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Journal ArticleDOI

Cortical Activations During Auditory Verbal Hallucinations in Schizophrenia: A Coordinate-Based Meta-Analysis

01 Jan 2011-American Journal of Psychiatry (Am J Psychiatry)-Vol. 168, Iss: 1, pp 73-81
TL;DR: This meta-analysis demonstrated that experiencing AVHs is associated with increased activity in fronto-temporal areas involved in speech generation and speech perception, but also within the medial temporal lobe, a structure notably involved in verbal memory.
Abstract: Objective:Auditory verbal hallucinations (AVHs) constitute severe, incapacitating symptoms of schizophrenia. Despite increasing interest in the functional exploration of AVHs, the available findings remain difficult to integrate because of their considerable variability. The authors' aim was to perform a robust quantitative review of existing functional data in order to elucidate consistent patterns observed during the emergence of AVHs and to orient new pathophysiological models of hallucinations. Method:Ten positron emission tomography or functional magnetic resonance imaging studies were selected for the meta-analysis after systematic review. A total of 68 patients with schizophrenia spectrum disorders experiencing AVHs during scanning were included. According to a random-effects activation likelihood estimation algorithm, stereotaxic coordinates of 129 foci, reported as significant in the source studies, were extracted and computed to estimate the brain locations most consistently associated with AVHs...
Citations
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Journal ArticleDOI
TL;DR: A triple network model of aberrant saliency mapping and cognitive dysfunction in psychopathology is proposed, emphasizing the surprising parallels that are beginning to emerge across psychiatric and neurological disorders.

2,712 citations

Journal ArticleDOI
TL;DR: Evidence from imaging studies are brought together to understand the role of the salience network in schizophrenia and a model of insular dysfunction in psychosis is proposed.
Abstract: The insular cortex is one of the brain regions that show consistent abnormalities in both structural and functional neuroimaging studies of schizophrenia. In healthy individuals, the insula has been implicated in a myriad of physiologic functions. The anterior cingulate cortex (ACC) and insula together constitute the salience network, an intrinsic large-scale network showing strong functional connectivity. Considering the insula as a functional unit along with the ACC provides an integrated understanding of the role of the insula in information processing. In this review, we bring together evidence from imaging studies to understand the role of the salience network in schizophrenia and propose a model of insular dysfunction in psychosis.

480 citations


Cites background from "Cortical Activations During Auditor..."

  • ...A meta-analysis of fMRI studies of active auditory hallucinations reveals prominent involvement of the insula, bilateral Broca area and auditory cortex.(108) Evidence from the analysis of whole brain structure in hallucinating patients consistently implicates insular deficits....

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  • ...However, insular activation during hallucinations suggests that the salience network is generating an inappropriate proximal salience during an otherwise normal activity.(108) In particular, such an aberrant activation of the insula is noted alongside a prominent absence of cingulate activation, suggesting disruption in normal salience network activity(126) and perhaps disruption to error-monitoring circuitry....

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Journal ArticleDOI
TL;DR: A multicomponent model of the phenomenon informed by developmental, cognitive, and psycholinguistic considerations is presented, which appears to perform significant functions in human cognition, which in some cases reflect its developmental origins and its sharing of resources with other cognitive processes.
Abstract: Inner speech—also known as covert speech or verbal thinking—has been implicated in theories of cognitive development, speech monitoring, executive function, and psychopathology. Despite a growing body of knowledge on its phenomenology, development, and function, approaches to the scientific study of inner speech have remained diffuse and largely unintegrated. This review examines prominent theoretical approaches to inner speech and methodological challenges in its study, before reviewing current evidence on inner speech in children and adults from both typical and atypical populations. We conclude by considering prospects for an integrated cognitive science of inner speech, and present a multicomponent model of the phenomenon informed by developmental, cognitive, and psycholinguistic considerations. Despite its variability among individuals and across the life span, inner speech appears to perform significant functions in human cognition, which in some cases reflect its developmental origins and its sharing of resources with other cognitive processes.

410 citations


Cites result from "Cortical Activations During Auditor..."

  • ...Recent meta-analyses of symptomcapture studies have come to only partially overlapping conclusions: while Jardri et al. (2011) found AVHs to be associated with activation in left IFG, anterior insula, superior temporal, and hippocampal areas, Kühn and Gallinat (2012) could only find consistent…...

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Journal ArticleDOI
TL;DR: It is suggested that AHs arise from an interaction between abnormal neural activation patterns that produce salient auditory signals and top-down mechanisms that include signal detection errors, executive and inhibition deficits, a tapestry of expectations and memories, and state characteristics that influence how these experiences are interpreted.
Abstract: While the majority of cognitive studies on auditory hallucinations (AHs) have been conducted in schizophrenia (SZ), an increasing number of researchers are turning their attention to different clinical and nonclinical populations, often using SZ findings as a model for research. Recent advances derived from SZ studies can therefore be utilized to make substantial progress on AH research in other groups. The objectives of this article were to (1) present an up-to-date review regarding the cognitive mechanisms of AHs in SZ, (2) review findings from cognitive research conducted in other clinical and nonclinical groups, and (3) integrate these recent findings into a cohesive framework. First, SZ studies show that the cognitive underpinnings of AHs include self-source-monitoring deficits and executive and inhibitory control dysfunctions as well as distortions in top-down mechanisms, perceptual and linguistic processes, and emotional factors. Second, consistent with SZ studies, findings in other population groups point to the role of top-down processing, abnormalities in executive inhibition, and negative emotions. Finally, we put forward an integrated model of AHs that incorporates the above findings. We suggest that AHs arise from an interaction between abnormal neural activation patterns that produce salient auditory signals and top-down mechanisms that include signal detection errors, executive and inhibition deficits, a tapestry of expectations and memories, and state characteristics that influence how these experiences are interpreted. Emotional factors play a particular prominent role at all levels of this hierarchy. Our model is distinctively powerful in explaining a range of phenomenological characteristics of AH across a spectrum of disorders.

344 citations


Cites background from "Cortical Activations During Auditor..."

  • ...deficits in AH.(22) While cognitive evidence for attention and working memory updating remains inconclusive, the role of attention is clearly relevant in early auditory sensory detection mechanisms....

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  • ...This is thought to arise from hyperactivation in functional networks involving the auditory cortex that generate aberrant auditory signals, possibly due to a deviant trigger of activations in language-related areas responsible for AH.(22,53) Anomalous activations might be determined by environmental factors and/or internal (eg, emotional) conditions....

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References
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Journal ArticleDOI
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Journal ArticleDOI
TL;DR: The anatomical findings are relevant to the evolution of language, provide a framework for Lichtheim's symptom‐based neurological model of aphasia, and constrain, anatomically, contemporary connectionist accounts of language.
Abstract: Early anatomically based models of language consisted of an arcuate tract connecting Broca's speech and Wernicke's comprehension centers; a lesion of the tract resulted in conduction aphasia. However, the heterogeneous clinical presentations of conduction aphasia suggest a greater complexity of perisylvian anatomical connections than allowed for in the classical anatomical model. This article re-explores perisylvian language connectivity using in vivo diffusion tensor magnetic resonance imaging tractography. Diffusion tensor magnetic resonance imaging data from 11 right-handed healthy male subjects were averaged, and the arcuate fasciculus of the left hemisphere reconstructed from this data using an interactive dissection technique. Beyond the classical arcuate pathway connecting Broca's and Wernicke's areas directly, we show a previously undescribed, indirect pathway passing through inferior parietal cortex. The indirect pathway runs parallel and lateral to the classical arcuate fasciculus and is composed of an anterior segment connecting Broca's territory with the inferior parietal lobe and a posterior segment connecting the inferior parietal lobe to Wernicke's territory. This model of two parallel pathways helps explain the diverse clinical presentations of conduction aphasia. The anatomical findings are also relevant to the evolution of language, provide a framework for Lichtheim's symptom-based neurological model of aphasia, and constrain, anatomically, contemporary connectionist accounts of language. Ann Neurol 2005

1,653 citations

Journal ArticleDOI
TL;DR: The authors showed that the revised ALE‐algorithm overcomes conceptual problems of former meta‐analyses and increases the specificity of the ensuing results without loosing the sensitivity of the original approach, and may provide a methodologically improved tool for coordinate‐based meta-analyses on functional imaging data.
Abstract: A widely used technique for coordinate-based meta-analyses of neuroimaging data is activation likelihood estimation (ALE). ALE assesses the overlap between foci based on modeling them as probability distributions centered at the respective coordinates. In this Human Brain Project/Neuroinformatics research, the authors present a revised ALE algorithm addressing drawbacks associated with former implementations. The first change pertains to the size of the probability distributions, which had to be specified by the used. To provide a more principled solution, the authors analyzed fMRI data of 21 subjects, each normalized into MNI space using nine different approaches. This analysis provided quantitative estimates of between-subject and between-template variability for 16 functionally defined regions, which were then used to explicitly model the spatial uncertainty associated with each reported coordinate. Secondly, instead of testing for an above-chance clustering between foci, the revised algorithm assesses above-chance clustering between experiments. The spatial relationship between foci in a given experiment is now assumed to be fixed and ALE results are assessed against a null-distribution of random spatial association between experiments. Critically, this modification entails a change from fixed- to random-effects inference in ALE analysis allowing generalization of the results to the entire population of studies analyzed. By comparative analysis of real and simulated data, the authors showed that the revised ALE-algorithm overcomes conceptual problems of former meta-analyses and increases the specificity of the ensuing results without loosing the sensitivity of the original approach. It may thus provide a methodologically improved tool for coordinate-based meta-analyses on functional imaging data.

1,609 citations