Green M F, Hugdahl K, Mitchell S
Department of Psychiatry and Biobehavioral Sciences, UCLA.
Am J Psychiatry. 1994 Mar;151(3):357-62. doi: 10.1176/ajp.151.3.357.
Auditory hallucinations are a serious problem for a large subgroup of psychotic patients who do not respond optimally to neuroleptic medication. It has been hypothesized that hearing imaginary voices involves the same physiological processes as those involved in hearing real voices, but this hypothesis has not been conclusively confirmed.
In this study a consonant-vowel version of the Dichotic Listening Test was used to assess the functional integration of the left hemisphere in hallucinating and nonhallucinating psychotic patients. The test was administered under three conditions: a nonforced attention condition, a condition in which attention was forced to the left ear, and one in which attention was forced to the right ear.
The nonhallucinating patients showed the normal right ear advantage, which indicates a left hemisphere superiority in the processing of linguistic stimuli. In contrast, the hallucinating patients showed no ear advantage. Neither group was able to modify its performance when instructed to attend to either the left or the right ear. A subgroup of patients was tested in both hallucinating and nonhallucinating states, but the ear asymmetry was not noticeably different between these states.
The results suggest that auditory hallucinations are associated with abnormalities in left hemisphere functioning and that these abnormalities might not be limited to the time of the auditory hallucinations. It is hypothesized that a relatively enduring left hemisphere abnormality may leave some patients at risk for auditory hallucinations.
幻听是一大类对抗精神病药物反应欠佳的精神病患者面临的严重问题。有假说认为，听到想象中的声音所涉及的生理过程与听到真实声音时相同，但这一假说尚未得到确凿证实。
在本研究中，使用了辅音 - 元音版本的双耳分听测试来评估幻觉型和非幻觉型精神病患者左半球的功能整合。该测试在三种条件下进行：非强制注意条件、注意力强制集中于左耳的条件以及注意力强制集中于右耳的条件。
非幻觉型患者表现出正常的右耳优势，这表明左半球在语言刺激处理方面具有优势。相比之下，幻觉型患者未表现出耳优势。当被指示注意左耳或右耳时，两组患者均无法改变其表现。对一组患者在幻觉状态和非幻觉状态下均进行了测试，但这些状态下的耳不对称性并无明显差异。
结果表明，幻听与左半球功能异常有关，且这些异常可能不限于幻听发生时。据推测，相对持久的左半球异常可能使一些患者面临幻听风险。
