Department of Psychiatry and Behavioral Sciences, Oregon Health and Science University, and the Portland VA Health Care System, Portland, OR, USA.
Department of Neurology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
Schizophr Res. 2024 Mar;265:14-19. doi: 10.1016/j.schres.2024.03.001. Epub 2024 Mar 5.
Wide range of evidence associates auditory verbal hallucinations (AVH) with frontotemporal corollary discharge deficit. AVH likely reflect altered experiences of the inner voice and are phenomenologically diverse. The aspects of hallucinations (and related inner voice experiences) that could be explained by this deficit remain unclear. To address this important subject, we examined the temporal cortex activity during two tasks with and without corollary discharge.
We carried out an event-related BOLD fMRI study to examine temporal cortex activity in seven patients and eight healthy controls during two tasks with and without corollary discharge: reading aloud and hearing, respectively. Data were denoised by removing independent components related to head movement and subsequently processed using finite impulse response basis function to address hemodynamic response variations. To mitigate the small sample size, final analyses were carried out using permutation-based analysis of variance.
There was a significant group interaction in the Read relative to Hear condition during the early post-stimulus stage in the left Heschl's Gyrus (p<0.01, corrected for multiple comparisons, at peak voxel [-72,53,41]). This effect was driven by a higher activity in the Read relative to the Hear condition in the same area in the patients (p<0.02, corrected).
Our results are consistent with prior literature indicating abnormal frontotemporal disconnection in participants with hallucinations. The functional repercussions of this deficit were limited to the primary auditory cortex in early post-stimulus stage, which suggests louder experience of the inner voice in patients and could account for the loudness of their hallucinations.
大量证据表明，听觉言语幻觉（AVH）与额颞叶传出放电缺陷有关。AVH 可能反映了内部声音体验的改变，且具有现象学上的多样性。这种缺陷可以解释幻觉（和相关的内部声音体验）的哪些方面仍不清楚。为了解决这个重要的问题，我们在有和没有传出放电的两种任务中检查了颞叶皮层的活动。
我们进行了一项事件相关的 BOLD fMRI 研究，以检查 7 名患者和 8 名健康对照者在有和没有传出放电的两种任务（分别为朗读和听觉）期间颞叶皮层的活动。通过去除与头部运动相关的独立成分对数据进行去噪，随后使用有限脉冲响应基函数处理数据以解决血液动力学响应变化。为了缓解小样本量的问题，最终分析使用基于置换的方差分析进行。
在左颞上回（Heschl's Gyrus），在刺激后早期阶段，与听觉相比，阅读任务在患者和健康对照组之间存在显著的组间交互作用（p<0.01，经多重比较校正，在峰值体素[-72,53,41]）。这一效应是由患者在阅读任务中相对于听觉任务在同一区域的更高活性驱动的（p<0.02，经校正）。
我们的结果与先前的文献一致，表明有幻觉的参与者存在异常的额颞叶连接中断。这种缺陷的功能影响仅限于刺激后早期的初级听觉皮层，这表明患者的内部声音体验更响亮，这可以解释他们的幻觉的响度。
