carolyn McGettigan
- Department of Speech, Hearing and Phonetic Sciences, University College London, United Kingdom
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3
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Duggirala SX, Schwartze M, Goller LK, Linden DEJ, Pinheiro AP, Kotz SA. Hallucination Proneness Alters Sensory Feedback Processing in Self-voice Production. Schizophr Bull 2024:sbae095. [PMID: 38824450 DOI: 10.1093/schbul/sbae095] [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: 06/03/2024]
Abstract
BACKGROUND Sensory suppression occurs when hearing one's self-generated voice, as opposed to passively listening to one's own voice. Quality changes in sensory feedback to the self-generated voice can increase attentional control. These changes affect the self-other voice distinction and might lead to hearing voices in the absence of an external source (ie, auditory verbal hallucinations). However, it is unclear how changes in sensory feedback processing and attention allocation interact and how this interaction might relate to hallucination proneness (HP). STUDY DESIGN Participants varying in HP self-generated (via a button-press) and passively listened to their voice that varied in emotional quality and certainty of recognition-100% neutral, 60%-40% neutral-angry, 50%-50% neutral-angry, 40%-60% neutral-angry, 100% angry, during electroencephalography (EEG) recordings. STUDY RESULTS The N1 auditory evoked potential was more suppressed for self-generated than externally generated voices. Increased HP was associated with (1) an increased N1 response to the self- compared with externally generated voices, (2) a reduced N1 response for angry compared with neutral voices, and (3) a reduced N2 response to unexpected voice quality in sensory feedback (60%-40% neutral-angry) compared with neutral voices. CONCLUSIONS The current study highlights an association between increased HP and systematic changes in the emotional quality and certainty in sensory feedback processing (N1) and attentional control (N2) in self-voice production in a nonclinical population. Considering that voice hearers also display these changes, these findings support the continuum hypothesis.
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Affiliation(s)
- Suvarnalata Xanthate Duggirala
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
- Department of Psychology, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health and Medical Sciences, Maastricht University, Maastricht, Netherlands
| | - Michael Schwartze
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Lisa K Goller
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - David E J Linden
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health and Medical Sciences, Maastricht University, Maastricht, Netherlands
- Maastricht University Medical Center, Maastricht, Netherlands
| | - Ana P Pinheiro
- Department of Psychology, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
| | - Sonja A Kotz
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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4
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Zhao W, Zhang Q, An H, Yun Y, Fan N, Yan S, Gan M, Tan S, Yang F. Vocal emotion perception in schizophrenia and its diagnostic significance. BMC Psychiatry 2023; 23:760. [PMID: 37848849 PMCID: PMC10580536 DOI: 10.1186/s12888-023-05110-2] [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: 05/02/2023] [Accepted: 08/13/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Cognitive and emotional impairment are among the core features of schizophrenia; assessment of vocal emotion recognition may facilitate the detection of schizophrenia. We explored the differences between cognitive and social aspects of emotion using vocal emotion recognition and detailed clinical characterization. METHODS Clinical symptoms and social and cognitive functioning were assessed by trained clinical psychiatrists. A vocal emotion perception test, including an assessment of emotion recognition and emotional intensity, was conducted. One-hundred-six patients with schizophrenia (SCZ) and 230 healthy controls (HCs) were recruited. RESULTS Considering emotion recognition, scores for all emotion categories were significantly lower in SCZ compared to HC. Considering emotional intensity, scores for anger, calmness, sadness, and surprise were significantly lower in the SCZs. Vocal recognition patterns showed a trend of unification and simplification in SCZs. A direct correlation was confirmed between vocal recognition impairment and cognition. In diagnostic tests, only the total score of vocal emotion recognition was a reliable index for the presence of schizophrenia. CONCLUSIONS This study shows that patients with schizophrenia are characterized by impaired vocal emotion perception. Furthermore, explicit and implicit vocal emotion perception processing in individuals with schizophrenia are viewed as distinct entities. This study provides a voice recognition tool to facilitate and improve the diagnosis of schizophrenia.
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Affiliation(s)
- Wenxuan Zhao
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Qi Zhang
- Wuxi Mental Health Center, Wuxi, China
| | - Huimei An
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Yajun Yun
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Ning Fan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Shaoxiao Yan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Mingyuan Gan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Shuping Tan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China.
| | - Fude Yang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China.
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5
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Marschall TM, Koops S, Brederoo SG, Cabral J, Ćurčić-Blake B, Sommer IEC. Time varying dynamics of hallucinations in clinical and non-clinical voice-hearers. Neuroimage Clin 2023; 37:103351. [PMID: 36805417 PMCID: PMC9969260 DOI: 10.1016/j.nicl.2023.103351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/24/2023] [Accepted: 02/12/2023] [Indexed: 02/16/2023]
Abstract
Auditory verbal hallucinations (AVH) are frequently associated with psychotic disorders, yet also occur in non-clinical voice-hearers. AVH in this group are similar to those within clinical voice-hearers in terms of several phenomenological aspects, but non-clinical voice-hearers report to have more control over their AVH and attribute less emotional valence to them. These dissimilarities may stem from differences on the neurobiological level, as it is still under debate whether the mechanisms involved in AVH are the same in clinical and non-clinical voice-hearers. In this study, 21 clinical and 21 non-clinical voice-hearers indicated the onset and offsets of AVH during an fMRI scan. Using a method called leading eigenvector dynamics analysis (LEiDA), we examined time-varying dynamics of functional connectivity involved in AVH with a sub-second temporal resolution. We assessed differences between groups, and between hallucination and rest periods in dwell time, switching frequency, probability of occurrence, and transition probabilities of nine recurrent states of functional connectivity with a permutation ANOVA. Deviations in dwell times, switching frequencies, and switch probabilities in the hallucination period indicated more erratic dynamics during this condition regardless of their clinical status. Post-hoc analyses of the dwell times exhibited the most distinct differences between the rest and hallucination condition for the non-clinical sample, suggesting stronger differences between the two conditions in this group. Overall, these findings suggest that the neurobiological mechanisms involved in AVH are similar in clinical and non-clinical individuals.
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Affiliation(s)
- Theresa M Marschall
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
| | - Sanne Koops
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Sanne G Brederoo
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Joana Cabral
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK; Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
| | - Branislava Ćurčić-Blake
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Iris E C Sommer
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
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6
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Pinheiro AP, Sarzedas J, Roberto MS, Kotz SA. Attention and emotion shape self-voice prioritization in speech processing. Cortex 2023; 158:83-95. [PMID: 36473276 DOI: 10.1016/j.cortex.2022.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/27/2022] [Accepted: 10/06/2022] [Indexed: 01/18/2023]
Abstract
Both self-voice and emotional speech are salient signals that are prioritized in perception. Surprisingly, self-voice perception has been investigated to a lesser extent than the self-face. Therefore, it remains to be clarified whether self-voice prioritization is boosted by emotion, and whether self-relevance and emotion interact differently when attention is focused on who is speaking vs. what is being said. Thirty participants listened to 210 prerecorded words spoken in one's own or an unfamiliar voice and differing in emotional valence in two tasks, manipulating the attention focus on either speaker identity or speech emotion. Event-related potentials (ERP) of the electroencephalogram (EEG) informed on the temporal dynamics of self-relevance, emotion, and attention effects. Words spoken in one's own voice elicited a larger N1 and Late Positive Potential (LPP), but smaller N400. Identity and emotion interactively modulated the P2 (self-positivity bias) and LPP (self-negativity bias). Attention to speaker identity modulated more strongly ERP responses within 600 ms post-word onset (N1, P2, N400), whereas attention to speech emotion altered the late component (LPP). However, attention did not modulate the interaction of self-relevance and emotion. These findings suggest that the self-voice is prioritized for neural processing at early sensory stages, and that both emotion and attention shape self-voice prioritization in speech processing. They also confirm involuntary processing of salient signals (self-relevance and emotion) even in situations in which attention is deliberately directed away from those cues. These findings have important implications for a better understanding of symptoms thought to arise from aberrant self-voice monitoring such as auditory verbal hallucinations.
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Affiliation(s)
- Ana P Pinheiro
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal; Basic and Applied NeuroDynamics Lab, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - João Sarzedas
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Magda S Roberto
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Sonja A Kotz
- Basic and Applied NeuroDynamics Lab, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
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7
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Heim S, Polyak S, Hußmann K. Mimicking effects of auditory verbal hallucinations on language production at the level of words, sentences and stories. Front Psychol 2022; 13:1017865. [DOI: 10.3389/fpsyg.2022.1017865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Schizophrenia is characterised foremost by hallucinations, delusions and disorganised speech. Deficits in the internal speech monitor may contribute to the development of auditory-verbal hallucinations. This study investigates potential effects in the opposite direction: could the presence of auditory-verbal hallucinations have an effect on speech production? To this end, a recent mimicking/simulation approach was adopted for 40 healthy participants who perceived either white noise or hallucination-like speech recordings during different language production tasks with increasing demands: picture naming, verbal fluency with and without category switch, sentence production, and discourse. In line with reports about real schizophrenia cases in the literature, mimicking auditory-verbal hallucinations affected verbal fluency (switch condition) and sentence production (duration) in a different way than mere noise. These effects were not correlated, suggesting that hallucinations may even affect different levels of linguistic complexity in different ways. Anyway, in both cases (mimicked), auditory hallucination appear to contribute to the emergence of disordered speech. The mimicking/simulation paradigm may in future help to identify and disentangle the various factors contributing to disorganised speech in schizophrenia. They may also support the development and implementation of new protocols, e.g., in speech and language therapy in persons with schizophrenia in order to improve their communication skills despite the presence of auditory-verbal hallucinations.
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8
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Barbato M, Thomas J, Jogia J. An exploratory study of hallucination-proneness and own-voice discrimination among bilingual college students. Psychiatry Res 2022; 317:114903. [PMID: 37732852 DOI: 10.1016/j.psychres.2022.114903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 10/04/2022] [Accepted: 10/09/2022] [Indexed: 11/20/2022]
Affiliation(s)
- Mariapaola Barbato
- Department of Psychology, College of Natural and Health Sciences, Zayed University Dubai Campus, P.O. Box 19282, Dubai, United Arab Emirates
| | - Justin Thomas
- School of Psychology, Liverpool John Moores University, UK.
| | - Jigar Jogia
- Department of Psychology, College of Natural and Health Sciences, Zayed University Dubai Campus, P.O. Box 19282, Dubai, United Arab Emirates
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9
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Johnson JF, Belyk M, Schwartze M, Pinheiro AP, Kotz SA. Hypersensitivity to passive voice hearing in hallucination proneness. Front Hum Neurosci 2022; 16:859731. [PMID: 35966990 PMCID: PMC9366353 DOI: 10.3389/fnhum.2022.859731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/29/2022] [Indexed: 11/21/2022] Open
Abstract
Voices are a complex and rich acoustic signal processed in an extensive cortical brain network. Specialized regions within this network support voice perception and production and may be differentially affected in pathological voice processing. For example, the experience of hallucinating voices has been linked to hyperactivity in temporal and extra-temporal voice areas, possibly extending into regions associated with vocalization. Predominant self-monitoring hypotheses ascribe a primary role of voice production regions to auditory verbal hallucinations (AVH). Alternative postulations view a generalized perceptual salience bias as causal to AVH. These theories are not mutually exclusive as both ascribe the emergence and phenomenology of AVH to unbalanced top-down and bottom-up signal processing. The focus of the current study was to investigate the neurocognitive mechanisms underlying predisposition brain states for emergent hallucinations, detached from the effects of inner speech. Using the temporal voice area (TVA) localizer task, we explored putative hypersalient responses to passively presented sounds in relation to hallucination proneness (HP). Furthermore, to avoid confounds commonly found in in clinical samples, we employed the Launay-Slade Hallucination Scale (LSHS) for the quantification of HP levels in healthy people across an experiential continuum spanning the general population. We report increased activation in the right posterior superior temporal gyrus (pSTG) during the perception of voice features that positively correlates with increased HP scores. In line with prior results, we propose that this right-lateralized pSTG activation might indicate early hypersensitivity to acoustic features coding speaker identity that extends beyond own voice production to perception in healthy participants prone to experience AVH.
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Affiliation(s)
- Joseph F. Johnson
- Department of Neuropsychology and Psychopharmacology, University of Maastricht, Maastricht, Netherlands
| | - Michel Belyk
- Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - Michael Schwartze
- Department of Neuropsychology and Psychopharmacology, University of Maastricht, Maastricht, Netherlands
| | - Ana P. Pinheiro
- Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
| | - Sonja A. Kotz
- Department of Neuropsychology and Psychopharmacology, University of Maastricht, Maastricht, Netherlands
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- *Correspondence: Sonja A. Kotz,
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10
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Uncovering hidden resting state dynamics: A new perspective on auditory verbal hallucinations. Neuroimage 2022; 255:119188. [PMID: 35398281 DOI: 10.1016/j.neuroimage.2022.119188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/25/2022] [Accepted: 03/13/2022] [Indexed: 11/24/2022] Open
Abstract
In the absence of sensory stimulation, the brain transits between distinct functional networks. Network dynamics such as transition patterns and the time the brain stays in each network link to cognition and behavior and are subject to much investigation. Auditory verbal hallucinations (AVH), the temporally fluctuating unprovoked experience of hearing voices, are associated with aberrant resting state network activity. However, we lack a clear understanding of how different networks contribute to aberrant activity over time. An accurate characterization of latent network dynamics and their relation to neurocognitive changes necessitates methods that capture the sub-second temporal fluctuations of the networks' functional connectivity signatures. Here, we critically evaluate the assumptions and sensitivity of several approaches commonly used to assess temporal dynamics of brain connectivity states in M/EEG and fMRI research, highlighting methodological constraints and their clinical relevance to AVH. Identifying altered brain connectivity states linked to AVH can facilitate the detection of predictive disease markers and ultimately be valuable for generating individual risk profiles, differential diagnosis, targeted intervention, and treatment strategies.
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11
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Amorim M, Roberto MS, Kotz SA, Pinheiro AP. The perceived salience of vocal emotions is dampened in non-clinical auditory verbal hallucinations. Cogn Neuropsychiatry 2022; 27:169-182. [PMID: 34261424 DOI: 10.1080/13546805.2021.1949972] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Introduction: Auditory verbal hallucinations (AVH) are a cardinal symptom of schizophrenia but are also reported in the general population without need for psychiatric care. Previous evidence suggests that AVH may reflect an imbalance of prior expectation and sensory information, and that altered salience processing is characteristic of both psychotic and non-clinical voice hearers. However, it remains to be shown how such an imbalance affects the categorisation of vocal emotions in perceptual ambiguity.Methods: Neutral and emotional nonverbal vocalisations were morphed along two continua differing in valence (anger; pleasure), each including 11 morphing steps at intervals of 10%. College students (N = 234) differing in AVH proneness (measured with the Launay-Slade Hallucination Scale) evaluated the emotional quality of the vocalisations.Results: Increased AVH proneness was associated with more frequent categorisation of ambiguous vocalisations as 'neutral', irrespective of valence. Similarly, the perceptual boundary for emotional classification was shifted by AVH proneness: participants needed more emotional information to categorise a voice as emotional.Conclusions: These findings suggest that emotional salience in vocalisations is dampened as a function of increased AVH proneness. This could be related to changes in the acoustic representations of emotions or reflect top-down expectations of less salient information in the social environment.
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Affiliation(s)
- Maria Amorim
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Magda S Roberto
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Sonja A Kotz
- Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, The Netherlands.,Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ana P Pinheiro
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal.,Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, The Netherlands
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12
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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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13
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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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Zhuo C, Xiao B, Chen C, Jiang D, Li G, Ma X, Li R, Wang L, Xu Y, Zhou C, Lin X. Abberant inverted U-shaped brain pattern and trait-related retinal impairment in schizophrenia patients with combined auditory and visual hallucinations: a pilot study. Brain Imaging Behav 2021; 15:738-747. [PMID: 32304019 PMCID: PMC8032576 DOI: 10.1007/s11682-020-00281-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Schizophrenic patients often experience auditory hallucinations (AHs) and visual hallucinations (VHs). However, brain and retinal alterations associated with combined AHs and VHs in schizophrenic patients are unknown. This study aimed o investigate brain and retinal alterations in first episode un-treated schizophrenic patients with combined AHs and VHs (FUSCHAV). FUSCHAV patients (n = 120), divided into four groups according to severity of AH and VH symptoms, were compared to healthy controls (n = 30). Gray matter volume (GMV) and global functional connectivity density (gFCD) were recorded to reflect brain structure and functional alterations. Total retinal thickness was acquired by optical coherence tomography to assess retinal impairment. The majority of FUSCHAV patients (85.8%) demonstrated both GMV reduction and gFCD increases along with retinal thinning compared to healthy controls. The severity of GMV reduction and gFCD increase differed between patient groups, ranked from highest to lowest severity as follows: severe AHs combined with severe VHs (FUSCHSASV, 20 patients), moderate AHs combined with severe VHs (FUSCHMASV, 23 patients), severe AHs combined with moderate VHs (FUSCHSAMV, 28 patients), and moderate AHs combined with moderate VHs (FUSCHMAMV, 26). Retinal impairment was similar among the four FUSCHAV groups. GMV reduction and gFCD increases in the frontal-parietal lobule show an inverted U-shaped pattern among FUSCHAV patients according to AH and VH severity, while retinal impairment remains stable among FUSCHAV groups. These findings indicate a reciprocal deterioration in auditory and visual disturbances among FUSCHAV patients.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry Pattern Recognition, Department of Genetics Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, 272119, Shandong Province, China.
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China.
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory(PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, Tianjin, 300222, China.
- 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, China.
- Department of Psychiatry, Tianjin Medical University, Tianjin, 300074, China.
- Department of Medical Big Data Centre, Shanxi Medical University, Taiyuan, China.
| | - Bo Xiao
- Department of OCT, Tianjin Eye Hospital, Tianjin, 300274, China
| | - Ce Chen
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Gongying Li
- Department of Psychiatry Pattern Recognition, Department of Genetics Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, 272119, Shandong Province, China
| | - Xiaoyan Ma
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory(PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, Tianjin, 300222, China
| | - Ranli Li
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory(PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, Tianjin, 300222, China
| | - Lina Wang
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory(PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, Tianjin, 300222, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Chunhua Zhou
- Department of Pharmacoloy, The First Hospital of Hebei Medical Universtiy, Shijiazhuang, 05000, Hebei Province, China.
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China.
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15
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Johnson JF, Belyk M, Schwartze M, Pinheiro AP, Kotz SA. Expectancy changes the self-monitoring of voice identity. Eur J Neurosci 2021; 53:2681-2695. [PMID: 33638190 PMCID: PMC8252045 DOI: 10.1111/ejn.15162] [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: 07/21/2020] [Revised: 01/18/2021] [Accepted: 02/20/2021] [Indexed: 12/02/2022]
Abstract
Self‐voice attribution can become difficult when voice characteristics are ambiguous, but functional magnetic resonance imaging (fMRI) investigations of such ambiguity are sparse. We utilized voice‐morphing (self‐other) to manipulate (un‐)certainty in self‐voice attribution in a button‐press paradigm. This allowed investigating how levels of self‐voice certainty alter brain activation in brain regions monitoring voice identity and unexpected changes in voice playback quality. FMRI results confirmed a self‐voice suppression effect in the right anterior superior temporal gyrus (aSTG) when self‐voice attribution was unambiguous. Although the right inferior frontal gyrus (IFG) was more active during a self‐generated compared to a passively heard voice, the putative role of this region in detecting unexpected self‐voice changes during the action was demonstrated only when hearing the voice of another speaker and not when attribution was uncertain. Further research on the link between right aSTG and IFG is required and may establish a threshold monitoring voice identity in action. The current results have implications for a better understanding of the altered experience of self‐voice feedback in auditory verbal hallucinations.
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Affiliation(s)
- Joseph F Johnson
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
| | - Michel Belyk
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Michael Schwartze
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
| | - Ana P Pinheiro
- Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
| | - Sonja A Kotz
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands.,Department of Neuropsychology, Max Planck Institute for Human and Cognitive Sciences, Leipzig, Germany
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16
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Acoustic salience in emotional voice perception and its relationship with hallucination proneness. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 21:412-425. [DOI: 10.3758/s13415-021-00864-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/23/2020] [Indexed: 01/01/2023]
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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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18
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Zhuo C, Chen M, Xu Y, Jiang D, Chen C, Ma X, Li R, Sun Y, Li Q, Zhou C, Lin X. Reciprocal deterioration of visual and auditory hallucinations in schizophrenia presents V-shaped cognition impairment and widespread reduction in brain gray matter-A pilot study. J Clin Neurosci 2020; 79:154-159. [PMID: 33070887 DOI: 10.1016/j.jocn.2020.07.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 05/07/2020] [Accepted: 07/19/2020] [Indexed: 10/23/2022]
Abstract
Schizophrenic patients often experience visual hallucinations (VHs) and auditory hallucinations (AHs); however, brain aberrations associated with combined VH and AH in schizophrenic patients remains poorly documented. Changes to the brain and cognition during the first episode of untreated schizophrenic patients (FUSCH) with both VHs and AHs (FUSCHVA) were evaluated. One-hundred and fifty-seven patients were enrolled that had FUSCH (1) with VHs but not AHs (FUSCHV), and (2) with AHs but not VHs (FUSCHA), plus FUSCHVA and healthy controls (n = 30). Gray matter volume (GMV) and MATRICS Consensus Cognitive Battery (MCCB) was measured to reflect impairments to the brain and cognition, respectively. FUSCHVA patients had the severest cognitive impairment for all components of the MCCB, followed by FUSCHV and FUSCHA patients. Compared to healthy patients, FUSCHVA patients had reduced GMV in the occipital, parietal, frontal, and temporal cortex, and increased GMV in the hippocampus and striatum. Compared to FUSCHV patients, FUSCHVA patients had reduced GMV in the occipital cortex and postcentral gyrus, and increased GMV in the posterio-parietal lobe. Compared to patients with FUSCHA, the GMV in patients with FUSCHVV was reduced in the occipital cortex and posterio parietal lobe. In conclusion, visual and auditory hallucinations appear to deteriorate reciprocally in FUSCHVA patients, accompanied with sever cognitive impairments. Compared to AHs, VHs might be accompanied with severe GMV impairment in the brain, especially in the primary visual cortex and higher perception integration cortex (posterio parietal lobe) in patients with FUSCH.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Neuroimage-Genetics Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining 272119, Shandong Province, China; 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, China; Department of Psychiatric-Neuroimage-Genetics, Wenzhou Seventh People's Hospital, Wenzhou 325000, China; Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, 300222 Tianjin, China; Key labaratory of Real Time of Brain Circuits Tracing For Neurology and Psychiatry, Tianjin Medical University Affiliated Tianjin Forth Centre Hospital, Tianjin Fourth Centre Hospital, Tianjin 300024, China.
| | - Min Chen
- Department of Neuroimage-Genetics Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining 272119, Shandong Province, 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, China
| | - Deguo Jiang
- Department of Psychiatric-Neuroimage-Genetics, Wenzhou Seventh People's Hospital, Wenzhou 325000, China
| | - Ce Chen
- Department of Psychiatric-Neuroimage-Genetics, Wenzhou Seventh People's Hospital, Wenzhou 325000, China
| | - Xiaoyan Ma
- Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, 300222 Tianjin, China
| | - Ranli Li
- Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, 300222 Tianjin, China
| | - Yun Sun
- Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Heath Teaching Hospital, 300222 Tianjin, China
| | - Qianchen Li
- Department of Pharmacoloy, The First Hospital of Hebei Medical University, Shijiazhuang 05000, Hebei Province, China
| | - Chunhua Zhou
- Department of Pharmacoloy, The First Hospital of Hebei Medical University, Shijiazhuang 05000, Hebei Province, China.
| | - Xiaodong Lin
- Department of Pharmacoloy, The First Hospital of Hebei Medical University, Shijiazhuang 05000, Hebei Province, China
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19
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Pinheiro AP, Schwartze M, Gutiérrez-Domínguez F, Kotz SA. Real and imagined sensory feedback have comparable effects on action anticipation. Cortex 2020; 130:290-301. [PMID: 32698087 DOI: 10.1016/j.cortex.2020.04.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/23/2020] [Accepted: 04/13/2020] [Indexed: 01/08/2023]
Abstract
The forward model monitors the success of sensory feedback to an action and links it to an efference copy originating in the motor system. The Readiness Potential (RP) of the electroencephalogram has been denoted as a neural signature of the efference copy. An open question is whether imagined sensory feedback works similarly to real sensory feedback. We investigated the RP to audible and imagined sounds in a button-press paradigm and assessed the role of sound complexity (vocal vs. non-vocal sound). Sensory feedback (both audible and imagined) in response to a voluntary action modulated the RP amplitude time-locked to the button press. The RP amplitude increase was larger for actions with expected sensory feedback (audible and imagined) than those without sensory feedback, and associated with N1 suppression for audible sounds. Further, the early RP phase was increased when actions elicited an imagined vocal (self-voice) compared to non-vocal sound. Our results support the notion that sensory feedback is anticipated before voluntary actions. This is the case for both audible and imagined sensory feedback and confirms a role of overt and covert feedback in the forward model.
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Affiliation(s)
- Ana P Pinheiro
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal; Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, The Netherlands.
| | - Michael Schwartze
- Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, The Netherlands
| | | | - Sonja A Kotz
- Faculty of Psychology and Neuroscience, University of Maastricht, Maastricht, The Netherlands
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20
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Pinheiro AP, Schwartze M, Amorim M, Coentre R, Levy P, Kotz SA. Changes in motor preparation affect the sensory consequences of voice production in voice hearers. Neuropsychologia 2020; 146:107531. [PMID: 32553846 DOI: 10.1016/j.neuropsychologia.2020.107531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 05/11/2020] [Accepted: 06/08/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Auditory verbal hallucinations (AVH) are a cardinal symptom of psychosis but are also present in 6-13% of the general population. Alterations in sensory feedback processing are a likely cause of AVH, indicative of changes in the forward model. However, it is unknown whether such alterations are related to anomalies in forming an efference copy during action preparation, selective for voices, and similar along the psychosis continuum. By directly comparing psychotic and nonclinical voice hearers (NCVH), the current study specifies whether and how AVH proneness modulates both the efference copy (Readiness Potential) and sensory feedback processing for voices and tones (N1, P2) with event-related brain potentials (ERPs). METHODS Controls with low AVH proneness (n = 15), NCVH (n = 16) and first-episode psychotic patients with AVH (n = 16) engaged in a button-press task with two types of stimuli: self-initiated and externally generated self-voices or tones during EEG recordings. RESULTS Groups differed in sensory feedback processing of expected and actual feedback: NCVH displayed an atypically enhanced N1 to self-initiated voices, while N1 suppression was reduced in psychotic patients. P2 suppression for voices and tones was strongest in NCVH, but absent for voices in patients. Motor activity preceding the button press was reduced in NCVH and patients, specifically for sensory feedback to self-voice in NCVH. CONCLUSIONS These findings suggest that selective changes in sensory feedback to voice are core to AVH. These changes already show in preparatory motor activity, potentially reflecting changes in forming an efference copy. The results provide partial support for continuum models of psychosis.
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Affiliation(s)
- Ana P Pinheiro
- Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal.
| | - Michael Schwartze
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Maria Amorim
- Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Ricardo Coentre
- Serviço de Psiquiatria e Saúde Mental, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Pedro Levy
- Serviço de Psiquiatria e Saúde Mental, Centro Hospitalar Universitário Lisboa Norte EPE, Lisboa, Portugal
| | - Sonja A Kotz
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Zhuo C, Xiao B, Chen C, Jiang D, Li G, Ma X, Li R, Wang L, Xu Y, Zhou C, Lin X. Antipsychotic agents deteriorate brain and retinal function in schizophrenia patients with combined auditory and visual hallucinations: A pilot study and secondary follow-up study. Brain Behav 2020; 10:e01611. [PMID: 32285647 PMCID: PMC7303384 DOI: 10.1002/brb3.1611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/13/2020] [Accepted: 03/10/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Schizophrenia patients often experience auditory hallucinations (AHs) and visual hallucinations (VHs). However, the degree and type of brain and retinal alterations associated with combined AHs and VHs in schizophrenia patients remain unknown. There is an urgent need for a study that investigates the trajectory of brain and retinal alterations in patients with first-episode untreated schizophrenia accompanied by combined AHs and VHs (FUSCHAV). METHODS FUSCHAV patients (n = 120), divided into four groups according to AH and VH symptom severity (severe AHs combined with severe VHs [FUSCHSASV, 20 patients]; middle-to-moderate AHs combined with severe VHs [FUSCHMASV, 23 patients]; severe AHs combined with middle-to-moderate VHs [FUSCHSAMV, 28 patients]; and middle-to-moderate AHs combined with middle-to-moderate VHs [FUSCHMAMV, 26 patients]), were compared to healthy controls (n = 30). Gray matter volume (GMV) was adopted for brain structural alteration assessment. Total retinal thickness was adopted as a measure of retinal thickness impairment. RESULTS In the pilot study, the rate of GMV reduction showed an inverted U-shaped pattern across the different FUSCHAV patient groups according to AH and VH severity. The degree of retinal impairment remained stable across the groups. More notably, in the secondary follow-up study, we observed that, after 6 months of treatment with antipsychotic agents, all the GMV reduction-related differences across the different patient groups disappeared, and both GMV and retinal thickness demonstrated a tendency to deteriorate. CONCLUSIONS These findings indicate the need for heightened alertness on brain and retinal impairments in patients with FUSCHAV. Further deteriorations induced by antipsychotic agent treatment should be monitored in clinical practice.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry Pattern Recognition, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China.,Department of Genetics, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China.,Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China.,Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China.,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, China
| | - Bo Xiao
- Department of OCT, Tianjin Eye Hospital, Tianjin, China
| | - Ce Chen
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Gongying Li
- Department of Psychiatry Pattern Recognition, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China.,Department of Genetics, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China
| | - Xiaoyan Ma
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China
| | - Ranli Li
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China
| | - Lina Wang
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, 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, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
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