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1.
Neurosignals ; 31(1): 1-25, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38967556

RESUMO

Hallucination is a sensory perception that occurs in the absence of external stimuli during abnormal neurological disturbances and various mental diseases. Hallucination is recognized as a core psychotic symptom and is particularly more prevalent in individuals with schizophrenia. Strikingly, a significant number of subjects with Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and other neurological diseases like cerebral stroke and epileptic seizure also experience hallucination. While aberrant neurotransmission has been linked to the neuropathogenic events of schizophrenia, the precise cellular mechanism accounting for hallucinations remains obscure. Neurogenesis is a cellular process of producing new neurons from the neural stem cells (NSC)-derived neuroblasts in the brain that contribute to the regulation of pattern separation, mood, olfaction, learning, and memory in adulthood. Impaired neurogenesis in the hippocampus of the adult brain has been linked to stress, anxiety, depression, and dementia. Notably, many neurodegenerative disorders are characterized by the mitotic and functional activation of neuroblasts and cell cycle re-entry of mature neurons leading to a drastic alteration in neurogenic process, known as reactive neuroblastosis. Considering their neurophysiological properties, the abnormal integration of neuroblasts into the existing neural network or withdrawal of their connections can lead to abnormal synaptogenesis, and neurotransmission. Eventually, this would be expected to result in altered perception accounting for hallucination. Thus, this article emphasizes a hypothesis that aberrant neurogenic processes at the level of reactive neuroblastosis could be an underlying mechanism of hallucination in schizophrenia and other neurological diseases.


Assuntos
Alucinações , Hipocampo , Neurogênese , Plasticidade Neuronal , Esquizofrenia , Humanos , Esquizofrenia/patologia , Esquizofrenia/fisiopatologia , Alucinações/patologia , Alucinações/fisiopatologia , Plasticidade Neuronal/fisiologia , Hipocampo/patologia , Neurogênese/fisiologia , Animais , Células-Tronco Neurais/patologia , Neurônios/patologia , Neurônios/metabolismo
2.
Sci Rep ; 14(1): 16569, 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39019949

RESUMO

This randomised, crossover, sham-controlled study explored the neural basis of source-monitoring, a crucial cognitive process implicated in schizophrenia. Left superior temporal gyrus (STG) and dorsolateral prefrontal cortex (DLPFC) were the key focus areas. Thirty participants without neurological or psychological disorders underwent offline sham and active tDCS sessions with specific electrode montage targeting the left STG and DLPFC. Source-monitoring tasks, reality monitoring (Hear-Imagine), internal source-monitoring (Say-Imagine), and external source monitoring (Virtual-Real) were administered. Paired t-test and estimation statistics was performed with Graphpad version 10.1.0. The Benjamini-Hochberg procedure was employed to control the false discovery rate in multiple hypothesis testing. A significant improvement in internal source monitoring tasks (p = 0.001, Cohen's d = 0.97) was observed, but reality monitoring tasks demonstrated moderate improvement (p = 0.02, Cohen's d = 0.44). The study provides insights into the neural mechanisms of source monitoring in healthy individuals and proposes tDCS as a therapeutic intervention, laying the foundation for future studies to refine tDCS protocols and develop individualized approaches to address source monitoring deficits in schizophrenia.


Assuntos
Estudos Cross-Over , Alucinações , Esquizofrenia , Estimulação Transcraniana por Corrente Contínua , Humanos , Estimulação Transcraniana por Corrente Contínua/métodos , Masculino , Feminino , Alucinações/terapia , Alucinações/fisiopatologia , Adulto , Esquizofrenia/terapia , Esquizofrenia/fisiopatologia , Adulto Jovem , Córtex Pré-Frontal Dorsolateral/fisiologia , Lobo Temporal/fisiopatologia , Lobo Temporal/fisiologia
3.
Sci Rep ; 14(1): 14748, 2024 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-38926597

RESUMO

Visual hallucinations in Lewy body disease (LBD) can be differentiated based on phenomenology into minor phenomena (MVH) and complex hallucinations (CVH). MVH include a variety of phenomena, such as illusions, presence and passage hallucinations occurring at early stages of LBD. The neural mechanisms of visual hallucinations are largely unknown. The hodotopic model posits that the hallucination state is due to abnormal activity in specialized visual areas, that occurs in the context of wider network connectivity alterations and that phenomenology of VH, including content and temporal characteristics, may help identify brain regions underpinning these phenomena. Here we investigated both the topological and hodological neural basis of visual hallucinations integrating grey and white matter imaging analyses. We studied LBD patients with VH and age matched healthy controls (HC). VH were assessed using a North-East-Visual-Hallucinations-Interview that captures phenomenological detail. Then we applied voxel-based morphometry and tract based spatial statistics approaches to identify grey and white matter changes. First, we compared LBD patients and HC. We found a reduced grey matter volume and a widespread damage of white tracts in LBD compared to HC. Then we tested the association between CVH and MVH and grey and white matter indices. We found that CVH duration was associated with decreased grey matter volume in the fusiform gyrus suggesting that LBD neurodegeneration-related abnormal activity in this area is responsible for CVH. An unexpected finding was that MVH severity was associated with a greater integrity of white matter tracts, specifically those connecting dorsal, ventral attention networks and visual areas. Our results suggest that networks underlying MVH need to be partly intact and functional for MVH experiences to occur, while CVH occur when cortical areas are damaged. The findings support the hodotopic view and the hypothesis that MVH and CVH relate to different neural mechanisms, with wider implications for the treatment of these symptoms in a clinical context.


Assuntos
Substância Cinzenta , Alucinações , Doença por Corpos de Lewy , Substância Branca , Humanos , Alucinações/fisiopatologia , Alucinações/etiologia , Alucinações/diagnóstico por imagem , Doença por Corpos de Lewy/fisiopatologia , Doença por Corpos de Lewy/patologia , Doença por Corpos de Lewy/diagnóstico por imagem , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Substância Cinzenta/fisiopatologia , Feminino , Substância Branca/diagnóstico por imagem , Substância Branca/patologia , Substância Branca/fisiopatologia , Masculino , Idoso , Imageamento por Ressonância Magnética , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Pessoa de Meia-Idade
4.
Behav Neurosci ; 138(3): 195-211, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38934921

RESUMO

In recent years, there have been significant advances in our understanding of the positive symptoms of schizophrenia, such as hallucinations and delusions. This progress has been significantly aided by the use of associative learning-based approaches in human subjects and preclinical animal models. Here, we first review experimental research focusing on the abnormal processing of absent stimuli using three different conditioning phenomena: conditioned hallucinations, mediated conditioning, and trace conditioning. We then review studies investigating the ability to reduce focal processing of physically present but informationally redundant stimuli using habituation, latent inhibition, and blocking. The results of these different lines of research are then summarized within the framework of Wagner's (1981) standard operating procedures model, an associative learning model with explicit reference to the internal representations of both present and absent stimuli. Within this framework, the central deficit associated with positive symptoms can be described as a failure to suppress the focal processing of both absent stimuli and present but irrelevant stimuli. This can explain the wide range of results obtained in different experimental settings. Finally, we briefly discuss the role of the hippocampus and its interaction with dopaminergic transmission in the emergence of such abnormal stimulus representations and learning. Overall, we hope that the theoretical framework and empirical findings offered by the associative learning approach will continue to facilitate and integrate analyses of schizophrenia conducted at the psychological and behavioral levels on the one hand, and at the neural and molecular levels on the other, by serving as a useful interface between them. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Aprendizagem por Associação , Esquizofrenia , Humanos , Aprendizagem por Associação/fisiologia , Esquizofrenia/fisiopatologia , Animais , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/fisiopatologia , Alucinações/fisiopatologia , Psicologia do Esquizofrênico , Condicionamento Clássico/fisiologia , Hipocampo/fisiologia , Percepção/fisiologia
5.
Schizophr Res ; 269: 64-70, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38733801

RESUMO

BACKGROUND AND HYPOTHESIS: Hearing voices is a common and often distressing experience for people with psychosis, and many individuals experience medication-resistant auditory verbal hallucinations (AVH). Psychosocial interventions are often employed to address distress over hearing voices. However, although links have been made between adverse social experiences and psychosis broadly, no work has yet delineated the relationship between day-to-day social stress and hallucination severity. We aimed to define that relationship in both clinical and non-clinical voice-hearers. STUDY DESIGN: A sample of 278 participants with a history of hearing voices was selected from the Yale Control Over Perceptual Experiences (COPE) Project. They were administered self-report measures of recent stress and recent auditory experiences within a cross-sectional design. Regression models were used to evaluate whether self-reported aspects of recent stress-and social stress in particular-were related to recent frequency of and distress over hearing voices. Related demographics and clinical characteristics were included as covariates. STUDY RESULTS: A significant relationship was observed between recent social stress and both recent frequency of and distress over hearing voices. While other aspects of recent stress were also related to recent distress over voices, social stressors uniquely predicted distress over voice-hearing, beyond the influence of other stressors. Depressive symptom severity was also related to distress over voices. CONCLUSIONS: Results suggest that daily social stress may be an important consideration and a potential treatment target for individuals experiencing clinical distress over auditory hallucinations.


Assuntos
Alucinações , Estresse Psicológico , Humanos , Alucinações/fisiopatologia , Alucinações/etiologia , Feminino , Masculino , Adulto , Estudos Transversais , Pessoa de Meia-Idade , Transtornos Psicóticos/fisiopatologia , Adulto Jovem , Autorrelato , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença
6.
Psychiatry Res Neuroimaging ; 341: 111824, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38754348

RESUMO

Auditory verbal hallucinations (AVHs) involve perceptions, often voices, in the absence of external stimuli, and rank among the most common symptoms of schizophrenia. Metrical stress evaluation requires determination of the stronger syllable in words, and therefore requires auditory imagery, of interest for investigation of hallucinations in schizophrenia. The current functional magnetic resonance imaging study provides an updated whole-brain network analysis of a previously published study on metrical stress, which showed reduced directed connections between Broca's and Wernicke's regions of interest (ROIs) for hallucinations. Three functional brain networks were extracted, with the language network (LN) showing an earlier and shallower blood-oxygen-level dependent (BOLD) response for hallucinating patients, in the auditory imagery condition only (the reduced activation for hallucinations observed in the original ROI-based results were not specific to the imagery condition). This suggests that hypoactivation of the LN during internal auditory imagery may contribute to the propensity to hallucinate. This accords with cognitive accounts holding that an impaired balance between internal and external linguistic processes (underactivity in networks involved in internal auditory imagery and overactivity in networks involved in speech perception) contributes to our understanding of the biological underpinnings of hallucinations.


Assuntos
Alucinações , Imageamento por Ressonância Magnética , Esquizofrenia , Humanos , Alucinações/fisiopatologia , Alucinações/diagnóstico por imagem , Alucinações/psicologia , Alucinações/etiologia , Esquizofrenia/fisiopatologia , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/complicações , Adulto , Masculino , Feminino , Imaginação/fisiologia , Idioma , Mapeamento Encefálico/métodos , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/fisiopatologia , Encéfalo/fisiopatologia , Encéfalo/diagnóstico por imagem , Percepção Auditiva/fisiologia
8.
Schizophr Res ; 269: 123-129, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38772324

RESUMO

BACKGROUND: Persistent auditory verbal hallucinations (pAVHs) are a fundamental manifestation of schizophrenia (SCZ), yet the exact connection between pAVHs and brain structure remains contentious. This study aims to explore the potential correlation between pAVHs and alterations in grey matter volume (GMV) within specific brain regions among individuals diagnosed with SCZ. METHODS: 76 SCZ patients with pAVHs (pAVH group), 57 SCZ patients without AVHs (non-AVH group), and 83 healthy controls (HC group) were investigated using 3 T magnetic resonance imaging. The P3 hallucination item of the Positive and Negative Syndrome Scale was used to assess the severity of pAVHs. Voxel-based morphometry was used to analyze the GMV profile between the three groups. RESULTS: Compared to the non-AVH and HC groups, the pAVH group exhibited extensive reduction in GMV within the frontotemporal cortex. Conversely, no significant difference in GMV was observed between the non-AVH and HC groups. The severity of pAVHs showed a negative correlation with GMV in several regions, including the right fusiform, right inferior temporal, right medial orbitofrontal, right superior frontal, and right temporal pole (p = 0.0036, Bonferroni correction). Stepwise linear regression analysis revealed that GMV in the right temporal pole (ß = -0.29, p = 0.001) and right fusiform (ß = -0.21, p = 0.01) were significantly associated with the severity of pAVHs. CONCLUSIONS: Widespread reduction in GMV is observed within the frontotemporal cortex, particularly involving the right temporal pole and right fusiform, which potentially contribute to the pathogenesis of pAVHs in individuals with chronic SCZ.


Assuntos
Substância Cinzenta , Alucinações , Imageamento por Ressonância Magnética , Esquizofrenia , Lobo Temporal , Humanos , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/patologia , Alucinações/diagnóstico por imagem , Alucinações/etiologia , Alucinações/patologia , Alucinações/fisiopatologia , Masculino , Feminino , Adulto , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/patologia , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologia , Doença Crônica , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Pessoa de Meia-Idade , Adulto Jovem , China , População do Leste Asiático
9.
Cell Rep ; 43(4): 114017, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38578827

RESUMO

The relationship between sensory stimuli and perceptions is brain-state dependent: in wakefulness, suprathreshold stimuli evoke perceptions; under anesthesia, perceptions are abolished; and during dreaming and in dissociated states, percepts are internally generated. Here, we exploit this state dependence to identify brain activity associated with internally generated or stimulus-evoked perceptions. In awake mice, visual stimuli phase reset spontaneous cortical waves to elicit 3-6 Hz feedback traveling waves. These stimulus-evoked waves traverse the cortex and entrain visual and parietal neurons. Under anesthesia as well as during ketamine-induced dissociation, visual stimuli do not disrupt spontaneous waves. Uniquely, in the dissociated state, spontaneous waves traverse the cortex caudally and entrain visual and parietal neurons, akin to stimulus-evoked waves in wakefulness. Thus, coordinated neuronal assemblies orchestrated by traveling cortical waves emerge in states in which perception can manifest. The awake state is privileged in that this coordination is reliably elicited by external visual stimuli.


Assuntos
Neurônios , Vigília , Animais , Vigília/fisiologia , Camundongos , Neurônios/fisiologia , Alucinações/fisiopatologia , Masculino , Camundongos Endogâmicos C57BL , Ketamina/farmacologia , Estimulação Luminosa , Ondas Encefálicas/fisiologia , Córtex Visual/fisiologia , Encéfalo/fisiologia
10.
Schizophr Res ; 267: 349-355, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38615563

RESUMO

INTRODUCTION: Predictive models of psychotic symptoms could improve ecological momentary interventions by dynamically providing help when it is needed. Wearable sensors measuring autonomic arousal constitute a feasible base for predictive models since they passively collect physiological data linked to the onset of psychotic experiences. To explore this potential, we investigated whether changes in autonomic arousal predict the onset of hallucination spectrum experiences (HSE) and paranoia in individuals with an increased likelihood of experiencing psychotic symptoms. METHOD: For 24 h of ambulatory assessment, 62 participants wore electrodermal activity and heart rate sensors and were provided with an Android smartphone to answer questions about their HSE-, and paranoia-levels every 20 min. We calculated random forests to detect the onset of HSEs and paranoia. The generalizability of our models was tested using leave-one-assessment-out and leave-one-person-out cross-validation. RESULTS: Leave-one-assessment-out models that relied on physiological data and participant ID yielded balanced accuracy scores of 80 % for HSE and 66 % for paranoia. Adding baseline information about lifetime experiences of psychotic symptoms increased balanced accuracy to 82 % (HSE) and 70 % (paranoia). Leave-one-person-out models yielded lower balanced accuracy scores (51 % to 58 %). DISCUSSION: Using passively collectible variables to predict the onset of psychotic experiences is possible and prediction models improve with additional information about lifetime experiences of psychotic symptoms. Generalizing to new individuals showed poor performance, so including personal data from a recipient may be necessary for symptom prediction. Completely individualized prediction models built solely with the data of the person to be predicted might increase accuracy further.


Assuntos
Avaliação Momentânea Ecológica , Resposta Galvânica da Pele , Alucinações , Transtornos Paranoides , Estudo de Prova de Conceito , Transtornos Psicóticos , Dispositivos Eletrônicos Vestíveis , Humanos , Masculino , Feminino , Adulto , Transtornos Psicóticos/fisiopatologia , Transtornos Psicóticos/diagnóstico , Alucinações/fisiopatologia , Alucinações/diagnóstico , Alucinações/etiologia , Resposta Galvânica da Pele/fisiologia , Adulto Jovem , Transtornos Paranoides/fisiopatologia , Transtornos Paranoides/diagnóstico , Frequência Cardíaca/fisiologia , Smartphone , Monitorização Ambulatorial/instrumentação , Pessoa de Meia-Idade
11.
J Neurosci Methods ; 407: 110138, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38648892

RESUMO

BACKGROUND: Resting state (RS) brain activity is inherently non-stationary. Hidden semi-Markov Models (HsMM) can characterize continuous RS data as a sequence of recurring and distinct brain states along with their spatio-temporal dynamics. NEW METHOD: Recent explorations suggest that HsMM state dynamics in the alpha frequency band link to auditory hallucination proneness (HP) in non-clinical individuals. The present study aimed to replicate these findings to elucidate robust neural correlates of hallucinatory vulnerability. Specifically, we aimed to investigate the reproducibility of HsMM states across different data sets and within-data set variants as well as the replicability of the association between alpha brain state dynamics and HP. RESULTS: We found that most brain states are reproducible in different data sets, confirming that the HsMM characterized robust and generalizable EEG RS dynamics on a sub-second timescale. Brain state topographies and temporal dynamics of different within-data set variants showed substantial similarities and were robust against reduced data length and number of electrodes. However, the association with HP was not directly reproducible across data sets. COMPARISON WITH EXISTING METHODS: The HsMM optimally leverages the high temporal resolution of EEG data and overcomes time-domain restrictions of other state allocation methods. CONCLUSION: The results indicate that the sensitivity of brain state dynamics to capture individual variability in HP may depend on the data recording characteristics and individual variability in RS cognition, such as mind wandering. Future studies should consider that the order in which eyes-open and eyes-closed RS data are acquired directly influences an individual's attentional state and generation of spontaneous thoughts, and thereby might mediate the link to hallucinatory vulnerability.


Assuntos
Ritmo alfa , Alucinações , Humanos , Ritmo alfa/fisiologia , Alucinações/fisiopatologia , Adulto , Masculino , Feminino , Eletroencefalografia/métodos , Adulto Jovem , Encéfalo/fisiologia , Descanso/fisiologia , Reprodutibilidade dos Testes
12.
Aust N Z J Psychiatry ; 58(6): 467-497, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38470085

RESUMO

OBJECTIVE: Auditory hallucinations (hearing voices) have been associated with a range of altered cognitive functions, pertaining to signal detection, source-monitoring, memory, inhibition and language processes. Yet, empirical results are inconsistent. Despite this, several theoretical models of auditory hallucinations persist, alongside increasing emphasis on the utility of a multidimensional framework. Thus, clarification of current evidence across the broad scope of proposed mechanisms is warranted. METHOD: A systematic search of the Web of Science, PubMed and Scopus databases was conducted. Records were screened to confirm the use of an objective behavioural cognitive task, and valid measurement of hallucinations specific to the auditory modality. RESULTS: Auditory hallucinations were primarily associated with difficulties in perceptual decision-making (i.e. reduced sensitivity/accuracy for signal-noise discrimination; liberal responding to ambiguity), source-monitoring (i.e. self-other and temporal context confusion), working memory and language function (i.e. reduced verbal fluency). Mixed or limited support was observed for perceptual feature discrimination, imagery vividness/illusion susceptibility, source-monitoring for stimulus form and spatial context, recognition and recall memory, executive functions (e.g. attention, inhibition), emotion processing and language comprehension/hemispheric organisation. CONCLUSIONS: Findings were considered within predictive coding and self-monitoring frameworks. Of concern was the portion of studies which - despite offering auditory-hallucination-specific aims and inferences - employed modality-general measures, and/or diagnostic-based contrasts with psychologically healthy individuals. This review highlights disparities within the literature between theoretical conceptualisations of auditory hallucinations and the body of rigorous empirical evidence supporting such inferences. Future cognitive investigations, beyond the schizophrenia-spectrum, which explicitly define and measure the timeframe and sensory modality of hallucinations, are recommended.


Assuntos
Alucinações , Alucinações/fisiopatologia , Humanos , Cognição/fisiologia , Percepção Auditiva/fisiologia , Função Executiva/fisiologia
13.
Schizophr Res ; 267: 86-98, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38531161

RESUMO

BACKGROUND: Auditory verbal hallucinations (AVH) are a disabling symptom for people with schizophrenia (SCZ), and do not always respond to antipsychotics. Repetitive transcranial magnetic stimulation (rTMS) has shown efficacy for medication-refractory AVH, though the underlying neural mechanisms by which rTMS produces these effects remain unclear. This systematic review evaluated the structural and functional impact of rTMS for AVH in SCZ, and its association with clinical outcomes. METHODS: A systematic search was conducted in Medline, PsychINFO, and PubMed using terms for four key concepts: AVH, SCZ, rTMS, neuroimaging. Using PRISMA guidelines, 18 studies were identified that collected neuroimaging data of an rTMS intervention for AVH in SCZ. Risk of bias assessments was conducted. RESULTS: Low frequency (<5 Hz) rTMS targeting left hemispheric language processing regions may normalize brain abnormalities in AVH patients at structural, functional, electrophysiological, and topological levels, with concurrent symptom improvement. Amelioration of aberrant neural activity in frontotemporal networks associated with speech and auditory processing was commonly observed, as well as in cerebellar and emotion regulation regions. Neuroimaging analyses identified neural substrates with direct correlations to post-rTMS AVH severity, propounding their use as therapeutic targets. DISCUSSION: Combined rTMS-neuroimaging highlights the multidimensional alterations of rTMS on brain activity and structure in treatment-resistant AVH, which may be used to develop more efficacious therapies. Larger randomized, sham-controlled studies are needed. Future studies should explore alternate stimulation targets, investigate the neural effects of high-frequency rTMS and evaluate long-term neuroimaging outcomes.


Assuntos
Alucinações , Esquizofrenia , Estimulação Magnética Transcraniana , Humanos , Alucinações/terapia , Alucinações/etiologia , Alucinações/fisiopatologia , Esquizofrenia/terapia , Esquizofrenia/fisiopatologia , Esquizofrenia/complicações , Esquizofrenia/diagnóstico por imagem , Avaliação de Resultados em Cuidados de Saúde
14.
Schizophr Res ; 267: 19-23, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38513330

RESUMO

BACKGROUND: A scale for self-assessment of auditory verbal hallucinations (SAVH) was developed for patients, and this study aimed to validate the scale by investigating its psychometric properties. METHODS: Forty one patients with schizophrenia or schizoaffective disorders (DSM-5) self-assessed their hallucinations using nine SAVH questions. Each question was scored from 0 to 5, indicating the severity of the symptoms. Patients were also evaluated with the Brief Psychiatric Rating Scale (BPRS), Auditory Hallucination Rating Scale (AHRS), and Birchwood Insight Scale (BIS). The psychometric properties of the SAVH were assessed by the face, internal consistency, construct, convergent and discriminant validities. RESULTS: SAVH scores were used to examine the psychometric properties. Cronbach's α and Guttman's Lambda-6 were 0.67 and 0.73 respectively. Significant correlations were observed between SAVH and AHRS total scores, as well as BPRS hallucinatory behavior subscores. No significant correlations were found between total SAVH scores and (i) levels of insight or (ii) negative BPRS subscores. Factor analysis on SAVH revealed three factors accounting for 59.3 % of the variance. Most patients found the questions clear, appropriate, and of adequate length. CONCLUSIONS: SAVH demonstrated good psychometric properties, suggesting its utility in assessing auditory verbal hallucinations (AVH). This self-assessment could be valuable in evaluating AVH treatment efficacy, monitoring AVH, and empowering patients.


Assuntos
Alucinações , Psicometria , Transtornos Psicóticos , Esquizofrenia , Humanos , Alucinações/diagnóstico , Alucinações/etiologia , Alucinações/fisiopatologia , Masculino , Feminino , Esquizofrenia/complicações , Esquizofrenia/fisiopatologia , Adulto , Psicometria/normas , Transtornos Psicóticos/fisiopatologia , Transtornos Psicóticos/complicações , Transtornos Psicóticos/diagnóstico , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Autoavaliação (Psicologia) , Escalas de Graduação Psiquiátrica/normas , Psicologia do Esquizofrênico , Adulto Jovem , Autoavaliação Diagnóstica , Análise Fatorial
15.
Artigo em Inglês | MEDLINE | ID: mdl-38311290

RESUMO

BACKGROUND: Sensory prediction allows the brain to anticipate and parse incoming self-generated sensory information from externally generated signals. Sensory prediction breakdowns may contribute to perceptual and agency abnormalities in psychosis (hallucinations, delusions). The pons, a central node in a cortico-ponto-cerebellar-thalamo-cortical circuit, is thought to support sensory prediction. Examination of pons connectivity in schizophrenia and its role in sensory prediction abnormalities is lacking. METHODS: We examined these relationships using resting-state functional magnetic resonance imaging and the electroencephalography-based auditory N1 event-related potential in 143 participants with psychotic spectrum disorders (PSPs) (with schizophrenia, schizoaffective disorder, or bipolar disorder); 63 first-degree relatives of individuals with psychosis; 45 people at clinical high risk for psychosis; and 124 unaffected comparison participants. This unique sample allowed examination across the psychosis spectrum and illness trajectory. Seeding from the pons, we extracted average connectivity values from thalamic and cerebellar clusters showing differences between PSPs and unaffected comparison participants. We predicted N1 amplitude attenuation during a vocalization task from pons connectivity and group membership. We correlated participant-level connectivity in PSPs and people at clinical high risk for psychosis with hallucination and delusion severity. RESULTS: Compared to unaffected comparison participants, PSPs showed pons hypoconnectivity to 2 cerebellar clusters, and first-degree relatives of individuals with psychosis showed hypoconnectivity to 1 of these clusters. Pons-to-cerebellum connectivity was positively correlated with N1 attenuation; only PSPs with heightened pons-to-postcentral gyrus connectivity showed this pattern, suggesting a possible compensatory mechanism. Pons-to-cerebellum hypoconnectivity was correlated with greater hallucination severity specifically among PSPs with schizophrenia. CONCLUSIONS: Deficient pons-to-cerebellum connectivity linked sensory prediction network breakdowns with perceptual abnormalities in schizophrenia. Findings highlight shared features and clinical heterogeneity across the psychosis spectrum.


Assuntos
Cerebelo , Eletroencefalografia , Alucinações , Imageamento por Ressonância Magnética , Ponte , Transtornos Psicóticos , Esquizofrenia , Humanos , Alucinações/fisiopatologia , Esquizofrenia/fisiopatologia , Esquizofrenia/complicações , Masculino , Feminino , Adulto , Transtornos Psicóticos/fisiopatologia , Transtornos Psicóticos/diagnóstico por imagem , Transtornos Psicóticos/complicações , Ponte/fisiopatologia , Cerebelo/fisiopatologia , Cerebelo/diagnóstico por imagem , Vias Neurais/fisiopatologia , Adulto Jovem
16.
Biol Psychiatry ; 96(3): 207-221, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38246250

RESUMO

BACKGROUND: Sensory attenuation (SA), the dampened perception of self-generated sensory information, is typically associated with reduced event-related potential signals, such as for the N1 component of auditory event-related potentials. SA, together with efficient monitoring of intentions and actions, should facilitate the distinction between self-generated and externally generated sensory events, thereby optimizing interaction with the world. According to many, SA is deficient in schizophrenia. The question arises whether altered SA reflects a sufficient mechanism to explain positive symptoms such as auditory hallucinations. A systematic association of reduced auditory SA in hallucinating patients would support this hypothesis. METHODS: We conducted a series of meta-analyses on 15 studies on auditory SA in which the N1 component of event-related potential-electroencephalogram signals was measured during talking (self-generated sensory signals condition) or when listening to prerecorded vocalizations (externally generated sensory signals condition). RESULTS: We found that individuals with schizophrenia did show some auditory SA because their N1 signal was significantly attenuated in talking conditions compared with listening conditions. However, the magnitude of such attenuation was reduced in individuals with schizophrenia compared to healthy control participants. This phenomenon generalizes independently from the stage of the disease, the severity of positive symptoms, and whether patients have auditory hallucinations or not. CONCLUSIONS: These findings suggest that reduced SA cannot be a sufficient mechanism for explaining positive symptoms such as auditory hallucinations in schizophrenia. Because reduced SA was also present in participants at risk of schizophrenia, reduced SA may represent a risk factor for the disorder. We discuss the implications of these results for clinical-cognitive models of schizophrenia.


Assuntos
Alucinações , Esquizofrenia , Alucinações/fisiopatologia , Alucinações/etiologia , Humanos , Esquizofrenia/fisiopatologia , Esquizofrenia/complicações , Fatores de Risco , Eletroencefalografia , Potenciais Evocados Auditivos/fisiologia , Percepção Auditiva/fisiologia , Potenciais Evocados/fisiologia , Estimulação Acústica
17.
Sleep ; 47(5)2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38197577

RESUMO

STUDY OBJECTIVES: Narcolepsy type 2 (NT2) is an understudied central disorder of hypersomnolence sharing some similarities with narcolepsy type 1 and idiopathic hypersomnia (IH). We aimed: (1) to assess systematically the symptoms in patients with NT2, with self-reported questionnaires: Epworth Sleepiness Scale (ESS), Narcolepsy Severity Scale (NSS), IH Severity Scale (IHSS), and (2) to evaluate the responsiveness of these scales to treatment. METHODS: One hundred and nine patients with NT2 (31.4 ±â€…12.2 years old, 47 untreated) diagnosed according to ICSD-3 were selected in a Reference Center for Narcolepsy. They all completed the ESS, subgroups completed the modified NSS (NSS-2, without cataplexy items) (n = 95) and IHSS (n = 76). Some patients completed the scales twice (before/during treatment): 42 ESS, 26 NSS-2, and 30 IHSS. RESULTS: Based on NSS-2, all untreated patients had sleepiness, 58% disrupted nocturnal sleep, 40% hallucinations, and 28% sleep paralysis. On IHSS, 76% reported a prolonged nocturnal sleep, and 83% sleep inertia. In the independent sample, ESS and NSS-2 scores were lower in treated patients, with same trend for IHSS scores. After treatment, ESS, NSS-2, and IHSS total scores were lower, with a mean difference of 3.7 ±â€…4.1, 5.3 ±â€…6.7, and 4.1 ±â€…6.2, respectively. The minimum clinically important difference between untreated and treated patients were 2.1 for ESS, 3.3 for NSS-2, and 3.1 for IHSS. After treatment, 61.9% of patients decreased their ESS > 2 points, 61.5% their NSS-2 > 3 points, and 53.3% their IHSS > 3 points. CONCLUSIONS: NSS-2 and IHSS correctly quantified symptoms' severity and consequences in NT2, with good performances to objectify response to medications. These tools are useful for monitoring and optimizing NT2 management, and for use in clinical trials.


Assuntos
Hipersonia Idiopática , Narcolepsia , Índice de Gravidade de Doença , Humanos , Narcolepsia/diagnóstico , Narcolepsia/fisiopatologia , Narcolepsia/tratamento farmacológico , Masculino , Feminino , Adulto , Hipersonia Idiopática/diagnóstico , Hipersonia Idiopática/fisiopatologia , Inquéritos e Questionários , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Distúrbios do Sono por Sonolência Excessiva/fisiopatologia , Alucinações/diagnóstico , Alucinações/fisiopatologia , Pessoa de Meia-Idade , Modafinila/uso terapêutico , Adulto Jovem , Paralisia do Sono/diagnóstico , Paralisia do Sono/fisiopatologia , Autorrelato , Promotores da Vigília/uso terapêutico
18.
Psychiatry Res Neuroimaging ; 331: 111632, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36958075

RESUMO

Auditory verbal hallucinations (AVH) are a core positive symptom of schizophrenia and are regarded as a consequence of the functional breakdown in the related sensory process. Yet, the potential mechanism of AVH is still lacking. In the present study, we explored the difference between AVHs (n = 23) and non-AVHs (n = 19) in schizophrenia and healthy controls (n = 29) by using multidimensional electroencephalograms data during an auditory oddball task. Compared to healthy controls, both AVH and non-AVH groups showed reduced P300 amplitudes. Additionally, the results from brain networks analysis revealed that AVH patients showed reduced left frontal to posterior parietal/temporal connectivity compared to non-AVH patients. Moreover, using the fused network properties of both delta and theta bands as features for in-depth learning made it possible to identify the AVH from non-AVH patients at an accuracy of 80.95%. The left frontal-parietal/temporal networks seen in the auditory oddball paradigm might be underlying biomarkers of AVH in schizophrenia. This study demonstrated for the first time the functional breakdown of the auditory processing pathway in the AVH patients, leading to a better understanding of the atypical brain network of the AVH patients.


Assuntos
Percepção Auditiva , Encéfalo , Eletroencefalografia , Alucinações , Vias Neurais , Esquizofrenia , Adolescente , Adulto , Humanos , Adulto Jovem , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Potenciais Evocados P300 , Alucinações/complicações , Alucinações/fisiopatologia , Esquizofrenia/complicações , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/fisiopatologia
19.
Neuroimage ; 248: 118862, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34971766

RESUMO

The perception that someone is nearby, although nobody can be seen or heard, is called presence hallucination (PH). Being a frequent hallucination in patients with Parkinson's disease, it has been argued to be indicative of a more severe and rapidly advancing form of the disease, associated with psychosis and cognitive decline. PH may also occur in healthy individuals and has recently been experimentally induced, in a controlled manner during fMRI, using MR-compatible robotics and sensorimotor stimulation. Previous neuroimaging correlates of such robot-induced PH, based on conventional time-averaged fMRI analysis, identified altered activity in the posterior superior temporal sulcus and inferior frontal gyrus in healthy individuals. However, no link with the strength of the robot-induced PH was observed, and such activations were also associated with other sensations induced by robotic stimulation. Here we leverage recent advances in dynamic functional connectivity, which have been applied to different psychiatric conditions, to decompose fMRI data during PH-induction into a set of co-activation patterns that are tracked over time, as to characterize their occupancies, durations, and transitions. Our results reveal that, when PH is induced, the identified brain patterns significantly and selectively increase their transition probabilities towards a specific brain pattern, centred on the posterior superior temporal sulcus, angular gyrus, dorso-lateral prefrontal cortex, and middle prefrontal cortex. This change is not observed in any other control conditions, nor is it observed in association with other sensations induced by robotic stimulation. The present findings describe the neural mechanisms of PH in healthy individuals and identify a specific disruption of the dynamics of network interactions, extending previously reported network dysfunctions in psychotic patients with hallucinations to an induced robot-controlled specific hallucination in healthy individuals.


Assuntos
Conectoma , Alucinações/fisiopatologia , Imageamento por Ressonância Magnética , Robótica , Adolescente , Adulto , Feminino , Humanos , Masculino
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