Center for Neuroprosthetics, School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Laboratory of Cognitive Neuroscience, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
Center for Neuroprosthetics, School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Presurgical Epilepsy Evaluation Unit, "Functional Neurology and Neurosurgery" Program of the University Hospitals Lausanne and Geneva, Switzerland; Department of Neurology, University Hospital, Geneva, Switzerland.
Epilepsy Behav. 2014 Feb;31:181-6. doi: 10.1016/j.yebeh.2013.12.014. Epub 2014 Jan 14.
Complex auditory hallucinations are often characterized by hearing voices and are then called auditory verbal hallucinations (AVHs). While AVHs have been extensively investigated in psychiatric patients suffering from schizophrenia, reports from neurological patients are rare and, in most cases, incomplete. Here, we characterize AVHs in 9 patients suffering from pharmacoresistant epilepsy by analyzing the phenomenology of AVHs and patients' neuropsychological and lesion profiles. From a cohort of 352 consecutively examined patients with epilepsy, 9 patients suffering AVHs were identified and studied by means of a semistructured interview, neuropsychological tests, and multimodal imaging, relying on a combination of functional and structural neuroimaging data and surface and intracranial EEG. We found that AVHs in patients with epilepsy were associated with prevalent language deficits and damage to posterior language areas and basal language areas in the left temporal cortex. Auditory verbal hallucinations, most of the times, consisted in hearing a single voice of the same gender and language as the patient and had specific spatial features, being, most of the times, perceived in the external space, contralateral to the lesion. We argue that the consistent location of AVHs in the contralesional external space, the prominence of associated language deficits, and the prevalence of lesions to the posterior temporal language areas characterize AVHs of neurological origin, distinguishing them from those of psychiatric origin.
复杂的听觉幻觉通常表现为听到声音，因此被称为听觉言语幻觉 (AVH)。虽然 AVH 在患有精神分裂症的精神病患者中得到了广泛研究，但来自神经科患者的报告很少见，而且大多数情况下不完整。在这里，我们通过分析 AVH 的现象学以及患者的神经心理学和病变特征来描述 9 名患有耐药性癫痫的患者的 AVH。从连续检查的 352 名癫痫患者队列中，确定了 9 名患有 AVH 的患者，并通过半结构化访谈、神经心理学测试和多模态成像进行了研究，依赖于功能和结构神经影像学数据以及表面和颅内 EEG 的组合。我们发现，癫痫患者的 AVH 与普遍存在的语言缺陷以及左颞叶后部语言区和基底语言区的损伤有关。听觉言语幻觉大多数情况下是听到与患者性别和语言相同的单一声音，并具有特定的空间特征，大多数情况下被感知到在病变对侧的外部空间中。我们认为，AVH 一致位于对侧外部空间、与语言缺陷相关的突出性以及后颞语言区的病变普遍性是神经源性 AVH 的特征，将其与精神源性 AVH 区分开来。
