Relationship of imprecise corollary discharge in schizophrenia to auditory hallucinations
Relationship of imprecise corollary discharge in schizophrenia to auditory hallucinations
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DOI：
10.1001/archpsyc.64.3.286
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发表时间：
2007-03-01
影响因子：
--
通讯作者：
Ford, Judith M.
中科院分区：
文献类型：
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作者：
Heinks-Maldonado, Theda H.;Mathalon, Daniel H.;Ford, Judith M.
背景：预期的思想和行动的前向模型使感觉皮质为这些行动的结果的感觉做好准备。目的：使用听觉事件相关电位的N100成分来评估精神分裂症前向模型的精确度，以评估实时改变或未改变的言语。设计：前瞻性病例对照研究。地点：加州帕洛阿尔托社区精神卫生中心和帕洛阿尔托退伍军人事务卫生保健系统。参与者：20名精神分裂症患者和17名性别和年龄匹配的健康对照受试者。主要观察指标：N100对听觉反馈的反应，通过改变自己的声音音调、替换异类声音或改变异类声音的音调来改变。在每一次试验中，受试者判断反馈是“自我”、“他人”还是“不确定”。结果：在对照组中，N100对未改变的自身声音反馈相对于N100对改变的自身声音或异物听觉反馈的抑制。这种模式在出现幻觉的患者中看不到。这种不精确性与幻觉的严重程度和错误归因错误的百分比相关。结论：这些数据支持听觉语言幻觉和预示思想和行为的感觉后果的必然放电的不精确性之间的联系。
Context: A forward model of intended thoughts and actions prepares sensory cortex for sensations that are a consequence of those actions. Imprecision of the corollary discharge in schizophrenia may contribute to the misperception of inner experiences and thoughts as "voices" or auditory hallucinations.Objectives: To assess the precision of the forward model in schizophrenia using the N100 component of the auditory event-related potential to speech that is altered or unaltered, in real time, as it is being spoken. To assess the relationship between auditory hallucinations and the imprecision of the corollary discharge.Design: Prospective case-control study.Setting: Community mental health centers and Palo Alto Veterans Affairs Health Care System, Palo Alto, Calif.Participants: Twenty patients with schizophrenia and 17 sex- and age-matched healthy control subjects.Main Outcome Measures: N100 responses to auditory feedback, which was altered by pitch-shifting the self-voice, substituting an alien voice, or pitch-shifting the alien voice. On each trial, subjects judged whether feedback was "self," "other," or "unsure." Clinical ratings were used to assess severity of auditory hallucinations in patients.Results: In controls, N100 to unaltered self-voice feedback was dampened relative to N100 to altered self-voice or alien auditory feedback. This pattern was not seen in hallucinating patients. This imprecision correlated with the severity of hallucinations and with the percentage of misattribution errors.Conclusion: These data support a connection between auditory verbal hallucinations and the imprecision of the corollary discharge heralding the sensory consequences of thoughts and actions.