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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; 50:1147-1158. [PMID: 38824450 PMCID: PMC11349023 DOI: 10.1093/schbul/sbae095] [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] [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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2
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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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Zhang Y, Wang J, Lin X, Yang M, Qi S, Wang Y, Liang W, Lu H, Zhang Y, Zhai W, Hao W, Cao Y, Huang P, Guo J, Hu X, Zhu X. Distinct Brain Dynamic Functional Connectivity Patterns in Schizophrenia Patients With and Without Auditory Verbal Hallucinations. Front Hum Neurosci 2022; 16:838181. [PMID: 35463921 PMCID: PMC9023234 DOI: 10.3389/fnhum.2022.838181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
Schizophrenia patients with auditory verbal hallucinations (AVHs) are diseased groups of serious psychosis with still unknown etiology. The aim of this research was to identify the neurophysiological correlates of auditory verbal hallucinations. Revealing the neural correlates of auditory hallucination is not merely of great clinical significance, but it is also quite essential to study the pathophysiological correlates of schizophrenia. In this study, 25 Schizophrenia patients with AVHs (AVHs group, 23.2 ± 5.35 years), 52 Schizophrenia patients without AVHs (non-AVHs group, 25.79 ± 5.63 years) and 28 healthy subjects (NC group, 26.14 ± 5.45 years) were enrolled. Dynamic functional connectivity was studied with a sliding-window method and functional connectivity states were then obtained with the k-means clustering algorithm in the three groups. We found that schizophrenia patients with AVHs were characterized by significant decreased static functional connectivity and enhanced variability of dynamic functional connectivity (non-parametric permutation test, Bonferroni correction, p < 0.05). In addition, the AVHs group also demonstrated increased number of brain states, suggesting brain dynamics enhanced in these patients compared with the non-AVHs group. Our findings suggested that there were abnormalities in the connection of brain language regions in auditory verbal hallucinations. It appears that the interruption of connectivity from the language region might be critical to the pathological basis of AVHs.
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Affiliation(s)
- Yao Zhang
- Military Medical Center, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jia Wang
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Xin Lin
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Min Yang
- Fundamentals Department, Air Force Engineering University, Xi'an, China
| | - Shun Qi
- Department of Radiology, Fourth Military Medical University, Xi'an, China
| | - Yuhan Wang
- School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Wei Liang
- Department of Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Huijie Lu
- Department of Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Yan Zhang
- Department of Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Wensheng Zhai
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, China
| | - Wanting Hao
- Military Medical Center, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yang Cao
- Department of Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Peng Huang
- Department of Medical Psychology, Fourth Military Medical University, Xi'an, China
| | - Jianying Guo
- Military Medical Center, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xuehui Hu
- Department of Nursing, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xia Zhu
- Department of Medical Psychology, Fourth Military Medical University, Xi'an, China
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4
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Faramarzi M, Kasten FH, Altaş G, Aleman A, Ćurčić-Blake B, Herrmann CS. Similar EEG Activity Patterns During Experimentally-Induced Auditory Illusions and Veridical Perceptions. Front Neurosci 2021; 15:602437. [PMID: 33867913 PMCID: PMC8047478 DOI: 10.3389/fnins.2021.602437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/12/2021] [Indexed: 12/31/2022] Open
Abstract
Hallucinations and illusions are two instances of perceptual experiences illustrating how perception might diverge from external sensory stimulations and be generated or altered based on internal brain states. The occurrence of these phenomena is not constrained to patient populations. Similar experiences can be elicited in healthy subjects by means of suitable experimental procedures. Studying the neural mechanisms underlying these experiences not only has the potential to expand our understanding of the brain's perceptual machinery but also of how it might get impaired. In the current study, we employed an auditory signal detection task to induce auditory illusions by presenting speech snippets at near detection threshold intensity embedded in noise. We investigated the neural correlates of auditory false perceptions by examining the EEG activity preceding the responses in speech absent (false alarm, FA) trials and comparing them to speech present (hit) trials. The results of the comparison of event-related potentials (ERPs) in the activation period vs. baseline revealed the presence of an early negativity (EN) and a late positivity (LP) similar in both hits and FAs, which were absent in misses, correct rejections (CR) and control button presses (BPs). We postulate that the EN and the LP might represent the auditory awareness negativity (AAN) and centro-parietal positivity (CPP) or P300, respectively. The event-related spectral perturbations (ERSPs) exhibited a common power enhancement in low frequencies (<4 Hz) in hits and FAs. The low-frequency power enhancement has been frequently shown to be accompanied with P300 as well as separately being a marker of perceptual awareness, referred to as slow cortical potentials (SCP). Furthermore, the comparison of hits vs. FAs showed a significantly higher LP amplitude and low frequency power in hits compared to FAs. Generally, the observed patterns in the present results resembled some of the major neural correlates associated with perceptual awareness in previous studies. Our findings provide evidence that the neural correlates associated with conscious perception, can be elicited in similar ways in both presence and absence of externally presented sensory stimuli. The present findings did not reveal any pre-stimulus alpha and beta modulations distinguishing conscious vs. unconscious perceptions.
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Affiliation(s)
- Maryam Faramarzi
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Florian H. Kasten
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
- Neuroimaging Unit, European Medical School, Carl von Ossietzky University, Oldenburg, Germany
| | - Gamze Altaş
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
| | - André Aleman
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Branislava Ćurčić-Blake
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Christoph S. Herrmann
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4All,” Carl von Ossietzky University, Oldenburg, Germany
- Neuroimaging Unit, European Medical School, Carl von Ossietzky University, Oldenburg, Germany
- Research Center Neurosensory Science, Carl von Ossietzky University, Oldenburg, Germany
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Thakkar KN, Mathalon DH, Ford JM. Reconciling competing mechanisms posited to underlie auditory verbal hallucinations. Philos Trans R Soc Lond B Biol Sci 2021; 376:20190702. [PMID: 33308062 PMCID: PMC7741078 DOI: 10.1098/rstb.2019.0702] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2020] [Indexed: 01/21/2023] Open
Abstract
Perception is not the passive registration of incoming sensory data. Rather, it involves some analysis by synthesis, based on past experiences and context. One adaptive consequence of this arrangement is imagination-the ability to richly simulate sensory experiences, interrogate and manipulate those simulations, in service of action and decision making. In this paper, we will discuss one possible cost of this adaptation, namely hallucinations-perceptions without sensory stimulation, which characterize serious mental illnesses like schizophrenia, but which also occur in neurological illnesses, and-crucially for the present piece-are common also in the non-treatment-seeking population. We will draw upon a framework for imagination that distinguishes voluntary from non-voluntary experiences and explore the extent to which the varieties and features of hallucinations map onto this distinction, with a focus on auditory-verbal hallucinations (AVHs)-colloquially, hearing voices. We will propose that sense of agency for the act of imagining is key to meaningfully dissecting different forms and features of AVHs, and we will outline the neural, cognitive and phenomenological sequelae of this sense. We will conclude that a compelling unifying framework for action, perception and belief-predictive processing-can incorporate observations regarding sense of agency, imagination and hallucination. This article is part of the theme issue 'Offline perception: voluntary and spontaneous perceptual experiences without matching external stimulation'.
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Affiliation(s)
- Katharine N. Thakkar
- Department of Psychology, Michigan State University, East Lansing, MI, USA
- Department of Psychiatry and Behavioral Medicine, Michigan State University, East Lansing, MI, USA
| | - Daniel H. Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA
| | - Judith M. Ford
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, USA
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6
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Mourgues C, Negreira AM, Quagan B, Mercan NE, Niles H, Kafadar E, Bien C, Kamal F, Powers AR. Development of Voluntary Control Over Voice-Hearing Experiences: Evidence From Treatment-Seeking and Non-Treatment-Seeking Voice-Hearers. SCHIZOPHRENIA BULLETIN OPEN 2020; 1:sgaa052. [PMID: 33196043 PMCID: PMC7643545 DOI: 10.1093/schizbullopen/sgaa052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Voluntary control over voice-hearing experiences is one of the most consistent predictors of functioning among voice-hearers. However, control over voice-hearing experiences is likely to be more nuanced and variable than may be appreciated through coarse clinician-rated measures, which provide little information about how control is conceptualized and developed. We aimed to identify key factors in the evolution of control over voice-hearing experiences in treatment-seeking (N = 7) and non-treatment-seeking (N = 8) voice-hearers. Treatment-seeking voice-hearers were drawn from local chapters of the Connecticut Hearing Voices Network, and non-treatment-seeking voice-hearers were recruited from local spiritually oriented organizations. Both groups participated in a clinical assessment, and a semi-structured interview meant to explore the types of control exhibited and how it is fostered. Using Grounded Theory, we identified that participants from both groups exerted direct and indirect control over their voice-hearing experiences. Participants that developed a spiritual explanatory framework were more likely to exert direct control over the voice-hearing experiences than those that developed a pathologizing framework. Importantly, despite clear differences in explanatory framework and distress because of their experiences, both groups underwent similar trajectories to develop control and acceptance over their voice-hearing experiences. Understanding these factors will be critical in transforming control over voice-hearing experiences from a phenomenological observation to an actionable route for clinical intervention.
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Affiliation(s)
- Catalina Mourgues
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Alyson M Negreira
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Brittany Quagan
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | | | - Halsey Niles
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT.,Yale University School of Medicine, New Haven, CT
| | | | - Claire Bien
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Faria Kamal
- Department of Psychiatry, Columbia University, New York, NY
| | - Albert R Powers
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT.,Yale University School of Medicine, New Haven, CT.,Department of Psychology, Yale University, New Haven, CT
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7
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Reflections on Eriksen's seminal essay on discrimination, performance and learning without awareness. Atten Percept Psychophys 2020; 83:546-557. [PMID: 32935288 DOI: 10.3758/s13414-020-02098-9] [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] [Indexed: 11/08/2022]
Abstract
Early in his career C.W. Eriksen published in Psychological Review what turned out to be a highly impactful critique on methods and findings on the topic of unconscious influences on discrimination and awareness. His incisive commentary on extant methodology employed at that time - especially the heavy dependence on subjective reports - clearly was heard by others moving forward, as evidenced by the subsequent, lively discussions within the literature concerning the very definition of the notion of unconscious processing. Of equal importance, Eriksen's paper provided an impetus for the development of more refined techniques for manipulating perceptual awareness and for measuring the consequences of those manipulations. My purpose in this essay is to ensure that Eriksen's seminal contributions concerning unconscious phenomena remain within the awareness of the many current investigators working on this popular topic.
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[Cognitive explanations of auditory verbal hallucinations in schizophrenia: An inventory of the scientific literature]. Encephale 2020; 46:217-221. [PMID: 32156419 DOI: 10.1016/j.encep.2019.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 11/24/2019] [Accepted: 11/28/2019] [Indexed: 01/02/2023]
Abstract
AIMS Our article consists in both analysis and synthesis of contemporary cognitive models of auditory verbal hallucinations (AVHs) in schizophrenia. Our work is based on the analysis of the scientific literature including original articles, literature reviews as well as meta-analysis. METHODOLOGY In order to identify the most pertinent studies in the electronic search, the three following databases were systematically searched: PubMed, PsycINFO and MEDLINE. For both the analysis and synthesis we selected original articles, literature reviews as well as meta-analysis referring to any cognitive explanation of the auditory hallucinatory experience in schizophrenia. A cognitive model of auditory hallucinations refers to any incorporation of cognitive frameworks and explanations in one's conceptualization of the hallucinatory phenomenon in schizophrenia. We also focused our work on past conceptualization of auditory hallucinations in order to explain the development and the contribution of current cognitive models in the understanding of the onset and the maintaining of AVHs. After a brief review of clinical characteristics and historical conceptualization of auditory verbal hallucinations, contemporary explanations were presented in the area of schizophrenia. These explanations referred to researches into cognitive psychopathology including metacognitive as well as neuroimaging studies. RESULTS The examination of scientific literature highlighted the complexity of AVHs through multifactorial explanations here mostly explained by cognitive and metacognitive deficits. We synthesized former conceptualizations of AVHs, which were sustained on mechanistic or sensory explanations. Esquirol, Baillarger and Briere de Boismont were the first as conceiving AVHs as a perception disorder and introduced the idea that auditory hallucinations resulted from a failure to control one's memories/fantasies. Later, Broca and Wernicke discovered auditory areas in the human brain implicated in language comprehension and production. AVHs began to be conceptualized by the scientific world as being mechanistically brain-related. Sigmund Freud was among the first to study the meaning of AVHs, a domain still being investigated by todays cognitive sciences. More recently, neuroimaging studies allowed the validation of these sensory explanations in considering the onset of AVHs through the deficit of cortical and subcortical areas implicated in the process of languages (e.g. Broca and Wernicke areas) and emotions (e.g. limbic system, amygdala, hippocampus). At a more mechanistic level, contemporary cognitive models of AVHs explained AVHs as an intrusive verbal representation into the awareness which is non-inhibited (i.e. deficit in intentional inhibition) and also non-recognized as one's own experience (i.e. deficit in source monitoring, planning and metacognition), or even attributed to an external source (attribution bias). In terms of inhibitory control, inhibition is a basic cognitive mechanism defined as a collection of processes that allows the suppression of previously activated cognitive contents and the clearing of irrelevant actions or attention from consciousness. Intentional inhibition is effortful and occurs when an individual deliberately suppresses the activation of an item after deciding it is irrelevant. Theoretical support for the suggestion that an inhibitory failure is involved in AVHs in schizophrenia arises from studies that have shown that a failure in inhibition results in intrusive thoughts from long-term memory. Recent findings also found that individuals with AVHs in schizophrenia demonstrated an impaired source monitoring. In episodic memory research, a distinction was made between content (an event) and context (e.g. source or temporal characteristics of an event) information. The context of memories provides cues that allow an individual to differentiate one memory from other memories. AVHs are conceptualized as a failure to access the contextual cues that would allow voice-hearer to form an intact representation of events in memories. Regarding planning, AVHs refer to the intrusion of unwanted memories into the inner speech that are not recognized from one's own representation. Previous cognitive theories highlighted the important role played by metacognitive skills and belief (i.e. thinking about one's thinking) in the explanation of AVHs. Finally, the external attribution bias was extensively studied over the last three decades and refers to the tendency to attribute negative events (situational or cognitive) to an external source. In this framework, AVHs refer to intrusive thoughts externally attributed to a voice. CONCLUSION For more than one century, scientific discoveries in (bio)medical science have allowed the validation of former sensory and mechanistic explanations of AVHs. Nevertheless, many explanatory models account for the way AVHs are maintained (source monitoring, deficit in planning, externalizing bias), while they scarcely expose how they are triggered (intrusive thoughts, deficit in inhibition). The relation between AVHs and intrusive thoughts still remain unclear, and further studies are needed for the understanding of a potential causal relationship.
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Lin X, Zhuo C, Li G, Li J, Gao X, Chen C, Jiang D. Functional brain alterations in auditory hallucination subtypes in individuals with auditory hallucinations without the diagnosis of specific neurological diseases and mental disorders at the current stage. Brain Behav 2020; 10:e01487. [PMID: 31782626 PMCID: PMC6955821 DOI: 10.1002/brb3.1487] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/20/2019] [Accepted: 11/10/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND We explored common and distinct pathological features of different subtypes of auditory hallucinations (AHs) to elucidate the underlying pathological mechanisms. METHODS We recruited 39 individuals with constant commanding and commenting auditory verbal hallucinations (CCCAVHs), 49 with own thought auditory verbal hallucinations (OTAVHs), 46 with nonverbal AHs (NVAHs), 32 with replay AVHs (RAVHs), and 50 healthy controls. Functional connectivity density mapping was used to investigate global functional connectivity density (gFCD) alterations in these AH groups relative to the control group. RESULTS We observed common brain functional alterations among four subtypes of AHs, such as increased gFCD in the bilateral superior temporal gyrus and mesial frontal lobe, and decreased gFCD in the bilateral medial prefrontal cortex. Increased gFCD was detected in the bilateral insula in CCCAVH individuals, bilateral thalamus in OTAVH individuals, bilateral precuneus in NVAH individuals, and bilateral hippocampus in RAVH individuals. The common and distinct gFCD alterations among four AH subtypes were located in main components of the frontoparietal, default mode, salience, central executive, and memory networks. Different AH subtypes exhibited specific aberrant patterns. CONCLUSIONS Our findings suggest that aberrant functional activity and metabolism in the abovementioned networks play key roles in the occurrence of AHs. Our findings provide evidence for distinct gFCD alterations in specific AH subtypes.
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Affiliation(s)
- Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Chuanjun Zhuo
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China.,Department of Psychiatry-Brian Micro and Macro Imaging Centre, Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, China.,Psychiatric-Neuroimging-Genetics and Comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Gongying Li
- Department of Psychiatry-Brian Micro and Macro Imaging Centre, Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, China
| | - Jie Li
- Psychiatric-Neuroimging-Genetics and Comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Xiangyang Gao
- Center for Health Statistics, Big Data Center of Chronic Disease, Health Management Institute, 301 Hospital of Chinese People's Liberation Army, General Hospital of Chinese People's Liberation Army, Beijing, 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
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10
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Huang J, Zhuo C, Xu Y, Lin X. Auditory verbal hallucination and the auditory network: From molecules to connectivity. Neuroscience 2019; 410:59-67. [PMID: 31082536 DOI: 10.1016/j.neuroscience.2019.04.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 12/20/2022]
Abstract
Auditory verbal hallucinations (AVHs) frequently occur across multiple psychiatric diseases especially in schizophrenia (SCZ) patients. Functional imaging studies have revealed the hyperactivity of the auditory cortex and disrupted auditory-verbal network activity underlying AVH etiology. This review will firstly summarize major findings from both human AVH patients and animal models, with focuses on the auditory cortex and associated cortical/sub-cortical areas. Besides mesoscale connectivity or activity data, structure and functions at synaptic level will be discussed, in conjunction with molecular mechanisms. We have summarized major findings for the pathogenesis of AVH in SCZ patients, with focuses in the auditory cortex and prefrontal cortex (PFC). Those discoveries provide explanations for AVH from different perspectives including inter-regional connectivity, local activity in specific areas, structure and functions of synapse, and potentially molecular targets. Due to the uniqueness of AVH in humans, full replica using animals seems impossible. However, we can still extract useful information from animal SCZ models based on the disruption of auditory pathway during AVH episodes. Therefore, we will further interpolate the synaptic structures and molecular targets, whose dysregulation in SCZ models may be highly related with AVH episodes. As the last part, implications for future development of treatment strategies will be discussed.
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Affiliation(s)
- Jianjie Huang
- Department of Psychiatric-Neuroimging-Genetics Laboratory(PNG-Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, 325000, China
| | - Chuanjun Zhuo
- Department of Psychiatric-Neuroimging-Genetics Laboratory(PNG-Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, 325000, China; Department of Psychiatry, Institute of Mental Health, Jining University, Jining Shandong Province, 272191, China; Department of Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, China, 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.
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Xiaodong Lin
- Department of Psychiatric-Neuroimging-Genetics Laboratory(PNG-Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, 325000, China
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11
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Impaired brain white matter and functional networks in healthy individuals with auditory verbal hallucinations. Chin Med J (Engl) 2019; 132:606-608. [PMID: 30741828 PMCID: PMC6416001 DOI: 10.1097/cm9.0000000000000106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Qiu L, Yan H, Zhu R, Yan J, Yuan H, Han Y, Yue W, Tian L, Zhang D. Correlations between exploratory eye movement, hallucination, and cortical gray matter volume in people with schizophrenia. BMC Psychiatry 2018; 18:226. [PMID: 30005610 PMCID: PMC6045825 DOI: 10.1186/s12888-018-1806-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Widespread cortical gray matter alternations in people with schizophrenia are correlated with both psychotic symptoms and cognitive/behavioral abnormalities, including the impairments of exploratory eye movement (EEM). Particularly, the loss of gray matter density is specifically related to deficits of the responsive search score (RSS) of EEM in schizophrenia. It is unknown, however, whether the schizophrenia-related RSS deficits are associated with certain psychotic symptoms, such as hallucinations. METHODS In 33 participants with schizophrenia, the measurement of EEM, assessment of the hallucination severity using Positive and Negative Syndrome Scale (PANSS) and a voxel-based morphometric analysis of cortical gray matter volume (GMV) were conducted to investigate the relationships between the RSS of EEM, symptom severity, and GMV. In 29 matched healthy controls, the measurement of EEM and a voxel-based morphometric analysis of cortical GMV were also conducted to investigate the relationship between the RSS of EEM and GMV. RESULTS In participants with schizophrenia, the hallucination severity was significantly negatively correlated with both the RSS and the GMV of a large number of brain regions in the frontal, temporal, parietal, orbitofrontal, calcarine, cingulate, and insular cortices, and rolandic operculum, hippocampus, parahippocampal gyrus, and thalamus. Also in participants with schizophrenia, the RSS was significantly positively correlated with the GMV in the left supplementary motor area (SMA), left superior frontal cortex (SFG), bilateral precentral gyri, bilateral postcentral gyri, and bilateral middle frontal cortices. More importantly, the GMV of the SMA, SFG, and precentral gyrus in the left hemisphere was not only significantly negatively correlated with the hallucination severity but also significantly positively correlated with the RSS. No significant correlation could be revealed between the RSS and the GMV of any brain regions in healthy controls. CONCLUSIONS There was a significantly negative association between the hallucination severity and the RSS of EEM, suggesting that the RSS may be a potential biomarker for predicting the hallucination severity of schizophrenia. Also, the GMV of the left SMA, SFG, and precentral gyrus may be the common substrates underlying both hallucination induction and the RSS in people with schizophrenia.
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Affiliation(s)
- Linlin Qiu
- 0000 0000 9490 772Xgrid.186775.aDepartment of Medical Psychology, Chaohu Hospital, Anhui Medical University, Hefei, Anhui China ,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders & Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui China ,0000 0004 1798 0615grid.459847.3Peking University Sixth Hospital (Institute of Mental Health), Beijing, China ,0000 0004 1769 3691grid.453135.5National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Hao Yan
- 0000 0004 1798 0615grid.459847.3Peking University Sixth Hospital (Institute of Mental Health), Beijing, China ,0000 0004 1769 3691grid.453135.5National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Risheng Zhu
- 0000 0004 1798 0615grid.459847.3Peking University Sixth Hospital (Institute of Mental Health), Beijing, China ,0000 0004 1769 3691grid.453135.5National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Jun Yan
- 0000 0004 1798 0615grid.459847.3Peking University Sixth Hospital (Institute of Mental Health), Beijing, China ,0000 0004 1769 3691grid.453135.5National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Huishu Yuan
- 0000 0004 0605 3760grid.411642.4The Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Yonghua Han
- 0000 0004 1798 0615grid.459847.3Peking University Sixth Hospital (Institute of Mental Health), Beijing, China ,0000 0004 1769 3691grid.453135.5National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Weihua Yue
- 0000 0004 1798 0615grid.459847.3Peking University Sixth Hospital (Institute of Mental Health), Beijing, China ,0000 0004 1769 3691grid.453135.5National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Lin Tian
- Peking University Sixth Hospital (Institute of Mental Health), Beijing, China. .,National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China. .,Department of Psychiatry, the Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, Jiangsu, China.
| | - Dai Zhang
- Peking University Sixth Hospital (Institute of Mental Health), Beijing, China. .,National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China.
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13
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Spray A, Beer AL, Bentall RP, Sluming V, Meyer G. Microstructure of the superior temporal gyrus and hallucination proneness - a multi-compartment diffusion imaging study. NEUROIMAGE-CLINICAL 2018; 20:1-6. [PMID: 29988951 PMCID: PMC6034584 DOI: 10.1016/j.nicl.2018.06.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 06/21/2018] [Accepted: 06/24/2018] [Indexed: 01/16/2023]
Abstract
Previous studies reported that the volume of the left superior temporal gyrus (STG) is reduced in patients with schizophrenia and negatively correlated with hallucination severity. Moreover, diffusion-tensor imaging studies suggested a relationship between the brain microstructure in the STG of patients and auditory hallucinations. Hallucinations are also experienced in non-patient groups. This study investigated the relationship between hallucination proneness and the brain structure of the STG. Hallucination proneness was assessed by the Launey Slade Hallucination Scale (LSHS) in 25 healthy individuals who varied in their propensity to hear voices. Brain volume and microstructure of the STG was assessed by magnetic resonance imaging (MRI). Microstructure was examined by conventional diffusion-tensor imaging as well as by neurite orientation dispersion and density imaging (NODDI). The latter decomposes diffusion-based MRI into multiple compartments that characterize the brain microstructure by its neurite complexity known as orientation dispersion (ODI) and by its neurite density (NDI). Hallucination proneness was negatively correlated with the volume and microstructure (fractional anisotropy, neurite complexity) of the left but not the right STG. The strongest relationship (r = −0.563) was observed for neurite complexity (ODI). No correlation was observed for neurite density (NDI). These findings suggest that there is a relationship between the volume and the microstructure of the left STG and hallucination proneness. Dendritic complexity (but not neurite density) is inversely related to hallucination proneness. Metrics based on multi-compartment diffusion models seem to be more sensitive for hallucination-related neural processes than conventional MRI-based metrics. Hallucination proneness is predicted by structural characteristics of left STG Hallucination proneness negatively correlates with left STG volume Hallucination proneness negatively correlates with left STG fractional anisotropy Hallucination proneness negatively correlates with left STG orientation dispersion Reduced functional integration may be due to reduced dendritic complexity of neurons
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Key Words
- AVH, auditory verbal hallucination
- CVH, clinical voice hearer
- DTI, diffusion-tensor imaging
- DWI, diffusion-weighted imaging
- Diffusion MRI
- FA, fractional anisotropy
- HVH, healthy voice hearer
- Hallucination
- LSHS
- LSHS, Launey Slade Hallucination Scale
- MD, mean diffusivity
- MRI, magnetic resonance imaging
- NDI, neurite density index
- NODDI
- NODDI, neurite orientation dispersion and density imaging
- ODI, orientation dispersion index
- ROI, region of interest
- STG, superior temporal gyrus
- Schizophrenia
- Superior temporal gyrus
- fMRI, functional magnetic resonance imaging
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Affiliation(s)
- Amy Spray
- University of Liverpool, Liverpool, UK.
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14
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Ford JM. Studying auditory verbal hallucinations using the RDoC framework. Psychophysiology 2017; 53:298-304. [PMID: 26877116 DOI: 10.1111/psyp.12457] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 05/05/2015] [Indexed: 01/23/2023]
Abstract
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.
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Affiliation(s)
- Judith M Ford
- San Francisco VA Medical Center, San Francisco, California, USA.,Department of Psychiatry, University of California, San Francisco (UCSF), San Francisco, California, USA
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15
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Affiliation(s)
- Judith M. Ford
- Psychiatry Service (116D), San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121;,Department of Psychiatry, University of California, San Francisco, San Francisco, CA,*To whom correspondence should be addressed; Psychiatry Service (116D), San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121, US; tel: 415-221-4810, extension 24187, fax: 415-750-6622, e-mail:
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16
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Instrumental measurements of spontaneous dyskinesia and schizotypy in subjects with auditory verbal hallucinations and healthy controls. Psychiatry Res 2016; 244:24-7. [PMID: 27455147 DOI: 10.1016/j.psychres.2016.06.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 06/04/2016] [Accepted: 06/19/2016] [Indexed: 11/20/2022]
Abstract
Spontaneous dyskinesia is associated with non-affective psychosis. Few studies investigated dyskinesia in individuals with subclinical psychotic experiences. We examined dyskinesia using instrumental measurements of force variability in 34 individuals with frequent auditory verbal hallucinations but without a clinical psychotic disorder and 31 matched healthy controls. Schizotypy was assessed using the Schizotypal Personality Questionnaire. We found a positive correlation between dyskinesia and schizotypy in the total group. In addition, when using a cut-off point based on the 95th percentile of force variability in the control group, we found a greater proportion of subjects with dyskinesia in the group with auditory verbal hallucinations than in the control subjects. Current findings are in agreement with the concept of psychosis as a continuous phenomenon and with movement disorders being an integral part of psychosis.
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17
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Powers AR, Kelley M, Corlett PR. Hallucinations as top-down effects on perception. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016. [PMID: 28626813 DOI: 10.1016/j.bpsc.2016.04.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The problem of whether and how information is integrated across hierarchical brain networks embodies a fundamental tension in contemporary cognitive neuroscience, and by extension, cognitive neuropsychiatry. Indeed, the penetrability of perceptual processes in a 'top-down' manner by higher-level cognition-a natural extension of hierarchical models of perception-may contradict a strictly modular view of mental organization. Furthermore, some in the cognitive science community have challenged cognitive penetration as an unlikely, if not impossible, process. We review the evidence for and against top-down influences in perception, informed by a predictive coding model of perception and drawing heavily upon the literature of computational neuroimaging. We extend these findings to propose a way in which these processes may be altered in mental illness. We propose that hallucinations - perceptions without stimulus - can be understood as top-down effects on perception, mediated by inappropriate perceptual priors.
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18
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Daalman K, Diederen KMJ, Hoekema L, van Lutterveld R, Sommer IEC. Five year follow-up of non-psychotic adults with frequent auditory verbal hallucinations: are they still healthy? Psychol Med 2016; 46:1897-1907. [PMID: 26961499 DOI: 10.1017/s0033291716000386] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Previously, we described 103 adults (mean age 41 years) who experienced frequent, auditory verbal hallucinations (AVH), in the absence of a need for mental healthcare. Importantly, these adults were largely past the peak incidence age for psychosis (15-35 years). It is unclear if these older individuals with AVH are still at increased risk for psychosis or other psychopathology. To address this question, we conducted a 5-year follow-up of previously included individuals (103 with AVH, 60 controls). METHOD Eighty-one adults with AVH (78.6%) and forty-nine controls (81.7%) could be contacted and were willing to participate. Participants were screened for psychosis and a need for mental healthcare at follow-up using the Comprehensive Assessment of Symptoms and History interview (CASH). Need for mental healthcare was defined as a clinical diagnosis as identified using the CASH and/or treatment by a mental healthcare specialist. Phenomenology of AVH was assessed with the PSYRATS Auditory Hallucinations Rating Scale. RESULTS Five individuals with AVH (6.2%) had developed psychosis and 32 (39.5%) had developed a need for mental healthcare. Voice-related distress at baseline significantly predicted need for mental healthcare. AVH persisted in most individuals (86.4%), without significant changes in phenomenology. None of the controls had developed psychotic symptoms, and need for mental healthcare (n = 6, 12.2%) was significantly lower in this group. CONCLUSIONS These findings suggest that frequent AVH in non-psychotic adults past the peak incidence age for psychosis constitute a rather static symptom and that individuals with AVH may be best viewed as situated on a need for care continuum.
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Affiliation(s)
- K Daalman
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - K M J Diederen
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - L Hoekema
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - R van Lutterveld
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - I E C Sommer
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
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19
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Dyck MS, Mathiak KA, Bergert S, Sarkheil P, Koush Y, Alawi EM, Zvyagintsev M, Gaebler AJ, Shergill SS, Mathiak K. Targeting Treatment-Resistant Auditory Verbal Hallucinations in Schizophrenia with fMRI-Based Neurofeedback - Exploring Different Cases of Schizophrenia. Front Psychiatry 2016; 7:37. [PMID: 27014102 PMCID: PMC4791600 DOI: 10.3389/fpsyt.2016.00037] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 02/29/2016] [Indexed: 01/13/2023] Open
Abstract
Auditory verbal hallucinations (AVHs) are a hallmark of schizophrenia and can significantly impair patients' emotional, social, and occupational functioning. Despite progress in psychopharmacology, over 25% of schizophrenia patients suffer from treatment-resistant hallucinations. In the search for alternative treatment methods, neurofeedback (NF) emerges as a promising therapy tool. NF based on real-time functional magnetic resonance imaging (rt-fMRI) allows voluntarily change of the activity in a selected brain region - even in patients with schizophrenia. This study explored effects of NF on ongoing AVHs. The selected participants were trained in the self-regulation of activity in the anterior cingulate cortex (ACC), a key monitoring region involved in generation and intensity modulation of AVHs. Using rt-fMRI, three right-handed patients, suffering from schizophrenia and ongoing, treatment-resistant AVHs, learned control over ACC activity on three separate days. The effect of NF training on hallucinations' severity was assessed with the Auditory Vocal Hallucination Rating Scale (AVHRS) and on the affective state - with the Positive and Negative Affect Schedule (PANAS). All patients yielded significant upregulation of the ACC and reported subjective improvement in some aspects of AVHs (AVHRS) such as disturbance and suffering from the voices. In general, mood (PANAS) improved during NF training, though two patients reported worse mood after NF on the third day. ACC and reward system activity during NF learning and specific effects on mood and symptoms varied across the participants. None of them profited from the last training set in the prolonged three-session training. Moreover, individual differences emerged in brain networks activated with NF and in symptom changes, which were related to the patients' symptomatology and disease history. NF based on rt-fMRI seems a promising tool in therapy of AVHs. The patients, who suffered from continuous hallucinations for years, experienced symptom changes that may be attributed to the NF training. In order to assess the effectiveness of NF as a therapeutic method, this effect has to be studied systematically in larger groups; further, long-term effects need to be assessed. Particularly in schizophrenia, future NF studies should take into account the individual differences in reward processing, fatigue, and motivation to develop individualized training protocols.
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Affiliation(s)
- Miriam S Dyck
- Department of Psychiatry, Psychotherapy and Psychosomatics, Jülich-Aachen Research Alliance (JARA)-Brain, RWTH Aachen University, Aachen, Germany; Jülich-Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich, Aachen, Germany
| | - Krystyna A Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Jülich-Aachen Research Alliance (JARA)-Brain, RWTH Aachen University, Aachen, Germany; Jülich-Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich, Aachen, Germany; Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Susanne Bergert
- Department of Psychiatry, Psychotherapy and Psychosomatics, Jülich-Aachen Research Alliance (JARA)-Brain, RWTH Aachen University, Aachen, Germany; Jülich-Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich, Aachen, Germany
| | - Pegah Sarkheil
- Department of Psychiatry, Psychotherapy and Psychosomatics, Jülich-Aachen Research Alliance (JARA)-Brain, RWTH Aachen University, Aachen, Germany; Jülich-Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich, Aachen, Germany
| | - Yury Koush
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland; Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Eliza M Alawi
- Department of Psychiatry, Psychotherapy and Psychosomatics, Jülich-Aachen Research Alliance (JARA)-Brain, RWTH Aachen University, Aachen, Germany; Jülich-Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich, Aachen, Germany
| | - Mikhail Zvyagintsev
- Department of Psychiatry, Psychotherapy and Psychosomatics, Jülich-Aachen Research Alliance (JARA)-Brain, RWTH Aachen University, Aachen, Germany; Jülich-Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich, Aachen, Germany
| | - Arnim J Gaebler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Jülich-Aachen Research Alliance (JARA)-Brain, RWTH Aachen University, Aachen, Germany; Jülich-Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich, Aachen, Germany
| | - Sukhi S Shergill
- Institute of Psychiatry, Psychology and Neuroscience, King's College London , London , UK
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Jülich-Aachen Research Alliance (JARA)-Brain, RWTH Aachen University, Aachen, Germany; Jülich-Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich, Aachen, Germany; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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20
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Prete G, Marzoli D, Brancucci A, Tommasi L. Hearing it right: Evidence of hemispheric lateralization in auditory imagery. Hear Res 2015; 332:80-86. [PMID: 26706706 DOI: 10.1016/j.heares.2015.12.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/26/2015] [Accepted: 12/02/2015] [Indexed: 11/19/2022]
Abstract
An advantage of the right ear (REA) in auditory processing (especially for verbal content) has been firmly established in decades of behavioral, electrophysiological and neuroimaging research. The laterality of auditory imagery, however, has received little attention, despite its potential relevance for the understanding of auditory hallucinations and related phenomena. In Experiments 1-4 we find that right-handed participants required to imagine hearing a voice or a sound unilaterally show a strong population bias to localize the self-generated auditory image at their right ear, likely the result of left-hemispheric dominance in auditory processing. In Experiments 5-8 - by means of the same paradigm - it was also ascertained that the right-ear bias for hearing imagined voices depends just on auditory attention mechanisms, as biases due to other factors (i.e., lateralized movements) were controlled. These results, suggesting a central role of the left hemisphere in auditory imagery, demonstrate that brain asymmetries can drive strong lateral biases in mental imagery.
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Affiliation(s)
- Giulia Prete
- Department of Psychological Science, Health and Territory, 'G. d'Annunzio' University of Chieti-Pescara, Italy.
| | - Daniele Marzoli
- Department of Psychological Science, Health and Territory, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Alfredo Brancucci
- Department of Psychological Science, Health and Territory, 'G. d'Annunzio' University of Chieti-Pescara, Italy
| | - Luca Tommasi
- Department of Psychological Science, Health and Territory, 'G. d'Annunzio' University of Chieti-Pescara, Italy
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21
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Badcock JC. A Neuropsychological Approach to Auditory Verbal Hallucinations and Thought Insertion - Grounded in Normal Voice Perception. ACTA ACUST UNITED AC 2015; 7:631-652. [PMID: 27617046 PMCID: PMC4995233 DOI: 10.1007/s13164-015-0270-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A neuropsychological perspective on auditory verbal hallucinations (AVH) links key phenomenological features of the experience, such as voice location and identity, to functionally separable pathways in normal human audition. Although this auditory processing stream (APS) framework has proven valuable for integrating research on phenomenology with cognitive and neural accounts of hallucinatory experiences, it has not yet been applied to other symptoms presumed to be closely related to AVH – such as thought insertion (TI). In this paper, I propose that an APS framework offers a useful way of thinking about the experience of TI as well as AVH, providing a common conceptual framework for both. I argue that previous self-monitoring theories struggle to account for both the differences and similarities in the characteristic features of AVH and TI, which can be readily accommodated within an APS framework. Furthermore, the APS framework can be integrated with predictive processing accounts of psychotic symptoms; makes predictions about potential sites of prediction error signals; and may offer a template for understanding a range of other symptoms beyond AVH and TI.
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Affiliation(s)
- Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, 6009 Western Australia
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22
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Northoff G. Are Auditory Hallucinations Related to the Brain's Resting State Activity? A 'Neurophenomenal Resting State Hypothesis'. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2014; 12:189-95. [PMID: 25598821 PMCID: PMC4293163 DOI: 10.9758/cpn.2014.12.3.189] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 06/19/2014] [Accepted: 06/23/2014] [Indexed: 11/23/2022]
Abstract
While several hypotheses about the neural mechanisms underlying auditory verbal hallucinations (AVH) have been suggested, the exact role of the recently highlighted intrinsic resting state activity of the brain remains unclear. Based on recent findings, we therefore developed what we call the 'resting state hypotheses' of AVH. Our hypothesis suggest that AVH may be traced back to abnormally elevated resting state activity in auditory cortex itself, abnormal modulation of the auditory cortex by anterior cortical midline regions as part of the default-mode network, and neural confusion between auditory cortical resting state changes and stimulus-induced activity. We discuss evidence in favour of our 'resting state hypothesis' and show its correspondence with phenomenal, i.e., subjective-experiential features as explored in phenomenological accounts. Therefore I speak of a 'neurophenomenal resting state hypothesis' of auditory hallucinations in schizophrenia.
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Affiliation(s)
- Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada. ; Taipei Medical University, Graduate Institute of Humanities in Medicine, Taipei, Taiwan. ; Taipei Medical University-Shuang Ho Hospital, Brain and Consciousness Research Center, New Taipei City, Taiwan. ; National Chengchi University, Research Center for Mind, Brain and Learning, Taipei, Taiwan. ; National Chengchi University, Department of Psychology, Taipei, Taiwan. ; Centre for Cognition and Brain Disorders (CBBD), Normal University Hangzhou, Hangzhou, China
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23
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Johns LC, Kompus K, Connell M, Humpston C, Lincoln TM, Longden E, Preti A, Alderson-Day B, Badcock JC, Cella M, Fernyhough C, McCarthy-Jones S, Peters E, Raballo A, Scott J, Siddi S, Sommer IE, Larøi F. Auditory verbal hallucinations in persons with and without a need for care. Schizophr Bull 2014; 40 Suppl 4:S255-64. [PMID: 24936085 PMCID: PMC4141313 DOI: 10.1093/schbul/sbu005] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Auditory verbal hallucinations (AVH) are complex experiences that occur in the context of various clinical disorders. AVH also occur in individuals from the general population who have no identifiable psychiatric or neurological diagnoses. This article reviews research on AVH in nonclinical individuals and provides a cross-disciplinary view of the clinical relevance of these experiences in defining the risk of mental illness and need for care. Prevalence rates of AVH vary according to measurement tool and indicate a continuum of experience in the general population. Cross-sectional comparisons of individuals with AVH with and without need for care reveal similarities in phenomenology and some underlying mechanisms but also highlight key differences in emotional valence of AVH, appraisals, and behavioral response. Longitudinal studies suggest that AVH are an antecedent of clinical disorders when combined with negative emotional states, specific cognitive difficulties and poor coping, plus family history of psychosis, and environmental exposures such as childhood adversity. However, their predictive value for specific psychiatric disorders is not entirely clear. The theoretical and clinical implications of the reviewed findings are discussed, together with directions for future research.
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Affiliation(s)
- Louise C. Johns
- King’s College London, Institute of Psychiatry, Department of Psychology, London, UK;,South London and Maudsley NHS Foundation Trust, London, UK
| | - Kristiina Kompus
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway;
| | - Melissa Connell
- The University of Queensland Centre for Clinical Research, Metro North Mental Health, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Clara Humpston
- King’s College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
| | | | - Eleanor Longden
- Institute of Psychological Sciences, University of Leeds, Leeds, UK
| | - Antonio Preti
- Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | | | - Johanna C. Badcock
- School of Psychology, University of Western Australia, Crawley, Australia
| | - Matteo Cella
- King’s College London, Institute of Psychiatry, Department of Psychology, London, UK;,National Institute for Health Research (NIHR), Biomedical Research Centre for Mental Health at South London and Maudsley, NHS Foundation Trust, London, UK
| | | | - Simon McCarthy-Jones
- ARC Centre of Excellence in Cognition and Its Disorders, Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Emmanuelle Peters
- King’s College London, Institute of Psychiatry, Department of Psychology, London, UK;,National Institute for Health Research (NIHR), Biomedical Research Centre for Mental Health at South London and Maudsley, NHS Foundation Trust, London, UK
| | - Andrea Raballo
- Department of Mental Health and Pathological Addiction, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - James Scott
- The University of Queensland Centre for Clinical Research, Metro North Mental Health, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Sara Siddi
- Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Iris E. Sommer
- Psychiatry Department, University of Utrecht, Utrecht, The Netherlands
| | - Frank Larøi
- Department of Psychology, University of Liège, Liège, Belgium
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24
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Perogamvros L. Esse est percipi: a neurophilosophical model of psychosis. Psychopathology 2014; 47:275-84. [PMID: 25060543 DOI: 10.1159/000362565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 03/31/2014] [Indexed: 11/19/2022]
Abstract
Philosophers, psychiatrists and neuroscientists have all expressed interest in and formulated hypotheses on the nature of hallucinations, but no sufficient integration of these models exists to this date. The objective of this article is to present a neurophilosophical model of psychosis linking the neurobiology with the phenomenology of hallucinations and delusions. It is proposed that psychotic hallucinations could be regarded as 'intrusions' of subjective idealism, a condition where reality is mind dependent, into realism, a condition where reality is mind independent. Furthermore, delusions would be an attempt by the person to make sense of these intrusions. This approach is supported by phenomenological evidence of increased self-relatedness in hallucinations and delusions, and by current neurobiological evidence on the role of the reward system, default mode network and corollary discharge circuit in positive symptomatology. This model has clinical, research and therapeutic implications, and also demonstrates how scientific results can be informed and enhanced by philosophical theories and vice versa.
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Affiliation(s)
- Lampros Perogamvros
- Department of Psychiatry, Geneva University Hospitals, and Department of Neuroscience, University of Geneva, Geneva, Switzerland
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25
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Diederen KMJ, Neggers SFW, de Weijer AD, van Lutterveld R, Daalman K, Eickhoff SB, Clos M, Kahn RS, Sommer IEC. Aberrant resting-state connectivity in non-psychotic individuals with auditory hallucinations. Psychol Med 2013; 43:1685-1696. [PMID: 23199762 DOI: 10.1017/s0033291712002541] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although auditory verbal hallucinations (AVH) are a core symptom of schizophrenia, they also occur in non-psychotic individuals, in the absence of other psychotic, affective, cognitive and negative symptoms. AVH have been hypothesized to result from deviant integration of inferior frontal, parahippocampal and superior temporal brain areas. However, a direct link between dysfunctional connectivity and AVH has not yet been established. To determine whether hallucinations are indeed related to aberrant connectivity, AVH should be studied in isolation, for example in non-psychotic individuals with AVH. METHOD Resting-state connectivity was investigated in 25 non-psychotic subjects with AVH and 25 matched control subjects using seed regression analysis with the (1) left and (2) right inferior frontal, (3) left and (4) right superior temporal and (5) left parahippocampal areas as the seed regions. To correct for cardiorespiratory (CR) pulsatility rhythms in the functional magnetic resonance imaging (fMRI) data, heartbeat and respiration were monitored during scanning and the fMRI data were corrected for these rhythms using the image-based method for retrospective correction of physiological motion effects RETROICOR. RESULTS In comparison with the control group, non-psychotic individuals with AVH showed increased connectivity between the left and the right superior temporal regions and also between the left parahippocampal region and the left inferior frontal gyrus. Moreover, this group did not show a negative correlation between the left superior temporal region and the right inferior frontal region, as was observed in the healthy control group. CONCLUSIONS Aberrant connectivity of frontal, parahippocampal and superior temporal brain areas can be specifically related to the predisposition to hallucinate in the auditory domain.
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Affiliation(s)
- K M J Diederen
- Neuroscience Division, University Medical Centre Utrecht and Rudolf Magnus Institute for Neuroscience, Utrecht, The Netherlands.
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26
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Auditory hallucinations and reduced language lateralization in schizophrenia: a meta-analysis of dichotic listening studies. J Int Neuropsychol Soc 2013; 19:410-8. [PMID: 23332000 DOI: 10.1017/s1355617712001476] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Reduced left-hemispheric language lateralization has been proposed to be a trait marker for schizophrenia, but the empirical evidence is ambiguous. Recent studies suggest that auditory hallucinations are critical for whether a patient shows reduced language lateralization. Therefore, the aim of the study was to statistically integrate studies investigating language lateralization in schizophrenia patients using dichotic listening. To this end, two meta-analyses were conducted, one comparing schizophrenia patients with healthy controls (n = 1407), the other comparing schizophrenia patients experiencing auditory hallucinations with non-hallucinating controls (n = 407). Schizophrenia patients showed weaker language lateralization than healthy controls but the effect size was small (g = -0.26). When patients with auditory hallucinations were compared to non-hallucinating controls, the effect size was substantially larger (g = -0.45). These effect sizes suggest that reduced language lateralization is a weak trait marker for schizophrenia as such and a strong trait marker for the experience of auditory hallucinations within the schizophrenia population.
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