Parkinson's Disease Research Clinic, Brain and Mind Research Institute, The University of Sydney, NSW, Australia.
Parkinson's Disease Research Clinic, Brain and Mind Research Institute, The University of Sydney, NSW, Australia; Neuroscience Research Australia and the University of New South Wales, Sydney, NSW, Australia.
Prog Neurobiol. 2014 May;116:58-65. doi: 10.1016/j.pneurobio.2014.01.004. Epub 2014 Feb 10.
Visual hallucinations are common across a number of disorders but to date, a unifying pathophysiology underlying these phenomena has not been described. In this manuscript, we combine insights from neuropathological, neuropsychological and neuroimaging studies to propose a testable common neural mechanism for visual hallucinations. We propose that 'simple' visual hallucinations arise from disturbances within regions responsible for the primary processing of visual information, however with no further modulation of perceptual content by attention. In contrast, 'complex' visual hallucinations reflect dysfunction within and between the Attentional Control Networks, leading to the inappropriate interpretation of ambiguous percepts. The incorrect information perceived by hallucinators is often differentially interpreted depending on the time-course and the neuroarchitecture underlying the interpretation. Disorders with 'complex' hallucinations without retained insight are proposed to be associated with a reduction in the activity within the Dorsal Attention Network. The review concludes by showing that a variety of pathological processes can ultimately manifest in any of these three categories, depending on the precise location of the impairment.
视觉幻觉在许多疾病中都很常见，但迄今为止，尚未描述这些现象背后的统一病理生理学机制。在本文中，我们结合神经病理学、神经心理学和神经影像学研究的见解，提出了一个可测试的视觉幻觉共同神经机制。我们提出，“简单”的视觉幻觉是由于负责视觉信息初级处理的区域出现紊乱引起的，但注意力对感知内容没有进一步的调节。相比之下，“复杂”的视觉幻觉反映了注意力控制网络内部和之间的功能障碍，导致对模棱两可的知觉的不当解释。幻觉患者感知到的错误信息通常根据解释的时间进程和神经结构的不同而有不同的解释。我们提出，没有保留洞察力的“复杂”幻觉障碍与背侧注意网络内的活动减少有关。综述最后表明，取决于损伤的确切位置，各种病理过程最终都可能表现为这三种类型中的任何一种。
