Perception of Voices That Do Not ExistNeuronal Mechanisms in Clinical and Non-Clinical Hallucinations
Auditory verbal hallucinations (AVH) consist of hearing voices that are not physically present. This perceptual phenomenon is of increasing interest for many research fields. In psychiatric patients, negative and distressing AVH reduce the quality of life, and understanding the mechanisms causing AVH is relevant for advancing clinical interventions. The cognitive and neural mechanisms of AVH are also of interest for research into neural underpinnings of speech processing. This chapter reviews theories of AVH and gives an overview of the main findings from behavioural and neuroimaging studies on individuals with AVH. Individuals who experience AVH show structural changes to auditory perception regions in the superior temporal lobes, as well as altered structural and functional connectivity patterns between auditory perception areas and other brain regions. The active ‘state’ of AVH is associated with increased neural activity in the primary and secondary auditory areas. Taken together, AVH are a perceptual phenomenon that represents a dysfunctional bottom-up activity in the temporal lobe auditory perception region, and altered connectivity with the areas responsible for implementing top-down control in the frontal cortex.