Abstract
In this article, we have reviewed recent findings from our laboratory, originally presented in Hugdahl et al. (2008). These findings reveal that auditory hallucinations in schizophrenia should best be conceptualized as internally generated speech mis-representations lateralized to the left superior temporal gyrus and sulcus, not cognitively suppressed due to enhanced attention to the ‘voices’ and failure of fronto-parietal executive control functions. An overview of diagnostic questionnaires for scoring of symptoms is presented together with a review of behavioral, structural, and functional MRI data. Functional imaging data have either shown increased or decreased activation depending on whether patients have been presented an external stimulus during scanning. Structural imaging data have shown reduction of grey matter density and volume in the same areas in the temporal lobe. We have proposed a model for the understanding of auditory hallucinations that trace the origin of auditory hallucinations to neuronal abnormality in the speech areas in the left temporal lobe, which is not suppressed by volitional cognitive control processes, due to dysfunctional fronto-parietal executive cortical networks.
Highlights
Auditory hallucinations in schizophreniaAuditory hallucinations Auditory hallucinations in schizophrenia are seen as perceptual mis-representations
We have proposed a model for the understanding of auditory hallucinations that trace the origin of auditory hallucinations to neuronal abnormality in the speech areas in the left temporal lobe, which is not suppressed by volitional cognitive control processes, due to dysfunctional fronto-parietal executive cortical networks
Summary and conclusions The research on which the present review is based (Hugdahl et al, 2008) have shown that patients with schizophrenia who experience frequent auditory hallucinations show reduced grey matter density and neuronal activation when measured with voxel-based morphometry (VBM) analysis from structural MR images
Summary
Auditory hallucinations Auditory hallucinations in schizophrenia are seen as perceptual mis-representations. The voices experienced by patients with schizophrenia often have an emotional and negative content,like‘You are worthless, and could as well be dead’, or could take the form of imperative statements like ‘Get lost, you should not be here’. It will be interesting to find out if the ‘voices’ heard by non-psychotic individuals share cognitive and/or neuronal symptoms with individuals diagnosed with schizophrenia. The BPRS, PANSS, and SANS/SAPS scales contain statements regarding the experience of specific symptoms that are scored according to frequency and intensity. The BAVQ-R is a self-report scale that does not need interpretation of the patient’s response by a clinician to get a score, and contains simple statements, like ‘the voice is controlling my life’, that the patient answers by marking whether he/she agrees or disagrees.
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