The corollary discharge in humans is related to synchronous neural oscillations

Hallucination Proneness Alters Sensory Feedback Processing in Self-voice Production

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.

Corollary Discharge Dysfunction as a Possible Substrate of Anomalous Self-experiences in Schizophrenia

BACKGROUND AND HYPOTHESIS

Corollary discharge mechanism suppresses the conscious auditory sensory perception of self-generated speech and attenuates electrophysiological markers such as the auditory N1 Event-Related Potential (ERP) during Electroencephalographic (EEG) recordings. This phenomenon contributes to self-identification and seems to be altered in people with schizophrenia. Therefore, its alteration could be related to the anomalous self-experiences (ASEs) frequently found in these patients.

STUDY DESIGN

To analyze corollary discharge dysfunction as a possible substrate of ASEs, we recorded EEG ERP from 43 participants with schizophrenia and 43 healthy controls and scored ASEs with the 'Inventory of Psychotic-Like Anomalous Self-Experiences' (IPASE). Positive and negative symptoms were also scored with the 'Positive and Negative Syndrome Scale for Schizophrenia' (PANSS) and with the 'Brief Negative Symptom Scale' (BNSS) respectively. The N1 components were elicited by two task conditions: (1) concurrent listening to self-pronounced vowels (talk condition) and (2) subsequent non-concurrent listening to the same previously self-uttered vowels (listen condition).

STUDY RESULTS

The amplitude of the N1 component elicited by the talk condition was lower compared to the listen condition in people with schizophrenia and healthy controls. However, the difference in N1 amplitude between both conditions was significantly higher in controls than in schizophrenia patients. The values of these differences in patients correlated significantly and negatively with the IPASE, PANSS, and BNSS scores.

CONCLUSIONS

These results corroborate previous data relating auditory N1 ERP amplitude with altered corollary discharge mechanisms in schizophrenia and support corollary discharge dysfunction as a possible underpinning of ASEs in this illness.

Corollary discharge and anomalous self-experiences in schizophrenia and bipolar disorder: A specificity analysis

OBJECTIVE

The Corollary Discharge (CD) mechanism inhibits self-generated speech sound perception, appearing disrupted in schizophrenia and potentially contributing to Anomalous Self-Experiences (ASEs). However, it remains unclear if this alteration and its correlation with ASEs extend to other psychotic disorders.

METHODS

Electroencephalography was used to study the N1 Event-Related Potential (ERP) as an index of CD-mediated suppression in the auditory cortex across thirty-five participants with schizophrenia, twenty-six with bipolar disorder, and thirty healthy controls. Auditory N1 was elicited by two conditions: real-time listening to self-pronounced vowels while speaking through connected microphone and earphones (listen/talk -or talk condition in previous literature-) and passive listening to the same previously recorded self-uttered vowels (listen/no talk -or listen condition-).

RESULTS

N1 ERP amplitude was lower in the listen/talk condition compared to listen/no talk across all groups. However, N1 suppression was significantly reduced in schizophrenia, with bipolar patients showing intermediate attenuation between both groups (i.e., non-significantly different from controls). Furthermore, N1 suppression inversely correlated with ASEs severity only in schizophrenia.

CONCLUSIONS

Dysfunction of the CD mechanism may be a defining feature of schizophrenia, where it is connected to ASEs.

SIGNIFICANCE

These results corroborate previous findings linking auditory N1 ERP suppression with disrupted CD mechanism in schizophrenia, but not in bipolar disorder.

Innovative strategies for managing hallucinations by exploring effects of tDCS on source monitoring abilities

This randomised, crossover, sham-controlled study explored the neural basis of source-monitoring, a crucial cognitive process implicated in schizophrenia. Left superior temporal gyrus (STG) and dorsolateral prefrontal cortex (DLPFC) were the key focus areas. Thirty participants without neurological or psychological disorders underwent offline sham and active tDCS sessions with specific electrode montage targeting the left STG and DLPFC. Source-monitoring tasks, reality monitoring (Hear-Imagine), internal source-monitoring (Say-Imagine), and external source monitoring (Virtual-Real) were administered. Paired t-test and estimation statistics was performed with Graphpad version 10.1.0. The Benjamini-Hochberg procedure was employed to control the false discovery rate in multiple hypothesis testing. A significant improvement in internal source monitoring tasks (p = 0.001, Cohen's d = 0.97) was observed, but reality monitoring tasks demonstrated moderate improvement (p = 0.02, Cohen's d = 0.44). The study provides insights into the neural mechanisms of source monitoring in healthy individuals and proposes tDCS as a therapeutic intervention, laying the foundation for future studies to refine tDCS protocols and develop individualized approaches to address source monitoring deficits in schizophrenia.

Pons-to-Cerebellum Hypoconnectivity Along the Psychosis Spectrum and Associations With Sensory Prediction and Hallucinations in Schizophrenia

BACKGROUND

Sensory prediction allows the brain to anticipate and parse incoming self-generated sensory information from externally generated signals. Sensory prediction breakdowns may contribute to perceptual and agency abnormalities in psychosis (hallucinations, delusions). The pons, a central node in a cortico-ponto-cerebellar-thalamo-cortical circuit, is thought to support sensory prediction. Examination of pons connectivity in schizophrenia and its role in sensory prediction abnormalities is lacking.

METHODS

We examined these relationships using resting-state functional magnetic resonance imaging and the electroencephalography-based auditory N1 event-related potential in 143 participants with psychotic spectrum disorders (PSPs) (with schizophrenia, schizoaffective disorder, or bipolar disorder); 63 first-degree relatives of individuals with psychosis; 45 people at clinical high risk for psychosis; and 124 unaffected comparison participants. This unique sample allowed examination across the psychosis spectrum and illness trajectory. Seeding from the pons, we extracted average connectivity values from thalamic and cerebellar clusters showing differences between PSPs and unaffected comparison participants. We predicted N1 amplitude attenuation during a vocalization task from pons connectivity and group membership. We correlated participant-level connectivity in PSPs and people at clinical high risk for psychosis with hallucination and delusion severity.

RESULTS

Compared to unaffected comparison participants, PSPs showed pons hypoconnectivity to 2 cerebellar clusters, and first-degree relatives of individuals with psychosis showed hypoconnectivity to 1 of these clusters. Pons-to-cerebellum connectivity was positively correlated with N1 attenuation; only PSPs with heightened pons-to-postcentral gyrus connectivity showed this pattern, suggesting a possible compensatory mechanism. Pons-to-cerebellum hypoconnectivity was correlated with greater hallucination severity specifically among PSPs with schizophrenia.

CONCLUSIONS

Deficient pons-to-cerebellum connectivity linked sensory prediction network breakdowns with perceptual abnormalities in schizophrenia. Findings highlight shared features and clinical heterogeneity across the psychosis spectrum.

Speech-induced suppression during natural dialogues

When engaged in a conversation, one receives auditory information from the other's speech but also from their own speech. However, this information is processed differently by an effect called Speech-Induced Suppression. Here, we studied brain representation of acoustic properties of speech in natural unscripted dialogues, using electroencephalography (EEG) and high-quality speech recordings from both participants. Using encoding techniques, we were able to reproduce a broad range of previous findings on listening to another's speech, and achieving even better performances when predicting EEG signal in this complex scenario. Furthermore, we found no response when listening to oneself, using different acoustic features (spectrogram, envelope, etc.) and frequency bands, evidencing a strong effect of SIS. The present work shows that this mechanism is present, and even stronger, during natural dialogues. Moreover, the methodology presented here opens the possibility of a deeper understanding of the related mechanisms in a wider range of contexts.

Causal role of medial superior frontal cortex on enhancing neural information flow and self-agency judgments in the self-agency network

Self-agency is being aware of oneself as the agent of one's thoughts and actions. Self-agency is necessary for successful interactions with the outside world (reality-monitoring). Prior research has shown that the medial superior prefrontal gyri (mPFC/SFG) may represent one neural correlate underlying self-agency judgments. However, the causal relationship remains unknown. Here, we applied high-frequency 10Hz repetitive transcranial magnetic stimulation (rTMS) to modulate the excitability of the mPFC/SFG site that we have previously shown to mediate self-agency. For the first time, we delineate causal neural mechanisms, revealing precisely how rTMS modulates SFG excitability and impacts directional neural information flow in the self-agency network by implementing innovative magnetoencephalography (MEG) phase-transfer entropy (PTE) metrics, measured from pre-to-post rTMS. We found that, compared to control rTMS, enhancing SFG excitability by rTMS induced significant increases in information flow between SFG and specific cingulate and paracentral regions in the self-agency network in delta-theta, alpha, and gamma bands, which predicted improved self-agency judgments. This is the first multimodal imaging study in which we implement MEG PTE metrics of 5D imaging of space, frequency and time, to provide cutting-edge analyses of the causal neural mechanisms of how rTMS enhances SFG excitability and improves neural information flow between distinct regions in the self-agency network to potentiate improved self-agency judgments. Our findings provide a novel perspective for investigating causal neural mechanisms underlying self-agency and create a path towards developing novel neuromodulation interventions to improve self-agency that will be particularly useful for patients with psychosis who exhibit severe impairments in self-agency.

Short-Term Effect of Auditory Stimulation on Neural Activities: A Scoping Review of Longitudinal Electroencephalography and Magnetoencephalography Studies

Explored through EEG/MEG, auditory stimuli function as a suitable research probe to reveal various neural activities, including event-related potentials, brain oscillations and functional connectivity. Accumulating evidence in this field stems from studies investigating neuroplasticity induced by long-term auditory training, specifically cross-sectional studies comparing musicians and non-musicians as well as longitudinal studies with musicians. In contrast, studies that address the neural effects of short-term interventions whose duration lasts from minutes to hours are only beginning to be featured. Over the past decade, an increasing body of evidence has shown that short-term auditory interventions evoke rapid changes in neural activities, and oscillatory fluctuations can be observed even in the prestimulus period. In this scoping review, we divided the extracted neurophysiological studies into three groups to discuss neural activities with short-term auditory interventions: the pre-stimulus period, during stimulation, and a comparison of before and after stimulation. We show that oscillatory activities vary depending on the context of the stimuli and are greatly affected by the interplay of bottom-up and top-down modulational mechanisms, including attention. We conclude that the observed rapid changes in neural activitiesin the auditory cortex and the higher-order cognitive part of the brain are causally attributed to short-term auditory interventions.

Altered corollary discharge signaling in the auditory cortex of a mouse model of schizophrenia predisposition

The ability to distinguish sensations that are self-generated from those caused by external events is disrupted in schizophrenia patients. However, the neural circuit abnormalities underlying this sensory impairment and its relationship to the risk factors for the disease is not well understood. To address this, we examined the processing of self-generated sounds in male Df(16)A+/- mice, which model one of the largest genetic risk factors for schizophrenia, the 22q11.2 microdeletion. We find that auditory cortical neurons in Df(16)A+/- mice fail to attenuate their responses to self-generated sounds, recapitulating deficits seen in schizophrenia patients. Notably, the auditory cortex of Df(16)A+/- mice displayed weaker motor-related signals and received fewer inputs from the motor cortex, suggesting an anatomical basis underlying the sensory deficit. These results provide insights into the mechanisms by which a major genetic risk factor for schizophrenia disrupts the top-down processing of sensory information.

Bridging phenomenology and neural mechanisms of inner speech: ALE meta-analysis on egocentricity and spontaneity in a dual-mechanistic framework

The neural mechanisms of inner speech remain unclear despite its importance in a variety of cognitive processes and its implication in aberrant perceptions such as auditory verbal hallucinations. Previous research has proposed a corollary discharge model in which inner speech is a truncated form of overt speech, relying on speech production-related regions (e.g. left inferior frontal gyrus). This model does not fully capture the diverse phenomenology of inner speech and recent research suggesting alternative perception-related mechanisms of generation. Therefore, we present and test a framework in which inner speech can be generated by two separate mechanisms, depending on its phenomenological qualities: a corollary discharge mechanism relying on speech production regions and a perceptual simulation mechanism within speech perceptual regions. The results of the activation likelihood estimation meta-analysis examining inner speech studies support the idea that varieties of inner speech recruit different neural mechanisms.

Corollary discharge function in healthy controls: Evidence about self-speech and external speech processing

As we speak, corollary discharge mechanisms suppress the auditory conscious perception of the self-generated voice in healthy subjects. This suppression has been associated with the attenuation of the auditory N1 component. To analyse this corollary discharge phenomenon (agency and ownership), we registered the event-related potentials of 42 healthy subjects. The N1 and P2 components were elicited by spoken vowels (talk condition; agency), by played-back vowels recorded with their own voice (listen-self condition; ownership) and by played-back vowels recorded with an external voice (listen-other condition). The N1 amplitude elicited by the talk condition was smaller compared with the listen-self and listen-other conditions. There were no amplitude differences in N1 between listen-self and listen-other conditions. The P2 component did not show differences between conditions. Additionally, a peak latency analysis of N1 and P2 components between the three conditions showed no differences. These findings corroborate previous results showing that the corollary discharge mechanisms dampen sensory responses to self-generated speech (agency experience) and provide new neurophysiological evidence about the similarities in the processing of played-back vowels with our own voice (ownership experience) and with an external voice.

Online Ternary Classification of Covert Speech by Leveraging the Passive Perception of Speech

Brain-computer interfaces (BCIs) provide communicative alternatives to those without functional speech. Covert speech (CS)-based BCIs enable communication simply by thinking of words and thus have intuitive appeal. However, an elusive barrier to their clinical translation is the collection of voluminous examples of high-quality CS signals, as iteratively rehearsing words for long durations is mentally fatiguing. Research on CS and speech perception (SP) identifies common spatiotemporal patterns in their respective electroencephalographic (EEG) signals, pointing towards shared encoding mechanisms. The goal of this study was to investigate whether a model that leverages the signal similarities between SP and CS can differentiate speech-related EEG signals online. Ten participants completed a dyadic protocol where in each trial, they listened to a randomly selected word and then subsequently mentally rehearsed the word. In the offline sessions, eight words were presented to participants. For the subsequent online sessions, the two most distinct words (most separable in terms of their EEG signals) were chosen to form a ternary classification problem (two words and rest). The model comprised a functional mapping derived from SP and CS signals of the same speech token (features are extracted via a Riemannian approach). An average ternary online accuracy of 75.3% (60% chance level) was achieved across participants, with individual accuracies as high as 93%. Moreover, we observed that the signal-to-noise ratio (SNR) of CS signals was enhanced by perception-covert modeling according to the level of high-frequency ([Formula: see text]-band) correspondence between CS and SP. These findings may lead to less burdensome data collection for training speech BCIs, which could eventually enhance the rate at which the vocabulary can grow.

Disrupted auditory N1, theta power and coherence suppression to willed speech in people with schizophrenia

The phenomenon of sensory self-suppression - also known as sensory attenuation - occurs when a person generates a perceptible stimulus (such as a sound) by performing an action (such as speaking). The sensorimotor control system is thought to actively predict and then suppress the vocal sound in the course of speaking, resulting in lowered cortical responsiveness when speaking than when passively listening to an identical sound. It has been hypothesized that auditory hallucinations in schizophrenia result from a reduction in self-suppression due to a disruption of predictive mechanisms required to anticipate and suppress a specific, self-generated sound. It has further been hypothesized that this suppression is evident primarily in theta band activity. Fifty-one people, half of whom had a diagnosis of schizophrenia, were asked to repeatedly utter a single syllable, which was played back to them concurrently over headphones while EEG was continuously recorded. In other conditions, recordings of the same spoken syllables were played back to participants while they passively listened, or were played back with their onsets preceded by a visual cue. All participants experienced these conditions with their voice artificially shifted in pitch and also with their unaltered voice. Suppression was measured using event-related potentials (N1 component), theta phase coherence and power. We found that suppression was generally reduced on all metrics in the patient sample, and when voice alteration was applied. We additionally observed reduced theta coherence and power in the patient sample across all conditions. Visual cueing affected theta coherence only. In aggregate, the results suggest that sensory self-suppression of theta power and coherence is disrupted in schizophrenia.

A comparison and classification of oscillatory characteristics in speech perception and covert speech

Covert speech, the mental imagery of speaking, has been studied increasingly to understand and decode thoughts in the context of brain-computer interfaces. In studies of speech comprehension, neural oscillations are thought to play a key role in the temporal encoding of speech. However, little is known about the role of oscillations in covert speech. In this study, we investigated the oscillatory involvements in covert speech and speech perception. Data were collected from 10 participants with 64 channel EEG. Participants heard the words, 'blue' and 'orange', and subsequently mentally rehearsed them. First, continuous wavelet transform was performed on epoched signals and subsequently two-tailed t-tests between two classes were conducted to determine statistical differences in frequency and time (t-CWT). Features were also extracted using t-CWT and subsequently classified using a support vector machine. θ and γ phase amplitude coupling (PAC) was also assessed within and between tasks. All binary classifications produced accuracies significantly greater (80-90%) than chance level, supporting the use of t-CWT in determining relative oscillatory involvements. While the perception task dynamically invoked all frequencies with more prominent θ and α activity, the covert task favoured higher frequencies with significantly higher γ activity than perception. Moreover, the perception condition produced significant θ-γ PAC, corroborating a reported linkage between syllabic and phonemic sampling. Although this coupling was found to be suppressed in the covert condition, we found significant cross-task coupling between perception θ and covert speech γ. Covert speech processing appears to be largely associated with higher frequencies of EEG. Importantly, the significant cross-task coupling between speech perception and covert speech, in the absence of within-task covert speech PAC, supports the notion that the γ- and θ-bands subserve, respectively, shared and unique encoding processes across tasks.

The phenomenology of auditory verbal hallucinations in schizophrenia and the challenge from pseudohallucinations

In trying to make sense of the extensive phenomenological variation of first-personal reports on auditory verbal hallucinations, the concept of pseudohallucination is originally introduced to designate any hallucinatory-like phenomena not exhibiting some of the paradigmatic features of "genuine" hallucinations. After its introduction, Karl Jaspers locates the notion of pseudohallucinations into the auditory domain, appealing to a distinction between hallucinatory voices heard within the subjective inner space (pseudohallucination) and voices heard in the outer external space (real hallucinations) with differences in their sensory richness. Jaspers' characterization of the term has been the target of a number of phenomenological, conceptual and empirically-based criticisms. From this latter point of view, it has been claimed that the concept cannot capture distinct phenomena at the neurobiological level. Over the last years, the notion of pseudohallucination seems to be falling into disuse as no major diagnostic system seems to refer to it. In this paper, we propose that even if the concept of pseudohallucination is not helpful to differentiate distinct phenomena at the neurobiological level, the inner/outer distinction highlighted by Jaspers' characterization of the term still remains an open explanatory challenge for dominant theories about the neurocognitive origin of auditory verbal hallucinations. We call this, "the challenge from pseudohallucinations". After exploring this issue in detail, we propose some phenomenological, conceptual, and empirical paths for future research that might help to build up a more contextualized and dynamic view of auditory verbal hallucinatory phenomena.

Transcranial direct current stimulation (tDCS) enhances internal source monitoring abilities in healthy participants

Source monitoring refers to the ability to identify the origin of a memory, for example, whether you remember saying something or thinking about it, and confusions of these sources have been associated with the experience of auditory verbal hallucinations (AVHs). Both AVHs and source confusions are reported to originate from dysfunctional brain activations in the prefrontal cortex (PFC) and the superior temporal gyrus (STG); specifically, it is assumed that a hypoactive PFC and a hyperactive STG gives rise to AVHs and source confusions. We set out to test this assumption by trying to mimic this hypertemporal/hypofrontal model in healthy individuals with transcranial direct current stimulation (tDCS): the inhibitory cathode was placed over the left PFC and the excitatory anode over the left dorsolateral STG. Participants completed a reality monitoring task (distinguishing between external and internal memory sources) and an internal source monitoring task (distinguishing between two or more internal memory sources) in two separate experiments (offline vs. online tDCS). In the offline experiment (n = 34), both source monitoring tasks were completed after tDCS stimulation, and in the online experiment (n = 27) source monitoring tasks were completed while simultaneously being stimulated with tDCS. We found that internal source monitoring abilities were significantly enhanced during active online tDCS, while reality monitoring abilities were unaffected by stimulation in both experiments. We speculate, based on combining the present findings with previous studies, that there might be different brain areas involved in reality and internal source monitoring. While internal source monitoring seems to involve speech production areas, specifically Broca’s area, as suggested in the present study, reality monitoring seems to rely more on the STG and DLPFC, as shown in other studies of the field.

Vocalizing and singing reveal complex patterns of corollary discharge function in schizophrenia

INTRODUCTION

As we vocalize, our brains generate predictions of the sounds we produce to enable suppression of neural responses when intentions match vocalizations and to make adjustments when they do not. This may be instantiated by efference copy and corollary discharge mechanisms, which are impaired in people with schizophrenia (SZ). Although innate, these mechanisms can be affected by intentions. We asked if attending to pitch during vocalizations would take these mechanisms "off-line" and reduce suppression.

METHODS

Event-related potentials (ERP) were recorded from 96 SZ and 92 healthy controls (HC) as they vocalized triplets in monotone (Phrase) or sang triplets in ascending thirds (Pitch). Pre-vocalization activity (Bereitschaftspotential, BP), N1, and P2 ERP components to sounds were compared during vocalization and playback.

RESULTS

N1 was not as suppressed during Pitch as during Phrase. N1 suppression was not affected by SZ in either task when all data were collapsed across pitches (Pitch) and positions (Phrase). However, when binned according to vocalization performance, SZ showed less N1 suppression than HC at longer (>2 s) inter-stimulus intervals (Phrase) and inconsistent suppression across pitches (Pitch). Unlike N1, P2 was more suppressed during Pitch than Phrase and not affected by SZ. BP was greater during vocalization than playback but did not contribute to N1 or P2 effects. Pitch variability was inversely related to negative symptoms.

CONCLUSIONS

Neural processing is not suppressed when patients and controls sing, and corollary discharge abnormalities in schizophrenia are only seen at long vocalization intervals.

Theta Phase Synchrony Is Sensitive to Corollary Discharge Abnormalities in Early Illness Schizophrenia but Not in the Psychosis Risk Syndrome

BACKGROUND

Prior studies have shown that the auditory N1 event-related potential component elicited by self-generated vocalizations is reduced relative to played back vocalizations, putatively reflecting a corollary discharge mechanism. Schizophrenia patients and psychosis risk syndrome (PRS) youth show deficient N1 suppression during vocalization, consistent with corollary discharge dysfunction. Because N1 is an admixture of theta (4-7 Hz) power and phase synchrony, we examined their contributions to N1 suppression during vocalization, as well as their sensitivity, relative to N1, to corollary discharge dysfunction in schizophrenia and PRS individuals.

METHODS

Theta phase and power values were extracted from electroencephalography data acquired from PRS youth (n = 71), early illness schizophrenia patients (ESZ; n = 84), and healthy controls (HCs; n = 103) as they said "ah" (Talk) and then listened to the playback of their vocalizations (Listen). A principal component analysis extracted theta intertrial coherence (ITC; phase consistency) and event-related spectral power, peaking in the N1 latency range. Talk-Listen suppression scores were analyzed.

RESULTS

Talk-Listen suppression was greater for theta ITC (Cohen's d = 1.46) than for N1 in HC (d = 0.63). Both were deficient in ESZ, but only N1 suppression was deficient in PRS. When deprived of variance shared with theta ITC suppression, N1 suppression no longer differentiated ESZ and PRS individuals from HC. Deficits in theta ITC suppression were correlated with delusions (P = .007) in ESZ. Theta power suppression did not differentiate groups.

CONCLUSIONS

Theta ITC-suppression during vocalization is a more sensitive index of corollary discharge-mediated auditory cortical suppression than N1 suppression and is more sensitive to corollary discharge dysfunction in ESZ than in PRS individuals.

Changes in motor preparation affect the sensory consequences of voice production in voice hearers

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.

A neurophysiological model of speech production deficits in fragile X syndrome

Fragile X syndrome is the most common inherited intellectual disability and monogenic cause of autism spectrum disorder. Expressive language deficits, especially in speech production, are nearly ubiquitous among individuals with fragile X, but understanding of the neurological bases for these deficits remains limited. Speech production depends on feedforward control and the synchronization of neural oscillations between speech-related areas of frontal cortex and auditory areas of temporal cortex. Interaction in this circuitry allows the corollary discharge of intended speech generated from an efference copy of speech commands to be compared against actual speech sounds, which is critical for making adaptive adjustments to optimize future speech. We aimed to determine whether alterations in coherence between frontal and temporal cortices prior to speech production are present in individuals with fragile X and whether they relate to expressive language dysfunction. Twenty-one participants with full-mutation fragile X syndrome (aged 7-55 years, eight females) and 20 healthy controls (matched on age and sex) completed a talk/listen paradigm during high-density EEG recordings. During the talk task, participants repeated pronounced short vocalizations of 'Ah' every 1-2 s for a total of 180 s. During the listen task, participants passively listened to their recordings from the talk task. We compared pre-speech event-related potential activity, N1 suppression to speech sounds, single trial gamma power and fronto-temporal coherence between groups during these tasks and examined their relation to performance during a naturalistic language task. Prior to speech production, fragile X participants showed reduced pre-speech negativity, reduced fronto-temporal connectivity and greater frontal gamma power compared to controls. N1 suppression during self-generated speech did not differ between groups. Reduced pre-speech activity and increased frontal gamma power prior to speech production were related to less intelligible speech as well as broader social communication deficits in fragile X syndrome. Our findings indicate that coordinated pre-speech activity between frontal and temporal cortices is disrupted in individuals with fragile X in a clinically relevant way and represents a mechanism contributing to prominent speech production problems in the disorder.

Auditory Predictions and Prediction Errors in Response to Self-Initiated Vowels

It has been suggested that speech production is accomplished by an internal forward model, reducing processing activity directed to self-produced speech in the auditory cortex. The current study uses an established N1-suppression paradigm comparing self- and externally initiated natural speech sounds to answer two questions: (1) Are forward predictions generated to process complex speech sounds, such as vowels, initiated via a button press? (2) Are prediction errors regarding self-initiated deviant vowels reflected in the corresponding ERP components? Results confirm an N1-suppression in response to self-initiated speech sounds. Furthermore, our results suggest that predictions leading to the N1-suppression effect are specific, as self-initiated deviant vowels do not elicit an N1-suppression effect. Rather, self-initiated deviant vowels elicit an enhanced N2b and P3a compared to externally generated deviants, externally generated standard, or self-initiated standards, again confirming prediction specificity. Results show that prediction errors are salient in self-initiated auditory speech sounds, which may lead to more efficient error correction in speech production.

Corollary Discharge Mechanisms During Vocal Production in Marmoset Monkeys

Interactions between motor systems and sensory processing are ubiquitous throughout the animal kingdom and play an important role in many sensorimotor behaviors, including both human speech and animal vocalization. During vocal production, the auditory system plays important roles in both encoding feedback of produced sounds, allowing one to self-monitor for vocal errors, and simultaneously maintaining sensitivity to the outside acoustic environment. Supporting these roles is an efferent motor-to-sensory signal known as a corollary discharge. This review summarizes recent work on the role of such signaling during vocalization in the marmoset monkey, a nonhuman primate model of social vocal communication.

Deficient auditory predictive coding during vocalization in the psychosis risk syndrome and in early illness schizophrenia: the final expanded sample

BACKGROUND

During vocalization, efference copy/corollary discharge mechanisms suppress the auditory cortical response to self-generated sounds. Previously, we found attenuated vocalization-related auditory cortical suppression in psychosis and a similar trend in the psychosis risk syndrome. Here, we report data from the final sample of early illness schizophrenia patients (ESZ), individuals at clinical high risk for psychosis (CHR), and healthy controls (HC).

METHODS

Event-related potentials (ERP) were recorded from ESZ (n = 84), CHR (n = 71), and HC (n = 103) participants during a vocalization paradigm. The N1 ERP component was elicited during production (Talk) and playback (Listen) of vocalization. Age effects on N1 suppression (Talk-Listen), Talk N1, and Listen N1 were compared across groups. N1 measures were adjusted for normal aging before testing for group differences.

RESULTS

Both ESZ and CHR groups showed reduced Talk-Listen N1 suppression relative to HC, but did not differ from each other. Listen N1 was reduced in ESZ, but not in CHR, relative to HC. Deficient Talk-Listen N1 suppression was associated with greater unusual thought content in CHR individuals. N1 suppression increased with age in HC (12-36 years), and while CHR individuals showed a similar age-related increase, no such relationship was evident in ESZ.

CONCLUSIONS

Putative efference copy/corollary discharge-mediated auditory cortical suppression during vocalization is deficient in ESZ and precedes psychosis onset, particularly in CHR individuals with greater unusual thought content. Furthermore, this suppression increases from adolescence through early adulthood, likely reflecting the effects of normal brain maturation. This maturation effect is disrupted in ESZ, presumably due to countervailing illness effects.

Prediction, Psychosis, and the Cerebellum

An increasingly influential hypothesis posits that many of the diverse symptoms of psychosis can be viewed as reflecting dysfunctional predictive mechanisms. Indeed, to perceive something is to take a sensory input and make a prediction of the external source of that signal; thus, prediction is perhaps the most fundamental neural computation. Given the ubiquity of prediction, a more challenging problem is to specify the unique predictive role or capability of a particular brain structure. This question is relevant when considering recent claims that one aspect of the predictive deficits observed in psychotic disorders might be related to cerebellar dysfunction, a subcortical structure known to play a critical role in predictive sensorimotor control and perhaps higher-level cognitive function. Here, we review evidence bearing on this question. We first focus on clinical, behavioral, and neuroimaging findings suggesting cerebellar involvement in psychosis and, specifically, schizophrenia. We then review a relatively novel line of research exploring whether computational models of cerebellar motor function can also account for cerebellar involvement in higher-order human cognition, and in particular, language function. We end the review by highlighting some key gaps in these literatures, limitations that currently preclude strong conclusions regarding cerebellar involvement in psychosis.

Schizophrenia and Corollary Discharge: A Neuroscientific Overview and Translational Implications

Corollary discharge mechanism refers to the suppression of sensory consequences of self-generated actions; a process that serves to distinguish between self and non-self based on discrimination of origination of action. It explains, say for example, why we cannot tickle ourselves. This review discusses how corollary discharge model is an essential neural integration mechanism central to the motor functioning of animal kingdom. In this article, research conducted in the field of corollary discharge has been reviewed to understand the neuroanatomical and neurophysiological basis of corollary discharge and gain insight into the biochemical basis of its dysfunction. This review article also explores the role of corollary discharge and its dysfunction in the presentation of symptoms of schizophrenia, discussing the findings from corollary discharge studies on schizophrenia population. Lastly, the link between schizophrenia psychopathology and corollary discharge dysfunction has been highlighted, and an attempt has been made to establish a case for correction of corollary discharge deficit in schizophrenia through neuromodulation.

Speaking-Induced Suppression of the Auditory Cortex in Humans and Its Relevance to Schizophrenia

Speaking-induced suppression (SIS) is the phenomenon that the sounds one generates by overt speech elicit a smaller neurophysiological response in the auditory cortex than comparable sounds that are externally generated. SIS is a specific example of the more general phenomenon of self-suppression. SIS has been well established in nonhuman animals and is believed to involve the action of corollary discharges. This review summarizes, first, the evidence for SIS in heathy human participants, where it has been most commonly assessed with electroencephalography and/or magnetoencephalography using an experimental paradigm known as "Talk-Listen"; and second, the growing number of Talk-Listen studies that have reported subnormal levels of SIS in patients with schizophrenia. This result is theoretically significant, as it provides a plausible explanation for some of the most distinctive and characteristic symptoms of schizophrenia, namely the first-rank symptoms. In particular, while the failure to suppress the neural consequences of self-generated movements (such as those associated with overt speech) provides a prima facie explanation for delusions of control, the failure to suppress the neural consequences of self-generated inner speech provides a plausible explanation for certain classes of auditory-verbal hallucinations, such as audible thoughts. While the empirical evidence for a relationship between SIS and the first-rank symptoms is currently limited, I predict that future studies with more sensitive experimental designs will confirm its existence. Establishing the existence of a causal, mechanistic relationship would represent a major step forward in our understanding of schizophrenia, which is a necessary precursor to the development of novel treatments.

Efference copy/corollary discharge function and targeted cognitive training in patients with schizophrenia

INTRODUCTION

During vocalization, efference copy/corollary discharge mechanisms suppress the auditory cortical response to self-generated sounds as reflected in the N1 component of the auditory event-related potential (ERP). N1 suppression during talking is reduced in patients with schizophrenia. We hypothesized that these deficits would recover with auditory training that targets the speech processing system.

METHODS

Forty-nine individuals early in the course of a schizophrenia-spectrum illness (ESZ) were randomly assigned to 40 h of Targeted Auditory Training (TAT; n = 23) or Computer Games (CG; n = 26). The N1 ERP component was elicited during production (Talk) and playback (Listen) of vocalization. Effects of Treatment on Global Cognition, N1 suppression (Talk-Listen), N1 during Talking and Listening were assessed. Simple effects of the passage of time were also assessed in the HC after 28 weeks.

RESULTS

There was a Treatment × Time interaction revealing that N1 suppression was improved with TAT, but not with CG. TAT, but not CG, also improved Global Cognition. However, TAT and CG groups differed in their pre-treatment N1 suppression, and greater N1-suppression abnormalities were strongly associated with greater improvement in N1 suppression.

CONCLUSIONS

In this sample of ESZ individuals, targeted auditory training appeared to improve the function of the efference copy/corollary discharge mechanism which tended to deteriorate with computer games. It remains to be determined if baseline N1 suppression abnormalities are necessary for TAT treatment to have a positive effect on efference copy/corollary discharge function or if improvements observed in this study represent a regression to the mean N1 suppression in ESZ.

TRIAL REGISTRATION

ClinicalTrials.govNCT00694889. Registered 1 August 2007.

Auditory prediction during speaking and listening

In the present EEG study, the role of auditory prediction in speech was explored through the comparison of auditory cortical responses during active speaking and passive listening to the same acoustic speech signals. Two manipulations of sensory prediction accuracy were used during the speaking task: (1) a real-time change in vowel F1 feedback (reducing prediction accuracy relative to unaltered feedback) and (2) presenting a stable auditory target rather than a visual cue to speak (enhancing auditory prediction accuracy during baseline productions, and potentially enhancing the perturbing effect of altered feedback). While subjects compensated for the F1 manipulation, no difference between the auditory-cue and visual-cue conditions were found. Under visually-cued conditions, reduced N1/P2 amplitude was observed during speaking vs. listening, reflecting a motor-to-sensory prediction. In addition, a significant correlation was observed between the magnitude of behavioral compensatory F1 response and the magnitude of this speaking induced suppression (SIS) for P2 during the altered auditory feedback phase, where a stronger compensatory decrease in F1 was associated with a stronger the SIS effect. Finally, under the auditory-cued condition, an auditory repetition-suppression effect was observed in N1/P2 amplitude during the listening task but not active speaking, suggesting that auditory predictive processes during speaking and passive listening are functionally distinct.

Single-Trial Classification of Disfluent Brain States in Adults Who Stutter

Normal human speech requires precise coordination between motor planning and sensory processing. Speech disfluencies are common when children learn to talk, but usually abate with time. About 5% of children experience stuttering. For most, this resolves within a year. However, for approximately 1% of the world population, stuttering continues into adulthood, which is termed 'persistent developmental stuttering'. Most stuttering events occur at the beginning of an utterance. So, in principle, brain activity before speaking should differ between fluent and stuttered speech. Here we present a method for classifying brain network states associated with fluent vs. stuttered speech on a single trial basis. Brain activity was recorded with EEG before people who stutter read aloud pseudo-word pairs. Offline independent component analysis (ICA) was used to identify the independent neural sources that underlie speech preparation. A time window selection algorithm extracted spectral power and coherence data from salient windows specific to each neural source. A stepwise linear discriminant analysis (sLDA) algorithm predicted fluent vs. stuttered speech for 81% of trials in two subjects. These results support the feasibility of developing a brain-computer interface (BCI) system to detect stuttering before it occurs, with potential for therapeutic application.

Long-range gamma phase synchronization as a compensatory strategy during working memory in high-performing patients with schizophrenia

Working memory deficits in schizophrenia may be associated with impairments in the integration of neural activity across a distributed network of cortical areas. However, evaluation of the contribution of this integration to working memory impairments in patients is severely confounded by behavioral performance. In the present multidimensional-neuroimaging study, measures of neural oscillations at baseline and during a working memory task, baseline gamma-aminobutyric acid (GABA) level in the left dorsolateral prefrontal cortex (DLPFC), and behavioral performance were obtained. Controlling behavioral performance by recruiting only "high-performing" patients with schizophrenia, we investigated whether the strength of cross-area communications differs between patients with schizophrenia and healthy participants under accurate and equivalent behavioral performance. Results of phase-locking value indicated that these high-performing patients recruited significantly more between frontal and occipital regions in the left hemisphere, t(13) = -2.16, p = .05, Cohen's d = -1.20, and between frontal and temporal regions in the right hemisphere, t(13) = -2.63, p = .02, Cohen's d = -1.46. These cross-area communication patterns may be associated with visuoverbal and visuospatial working memory networks of the left and right hemispheres, respectively. Moreover, correlations of patient's cross-area communication with in vivo GABA levels of the left DLPFC revealed a significant positive relationship (r = .77, p = .04), demonstrating that the critical role of GABA functions in gamma band oscillations may go beyond local neuronal assemblies in the left DLPFC. Altogether, these exploratory findings point to the heterogeneity among schizophrenia patients and highlight the notion that high-performing patients may engage in potential compensatory mechanisms and may represent a subgroup of patients that may be categorically or dimensionally divergent in psychopathology.

The function and failure of sensory predictions

Humans and other primates are equipped with neural mechanisms that allow them to automatically make predictions about future events, facilitating processing of expected sensations and actions. Prediction-driven control and monitoring of perceptual and motor acts are vital to normal cognitive functioning. This review provides an overview of corollary discharge mechanisms involved in predictions across sensory modalities and discusses consequences of predictive coding for cognition and behavior. Converging evidence now links impairments in corollary discharge mechanisms to neuropsychiatric symptoms such as hallucinations and delusions. We review studies supporting a prediction-failure hypothesis of perceptual and cognitive disturbances. We also outline neural correlates underlying prediction function and failure, highlighting similarities across the visual, auditory, and somatosensory systems. In linking basic psychophysical and psychophysiological evidence of visual, auditory, and somatosensory prediction failures to neuropsychiatric symptoms, our review furthers our understanding of disease mechanisms.

Attenuation of Responses to Self-Generated Sounds in Auditory Cortical Neurons

Many of the sounds that we perceive are caused by our own actions, for example when speaking or moving, and must be distinguished from sounds caused by external events. Studies using macroscopic measurements of brain activity in human subjects have consistently shown that responses to self-generated sounds are attenuated in amplitude. However, the underlying manifestation of this phenomenon at the cellular level is not well understood. To address this, we recorded the activity of neurons in the auditory cortex of mice in response to sounds generated by their own behavior. We found that the responses of auditory cortical neurons to these self-generated sounds were consistently attenuated, compared with the same sounds generated independently of the animals' behavior. This effect was observed in both putative pyramidal neurons and in interneurons and was stronger in lower layers of auditory cortex. Downstream of the auditory cortex, we found that responses of hippocampal neurons to self-generated sounds were almost entirely suppressed. Responses to self-generated optogenetic stimulation of auditory thalamocortical terminals were also attenuated, suggesting a cortical contribution to this effect. Further analyses revealed that the attenuation of self-generated sounds was not simply due to the nonspecific effects of movement or behavioral state on auditory responsiveness. However, the strength of attenuation depended on the degree to which self-generated sounds were expected to occur, in a cell-type-specific manner. Together, these results reveal the cellular basis underlying attenuated responses to self-generated sounds and suggest that predictive processes contribute to this effect.

SIGNIFICANCE STATEMENT

Distinguishing self-generated from externally generated sensory input poses a fundamental problem for behaving organisms. Our study in mice shows for the first time that responses of auditory cortical neurons are attenuated to sounds generated manually by the animals' own behavior. This effect is distinct from the nonspecific effect of behavioral activity on auditory responsiveness that has previously been reported and its magnitude is modulated by the probability with which self-generated sounds occur, suggesting an underlying predictive process. We also reveal how this effect varies across cell types and cortical layers. These findings lay a foundation for studying impairments in the processing of self-generated sounds, which are observed in psychiatric illness, in animal disease models.

Role of N-Methyl-D-Aspartate Receptors in Action-Based Predictive Coding Deficits in Schizophrenia

BACKGROUND

Recent theoretical models of schizophrenia posit that dysfunction of the neural mechanisms subserving predictive coding contributes to symptoms and cognitive deficits, and this dysfunction is further posited to result from N-methyl-D-aspartate glutamate receptor (NMDAR) hypofunction. Previously, by examining auditory cortical responses to self-generated speech sounds, we demonstrated that predictive coding during vocalization is disrupted in schizophrenia. To test the hypothesized contribution of NMDAR hypofunction to this disruption, we examined the effects of the NMDAR antagonist, ketamine, on predictive coding during vocalization in healthy volunteers and compared them with the effects of schizophrenia.

METHODS

In two separate studies, the N1 component of the event-related potential elicited by speech sounds during vocalization (talk) and passive playback (listen) were compared to assess the degree of N1 suppression during vocalization, a putative measure of auditory predictive coding. In the crossover study, 31 healthy volunteers completed two randomly ordered test days, a saline day and a ketamine day. Event-related potentials during the talk/listen task were obtained before infusion and during infusion on both days, and N1 amplitudes were compared across days. In the case-control study, N1 amplitudes from 34 schizophrenia patients and 33 healthy control volunteers were compared.

RESULTS

N1 suppression to self-produced vocalizations was significantly and similarly diminished by ketamine (Cohen's d = 1.14) and schizophrenia (Cohen's d = .85).

CONCLUSIONS

Disruption of NMDARs causes dysfunction in predictive coding during vocalization in a manner similar to the dysfunction observed in schizophrenia patients, consistent with the theorized contribution of NMDAR hypofunction to predictive coding deficits in schizophrenia.

Analgesia induced by self-initiated electrotactile sensation is mediated by top-down modulations

It is well known that sensory perception can be attenuated when sensory stimuli are controlled by self-initiated actions. This phenomenon is explained by the consistency between forward models of anticipated action effects and actual sensory feedback. Specifically, the brain state related to the binding between motor processing and sensory perception would have inhibitory function by gating sensory information via top-down control. Since the brain state could casually influence the perception of subsequent stimuli of different sensory modalities, we hypothesize that pain evoked by nociceptive stimuli following the self-initiated tactile stimulation would be attenuated as compared to that following externally determined tactile stimulation. Here, we compared psychophysical and neurophysiological responses to identical nociceptive-specific laser stimuli in two different conditions: self-initiated tactile sensation condition (STS) and nonself-initiated tactile sensation condition (N-STS). We observed that pain intensity and unpleasantness, as well as laser-evoked brain responses, were significantly reduced in the STS condition compared to the N-STS condition. In addition, magnitudes of alpha and beta oscillations prior to laser onset were significantly larger in the STS condition than in the N-STS condition. These results confirmed that pain perception and pain-related brain responses were attenuated when the tactile stimulation was initiated by subjects' voluntary actions, and exploited neural oscillations reflecting the binding between motor processing and sensory feedback. Thus, our study elaborated the understanding of underlying neural mechanisms related to top-down modulations of the analgesic effect induced by self-initiated tactile sensation, which provided theoretical basis to improve the analgesic effect in various clinical applications.

Studying auditory verbal hallucinations using the RDoC framework

In this paper, I explain why I adopted a Research Domain Criteria (RDoC) approach to study the neurobiology of auditory verbal hallucinations (AVH), or voices. I explain that the RDoC construct of "agency" fits well with AVH phenomenology. To the extent that voices sound nonself, voice hearers lack a sense of agency over the voices. Using a vocalization paradigm like those used with nonhuman primates to study mechanisms subserving the sense of agency, we find that the auditory N1 ERP is suppressed during vocalization, that EEG synchrony preceding speech onset is related to N1 suppression, and that both are reduced in patients with schizophrenia. Reduced cortical suppression is also seen across multiple psychotic disorders and in clinically high-risk youth, but it is not related to AVH. The motor activity preceding talking and connectivity between frontal and temporal lobes during talking have both proved sensitive to AVH, suggesting neural activity and connectivity associated with intentions to act may be a better way to study agency and predictions based on agency.

Interaction of language, auditory and memory brain networks in auditory verbal hallucinations

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The language, auditory and memory/limbic networks are of particular relevance for auditory verbal hallucinations.

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An increased interaction among the auditory-language and striatal brain regions occurs while patients hallucinate.

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Fronto-temporal connections are often altered in AVH individuals, but there is no consensus regarding increase or decrease.

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Connections of the interhemispheric auditory pathway are stronger for first episode patients, but they are weaker in chronic patients.

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The majority of studies support hybrid AVH hypotheses in which all three networks and the striatal network are involved.

Auditory verbal hallucinations (AVH) occur in psychotic disorders, but also as a symptom of other conditions and even in healthy people. Several current theories on the origin of AVH converge, with neuroimaging studies suggesting that the language, auditory and memory/limbic networks are of particular relevance. However, reconciliation of these theories with experimental evidence is missing. We review 50 studies investigating functional (EEG and fMRI) and anatomic (diffusion tensor imaging) connectivity in these networks, and explore the evidence supporting abnormal connectivity in these networks associated with AVH. We distinguish between functional connectivity during an actual hallucination experience (symptom capture) and functional connectivity during either the resting state or a task comparing individuals who hallucinate with those who do not (symptom association studies). Symptom capture studies clearly reveal a pattern of increased coupling among the auditory, language and striatal regions. Anatomical and symptom association functional studies suggest that the interhemispheric connectivity between posterior auditory regions may depend on the phase of illness, with increases in non-psychotic individuals and first episode patients and decreases in chronic patients. Leading hypotheses involving concepts as unstable memories, source monitoring, top-down attention, and hybrid models of hallucinations are supported in part by the published connectivity data, although several caveats and inconsistencies remain. Specifically, possible changes in fronto-temporal connectivity are still under debate. Precise hypotheses concerning the directionality of connections deduced from current theoretical approaches should be tested using experimental approaches that allow for discrimination of competing hypotheses.

Using concurrent EEG and fMRI to probe the state of the brain in schizophrenia

Perceptional abnormalities in schizophrenia are associated with hallucinations and delusions, but also with negative symptoms and poor functional outcome. Perception can be studied using EEG-derived event related potentials (ERPs). Because of their excellent temporal resolution, ERPs have been used to ask when perception is affected by schizophrenia. Because of its excellent spatial resolution, functional magnetic resonance imaging (fMRI) has been used to ask where in the brain these effects are seen. We acquired EEG and fMRI data simultaneously to explore when and where auditory perception is affected by schizophrenia. Thirty schizophrenia (SZ) patients and 23 healthy comparison subjects (HC) listened to 1000 Hz tones occurring about every second. We used joint independent components analysis (jICA) to combine EEG-based event-related potential (ERP) and fMRI responses to tones. Five ERP-fMRI joint independent components (JIC) were extracted. The "N100" JIC had temporal weights during N100 (peaking at 100 ms post-tone onset) and fMRI spatial weights in superior and middle temporal gyri (STG/MTG); however, it did not differ between groups. The "P200" JIC had temporal weights during P200 and positive fMRI spatial weights in STG/MTG and frontal areas, and negative spatial weights in the nodes of the default mode network (DMN) and visual cortex. Groups differed on the "P200" JIC: SZ had smaller "P200" JIC, especially those with more severe avolition/apathy. This is consistent with negative symptoms being related to perceptual deficits, and suggests patients with avolition/apathy may allocate too few resources to processing external auditory events and too many to processing internal events.

Increased MRI-based cortical grey/white-matter contrast in sensory and motor regions in schizophrenia and bipolar disorder

BACKGROUND

Schizophrenia and bipolar disorder share genetic risk factors and one possible illness mechanism is abnormal myelination. T1-weighted magnetic resonance imaging (MRI) tissue intensities are sensitive to myelin content. Therefore, the contrast between grey- and white-matter intensities may reflect myelination along the cortical surface.

METHOD

MRI images were obtained from patients with schizophrenia (n = 214), bipolar disorder (n = 185), and healthy controls (n = 278) and processed in FreeSurfer. The grey/white-matter contrast was computed at each vertex as the difference between average grey-matter intensity (sampled 0-60% into the cortical ribbon) and average white-matter intensity (sampled 0-1.5 mm into subcortical white matter), normalized by their average. Group differences were tested using linear models covarying for age and sex.

RESULTS

Patients with schizophrenia had increased contrast compared to controls bilaterally in the post- and precentral gyri, the transverse temporal gyri and posterior insulae, and in parieto-occipital regions. In bipolar disorder, increased contrast was primarily localized in the left precentral gyrus. There were no significant differences between schizophrenia and bipolar disorder. Findings of increased contrast remained after adjusting for cortical area, thickness, and gyrification. We found no association with antipsychotic medication dose.

CONCLUSIONS

Increased contrast was found in highly myelinated low-level sensory and motor regions in schizophrenia, and to a lesser extent in bipolar disorder. We propose that these findings indicate reduced intracortical myelin. In accordance with the corollary discharge hypothesis, this could cause disinhibition of sensory input, resulting in distorted perceptual processing leading to the characteristic positive symptoms of schizophrenia.

Non-invasive Brain Stimulation and Auditory Verbal Hallucinations: New Techniques and Future Directions

Auditory verbal hallucinations (AVHs) are the experience of hearing a voice in the absence of any speaker. Results from recent attempts to treat AVHs with neurostimulation (rTMS or tDCS) to the left temporoparietal junction have not been conclusive, but suggest that it may be a promising treatment option for some individuals. Some evidence suggests that the therapeutic effect of neurostimulation on AVHs may result from modulation of cortical areas involved in the ability to monitor the source of self-generated information. Here, we provide a brief overview of cognitive models and neurostimulation paradigms associated with treatment of AVHs, and discuss techniques that could be explored in the future to improve the efficacy of treatment, including alternating current and random noise stimulation. Technical issues surrounding the use of neurostimulation as a treatment option are discussed (including methods to localize the targeted cortical area, and the state-dependent effects of brain stimulation), as are issues surrounding the acceptability of neurostimulation for adolescent populations and individuals who experience qualitatively different types of AVH.

Brain Network Connectivity During Language Comprehension: Interacting Linguistic and Perceptual Subsystems

The dynamic neural processes underlying spoken language comprehension require the real-time integration of general perceptual and specialized linguistic information. We recorded combined electro- and magnetoencephalographic measurements of participants listening to spoken words varying in perceptual and linguistic complexity. Combinatorial linguistic complexity processing was consistently localized to left perisylvian cortices, whereas competition-based perceptual complexity triggered distributed activity over both hemispheres. Functional connectivity showed that linguistically complex words engaged a distributed network of oscillations in the gamma band (20-60 Hz), which only partially overlapped with the network supporting perceptual analysis. Both processes enhanced cross-talk between left temporal regions and bilateral pars orbitalis (BA47). The left-lateralized synchrony between temporal regions and pars opercularis (BA44) was specific to the linguistically complex words, suggesting a specific role of left frontotemporal cross-cortical interactions in morphosyntactic computations. Synchronizations in oscillatory dynamics reveal the transient coupling of functional networks that support specific computational processes in language comprehension.

High-gamma band fronto-temporal coherence as a measure of functional connectivity in speech motor control

The neural basis of human speech is unclear. Intracranial electrophysiological recordings have revealed that high-gamma band oscillations (70-150Hz) are observed in the frontal lobe during speech production and in the temporal lobe during speech perception. Here, we tested the hypothesis that the frontal and temporal brain regions had high-gamma coherence during speech. We recorded electrocorticography (ECoG) from the frontal and temporal cortices of five humans who underwent surgery for medically intractable epilepsy, and studied coherence between the frontal and temporal cortex during vocalization and playback of vocalization. We report two novel results. First, we observed high-gamma band as well as theta (4-8Hz) coherence between frontal and temporal lobes. Second, both high-gamma and theta coherence were stronger when subjects were actively vocalizing as compared to playback of the same vocalizations. These findings provide evidence that coupling between sensory-motor networks measured by high-gamma coherence plays a key role in feedback-based monitoring and control of vocal output for human vocalization.

Subnormal sensory attenuation to self-generated speech in schizotypy: Electrophysiological evidence for a 'continuum of psychosis'

BACKGROUND

A 'continuum of psychosis' refers to the concept that psychotic-like experiences occur to certain extents in the healthy population and to more severe extents in individuals with psychotic disorders. If this concept is valid, neurophysiological abnormalities exhibited by patients with schizophrenia should also be present, to some degree, in non-clinical individuals who score highly on the personality dimension of schizotypy. Patients with schizophrenia have consistently been shown to exhibit electrophysiological suppression abnormalities to self-generated speech. The present study aimed to investigate whether these electrophysiological suppression abnormalities were also present in non-clinical individuals who scored highly on schizotypy.

METHODS

Thirty-seven non-clinical individuals scoring High (above median) and 37 individuals scoring Low (below median) on the Schizotypal Personality Questionnaire (SPQ; a commonly used schizotypy scale) underwent electroencephalographic (EEG) recording. The amplitude of the N1 component of the auditory-evoked potential was measured while participants (a) vocalized simple syllables (Talk condition), (b) passively listened to a recording of these vocalizations (Listen condition) and (c) listened to a recording of the vocalizations while simultaneously watching a video depicting the sound-wave of the forthcoming vocalizations, allowing them to be temporally predicted (Cued Listen condition).

RESULTS

The Low Schizotypy group exhibited significantly reduced N1-amplitude in the Talk condition relative to both the Listen and Cued Listen conditions; that is, they exhibited significant N1-suppression. The High Schizotypy group exhibited significantly lower levels of N1-suppression compared to the Low Schizotypy group. Furthermore, while the Cued Listen condition induced significantly lower N1-amplitudes compared to the Listen condition in the Low Schizotypy group, this was not the case for the High Schizotypy group.

CONCLUSIONS

The results suggest that non-clinical, highly schizotypal individuals exhibit subnormal levels of N1-suppression to self-generated speech, similar to the N1-suppression abnormalities which have previously been reported in patients with schizophrenia. This finding provides empirical support for the existence of a neurophysiological 'continuum of psychosis'.

Enhanced Alpha-oscillations in Visual Cortex during Anticipation of Self-generated Visual Stimulation

The perceived intensity of sensory stimuli is reduced when these stimuli are caused by the observer's actions. This phenomenon is traditionally explained by forward models of sensory action–outcome, which arise from motor processing. Although these forward models critically predict anticipatory modulation of sensory neural processing, neurophysiological evidence for anticipatory modulation is sparse and has not been linked to perceptual data showing sensory attenuation. By combining a psychophysical task involving contrast discrimination with source-level time–frequency analysis of MEG data, we demonstrate that the amplitude of alpha-oscillations in visual cortex is enhanced before the onset of a visual stimulus when the identity and onset of the stimulus are controlled by participants' motor actions. Critically, this prestimulus enhancement of alpha-amplitude is paralleled by psychophysical judgments of a reduced contrast for this stimulus. We suggest that alpha-oscillations in visual cortex preceding self-generated visual stimulation are a likely neurophysiological signature of motor-induced sensory anticipation and mediate sensory attenuation. We discuss our results in relation to proposals that attribute generic inhibitory functions to alpha-oscillations in prioritizing and gating sensory information via top–down control.

Did I do that? Abnormal predictive processes in schizophrenia when button pressing to deliver a tone

Motor actions are preceded by an efference copy of the motor command, resulting in a corollary discharge of the expected sensation in sensory cortex. These mechanisms allow animals to predict sensations, suppress responses to self-generated sensations, and thereby process sensations efficiently and economically. During talking, patients with schizophrenia show less evidence of pretalking activity and less suppression of the speech sound, consistent with dysfunction of efference copy and corollary discharge, respectively. We asked if patterns seen in talking would generalize to pressing a button to hear a tone, a paradigm translatable to less vocal animals. In 26 patients [23 schizophrenia, 3 schizoaffective (SZ)] and 22 healthy controls (HC), suppression of the N1 component of the auditory event-related potential was estimated by comparing N1 to tones delivered by button presses and N1 to those tones played back. The lateralized readiness potential (LRP) associated with the motor plan preceding presses to deliver tones was estimated by comparing right and left hemispheres' neural activity. The relationship between N1 suppression and LRP amplitude was assessed. LRP preceding button presses to deliver tones was larger in HC than SZ, as was N1 suppression. LRP amplitude and N1 suppression were correlated in both groups, suggesting stronger efference copies are associated with stronger corollary discharges. SZ have reduced N1 suppression, reflecting corollary discharge action, and smaller LRPs preceding button presses to deliver tones, reflecting the efference copy of the motor plan. Effects seen during vocalization largely extend to other motor acts more translatable to lab animals.

Action planning and predictive coding when speaking

Across the animal kingdom, sensations resulting from an animal's own actions are processed differently from sensations resulting from external sources, with self-generated sensations being suppressed. A forward model has been proposed to explain this process across sensorimotor domains. During vocalization, reduced processing of one's own speech is believed to result from a comparison of speech sounds to corollary discharges of intended speech production generated from efference copies of commands to speak. Until now, anatomical and functional evidence validating this model in humans has been indirect. Using EEG with anatomical MRI to facilitate source localization, we demonstrate that inferior frontal gyrus activity during the 300ms before speaking was associated with suppressed processing of speech sounds in auditory cortex around 100ms after speech onset (N1). These findings indicate that an efference copy from speech areas in prefrontal cortex is transmitted to auditory cortex, where it is used to suppress processing of anticipated speech sounds. About 100ms after N1, a subsequent auditory cortical component (P2) was not suppressed during talking. The combined N1 and P2 effects suggest that although sensory processing is suppressed as reflected in N1, perceptual gaps may be filled as reflected in the lack of P2 suppression, explaining the discrepancy between sensory suppression and preserved sensory experiences. These findings, coupled with the coherence between relevant brain regions before and during speech, provide new mechanistic understanding of the complex interactions between action planning and sensory processing that provide for differentiated tagging and monitoring of one's own speech, processes disrupted in neuropsychiatric disorders.

Auditory cortex processes variation in our own speech

As we talk, we unconsciously adjust our speech to ensure it sounds the way we intend it to sound. However, because speech production involves complex motor planning and execution, no two utterances of the same sound will be exactly the same. Here, we show that auditory cortex is sensitive to natural variations in self-produced speech from utterance to utterance. We recorded event-related potentials (ERPs) from ninety-nine subjects while they uttered “ah” and while they listened to those speech sounds played back. Subjects' utterances were sorted based on their formant deviations from the previous utterance. Typically, the N1 ERP component is suppressed during talking compared to listening. By comparing ERPs to the least and most variable utterances, we found that N1 was less suppressed to utterances that differed greatly from their preceding neighbors. In contrast, an utterance's difference from the median formant values did not affect N1. Trial-to-trial pitch (f0) deviation and pitch difference from the median similarly did not affect N1. We discuss mechanisms that may underlie the change in N1 suppression resulting from trial-to-trial formant change. Deviant utterances require additional auditory cortical processing, suggesting that speaking-induced suppression mechanisms are optimally tuned for a specific production.