Neural Mechanisms of Voluntary Control Over Hallucinations

自愿控制幻觉的神经机制

• 批准号: 10586487
• 负责人: Albert R Powers
• 金额: $ 83.75万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10586487
• 关键词: Acoustics; Automobile Driving; Behavioral; Belief; Biological Assay; Brain; Clinical; Cognitive; Cross-Sectional Studies; Development; Distress; Electroencephalography; Exertion; Exhibits; Goals; Hallucinations; Hearing; Image; Individual; Knowledge; Lead; Location; Loudness; Measures; Participant; Patients; Perception; Persons; Population; Process; Psychoses; Reporting; Route; Running; Symptoms; Translating; Translations; Update; Verbal Auditory Hallucinations; Voice; base; design; disability; experience; insight; neuromechanism; recruit; response; skills; suicidal risk; treatment strategy

Auditory verbal hallucinations (AVH) are among the most distressing symptoms in psychosis, and up to 30% of patients exhibit little to no response to current treatments. This is especially concerning given that the presence of hallucinations alone increases risk of suicide in patients with psychosis. One potential route toward development of new treatments for AVH is based on new evidence that many people with AVH never develop the need to seek treatment, despite the fact that AVH in treatment-seeking and non-treatment-seeking individuals tend to be similar in terms of low-level acoustic qualities such as loudness, duration, and location of voices. One particularly promising predictor comes from the fact that non-treatment-seeking voice-hearing populations consistently endorse a higher degree of control over their experiences than their treatmentseeking counterparts. Perhaps most strikingly, some individuals report an ability to fully control the onset and offset of their voices, which may make the experience of living with these voices significantly less disruptive and distressing. Moreover, new evidence indicates that voluntary inhibition of AVH may be developed in both treatment-seeking and non-treatment-seeking voice-hearers. Understanding the mechanisms specifically driving voluntary control over AVH could lead to new insights into potential treatment strategies to bolster these abilities. We and others have proposed hypotheses for how voluntary control of AVH might arise from cognitive inhibition, alterations in perceptual inference, or interactions between these processes. We propose to identify the mechanisms underlying inhibitory control of hallucinations. We will recruit 102 clinical and non-clinical voice-hearers with a range of control abilities for participation in a set of behavioral, imaging, and electrophysiological tasks designed to identify how voluntary control over voice-hearing occurs. Controlling for key confounds, we will relate our proposed measures to control abilities as measured on the newly-validated Yale Control Over Perceptual Experiences (COPE) Scale. We will also follow a subset of 60 of these participants over two years to identify predictors and correlates of changes in control abilities. To control for presence of hallucinations and psychosis, respectively, we will also recruit 51 matched healthy controls and 51 participants with psychosis but no voice-hearing to participate in the cross-sectional study. Principally, we hypothesize that exertion of control over AVH will result in: 1) activation of separable AVH- and control-related brain networks, the interaction between which will relate to abilities to exert control over AVH; 2) specific alterations in perception as demonstrated by the Conditioned Hallucinations task and EEG measures, corresponding to a decreased precision of perceptual priors, increased perceptual belief updating, or both; and 3) dual-task interference on the Think/No-Think task, an assay of cognitive inhibitory skills. Our goal is to translate the insights gained to new, mechanistically-informed treatments to enhance control over AVH.

听觉语言幻觉（AVH）是最常见的 精神病患者的痛苦症状，高达30%的患者表现出对电流几乎没有反应， 治疗。考虑到幻觉本身的存在会增加风险， 精神病患者的自杀率一种潜在的治疗方法， AVH是基于新的证据，许多人与AVH从来没有发展需要寻求治疗， 尽管寻求治疗和非寻求治疗个体的AVH倾向于相似， 在诸如声音的响度、持续时间和位置的低水平声学质量方面。一 一个特别有希望的预测来自这样一个事实，即非寻求治疗的语音听力 与寻求治疗相比， 同行也许最引人注目的是，有些人报告说，他们有能力完全控制自己的身体。 他们的声音的开始和抵消，这可能会使与这些声音一起生活的经历显着 更少的破坏性和痛苦。此外，新的证据表明，主动抑制AVH可能 在寻求治疗和非寻求治疗的声音听众中发展。了解 特别是驱动对AVH的自愿控制的机制可能会导致对潜在的新见解 治疗策略来增强这些能力。我们和其他人已经提出了假设， AVH的自主控制可能来自认知抑制、知觉推理的改变或 这些过程之间的相互作用。我们建议确定潜在的抑制机制， 控制幻觉。我们将招募102名临床和非临床听音师， 参与一系列行为、成像和电生理任务的控制能力， 来确定对声音听觉的自愿控制是如何发生的。控制关键混淆，我们将 我们提出的控制能力的措施，如新验证的耶鲁控制， 知觉经验量表（科普）。我们还将跟踪60名参与者的子集， 年来确定预测和控制能力的变化相关。控制…的存在 幻觉和精神病，我们还将招募51名匹配的健康对照和51名 患有精神病但没有声音听力的参与者参加了横断面研究。主要是， 我们假设对AVH的控制将导致：1）激活可分离的AVH-和 与控制相关的大脑网络，它们之间的相互作用将与控制能力有关。 AVH; 2）通过条件性幻觉任务证明的感知的特定改变， EEG测量，对应于知觉先验精度的降低，增加了知觉 信念更新，或两者兼而有之; 3）思考/不思考任务上的双任务干扰，认知能力的测定 抑制技能我们的目标是将获得的见解转化为新的，机械上知情的治疗方法 加强对AVH的控制。