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精神分裂症中的伴随放电功能障碍:它能解释幻听吗?

Corollary discharge dysfunction in schizophrenia: can it explain auditory hallucinations?

作者信息

Ford Judith M, Mathalon Daniel H

机构信息

Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.

出版信息

Int J Psychophysiol. 2005 Nov-Dec;58(2-3):179-89. doi: 10.1016/j.ijpsycho.2005.01.014. Epub 2005 Aug 31.

DOI:10.1016/j.ijpsycho.2005.01.014
PMID:16137779
Abstract

Failure of corollary discharge, a mechanism for distinguishing self-generated from externally generated percepts, has been posited to underlie certain positive symptoms of schizophrenia, including auditory hallucinations. Although originally described in the visual system, corollary discharge may exist in the auditory system, whereby signals from motor speech commands prepare auditory cortex for self-generated speech. While associated with sensorimotor systems, it might also apply to inner speech or thought, regarded as our most complex motor act. In this paper, we describe the results of a series of studies in which we have shown that: (1) event-related brain potentials (ERPs) can be used to demonstrate the corollary discharge phenomenon during talking, (2) corollary discharge is abnormal in patients with schizophrenia, (3) EEG gamma band coherence between frontal and temporal lobes is greater during talking than listening and is disrupted by distorted feedback during talking in normals, and (4) patients with schizophrenia do not show this pattern for EEG gamma coherence. While these studies have identified ERPs and EEG gamma coherence indices of the efference copy/corollary discharge system and documented abnormalities in these systems in patients with schizophrenia, we have so far had limited success in establishing a relationship between these neurobiologic indicators of corollary discharge abnormality and reports of hallucinations in patients.

摘要

推测放电功能的缺失被认为是精神分裂症某些阳性症状(包括幻听)的潜在原因,推测放电是一种区分自我产生的感知和外部产生的感知的机制。尽管推测放电最初是在视觉系统中被描述的,但它也可能存在于听觉系统中,即来自运动言语指令的信号会让听觉皮层为自我产生的言语做好准备。虽然推测放电与感觉运动系统有关,但它也可能适用于内心言语或思维,内心言语或思维被视为我们最复杂的运动行为。在本文中,我们描述了一系列研究的结果,这些结果表明:(1)事件相关脑电位(ERP)可用于证明说话过程中的推测放电现象;(2)精神分裂症患者的推测放电存在异常;(3)在说话过程中,额叶和颞叶之间的脑电图伽马波段连贯性比倾听时更强,并且在正常人群中,说话过程中扭曲的反馈会破坏这种连贯性;(4)精神分裂症患者在脑电图伽马连贯性方面没有表现出这种模式。虽然这些研究已经确定了传出副本/推测放电系统的ERP和脑电图伽马连贯性指标,并记录了精神分裂症患者这些系统的异常情况,但到目前为止,我们在建立推测放电异常的这些神经生物学指标与患者幻觉报告之间的关系方面,取得的成功有限。

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