Neurobiology of Auditory Hallucinations

2019 ◽  
Author(s):  
Judith M. Ford ◽  
Holly K. Hamilton ◽  
Alison Boos
Keyword(s):  
Help Seeking ◽  
Treatment Approach ◽  
Neural Mechanisms ◽  
Hearing Voices ◽  
Auditory Verbal Hallucinations ◽  
Self And Other ◽  
Neurological Conditions ◽  
Language Areas ◽  
The Voice ◽  
The Brain

Auditory verbal hallucinations (AVH), also referred to as “hearing voices,” are vivid perceptions of speech that occur in the absence of any corresponding external stimulus but seem very real to the voice hearer. They are experienced by the majority of people with schizophrenia, less frequently in other psychiatric and neurological conditions, and are relatively rare in the general population. Because antipsychotic medications are not always successful in reducing the severity or frequency of AVH, a better understanding is needed of their neurobiological basis, which may ultimately lead to more precise treatment targets. What voices say and how the voices sound, or their phenomenology, varies widely within and across groups of people who hear them. In help-seeking populations, such as people with schizophrenia, the voices tend to be threatening and menacing, typically spoken in a non-self-voice, often commenting and sometimes commanding the voice hearers to do things they would not otherwise do. In psychotic populations, voices differ from normal inner speech by being unbidden and unintended, co-opting the voice hearer’s attention. In healthy voice-hearing populations, voices are not typically distressing nor disabling, and are sometimes comforting and reassuring. Regardless of content and valence, voices tend to activate some speech and language areas of the brain. Efforts to silence these brain areas with neurostimulation have had mixed success in reducing the frequency and salience of voices. Progress with this treatment approach would likely benefit from more precise anatomical targets and more precisely dosed neurostimulation. Neural mechanisms that may underpin the experience of voices are being actively investigated and include mechanisms enabling context-based predictions and distinctions between experiences coming from self and other. Both these mechanisms can be studied in non-human animal “models” and both can provide new anatomical targets for neurostimulation.

Listening to the Voices People Hear: Auditory Hallucinations Beyond a Diagnostic Framework

2017 ◽  
Vol 57 (6) ◽  
pp. 573-601 ◽  
Author(s):  
Eleanor Longden
Keyword(s):  
Environmental Stressors ◽  
Auditory Hallucinations ◽  
Hearing Voices ◽  
Auditory Verbal Hallucinations ◽  
Clinical Diagnoses ◽  
History Of ◽  
Different Populations ◽  
Diagnostic Framework ◽  
The Impact ◽  
The Voice

While voice hearing (auditory verbal hallucinations) is closely allied with psychosis/schizophrenia, it is well-established that the experience is reported by individuals with nonpsychotic diagnoses, as well as those with no history of psychiatric contact. The phenomenological similarities in voice hearing within these different populations, as well as increased recognition of associations between adversity exposure and voice presence/content, have helped strengthened the contention that voice hearing may be more reliably associated with psychosocial variables per se rather than specific clinical diagnoses. Evidence is examined for understanding voice hearing as a psychological response to environmental stressors, and the implications of this for clinical practice. Consideration is also given to the impact of the International Hearing Voices Movement, an influential survivor-led initiative that promotes person-centered, nondiagnostic approaches to the voice-hearing experience.

scholarly journals M140. WHAT HAPPENS IN THE BRAIN A FEW SECONDS BEFORE THE ONSET AND OFFSET OF AN HALLUCINATORY EPISODE?

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S188-S189
Author(s):  
Alexander Craven ◽  
Lars Ersland ◽  
Drozdstoy Stoyanov ◽  
Sevdalina Kandilarova ◽  
Iris Sommer ◽  
...  
Keyword(s):  
Functional Data ◽  
Time Course ◽  
Medical Center ◽  
Onset Time ◽  
Superior Temporal Gyrus ◽  
Button Press ◽  
Auditory Verbal Hallucinations ◽  
Meta Analyses ◽  
Language Areas ◽  
The Brain

Abstract Background Auditory verbal hallucinations (AVH), the sense of “hearing voices” in the absence of a corresponding auditory source, are a major symptom in schizophrenia. Hemodynamic and electrophysiology studies have shown aberrant activation in fronto-temporal speech and language areas (Curcic-Blake et al., 2017 for review) – indicating neurobiological mediators relating to onset and duration of AVH episodes. However, unanswered is the question of specific neuronal precursors to the spontaneous cessation of an AVH episode. We therefore studied what happens in the brain a few seconds before both the onset and offset of an AVH episode. Methods Structural and functional MRI data were collected from 44 patients diagnosed with a schizophrenia spectrum disorder, at three sites (University of Bergen, Norway, n=12; Medical University of Plovdiv, Bulgaria, n=13; Utrecht University Medical Center, Netherlands, n=19, total 25m, 19f, age 37.9+/-13.2 years). Symptom severity was assessed with the PANSS; mean total (+/-SD) 64.9+/-16.9; P3 hallucinatory behaviour 4.6+/-1.1. Additional assessments (not reported), scanner hardware and particulars of the MR acquisition varied between sites. Functional data were collected with a “symptom-capture” paradigm (Sommer et al., 2008), where subjects were instructed to press a button when a hallucinatory episode began, and another when the episode ended. Functional data were processed using an FSL FEAT pipeline, with additional filtering using the ICA_AROMA method. Data were then subjected to statistical analysis, contrasting hallucinatory with non-hallucinatory periods; higher-level analysis allowed comparison with findings from previous meta-analyses (Kompus et al. 2011, Jardri et al., 2011). A number of regions of interest were selected based on an initial PCA, in addition to regions nominated in the meta-analyses. For each region, for each start- and end-of-hallucination event, a time-course was extracted for the interval t=-10 to +15sec with respect to button-press onset. Time-courses were aligned and group-averaged (rejecting outliers iteratively) to yield a model time-course for start- and end- hallucinatory events in each region. Permutation analysis (n=5000) was performed to identify differential effects between start and end events. Results Functional block-analysis revealed several clusters of activation, including among others the left fronto-temporal language areas (superior temporal gyrus and Broca’s area). Similar patterns were present on a per-site basis. Time-course analysis demonstrated a differential effect in the left paracingulate sulcus, characterized by a significant dip in activation (Δ=-158iu, p=0.021) at the end-of-hallucination events, in contrast to a significant peak (Δ=35iu, p=0.0142) at the start-of-hallucination events. This activity preceded the motor response for the same events. Discussion Clusters identified in the block-analysis at group-level were consistent with findings from meta-analyses; this attests to the validity of the source data and initial processing. The novel finding of anticipatory neuronal activity in the paracingulate region, differentiated between onset and offset of AVH- events, complements recent findings of reduced functional connectivity (Alonso-Solís et al., 2015) and morphological differences (Garrison et al., 2019) in the same region. This suggests that the paracingulate region may be crucial in both the initiation and the cessation of an AVH-episode and speaks to a kind of regulatory role for the region. This may in turn point to differential action of excitatory and inhibitory transmitters at a lower level of explanation.

Dissecting the Therapeutic Relevance of Gene Therapy in NeuroAIDS: An Evolving Epidemic

2020 ◽  
Vol 20 (3) ◽  
pp. 174-183
Author(s):  
Bushra Nabi ◽  
Saleha Rehman ◽  
Faheem Hyder Pottoo ◽  
Sanjula Baboota ◽  
Javed Ali
Keyword(s):  
Viral Entry ◽  
Due Process ◽  
Intrinsic Property ◽  
Antiretroviral Drugs ◽  
Viral Reservoir ◽  
Primary Concern ◽  
Cellular Delivery ◽  
Formidable Challenge ◽  
Neurological Conditions ◽  
The Brain

: NeuroAIDS, a disease incorporating both infectious and neurodegenerative pathways, is still a formidable challenge for the researchers to deal with. The primary concern for the treatment of neuroAIDS still remains the inaccessibility of the viral reservoir, making it indispensable for novel techniques to be continuously innovated. Since the brain serves as a reservoir for viral replication, it is pragmatic and a prerequisite to overcome the related barriers in order to improve the drug delivery to the brain. The current treatment ideology is based on the combinatorial approach of a mocktail of antiretroviral drugs. However, complete eradication of the disease could not be achieved. Thereby the arena of gene-based cellular delivery is trending and has created a niche for itself in the present scenario. To establish the supremacy of gene delivery, it is advisable to have a better understanding of the molecular mechanism involved in the due process. The mechanism associated with the activity of the anti-HIV gene lies in their intrinsic property to impart resistance to the HIV infection by targeting the viral entry channels. This review principally emphasizes on different types of gene therapies explored so far for the management of AIDS and its associated neurological conditions. Therefore it could rightly be said that we are at the crossroad where the need of the hour is to develop novel strategies for curbing AIDS and its associated neurological conditions.

scholarly journals Antagonism between brain regions relevant for cognitive control and emotional memory facilitates the generation of humorous ideas

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Florian Bitsch ◽  
Philipp Berger ◽  
Andreas Fink ◽  
Arne Nagels ◽  
Benjamin Straube ◽  
...  
Keyword(s):  
Cognitive Control ◽  
Positive Emotions ◽  
Emotional Memory ◽  
Brain Regions ◽  
Neural Mechanisms ◽  
Functional Magnetic Resonance ◽  
Frontal Brain ◽  
Successful Resolution ◽  
Neural Underpinnings ◽  
The Brain

AbstractThe ability to generate humor gives rise to positive emotions and thus facilitate the successful resolution of adversity. Although there is consensus that inhibitory processes might be related to broaden the way of thinking, the neural underpinnings of these mechanisms are largely unknown. Here, we use functional Magnetic Resonance Imaging, a humorous alternative uses task and a stroop task, to investigate the brain mechanisms underlying the emergence of humorous ideas in 24 subjects. Neuroimaging results indicate that greater cognitive control abilities are associated with increased activation in the amygdala, the hippocampus and the superior and medial frontal gyrus during the generation of humorous ideas. Examining the neural mechanisms more closely shows that the hypoactivation of frontal brain regions is associated with an hyperactivation in the amygdala and vice versa. This antagonistic connectivity is concurrently linked with an increased number of humorous ideas and enhanced amygdala responses during the task. Our data therefore suggests that a neural antagonism previously related to the emergence and regulation of negative affective responses, is linked with the generation of emotionally positive ideas and may represent an important neural pathway supporting mental health.

scholarly journals Hearing spiritually significant voices: A phenomenological survey and taxonomy

2020 ◽  
pp. medhum-2020-012021
Author(s):  
Christopher C H Cook ◽  
Adam Powell ◽  
Ben Alderson-Day ◽  
Angela Woods
Keyword(s):  
Medical Humanities ◽  
Adult Life ◽  
Religious Studies ◽  
Religious Experiences ◽  
Pastoral Work ◽  
Auditory Verbal Hallucinations ◽  
Single Voice ◽  
The Voice

Whereas previous research in the medical humanities has tended to neglect theology and religious studies, these disciplines sometimes have a very important contribution to make. The hearing of spiritually significant voices provides a case in point. The context, content and identity of these voices, all of which have typically not been seen as important in the assessment of auditory–verbal hallucinations (AVHs) within psychiatry, are key to understanding their spiritual significance. A taxonomy of spiritually significant voices is proposed, which takes into account frequency, context, affect and identity of the voice. In a predominantly Christian sample of 58 people who reported having heard spiritually significant voices, most began in adult life and were infrequent experiences. Almost 90% reported that the voice was divine in identity and approximately one-third were heard in the context of prayer. The phenomenological characteristics of these voices were different from those in previous studies of voice hearing (AVHs). Most comprised a single voice; half were auditory; and a quarter were more thought-like (the rest being a mixture). Only half were characterful, and one-third included commands or prompts. The voices were experienced positively and as meaningful. The survey has implications for both clinical and pastoral work. The phenomenology of spiritually significant voices may be confused with that of psychopathology, thus potentially leading to misdiagnosis of normal religious experiences. The finding of meaning in content and context may be important in voice hearing more widely, and especially in coping with negative or distressing voices.

Neural Mechanisms of Negative Symptoms

1989 ◽  
Vol 155 (S7) ◽  
pp. 93-98 ◽  
Author(s):  
Nancy C. Andreasen
Keyword(s):  
Frontal Cortex ◽  
Negative Symptoms ◽  
Neural Mechanism ◽  
Brain Regions ◽  
Brain Dysfunction ◽  
Neural Mechanisms ◽  
Dementia Praecox ◽  
Intellectual Abilities ◽  
The Brain ◽  
Psychic Mechanisms

When Kraepelin originally defined and described dementia praecox, he assumed that it was due to some type of neural mechanism. He hypothesised that abnormalities could occur in a variety of brain regions, including the prefrontal, auditory, and language regions of the cortex. Many members of his department, including Alzheimer and Nissl, were actively involved in the search for the neuropathological lesions that would characterise schizophrenia. Although Kraepelin did not use the term ‘negative symptoms', he describes them comprehensively and states explicitly that he believes the symptoms of schizophrenia can be explained in terms of brain dysfunction:“If it should be confirmed that the disease attacks by preference the frontal areas of the brain, the central convolutions and central lobes, this distribution would in a certain measure agree with our present views about the site of the psychic mechanisms which are principally injured by the disease. On various grounds, it is easy to believe that the frontal cortex, which is specially well developed in man, stands in closer relation to his higher intellectual abilities, and these are the faculties which in our patients invariably suffer profound loss in contrast to memory and acquired ability.” Kraepelin (1919, p. 219)

scholarly journals Representation of Grammatical Categories of Words in the Brain

1995 ◽  
Vol 7 (3) ◽  
pp. 396-407 ◽  
Author(s):  
Argye E. Hillis ◽  
Alfonso Caramazza
Keyword(s):  
Neural Mechanisms ◽  
Single Patient ◽  
Grammatical Category ◽  
Lexical Knowledge ◽  
Double Dissociation ◽  
Category Information ◽  
Orthographic Representations ◽  
Organizational Principle ◽  
The Brain ◽  
Verbal Output

We report the performance of a patient who, as a consequence of left frontal and temporoparietal strokes, makes far more errors on nouns than on verbs in spoken output tasks, but makes far more errors on verbs than on nouns in written input tasks. This double dissociation within a single patient with respect to grammatical category provides evidence for the hypothesis that phonological and orthographic representations of nouns and verbs are processed by independent neural mechanisms. Furthermore, the opposite dissociation in the verbal output modality, an advantage for nouns over verbs in spoken tasks, by a different patient using the same stimuli has also been reported (Caramazza & Hillis, 1991). This double dissociation across patients on the same task indicates that results cannot be ascribed to "greater difficulty" with one type of stimulus, and provides further evidence for the view that grammatical category information is an important organizational principle of lexical knowledge in the brain.

scholarly journals Talent in the taxi: a model system for exploring expertise

2009 ◽  
Vol 364 (1522) ◽  
pp. 1407-1416 ◽  
Author(s):  
Katherine Woollett ◽  
Hugo J. Spiers ◽  
Eleanor A. Maguire
Keyword(s):  
Model System ◽  
Neural Mechanisms ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Taxi Drivers ◽  
The Brain ◽  
Use Of Expertise ◽  
Widespread Interest ◽  
Key Questions ◽  
Extensive Practice

While there is widespread interest in and admiration of individuals with exceptional talents, surprisingly little is known about the cognitive and neural mechanisms underpinning talent, and indeed how talent relates to expertise. Because many talents are first identified and nurtured in childhood, it can be difficult to determine whether talent is innate, can be acquired through extensive practice or can only be acquired in the presence of the developing brain. We sought to address some of these issues by studying healthy adults who acquired expertise in adulthood. We focused on the domain of memory and used licensed London taxi drivers as a model system. Taxi drivers have to learn the layout of 25 000 streets in London and the locations of thousands of places of interest, and pass stringent examinations in order to obtain an operating licence. Using neuropsychological assessment and structural and functional magnetic resonance imaging, we addressed a range of key questions: in the context of a fully developed brain and an average IQ, can people acquire expertise to an exceptional level; what are the neural signatures, both structural and functional, associated with the use of expertise; does expertise change the brain compared with unskilled control participants; does it confer any cognitive advantages, and similarly, does it come at a cost to other functions? By studying retired taxi drivers, we also consider what happens to their brains and behaviour when experts stop using their skill. Finally, we discuss how the expertise of taxi drivers might relate to the issue of talent and innate abilities. We suggest that exploring talent and expertise in this manner could have implications for education, rehabilitation of patients with cognitive impairments, understanding individual differences and possibly conditions such as autism where exceptional abilities can be a feature.

Adolescents' help-seeking behaviour: the difference between self- and other-referral

2000 ◽  
Vol 23 (6) ◽  
pp. 721-740 ◽  
Author(s):  
AMIRAM RAVIV ◽  
RACHEL SILLS ◽  
ALONA RAVIV ◽  
PAMELA WILANSKY
Keyword(s):  
Help Seeking ◽  
Self And Other ◽  
Help Seeking Behaviour ◽  
The Difference

Domain-Specific Knowledge Systems in the Brain: The Animate-Inanimate Distinction

1998 ◽  
Vol 10 (1) ◽  
pp. 1-34 ◽  
Author(s):  
Alfonso Caramazza ◽  
Jennifer R. Shelton
Keyword(s):  
Knowledge Systems ◽  
Neural Mechanisms ◽  
Specific Knowledge ◽  
Knowledge Framework ◽  
Semantic Categories ◽  
Domain Specific ◽  
Domain Specific Knowledge ◽  
Cognitive Neuropsychological ◽  
The Brain ◽  
Selective Impairment

We claim that the animate and inanimate conceptual categories represent evolutionarily adapted domain-specific knowledge systems that are subserved by distinct neural mechanisms, thereby allowing for their selective impairment in conditions of brain damage. On this view, (some of) the category-specific deficits that have recently been reported in the cognitive neuropsychological literature—for example, the selective damage or sparing of knowledge about animals—are truly categorical effects. Here, we articulate and defend this thesis against the dominant, reductionist theory of category-specific deficits, which holds that the categorical nature of the deficits is the result of selective damage to noncategorically organized visual or functional semantic subsystems. On the latter view, the sensory/functional dimension provides the fundamental organizing principle of the semantic system. Since, according to the latter theory, sensory and functional properties are differentially important in determining the meaning of the members of different semantic categories, selective damage to the visual or the functional semantic subsystem will result in a category-like deficit. A review of the literature and the results of a new case of category-specific deficit will show that the domain-specific knowledge framework provides a better account of category-specific deficits than the sensory/functional dichotomy theory.

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