Department of Neuroscience, University Medical Center Groningen, Groningen, The Netherlands.
Schizophr Bull. 2011 Sep;37(5):1009-16. doi: 10.1093/schbul/sbq007. Epub 2010 Feb 17.
One of the most influential cognitive models of auditory verbal hallucinations (AVH) suggests that a failure to adequately monitor the production of one's own inner speech leads to verbal thought being misidentified as an alien voice. However, it is unclear whether this theory can explain the phenomenological complexity of AVH. We aimed to assess whether subjective perceptual and experiential characteristics may be linked to neural activation in the inner speech processing network.
Twenty-two patients with schizophrenia and AVH underwent a 3-T functional magnetic resonance imaging scan, while performing a metrical stress evaluation task, which has been shown to activate both inner speech production and perception regions. Regions of interest (ROIs) comprising the putative inner speech network were defined using the Anatomical Automatic Labeling system. Correlations were calculated between scores on the "loudness" and "reality" subscales of the Auditory Hallucination Rating Scale (AHRS) and activation in these ROIs. Second, the AHRS subscales, and general AVH severity, indexed by the Positive and Negative Syndrome Scale, were correlated with a language lateralization index.
Louder AVH were associated with reduced task-related activity in bilateral angular gyrus, anterior cingulate gyrus, left inferior frontal gyrus, left insula, and left temporal cortex. This could potentially be due to a competition for shared neural resources. Reality on the other hand was found to be associated with reduced language lateralization.
Strong activation of the inner speech processing network may contribute to the subjective loudness of AVH. However, a relatively increased contribution from right hemisphere language areas may be responsible for the more complex experiential characteristics, such as the nonself source or how real AVH are.
听觉言语幻觉（AVH）最具影响力的认知模型之一表明，未能充分监测自身内部言语的产生会导致言语思维被错误识别为外来声音。然而，目前尚不清楚该理论是否可以解释 AVH 的现象学复杂性。我们旨在评估主观感知和体验特征是否与内部言语处理网络的神经激活有关。
22 名伴有 AVH 的精神分裂症患者接受了 3T 功能磁共振成像扫描，同时进行了度量重音评估任务，该任务已被证明可激活内部言语产生和感知区域。使用解剖自动标记系统定义了假定的内部言语网络的感兴趣区域（ROI）。计算了听觉幻觉评定量表（AHRS）的“响度”和“真实感”分量表得分与这些 ROI 中激活之间的相关性。其次，AHRS 分量表以及阳性和阴性症状量表（PANSS）所评估的一般 AVH 严重程度与语言侧化指数相关。
更响亮的 AVH 与双侧角回、前扣带回、左额下回、左岛叶和左颞叶的任务相关活动减少有关。这可能是由于共享神经资源的竞争所致。另一方面，现实感与语言侧化程度降低有关。
内部言语处理网络的强烈激活可能导致 AVH 的主观响度增加。然而，来自右半球语言区域的相对增加的贡献可能是导致更复杂的体验特征（例如非自我来源或 AVH 的真实程度）的原因。
