Perception of self-generated action in schizophrenia

Abstract

Introduction. Self-generated actions involve central processes of sensorimotor integration that continuously monitor sensory inputs to ensure that motor outputs are congruent with our intentions. This mechanism works automatically in normal conditions but becomes conscious whenever a mismatch happens during the execution of action between expected and current sensorimotor reafferences. It is now admitted in the literature that sensorimotor processes as well as the ability to predict the consequences of our own actions imply the existence of a forward model of action, which is based on efference copies. Recently, it has been proposed that positive symptoms expressed by schizophrenic patients, such as delusions of control or thought insertions, arise because of a deficiency in this forward model, and more particularly, because of a lack of awareness of certain aspects of motor control derived from such an internal model. Method. To test further this hypothesis, 19 schizophrenic patients (10 with and 9 without Schneiderian symptoms) and 19 control subjects performed a visuo-motor conflict task and had verbally to report the felt position of their hand at the end of each trial. Results. Under this experimental procedure, schizophrenic patients - whatever their clinical phenotype - failed to switch to a conscious representation of their hand movements, and then consequently to maintain their level of performance for the sensorimotor adjustment in comparison with controls. Conclusion. Our findings suggest two facts. First, that a functional monitoring of action, based on a forward