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Pilon F, Boisvert M, Potvin S. Losing the chain of thought: A meta-analysis of functional neuroimaging studies using verbal tasks in schizophrenia. J Psychiatr Res 2024; 169:238-246. [PMID: 38048673 DOI: 10.1016/j.jpsychires.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 10/30/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Disorganization symptoms are a main feature of schizophrenia, which include illogical and incoherent thinking, circumstantiality, tangentiality and loose associations. As these symptoms entail language deficits, several functional neuroimaging studies have been performed in schizophrenia using verbal tasks, producing somewhat heterogenous results. Hence, we performed a meta-analysis seeking to identify the most reliable neural alterations observed in schizophrenia patients during such tasks. METHODS Web of Sciences, PubMed, and EMBASE were searched for functional neuroimaging studies during verbal tasks (e.g. verbal fluency and semantic processing) in schizophrenia. Out of 795 screened articles, 33 were eligible for this meta-analysis. A coordinated-based meta-analysis was performed with the activation likelihood estimation (ALE) approach, using the cluster-level family-wise error (FWE) correction set at p < 0.05. RESULTS In schizophrenia, hyperactivations were observed in the left inferior frontal gyrus (IFG) and middle frontal gyrus (MFG) and hypoactivations were observed in the right IFG, the precentral gyrus and the left caudate nucleus. Another analysis pooling hyper- and hypoactivations revealed altered activations, firstly, in the left IFG and MFG, secondly, in the left precentral gyrus, IFG and insula, and, thirdly, in the left angular gyrus and precuneus. In the light of these results, not only classic language-related regions are abnormally activated during verbal tasks in schizophrenia, but also brain regions involved in executive functions, autobiographical memory and, unexpectedly, in motor functions. Further functional neuroimaging studies are needed to investigate the role of the striatum in linguistic sequencing in schizophrenia.
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Affiliation(s)
- Florence Pilon
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Mélanie Boisvert
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Stéphane Potvin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.
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2
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Romeo Z, Marino M, Mantini D, Angrilli A, Spironelli C. Language Network Connectivity of Euthymic Bipolar Patients Is Altered at Rest and during a Verbal Fluency Task. Biomedicines 2023; 11:1647. [PMID: 37371743 DOI: 10.3390/biomedicines11061647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/25/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Abnormalities of the Language Network (LN) have been found in different psychiatric conditions (e.g., schizophrenia and bipolar disorder), supporting the hypothesis that language plays a central role in a high-level integration/connectivity of second-level cognitive processes and the underlying cortical regions. This view implies a continuum of shared neural alterations along the psychotic disorder spectrum. In particular, bipolar disorder (BD) patients were recently documented to have an altered LN asymmetry during resting state. The extent to which the LN architecture is altered and stable also during a language task has yet to be investigated. To address this question, we analyzed fMRI data recorded during an open-eyes resting state session and a silent verbal fluency task in 16 euthymic BD patients and 16 matched healthy controls (HC). Functional connectivity in the LN of both groups was computed using spatial independent component analysis, and group comparisons were carried out to assess the network organization during both rest and active linguistic task conditions. The LN of BD patients involved left and right brain areas during both resting state and linguistic task. Compared to the left-lateralized network found in HC, the BD group was characterized by two anterior clusters (in left frontal and right temporo-insular regions) and the disengagement of the posterior language areas, especially during the verbal fluency task. Our findings support the hypothesis that reduced language lateralization may represent a biological marker across different psychotic disorders and that the altered language network connectivity found at rest in bipolar patients is stable and pervasive as it is also impaired during a verbal fluency task.
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Affiliation(s)
- Zaira Romeo
- Department of General Psychology, University of Padova, 35131 Padova, Italy
| | - Marco Marino
- Department of General Psychology, University of Padova, 35131 Padova, Italy
- Movement Control and Neuroplasticity Research Group, KU Leuven, 3001 Leuven, Belgium
| | - Dante Mantini
- Movement Control and Neuroplasticity Research Group, KU Leuven, 3001 Leuven, Belgium
| | - Alessandro Angrilli
- Department of General Psychology, University of Padova, 35131 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35131 Padova, Italy
| | - Chiara Spironelli
- Department of General Psychology, University of Padova, 35131 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35131 Padova, Italy
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3
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Ngo HVV, Oster H, Andreou C, Obleser J. Circadian rhythms in auditory hallucinations and psychosis. Acta Physiol (Oxf) 2023; 237:e13944. [PMID: 36744985 DOI: 10.1111/apha.13944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/07/2023]
Abstract
Circadian rhythms are imprinted in all organisms and influence virtually all aspects of physiology and behavior in adaptation to the 24-h day-night cycle. This recognition of a circadian timekeeping system permeating essentially all healthy functioning of body and mind quickly leads to the realization that, in turn, human ailments should be probed for the degree to which they are rooted in or marked by disruptions and dysregulations of circadian clock functions in the human body. In this review, we will focus on psychosis as a key mental illness and foremost one of its cardinal symptoms: auditory hallucinations. We will discuss recent empirical evidence and conceptual advances probing the potential role of circadian disruption in auditory hallucinations. Moreover, a dysbalance in excitation and inhibition within cortical networks, which in turn drive a disinhibition of dopaminergic signaling, will be highlighted as central physiological mechanism. Finally, we will propose two avenues for experimentally intervening on the circadian influences to potentially alleviate hallucinations in psychotic disorders.
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Affiliation(s)
- Hong-Viet V Ngo
- Department of Psychology, University of Lübeck, Lübeck, Germany
- Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
| | - Henrik Oster
- Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
- Institute of Neurobiology, University of Lübeck, Lübeck, Germany
| | - Christina Andreou
- Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Jonas Obleser
- Department of Psychology, University of Lübeck, Lübeck, Germany
- Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
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4
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Marschall TM, Koops S, Brederoo SG, Cabral J, Ćurčić-Blake B, Sommer IEC. Time varying dynamics of hallucinations in clinical and non-clinical voice-hearers. Neuroimage Clin 2023; 37:103351. [PMID: 36805417 PMCID: PMC9969260 DOI: 10.1016/j.nicl.2023.103351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/24/2023] [Accepted: 02/12/2023] [Indexed: 02/16/2023]
Abstract
Auditory verbal hallucinations (AVH) are frequently associated with psychotic disorders, yet also occur in non-clinical voice-hearers. AVH in this group are similar to those within clinical voice-hearers in terms of several phenomenological aspects, but non-clinical voice-hearers report to have more control over their AVH and attribute less emotional valence to them. These dissimilarities may stem from differences on the neurobiological level, as it is still under debate whether the mechanisms involved in AVH are the same in clinical and non-clinical voice-hearers. In this study, 21 clinical and 21 non-clinical voice-hearers indicated the onset and offsets of AVH during an fMRI scan. Using a method called leading eigenvector dynamics analysis (LEiDA), we examined time-varying dynamics of functional connectivity involved in AVH with a sub-second temporal resolution. We assessed differences between groups, and between hallucination and rest periods in dwell time, switching frequency, probability of occurrence, and transition probabilities of nine recurrent states of functional connectivity with a permutation ANOVA. Deviations in dwell times, switching frequencies, and switch probabilities in the hallucination period indicated more erratic dynamics during this condition regardless of their clinical status. Post-hoc analyses of the dwell times exhibited the most distinct differences between the rest and hallucination condition for the non-clinical sample, suggesting stronger differences between the two conditions in this group. Overall, these findings suggest that the neurobiological mechanisms involved in AVH are similar in clinical and non-clinical individuals.
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Affiliation(s)
- Theresa M Marschall
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
| | - Sanne Koops
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Sanne G Brederoo
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Joana Cabral
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK; Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
| | - Branislava Ćurčić-Blake
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Iris E C Sommer
- University of Groningen, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
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5
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Moseley P, Alderson-Day B, Common S, Dodgson G, Lee R, Mitrenga K, Moffatt J, Fernyhough C. Continuities and Discontinuities in the Cognitive Mechanisms Associated With Clinical and Nonclinical Auditory Verbal Hallucinations. Clin Psychol Sci 2022; 10:752-766. [PMID: 35846173 PMCID: PMC9280701 DOI: 10.1177/21677026211059802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 10/01/2021] [Indexed: 11/15/2022]
Abstract
Auditory verbal hallucinations (AVHs) are typically associated with schizophrenia but also occur in individuals without any need for care (nonclinical voice hearers [NCVHs]). Cognitive models of AVHs posit potential biases in source monitoring, top-down processes, or a failure to inhibit intrusive memories. However, research across clinical/nonclinical groups is limited, and the extent to which there may be continuity in cognitive mechanism across groups, as predicted by the psychosis-continuum hypothesis, is unclear. We report two studies in which voice hearers with psychosis ( n = 31) and NCVH participants reporting regular spiritual voices ( n = 26) completed a battery of cognitive tasks. Compared with non-voice-hearing groups ( ns = 33 and 28), voice hearers with psychosis showed atypical performance on signal detection, dichotic listening, and memory-inhibition tasks but intact performance on the source-monitoring task. NCVH participants, however, showed only atypical signal detection, which suggests differences between clinical and nonclinical voice hearers potentially related to attentional control and inhibition. These findings suggest that at the level of cognition, continuum models of hallucinations may need to take into account continuity but also discontinuity between clinical and nonclinical groups.
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Affiliation(s)
- Peter Moseley
- Department of Psychology, Northumbria University
- Peter Moseley, Department of Psychology, Northumbria University
| | | | - Stephanie Common
- Tees, Esk, & Wear Valley National Health Service (NHS) Foundation Trust, West Park Hospital, Darlington, England
| | - Guy Dodgson
- Cumbria, Northumberland, Tyne, & Wear NHS Foundation Trust, St. Nicholas Hospital, Newcastle upon Tyne, England
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Mourgues C, Negreira AM, Quagan B, Mercan NE, Niles H, Kafadar E, Bien C, Kamal F, Powers AR. Development of Voluntary Control Over Voice-Hearing Experiences: Evidence From Treatment-Seeking and Non-Treatment-Seeking Voice-Hearers. SCHIZOPHRENIA BULLETIN OPEN 2020; 1:sgaa052. [PMID: 33196043 PMCID: PMC7643545 DOI: 10.1093/schizbullopen/sgaa052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Voluntary control over voice-hearing experiences is one of the most consistent predictors of functioning among voice-hearers. However, control over voice-hearing experiences is likely to be more nuanced and variable than may be appreciated through coarse clinician-rated measures, which provide little information about how control is conceptualized and developed. We aimed to identify key factors in the evolution of control over voice-hearing experiences in treatment-seeking (N = 7) and non-treatment-seeking (N = 8) voice-hearers. Treatment-seeking voice-hearers were drawn from local chapters of the Connecticut Hearing Voices Network, and non-treatment-seeking voice-hearers were recruited from local spiritually oriented organizations. Both groups participated in a clinical assessment, and a semi-structured interview meant to explore the types of control exhibited and how it is fostered. Using Grounded Theory, we identified that participants from both groups exerted direct and indirect control over their voice-hearing experiences. Participants that developed a spiritual explanatory framework were more likely to exert direct control over the voice-hearing experiences than those that developed a pathologizing framework. Importantly, despite clear differences in explanatory framework and distress because of their experiences, both groups underwent similar trajectories to develop control and acceptance over their voice-hearing experiences. Understanding these factors will be critical in transforming control over voice-hearing experiences from a phenomenological observation to an actionable route for clinical intervention.
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Affiliation(s)
- Catalina Mourgues
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Alyson M Negreira
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Brittany Quagan
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | | | - Halsey Niles
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT.,Yale University School of Medicine, New Haven, CT
| | | | - Claire Bien
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT
| | - Faria Kamal
- Department of Psychiatry, Columbia University, New York, NY
| | - Albert R Powers
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven CT.,Yale University School of Medicine, New Haven, CT.,Department of Psychology, Yale University, New Haven, CT
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7
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Abnormal cerebellar volume in somatic vs. non-somatic delusional disorders. CEREBELLUM & ATAXIAS 2020; 7:2. [PMID: 31993210 PMCID: PMC6971987 DOI: 10.1186/s40673-020-0111-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/08/2020] [Indexed: 12/16/2022]
Abstract
Background There is abundant evidence for cerebellar involvement in schizophrenia, where the cerebellum has been suggested to contribute to cognitive, affective and motor dysfunction. More recently, specific cerebellar regions have also been associated with psychotic symptoms, particularly with auditory verbal hallucinations. In contrast, little is known about cerebellar contributions to delusions, and even less is known about whether cerebellar involvement differs by delusional content. Methods Using structural magnetic resonance imaging at 1.0 T together with cerebellum-optimized segmentation techniques, we investigated gray matter volume (GMV) in 14 patients with somatic-type delusional disorder (S-DD), 18 patients with non-somatic delusional disorder (NS-DD) and 18 patients with schizophrenia (SZ) with persistent non-somatic delusions. A total of 32 healthy controls (HC) were included. Between-group comparisons were adjusted for age, gender, chlorpromazine equivalents and illness duration. Results Compared to HC, S-DD patients showed decreased GMV in left lobule VIIIa. In addition, S-DD patients showed decreased GMV in lobule V and increased GMV in bilateral lobule VIIa/crus II compared to NS-DD. Patients with SZ showed increased GMV in right lobule VI and VIIa/crus I compared to HC. Significant differences between HC and NS-DD were not found. Conclusions The data support the notion of cerebellar dysfunction in psychotic disorders. Distinct cerebellar deficits, predominantly linked to sensorimotor processing, may be detected in delusional disorders presenting with predominantly somatic content.
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8
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Bykowsky O, Harrisberger F, Schmidt A, Smieskova R, Hauke DJ, Egloff L, Riecher-Rössler A, Fusar-Poli P, Huber CG, Lang UE, Andreou C, Borgwardt S. Association of antidepressants with brain morphology in early stages of psychosis: an imaging genomics approach. Sci Rep 2019; 9:8516. [PMID: 31186482 PMCID: PMC6560086 DOI: 10.1038/s41598-019-44903-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 05/28/2019] [Indexed: 11/09/2022] Open
Abstract
Depressive symptoms in subjects at Clinical High Risk for Psychosis (CHR-P) or at first-episode psychosis (FEP) are often treated with antidepressants. Our cross-sectional study investigated whether brain morphology is altered by antidepressant medication. High-resolution T1-weighted structural MRI scans of 33 CHR-P and FEP subjects treated with antidepressants, 102 CHR-P and FEP individuals without antidepressant treatment and 55 controls, were automatically segmented using Freesurfer 6.0. Linear mixed-effects modelling was applied to assess the differences in subcortical volume, surface area and cortical thickness in treated, non-treated and healthy subjects, taking into account converted dosages of antidepressants. Increasing antidepressant dose was associated with larger volume of the pallidum and the putamen, and larger surface of the left inferior temporal gyrus. In a pilot subsample of separately studied subjects of known genomic risk loci, we found that in the right postcentral gyrus, the left paracentral lobule and the precentral gyrus antidepressant dose-associated surface increase depended on polygenic schizophrenia-related-risk score. As the reported regions are linked to the symptoms of psychosis, our findings reflect the possible beneficial effects of antidepressant treatment on an emerging psychosis.
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Affiliation(s)
- Oleg Bykowsky
- Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.,Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland.,Center for Addiction Medicine, Châlons-en-Champagne General Hospital, Châlons-en-Champagne, France
| | - Fabienne Harrisberger
- Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.,Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland
| | - André Schmidt
- Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.,Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland
| | - Renata Smieskova
- Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.,Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland
| | - Daniel J Hauke
- Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.,Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland.,Department of Mathematics and Computer Science, University of Basel, Basel, Switzerland
| | - Laura Egloff
- Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.,Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland
| | | | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical Detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Christian G Huber
- Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland
| | - Undine E Lang
- Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland
| | - Christina Andreou
- Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), University of Basel, Basel, Switzerland. .,Psychiatric University Hospital (UPK), University of Basel, Basel, Switzerland. .,Early Psychosis: Interventions and Clinical Detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
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9
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Cortical folding abnormalities in patients with schizophrenia who have persistent auditory verbal hallucinations. Eur Neuropsychopharmacol 2018; 28:297-306. [PMID: 29305294 DOI: 10.1016/j.euroneuro.2017.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/28/2017] [Accepted: 12/06/2017] [Indexed: 01/28/2023]
Abstract
In schizophrenia temporal cortical volume loss differs between patients presenting with persistent auditory verbal hallucinations (pAVH) in contrast to those without hallucinatory symptoms (nAVH). However, it is unknown whether this deficit reflects a neural signature of neurodevelopmental origin or if abnormal temporal cortical volume is reflective of factors which may be relevant at later stages of the disorder. Here, we tested the hypothesis that local gyrification index (LGI) in regions of the temporal cortex differs between patients with pAVH (n=10) and healthy controls (n=14), and that abnormal temporal LGI discriminates between pAVH and nAVH (n=10). Structural magnetic resonance imaging at 3T along with surface-based data analysis methods was used. Contrary to our expectations, patients with pAVH showed lower LGI in Broca´s region compared to both healthy persons and nAVH. Compared to nAVH, those individuals presenting with pAVH also showed lower LGI in right Broca's homologue and right superior middle frontal cortex, together with increased LGI in the precuneus and superior parietal cortex. Regions with abnormal LGI common to both patient samples were found in anterior cingulate and superior frontal areas. Inferior cortical regions exhibiting abnormal LGI in pAVH patients were associated with overall symptom load (BPRS), but not with measures of AVH symptom severity. The pattern of abnormal cortical folding in this sample suggests a neurodevelopmental signature in Broca's region, consistent with current AVH models emphasizing the pivotal role of language circuits and inner speech. Temporal cortical deficits may characterize patients with pAVH during later stages of the disorder.
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10
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Alderson-Day B, Lima CF, Evans S, Krishnan S, Shanmugalingam P, Fernyhough C, Scott SK. Distinct processing of ambiguous speech in people with non-clinical auditory verbal hallucinations. Brain 2017; 140:2475-2489. [PMID: 29050393 DOI: 10.1093/brain/awx206] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 06/29/2017] [Indexed: 01/17/2023] Open
Abstract
Auditory verbal hallucinations (hearing voices) are typically associated with psychosis, but a minority of the general population also experience them frequently and without distress. Such 'non-clinical' experiences offer a rare and unique opportunity to study hallucinations apart from confounding clinical factors, thus allowing for the identification of symptom-specific mechanisms. Recent theories propose that hallucinations result from an imbalance of prior expectation and sensory information, but whether such an imbalance also influences auditory-perceptual processes remains unknown. We examine for the first time the cortical processing of ambiguous speech in people without psychosis who regularly hear voices. Twelve non-clinical voice-hearers and 17 matched controls completed a functional magnetic resonance imaging scan while passively listening to degraded speech ('sine-wave' speech), that was either potentially intelligible or unintelligible. Voice-hearers reported recognizing the presence of speech in the stimuli before controls, and before being explicitly informed of its intelligibility. Across both groups, intelligible sine-wave speech engaged a typical left-lateralized speech processing network. Notably, however, voice-hearers showed stronger intelligibility responses than controls in the dorsal anterior cingulate cortex and in the superior frontal gyrus. This suggests an enhanced involvement of attention and sensorimotor processes, selectively when speech was potentially intelligible. Altogether, these behavioural and neural findings indicate that people with hallucinatory experiences show distinct responses to meaningful auditory stimuli. A greater weighting towards prior knowledge and expectation might cause non-veridical auditory sensations in these individuals, but it might also spontaneously facilitate perceptual processing where such knowledge is required. This has implications for the understanding of hallucinations in clinical and non-clinical populations, and is consistent with current 'predictive processing' theories of psychosis.
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Affiliation(s)
- Ben Alderson-Day
- Department of Psychology, Durham University, Science Laboratories, South Road, Durham, DH1 3LE, UK
| | - César F Lima
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK.,Faculty of Psychology and Education Sciences, University of Porto, Rua Alfredo Allen, 4200-135 Porto, Portugal
| | - Samuel Evans
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK.,Department of Psychology, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK
| | - Saloni Krishnan
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK.,Department of Experimental Psychology, University of Oxford, S Parks Rd, Oxford OX1 3UD, UK
| | - Pradheep Shanmugalingam
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK
| | - Charles Fernyhough
- Department of Psychology, Durham University, Science Laboratories, South Road, Durham, DH1 3LE, UK
| | - Sophie K Scott
- Institute of Cognitive Neuroscience, University College London, 17-19 Queen Square, London, WC1N 3AR, UK
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11
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Cerebellar Contributions to Persistent Auditory Verbal Hallucinations in Patients with Schizophrenia. THE CEREBELLUM 2017; 16:964-972. [DOI: 10.1007/s12311-017-0874-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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12
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Multi-factorial modulation of hemispheric specialization and plasticity for language in healthy and pathological conditions: A review. Cortex 2017; 86:314-339. [DOI: 10.1016/j.cortex.2016.05.013] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/16/2016] [Accepted: 05/13/2016] [Indexed: 12/16/2022]
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13
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Baumeister D, Sedgwick O, Howes O, Peters E. Auditory verbal hallucinations and continuum models of psychosis: A systematic review of the healthy voice-hearer literature. Clin Psychol Rev 2016; 51:125-141. [PMID: 27866082 PMCID: PMC5240854 DOI: 10.1016/j.cpr.2016.10.010] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 09/05/2016] [Accepted: 10/29/2016] [Indexed: 12/22/2022]
Abstract
Recent decades have seen a surge of research interest in the phenomenon of healthy individuals who experience auditory verbal hallucinations, yet do not exhibit distress or need for care. The aims of the present systematic review are to provide a comprehensive overview of this research and examine how healthy voice-hearers may best be conceptualised in relation to the diagnostic versus ‘quasi-‘ and ‘fully-dimensional’ continuum models of psychosis. A systematic literature search was conducted, resulting in a total of 398 article titles and abstracts that were scrutinised for appropriateness to the present objective. Seventy articles were identified for full-text analysis, of which 36 met criteria for inclusion. Subjective perceptual experience of voices, such as loudness or location (i.e., inside/outside head), is similar in clinical and non-clinical groups, although clinical voice-hearers have more frequent voices, more negative voice content, and an older age of onset. Groups differ significantly in beliefs about voices, control over voices, voice-related distress, and affective difficulties. Cognitive biases, reduced global functioning, and psychiatric symptoms such as delusions, appear more prevalent in healthy voice-hearers than in healthy controls, yet less than in clinical samples. Transition to mental health difficulties is increased in HVHs, yet only occurs in a minority and is predicted by previous mood problems and voice distress. Whilst healthy voice-hearers show similar brain activity during hallucinatory experiences to clinical voice-hearers, other neuroimaging measures, such as mismatch negativity, have been inconclusive. Risk factors such as familial and childhood trauma appear similar between clinical and non-clinical voice-hearers. Overall the results of the present systematic review support a continuum view rather than a diagnostic model, but cannot distinguish between ‘quasi’ and ‘fully’ dimensional models. Healthy voice-hearers may be a key resource in informing transdiagnostic approaches to research of auditory hallucinations. Subjective perceptual experiences of voices appear similar in clinical and non-clinical groups. Healthy voice-hearers hear voices less frequently, with less negative content, more perceived control and from an earlier age. Healthy and clinical voice-hearers differ in beliefs about voices, voice-related distress, and affective difficulties. Healthy voice-hearers show more cognitive biases, psychiatric symptoms and functional impairments than healthy controls. Risk factors such as familial and childhood trauma appear similar between clinical and non-clinical voice-hearers.
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Affiliation(s)
- David Baumeister
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychology, London, UK.
| | - Ottilie Sedgwick
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychology, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
| | - Oliver Howes
- NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK; Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychosis Studies, London, UK
| | - Emmanuelle Peters
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Department of Psychology, London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
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de Boer JN, Heringa SM, van Dellen E, Wijnen FNK, Sommer IEC. A linguistic comparison between auditory verbal hallucinations in patients with a psychotic disorder and in nonpsychotic individuals: Not just what the voices say, but how they say it. BRAIN AND LANGUAGE 2016; 162:10-18. [PMID: 27501385 DOI: 10.1016/j.bandl.2016.07.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 06/10/2016] [Accepted: 07/29/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Auditory verbal hallucinations (AVH) in psychotic patients are associated with activation of right hemisphere language areas, although this hemisphere is non-dominant in most people. Language generated in the right hemisphere can be observed in aphasia patients with left hemisphere damage. It is called "automatic speech", characterized by low syntactic complexity and negative emotional valence. AVH in nonpsychotic individuals, by contrast, predominantly have a neutral or positive emotional content and may be less dependent on right hemisphere activity. We hypothesize that right hemisphere language characteristics can be observed in the language of AVH, differentiating psychotic from nonpsychotic individuals. METHOD 17 patients with a psychotic disorder and 19 nonpsychotic individuals were instructed to repeat their AVH verbatim directly upon hearing them. Responses were recorded, transcribed and analyzed for total words, mean length of utterance, proportion of grammatical utterances, proportion of negations, literal and thematic perseverations, abuses, type-token ratio, embeddings, verb complexity, noun-verb ratio, and open-closed class ratio. RESULTS Linguistic features of AVH overall differed between groups F(13,24)=3.920, p=0.002; Pillai's Trace 0.680. AVH of psychotic patients compared with AVH of nonpsychotic individuals had a shorter mean length of utterance, lower verb complexity, and more verbal abuses and perseverations (all p<0.05). Other features were similar between groups. CONCLUSION AVH of psychotic patients showed lower syntactic complexity and higher levels of repetition and abuses than AVH of nonpsychotic individuals. These differences are in line with a stronger involvement of the right hemisphere in the origination of AVH in patients than in nonpsychotic voice hearers.
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Affiliation(s)
- J N de Boer
- University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
| | - S M Heringa
- University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, Netherlands.
| | - E van Dellen
- University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
| | - F N K Wijnen
- Utrecht Institute of Linguistics OTS, Utrecht University, Trans 10, 3512 JK Utrecht, Netherlands
| | - I E C Sommer
- University Medical Center Utrecht, Brain Center Rudolf Magnus, Department of Psychiatry, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
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15
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Alderson-Day B, Diederen K, Fernyhough C, Ford JM, Horga G, Margulies DS, McCarthy-Jones S, Northoff G, Shine JM, Turner J, van de Ven V, van Lutterveld R, Waters F, Jardri R. Auditory Hallucinations and the Brain's Resting-State Networks: Findings and Methodological Observations. Schizophr Bull 2016; 42:1110-23. [PMID: 27280452 PMCID: PMC4988751 DOI: 10.1093/schbul/sbw078] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In recent years, there has been increasing interest in the potential for alterations to the brain's resting-state networks (RSNs) to explain various kinds of psychopathology. RSNs provide an intriguing new explanatory framework for hallucinations, which can occur in different modalities and population groups, but which remain poorly understood. This collaboration from the International Consortium on Hallucination Research (ICHR) reports on the evidence linking resting-state alterations to auditory hallucinations (AH) and provides a critical appraisal of the methodological approaches used in this area. In the report, we describe findings from resting connectivity fMRI in AH (in schizophrenia and nonclinical individuals) and compare them with findings from neurophysiological research, structural MRI, and research on visual hallucinations (VH). In AH, various studies show resting connectivity differences in left-hemisphere auditory and language regions, as well as atypical interaction of the default mode network and RSNs linked to cognitive control and salience. As the latter are also evident in studies of VH, this points to a domain-general mechanism for hallucinations alongside modality-specific changes to RSNs in different sensory regions. However, we also observed high methodological heterogeneity in the current literature, affecting the ability to make clear comparisons between studies. To address this, we provide some methodological recommendations and options for future research on the resting state and hallucinations.
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Affiliation(s)
| | - Kelly Diederen
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | | | - Judith M. Ford
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA
| | - Guillermo Horga
- New York State Psychiatric Institute, Columbia University Medical Center, New York, NY
| | - Daniel S. Margulies
- Max Planck Research Group for Neuroanatomy & Connectivity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | | | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, The Royal’s Institute of Mental Health Research, Ottawa, ON, Canada
| | - James M. Shine
- Department of Psychology, Stanford University, Stanford, CA
| | - Jessica Turner
- Department of Psychology, Neuroscience Institute, Georgia State University, Atlanta, GA
| | - Vincent van de Ven
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Remko van Lutterveld
- Center for Mindfulness, University of Massachusetts Medical School, Worcester, MA
| | - Flavie Waters
- North Metro Health Service Mental Health, Graylands Health Campus, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia
| | - Renaud Jardri
- Univ Lille, CNRS (UMR 9193), SCALab & CHU Lille, Psychiatry dept. (CURE), Lille, France
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16
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Murphy E, Benítez-Burraco A. Bridging the Gap between Genes and Language Deficits in Schizophrenia: An Oscillopathic Approach. Front Hum Neurosci 2016; 10:422. [PMID: 27601987 PMCID: PMC4993770 DOI: 10.3389/fnhum.2016.00422] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 08/08/2016] [Indexed: 12/11/2022] Open
Abstract
Schizophrenia is characterized by marked language deficits, but it is not clear how these deficits arise from the alteration of genes related to the disease. The goal of this paper is to aid the bridging of the gap between genes and schizophrenia and, ultimately, give support to the view that the abnormal presentation of language in this condition is heavily rooted in the evolutionary processes that brought about modern language. To that end we will focus on how the schizophrenic brain processes language and, particularly, on its distinctive oscillatory profile during language processing. Additionally, we will show that candidate genes for schizophrenia are overrepresented among the set of genes that are believed to be important for the evolution of the human faculty of language. These genes crucially include (and are related to) genes involved in brain rhythmicity. We will claim that this translational effort and the links we uncover may help develop an understanding of language evolution, along with the etiology of schizophrenia, its clinical/linguistic profile, and its high prevalence among modern populations.
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Affiliation(s)
- Elliot Murphy
- Division of Psychology and Language Sciences, University College London London, UK
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17
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Murphy E, Benítez-Burraco A. Language deficits in schizophrenia and autism as related oscillatory connectomopathies: An evolutionary account. Neurosci Biobehav Rev 2016; 83:742-764. [PMID: 27475632 DOI: 10.1016/j.neubiorev.2016.07.029] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 06/23/2016] [Accepted: 07/25/2016] [Indexed: 01/28/2023]
Abstract
Schizophrenia (SZ) and autism spectrum disorders (ASD) are characterised by marked language deficits, but it is not clear how these arise from gene mutations associated with the disorders. Our goal is to narrow the gap between SZ and ASD and, ultimately, give support to the view that they represent abnormal (but related) ontogenetic itineraries for the human faculty of language. We will focus on the distinctive oscillatory profiles of the SZ and ASD brains, in turn using these insights to refine our understanding of how the brain implements linguistic computations by exploring a novel model of linguistic feature-set composition. We will argue that brain rhythms constitute the best route to interpreting language deficits in both conditions and mapping them to neural dysfunction and risk alleles of the genes. Importantly, candidate genes for SZ and ASD are overrepresented among the gene sets believed to be important for language evolution. This translational effort may help develop an understanding of the aetiology of SZ and ASD and their high prevalence among modern populations.
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Affiliation(s)
- Elliot Murphy
- Division of Psychology and Language Sciences, University College London, London, United Kingdom.
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18
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Daalman K, Diederen KMJ, Hoekema L, van Lutterveld R, Sommer IEC. Five year follow-up of non-psychotic adults with frequent auditory verbal hallucinations: are they still healthy? Psychol Med 2016; 46:1897-1907. [PMID: 26961499 DOI: 10.1017/s0033291716000386] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Previously, we described 103 adults (mean age 41 years) who experienced frequent, auditory verbal hallucinations (AVH), in the absence of a need for mental healthcare. Importantly, these adults were largely past the peak incidence age for psychosis (15-35 years). It is unclear if these older individuals with AVH are still at increased risk for psychosis or other psychopathology. To address this question, we conducted a 5-year follow-up of previously included individuals (103 with AVH, 60 controls). METHOD Eighty-one adults with AVH (78.6%) and forty-nine controls (81.7%) could be contacted and were willing to participate. Participants were screened for psychosis and a need for mental healthcare at follow-up using the Comprehensive Assessment of Symptoms and History interview (CASH). Need for mental healthcare was defined as a clinical diagnosis as identified using the CASH and/or treatment by a mental healthcare specialist. Phenomenology of AVH was assessed with the PSYRATS Auditory Hallucinations Rating Scale. RESULTS Five individuals with AVH (6.2%) had developed psychosis and 32 (39.5%) had developed a need for mental healthcare. Voice-related distress at baseline significantly predicted need for mental healthcare. AVH persisted in most individuals (86.4%), without significant changes in phenomenology. None of the controls had developed psychotic symptoms, and need for mental healthcare (n = 6, 12.2%) was significantly lower in this group. CONCLUSIONS These findings suggest that frequent AVH in non-psychotic adults past the peak incidence age for psychosis constitute a rather static symptom and that individuals with AVH may be best viewed as situated on a need for care continuum.
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Affiliation(s)
- K Daalman
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - K M J Diederen
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - L Hoekema
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - R van Lutterveld
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
| | - I E C Sommer
- Department of Psychiatry, Neuroscience Division,University Medical Center Utrecht,Utrecht,The Netherlands
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19
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Upthegrove R, Broome MR, Caldwell K, Ives J, Oyebode F, Wood SJ. Understanding auditory verbal hallucinations: a systematic review of current evidence. Acta Psychiatr Scand 2016; 133:352-67. [PMID: 26661730 DOI: 10.1111/acps.12531] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Auditory verbal hallucinations (AVHs) are core features of psychotic illness and remain significant in predicting poor outcome and risk. There has been a wide range of approaches to understanding these experiences. METHOD A systematic literature review summarizing different methods of investigation and their results; phenomenology, descriptive psychopathology, psychological, cognitive neurobiology, and neuroimaging. RESULTS A number of 764 papers and texts were screened and 113 reviewed. Phenomenological studies are comparably few in number, and psychopathology remains based on concepts defined in the early 20th century. Psychological models focus on voice content and emotional reaction, and suggest a continuum of AVHs from normal experience. Neuropsychological models include AVHs as misattribution of inner speech, whilst functional neuroimaging studies focus on the spontaneous activity and connectivity of auditory networks. CONCLUSION There has been a large growth in research on AVHs in recent decades dominated by neurobiological and neuroimaging studies. Future research should include focus on phenomenological aspects and AVHs change over the course of developing illness. Integration between branches of enquiry is needed, and the risk is that without this, models are proposed and investigated that bear scant relevance to the symptom itself.
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Affiliation(s)
- R Upthegrove
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - M R Broome
- Department of Psychiatry, University of Oxford, Oxford, UK.,Warneford Hospital, Oxford Health NHS Foundation Trust, Oxford, UK
| | - K Caldwell
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - J Ives
- Medicine, Ethics, Society and History, The University of Birmingham, Birmingham, UK
| | - F Oyebode
- Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - S J Wood
- School of Psychology, University of Birmingham, Birmingham, UK.,Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Melbourne, Vic., Australia
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20
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van Dellen E, Bohlken MM, Draaisma L, Tewarie PK, van Lutterveld R, Mandl R, Stam CJ, Sommer IE. Structural Brain Network Disturbances in the Psychosis Spectrum. Schizophr Bull 2016; 42:782-9. [PMID: 26644605 PMCID: PMC4838099 DOI: 10.1093/schbul/sbv178] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Individuals with subclinical psychotic symptoms provide a unique window on the pathophysiology of psychotic experiences as these individuals are free of confounders such as hospitalization, negative and cognitive symptoms and medication use. Brain network disturbances of white matter connections are thought to play a central role in the pathophysiology of psychosis. Based on the structural network disconnection hypothesis in schizophrenia, we expect less and weaker connections, and altered brain network organization in individuals with clinical and those with subclinical psychotic symptoms. METHODS We used diffusion tensor imaging to study 35 patients with a psychotic disorder, 35 subjects with subclinical psychotic symptoms, and 36 healthy controls. The structural brain network was analyzed on 3 levels: connection density, white matter microstructure (fractional anisotropy, mean diffusivity, and magnetic transfer ratio), and network organization. Network organization was studied with minimum spanning tree analysis, a method to reconstruct a backbone of structural highways in the brain. RESULTS Decreased fractional anisotropy and increased mean diffusivity was found in both groups with psychotic symptoms, while their network topology showed decreased overlap with a healthy reference network. Decreased centrality was found in several brain regions, including parietal hubs and language areas, in both groups with psychotic symptoms. Deviation of network characteristics was more apparent in clinical subjects than in subclinical subjects. DISCUSSION Weaker connections and decreased centrality of parietal hubs characterize the structural brain network in subjects with psychotic symptoms. These differences are more notable in clinical than in subclinical subjects with psychotic experiences.
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Affiliation(s)
- Edwin van Dellen
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands;
| | - Marc M. Bohlken
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands;,Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Laurijn Draaisma
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands;,Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Prejaas K. Tewarie
- Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Remko van Lutterveld
- Center for Mindfulness, University of Massachusetts School of Medicine, Shrewsbury, MA
| | - René Mandl
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands;,Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Cornelis J. Stam
- Department of Clinical Neurophysiology and MEG Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Iris E. Sommer
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands;,Department of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands
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21
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Intra- and Inter-hemispheric Connectivity Supporting Hemispheric Specialization. MICRO-, MESO- AND MACRO-CONNECTOMICS OF THE BRAIN 2016. [DOI: 10.1007/978-3-319-27777-6_9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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22
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Kleinloog D, Rombouts S, Zoethout R, Klumpers L, Niesters M, Khalili-Mahani N, Dahan A, van Gerven J. Subjective Effects of Ethanol, Morphine, Δ(9)-Tetrahydrocannabinol, and Ketamine Following a Pharmacological Challenge Are Related to Functional Brain Connectivity. Brain Connect 2015; 5:641-8. [PMID: 26390148 DOI: 10.1089/brain.2014.0314] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This analysis examines the neuronal foundation of drug-induced psychomimetic symptoms by relating the severity of these symptoms to changes in functional connectivity for a range of different psychoactive compounds with varying degrees of psychomimetic effects. The repeated measures design included 323 resting-state functional magnetic resonance imaging time series and measures of subjective effects in 36 healthy male volunteers. Four different pharmacological challenges with ethanol, morphine, Δ(9)-tetrahydrocannabinol, and ketamine (12 subjects per drug) were applied. A set of 10 "template" resting-state networks was used to determine individual connectivity maps. Linear regression was used for each individual subject to relate these connectivity maps to three clusters of drug-induced subjective psychomimetic effects ("perception," "relaxation," and "dysphoria") as measured with visual analogue scales. Group analysis showed that the subjective effects of perception correlated significantly across drugs with the connectivity of the posterior cingulate cortex and precentral gyrus with the sensorimotor network (p < 0.005, corrected). No significant correlations were found for relaxation or dysphoria. The posterior cingulate cortex has a role in visuospatial evaluation and the precentral gyrus has been associated with auditory hallucinations. Both the posterior cingulate cortex and the precentral gyrus show changes in activation in patients with schizophrenia, which can be related to the severity of positive symptoms (i.e., hallucinations and delusions), and have previously been related to changes induced by psychoactive drugs. The similarity of functional connectivity changes for drug-induced psychomimetic effects and symptoms of psychosis provides further support for the use of pharmacological challenges with psychomimetic drugs as models for psychosis.
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Affiliation(s)
- Daniël Kleinloog
- 1 Centre for Human Drug Research , Leiden, The Netherlands .,2 Leiden Institute for Brain and Cognition , Leiden, The Netherlands .,3 Leiden University Medical Centre , Leiden, The Netherlands
| | - Serge Rombouts
- 2 Leiden Institute for Brain and Cognition , Leiden, The Netherlands .,3 Leiden University Medical Centre , Leiden, The Netherlands .,4 Institute of Psychology, Leiden University , Leiden, The Netherlands
| | - Remco Zoethout
- 1 Centre for Human Drug Research , Leiden, The Netherlands
| | - Linda Klumpers
- 1 Centre for Human Drug Research , Leiden, The Netherlands
| | | | - Najmeh Khalili-Mahani
- 2 Leiden Institute for Brain and Cognition , Leiden, The Netherlands .,3 Leiden University Medical Centre , Leiden, The Netherlands
| | - Albert Dahan
- 3 Leiden University Medical Centre , Leiden, The Netherlands
| | - Joop van Gerven
- 1 Centre for Human Drug Research , Leiden, The Netherlands .,3 Leiden University Medical Centre , Leiden, The Netherlands
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Alderson-Day B, Fernyhough C. Inner Speech: Development, Cognitive Functions, Phenomenology, and Neurobiology. Psychol Bull 2015; 141:931-65. [PMID: 26011789 PMCID: PMC4538954 DOI: 10.1037/bul0000021] [Citation(s) in RCA: 221] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 03/19/2015] [Accepted: 04/04/2015] [Indexed: 12/17/2022]
Abstract
Inner speech-also known as covert speech or verbal thinking-has been implicated in theories of cognitive development, speech monitoring, executive function, and psychopathology. Despite a growing body of knowledge on its phenomenology, development, and function, approaches to the scientific study of inner speech have remained diffuse and largely unintegrated. This review examines prominent theoretical approaches to inner speech and methodological challenges in its study, before reviewing current evidence on inner speech in children and adults from both typical and atypical populations. We conclude by considering prospects for an integrated cognitive science of inner speech, and present a multicomponent model of the phenomenon informed by developmental, cognitive, and psycholinguistic considerations. Despite its variability among individuals and across the life span, inner speech appears to perform significant functions in human cognition, which in some cases reflect its developmental origins and its sharing of resources with other cognitive processes.
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Hinzen W, Rosselló J. The linguistics of schizophrenia: thought disturbance as language pathology across positive symptoms. Front Psychol 2015; 6:971. [PMID: 26236257 PMCID: PMC4503928 DOI: 10.3389/fpsyg.2015.00971] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 06/28/2015] [Indexed: 11/13/2022] Open
Abstract
We hypothesize that linguistic (dis-)organization in the schizophrenic brain plays a more central role in the pathogenesis of this disease than commonly supposed. Against the standard view, that schizophrenia is a disturbance of thought or selfhood, we argue that the origins of the relevant forms of thought and selfhood at least partially depend on language. The view that they do not is premised by a theoretical conception of language that we here identify as 'Cartesian' and contrast with a recent 'un-Cartesian' model. This linguistic model empirically argues for both (i) a one-to-one correlation between human-specific thought or meaning and forms of grammatical organization, and (ii) an integrative and co-dependent view of linguistic cognition and its sensory-motor dimensions. Core dimensions of meaning mediated by grammar on this model specifically concern forms of referential and propositional meaning. A breakdown of these is virtually definitional of core symptoms. Within this model the three main positive symptoms of schizophrenia fall into place as failures in language-mediated forms of meaning, manifest either as a disorder of speech perception (Auditory Verbal Hallucinations), abnormal speech production running without feedback control (Formal Thought Disorder), or production of abnormal linguistic content (Delusions). Our hypothesis makes testable predictions for the language profile of schizophrenia across symptoms; it simplifies the cognitive neuropsychology of schizophrenia while not being inconsistent with a pattern of neurocognitive deficits and their correlations with symptoms; and it predicts persistent findings on disturbances of language-related circuitry in the schizophrenic brain.
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Affiliation(s)
- Wolfram Hinzen
- Institució Catalana de Recerca i Estudis AvançatsBarcelona, Spain
- Department of Philosophy, University of DurhamDurham, UK
- Department of Linguistics, Grammar & Cognition Lab, Universitat de BarcelonaBarcelona, Spain
| | - Joana Rosselló
- Department of Linguistics, Grammar & Cognition Lab, Universitat de BarcelonaBarcelona, Spain
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25
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Distinct inter-hemispheric dysconnectivity in schizophrenia patients with and without auditory verbal hallucinations. Sci Rep 2015; 5:11218. [PMID: 26053998 PMCID: PMC4459220 DOI: 10.1038/srep11218] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 05/19/2015] [Indexed: 01/26/2023] Open
Abstract
Evidence from behavioral, electrophysiological and diffusion-weighted imaging studies suggest that schizophrenia patients suffer from deficiencies in bilateral brain communication, and this disruption may be related to the occurrence of auditory verbal hallucinations (AVH). To increase our understanding of aberrant inter-hemispheric communication in relation to AVH, we recruited two groups of first-episode schizophrenia patients: one group with AVH (N = 18 AVH patients) and one without hallucinations (N = 18 Non-AVH patients), and 20 healthy controls. All participants received T1 structural imaging and resting-state fMRI scanning. We adopted a newly developed index, voxel-mirrored homotopic connectivity (VMHC), to quantitatively describe bilateral functional connectivity. The whole-brain VMHC measure was compared among the three groups and correlation analyses were conducted between symptomology scores and neurological measures. Our findings suggest all patients shared abnormalities in parahippocampus and striatum. Aberrant bilateral connectivity of default mode network (DMN), inferior frontal gyrus and cerebellum only showed in AVH patients, whereas aberrances in superior temporal gyrus and precentral gyrus were specific to Non-AVH patients. Meanwhile, inter-hemispheric connectivity of DMN correlated with patients' symptomatology scores. This study corroborates that schizophrenia is characterized by inter-hemispheric dysconnectivity, and suggests the localization of such abnormalities may be crucial to whether auditory verbal hallucinations develop.
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A setup for administering TMS to medial and lateral cortical areas during whole-brain FMRI recording. J Clin Neurophysiol 2015; 31:474-87. [PMID: 25271688 DOI: 10.1097/wnp.0000000000000075] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
SUMMARY Stimulating brain areas with transcranial magnetic stimulation (TMS) while concurrently and noninvasively recording brain activity changes through functional MRI enables a new range of investigations about causal interregional interactions in the human brain. However, standard head-coil arrangements for current methods for concurrent TMS-functional MRI somewhat restrict the cortical brain regions that can be targeted with TMS because space in typical MR head coils is limited. Another limitation for concurrent TMS-functional MRI approaches concerns the estimation of the precise stimulation site, which can limit the interpretation of the activity changes induced by TMS and increase the variability of the stimulation effects. Here, we present a novel approach using flexible MR receiver coils, allowing for stimulation of a large part of the cortex including more lateral areas. Furthermore, we present a fast and economical method to determine the precise location of the stimulation coil during scanning. This point-based registration method can accurately compute, during scanning, where TMS pulses are delivered. We validated this approach by stimulating medial (M1) and more lateral (dorsal part of the supramarginal gyrus) brain areas concurrently with functional MRI. Activation close to but not directly at the stimulated location and in distal areas connected to the targeted site was observed. This study provides a proof of concept that TMS of medial and lateral brain areas is feasible without significantly compromising brain coverage and that one can precisely determine the exact coil location inside the bore to verify targeting of brain areas.
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Affiliation(s)
- Flavie Waters
- Clinical Research Centre, Graylands Campus, North Metro Health Service Mental Health, and School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia;
| | - Renaud Jardri
- CHRU Lille, Université de Lille, Lille, France;,Group for Neural Theory, École Normale Supérieure, Paris, France
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Wu CH, Hwang TJ, Chen PJ, Chou TL, Hsu YC, Liu CM, Wang HL, Chen CM, Hua MS, Hwu HG, Tseng WYI. Reduced structural integrity and functional lateralization of the dorsal language pathway correlate with hallucinations in schizophrenia: a combined diffusion spectrum imaging and functional magnetic resonance imaging study. Psychiatry Res 2014; 224:303-10. [PMID: 25241043 DOI: 10.1016/j.pscychresns.2014.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 06/15/2014] [Accepted: 08/15/2014] [Indexed: 12/01/2022]
Abstract
Recent studies suggest that structural and functional alterations of the language network are associated with auditory verbal hallucinations (AVHs) in schizophrenia. However, the ways in which the underlying structure and function of the network are altered and how these alterations are related to each other remain unclear. To elucidate this, we used diffusion spectrum imaging (DSI) to reconstruct the dorsal and ventral pathways and employed functional magnetic resonance imaging (fMRI) in a semantic task to obtain information about the functional activation in the corresponding regions in 18 patients with schizophrenia and 18 matched controls. The results demonstrated decreased structural integrity in the left ventral, right ventral and right dorsal tracts, and decreased functional lateralization of the dorsal pathway in schizophrenia. There was a positive correlation between the microstructural integrity of the right dorsal pathway and the functional lateralization of the dorsal pathway in patients with schizophrenia. Additionally, both functional lateralization of the dorsal pathway and microstructural integrity of the right dorsal pathway were negatively correlated with the scores of the delusion/hallucination symptom dimension. Our results suggest that impaired structural integrity of the right dorsal pathway is related to the reduction of functional lateralization of the dorsal pathway, and these alterations may aggravate AVHs in schizophrenia.
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Affiliation(s)
- Chen-Hao Wu
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Center for Optoelectronic Biomedicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pin-Jane Chen
- Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Tai-Li Chou
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychology, National Taiwan University, Taipei, Taiwan.
| | - Yung-Chin Hsu
- Center for Optoelectronic Biomedicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsiao-Lan Wang
- Center for Optoelectronic Biomedicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chung-Ming Chen
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Mau-Sun Hua
- Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Hai-Gwo Hwu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wen-Yih Isaac Tseng
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Center for Optoelectronic Biomedicine, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
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29
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Johns LC, Kompus K, Connell M, Humpston C, Lincoln TM, Longden E, Preti A, Alderson-Day B, Badcock JC, Cella M, Fernyhough C, McCarthy-Jones S, Peters E, Raballo A, Scott J, Siddi S, Sommer IE, Larøi F. Auditory verbal hallucinations in persons with and without a need for care. Schizophr Bull 2014; 40 Suppl 4:S255-64. [PMID: 24936085 PMCID: PMC4141313 DOI: 10.1093/schbul/sbu005] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Auditory verbal hallucinations (AVH) are complex experiences that occur in the context of various clinical disorders. AVH also occur in individuals from the general population who have no identifiable psychiatric or neurological diagnoses. This article reviews research on AVH in nonclinical individuals and provides a cross-disciplinary view of the clinical relevance of these experiences in defining the risk of mental illness and need for care. Prevalence rates of AVH vary according to measurement tool and indicate a continuum of experience in the general population. Cross-sectional comparisons of individuals with AVH with and without need for care reveal similarities in phenomenology and some underlying mechanisms but also highlight key differences in emotional valence of AVH, appraisals, and behavioral response. Longitudinal studies suggest that AVH are an antecedent of clinical disorders when combined with negative emotional states, specific cognitive difficulties and poor coping, plus family history of psychosis, and environmental exposures such as childhood adversity. However, their predictive value for specific psychiatric disorders is not entirely clear. The theoretical and clinical implications of the reviewed findings are discussed, together with directions for future research.
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Affiliation(s)
- Louise C. Johns
- King’s College London, Institute of Psychiatry, Department of Psychology, London, UK;,South London and Maudsley NHS Foundation Trust, London, UK
| | - Kristiina Kompus
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway;
| | - Melissa Connell
- The University of Queensland Centre for Clinical Research, Metro North Mental Health, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Clara Humpston
- King’s College London, Institute of Psychiatry, Department of Psychosis Studies, London, UK
| | | | - Eleanor Longden
- Institute of Psychological Sciences, University of Leeds, Leeds, UK
| | - Antonio Preti
- Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | | | - Johanna C. Badcock
- School of Psychology, University of Western Australia, Crawley, Australia
| | - Matteo Cella
- King’s College London, Institute of Psychiatry, Department of Psychology, London, UK;,National Institute for Health Research (NIHR), Biomedical Research Centre for Mental Health at South London and Maudsley, NHS Foundation Trust, London, UK
| | | | - Simon McCarthy-Jones
- ARC Centre of Excellence in Cognition and Its Disorders, Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Emmanuelle Peters
- King’s College London, Institute of Psychiatry, Department of Psychology, London, UK;,National Institute for Health Research (NIHR), Biomedical Research Centre for Mental Health at South London and Maudsley, NHS Foundation Trust, London, UK
| | - Andrea Raballo
- Department of Mental Health and Pathological Addiction, AUSL Reggio Emilia, Reggio Emilia, Italy
| | - James Scott
- The University of Queensland Centre for Clinical Research, Metro North Mental Health, Royal Brisbane and Women’s Hospital, Brisbane, Australia
| | - Sara Siddi
- Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Iris E. Sommer
- Psychiatry Department, University of Utrecht, Utrecht, The Netherlands
| | - Frank Larøi
- Department of Psychology, University of Liège, Liège, Belgium
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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] [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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31
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Shifted coupling of EEG driving frequencies and fMRI resting state networks in schizophrenia spectrum disorders. PLoS One 2013; 8:e76604. [PMID: 24124576 PMCID: PMC3790692 DOI: 10.1371/journal.pone.0076604] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 08/26/2013] [Indexed: 01/05/2023] Open
Abstract
Introduction The cerebral resting state in schizophrenia is altered, as has been demonstrated separately by electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) resting state networks (RSNs). Previous simultaneous EEG/fMRI findings in healthy controls suggest that a consistent spatiotemporal coupling between neural oscillations (EEG frequency correlates) and RSN activity is necessary to organize cognitive processes optimally. We hypothesized that this coupling is disorganized in schizophrenia and related psychotic disorders, in particular regarding higher cognitive RSNs such as the default-mode (DMN) and left-working-memory network (LWMN). Methods Resting state was investigated in eleven patients with a schizophrenia spectrum disorder (n = 11) and matched healthy controls (n = 11) using simultaneous EEG/fMRI. The temporal association of each RSN to topographic spectral changes in the EEG was assessed by creating Covariance Maps. Group differences within, and group similarities across frequencies were estimated for the Covariance Maps. Results The coupling of EEG frequency bands to the DMN and the LWMN respectively, displayed significant similarities that were shifted towards lower EEG frequencies in patients compared to healthy controls. Conclusions By combining EEG and fMRI, each measuring different properties of the same pathophysiology, an aberrant relationship between EEG frequencies and altered RSNs was observed in patients. RSNs of patients were related to lower EEG frequencies, indicating functional alterations of the spatiotemporal coupling. Significance The finding of a deviant and shifted coupling between RSNs and related EEG frequencies in patients with a schizophrenia spectrum disorder is significant, as it might indicate how failures in the processing of internal and external stimuli, as commonly seen during this symptomatology (i.e. thought disorders, hallucinations), arise.
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32
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Daalman K, Diederen KM. A final common pathway to hearing voices: examining differences and similarities in clinical and non-clinical individuals. PSYCHOSIS 2013. [DOI: 10.1080/17522439.2013.796402] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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33
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Diederen KMJ, Neggers SFW, de Weijer AD, van Lutterveld R, Daalman K, Eickhoff SB, Clos M, Kahn RS, Sommer IEC. Aberrant resting-state connectivity in non-psychotic individuals with auditory hallucinations. Psychol Med 2013; 43:1685-1696. [PMID: 23199762 DOI: 10.1017/s0033291712002541] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although auditory verbal hallucinations (AVH) are a core symptom of schizophrenia, they also occur in non-psychotic individuals, in the absence of other psychotic, affective, cognitive and negative symptoms. AVH have been hypothesized to result from deviant integration of inferior frontal, parahippocampal and superior temporal brain areas. However, a direct link between dysfunctional connectivity and AVH has not yet been established. To determine whether hallucinations are indeed related to aberrant connectivity, AVH should be studied in isolation, for example in non-psychotic individuals with AVH. METHOD Resting-state connectivity was investigated in 25 non-psychotic subjects with AVH and 25 matched control subjects using seed regression analysis with the (1) left and (2) right inferior frontal, (3) left and (4) right superior temporal and (5) left parahippocampal areas as the seed regions. To correct for cardiorespiratory (CR) pulsatility rhythms in the functional magnetic resonance imaging (fMRI) data, heartbeat and respiration were monitored during scanning and the fMRI data were corrected for these rhythms using the image-based method for retrospective correction of physiological motion effects RETROICOR. RESULTS In comparison with the control group, non-psychotic individuals with AVH showed increased connectivity between the left and the right superior temporal regions and also between the left parahippocampal region and the left inferior frontal gyrus. Moreover, this group did not show a negative correlation between the left superior temporal region and the right inferior frontal region, as was observed in the healthy control group. CONCLUSIONS Aberrant connectivity of frontal, parahippocampal and superior temporal brain areas can be specifically related to the predisposition to hallucinate in the auditory domain.
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Affiliation(s)
- K M J Diederen
- Neuroscience Division, University Medical Centre Utrecht and Rudolf Magnus Institute for Neuroscience, Utrecht, The Netherlands.
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34
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de Leede-Smith S, Barkus E. A comprehensive review of auditory verbal hallucinations: lifetime prevalence, correlates and mechanisms in healthy and clinical individuals. Front Hum Neurosci 2013; 7:367. [PMID: 23882203 PMCID: PMC3712258 DOI: 10.3389/fnhum.2013.00367] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 06/25/2013] [Indexed: 12/27/2022] Open
Abstract
Over the years, the prevalence of auditory verbal hallucinations (AVHs) have been documented across the lifespan in varied contexts, and with a range of potential long-term outcomes. Initially the emphasis focused on whether AVHs conferred risk for psychosis. However, recent research has identified significant differences in the presentation and outcomes of AVH in patients compared to those in non-clinical populations. For this reason, it has been suggested that auditory hallucinations are an entity by themselves and not necessarily indicative of transition along the psychosis continuum. This review will examine the presentation of auditory hallucinations across the life span, as well as in various clinical groups. The stages described include childhood, adolescence, adult non-clinical populations, hypnagogic/hypnopompic experiences, high schizotypal traits, schizophrenia, substance induced AVH, AVH in epilepsy, and AVH in the elderly. In children, need for care depends upon whether the child associates the voice with negative beliefs, appraisals and other symptoms of psychosis. This theme appears to carry right through to healthy voice hearers in adulthood, in which a negative impact of the voice usually only exists if the individual has negative experiences as a result of their voice(s). This includes features of the voices such as the negative content, frequency, and emotional valence as well as anxiety and depression, independently or caused by voices presence. It seems possible that the mechanisms which maintain AVH in non-clinical populations are different from those which are behind AVH presentations in psychotic illness. For example, the existence of maladaptive coping strategies in patient populations is one significant difference between clinical and non-clinical groups which is associated with a need for care. Whether or not these mechanisms start out the same and have differential trajectories is not yet evidenced. Future research needs to focus on the comparison of underlying factors and mechanisms that lead to the onset of AVH in both patient and non-clinical populations.
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35
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Palaniyappan L, Crow TJ, Hough M, Voets NL, Liddle PF, James S, Winmill L, James AC. Gyrification of Broca's region is anomalously lateralized at onset of schizophrenia in adolescence and regresses at 2 year follow-up. Schizophr Res 2013; 147:39-45. [PMID: 23602598 DOI: 10.1016/j.schres.2013.03.028] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Revised: 03/18/2013] [Accepted: 03/21/2013] [Indexed: 01/27/2023]
Abstract
Gyrification of the human cerebral cortex starts in the foetus and progresses in early infancy; the pattern of folding in later life provides a lead to early developmental aberration. By studying gyrification at illness onset in adolescence we hoped to clarify the pathophysiology of schizophrenia. Here we find 1) an area of hypergyria includes Broca's area and extends into the Sylvian fissure to encroach on the anterior insula in the left hemisphere, and 2) an area of hypogyria in the superior temporal lobe approximates to Wernicke's area but is located in the right hemisphere and encroaches on the posterior insula. In Broca's/anterior insula area, right lateralization was present in healthy controls but patients were left lateralized: at two year follow-up gyrification had decreased in patients while it increased in controls, and the reduction predicted impaired category fluency. Progressive change was unaccompanied by cortical thinning (investigated only in the brain regions showing baseline changes in gyrification) indicating that the disease process affecting these brain regions (insula, inferior frontal and superior temporal) is not primarily degenerative. A deviation in the lateralized development of peri-Sylvian areas for language production and comprehension appears critical to the pathophysiology of schizophrenia and may point to its species-specific origin.
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Affiliation(s)
- L Palaniyappan
- Division of Psychiatry, Institute of Mental Health, University of Nottingham, Nottingham NG7 2TU, UK; Nottinghamshire Healthcare NHS Trust, Nottingham, UK.
| | - T J Crow
- SANE-POWIC, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK
| | - M Hough
- Smith-Kettlewell Eye Research Institute, San Francisco, CA 94114, United States
| | - N L Voets
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, OX3 9DU UK
| | - P F Liddle
- Division of Psychiatry, Institute of Mental Health, University of Nottingham, Nottingham NG7 2TU, UK
| | - S James
- Highfield Adolescent Unit, Warneford Hospital, Oxford OX3 7JX, UK
| | - L Winmill
- Highfield Adolescent Unit, Warneford Hospital, Oxford OX3 7JX, UK
| | - A C James
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
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Kompus K, Falkenberg LE, Bless JJ, Johnsen E, Kroken RA, Kråkvik B, Larøi F, Løberg EM, Vedul-Kjelsås E, Westerhausen R, Hugdahl K. The role of the primary auditory cortex in the neural mechanism of auditory verbal hallucinations. Front Hum Neurosci 2013. [PMID: 23630479 DOI: 10.3389/fnhum.2013.0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Auditory verbal hallucinations (AVHs) are a subjective experience of "hearing voices" in the absence of corresponding physical stimulation in the environment. The most remarkable feature of AVHs is their perceptual quality, that is, the experience is subjectively often as vivid as hearing an actual voice, as opposed to mental imagery or auditory memories. This has lead to propositions that dysregulation of the primary auditory cortex (PAC) is a crucial component of the neural mechanism of AVHs. One possible mechanism by which the PAC could give rise to the experience of hallucinations is aberrant patterns of neuronal activity whereby the PAC is overly sensitive to activation arising from internal processing, while being less responsive to external stimulation. In this paper, we review recent research relevant to the role of the PAC in the generation of AVHs. We present new data from a functional magnetic resonance imaging (fMRI) study, examining the responsivity of the left and right PAC to parametrical modulation of the intensity of auditory verbal stimulation, and corresponding attentional top-down control in non-clinical participants with AVHs, and non-clinical participants with no AVHs. Non-clinical hallucinators showed reduced activation to speech sounds but intact attentional modulation in the right PAC. Additionally, we present data from a group of schizophrenia patients with AVHs, who do not show attentional modulation of left or right PAC. The context-appropriate modulation of the PAC may be a protective factor in non-clinical hallucinations.
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Affiliation(s)
- Kristiina Kompus
- Department of Biological and Medical Psychology, University of Bergen Bergen, Norway
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37
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Kompus K, Falkenberg LE, Bless JJ, Johnsen E, Kroken RA, Kråkvik B, Larøi F, Løberg EM, Vedul-Kjelsås E, Westerhausen R, Hugdahl K. The role of the primary auditory cortex in the neural mechanism of auditory verbal hallucinations. Front Hum Neurosci 2013; 7:144. [PMID: 23630479 PMCID: PMC3633947 DOI: 10.3389/fnhum.2013.00144] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 04/02/2013] [Indexed: 12/21/2022] Open
Abstract
Auditory verbal hallucinations (AVHs) are a subjective experience of “hearing voices” in the absence of corresponding physical stimulation in the environment. The most remarkable feature of AVHs is their perceptual quality, that is, the experience is subjectively often as vivid as hearing an actual voice, as opposed to mental imagery or auditory memories. This has lead to propositions that dysregulation of the primary auditory cortex (PAC) is a crucial component of the neural mechanism of AVHs. One possible mechanism by which the PAC could give rise to the experience of hallucinations is aberrant patterns of neuronal activity whereby the PAC is overly sensitive to activation arising from internal processing, while being less responsive to external stimulation. In this paper, we review recent research relevant to the role of the PAC in the generation of AVHs. We present new data from a functional magnetic resonance imaging (fMRI) study, examining the responsivity of the left and right PAC to parametrical modulation of the intensity of auditory verbal stimulation, and corresponding attentional top-down control in non-clinical participants with AVHs, and non-clinical participants with no AVHs. Non-clinical hallucinators showed reduced activation to speech sounds but intact attentional modulation in the right PAC. Additionally, we present data from a group of schizophrenia patients with AVHs, who do not show attentional modulation of left or right PAC. The context-appropriate modulation of the PAC may be a protective factor in non-clinical hallucinations.
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Affiliation(s)
- Kristiina Kompus
- Department of Biological and Medical Psychology, University of Bergen Bergen, Norway
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38
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Auditory hallucinations and reduced language lateralization in schizophrenia: a meta-analysis of dichotic listening studies. J Int Neuropsychol Soc 2013; 19:410-8. [PMID: 23332000 DOI: 10.1017/s1355617712001476] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Reduced left-hemispheric language lateralization has been proposed to be a trait marker for schizophrenia, but the empirical evidence is ambiguous. Recent studies suggest that auditory hallucinations are critical for whether a patient shows reduced language lateralization. Therefore, the aim of the study was to statistically integrate studies investigating language lateralization in schizophrenia patients using dichotic listening. To this end, two meta-analyses were conducted, one comparing schizophrenia patients with healthy controls (n = 1407), the other comparing schizophrenia patients experiencing auditory hallucinations with non-hallucinating controls (n = 407). Schizophrenia patients showed weaker language lateralization than healthy controls but the effect size was small (g = -0.26). When patients with auditory hallucinations were compared to non-hallucinating controls, the effect size was substantially larger (g = -0.45). These effect sizes suggest that reduced language lateralization is a weak trait marker for schizophrenia as such and a strong trait marker for the experience of auditory hallucinations within the schizophrenia population.
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39
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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] [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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Clos M, Diederen KMJ, Meijering AL, Sommer IE, Eickhoff SB. Aberrant connectivity of areas for decoding degraded speech in patients with auditory verbal hallucinations. Brain Struct Funct 2013; 219:581-94. [PMID: 23423461 DOI: 10.1007/s00429-013-0519-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 02/02/2013] [Indexed: 10/27/2022]
Abstract
Auditory verbal hallucinations (AVH) are a hallmark of psychotic experience. Various mechanisms including misattribution of inner speech and imbalance between bottom-up and top-down factors in auditory perception potentially due to aberrant connectivity between frontal and temporo-parietal areas have been suggested to underlie AVH. Experimental evidence for disturbed connectivity of networks sustaining auditory-verbal processing is, however, sparse. We compared functional resting-state connectivity in 49 psychotic patients with frequent AVH and 49 matched controls. The analysis was seeded from the left middle temporal gyrus (MTG), thalamus, angular gyrus (AG) and inferior frontal gyrus (IFG) as these regions are implicated in extracting meaning from impoverished speech-like sounds. Aberrant connectivity was found for all seeds. Decreased connectivity was observed between the left MTG and its right homotope, between the left AG and the surrounding inferior parietal cortex (IPC) and the left inferior temporal gyrus, between the left thalamus and the right cerebellum, as well as between the left IFG and left IPC, and dorsolateral and ventrolateral prefrontal cortex (DLPFC/VLPFC). Increased connectivity was observed between the left IFG and the supplementary motor area (SMA) and the left insula and between the left thalamus and the left fusiform gyrus/hippocampus. The predisposition to experience AVH might result from decoupling between the speech production system (IFG, insula and SMA) and the self-monitoring system (DLPFC, VLPFC, IPC) leading to misattribution of inner speech. Furthermore, decreased connectivity between nodes involved in speech processing (AG, MTG) and other regions implicated in auditory processing might reflect aberrant top-down influences in AVH.
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Affiliation(s)
- Mareike Clos
- Institute of Neuroscience and Medicine (INM-1, INM-2), Research Centre Jülich, 52425, Jülich, Germany,
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Daalman K, Diederen KMJ, Derks EM, van Lutterveld R, Kahn RS, Sommer IEC. Childhood trauma and auditory verbal hallucinations. Psychol Med 2012; 42:2475-2484. [PMID: 22716897 DOI: 10.1017/s0033291712000761] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Hallucinations have consistently been associated with traumatic experiences during childhood. This association appears strongest between physical and sexual abuse and auditory verbal hallucinations (AVH). It remains unclear whether traumatic experiences mainly colour the content of AVH or whether childhood trauma triggers the vulnerability to experience hallucinations in general. In order to investigate the association between hallucinations, childhood trauma and the emotional content of hallucinations, experienced trauma and phenomenology of AVH were investigated in non-psychotic individuals and in patients with a psychotic disorder who hear voices. METHOD A total of 127 non-psychotic individuals with frequent AVH, 124 healthy controls and 100 psychotic patients with AVH were assessed for childhood trauma. Prevalence of childhood trauma was compared between groups and the relation between characteristics of voices, especially emotional valence of content, and childhood trauma was investigated. RESULTS Both non-psychotic individuals with AVH and patients with a psychotic disorder and AVH experienced more sexual and emotional abuse compared with the healthy controls. No difference in the prevalence of traumatic experiences could be observed between the two groups experiencing AVH. In addition, no type of childhood trauma could distinguish between positive or negative emotional valence of the voices and associated distress. No correlations were found between sexual abuse and emotional abuse and other AVH characteristics. CONCLUSIONS These results suggest that sexual and emotional trauma during childhood render a person more vulnerable to experience AVH in general, which can be either positive voices without associated distress or negative voices as part of a psychotic disorder.
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Affiliation(s)
- K Daalman
- Department of Psychiatry, Neuroscience Division, University Medical Center Utrecht and Rudolf Magnus Institute for Neuroscience, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
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Diederen KMJ, Daalman K, de Weijer AD, Neggers SFW, van Gastel W, Blom JD, Kahn RS, Sommer IEC. Auditory hallucinations elicit similar brain activation in psychotic and nonpsychotic individuals. Schizophr Bull 2012; 38:1074-82. [PMID: 21527413 PMCID: PMC3446229 DOI: 10.1093/schbul/sbr033] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
While auditory verbal hallucinations (AVH) are most characteristic for schizophrenia, they also occur in nonpsychotic individuals in the absence of a psychiatric or neurological disorder and in the absence of substance abuse. At present, it is unclear if AVH in these nonpsychotic individuals constitute the same phenomenon as AVH in psychotic patients. Comparing brain activation during AVH between nonpsychotic and psychotic individuals could provide important clues regarding this question. 21 nonpsychotic subjects with AVH and 21 matched psychotic patients indicated the presence of AVH during 3T functional magnetic resonance imaging (fMRI) scanning. To identify common areas of activation during the experience of AVH in both groups, a conjunction analysis was performed. In addition, a 2-sample t-test was employed to discover possible differences in AVH-related activation between the groups. Several common areas of activation were observed for the psychotic and nonpsychotic subjects during the experience of AVH, consisting of the bilateral inferior frontal gyri, insula, superior temporal gyri, supramarginal gyri and postcentral gyri, left precentral gyrus, inferior parietal lobule, superior temporal pole, and right cerebellum. No significant differences in AVH-related brain activation were present between the groups. The presence of multiple common areas of AVH-related activation in psychotic and nonpsychotic individuals, in the absence of significant differences, implicates the involvement of the same cortical network in the experience of AVH in both groups.
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Affiliation(s)
- Kelly M. J. Diederen
- Department of Psychiatry, Neuroscience Division, Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht, B01.206, Heidelberglaan 100, 3584 CX, The Netherlands,To whom correspondence should be addressed; tel: +31887556370, fax: +31887555509, e-mail:
| | - Kirstin Daalman
- Department of Psychiatry, Neuroscience Division, Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht, B01.206, Heidelberglaan 100, 3584 CX, The Netherlands
| | - Antoin D. de Weijer
- Department of Psychiatry, Neuroscience Division, Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht, B01.206, Heidelberglaan 100, 3584 CX, The Netherlands
| | - Sebastiaan F. W. Neggers
- Department of Psychiatry, Neuroscience Division, Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht, B01.206, Heidelberglaan 100, 3584 CX, The Netherlands
| | - Willemijn van Gastel
- Department of Psychiatry, Neuroscience Division, Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht, B01.206, Heidelberglaan 100, 3584 CX, The Netherlands
| | - Jan Dirk Blom
- Parnassia Bavo Group, The Hague, The Netherlands,Department of Psychiatry, University of Groningen, Groningen, The Netherlands
| | - René S. Kahn
- Department of Psychiatry, Neuroscience Division, Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht, B01.206, Heidelberglaan 100, 3584 CX, The Netherlands
| | - Iris E. C. Sommer
- Department of Psychiatry, Neuroscience Division, Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht, B01.206, Heidelberglaan 100, 3584 CX, The Netherlands
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Daalman K, Verkooijen S, Derks EM, Aleman A, Sommer IEC. The influence of semantic top-down processing in auditory verbal hallucinations. Schizophr Res 2012; 139:82-6. [PMID: 22727455 DOI: 10.1016/j.schres.2012.06.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 05/08/2012] [Accepted: 06/04/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Auditory verbal hallucinations (AVH) are one of the most prominent symptoms of schizophrenia but have also been reported in the general population. Several cognitive models have tried to elucidate the mechanism behind auditory verbal hallucinations, among which a top-down model. According to this model, perception is biased towards top-down information (e.g., expectations), reducing the influence of bottom-up information coming from the sense organs. This bias predisposes to false perceptions, i.e., hallucinations. METHODS The current study investigated this hypothesis in non-psychotic individuals with frequent AVH, psychotic patients with AVH and healthy control subjects by applying a semantic top-down task. In this task, top-down processes are manipulated through the semantic context of a sentence. In addition, the association between hallucination proneness and semantic top-down errors was investigated. RESULTS Non-psychotic individuals with AVH made significantly more top-down errors compared to healthy controls, while overall accuracy was similar. The number of top-down errors, corrected for overall accuracy, in the patient group was in between those of the other two groups and did not differ significantly from either the non-psychotic individuals with AVH or the healthy controls. The severity of hallucination proneness correlated with the number of top-down errors. DISCUSSION These findings confirm that non-psychotic individuals with AVH are stronger influenced by top-down processing (i.e., perceptual expectations) than healthy controls. In contrast, our data suggest that in psychotic patients semantic expectations do not play a role in the etiology of AVH. This finding may point towards different cognitive mechanisms for pathological and nonpathological hallucinations.
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Affiliation(s)
- Kirstin Daalman
- Department of Psychiatry, Neuroscience Division, University Medical Center Utrecht & Rudolf Magnus Institute for Neuroscience, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
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Allen P, Modinos G, Hubl D, Shields G, Cachia A, Jardri R, Thomas P, Woodward T, Shotbolt P, Plaze M, Hoffman R. Neuroimaging auditory hallucinations in schizophrenia: from neuroanatomy to neurochemistry and beyond. Schizophr Bull 2012; 38:695-703. [PMID: 22535906 PMCID: PMC3406523 DOI: 10.1093/schbul/sbs066] [Citation(s) in RCA: 163] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Despite more than 2 decades of neuroimaging investigations, there is currently insufficient evidence to fully understand the neurobiological substrate of auditory hallucinations (AH). However, some progress has been made with imaging studies in patients with AH consistently reporting altered structure and function in speech and language, sensory, and nonsensory regions. This report provides an update of neuroimaging studies of AH with a particular emphasis on more recent anatomical, physiological, and neurochemical imaging studies. Specifically, we provide (1) a review of findings in schizophrenia and nonschizophrenia voice hearers, (2) a discussion regarding key issues that have interfered with progress, and (3) practical recommendations for future studies.
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Affiliation(s)
- Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, King's College, DeCrespigny Park, London SE5 8AF, UK.
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, King's College, DeCrespigny Park, London SE5 8AF, UK
| | - Daniela Hubl
- University Hospital of Psychiatry, Bern, Switzerland
| | - Gregory Shields
- Department of Psychological Medicine, Institute of Psychiatry, King’s College, London, UK
| | - Arnaud Cachia
- UMR INSERM 894, Centre de Psychiatrie & Neurosciences, Centre Hospitalier Sainte-Anne & UMR CNRS 6232, Groupe d'imagerie neurofonctionnelle du développement, Sorbonne Université Paris Descartes, France
| | - Renaud Jardri
- Psychiatry Department, University Medical Centre of Lille, Lille North of France University, Lille, France
| | - Pierre Thomas
- Psychiatry Department, University Medical Centre of Lille, Lille North of France University, Lille, France
| | - Todd Woodward
- Department of Psychiatry, University of British Columbia BC Mental Health and Addiction Research Institute, Vancouver, Canada
| | - Paul Shotbolt
- Department of Psychological Medicine, Institute of Psychiatry, King’s College, London, UK
| | - Marion Plaze
- Service Hospitalo-Universitaire & UMR INSERM 894, Centre de Psychiatrie & Neurosciences, Centre Hospitalier Sainte-Anne; Université Paris Descartes, France
| | - Ralph Hoffman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
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Diederen KMJ, van Lutterveld R, Sommer IEC. Neuroimaging of voice hearing in non-psychotic individuals: a mini review. Front Hum Neurosci 2012; 6:111. [PMID: 22582042 PMCID: PMC3348719 DOI: 10.3389/fnhum.2012.00111] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Accepted: 04/12/2012] [Indexed: 11/23/2022] Open
Abstract
Auditory verbal hallucinations (AVH) or “voices” are a characteristic symptom of schizophrenia, but can also be observed in healthy individuals in the general population. As these non-psychotic individuals experience AVH in the absence of other psychiatric symptoms and medication-use they provide an excellent model to study AVH in isolation. Indeed a number of studies used this approach and investigated brain structure and function in non-psychotic individuals with AVH. These studies showed that increased sensitivity of auditory areas to auditory stimulation and aberrant connectivity of language production and perception areas is associated with AVH. This is in concordance with investigations that observed prominent activation of these areas during the state of AVH. Moreover, while effortful attention appears not to be related to AVH, individuals prone to hallucinate seem to have an enhanced attention bias to auditory stimuli which may stem from aberrant activation of the anterior cingulated regions. Furthermore, it was observed that decreased cerebral dominance for language and dopamine dysfunction, which are consistently found in schizophrenia, are most likely not specifically related to AVH as these abnormalities were absent in healthy voice hearers. Finally, specific aspects of AVH such as voluntary control may be related to the timing of the supplementary motor area and language areas in the experience of AVH.
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Affiliation(s)
- Kelly Maria Johanna Diederen
- Neuroscience Division, Rudolf Magnus Institute for Neuroscience, University Medical Center Utrecht Utrecht, Netherlands
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Liemburg EJ, Vercammen A, Ter Horst GJ, Curcic-Blake B, Knegtering H, Aleman A. Abnormal connectivity between attentional, language and auditory networks in schizophrenia. Schizophr Res 2012; 135:15-22. [PMID: 22226903 DOI: 10.1016/j.schres.2011.12.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 11/22/2011] [Accepted: 12/12/2011] [Indexed: 01/08/2023]
Abstract
Brain circuits involved in language processing have been suggested to be compromised in patients with schizophrenia. This does not only include regions subserving language production and perception, but also auditory processing and attention. We investigated resting state network connectivity of auditory, language and attention networks of patients with schizophrenia and hypothesized that patients would show reduced connectivity. Patients with schizophrenia (n = 45) and healthy controls (n = 30) underwent a resting state fMRI scan. Independent components analysis was used to identify networks of the auditory cortex, left inferior frontal language regions and the anterior cingulate region, associated with attention. The time courses of the components where correlated with each other, the correlations were transformed by a Fisher's Z transformation, and compared between groups. In patients with schizophrenia, we observed decreased connectivity between the auditory and language networks. Conversely, patients showed increased connectivity between the attention and language network compared to controls. There was no relationship with severity of symptoms such as auditory hallucinations. The decreased connectivity between auditory and language processing areas observed in schizophrenia patients is consistent with earlier research and may underlie language processing difficulties. Altered anterior cingulate connectivity in patients may be a correlate of habitual suppression of unintended speech, or of excessive attention to internally generated speech. This altered connectivity pattern appears to be present independent of symptom severity, and may be suggestive of a trait, rather than a state characteristic.
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Affiliation(s)
- Edith J Liemburg
- Department of Neuroscience, University Medical Center Groningen, & BCN NeuroImaging Center, University of Groningen, Antonius Deusinglaan 2, 9713 AW Groningen, The Netherlands.
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Butler T, Weisholtz D, Isenberg N, Harding E, Epstein J, Stern E, Silbersweig D. Neuroimaging of frontal-limbic dysfunction in schizophrenia and epilepsy-related psychosis: toward a convergent neurobiology. Epilepsy Behav 2012; 23:113-22. [PMID: 22209327 PMCID: PMC3339259 DOI: 10.1016/j.yebeh.2011.11.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 09/28/2011] [Accepted: 11/06/2011] [Indexed: 12/27/2022]
Abstract
Psychosis is a devastating, prevalent condition considered to involve dysfunction of frontal and medial temporal limbic brain regions as key nodes in distributed brain networks involved in emotional regulation. The psychoses of epilepsy represent an important, though understudied, model relevant to understanding the pathophysiology of psychosis in general. In this review, we (1) discuss the classification of epilepsy-related psychoses and relevant neuroimaging and other studies; (2) review structural and functional neuroimaging studies of schizophrenia focusing on evidence of frontal-limbic dysfunction; (3) report our laboratory's PET, fMRI, and electrophysiological findings; (4) describe a theoretical framework in which frontal hypoactivity and intermittent medial temporal hyperactivity play a critical role in the etiopathology of psychosis both associated and unassociated with epilepsy; and (5) suggest avenues for future research.
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Affiliation(s)
- Tracy Butler
- NYU Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York, NY, USA.
| | - Daniel Weisholtz
- Functional Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Nancy Isenberg
- Division of Behavioral Neurology, New Jersey Neuroscience Institute, Edison, NJ
| | - Elizabeth Harding
- Functional Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Jane Epstein
- Functional Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Emily Stern
- Functional Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - David Silbersweig
- Functional Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Badcock JC, Hugdahl K. Cognitive mechanisms of auditory verbal hallucinations in psychotic and non-psychotic groups. Neurosci Biobehav Rev 2011; 36:431-8. [PMID: 21827786 DOI: 10.1016/j.neubiorev.2011.07.010] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 07/07/2011] [Accepted: 07/23/2011] [Indexed: 12/29/2022]
Abstract
The continuum model of psychosis has been extremely influential. It assumes that psychotic symptoms, such as auditory verbal hallucinations (AVH), are not limited to patients with psychosis but also occur in healthy, non-clinical individuals - suggesting similar mechanisms of origin. Recent debate surrounding this model has highlighted certain differences, as well as similarities, in the phenomenology of AVH in clinical and non-clinical populations. These findings imply that there may, in fact, be only partial overlap of the mechanism(s) involved in generating AVH in these groups. We review evidence of continuity or similarity, and dissimilarity, in cognitive, and related neural processes, underlying AVH in clinical and non-clinical samples. The results reveal some shared (intrusive cognitions, inhibitory deficits) and some distinct (aspects of source memory and cerebral lateralization) mechanisms in these groups. The evidence, therefore, supports both continuous and categorical models of positive psychotic symptoms. The review considers potential risks of uncritical acceptance of the continuum model and highlights some important methodological issues for future research.
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Affiliation(s)
- Johanna C Badcock
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
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