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Altman MGG, Kuzmina SV, Irkabaeva AB, Mason DP, Luhrmann TM. Hearing voices among Russian patients with schizophrenia. Transcult Psychiatry 2023:13634615231191980. [PMID: 37583306 DOI: 10.1177/13634615231191980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
There has been relatively little work which systematically examines whether the content of hallucinations in individuals diagnosed with schizophrenia varies by cultural context. The work that exists finds that it does. The present project explores the way auditory hallucinations, or "voices," manifest in a Russian cultural context. A total of 28 individuals, diagnosed with schizophrenia, who reported hearing voices at the Republican Clinical Psychiatric Hospitals in Kazan, Russia, were interviewed about their experience of auditory hallucinations. The voices reported by our Russian participants did appear to have culturally specific content. Commands tended to be non-violent and focused on chores or other activities associated with daily life (byt). Many patients also reported sensory hallucinations involving other visions, sounds, and smells which sometimes reflected Russian folklore themes. For the most part, religious themes did not appear in patients' auditory vocal hallucinations, though nearly all patients expressed adherence to a religion. These findings support research that finds that the content, and perhaps the form, of auditory hallucinations may be shaped by local culture.
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Affiliation(s)
| | | | | | - Daniel Philippe Mason
- Department of Psychiatry and Behavioral Sciences,Stanford University, School of Medicine, Stanford, CA, USA
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Edwards CJ, Owrid O, Miller L, Jafari H, Emsley R, Rus-Calafell M, Craig TKJ, Clancy M, McLeod H, Fornells-Ambrojo M, McDonnell J, Montague A, Huckvale M, Bucci S, Haddock G, Garety P, Ward T. The voice characterisation checklist: psychometric properties of a brief clinical assessment of voices as social agents. Front Psychiatry 2023; 14:1192655. [PMID: 37559917 PMCID: PMC10408443 DOI: 10.3389/fpsyt.2023.1192655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/06/2023] [Indexed: 08/11/2023] Open
Abstract
AIM There is growing interest in tailoring psychological interventions for distressing voices and a need for reliable tools to assess phenomenological features which might influence treatment response. This study examines the reliability and internal consistency of the Voice Characterisation Checklist (VoCC), a novel 10-item tool which assesses degree of voice characterisation, identified as relevant to a new wave of relational approaches. METHODS The sample comprised participants experiencing distressing voices, recruited at baseline on the AVATAR2 trial between January 2021 and July 2022 (n = 170). Inter-rater reliability (IRR) and internal consistency analyses (Cronbach's alpha) were conducted. RESULTS The majority of participants reported some degree of voice personification (94%) with high endorsement of voices as distinct auditory experiences (87%) with basic attributes of gender and age (82%). While most identified a voice intention (75%) and personality (76%), attribution of mental states (35%) to the voice ('What are they thinking?') and a known historical relationship (36%) were less common. The internal consistency of the VoCC was acceptable (10 items, α = 0.71). IRR analysis indicated acceptable to excellent reliability at the item-level for 9/10 items and moderate agreement between raters' global (binary) classification of more vs. less highly characterised voices, κ = 0.549 (95% CI, 0.240-0.859), p < 0.05. CONCLUSION The VoCC is a reliable and internally consistent tool for assessing voice characterisation and will be used to test whether voice characterisation moderates treatment outcome to AVATAR therapy. There is potential wider utility within clinical trials of other relational therapies as well as routine clinical practice.
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Affiliation(s)
- Clementine J. Edwards
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Oliver Owrid
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Lucy Miller
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Hassan Jafari
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Richard Emsley
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Mar Rus-Calafell
- Mental Health Research and Treatment Centre, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Thomas K. J. Craig
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Moya Clancy
- University of Glasgow, Glasgow, United Kingdom
- NHS Greater Glasgow & Clyde, Glasgow, United Kingdom
| | - Hamish McLeod
- University of Glasgow, Glasgow, United Kingdom
- NHS Greater Glasgow & Clyde, Glasgow, United Kingdom
| | - Miriam Fornells-Ambrojo
- University College London, London, United Kingdom
- North East London NHS Foundation Trust, London, United Kingdom
| | - Jeffrey McDonnell
- University College London, London, United Kingdom
- North East London NHS Foundation Trust, London, United Kingdom
| | - Alice Montague
- University College London, London, United Kingdom
- North East London NHS Foundation Trust, London, United Kingdom
| | | | - Sandra Bucci
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Gillian Haddock
- School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Philippa Garety
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Thomas Ward
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Muacevic A, Adler JR, Ong SJ, Wee BB, Teo L. Primary Hyperparathyroidism Causing Psychosis: A Case Report. Cureus 2022; 14:e31935. [PMID: 36582554 PMCID: PMC9794925 DOI: 10.7759/cureus.31935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 11/28/2022] Open
Abstract
New-onset psychotic symptoms presenting late in life can be caused by various medical and psychiatric conditions. The index of suspicion for an organic cause for psychotic symptoms in an elderly person should be high, and every presenting patient should undergo a detailed history-taking and evaluation before attributing these symptoms to a primary psychiatric condition. Hyperparathyroidism is one condition that can present with psychiatric symptoms such as low mood and anxiety. While psychiatric symptoms are not uncommon in hyperparathyroidism, acute psychosis is rare. This case report highlights the importance of a thorough evaluation of an elderly person presenting with a new onset of psychosis.
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Ahn MH, Alsabbagh N, Lee HJ, Kim HJ, Jung MH, Hong SK. Neurobiological Signatures of Auditory False Perception and Phantom Perception as a Consequence of Sensory Prediction Errors. Biology (Basel) 2022; 11:biology11101501. [PMID: 36290405 PMCID: PMC9598671 DOI: 10.3390/biology11101501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
Abstract
In this study, we hypothesized that top-down sensory prediction error due to peripheral hearing loss might influence sensorimotor integration using the efference copy (EC) signals as functional connections between auditory and motor brain areas. Using neurophysiological methods, we demonstrated that the auditory responses to self-generated sound were not suppressed in a group of patients with tinnitus accompanied by significant hearing impairment and in a schizophrenia group. However, the response was attenuated in a group with tinnitus accompanied by mild hearing impairment, similar to a healthy control group. The bias of attentional networks to self-generated sound was also observed in the subjects with tinnitus with significant hearing impairment compared to those with mild hearing impairment and healthy subjects, but it did not reach the notable disintegration found in those in the schizophrenia group. Even though the present study had significant constraints in that we did not include hearing loss subjects without tinnitus, these results might suggest that auditory deafferentation (hearing loss) may influence sensorimotor integration process using EC signals. However, the impaired sensorimotor integration in subjects with tinnitus with significant hearing impairment may have resulted from aberrant auditory signals due to sensory loss, not fundamental deficits in the reafference system, as the auditory attention network to self-generated sound is relatively well preserved in these subjects.
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Affiliation(s)
- Min-Hee Ahn
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
| | - Nour Alsabbagh
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
| | - Hyo-Jeong Lee
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
| | - Hyung-Jong Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
| | - Myung-Hun Jung
- Department of Psychiatry, Hallym University College of Medicine, Anyang 14068, Korea
- Correspondence: (M.-H.J.); (S.-K.H.); Tel.: +82-31-380-3849 (S.-K.H.)
| | - Sung-Kwang Hong
- Laboratory of Brain & Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea
- Correspondence: (M.-H.J.); (S.-K.H.); Tel.: +82-31-380-3849 (S.-K.H.)
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Sheaves B, Johns L, Loe BS, Bold E, Černis E, Molodynski A, Freeman D. Listening to and Believing Derogatory and Threatening Voices. Schizophr Bull 2022; 49:151-160. [PMID: 35947487 PMCID: PMC9810006 DOI: 10.1093/schbul/sbac101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND HYPOTHESIS A plausible cause of distress for voice hearers is listening to and believing the threats and criticisms heard. Qualitative research indicates that patients have understandable reasons to listen. This study aimed to develop the understanding of distress using this listening and believing framework. Measures were developed of listening and believing voices and the reasons, and associations with distress tested. STUDY DESIGN A cross-sectional study of patients hearing derogatory and threatening voices (N = 591). Listening and Believing-Assessment and Listening and Believing-Reasons item pools were completed, and assessments of distress. Exploratory and confirmatory factor analyses and structural equation modeling (SEM) were conducted. STUDY RESULTS 52% (n = 307) of participants believed their voices most or all the time. Listening and believing had 4 factors: active listening, passive listening, believing, and disregarding. Higher levels of believing, active listening, and particularly passive listening were associated with higher levels of anxiety, depression, and voice distress. Reasons for listening and believing formed 7 factors: to better understand the threat; being too worn down to resist; to learn something insightful; being alone with time to listen; voices trying to capture attention; voices sounding like real people; and voices sounding like known people. Each type of reason was associated with active listening, passive listening, and believing. SEM showed that feeling worn down in particular accounted for listening and believing. Test-retest reliability of measures was excellent. CONCLUSIONS A framework of listening and believing negative voices has the potential to inform the understanding and treatment of voice distress.
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Affiliation(s)
- Bryony Sheaves
- To whom correspondence should be addressed; tel: 01865 618187, e-mail:
| | - Louise Johns
- Department of Psychiatry, University of Oxford, Oxford, UK,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Bao S Loe
- The Psychometrics Centre, University of Cambridge, Cambridge, UK
| | - Emily Bold
- Department of Psychiatry, University of Oxford, Oxford, UK,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Emma Černis
- Department of Psychiatry, University of Oxford, Oxford, UK,Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Andrew Molodynski
- Department of Psychiatry, University of Oxford, Oxford, UK,Oxford Health NHS Foundation Trust, Oxford, UK
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK,Oxford Health NHS Foundation Trust, Oxford, UK
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Burr C, Schnackenberg JK, Weidner F. Talk-based approaches to support people who are distressed by their experience of hearing voices: A scoping review. Front Psychiatry 2022; 13:983999. [PMID: 36299547 PMCID: PMC9589913 DOI: 10.3389/fpsyt.2022.983999] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The positive effects of both antipsychotic medication and cognitive behavioral therapy in psychosis (CBTp) for people who are distressed by their experience of hearing voices remain limited. As a result, there has been a recent surge in talk-based individual approaches. Many of these continue not to be very well known nor implemented in practice. Some of the approaches may focus more on understanding and dealing constructively with voices, an element that has been identified as potentially helpful by voice hearers. Existing barriers to a wider implementation include both the widespread pathologization of hearing voices and a lack of mental health professionals who have been trained and trusted to carry out these new interventions. METHODS This scoping review aimed to identify and describe a current synthesis of talk-based individual approaches for people who hear voices, including studies independently of method of study or approach, diagnosis of voice hearers nor of the professional background of interventionists. RESULTS Nine different talk-based approaches were identified. These included: (1) Cognitive Behavioral Therapy for Psychosis (CBTp); (2) AVATAR therapy; (3) Making Sense of Voices (MsV) aka Experience Focused Counselling (EFC); (4) Relating Therapy; (5) Acceptance and Commitment Therapy; (6) Smartphone-based Coping-focused Intervention; (7) Prolonged and Virtual Reality Exposure Therapy; (8) Eye Movement Desensitization and Reprocessing, and (9) Individual Mindfulness-based Program for Voice Hearing. The different approaches differed greatly in relation to the number of sessions, length of time offered and the scientific evidence on efficacy. Psychologists represented the main professional group of interventionists. CBTp and the MsV/EFC approach also included health professionals, like nurses, as implementers. Most of the approaches showed positive outcomes in relation to voice related distress levels. None identified overall or voice specific deteriorations. CONCLUSION There appears to be a strong case for the implementation of a broader heterogeneity of approaches in practice. This would also be in line with recommendations for recovery focused services and requirements of voice hearers. A greater emphasis on whole systems implementation and thus the involvement of frontline staff, like nurses, in the delivery of these approaches would likely reduce the research-practice implementation gap.
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Affiliation(s)
- Christian Burr
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.,University Hospital of Psychiatry and Psychotherapy, University Hospital for Mental Health, Bern, Switzerland.,Faculty of Nursing Science, Vinzenz Pallotti University, Vallendar, Germany
| | | | - Frank Weidner
- Faculty of Nursing Science, Vinzenz Pallotti University, Vallendar, Germany
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Watanabe M, Nakabayashi T, Nayanar G, Takao C, Maeda C, Tu TTH, Motomura H, Toyofuku A. Case Report: Auditory Hallucination Induced by Amitriptyline for the Treatment of Atypical Odontalgia. Front Psychiatry 2022; 13:863485. [PMID: 35586414 PMCID: PMC9108357 DOI: 10.3389/fpsyt.2022.863485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
Auditory hallucination is usually associated with psychiatric diseases and organic brain illness. It was rarely found as adverse events of antidepressants. Amitriptyline is considered as one of the first line medications for the psychopharmacotherapy of chronic pain including atypical odontalgia (AO) which shows chronic tooth pain without corresponding abnormalities. Anticholinergic adverse events induced by amitriptyline are usually bearable and not critical since the prescription dose is very low for the patients with AO. This is a first case report about the AO patients who showed auditory hallucination by the low dose of amitriptyline. A 43-years-old female, housewife, complained chronic toothache following dental procedures and was diagnosed as AO. Amitriptyline was initially prescribed 25 mg and gradually increased up to 60 mg with the improvement of AO symptoms in 7 months. Although the temporary recurrence was observed following to the retreatment of prosthodontic dental procedures, it improved in a few weeks. Therefore, the dose of amitriptyline was decreased, and the continuation dose was set 30 mg. In 24 months, the AO symptoms were very much improved; however, she reported that she had been heard the voices at midnight for a year. The voices were neighborhoods' and talking about the noise troubles she had claimed before. She had not realized that the voices were auditory hallucination since they were heard only at midnight infrequent and not bothering her daily life. At the time she reported auditory hallucination, she worried whether organic brain diseases are hiding because the frequency of voices was increased and sometimes occurred in daytime. The adverse event of amitriptyline was suspected since she had never had psychotic symptoms before. Amitriptyline was decreased and continued with the dose of 25 mg. Magnetic resonance imaging and psychiatric consultation revealed no abnormality of brain and in psychiatric aspects. After final prosthodontic treatment, the amitriptyline was discontinued in 30 months. Two months after the discontinuation, auditory hallucination was almost disappeared with no recurrence of AO. The present case report suggests that amitriptyline has possibility to induce auditory hallucination even in conventional dose throughout the treatment of chronic pain including AO.
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Affiliation(s)
- Motoko Watanabe
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuo Nakabayashi
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Gayatri Nayanar
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chihiro Takao
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chizuko Maeda
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Trang Thi Huyen Tu
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Basic Dental Sciences, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Haruhiko Motomura
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Toyofuku
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Shao X, Liao Y, Gu L, Chen W, Tang J. The Etiology of Auditory Hallucinations in Schizophrenia: From Multidimensional Levels. Front Neurosci 2021; 15:755870. [PMID: 34858129 PMCID: PMC8632545 DOI: 10.3389/fnins.2021.755870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/14/2021] [Indexed: 11/25/2022] Open
Abstract
Enormous efforts have been made to unveil the etiology of auditory hallucinations (AHs), and multiple genetic and neural factors have already been shown to have their own roles. Previous studies have shown that AHs in schizophrenia vary from those in other disorders, suggesting that they have unique features and possibly distinguishable mechanisms worthy of further investigation. In this review, we intend to offer a comprehensive summary of current findings related to AHs in schizophrenia from aspects of genetics and transcriptome, neurophysiology (neurometabolic and electroencephalogram studies), and neuroimaging (structural and functional magnetic resonance imaging studies and transcriptome–neuroimaging association study). Main findings include gene polymorphisms, glutamate level change, electroencephalographic alterations, and abnormalities of white matter fasciculi, cortical structure, and cerebral activities, especially in multiple regions, including auditory and language networks. More solid and comparable research is needed to replicate and integrate ongoing findings from multidimensional levels.
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Affiliation(s)
- Xu Shao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Gu
- RIKEN AIP, Tokyo, Japan.,Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Wei Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Okayasu H, Yasui-Furukori N, Shimoda K. A pregnant woman who experienced auditory hallucinations concurrent with hyperemesis gravidarum: A case report. Neuropsychopharmacol Rep 2021; 41:548-550. [PMID: 34472727 PMCID: PMC8698677 DOI: 10.1002/npr2.12206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 11/18/2022] Open
Abstract
We report the case of a pregnant woman who experienced auditory hallucinations only while suffering from hyperemesis gravidarum. To the best of our knowledge, the present report is the first report of a case of obvious auditory hallucinations and hyperemesis gravidarum at the same time in a pregnant woman who had not been diagnosed with any psychiatric disorder. The patient was a 24‐year‐old pregnant woman with no history of psychiatric disorder. Two years prior to this admission, she became pregnant for the first time, and she was admitted to an obstetrics clinic due to severe hyperemesis gravidarum. She developed mild auditory hallucinations at the same time. After she gave birth, the auditory hallucinations disappeared. When she was 24 years old, she became pregnant again. She suffered from severe hyperemesis gravidarum from the early stage of pregnancy. At 20 weeks of pregnancy, she visited the Department of Psychiatry of our hospital for a detailed psychiatric evaluation and treatment because her moderate auditory hallucinations had relapsed. We administered an antipsychotic agent, perospirone, to treat the auditory hallucinations, which disappeared, although the hyperemesis gravidarum persisted until childbirth. After childbirth, perospirone treatment was discontinued, and her auditory hallucinations did not relapse. The auditory hallucinations may have occurred as a result of complicated biological and psychosocial factors. Physicians should carefully evaluate psychotic symptoms, such as auditory hallucinations, not only during the postpartum period but also throughout the course of pregnancy. The present report is the first report of a case of obvious auditory hallucinations and hyperemesis gravidarum at the same time in a pregnant woman who had not been diagnosed with any psychiatric disorder. We administered an antipsychotic agent, perospirone, to treat the auditory hallucinations, which disappeared, although the hyperemesis gravidarum persisted until childbirth. After childbirth, perospirone treatment was discontinued, and her auditory hallucinations did not relapse.
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Affiliation(s)
- Hiroaki Okayasu
- Department of Psychiatry, Dokkyo Medical University, Mibu, Japan
| | | | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University, Mibu, Japan
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Salisbury DF, Wang Y, Yeh FC, Coffman BA. White Matter Microstructural Abnormalities in the Broca's-Wernicke's-Putamen "Hoffman Hallucination Circuit" and Auditory Transcallosal Fibers in First-Episode Psychosis With Auditory Hallucinations. Schizophr Bull 2020; 47:149-159. [PMID: 32766733 PMCID: PMC7825092 DOI: 10.1093/schbul/sbaa105] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Functional connectivity abnormalities between Broca's and Wernicke's areas and the putamen revealed by functional magnetic resonance imaging (fMRI) are related to auditory hallucinations (AH). In long-term schizophrenia, reduced white matter structural integrity revealed by diffusion imaging in left arcuate fasciculus (connecting Broca's and Wernicke's areas) is likely related to AH. The structural integrity of connections with putamen and their relation to AH are unknown. Little is known about this relationship in first-episode psychosis (FEP), although auditory transcallosal connections were reported to play a role. White matter in the Broca's-Wernicke's-putamen language-related circuit and auditory transcallosal fibers was examined to investigate associations with AH in FEP. METHODS White matter connectivity was measured in 40 FEP and 32 matched HC using generalized fractional anisotropy (gFA) derived from diffusion spectrum imaging (DSI). RESULTS FEP and HC did not differ in gFA in any fiber bundle. In FEP, AH severity was significantly inversely related to gFA in auditory transcallosal fibers and left arcuate fasciculus. Although the right hemisphere arcuate fasciculus-AH association did not attain significance, the left and right arcuate fasciculus associations were not significantly different. CONCLUSIONS Despite overall normal gFA in FEP, AH severity was significantly related to gFA in transcallosal auditory fibers and the left hemisphere connection between Broca's and Wernicke's areas. Other bilateral tracts' gFA were weakly associated with AH. At the first psychotic episode, AH are more robustly associated with left hemisphere arcuate fasciculus and interhemispheric auditory fibers microstructural deficits, likely reflecting mistiming of information flow between language-related cortical centers.
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Affiliation(s)
- Dean F Salisbury
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA,To whom correspondence should be addressed; Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, 3501 Forbes Ave, Pittsburgh, PA 15213; tel: 412-246-5123, fax: 412-246-6636, e-mail:
| | - Yiming Wang
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Brian A Coffman
- Clinical Neurophysiology Research Laboratory, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Zhuo C, Xiao B, Chen C, Jiang D, Li G, Ma X, Li R, Wang L, Xu Y, Zhou C, Lin X. Antipsychotic agents deteriorate brain and retinal function in schizophrenia patients with combined auditory and visual hallucinations: A pilot study and secondary follow-up study. Brain Behav 2020; 10:e01611. [PMID: 32285647 PMCID: PMC7303384 DOI: 10.1002/brb3.1611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/13/2020] [Accepted: 03/10/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Schizophrenia patients often experience auditory hallucinations (AHs) and visual hallucinations (VHs). However, the degree and type of brain and retinal alterations associated with combined AHs and VHs in schizophrenia patients remain unknown. There is an urgent need for a study that investigates the trajectory of brain and retinal alterations in patients with first-episode untreated schizophrenia accompanied by combined AHs and VHs (FUSCHAV). METHODS FUSCHAV patients (n = 120), divided into four groups according to AH and VH symptom severity (severe AHs combined with severe VHs [FUSCHSASV, 20 patients]; middle-to-moderate AHs combined with severe VHs [FUSCHMASV, 23 patients]; severe AHs combined with middle-to-moderate VHs [FUSCHSAMV, 28 patients]; and middle-to-moderate AHs combined with middle-to-moderate VHs [FUSCHMAMV, 26 patients]), were compared to healthy controls (n = 30). Gray matter volume (GMV) was adopted for brain structural alteration assessment. Total retinal thickness was adopted as a measure of retinal thickness impairment. RESULTS In the pilot study, the rate of GMV reduction showed an inverted U-shaped pattern across the different FUSCHAV patient groups according to AH and VH severity. The degree of retinal impairment remained stable across the groups. More notably, in the secondary follow-up study, we observed that, after 6 months of treatment with antipsychotic agents, all the GMV reduction-related differences across the different patient groups disappeared, and both GMV and retinal thickness demonstrated a tendency to deteriorate. CONCLUSIONS These findings indicate the need for heightened alertness on brain and retinal impairments in patients with FUSCHAV. Further deteriorations induced by antipsychotic agent treatment should be monitored in clinical practice.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry Pattern Recognition, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China.,Department of Genetics, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China.,Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China.,Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China.,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Bo Xiao
- Department of OCT, Tianjin Eye Hospital, Tianjin, China
| | - Ce Chen
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
| | - Gongying Li
- Department of Psychiatry Pattern Recognition, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China.,Department of Genetics, Laboratory of Schizophrenia, School of Mental Health, Jining Medical University, Jining, China
| | - Xiaoyan Ma
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China
| | - Ranli Li
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China
| | - Lina Wang
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin Medical University Mental Health Teaching Hospital, Tianjin Medical University, Tianjin, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, China
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12
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Guo Q, Hu Y, Zeng B, Tang Y, Li G, Zhang T, Wang J, Northoff G, Li C, Goff D, Wang J, Yang Z. Parietal memory network and default mode network in first-episode drug-naïve schizophrenia: Associations with auditory hallucination. Hum Brain Mapp 2020; 41:1973-1984. [PMID: 32112506 PMCID: PMC7267906 DOI: 10.1002/hbm.24923] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/29/2019] [Accepted: 01/01/2020] [Indexed: 12/17/2022] Open
Abstract
Atypical spontaneous activities in resting‐state networks may play a role in auditory hallucinations (AHs), but networks relevant to AHs are not apparent. Given the debating role of the default mode network (DMN) in AHs, a parietal memory network (PMN) may better echo cognitive theories of AHs in schizophrenia, because PMN is spatially adjacent to the DMN and more relevant to memory processing or information integration. To examine whether PMN is more relevant to AHs than DMN, we characterized these intrinsic networks in AHs with 59 first‐episode, drug‐naïve schizophrenics (26 AH+ and 33 AH−) and 60 healthy participants in resting‐state fMRI. We separated the PMN, DMN, and auditory network (AN) using independent component analysis, and compared their functional connectivity across the three groups. We found that only AH+ patients displayed dysconnectivity in PMN, both AH+ and AH− patients exhibited dysfunctions of AN, but neither patient group showed abnormal connectivity within DMN. The connectivity of PMN significantly correlated with memory performance of the patients. Further region‐of‐interest analyses confirmed that the connectivity between the core regions of PMN, the left posterior cingulate gyrus and the left precuneus, was significantly lower only in the AH+ group. In exploratory correlation analysis, this functional connectivity metric significantly correlated with the severity of AH symptoms. The results implicate that compared to the DMN, the PMN is more relevant to the AH symptoms in schizophrenia, and further provides a more precise potential brain modulation target for the intervention of AH symptoms.
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Affiliation(s)
- Qian Guo
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.,Department of Early Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
| | - Botao Zeng
- Department of Psychiatry, Qingdao Mental Health Center, Qingdao, China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guanjun Li
- Department of Early Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinhong Wang
- Department of Medical Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Georg Northoff
- University of Ottawa Brain and Mind Research Institute, and Mind Brain Imaging and Neuroethics Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.,Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Bio-X Institutes, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China.,Institute of Psychology and Behaviour Science, Shanghai Jiao Tong University, Shanghai, China
| | - Donald Goff
- Department of Psychiatry, New York University School of Medicine, New York, New York
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.,Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Bio-X Institutes, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China.,Institute of Psychology and Behaviour Science, Shanghai Jiao Tong University, Shanghai, China
| | - Zhi Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.,Institute of Psychology and Behaviour Science, Shanghai Jiao Tong University, Shanghai, China
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13
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Uemura T, Mochida M, Matsumi T, Yoshimoto K, Tatebayashi Y. Therapy-refractory schizophrenia in a patient who previously suffered from Meige's syndrome. Neuropsychopharmacol Rep 2019; 39:297-300. [PMID: 31743613 PMCID: PMC7292264 DOI: 10.1002/npr2.12081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 11/09/2022] Open
Abstract
The main symptoms of Meige's syndrome are involuntary eye blinking with muddled speech and uncontrollable contraction of the platysma muscle characterized by segmental, primarily oromandibular, dystonia (hyperkinesia). It can also develop after long‐term medication of first‐ and second‐generation antipsychotics. Here, we report the case of a Japanese female schizophrenic patient comorbid with Meige's syndrome and hyperthyroidism. We discuss the relationship between the three diseases, that is, schizophrenia, Meige's syndrome, and hyperthyroidism. Our intention is to consider the important role of the cerebral basal ganglia, where little attention has been given in regard to schizophrenia and Meige's syndrome. A part of this article was presented in a poster section at the joint congress of the 28th Annual Meeting of the Japanese Society of Clinical Neuropsychopharmacology and the 48th Annual Meeting of the Japanese Society of Neuropsychopharmacology held in 2018. We report the case of a Japanese female schizophrenic patient comorbid with Meige's syndrome and hyperthyroidism. We discuss the relationship between the three diseases considering the importance of the basal ganglia, where little attention has been given in regard to schizophrenia and Meige's syndrome.![]()
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Affiliation(s)
- Tomihiko Uemura
- Tama Hospital, Hachioji, Japan.,Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
| | | | | | - Katsuhiko Yoshimoto
- Tama Hospital, Hachioji, Japan.,Third Department of Internal Medicine, Kyorin University School of Medicine, Mitaka, Japan
| | - Yoshitaka Tatebayashi
- Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Japan
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14
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Liu S, Wang H, Song M, Lv L, Cui Y, Liu Y, Fan L, Zuo N, Xu K, Du Y, Yu Q, Luo N, Qi S, Yang J, Xie S, Li J, Chen J, Chen Y, Wang H, Guo H, Wan P, Yang Y, Li P, Lu L, Yan H, Yan J, Wang H, Zhang H, Zhang D, Calhoun VD, Jiang T, Sui J. Linked 4-Way Multimodal Brain Differences in Schizophrenia in a Large Chinese Han Population. Schizophr Bull 2019; 45:436-449. [PMID: 29897555 PMCID: PMC6403093 DOI: 10.1093/schbul/sby045] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Multimodal fusion has been regarded as a promising tool to discover covarying patterns of multiple imaging types impaired in brain diseases, such as schizophrenia (SZ). In this article, we aim to investigate the covarying abnormalities underlying SZ in a large Chinese Han population (307 SZs, 298 healthy controls [HCs]). Four types of magnetic resonance imaging (MRI) features, including regional homogeneity (ReHo) from resting-state functional MRI, gray matter volume (GM) from structural MRI, fractional anisotropy (FA) from diffusion MRI, and functional network connectivity (FNC) resulted from group independent component analysis, were jointly analyzed by a data-driven multivariate fusion method. Results suggest that a widely distributed network disruption appears in SZ patients, with synchronous changes in both functional and structural regions, especially the basal ganglia network, salience network (SAN), and the frontoparietal network. Such a multimodal coalteration was also replicated in another independent Chinese sample (40 SZs, 66 HCs). Our results on auditory verbal hallucination (AVH) also provide evidence for the hypothesis that prefrontal hypoactivation and temporal hyperactivation in SZ may lead to failure of executive control and inhibition, which is relevant to AVH. In addition, impaired working memory performance was found associated with GM reduction and FA decrease in SZ in prefrontal and superior temporal area, in both discovery and replication datasets. In summary, by leveraging multiple imaging and clinical information into one framework to observe brain in multiple views, we can integrate multiple inferences about SZ from large-scale population and offer unique perspectives regarding the missing links between the brain function and structure that may not be achieved by separate unimodal analyses.
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Affiliation(s)
- Shengfeng Liu
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China,School of Automation, Harbin University of Science and Technology, Harbin, China,University of Chinese Academy of Sciences, Beijing, China,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Haiying Wang
- School of Automation, Harbin University of Science and Technology, Harbin, China
| | - Ming Song
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China,Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China
| | - Yue Cui
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Yong Liu
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Lingzhong Fan
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Nianming Zuo
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Kaibin Xu
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Yuhui Du
- The Mind Research Network, Albuquerque, NM,School of Computer and Information Technology, Shanxi University, Taiyuan, China
| | - Qingbao Yu
- The Mind Research Network, Albuquerque, NM
| | - Na Luo
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China,University of Chinese Academy of Sciences, Beijing, China
| | - Shile Qi
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China,University of Chinese Academy of Sciences, Beijing, China
| | - Jian Yang
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Electronics, Beijing Institute of Technology, Beijing, China
| | - Sangma Xie
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Jian Li
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Jun Chen
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yunchun Chen
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Hua Guo
- Zhumadian Psychiatric Hospital, Zhumadian, China
| | - Ping Wan
- Zhumadian Psychiatric Hospital, Zhumadian, China
| | - Yongfeng Yang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China,Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China,Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Peng Li
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China,Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Lin Lu
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China,Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China,Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Hao Yan
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China,Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Jun Yan
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China,Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hongxing Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China,Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, China,Department of Psychology, Xinxiang Medical University, Xinxiang, China
| | - Dai Zhang
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China,Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China,Center for Life Sciences/PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, NM,Department of Electrical and Computer Engineering, The University of New Mexico, Albuquerque, NM
| | - Tianzi Jiang
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China,University of Chinese Academy of Sciences, Beijing, China,Queensland Brain Institute, University of Queensland, Brisbane, Australia,CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Jing Sui
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China,University of Chinese Academy of Sciences, Beijing, China,The Mind Research Network, Albuquerque, NM,CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China,To whom correspondence should be addressed; Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; tel: +86-10-8254-4518; fax: +86-10-8254-4777; e-mail:
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15
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Abstract
This study examined the phenomenological characteristics of inner speech during silent reading (inner reading voices or IRVs), a type of inner speech that may be particularly amenable to empirical study. A survey was conducted in the general population to assess IRV frequency, location, number, identity, and controllability, and auditory qualities of IRVs. Of 570 survey respondents, 80.7% reported sometimes or always hearing an inner voice during silent reading, and the remaining 19.3% reported always understanding words being read without hearing an inner voice. Results indicated that IRVs are a routine experience for many, with 34.2% of respondents with IRVs hearing an IRV every time something was read, and 45% reporting an IRV often. Most respondents reported IRVs with specific auditory qualities such as gender, accent, pitch, loudness, and emotional tone. IRVs were reported in participants' own voices, as well as in the voices of other people. Some respondents reported being unable to control any aspect of their IRVs, while others could control one or several aspects. These results indicate that there is considerable individual variation in inner speech during silent reading.
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16
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Li H, Wang Y, Jiang J, Li W, Li C. Effects of Transcranial Direct Current Stimulation (tDCS) for Auditory Hallucinations: A Systematic Review. Shanghai Arch Psychiatry 2016; 28:301-308. [PMID: 28638205 PMCID: PMC5434287 DOI: 10.11919/j.issn.1002-0829.216121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is a non-invasion brain stimulation, which has been suggested as a safe and promising treatment for auditory hallucinations, however, no systematic review has been conducted to evaluate the effects of tDCS on auditory hallucinations (AH). OBJECTIVE To investigate the efficacy and safety of tDCS for auditory hallucinations among patients with schizophrenia. METHODS We searched relevant randomized controlled trials (RCTs) from PubMed, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure, Chongqing VIP database for Chinese Technical Periodicals, WANFANG DATA, Chinese Biological Medical Literature Database, and Taiwan Electronic Periodical Services (TEPS) before February 13, 2016. Studies were selected based on pre-defined inclusion and exclusion criteria. The quality of each included study was assessed by the risk of bias table. The levels of evidence of primary outcomes were evaluated using GRADE criteria. Data synthesis was conducted using RevMan 5.3. RESULTS 304 papers were screened. Finally, three studies with a combined sample size of 87 patients were included in the meta-analysis. Two studies were classified as having 'low risk of bias', one study was classified as having 'unclear'. Inconsistent results and the overall level of evidence of primary outcome was graded as 'low'. CONCLUSIONS The sample sizes of the published studies were small and the results were inconsistent. We could not draw any strong conclusions from these trials. Further high quality RCTs with large sample sizes are needed to assess the efficacy of tDCS for auditory hallucinations in patients with schizophrenia.
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Affiliation(s)
- Haibin Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiran Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiangling Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
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17
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Matsumoto J, Nishimaru H, Takamura Y, Urakawa S, Ono T, Nishijo H. Amygdalar Auditory Neurons Contribute to Self-Other Distinction during Ultrasonic Social Vocalization in Rats. Front Neurosci 2016; 10:399. [PMID: 27703429 PMCID: PMC5028407 DOI: 10.3389/fnins.2016.00399] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 08/15/2016] [Indexed: 12/18/2022] Open
Abstract
Although, clinical studies reported hyperactivation of the auditory system and amygdala in patients with auditory hallucinations (hearing others' but not one's own voice, independent of any external stimulus), neural mechanisms of self/other attribution is not well understood. We recorded neuronal responses in the dorsal amygdala including the lateral amygdaloid nucleus to ultrasonic vocalization (USVs) emitted by subjects and conspecifics during free social interaction in 16 adult male rats. The animals emitting the USVs were identified by EMG recordings. One-quarter of the amygdalar neurons (15/60) responded to 50 kHz calls by the subject and/or conspecifics. Among the responsive neurons, most neurons (Type-Other neurons; 73%, 11/15) responded only to calls by conspecifics but not subjects. Two Type-Self neurons (13%, 2/15) responded to calls by the subject but not those by conspecifics, although their response selectivity to subjects vs. conspecifics was lower than that of Type-Other neurons. The remaining two neurons (13%) responded to calls by both the subject and conspecifics. Furthermore, population coding of the amygdalar neurons represented distinction of subject vs. conspecific calls. The present results provide the first neurophysiological evidence that the amygdala discriminately represents affective social calls by subject and conspecifics. These findings suggest that the amygdala is an important brain region for self/other attribution. Furthermore, pathological activation of the amygdala, where Type-Other neurons predominate, could induce external misattribution of percepts of vocalization.
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Affiliation(s)
- Jumpei Matsumoto
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama Toyama, Japan
| | - Hiroshi Nishimaru
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama Toyama, Japan
| | - Yusaku Takamura
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama Toyama, Japan
| | - Susumu Urakawa
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama Toyama, Japan
| | - Taketoshi Ono
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama Toyama, Japan
| | - Hisao Nishijo
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama Toyama, Japan
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18
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Dollfus S, Lecardeur L, Morello R, Etard O. Placebo Response in Repetitive Transcranial Magnetic Stimulation Trials of Treatment of Auditory Hallucinations in Schizophrenia: A Meta-Analysis. Schizophr Bull 2016; 42:301-8. [PMID: 26089351 PMCID: PMC4753589 DOI: 10.1093/schbul/sbv076] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Several meta-analyses have assessed the response of patients with schizophrenia with auditory verbal hallucinations (AVH) to treatment with repetitive transcranial magnetic stimulation (rTMS); however, the placebo response has never been explored. Typically observed in a therapeutic trial, the placebo effect may have a major influence on the effectiveness of rTMS. The purpose of this meta-analysis is to evaluate the magnitude of the placebo effect observed in controlled studies of rTMS treatment of AVH, and to determine factors that can impact the magnitude of this placebo effect, such as study design considerations and the type of sham used.The study included twenty-one articles concerning 303 patients treated by sham rTMS. A meta-analytic method was applied to obtain a combined, weighted effect size, Hedges's g. The mean weighted effect size of the placebo effect across these 21 studies was 0.29 (P < .001). Comparison of the parallel and crossover studies revealed distinct results for each study design; placebo has a significant effect size in the 13 parallel studies (g = 0.44, P < 10(-4)), but not in the 8 crossover studies (g = 0.06, P = .52). In meta-analysis of the 13 parallel studies, the 45° position coil showed the highest effect size. Our results demonstrate that placebo effect should be considered a major source of bias in the assessment of rTMS efficacy. These results fundamentally inform the design of further controlled studies, particularly with respect to studies of rTMS treatment in psychiatry.
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Affiliation(s)
| | - Laurent Lecardeur
- CHU de Caen, Service de Psychiatrie, Centre Esquirol, Caen, F-14000, France;,CNRS, UMR 6301, ISTCT, ISTS Group, GIP Cyceron, Caen, F-14074, France
| | - Rémy Morello
- CHU de Caen, Unité de Biostatistique et de Recherche Clinique, F-14000, France
| | - Olivier Etard
- UCBN, UFR de Médecine, Caen, F-14000, France;,CHU de Caen, Laboratoire d’Explorations Fonctionnelles Neurologiques, Caen, F-14000, France
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19
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Yun JY, Kim SN, Lee TY, Chon MW, Kwon JS. Individualized covariance profile of cortical morphology for auditory hallucinations in first-episode psychosis. Hum Brain Mapp 2015; 37:1051-65. [PMID: 26678706 DOI: 10.1002/hbm.23083] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 10/08/2015] [Accepted: 12/02/2015] [Indexed: 12/29/2022] Open
Abstract
Neocortical phenotype of cortical surface area (CSA) and thickness (CT) are influenced by distinctive genetic factors and undergo differential developmental trajectories, which could be captured using the individualized cortical structural covariance (ISC). Disturbed patterns of neocortical development and maturation underlie the perceptual disturbance of psychosis including auditory hallucination (AH). To demonstrate the utility of selected ISC features as primal biomarker of AH in first-episode psychosis (FEP) subjects experiencing AH (FEP-AH), we employed herein a support vector machine (SVM). A total of 147 subjects (FEP-AH, n = 27; FEP-NAH, n = 24; HC, n = 96) underwent T1 -weighted magnetic resonance imaging at 3T. The FreeSurfer software suite was used for cortical parcellation, with the CSA-ISC and CT-ISC then calculated. The most informative ISCs showing statistical significance (P < 0.001) across every run of leave-one-out group-comparison were aligned according to the absolute value of averaged t-statistics and were packaged into candidate feature sets for classification analysis using the SVM. An optimal feature set comprising three CSA-ISCs, including the intraparietal sulcus, Broca's complex, and the anterior insula, distinguished FEP-AH from FEP-NAH subjects with 83.6% accuracy (sensitivity = 82.8%; specificity = 85.7%). Furthermore, six CT-ISCs encompassing the executive control network and Wernicke's module classified FEP-AH from FEP-NAH subjects with 82.3% accuracy (sensitivity = 79.5%; specificity = 88.6%). Finally, extended sets of ISCs related to the default-mode network distinguished FEP-AH or FEP-NAH from HC subjects with 89.0-93.0% accuracy (sensitivity = 88.4-93.4%; specificity = 89.0-94.1%). This study established a distinctive intermediate phenotype of biological proneness for AH in FEP using CSA-ISCs as well as a state marker of disease progression using CT-ISCs.
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Affiliation(s)
- Je-Yeon Yun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung Nyun Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae Young Lee
- SNU-MRC, Institute of Human Behavioral Medicine, Seoul, Republic of Korea
| | - Myong-Wuk Chon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,SNU-MRC, Institute of Human Behavioral Medicine, Seoul, Republic of Korea.,Department of Brain and Cognitive Sciences, College of Natural Science, Seoul National University, Seoul, Republic of Korea
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Chen X, Liang S, Pu W, Song Y, Mwansisya TE, Yang Q, Liu H, Liu Z, Shan B, Xue Z. Reduced cortical thickness in right Heschl's gyrus associated with auditory verbal hallucinations severity in first-episode schizophrenia. BMC Psychiatry 2015; 15:152. [PMID: 26149490 PMCID: PMC4493802 DOI: 10.1186/s12888-015-0546-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 06/30/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Auditory verbal hallucinations (AVHs) represent one of the most intriguing phenomena in schizophrenia, however, brain abnormalities underlying AVHs remain unclear. The present study examined the association between cortical thickness and AVHs in first-episode schizophrenia. METHOD High-resolution MR images were obtained in 49 first-episode schizophrenia (FES) patients and 50 well-matched healthy controls (HCs). Among the FES patients, 18 suffered persistent AVHs ("auditory hallucination" AH group), and 31 never experienced AVHs ("no hallucination" NH group). The severity of AVHs was rated by the Auditory Hallucinations Rating Scale (AHRS). Cortical thickness differences among the three groups and their association with AVHs severity were examined. RESULTS Compared to both HCs and NH patients, AH patients showed lower cortical thickness in the right Heschl's gyrus. The degree of reduction in the cortical thickness was correlated with AVH severity in the AH patients. CONCLUSIONS Abnormalities of cortical thickness in the Heschl's gyrus may be a physiological factor underlying auditory verbal hallucinations in schizophrenia.
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Affiliation(s)
- Xudong Chen
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, People's Republic of China.
| | - Shengxiang Liang
- Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, People's Republic of China.
| | - Weidan Pu
- Medical Psychological Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
| | - Yinnan Song
- Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, People's Republic of China.
| | - Tumbwene E. Mwansisya
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan 410011 People’s Republic of China ,Department of Clinical Nursing and Community Health, the University of Dodoma, Dodoma, Tanzania
| | - Qing Yang
- Department of Medicine, Yale-New Haven Hospital, Yale School of Medicine, New Haven, CT, USA.
| | - Haihong Liu
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
| | - Zhening Liu
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, People's Republic of China.
| | - Baoci Shan
- Key Laboratory of Nuclear Analysis Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, People's Republic of China.
| | - Zhimin Xue
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, People's Republic of China.
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Abstract
BACKGROUND Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare. OBJECTIVE To review the effects of published treatment methods for musical hallucinations. METHODS A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. We analyzed the treatment results in relation to the etiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion, and other pathology, epilepsy or intoxication/pharmacology. RESULTS Musical hallucinations can disappear without intervention. When hallucinations are bearable, patients can be reassured without any other treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. Distinct etiological groups appear to respond differently to treatment. In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g., more acoustic stimulation) are frequently helpful. Pharmacological treatment methods can also be successful, with antidepressants being possibly more helpful than antiepileptics (which are still better than antipsychotics). The limited use of acetylcholinesterase inhibitors has looked promising. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. When intoxication/pharmacology is the main etiological factor, it is important to stop or switch the causative substance or medication. CONCLUSION Treatments for musical hallucinations tend to yield favorable results when they target the main etiological factor of these phenomena. There is a need to establish the natural course of musical hallucinations, their response to non-pharmacological treatments, and their effects on the patient's quality of life. There is also a need to standardize the assessment of treatment responses, and document long-term follow up.
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Affiliation(s)
- Jan A. F. Coebergh
- Department of Neurology, Haga HospitalThe Hague, Netherlands
- Department of Neurology, Ashford/St. Peter's HospitalChertsey, UK
- Department of Neurology, St. George's HospitalLondon, UK
| | - R. F. Lauw
- Parnassia Psychiatric InstituteThe Hague, Netherlands
| | - R. Bots
- ‘S Heeren LooNoordwijk, Netherlands
| | - I. E. C. Sommer
- Department of Psychiatry, University Medical Center UtrechtUtrecht, Netherlands
- Brain Centre Rudolf MagnusUtrecht, Netherlands
| | - J. D. Blom
- Parnassia Psychiatric InstituteThe Hague, Netherlands
- Department of Psychiatry, University of GroningenGroningen, Netherlands
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Otani VHO, Shiozawa P, Cordeiro Q, Uchida RR. A systematic review and meta-analysis of the use of repetitive transcranial magnetic stimulation for auditory hallucinations treatment in refractory schizophrenic patients. Int J Psychiatry Clin Pract 2015; 19:228-32. [PMID: 25356661 DOI: 10.3109/13651501.2014.980830] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The use of repetitive transcranial magnetic stimulation (rTMS) remains a promising therapeutic tool in the treatment of schizophrenia. Symptoms such as auditory hallucinations (AH) find contradictory results in many studies. Here we present an up-to-date systematic review and meta-analysis of rTMS in the treatment of AH in schizophrenia. METHODS We searched Pubmed-MEDLINE from 1999 to 2013 for double-blinded randomized sham-controlled trials that applied slow rTMS on the left temporoparietal cortex and assessed the outcome results using Hallucination Change Scale or Auditory Hallucination Rating Scale or Scale for Auditory Hallucinations (SAH). We identified 10 studies suitable for the meta-analysis. RESULTS We found a positive sized effect in favor of rTMS [random-effects model Hedges' g = 0.011, I-squared = 58.1%]. There was some variability between study effect sizes, but the sensitivity analysis concluded that none of them had sufficient weight to singularly alter the results of our meta-analysis. DISCUSSION rTMS appears to be an effective treatment for AH. The left temporoparietal cortex seems to be the area in which rTMS is effective. Although meta-analysis is a powerful analytical tool, more studies must be conducted in order to obtain a more expressive sample size to perform a more accurate analytical approach.
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Affiliation(s)
- Victor Henrique Oyamada Otani
- a Centro de Atenção Integrada em Saúde Mental, Faculdade de Ciências Médicas da Santa Casa de Misericórdia de São Paulo, Psychiatry , São Paulo , Brazil
| | - Pedro Shiozawa
- a Centro de Atenção Integrada em Saúde Mental, Faculdade de Ciências Médicas da Santa Casa de Misericórdia de São Paulo, Psychiatry , São Paulo , Brazil
| | - Quirino Cordeiro
- a Centro de Atenção Integrada em Saúde Mental, Faculdade de Ciências Médicas da Santa Casa de Misericórdia de São Paulo, Psychiatry , São Paulo , Brazil
| | - Ricardo Ryoiti Uchida
- a Centro de Atenção Integrada em Saúde Mental, Faculdade de Ciências Médicas da Santa Casa de Misericórdia de São Paulo, Psychiatry , São Paulo , Brazil
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Zhang Y, Liang W, Yang S, Dai P, Shen L, Wang C. Repetitive transcranial magnetic stimulation for hallucination in schizophrenia spectrum disorders: A meta-analysis. Neural Regen Res 2014; 8:2666-76. [PMID: 25206578 PMCID: PMC4146020 DOI: 10.3969/j.issn.1673-5374.2013.28.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 07/24/2013] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE This study assessed the efficacy and tolerability of repetitive transcranial magnetic stimulation for treatment of auditory hallucination of patients with schizophrenia spectrum disorders. DATA SOURCES Online literature retrieval was conducted using PubMed, ISI Web of Science, EMBASE, Medline and Cochrane Central Register of Controlled Trials databases from January 1985 to May 2012. Key words were "transcranial magnetic stimulation", "TMS", "repetitive transcranial magnetic stimulation", and "hallucination". STUDY SELECTION Selected studies were randomized controlled trials assessing therapeutic efficacy of repetitive transcranial magnetic stimulation for hallucination in patients with schizophrenia spectrum disorders. Experimental intervention was low-frequency repetitive transcranial magnetic stimulation in left temporoparietal cortex for treatment of auditory hallucination in schizophrenia spectrum disorders. Control groups received sham stimulation. MAIN OUTCOME MEASURES The primary outcome was total scores of Auditory Hallucinations Rating Scale, Auditory Hallucination Subscale of Psychotic Symptom Rating Scale, Positive and Negative Symptom Scale-Auditory Hallucination item, and Hallucination Change Scale. Secondary outcomes included response rate, global mental state, adverse effects and cognitive function. RESULTS Seventeen studies addressing repetitive transcranial magnetic stimulation for treatment of schizophrenia spectrum disorders were screened, with controls receiving sham stimulation. All data were completely effective, involving 398 patients. Overall mean weighted effect size for repetitive transcranial magnetic stimulation versus sham stimulation was statistically significant (MD = -0.42, 95%CI: -0.64 to -0.20, P = 0.000 2). Patients receiving repetitive transcranial magnetic stimulation responded more frequently than sham stimulation (OR = 2.94, 95%CI: 1.39 to 6.24, P = 0.005). No significant differences were found between active repetitive transcranial magnetic stimulation and sham stimulation for positive or negative symptoms. Compared with sham stimulation, active repetitive transcranial magnetic stimulation had equivocal outcome in cognitive function and commonly caused headache and facial muscle twitching. CONCLUSION Repetitive transcranial magnetic stimulation is a safe and effective treatment for auditory hallucination in schizophrenia spectrum disorders.
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Affiliation(s)
- Yingli Zhang
- Psychological Counseling Center, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, Henan Province, China
| | - Wei Liang
- Department of Clinical Psychology, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, Henan Province, China
| | - Shichang Yang
- Department of Psychology, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Ping Dai
- Library of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lijuan Shen
- Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
| | - Changhong Wang
- Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, Henan Province, China
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van Lutterveld R, van den Heuvel MP, Diederen KMJ, de Weijer AD, Begemann MJH, Brouwer RM, Daalman K, Blom JD, Kahn RS, Sommer IE. Cortical thickness in individuals with non-clinical and clinical psychotic symptoms. ACTA ACUST UNITED AC 2014; 137:2664-9. [PMID: 24951640 DOI: 10.1093/brain/awu167] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Symptoms that are linked to psychosis are also experienced by individuals who are not in need of care. In the present study, cortical thickness was investigated in these individuals. Fifty individuals with non-clinical auditory verbal hallucinations (most of them also experienced other non-clinical psychotic symptoms), 50 patients with a psychotic disorder and auditory verbal hallucinations, and 50 healthy control subjects underwent structural magnetic resonance imaging. Data were analysed using FreeSurfer. Cortical thickness in the pars orbitalis, paracentral lobule, fusiform gyrus and inferior temporal gyrus was lowest in patients, intermediate in the non-clinical hallucinating group, and highest in control subjects. The patients also showed thinning in widespread additional areas compared to the two other groups, whereas both hallucinating groups showed similar levels of thinning in the insula. Ranking the levels of cortical thickness per brain region across groups revealed that for 88% of brain regions, cortical thickness was lowest in patients, intermediate in the non-clinical hallucinating group, and highest in controls. These findings show that individuals with non-clinical psychotic symptoms show a similar but less pronounced pattern of cortical thinning as patients with a psychotic disorder, which is suggestive of a similar, but milder underlying pathophysiology in this group compared to the psychosis group.
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Affiliation(s)
- Remko van Lutterveld
- 1 Department of Psychiatry, University Medical Centre, 3584 CX Utrecht, The Netherlands 2 Rudolf Magnus Institute of Neuroscience, 3584 CG Utrecht, The Netherlands 3 Centre for Mindfulness, University of Massachusetts School of Medicine, Shrewsbury, 01545, Massachusetts, USA
| | - Martijn P van den Heuvel
- 1 Department of Psychiatry, University Medical Centre, 3584 CX Utrecht, The Netherlands 2 Rudolf Magnus Institute of Neuroscience, 3584 CG Utrecht, The Netherlands
| | - Kelly M J Diederen
- 1 Department of Psychiatry, University Medical Centre, 3584 CX Utrecht, The Netherlands 2 Rudolf Magnus Institute of Neuroscience, 3584 CG Utrecht, The Netherlands 4 Department of Physiology, Development and Neuroscience, Downing Street, University of Cambridge, Cambridge, CB2 3EG, UK
| | - Antoin D de Weijer
- 1 Department of Psychiatry, University Medical Centre, 3584 CX Utrecht, The Netherlands 2 Rudolf Magnus Institute of Neuroscience, 3584 CG Utrecht, The Netherlands 5 Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
| | - Marieke J H Begemann
- 1 Department of Psychiatry, University Medical Centre, 3584 CX Utrecht, The Netherlands 2 Rudolf Magnus Institute of Neuroscience, 3584 CG Utrecht, The Netherlands
| | - Rachel M Brouwer
- 1 Department of Psychiatry, University Medical Centre, 3584 CX Utrecht, The Netherlands 2 Rudolf Magnus Institute of Neuroscience, 3584 CG Utrecht, The Netherlands
| | - Kirstin Daalman
- 1 Department of Psychiatry, University Medical Centre, 3584 CX Utrecht, The Netherlands 2 Rudolf Magnus Institute of Neuroscience, 3584 CG Utrecht, The Netherlands
| | - Jan Dirk Blom
- 6 Parnassia Groep, 2553 RJ The Hague, The Netherlands 7 Department of Psychiatry, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - René S Kahn
- 1 Department of Psychiatry, University Medical Centre, 3584 CX Utrecht, The Netherlands 2 Rudolf Magnus Institute of Neuroscience, 3584 CG Utrecht, The Netherlands
| | - Iris E Sommer
- 1 Department of Psychiatry, University Medical Centre, 3584 CX Utrecht, The Netherlands 2 Rudolf Magnus Institute of Neuroscience, 3584 CG Utrecht, The Netherlands
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Abstract
The aim of this study was to determine if simulation aided by media technology contributes towards an increase in knowledge, empathy, and a change in attitudes in regards to auditory hallucinations for nursing students. A convenience sample of 60 second-year undergraduate nursing students from an Australian university was invited to be part of the study. A pre-post-test design was used, with data analysed using a paired samples t-test to identify pre- and post-changes on nursing students' scores on knowledge of auditory hallucinations. Nine of the 11 questions reported statistically-significant results. The remaining two questions highlighted knowledge embedded within the curriculum, with therapeutic communication being the core work of mental health nursing. The implications for practice are that simulation aided by media technology increases the knowledge of students in regards to auditory hallucinations.
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Affiliation(s)
- Kerry Mawson
- School of Nursing, Australian Catholic University, Sydney, New South Wales, Australia
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26
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Abstract
BACKGROUND We used British national survey data to test specific hypotheses that mood instability (1) is associated with psychosis and individual psychotic phenomena, (2) predicts the later emergence of auditory hallucinations and paranoid ideation, and (3) mediates the link between child sexual abuse and psychosis. METHODS We analyzed data from the 2000 and 2007 UK national surveys of psychiatric morbidity (N = 8580 and 7403, respectively). The 2000 survey included an 18-month follow-up of a subsample (N = 2406). Mood instability was assessed from the Structured Clinical Interview for DSM-IV Axis II (SCID-II) questionnaire. Our dependent variables comprised auditory hallucinations, paranoid ideation, the presence of psychosis overall, and a 15-item paranoia scale. RESULTS Mood instability was strongly associated in cross-sectional analyses with psychosis (2000: OR: 7.5; 95% CI: I 4.1-13.8; 2007: OR: 21.4; CI: 9.7-41.2), paranoid ideation (2000: OR: 4.7; CI: 4.1-5.4; 2007: OR: 5.7; CI: 4.9-6.7), auditory hallucinations (2000: OR: 3.4; CI: 2.6-4.4; 2007: OR 3.5; CI: 2.7-4.7), and paranoia total score (2000: Coefficient: 3.6; CI: 3.3-3.9), remaining so after adjustment for current mood state. Baseline mood instability significantly predicted 18-month inceptions of paranoid ideation (OR: 2.3; CI: 1.6-3.3) and of auditory hallucinations (OR: 2.6; CI: 1.5-4.4). Finally, it mediated a third of the total association of child sexual abuse with psychosis and persecutory ideation and a quarter of that with auditory hallucinations. CONCLUSIONS Mood instability is a prominent feature of psychotic experience and may have a role in its genesis. Targeting mood instability could lead to innovative treatments for psychosis.
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Affiliation(s)
- Steven Marwaha
- *To whom correspondence should be addressed; Mental Health Sciences Unit, University College London, 67-73 Riding House St. London W1W 7EJ, UK; tel: +44-20-7679-9465, fax: +44-20-7679-9426, e-mail:
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27
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Abstract
Using functional MRI, we investigated reality monitoring for auditory information. During scanning, healthy young adults heard words in another person's voice and imagined hearing other words in that same voice. Later, outside the scanner, participants judged words as "heard," "imagined," or "new." An area of left middle frontal gyrus (Brodmann's area, or BA, 6) was more active at encoding for imagined items subsequently correctly called "imagined" than for items incorrectly called "heard." An area of left inferior frontal gyrus (BA 45, 44) was more active at encoding for items subsequently called "heard" than "imagined," regardless of the actual source of the item. Scores on an Auditory Hallucination Experience Scale were positively related to activity in superior temporal gyrus (BA 22) for imagined words incorrectly called "heard." We suggest that activity in these areas reflects cognitive operations information (middle frontal gyrus) and semantic and perceptual detail (inferior frontal gyrus and superior temporal gyrus, respectively) used to make reality-monitoring attributions.
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Sasaki T, Kodaka F, Taniguchi G, Nishikawa T, Watanabe M. Experiential auditory hallucinations due to chronic epileptic discharges after radiotherapy for oligoastrocytoma. Epileptic Disord 2013; 15:188-92. [PMID: 23774105 DOI: 10.1684/epd.2013.0574] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Experiential auditory hallucinations have been reported in patients with epilepsy. We report the case of a 46-year-old woman with a history of more than three years of experiential auditory hallucinations caused by chronic epileptic discharges, which developed after radiotherapy for an oligoastrocytoma in the left temporal lobe. Electroencephalography revealed frequent spikes in the left temporal lobe. In response to clonazepam, but not antipsychotics, her auditory hallucinations almost completely disappeared and spikes were reduced. Her auditory hallucinations exhibited the characteristics of first-rank symptoms of schizophrenia, however, the content of experiential auditory hallucinations endured by our patient suggested an epileptic origin. We believe that the persistent subictal discharges, in combination with hyperexcitability of the temporal neocortex near radiation-induced necrotic lesions, were the cause of the auditory hallucinations.
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Hoskin R, Hunter MD, Woodruff PWR. The effect of psychological stress and expectation on auditory perception: A signal detection analysis. Br J Psychol 2013; 105:524-46. [PMID: 25280122 DOI: 10.1111/bjop.12048] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 07/18/2013] [Indexed: 11/26/2022]
Abstract
Both psychological stress and predictive signals relating to expected sensory input are believed to influence perception, an influence which, when disrupted, may contribute to the generation of auditory hallucinations. The effect of stress and semantic expectation on auditory perception was therefore examined in healthy participants using an auditory signal detection task requiring the detection of speech from within white noise. Trait anxiety was found to predict the extent to which stress influenced response bias, resulting in more anxious participants adopting a more liberal criterion, and therefore experiencing more false positives, when under stress. While semantic expectation was found to increase sensitivity, its presence also generated a shift in response bias towards reporting a signal, suggesting that the erroneous perception of speech became more likely. These findings provide a potential cognitive mechanism that may explain the impact of stress on hallucination-proneness, by suggesting that stress has the tendency to alter response bias in highly anxious individuals. These results also provide support for the idea that top-down processes such as those relating to semantic expectation may contribute to the generation of auditory hallucinations.
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Affiliation(s)
- Robert Hoskin
- Sheffield Cognition and Neuroimaging Lab (SCANLAB), Academic Clinical Psychiatry, Department of Neuroscience, Faculty of Medicine, Dentistry & Health, Longley Centre, University of Sheffield, UK
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van Lutterveld R, Diederen KMJ, Otte WM, Sommer IE. Network analysis of auditory hallucinations in nonpsychotic individuals. Hum Brain Mapp 2013; 35:1436-45. [PMID: 23426796 DOI: 10.1002/hbm.22264] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 12/11/2012] [Accepted: 01/03/2013] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Auditory verbal hallucinations (AVH) are a cardinal feature of schizophrenia and can severely disrupt behavior and decrease quality of life. Identification of areas with high functional connectivity (so-called hub regions) that are associated with the predisposition to hallucinate may provide potential targets for neuromodulation in the treatment of AVH. METHODS Resting-state fMRI scans during which no hallucinations had occurred were acquired from 29 nonpsychotic individuals with AVH and 29 matched controls. These nonpsychotic individuals with AVH provide the opportunity to study AVH without several confounds associated with schizophrenia, such as antipsychotic medication use and other symptoms related to the illness. Hub regions were identified by assessing weighted connectivity strength and betweenness centrality across groups using a permutation analysis. RESULTS Nonpsychotic individuals with AVH exhibited increased functioning as hub regions in the temporal cortices and the posterior cingulate/precuneus, which is an important area in the default mode network (DMN), compared to the nonhallucinating controls. In addition, the right inferior temporal gyrus, left paracentral lobule and right amygdala were less important as a hub region in the AVH group. CONCLUSIONS These results suggest that the predisposition to hallucinate may be related to aberrant functioning of the DMN and the auditory cortices.
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Affiliation(s)
- Remko van Lutterveld
- Department of Psychiatry, University Medical Center, Utrecht, the Netherlands and Rudolf Magnus Institute of Neuroscience, Utrecht, the Netherlands
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31
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Tian X, Poeppel D. Mental imagery of speech: linking motor and perceptual systems through internal simulation and estimation. Front Hum Neurosci 2012; 6:314. [PMID: 23226121 PMCID: PMC3508402 DOI: 10.3389/fnhum.2012.00314] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 11/06/2012] [Indexed: 11/13/2022] Open
Abstract
The neural basis of mental imagery has been investigated by localizing the underlying neural networks, mostly in motor and perceptual systems, separately. However, how modality-specific representations are top-down induced and how the action and perception systems interact in the context of mental imagery is not well understood. Imagined speech production ("articulation imagery"), which induces the kinesthetic feeling of articulator movement and its auditory consequences, provides a new angle because of the concurrent involvement of motor and perceptual systems. On the basis of previous findings in mental imagery of speech, we argue for the following regarding the induction mechanisms of mental imagery and the interaction between motor and perceptual systems: (1) Two distinct top-down mechanisms, memory retrieval and motor simulation, exist to induce estimation in perceptual systems. (2) Motor simulation is sufficient to internally induce the representation of perceptual changes that would be caused by actual movement (perceptual associations); however, this simulation process only has modulatory effects on the perception of external stimuli, which critically depends on context and task demands. Considering the proposed simulation-estimation processes as common mechanisms for interaction between motor and perceptual systems, we outline how mental imagery (of speech) relates to perception and production, and how these hypothesized mechanisms might underpin certain neural disorders.
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Affiliation(s)
- Xing Tian
- Poeppel Lab, Department of Psychology, New York University New York, NY, USA
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van der Feltz-Cornelis CM, Biemans H, Timmer J. Hearing voices: does it give your patient a headache? A case of auditory hallucinations as acoustic aura in migraine. Neuropsychiatr Dis Treat 2012; 8:105-11. [PMID: 22536065 PMCID: PMC3333787 DOI: 10.2147/ndt.s29300] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Auditory hallucinations are generally considered to be a psychotic symptom. However, they do occur without other psychotic symptoms in a substantive number of cases in the general population and can cause a lot of individual distress because of the supposed association with schizophrenia. We describe a case of nonpsychotic auditory hallucinations occurring in the context of migraine. METHOD Case report and literature review. RESULTS A 40-year-old man presented with imperative auditory hallucinations that caused depressive and anxiety symptoms. He reported migraine with visual aura as well which started at the same time as the auditory hallucinations. The auditory hallucinations occurred in the context of nocturnal migraine attacks, preceding them as aura. No psychotic disorder was present. After treatment of the migraine with propranolol 40 mg twice daily, explanation of the etiology of the hallucinations, and mirtazapine 45 mg daily, the migraine subsided and no further hallucinations occurred. The patient recovered. DISCUSSION Visual auras have been described in migraine and occur quite often. Auditory hallucinations as aura in migraine have been described in children without psychosis, but this is the first case describing auditory hallucinations without psychosis as aura in migraine in an adult. For description of this kind of hallucination, DSM-IV lacks an appropriate category. CONCLUSION Psychiatrists should consider migraine with acoustic aura as a possible etiological factor in patients without further psychotic symptoms presenting with auditory hallucinations, and they should ask for headache symptoms when they take the history. Prognosis may be favorable if the migraine is properly treated. Research is needed to explore the pathophysiological mechanism of auditory hallucinations as aura in migraine.
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van Lutterveld R, Sommer IEC, Ford JM. The neurophysiology of auditory hallucinations - a historical and contemporary review. Front Psychiatry 2011; 2:28. [PMID: 21629768 PMCID: PMC3099363 DOI: 10.3389/fpsyt.2011.00028] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 05/04/2011] [Indexed: 11/13/2022] Open
Abstract
Electroencephalography and magnetoencephalography are two techniques that distinguish themselves from other neuroimaging methodologies through their ability to directly measure brain-related activity and their high temporal resolution. A large body of research has applied these techniques to study auditory hallucinations. Across a variety of approaches, the left superior temporal cortex is consistently reported to be involved in this symptom. Moreover, there is increasing evidence that a failure in corollary discharge, i.e., a neural signal originating in frontal speech areas that indicates to sensory areas that forthcoming thought is self-generated, may underlie the experience of auditory hallucinations.
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Lee K, Yoshida T, Kubicki M, Bouix S, Westin CF, Kindlmann G, Niznikiewicz M, Cohen A, McCarley RW, Shenton ME. Increased diffusivity in superior temporal gyrus in patients with schizophrenia: a Diffusion Tensor Imaging study. Schizophr Res 2009; 108:33-40. [PMID: 19135872 DOI: 10.1016/j.schres.2008.11.024] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Revised: 11/12/2008] [Accepted: 11/15/2008] [Indexed: 11/20/2022]
Abstract
BACKGROUND Superior temporal gyrus (STG) volume reduction is one of the most consistent findings in schizophrenia. The goal of this study was to conduct the first Diffusion Tensor Imaging (DTI) study to investigate altered structural integrity in STG gray and white matter in patients with chronic schizophrenia compared with healthy controls. METHODS Magnetic resonance imaging (MRI) and DTI were acquired in 21 male patients with schizophrenia and 22 age-, handedness-, and parental social economic status-matched male comparison subjects. After manual segmentation of gray and white matter, mean diffusivity and fractional anisotropy were measured within STG. Correlational analyses were also conducted to test possible associations between DTI and clinical measures, including positive and negative symptoms of schizophrenia. RESULTS Compared with controls, patients demonstrated reduced volume, bilaterally, in STG gray matter but not in white matter. For DTI measures, patients showed increased mean diffusivity, bilaterally, in STG gray matter, and in left STG white matter. In addition, mean diffusivity in left STG white matter showed statistically significant correlations with auditory hallucinations and attentional impairments in patients. CONCLUSIONS These findings suggest a disruption of tissue integrity in STG gray and white matter in schizophrenia. In addition, increased water diffusivity in left-side STG, which was associated with auditory hallucinations and attentional impairments, suggests the possibility of a disconnection among auditory/language processing regions in schizophrenia.
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Fuse-Nagase Y, Boku M. Psychotic symptoms and a diagnosis of schizophrenia follow an initial diagnosis of tic disorder. J Psychiatry Neurosci 1996; 21:346-8. [PMID: 8973056 PMCID: PMC1188801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
We report a patient with a tic disorder who later developed psychotic symptoms and was diagnosed with schizophrenia.
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Affiliation(s)
- Y Fuse-Nagase
- Department of Neuropsychiatry, Faculty of Medicine, Tokyo Medical and Dental University, Japan
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