Hoffman R E, Varanko M
Department of Psychiatry, Yale University School of Medicine, Yale-New Haven Psychiatric Hospital, 184 Liberty Street LV108, New Haven, CT 06519, USA.
Acta Psychiatr Scand. 2006 Oct;114(4):290-2; discussion 292. doi: 10.1111/j.1600-0447.2006.00791.x.
The neurocognitive basis of verbal/auditory hallucinations remains uncertain. A leading hypothesis is that these hallucinations correspond to ordinary inner speech mislabeled as non-self. However, some studies suggest pathogenic activation of receptive language neurocircuitry as the cause. A form of visualized verbal hallucinations not previously reported in the literature is described that may shed light on this controversy.
Review of three cases.
Two patients described visual hallucinations of speech-like lip and mouth movements fused with simultaneous auditory verbal hallucinations superimposed on perceptions of faces of actual persons in their immediate environment. A third patient described similar experiences incorporated into visual hallucinations of human figures who also exhibited finger and hand movements corresponding to American Sign Language.
These fused, multimodal verbal hallucinations seem unlikely to be due to inner speech mislabeled as non-self, and instead suggest top-down re-shaping of activation in visual processing brain centers by pathogenically active receptive language neurocircuitry.
言语/听觉幻觉的神经认知基础仍不明确。一个主要假说是，这些幻觉对应于被错误标记为非自我的普通内心言语。然而，一些研究表明，感受性语言神经回路的病理性激活是其病因。本文描述了一种文献中此前未报道过的可视化言语幻觉形式，这可能有助于阐明这一争议。
回顾三例病例。
两名患者描述了类似言语的嘴唇和嘴巴动作的视觉幻觉，同时伴有听觉言语幻觉，这些幻觉叠加在他们周围实际人物面部的感知上。第三名患者描述了类似的体验，这些体验融入了人物的视觉幻觉中，这些人物还表现出与美国手语相对应的手指和手部动作。
这些融合的多模式言语幻觉似乎不太可能是由于被错误标记为非自我的内心言语所致，相反，这表明病理性活跃的感受性语言神经回路对视觉处理脑区的激活进行了自上而下的重塑。
