Resting state activity and the "stream of consciousness" in schizophrenia--neurophenomenal hypotheses.

Abstract

Schizophrenia is a multifaceted disorder with various symptoms including auditory hallucinations, egodisturbances, passivity phenomena, and delusions. Recent neurobiological approaches have focused on, especially, the abnormal contents of consciousness, the "substantive parts" as James said, to associate them with the neural mechanisms related to sensory, motor, and cognitive functions, and the brain's underlying stimulus-induced or task-evoked activity. This leaves open, however, the neural mechanisms that provide the temporal linkage or glue between the various contents, the transitive parts that makes possible the "stream of consciousness." Interestingly, schizophrenic patients seem to suffer from abnormalities specifically in the "transitive parts" when they experience contents as temporally disconnected or fragmented which in phenomenological psychiatry has been described as "temporal fragmentation." The aim of this article is to develop so-called neurophenomenal hypothesis about the direct relationship between phenomenal features of the "stream of consciousness," the "transitive parts," and the specific neuronal mechanisms in schizophrenia as based on healthy subjects. Rather than emphasizing stimulus-induced and task-evoked activity and sensory and lateral prefrontal cortical regions as in neurocognitive approaches with their focus on the "substantive parts," the focus shifts here to the brain's intrinsic activity, its resting state activity, which may account for the temporal linkage or glue between the contents of consciousness, the transitive parts.