Ćurčić-Blake Branislava, Ford Judith M, Hubl Daniela, Orlov Natasza D, Sommer Iris E, Waters Flavie, Allen Paul, Jardri Renaud, Woodruff Peter W, David Olivier, Mulert Christoph, Woodward Todd S, Aleman André
Department of Neuroscience, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
University of California and Veterans Affairs Medical Center, San Francisco, United States.
Prog Neurobiol. 2017 Jan;148:1-20. doi: 10.1016/j.pneurobio.2016.11.002. Epub 2016 Nov 24.
Auditory verbal hallucinations (AVH) occur in psychotic disorders, but also as a symptom of other conditions and even in healthy people. Several current theories on the origin of AVH converge, with neuroimaging studies suggesting that the language, auditory and memory/limbic networks are of particular relevance. However, reconciliation of these theories with experimental evidence is missing. We review 50 studies investigating functional (EEG and fMRI) and anatomic (diffusion tensor imaging) connectivity in these networks, and explore the evidence supporting abnormal connectivity in these networks associated with AVH. We distinguish between functional connectivity during an actual hallucination experience (symptom capture) and functional connectivity during either the resting state or a task comparing individuals who hallucinate with those who do not (symptom association studies). Symptom capture studies clearly reveal a pattern of increased coupling among the auditory, language and striatal regions. Anatomical and symptom association functional studies suggest that the interhemispheric connectivity between posterior auditory regions may depend on the phase of illness, with increases in non-psychotic individuals and first episode patients and decreases in chronic patients. Leading hypotheses involving concepts as unstable memories, source monitoring, top-down attention, and hybrid models of hallucinations are supported in part by the published connectivity data, although several caveats and inconsistencies remain. Specifically, possible changes in fronto-temporal connectivity are still under debate. Precise hypotheses concerning the directionality of connections deduced from current theoretical approaches should be tested using experimental approaches that allow for discrimination of competing hypotheses.
幻听（AVH）在精神障碍中出现，但也作为其他病症的症状出现，甚至在健康人群中也会出现。目前关于幻听起源的几种理论趋于一致，神经影像学研究表明，语言、听觉和记忆/边缘系统网络具有特别重要的意义。然而，这些理论与实验证据之间的协调尚付阙如。我们回顾了50项研究，这些研究调查了这些网络中的功能（脑电图和功能磁共振成像）和解剖（扩散张量成像）连接性，并探讨了支持与幻听相关的这些网络中异常连接性的证据。我们区分实际幻觉体验期间的功能连接性（症状捕捉）以及静息状态或比较幻觉者与非幻觉者的任务期间的功能连接性（症状关联研究）。症状捕捉研究清楚地揭示了听觉、语言和纹状体区域之间耦合增加的模式。解剖学和症状关联功能研究表明，后听觉区域之间的半球间连接性可能取决于疾病阶段，非精神病个体和首发患者中增加，而慢性患者中减少。涉及不稳定记忆、源监测、自上而下的注意力以及幻觉混合模型等概念的主要假设在一定程度上得到了已发表的连接性数据的支持，尽管仍存在一些警告和不一致之处。具体而言，额颞连接性的可能变化仍在争论中。应使用能够区分相互竞争假设的实验方法来检验从当前理论方法推导出来的关于连接方向性的精确假设。
