Visual 3D illusion: a systems-theoretical approach to psychosis

Quantifying body ownership information processing and perceptual bias in the rubber hand illusion

Bodily illusions have fascinated humankind for centuries, and researchers have studied them to learn about the perceptual and neural processes that underpin multisensory channels of bodily awareness. The influential rubber hand illusion (RHI) has been used to study changes in the sense of body ownership - that is, how a limb is perceived to belong to one's body, which is a fundamental building block in many theories of bodily awareness, self-consciousness, embodiment, and self-representation. However, the methods used to quantify perceptual changes in bodily illusions, including the RHI, have mainly relied on subjective questionnaires and rating scales, and the degree to which such illusory sensations depend on sensory information processing has been difficult to test directly. Here, we introduce a signal detection theory (SDT) framework to study the sense of body ownership in the RHI. We provide evidence that the illusion is associated with changes in body ownership sensitivity that depend on the information carried in the degree of asynchrony of correlated visual and tactile signals, as well as with perceptual bias and sensitivity that reflect the distance between the rubber hand and the participant's body. We found that the illusion's sensitivity to asynchrony is remarkably precise; even a 50 ms visuotactile delay significantly affected body ownership information processing. Our findings conclusively link changes in a complex bodily experience such as body ownership to basic sensory information processing and provide a proof of concept that SDT can be used to study bodily illusions.

Systematic review of visual illusions in schizophrenia

Visual illusions have long been used as tools to investigate sensory-perceptual deficits in schizophrenia. Recent conflicting accounts have called into question the assumption of abnormal illusion perception in patients and, therefore, the validity of this approach. Here, we present a systematic review of the current evidence regarding visual illusion perception abnormalities in patients with schizophrenia. Relevant publications were identified by a systematic search of PubMed, Literatura LILACS, PsycINFO, Embase, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), IBECS, BIOSIS, and Web of Science. Forty-five studies were selected which included illusions classified as 'Motion illusions', 'Geometric-optical illusions', 'Illusory contours', 'Depth inversion illusion', and 'Non-specific'. There is concordant evidence of abnormal processing of illusions in patients for most categories, especially in facial Depth Inversion and Müller-Lyer illusions. There were significant methodological disparities and shortcomings, but risk of bias was overall low for individual studies. The usefulness of visual illusions as tools in clinical settings as well as in basic research may be contingent on significant methodological refinements.

Acute effects of cannabis on speech illusions and psychotic-like symptoms: two studies testing the moderating effects of cannabidiol and adolescence

BACKGROUND

Acute cannabis administration can produce transient psychotic-like effects in healthy individuals. However, the mechanisms through which this occurs and which factors predict vulnerability remain unclear. We investigate whether cannabis inhalation leads to psychotic-like symptoms and speech illusion; and whether cannabidiol (CBD) blunts such effects (study 1) and adolescence heightens such effects (study 2).

METHODS

Two double-blind placebo-controlled studies, assessing speech illusion in a white noise task, and psychotic-like symptoms on the Psychotomimetic States Inventory (PSI). Study 1 compared effects of Cann-CBD (cannabis containing Δ-9-tetrahydrocannabinol (THC) and negligible levels of CBD) with Cann+CBD (cannabis containing THC and CBD) in 17 adults. Study 2 compared effects of Cann-CBD in 20 adolescents and 20 adults. All participants were healthy individuals who currently used cannabis.

RESULTS

In study 1, relative to placebo, both Cann-CBD and Cann+CBD increased PSI scores but not speech illusion. No differences between Cann-CBD and Cann+CBD emerged. In study 2, relative to placebo, Cann-CBD increased PSI scores and incidence of speech illusion, with the odds of experiencing speech illusion 3.1 (95% CIs 1.3-7.2) times higher after Cann-CBD. No age group differences were found for speech illusion, but adults showed heightened effects on the PSI.

CONCLUSIONS

Inhalation of cannabis reliably increases psychotic-like symptoms in healthy cannabis users and may increase the incidence of speech illusion. CBD did not influence psychotic-like effects of cannabis. Adolescents may be less vulnerable to acute psychotic-like effects of cannabis than adults.

Visuoperceptive Impairments in Severe Alcohol Use Disorder: A Critical Review of Behavioral Studies

The present literature review is aimed at offering a comprehensive and critical view of behavioral data collected during the past seventy years concerning visuoperception in severe alcohol use disorders (AUD). To pave the way for a renewal of research and clinical approaches in this very little understood field, this paper (1) provides a critical review of previous behavioral studies exploring visuoperceptive processing in severe AUD, (2) identifies the alcohol-related parameters and demographic factors that influence the deficits, and (3) addresses the limitations of this literature and their implications for current clinical strategies. By doing so, this review highlights the presence of visuoperceptive deficits but also shows how the lack of in-depth studies exploring the visual system in this clinical population results in the current absence of integration of these deficits in the dominant models of vision. Given the predominance of vision in everyday life, we stress the need to better delineate the extent, the specificity, and the actual implications of the deficits for severe AUD.

Critérios de decisão na ilusão da máscara côncava na esquizofrenia

RESUMO Objetivo Alguns estudos têm mostrado que indivíduos com esquizofrenia não experimentam a ilusão da máscara côncava. Nesse fenômeno, uma máscara apresentada em seu lado côncavo é percebida como convexa. A ocorrência dessa ilusão, de acordo com uma hipótese, dar-se-ia pela inibição dos processos top-down sobre os processos bottom-up. Neste estudo, foi investigado se havia uma diferença estatisticamente significativa entre os indivíduos com esquizofrenia comparados aos indivíduos saudáveis na distinção do lado côncavo do convexo de uma máscara, bem como qual hipótese melhor explicava o fenômeno, a inibição top-down ou critérios de decisão diferentes. Métodos Adotando a teoria da detecção do sinal e o método de coleta de dados, Confidence Rating , procurou-se verificar o desempenho nos julgamentos dos indivíduos com esquizofrenia comparados aos indivíduos saudáveis frente a uma máscara que ora foi apresentada em seu lado côncavo ora em seu lado convexo. Resultados Neste estudo, os indivíduos com esquizofrenia foram suscetíveis à ilusão e mais liberais em seus julgamentos diante do estímulo máscara. Conclusões A hipótese de inibição top-down sobre os processos bottom-up parece não ser uma explicação plausível. Talvez, a tomada de decisão ou critérios de decisão explique melhor os resultados encontrados neste estudo. Mais estudos são necessários para esclarecer melhor o fenômeno da ilusão da máscara côncava em indivíduos com esquizofrenia.

Visceral theory of sleep and origins of mental disorders

Visceral theory of sleep states that the same brain neurons, which process external information in wakefulness, during sleep switch to the processing of internal information coming from various visceral systems. Here we hypothesize that a failure in the commutation of exteroceptive and interoceptive information flows in the brain can manifest itself as a mental illness.

Visuospatial and Sensory Integration Tasks in Patients With Schizophrenia or Schizoaffective Disorder: Relationship to Body Mass Index and Smoking

Neurological soft signs (NSSs) are highly prevalent among patients with schizophrenia, but their pathophysiological significance remains unclear. The present study employed perceptual-motor and visuospatial processing tests that have not yet been attempted in this patient population. Patients with schizophrenia or schizoaffective disorder (n = 42) and mentally healthy subjects (n = 10) were administered Copy Figure Test, Detection and Recognition of an Object Test and Road Map Test. As compared to controls, schizophrenic and schizoaffective patients displayed significantly poorer ability to copy three-dimensional figures (namely, Necker- and hidden line elimination cubes) and to orient in space on a road-map test; group differences in copying two-dimensional figures and on objects' recognition against a background noise were not apparent. In the schizophrenia/schizoaffective group, more mistakes on the hidden line elimination cube was associated with greater body mass index and greater severity of nicotine dependence measured via the Fagerstrom Test of Nicotine Dependence. The above findings replicate those of prior reports and extend them to the tasks that do not involve motivational and attentional confounds. Furthermore, the present data support the hypothesis that subtle cerebral cortical abnormalities detected with specific NSSs tests may be related to some aspects of metabolic and motivational function in patients with schizophrenia/schizoaffective disorder.

Seeing more clearly through psychosis: Depth inversion illusions are normal in bipolar disorder but reduced in schizophrenia

Schizophrenia patients with more positive symptoms are less susceptible to depth inversion illusions (DIIs) in which concave objects appear as convex. It remains unclear, however, the extent to which this perceptual advantage uniquely characterizes the schizophrenia phenotype. To address the foregoing, we compared 30 bipolar disorder patients to a previously published sample of healthy controls (N=25) and schizophrenia patients (N=30). The task in all cases was to judge the apparent convexity of physically concave faces and scenes. Half of the concave objects were painted with realistic texture to enhance the convexity illusion and the remaining objects were untextured to reduce the illusion. Subjects viewed objects stereoscopically or via monocular motion parallax depth cues. For each group, DIIs were stronger with texture than without, and weaker with stereoscopic information than without, indicating a uniformly normal response to stimulus alterations across groups. Bipolar patients experienced DIIs more frequently than schizophrenia patients but as commonly as controls, irrespective of the face/scene category, texture, or viewing condition (motion/stereo). More severe positive and disorganized symptoms predicted reduced DIIs for schizophrenia patients and across all patients. These results suggest that people with schizophrenia, but not bipolar disorder, more accurately perceive object depth structure. Psychotic symptoms-or their accompanying neural dysfunction-may primarily drive the effect presumably through eroding the visual system's generalized tendency to construe unusual or ambiguous surfaces as convex. Because such symptoms are by definition more common in schizophrenia, DIIs are at once state-sensitive and diagnostically specific, offering a potential biomarker for the presence of acute psychosis.

Cellular perception and misperception: Internal models for decision-making shaped by evolutionary experience

Cells live in dynamic environments that necessitate perpetual adaptation. Since cells have limited resources to monitor external inputs, they are required to maximize the information content of perceived signals. This challenge is not unique to microscopic life: Animals use senses to perceive inputs and adequately respond. Research showed that sensory-perception is actively shaped by learning and expectation allowing internal cognitive models to "fill in the blanks" in face of limited information. We propose that cells employ analogous strategies and use internal models shaped through the long process of evolutionary adaptation. Given this perspective, we postulate that cells are prone to "misperceptions," analogous to visual illusions, leading them to incorrectly decode patterns of inputs that lie outside of their evolutionary experience. Mapping cellular misperception can serve as a fundamental approach for dissecting regulatory networks and could be harnessed to modulate cell behavior, a potentially new avenue for therapy.

Automatically Characterizing Sensory-Motor Patterns Underlying Reach-to-Grasp Movements on a Physical Depth Inversion Illusion

Recently, movement variability has been of great interest to motor control physiologists as it constitutes a physical, quantifiable form of sensory feedback to aid in planning, updating, and executing complex actions. In marked contrast, the psychological and psychiatric arenas mainly rely on verbal descriptions and interpretations of behavior via observation. Consequently, a large gap exists between the body's manifestations of mental states and their descriptions, creating a disembodied approach in the psychological and neural sciences: contributions of the peripheral nervous system to central control, executive functions, and decision-making processes are poorly understood. How do we shift from a psychological, theorizing approach to characterize complex behaviors more objectively? We introduce a novel, objective, statistical framework, and visuomotor control paradigm to help characterize the stochastic signatures of minute fluctuations in overt movements during a visuomotor task. We also quantify a new class of covert movements that spontaneously occur without instruction. These are largely beneath awareness, but inevitably present in all behaviors. The inclusion of these motions in our analyses introduces a new paradigm in sensory-motor integration. As it turns out, these movements, often overlooked as motor noise, contain valuable information that contributes to the emergence of different kinesthetic percepts. We apply these new methods to help better understand perception-action loops. To investigate how perceptual inputs affect reach behavior, we use a depth inversion illusion (DII): the same physical stimulus produces two distinct depth percepts that are nearly orthogonal, enabling a robust comparison of competing percepts. We find that the moment-by-moment empirically estimated motor output variability can inform us of the participants' perceptual states, detecting physiologically relevant signals from the peripheral nervous system that reveal internal mental states evoked by the bi-stable illusion. Our work proposes a new statistical platform to objectively separate changes in visual perception by quantifying the unfolding of movement, emphasizing the importance of including in the motion analyses all overt and covert aspects of motor behavior.

The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review

BACKGROUND

Sleep dysfunction is extremely common in patients with schizophrenia. Recent research indicates that sleep dysfunction may contribute to psychotic experiences such as delusions and hallucinations.

OBJECTIVES

The review aims to evaluate the evidence for a relationship between sleep dysfunction and individual psychotic experiences, make links between the theoretical understanding of each, and highlight areas for future research.

METHOD

A systematic search was conducted to identify studies investigating sleep and psychotic experiences across clinical and non-clinical populations.

RESULTS

66 papers were identified. This literature robustly supports the co-occurrence of sleep dysfunction and psychotic experiences, particularly insomnia with paranoia. Sleep dysfunction predicting subsequent psychotic experiences receives support from epidemiological surveys, research on the transition to psychosis, and relapse studies. There is also evidence that reducing sleep elicits psychotic experiences in non-clinical individuals, and that improving sleep in individuals with psychosis may lessen psychotic experiences. Anxiety and depression consistently arise as (partial) mediators of the sleep and psychosis relationship.

CONCLUSION

Studies are needed that: determine the types of sleep dysfunction linked to individual psychotic experiences; establish a causal connection between sleep and psychotic experiences; and assess treatments for sleep dysfunction in patients with non-affective psychotic disorders such as schizophrenia.

Perceptual instability in schizophrenia: Probing predictive coding accounts of delusions with ambiguous stimuli

Background

Delusions, a core symptom of schizophrenia, are thought to arise from an alteration in predictive coding mechanisms that underlie perceptual inference. Here, we aimed to empirically test the hypothesized link between delusions and perceptual inference.

Method

28 patients with schizophrenia and 32 healthy controls matched for age and gender took part in a behavioral experiment that assessed the influence of stabilizing predictions on perception of an ambiguous visual stimulus.

Results

Participants with schizophrenia exhibited a weaker tendency towards percept stabilization during intermittent viewing of the ambiguous stimulus compared to healthy controls. The tendency towards percept stabilization in participants with schizophrenia correlated negatively with delusional ideation as measured with a validated questionnaire.

Conclusion

Our results indicate an association between a weakened effect of sensory predictions in perceptual inference and delusions in schizophrenia. We suggest that attenuated predictive signaling during perceptual inference in schizophrenia may yield the experience of aberrant salience, thereby providing the starting point for the formation of delusions.

Accounting for the phenomenology and varieties of auditory verbal hallucination within a predictive processing framework

Two challenges that face popular self-monitoring theories (SMTs) of auditory verbal hallucination (AVH) are that they cannot account for the auditory phenomenology of AVHs and that they cannot account for their variety. In this paper I show that both challenges can be met by adopting a predictive processing framework (PPF), and by viewing AVHs as arising from abnormalities in predictive processing. I show how, within the PPF, both the auditory phenomenology of AVHs, and three subtypes of AVH, can be accounted for.

The hollow-face illusion monocularly observed in a box

Under monocular conditions, 40 students observed the reverse of polychrome and monochrome masks and judged them to be concave, convex or flat. The mask was presented upright and illuminated from above, below, right and left and in the upside down position illuminated from below. The magnitude of the perceived depth or relief was estimated using a retractable tape measure. Regardless of color, lighting and orientation, the majority of responses indicated that the hollow masks were perceived to be convex. No significant differences were observed between the depth or convexity of the metric magnitudes and scalar magnitudes of the concave masks in relation to variations in the light source direction, color, and position. The illusory depth, seeing the concave mask as convex, is a robust phenomenon that suggests the predominant role of higher-order processes over the low-order processes in visual face perception.

What visual illusions teach us about schizophrenia

Illusion, namely a mismatch between the objective and perceived properties of an object present in the environment, is a common feature of visual perception, both in normal and pathological conditions. This makes illusion a valuable tool with which to explore normal perception and its impairments. Although still debated, the hypothesis of a modified, and typically diminished, susceptibility to illusions in schizophrenia patients is supported by a growing number of studies. The current paper aimed to review how illusions have been used to explore and reveal the core features of visual perception in schizophrenia from a psychophysical, neurophysiological and functional point of view. We propose an integration of these findings into a common hierarchical Bayesian inference framework. The Bayesian formalism considers perception as the optimal combination between sensory evidence and prior knowledge, thereby highlighting the interweaving of perceptions and beliefs. Notably, it offers a holistic and convincing explanation for the perceptual changes observed in schizophrenia that might be ideally tested using illusory paradigms, as well as potential paths to explore neural mechanisms. Implications for psychopathology (in terms of positive symptoms, subjective experience or behavior disruptions) are critically discussed.

Percepção monocular da profundidade ou relevo na ilusão da máscara côncava na esquizofrenia

Este trabalho foi desenvolvido com o propósito de investigar a percepção monocular da profundidade ou relevo da máscara côncava por 29 indivíduos saudáveis, sete indivíduos com esquizofrenia sob uso de antipsicótico por um período inferior ou igual a quatro semanas e 29 sob uso de antipsicótico por um período superior a quatro semanas. Os três grupos classificaram o reverso de uma máscara policromada em duas situações de iluminação, por cima e por baixo. Os resultados indicaram que a maioria dos indivíduos com esquizofrenia inverteu a profundidade da máscara côncava na condição de observação monocular e perceberam-na como convexa, sendo, portanto, suscetíveis à ilusão da máscara côncava. Os indivíduos com esquizofrenia sob uso de medicação antipsicótica pelo período superior a quatro semanas estimaram a convexidade da máscara côncava iluminada por cima em menor comprimento comparados aos indivíduos saudáveis.

Impaired perceptual processing and conceptual cognition in patients with anxiety disorders: a pilot study with the binocular depth inversion paradigm

The binocular depth inversion test (BDIT) measures a common illusion of visual perception whereby implausible objects are seen as normal, e.g., a hollow face is perceived as a normal, convex face. Such inversion is frequent, especially for objects with a high degree of familiarity. Under normal conditions, cognitive factors apparently override the binocular disparity cues of stereopsis. This internal mechanism of "censorship" of perception, which balances "top-down" and "bottom-up" processes of perception to come to a cognitive coherence, which is congruent to previous experience and concepts, appears to be disturbed in (pro-)psychotic states. The BDIT has been shown to be a sensitive measure of impaired higher visual processing and conceptual cognition common to conditions including schizophrenia, cannabinoid-intoxication, and sleep deprivation but not depression. In this pilot study, we tested the performance of patients with anxiety disorders (ICD-10 F40 and F41) compared to matched controls using the BDIT paradigm. Anxiety patients scored significantly higher on the BDIT than controls, in a range comparable to propsychotic conditions. The findings suggest that anxiety patients could have abnormalities in central perceptual processing, top-down processing (conceptual cognition), and reality testing similar to (pro-)psychotic conditions. Implications of these findings are discussed in relation to therapeutic interventions with anxiety disorders.

[Neurotheology: neurobiological models of religious experience]

Religions are evolutionary selected social and cultural phenomena. They represent today belief and normative systems on which the main parts of our culture are based. For a long time religions have been seen as mainly originating from a spectrum of religious experiences. These include a broad spectrum of experiences and are astonishingly widespread in the population. The most consistent and transculturally uniform religious experiences are the mystical experiences. Only these (and the prayer experience) have factually been researched in detail neurobiologically. This article presents a review of empirical results and hypothetical approaches to explain mystical religious experiences neurobiologically. Some of the explanatory hypotheses possess logical evidence, some are even supported by neurobiological studies, but all of them have their pitfalls and are at best partially consistent. One important insight from the evidence reviewed here is that there may be a whole array of different neurophysiological conditions which may result in the same core religious mystical experiences.

Comprehensive model of how reality distortion and symptoms occur in schizophrenia: could impairment in learning-dependent predictive perception account for the manifestations of schizophrenia?

Conventional wisdom has not laid out a clear and uniform profile of schizophrenia as a unitary entity. One of the key first steps in elucidating the neurobiology of this entity would be to characterize the essential and common elements in the group of entities called schizophrenia. Kraepelin in his introduction notes 'the conviction seems to be more and more gaining ground that dementia praecox on the whole represents, a well characterized form of disease, and that we are justified in regarding the majority of the clinical pictures which are brought together here as the expression of a single morbid process, though outwardly they often diverge very far from one another'. But what is that single morbid process? We suggest that just as the uniform defect in all types of cancer is impaired regulation of cell proliferation, the primary defect in the group of entities called schizophrenia is persistent defective hierarchical temporal processing. This manifests in the form of chronic memory-prediction errors or deficits in learning-dependent predictive perception. These deficits account for the symptoms that present as reality distortion (delusions, thought disorder and hallucinations). This constellation of symptoms corresponds with the profile of most patients currently diagnosed as suffering from schizophrenia. In this paper we describe how these deficits can lead to the various symptoms of schizophrenia.

Reduced P300 and P600 amplitude in the hollow-mask illusion in patients with schizophrenia

Illusions provide a useful tool to study the mechanisms by which top-down and bottom-up processes interact in perception. Patients suffering from schizophrenia are not as subject to the hollow-mask illusion as healthy controls, since studies have shown that controls perceive a hollow mask as a normal face, while patients with schizophrenia do not. This insusceptibility to the illusion is indicating a weakened top-down processing in schizophrenia and little is understood about the neurobiology of this phenomenon. We used event-related potentials to investigate the hollow-mask illusion in patients with schizophrenia and healthy controls. We hypothesized that there would be a visible reduction of top-down processing in the patients' group and that this reduction would occur in the late stages of processing. We found significantly decreased amplitudes in the P300 and P600 components in the patients' group, indicating that visual information does not benefit from frontal, parietal or temporal activity for perceiving incoming stimuli. We propose that a deficit in functional connectivity may be responsible for impaired top-down visual processing in schizophrenia. These data further the understanding of the time course of top-down processing in patients with schizophrenia.

Glutamatergic model psychoses: prediction error, learning, and inference

Modulating glutamatergic neurotransmission induces alterations in conscious experience that mimic the symptoms of early psychotic illness. We review studies that use intravenous administration of ketamine, focusing on interindividual variability in the profundity of the ketamine experience. We will consider this individual variability within a hypothetical model of brain and cognitive function centered upon learning and inference. Within this model, the brains, neural systems, and even single neurons specify expectations about their inputs and responding to violations of those expectations with new learning that renders future inputs more predictable. We argue that ketamine temporarily deranges this ability by perturbing both the ways in which prior expectations are specified and the ways in which expectancy violations are signaled. We suggest that the former effect is predominantly mediated by NMDA blockade and the latter by augmented and inappropriate feedforward glutamatergic signaling. We suggest that the observed interindividual variability emerges from individual differences in neural circuits that normally underpin the learning and inference processes described. The exact source for that variability is uncertain, although it is likely to arise not only from genetic variation but also from subjects' previous experiences and prior learning. Furthermore, we argue that chronic, unlike acute, NMDA blockade alters the specification of expectancies more profoundly and permanently. Scrutinizing individual differences in the effects of acute and chronic ketamine administration in the context of the Bayesian brain model may generate new insights about the symptoms of psychosis; their underlying cognitive processes and neurocircuitry.

From drugs to deprivation: a Bayesian framework for understanding models of psychosis

INTRODUCTION

Various experimental manipulations, usually involving drug administration, have been used to produce symptoms of psychosis in healthy volunteers. Different drugs produce both common and distinct symptoms. A challenge is to understand how apparently different manipulations can produce overlapping symptoms. We suggest that current Bayesian formulations of information processing in the brain provide a framework that maps onto neural circuitry and gives us a context within which we can relate the symptoms of psychosis to their underlying causes. This helps us to understand the similarities and differences across the common models of psychosis.

MATERIALS AND METHODS

The Bayesian approach emphasises processing of information in terms of both prior expectancies and current inputs. A mismatch between these leads us to update inferences about the world and to generate new predictions for the future. According to this model, what we experience shapes what we learn, and what we learn modifies how we experience things.

DISCUSSION

This simple idea gives us a powerful and flexible way of understanding the symptoms of psychosis where perception, learning and inference are deranged. We examine the predictions of the cognitive model in light of what we understand about the neuropharmacology of psychotomimetic drugs and thereby attempt to account for the common and the distinctive effects of NMDA receptor antagonists, serotonergic hallucinogens, cannabinoids and dopamine agonists.

CONCLUSION

By acknowledging the importance of perception and perceptual aberration in mediating the positive symptoms of psychosis, the model also provides a useful setting in which to consider an under-researched model of psychosis-sensory deprivation.

Cor, iluminação e orientação do reverso de uma máscara facial não afetam a ilusão da máscara côncava

Em condição monocular, 40 observadores julgaram o reverso côncavo de uma máscara facial monocromada cinza e de outra policromada (iluminados por cima, por baixo, pela direita e pela esquerda na posição vertical e na posição vertical invertida, iluminado por baixo) como côncavos, planos ou convexos. Além disso, as magnitudes dos seus relevos percebidos foram reproduzidas ao se esticar uma trena retrátil. Independente da cor, iluminação e orientação das máscaras, a maioria das respostas indicou que os reversos das máscaras foram percebidos como convexos. E mesmo nas poucas respostas em que as máscaras foram classificadas como planas, houve atribuição de relevo mensurável. Estes resultados confirmam que a ilusória profundidade da máscara facial côncava como convexa é robusta sob influência de variáveis diversas, o que sugere atuação predominante de processos de alta ordem sobre os processos de baixa ordem na percepção visual de faces.

Binocular depth inversion as a paradigm of reduced visual information processing in prodromal state, antipsychotic-naïve and treated schizophrenia

The binocular depth inversion illusion test (BDII) represents a sensitive measure of impaired visual information processing that manifests in various experimental and naturally occurring psychotic states. This study explores impairment of visual processing in different major psychiatric diseases investigating 313 subjects, suffering of either an initial prodromal state of psychosis (IPS) or a first-episode, antipsychotic-naïve paranoid schizophrenia (SZ-N) as well as short-term antipsychotically treated schizophrenia (SZ-T), major depression (MDD), bipolar disorder (BD), dementia (D), and healthy controls (HC). Patients suffering from either IPS, SZ-N or a SZ-T showed significantly higher scores of BDII compared to HC, indicating that visual processing is already disturbed at an early state of the disease. For MDD, BD and D no statistically significant difference was found compared to HC. As the identification of individuals at high risk for developing schizophrenia relies on rating scales assessing subtle, pre-psychotic psychopathology, it would be of interest to have more diagnostic criteria available, testing, e.g. cognitive and perceptual impairment. We therefore analysed the receiver operating characteristic (ROC) curve, testing prodromal cases versus a clinically relevant sample of non-psychotic patients and controls, which included HC as well as the groups of patients suffering from MDD, BD or D revealing a AUC of 0.70. Thus, the BDII may be useful as an additional neuropsychological test for assessment of patients at high risk for developing schizophrenia.

Measuring Memory-Prediction Errors and their Consequences in Youth at Risk for Schizophrenia

The largely consistent columnar circuitry observed throughout the cortex may serve to continuously predict bottom-up activation based on invariant memories. This “memory-prediction” function is essential to efficient and accurate perception. Many of the defined cognitive deficits associated with schizophrenia suggest a breakdown of memory-prediction function. As deficits in memory-prediction function are proposed to lie more proximal to the biological causes of schizophrenia than deficits in standard cognitive constructs, tests that more directly probe memory-prediction function may be especially sensitive predictors of conversion in individuals at high-risk for schizophrenia. In this article, we review the conceptual basis for this hypothesis, and outline how it may be tested with specific cognitive paradigms. The accurate identification of cognitive processes that precede the onset of psychosis will not only be useful for clinicians to predict which young people are at greatest risk for schizophrenia, but will also help determine the neurobiology of psychosis onset, thus leading to new and effective treatments for preventing schizophrenia and other psychoses. Key words: Cognition, Cortical circuitry, Psychosis, Schizophrenia, Ultra high-risk

Understanding why patients with schizophrenia do not perceive the hollow-mask illusion using dynamic causal modelling

Patients suffering from schizophrenia are less susceptible to various visual illusions. For example, healthy participants perceive a hollow mask as a normal face, presumably due to the strength of constraining top-down influences, while patients with schizophrenia do not (Schneider, U., Leweke, F.M., Sternemann, U., Weber, M.M., Emrich, H.M., 1996. Visual 3D illusion: a systems-theoretical approach to psychosis. Eur. Arch. Psychiatry Clin. Neurosci. 246, 256-260; Scheider, U., Borsutzky, M., Seifert, J., Leweke, F.M., Huber, T.J., Rollnik J.D., Emrich, H.M., 2002. Reduced binocular depth inversion in schizophrenic patients. Schizophrenia Research 53, 101-108.; Emrich, H.M., Leweke, F.M., Schneider, U., 1997. Towards a cannabinoid hypothesis of schizophrenia: cognitive impairments due to a dysregulation of the endogenous cannabinoid system. Pharmacol. Biochem. Behav. 56, 803-807). However the neural mechanisms underpinning this effect remain poorly understood. We used functional magnetic resonance imaging to investigate the hollow-mask illusion in schizophrenic patients and healthy controls. The primary aim of this study was to use measures of effective connectivity arising from dynamic causal modelling (DCM) to explain differences in both the perception of the hollow-mask illusion and associated differences in neural responses between patients with schizophrenia and controls, which we hypothesised would be associated with difference in the influences of top-down and bottom-up processes between the groups. Consistent with this explanation, we identified differences between the two groups in effective connectivity. In particular, there was a strengthening of bottom-up processes, and weakening of top-down ones, during the presentation of 'hollow' faces for the patients. In contrast, the controls exhibited a strengthening of top-down processes when perceiving the same stimuli. These findings suggest that schizophrenic patients rely on stimulus-driven processing and are less able to employ conceptually-driven top-down strategies during perception, where incoming sensory data are constrained with reference to a generative model that entails stored information from past experience.

Cannabis and schizophrenia: towards a cannabinoid hypothesis of schizophrenia

Highlighting the association between schizophrenia and Cannabis sativa and the endogenous cannabinoid receptor system, respectively, two opposite aspects are of major relevance. On the one hand, cannabis is the most widely used illegal drug. There is substantial evidence that cannabis has to be classified as an independent risk factor for psychosis that may lead to a worse outcome of the disease. This risk seems to be increased in genetically predisposed people and may depend on the amount of cannabis used. On the other hand, during the last few years, an endogenous cannabinoid receptor system (including two known cannabinoid [CB(1) and CB(2)] receptors and five endogenous ligands) has been discovered. There are several lines of evidence suggesting that, at least in a subgroup of patients, alterations in the endocannabinoid system may contribute to the pathogenesis of schizophrenia (e.g., increased density of CB(1) receptor binding and increased levels of cerebrospinal fluid endocannabinoid anandamide). Accordingly, beside the 'dopamine hypothesis' of schizophrenia, a 'cannabinoid hypothesis' has been suggested. Interestingly, there is a complex interaction between the dopaminergic and the endocannabinoid receptor system. Thus, agents that interact with the cannabinoid receptor system, such as the nonpsychoactive cannabidiol, might be beneficial in the treatment of psychosis.

An fMRI study of the reverse perspective illusion

"Reverse perspective" is a powerful visual illusion similar to the hollow mask illusion, but more interesting in producing the perception of an illusory motion in a stationary picture. It is caused by conflict between motion parallax and pictorial depth cues in 3D "relief" paintings built with depth inversion. Here we report the measurement of brain activation using fMRI in response to a reverse perspective (RP) object, as well as a normal perspective, 3D-relief object ("shadow-box", SB) and a 2D painting of the same architectural scene. The stimuli were presented to 10 subjects in static and rotating conditions, subtraction of which revealed strong activation of area MT in all three cases. Contrasts between the RP, SB and 2D conditions showed the strongest activation for RP and almost no difference between SB and 2D. The similarity of brain activation between SB and 2D stimuli was interpreted as indicating that observers perceive the illusion of realistic 3D depth in 2D pictures as entirely normal and not qualitatively different from the 3D structure of the shadow-box stimulus. Contrasts between the RP stimulus and either the SB or the 2D stimulus revealed activation of Brodmann Areas 7, 19 and MT (and cerebellar cortex), suggesting the usage of brain regions involved in mental rotation and depth perception in response to the reverse perspective illusion.

Disturbances of visual information processing in early states of psychosis and experimental delta-9-tetrahydrocannabinol altered states of consciousness

Recent data on alterations of the endogenous cannabinoid system in schizophrenia have raised the question of its functional role in this disease. The psychoactive compound of Cannabis sativa, delta-9-tetrahydrocannabinol (Delta9-THC), has been shown to induce psychotic symptoms, but it is unknown to what extend prodromal states of psychoses are reflected by these experimental approaches. This study compares four groups of subjects: antipsychotic-naïve patients suffering from acute paranoid schizophrenic or schizophreniform psychosis (SZ), patients in the prodromal state (IPS), healthy controls without any pharmacological intervention (HC) and a second group of healthy volunteers who were orally administered synthetic Delta9-THC (Dronabinol) (HC-THC). Neither SZ and IPS nor HC received the experimental drug. All subjects were assessed using the Brief Psychiatric Rating Scale (BPRS) and the Binocular Depth Inversion Illusion Test (BDII). The latter represents a sensitive measure of impaired visual information processing that manifests in various experimental and naturally occurring psychotic states. BDII values were well comparable in SZ, IPS and HC-THC, and all groups differed significantly to HC. The BPRS revealed no significant difference between HC-THC and IPS while both were significantly different from SZ and HC, respectively. Our results suggest that Delta9-THC-induced altered states of consciousness may serve as a useful tool for modeling psychotic disorders, particularly their prodromal states. Furthermore, they provide insight into the perceptual and psychopathological alterations induced by Delta9-THC, which is essential for the understanding of the pro-psychotic effects of herbal cannabis preparations with highly enriched Delta9-THC content.

A inversão de profundidade visual em faces côncavas

Apresenta-se uma revisão de artigos sobre inversão de profundidade visual, principalmente relacionada à ilusão da face côncava (hollow face illusion). Enfatizam-se a supremacia dos processos de alta ordem (top-down) sobre os processos de baixa ordem (bottom-up) na percepção de profundidade invertida da face côncava, fatores e condições que a modulam, e plausíveis aplicações do fenômeno para se investigar condições comportamentais, psicopatológicas e psicofarmacológicas.

Reduced binocular depth inversion in regular cannabis users

The binocular depth inversion illusion (BDII) has been shown to be a sensitive measure of impaired visual information processing under conditions including cannabinoid-intoxicated states, alcohol withdrawal, sleep deprivation, and in patients with positive symptoms of schizophrenia. This study assessed whether the BDII could detect subtle cognitive impairment due to regular cannabis use by comparing 10 regular cannabis users and 10 healthy controls from the same community sources, matched for age, sex, and premorbid IQ. Subjects were also compared on measures of executive functioning, memory, and personality. Regular cannabis users were found to have significantly higher BDII scores for inverted images. This was not due to a problem in the primary processing of visual information, as there was no significant difference between the groups for depth perception of normal images. There was no relationship between BDII scores for inverted images and time since last dose, suggesting that the measured impairment of BDII more closely reflected chronic than acute effects of regular cannabis use. There were no significant differences between the groups for other neuropsychological measures of memory or executive function. A positive relationship was found between EPQ-R-psychoticism and cannabis, tobacco, and alcohol use. Cannabis users also used significantly larger amounts of alcohol. However, no relationship was found between BDII scores and drug use other than cannabis or psychoticism. Compared to the other neuropsychological tests used, the BDII appears to be a more sensitive tool for the detection of subtle impairments in visual information processing related to chronic cannabis use.

Effects of different subanaesthetic doses of (S)-ketamine on psychopathology and binocular depth inversion in man

The role of the N-methyl-D-aspartate (NMDA) neurotransmitter system in relation to psychoses is not completely understood, but represent a challenge in neurobiological research. The psychotic states induced by NMDA antagonists such as phencyclidine and ketamine have been described as being most similar to schizophrenia and the NMDA system has been implicated in the pathogenesis of schizophrenia. Binocular depth inversion, an illusion of visual perception, has been shown to be impaired in psychotic and psychotomimetic states in healthy and schizophrenic subjects. In this study, pictures of natural and artificial objects were presented stereoscopically to 12 healthy male volunteers and depth perception assessed using an operationalized method. The effects of the psychotomimetic S-enantiomer of the anaesthetic ketamine in two different subanaesthetic doses were compared with those of a placebo. In spite of dose dependence and grave subjective and significant objective psychopathology, no significant impairment of binocular depth perception was found with (S)-ketamine. Implications related to memory function, perceptogenesis and 'bottom-up' processing in ketamine model psychosis and schizophrenia are discussed.

Reduced binocular depth inversion in schizophrenic patients

Binocular depth inversion represents an illusion of visual perception, serving to invert the perception of implausible hollow objects, e.g. a hollow face into a normal face. Such inversion occurs frequently, especially when objects with a high degree of familiarity (e.g. photographs of faces) are displayed. Under normal conditions, cognitive factors apparently override the binocular disparity cues of stereopsis. This internal mechanism--a kind of "censorship" of perception balancing "top-down" and "bottom-up" processes of perception--appears to be disturbed in psychotic states. The clinical and neuropsychological performance of schizophrenic patients was assessed using the Brief Psychiatric Rating Scale (BPRS), the Positive And Negative Symptoms Scale (PANSS), the Clinical Global Impression Scale (CGI), the Mehrfach-Wahlwortschatz Intelligence Test (MWT-B) and the binocular depth inversion test (BDIT) using pictures with a high degree of familiarity. In schizophrenic patients, the performance in the BDIT differed significantly from healthy controls and from patients with major depression. The schizophrenic patients were more veridical in their judgements in the BDIT. During antipsychotic treatment, BPRS and PANSS scores improved and the inversed faces were seen as more illusionary, driven by an increase in top-down processing. At the end of treatment, there was no significant difference between the patient group and the healthy controls in the score of binocular depth inversion. These findings suggest that testing of binocular depth inversion can detect specific dysfunctions in visual perception and might be useful as a state-marker for psychotic states.

Different effects of nabilone and cannabidiol on binocular depth inversion in Man

The physiological and pathophysiological roles of the central nervous endogenous cannabinoid system are not completely understood, but still represent a challenge in basic neurobiological, cognitive, and psychiatric research. The system has been implicated in the pathogenesis of schizophrenia. Binocular depth inversion, an illusion of visual perception, provides a model of impaired perception during psychotic states. Using this model the effects of nabilone, a psychoactive synthetic 9-trans-ketocannabinoid, and of cannabidiol, the main natural component of herbal cannabis, and a combined application of both substances on binocular depth inversion and behavioural states were investigated in nine healthy male volunteers. The time course of the effects of both substances on binocular depth inversion was analysed after oral administration using three different groups of natural stimuli. A significant impairment of binocular depth perception was found when nabilone was administered, but combined application with cannabidiol revealed somewhat reduced effects on binocular depth inversion. The influence of psychoactive cannabinoids on this perceptual model and the role of the endogenous cannabinoid system in visual information processing are discussed.

Towards a cannabinoid hypothesis of schizophrenia: cognitive impairments due to dysregulation of the endogenous cannabinoid system

Cognitive impairments during psychotic episodes are assumed to be caused not only by one single putative classical neurotransmitter dysfunction but also by an impaired equilibrium of the interaction between different neurobiological generators of cognitive processes. Herein, the perceptual abnormalities induced by psychotogenic agents play a major role as tools for the understanding of model psychoses. The recently discovered cannabinoid receptor system with its endogenous ligand anandamide can be regarded as an extremely relevant regulator system, a dysfunctionality of which may explain at least one subtype of endogenous psychoses. Neuropsychological results (three-dimensional inversion illusion) in delta 9-tetrahydrocannabinol-intoxicated normal volunteers exhibit strong similarities with data acquired from patients suffering from productive schizophrenic psychoses, regarding disturbances in internal regulation of perceptual processes. The relevance of this finding to a general cognitive dysfunction concept of schizophrenic psychosis is discussed.