Auditory Detection Task Research Articles

Distinct dynamic connectivity profiles promote enhanced conscious perception of auditory stimuli

The neuroscience of consciousness aims to identify neural markers that distinguish brain dynamics in healthy individuals from those in unconscious conditions. Recent research has revealed that specific brain connectivity patterns correlate with conscious states and diminish with loss of consciousness. However, the contribution of these patterns to shaping conscious processing remains unclear. Our study investigates the functional significance of these neural dynamics by examining their impact on participants’ ability to process external information during wakefulness. Using fMRI recordings during an auditory detection task and rest, we show that ongoing dynamics are underpinned by brain patterns consistent with those identified in previous research. Detection of auditory stimuli at threshold is specifically improved when the connectivity pattern at stimulus presentation corresponds to patterns characteristic of conscious states. Conversely, the occurrence of these conscious state-associated patterns increases after detection, indicating a mutual influence between ongoing brain dynamics and conscious perception. Our findings suggest that certain brain configurations are more favorable to the conscious processing of external stimuli. Targeting these favorable patterns in patients with consciousness disorders may help identify windows of greater receptivity to the external world, guiding personalized treatments.

Attention-guided graph structure learning network for EEG-enabled auditory attention detection

Objective: Decoding auditory attention from brain signals is essential for the development of neuro-steered hearing aids. This study aims to overcome the challenges of extracting discriminative feature representations from electroencephalography (EEG) signals for auditory attention detection (AAD) tasks, particularly focusing on the intrinsic relationships between different EEG channels. Approach: We propose a novel attention-guided graph structure learning network, AGSLnet, which leverages potential relationships between EEG channels to improve AAD performance. Specifically, AGSLnet is designed to dynamically capture latent relationships between channels and construct a graph structure of EEG signals. Main result: We evaluated AGSLnet on two publicly available AAD datasets and demonstrated its superiority and robustness over state-of-the-art models. Visualization of the graph structure trained by AGSLnet supports previous neuroscience findings, enhancing our understanding of the underlying neural mechanisms. Significance: This study presents a novel approach for examining brain functional connections, improving AAD performance in low-latency settings, and supporting the development of neuro-steered hearing aids.

Pupil Size Sensitivity to Listening Demand Depends on Motivational State.

Motivation plays a role when a listener needs to understand speech under acoustically demanding conditions. Previous work has demonstrated pupil-linked arousal being sensitive to both listening demands and motivational state during listening. It is less clear how motivational state affects the temporal evolution of the pupil size and its relation to subsequent behavior. We used an auditory gap detection task (N = 33) to study the joint impact of listening demand and motivational state on the pupil size response and examine its temporal evolution. Task difficulty and a listener's motivational state were orthogonally manipulated through changes in gap duration and monetary reward prospect. We show that participants' performance decreased with task difficulty, but that reward prospect enhanced performance under hard listening conditions. Pupil size increased with both increased task difficulty and higher reward prospect, and this reward prospect effect was largest under difficult listening conditions. Moreover, pupil size time courses differed between detected and missed gaps, suggesting that the pupil response indicates upcoming behavior. Larger pre-gap pupil size was further associated with faster response times on a trial-by-trial within-participant level. Our results reiterate the utility of pupil size as an objective and temporally sensitive measure in audiology. However, such assessments of cognitive resource recruitment need to consider the individual's motivational state.

Social defeat and psychosis-related outcomes: Associative and experimental tests related to the nature of defeat, specificity of outcomes, and psychosis-proneness

Several forms of social defeat, including ostracism, discrimination, bullying, and related experiences, have been associated with psychotic disorders and experiences. The social defeat hypothesis of schizophrenia attempts to explain these associations by positing that chronic exclusion due to having outsider status leads to deleterious neurobiological changes that produce psychosis. Here, we test non-neurobiological tenets of this theory, including the relative impact of daily, real-world, chronic social defeat versus an acute, time-limited, experimentally-induced socially defeating experience (social exclusion), the moderating role of psychosis-proneness, and the specificity of social defeat on psychosis-related outcomes. We find that real-world, chronic, but not acute, time-limited, laboratory-based social defeat is associated with decreased trust, but not false-alarms on an auditory signal detection task. These associations were qualified by interactions that are in line with social reconnection (i.e., positive appraisals of social stimuli following exclusion). Real-world, chronic social defeat was also associated with delusion- and hallucination-proneness. Together, these data highlight the importance of daily, real-world forms of social defeat versus laboratory manipulations on specific psychosis-related outcomes.

How dual-task interference on word production is modulated by the timing of the secondary task: evidence from errors in people with aphasia

ABSTRACT Background Utterance production is affected under dual-task conditions, but so far studies have shown an impact either on lexical or on phonological processes, but not on both simultaneously. Aims In the present study, we aimed at investigating how interference on lexical and phonological encoding is modulated by the timing of the concurrent task and by the attentional requirement (divided vs focused attention). Methods Participants with aphasia (PWA) underwent a picture naming task and an auditory detection task, with auditory stimuli presented at different stimulus onset asynchronies (SOAs). The dual-task was performed under divided (Experiment 1) and focused attention (Experiment 2). Outcome & Results Omission errors increased under dual-task at early SOA only in Experiment 1 while phonological errors increased at later SOAs in both experiments. Conclusion These patterns of errors indicate that lexical and phonological processes are impacted under dual-task conditions, giving rise to an increase of specific types of errors at specific SOAs. They also show that very mild anomia may be more severe when assessed under dual-task conditions.

Relationships between age, fMRI correlates of familiarity and familiarity-based memory performance under single and dual task conditions

Using fMRI, we investigated the effects of age and divided attention on the neural correlates of familiarity and their relationship with memory performance. At study, word pairs were visually presented to young and older participants under the requirement to make a relational judgment on each pair. Participants were then scanned while undertaking an associative recognition test under single and dual (auditory tone detection) task conditions. The test items comprised studied, rearranged (words from different studied pairs) and new word pairs. fMRI familiarity effects were operationalized as greater activity elicited by studied pairs incorrectly identified as ‘rearranged’ than by correctly rejected new pairs. The reverse contrast was employed to identify ‘novelty’ effects. Behavioral familiarity estimates were equivalent across age groups and task conditions. Robust fMRI familiarity effects were identified in several regions, including medial and superior lateral parietal cortex, dorsal medial and left lateral prefrontal cortex, and bilateral caudate. fMRI novelty effects were identified in the anterior medial temporal lobe. Both familiarity and novelty effects were largely age-invariant and did not vary, or varied minimally, according to task condition. In addition, the familiarity effects correlated positively with a behavioral estimate of familiarity strength irrespective of age. These findings extend a previous report from our laboratory, and converge with prior behavioral reports, in demonstrating that the factors of age and divided attention have little impact on behavioral and neural estimates of familiarity.

Emotional distraction and facilitation across sense and time.

Emotional stimuli can disrupt or enhance task performance according to factors that are presently poorly understood. One potentially important determinant is the sensory modality involved. In unimodal visual paradigms (visual task-irrelevant stimuli during a visual task) emotional stimuli frequently produce distraction effects; however, the effects across modalities appear more complex and may also depend on factors related to stimulus timing. It is entirely unclear how task-irrelevant visual stimuli impact auditory task performance in cross-modal paradigms. This project explored task performance as a function of sensory modality, emotional valence, and stimulus timing. In Study 1, participants (N = 50) completed a visual stimulus detection task in the presence of task-irrelevant negative and neutral images and sounds. Accuracy was disrupted in the presence of visual but not auditory emotional stimuli, particularly when the target and task-irrelevant stimulus appeared simultaneously. In Study 2, participants (N = 38) completed an equivalent auditory stimulus detection task. In sharp contrast to the effects observed with visual targets, response times and accuracy were enhanced in the presence of auditory emotional stimuli at the first timepoint but disrupted at later timepoints. However, there was no effect of task-irrelevant visual stimuli on auditory task performance. These findings demonstrate the importance of both sensory modality and timing in determining how emotional stimuli affect task performance and lay the groundwork for future studies examining the interaction between emotional and attentional processes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The role of brain-localized gamma and alpha oscillations in inattentional deafness: implications for understanding human attention.

The processes involved in how the attention system selectively focuses on perceptual and motor aspects related to a specific task, while suppressing features of other tasks and/or objects in the environment, are of considerable interest for cognitive neuroscience. The goal of this experiment was to investigate neural processes involved in selective attention and performance under multi-task situations. Several studies have suggested that attention-related gamma-band activity facilitates processing in task-specific modalities, while alpha-band activity inhibits processing in non-task-related modalities. However, investigations into the phenomenon of inattentional deafness/blindness (inability to observe stimuli in non-dominant task when primary task is demanding) have yet to observe gamma-band activity. This EEG experiment utilizes an engaging whole-body perceptual motor task while carrying out a secondary auditory detection task to investigate neural correlates of inattentional deafness in natural immersive high workload conditions. Differences between hits and misses on the auditory detection task in the gamma (30-50 Hz) and alpha frequency (8-12 Hz) range were carried out at the cortical source level using LORETA. Participant auditory task performance correlated with an increase in gamma-band activity for hits over misses pre- and post-stimulus in left auditory processing regions. Alpha-band activity was greater for misses relative to hits in right auditory processing regions pre- and post-stimulus onset. These results are consistent with the facilitatory/inhibitory role of gamma/alpha-band activity for neural processing. Additional gamma- and alpha-band activity was found in frontal and parietal brain regions which are thought to reflect various attentional monitoring, selection, and switching processes. The results of this study help to elucidate the role of gamma and alpha frequency bands in frontal and modality-specific regions involved with selective attention in multi-task immersive situations.

Neural α Oscillations and Pupil Size Differentially Index Cognitive Demand under Competing Audiovisual Task Conditions.

Cognitive demand is thought to modulate two often used, but rarely combined, measures: pupil size and neural α (8-12 Hz) oscillatory power. However, it is unclear whether these two measures capture cognitive demand in a similar way under complex audiovisual-task conditions. Here we recorded pupil size and neural α power (using electroencephalography), while human participants of both sexes concurrently performed a visual multiple object-tracking task and an auditory gap detection task. Difficulties of the two tasks were manipulated independent of each other. Participants' performance decreased in accuracy and speed with increasing cognitive demand. Pupil size increased with increasing difficulty for both the auditory and the visual task. In contrast, α power showed diverging neural dynamics: parietal α power decreased with increasing difficulty in the visual task, but not with increasing difficulty in the auditory task. Furthermore, independent of task difficulty, within-participant trial-by-trial fluctuations in pupil size were negatively correlated with α power. Difficulty-induced changes in pupil size and α power, however, did not correlate, which is consistent with their different cognitive-demand sensitivities. Overall, the current study demonstrates that the dynamics of the neurophysiological indices of cognitive demand and associated effort are multifaceted and potentially modality-dependent under complex audiovisual-task conditions.SIGNIFICANCE STATEMENT Pupil size and oscillatory α power are associated with cognitive demand and effort, but their relative sensitivity under complex audiovisual-task conditions is unclear, as is the extent to which they share underlying mechanisms. Using an audiovisual dual-task paradigm, we show that pupil size increases with increasing cognitive demands for both audition and vision. In contrast, changes in oscillatory α power depend on the respective task demands: parietal α power decreases with visual demand but not with auditory task demand. Hence, pupil size and α power show different sensitivity to cognitive demands, perhaps suggesting partly different underlying neural mechanisms.

Prior experience modifies acquisition trajectories via response-strategy sampling.

Few studies have considered how signal detection parameters evolve during acquisition periods. We addressed this gap by training mice with differential prior experience in a conditional discrimination, auditory signal detection task. Naïve mice, mice given separate experience with each of the later correct choice options (Correct Choice Response Transfer, CCRT), and mice experienced in conditional discriminations (Conditional Discrimination Transfer, CDT) were trained to detect the presence or absence of a tone in white noise. We analyzed data assuming a two-period model of acquisition: a pre-solution and solution period (Heinemann EG (1983) in The Presolution period and the detection of statistical associations. In: Quantitative analyses of behavior: discrimination processes, vol. 4, pp. 21-36). Ballinger. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.536.1978andrep=rep1andtype=pdf ). The pre-solution period was characterized by a selective sampling of biased response strategies until adoption of a conditional responding strategy in the solution period. Correspondingly, discriminability remained low until the solution period; criterion took excursions reflecting response-strategy sampling. Prior experience affected the length and composition of the pre-solution period. Whereas CCRT and CDT mice had shorter pre-solution periods than naïve mice, CDT and Naïve mice developed substantial criterion biases and acquired asymptotic discriminability faster than CCRT mice. To explain these data, we propose a learning model in which mice selectively sample and test different response-strategies and corresponding task structures until they exit the pre-solution period. Upon exit, mice adopt the conditional responding strategy and task structure, with action values updated via inference and generalization from the other task structures. Simulations of representative mouse data illustrate the viability of this model.

Pre-stimulus gamma power in human posteromedial cortex shows supra-modal mechanisms in predicting the amplitude and latency of task-induced suppression.

Upon repetitively performing the same well-practiced task on identical bottom-up stimuli, our performance still varies. Although it has been well documented that elevated pre-stimulus baseline activity in the human default-mode network impairs the subsequent task performance, it remains unknown (i) the fine-grained temporal dynamics and (ii) whether the underlying neural dynamics are supra-modal or modality-specific. We utilized intracranial recordings in the human posteromedial cortex (PMC) during a simple visual and an auditory detection task. Our findings suggested that the pre-stimulus gamma power in PMC predicted the subsequent task performance. Critically, the higher the pre-stimulus gamma power, the longer it took for it to be suppressed, and the less suppressed it was during the task performance, which eventually resulted in deleterious effects on task performance, i.e. longer reaction times. These fine-grained temporal dynamics were consistent between the visual and auditory simple detection task. In addition, a direct comparison between the visual and auditory modality showed that the between-modality difference emerged during the recovery period from the maximal gamma suppression back to the baseline. Taken together, the present results contribute novel spatio-temporal mechanisms in human PMC on how simple detection performance varies across multiple repetitions, irrespective of the sensory modality involved.

Investigating Auditory Perception at Europe's Highest Mountain Lodge.

Altitude hypoxia can impair sensory and cognitive functions, from causing slowed responses to sensory hallucinations. In a field study, we tested 12 expeditioners at varied altitudes (low: 1696m; high: 4556m) with a simple auditory detection task and a dichotic listening paradigm in which a voice was presented, lateralized, within a binaural white noise stream. Slower reaction times and a reduced right ear advantage might be expected at high (vs. low) altitude, due to hypoxia. The participants' performances on both tasks did not differ between conditions, revealing that these functions are resistant to short-term hypoxia in young healthy adults.

EEG study of attention on an auditory target detection task in dolphins and humans

How do dolphins attend to echos and ignore background noise? Is the process similar to how humans attend to conversations in a crowded room? Studies of human selective attention have highlighted endogenous brain processes modulating the magnitude of early responses to sounds in auditory evoked potentials (AEPs), yet these rely on task-specific instructions difficult to employ in animal studies. We trained an adult male dolphin (Tursiops truncatus) to attend to a stream of rapidly presented tones, and provide a whistle response to a “target” tone while withholding responses to “background” tones in an amplitude discrimination task. The background sounds were designed to function as a tonal mismatch negativity paradigm with two frequencies: a standard tone presented 80% of the time, and a deviant presented 20% of the time. Depending on condition, the target could be the same frequency as the standard or the deviant. We observed an enhanced AEP response to a deviant of the same frequency as the target, while the AEP response to the standard-target condition was reduced. This was not predicted by previous human experiments, and we are currently following up with a pilot a human task modeled after the dolphin implicit target detection task.

Towards a Characterization of Background Music Audibility in Broadcasted TV.

In audiovisual contexts, different conventions determine the level at which background music is mixed into the final program, and sometimes, the mix renders the music to be practically or totally inaudible. From a perceptual point of view, the audibility of music is subject to auditory masking by other aural stimuli such as voice or additional sounds (e.g., applause, laughter, horns), and is also influenced by the visual content that accompanies the soundtrack, and by attentional and motivational factors. This situation is relevant to the music industry because, according to some copyright regulations, the non-audible background music must not generate any distribution rights, and the marginally audible background music must generate half of the standard value of audible music. In this study, we conduct two psychoacoustic experiments to identify several factors that influence background music perception, and their contribution to its variable audibility. Our experiments are based on auditory detection and chronometric tasks involving keyboard interactions with original TV content. From the collected data, we estimated a sound-to-music ratio range to define the audibility threshold limits of the barely audible class. In addition, results show that perception is affected by loudness level, listening condition, music sensitivity, and type of television content.

The impacts of training on change deafness and build-up in a flicker task.

Performance on auditory change detection tasks can be improved by training. We examined the stimulus specificity of these training effects in behavior and ERPs. A flicker change detection task was employed in which spatialized auditory scenes were alternated until a "change" or "same" response was made. For half of the trials, scenes were identical. The other half contained changes in the spatial locations of objects from scene to scene. On Day 1, participants were either trained on this auditory change detection task (trained group), or trained on a non-auditory change detection task (control group). On Day 2, all participants were tested on the flicker task while EEG was recorded. The trained group showed greater change detection accuracy than the control group. They were less biased to respond "same" and showed full generalization of learning from trained to novel auditory objects. ERPs for "change" compared to "same" trials showed more negative going P1, N1, and P2 amplitudes, as well as a larger P3b amplitude. The P3b amplitude also differed between the trained and control group, with larger amplitudes for the trained group. Analysis of ERPs to scenes viewed prior to a decision revealed build-up of a difference between "change" and "same" trials in N1 and P2. Results demonstrate that training has an impact early in the "same" versus "change" decision-making process, and that the flicker paradigm combined with the ERP method can be used to study the build-up of change detection in auditory scenes.

The speed acuity test as a diagnostic aid in cerebral visual impairment

One of the characteristics of children with cerebral visual impairments (CVI) is that they need more time to process visual information. However, currently, few tests are available that can reliably measure visual processing speed. The speed acuity test, a discrimination reaction-time test in which participants indicate the orientation of Landolt-C symbols as quickly and accurately as possible, was specifically developed to determine the time a child needs to discern visual details. The test measures both the accuracy and the latency of the responses for nine different optotype sizes in order to control for decreased visual acuity. The results show that children with CVI need significantly more time to respond to the largest optotype sizes than age-matched normally sighted children and children with visual impairments due to an ocular disorder (VIo). This effect is independent of the time it takes to make a motor response. However, the reaction-time difference between the children with CVI and VIo is not seen for optotype sizes at the acuity threshold. Together with reaction times on visual and auditory detection tasks as controls, reaction times measured in the speed-acuity test allow for acceptable discrimination (AUC in ROC analysis: 0.81) between CVI and VIo.

Context-prosody interaction in sarcasm comprehension: A functional magnetic resonance imaging study

During conversation, sarcasm is perceived as an incongruity between the context, content, and prosody of the utterance. We hypothesized that prosody modifies the context‒content incongruity effect. Thus, we conducted a functional magnetic resonance imaging study with an auditory sarcasm detection task in 22 healthy adult participants. The participants listened to a short conversation according to which they had done either a good or bad deed, about which their conversational partner made a positive comment. When the context was positive (congruent with the content of utterance), positive prosody lessened the sarcasm rating, whereas negative prosody enhanced this rating. When the context was negative, the positive prosody effect disappeared, while negative prosody increased the sarcasm rating. Thus, context‒content incongruity is the primary determinant of sarcasm comprehension; and is modified by prosody in a context-dependent manner. Neuroimaging results showed that the context‒content incongruity effect was notable in the cerebellum and the mentalizing network, representing what was uttered in a particular context. The content‒prosody incongruity effect was observed in the bilateral amygdala, representing the manner of utterance. The interaction between these incongruity effects was found in the bilateral dorsolateral prefrontal cortex, extending to the inferior frontal gyrus and the salience network, including the anterior insular cortex and the caudal part of the dorso-medial prefrontal cortex. These findings indicate that two distinct incongruity detection systems for sarcasm comprehension are integrated in the prefrontal cortices through the salience network.

Age and Hearing Ability Influence Selective Attention During Childhood.

The purpose of the present study was to determine whether age and hearing ability influence selective attention during childhood. Specifically, we hypothesized that immaturity and disrupted auditory experience impede selective attention during childhood. Seventy-seven school-age children (5 to 12 years of age) participated in this study: 61 children with normal hearing and 16 children with bilateral hearing loss who use hearing aids and/or cochlear implants. Children performed selective attention-based behavioral change detection tasks comprised of target and distractor streams in the auditory and visual modalities. In the auditory modality, children were presented with two streams of single-syllable words spoken by a male and female talker. In the visual modality, children were presented with two streams of grayscale images. In each task, children were instructed to selectively attend to the target stream, inhibit attention to the distractor stream, and press a key as quickly as possible when they detected a frequency (auditory modality) or color (visual modality) deviant stimulus in the target, but not distractor, stream. Performance on the auditory and visual change detection tasks was quantified by response sensitivity, which reflects children's ability to selectively attend to deviants in the target stream and inhibit attention to those in the distractor stream. Children also completed a standardized measure of attention and inhibitory control. Younger children and children with hearing loss demonstrated lower response sensitivity, and therefore poorer selective attention, than older children and children with normal hearing, respectively. The effect of hearing ability on selective attention was observed across the auditory and visual modalities, although the extent of this group difference was greater in the auditory modality than the visual modality due to differences in children's response patterns. Additionally, children's performance on a standardized measure of attention and inhibitory control related to their performance during the auditory and visual change detection tasks. Overall, the findings from the present study suggest that age and hearing ability influence children's ability to selectively attend to a target stream in both the auditory and visual modalities. The observed differences in response patterns across modalities, however, reveal a complex interplay between hearing ability, task modality, and selective attention during childhood. While the effect of age on selective attention is expected to reflect the immaturity of cognitive and linguistic processes, the effect of hearing ability may reflect altered development of selective attention due to disrupted auditory experience early in life and/or a differential allocation of attentional resources to meet task demands.

Aphasia recovery by language training using a brain-computer interface: a proof-of-concept study.

Aphasia, the impairment to understand or produce language, is a frequent disorder after stroke with devastating effects. Conventional speech and language therapy include each formal intervention for improving language and communication abilities. In the chronic stage after stroke, it is effective compared with no treatment, but its effect size is small. We present a new language training approach for the rehabilitation of patients with aphasia based on a brain–computer interface system. The approach exploits its capacity to provide feedback time-locked to a brain state. Thus, it implements the idea that reinforcing an appropriate language processing strategy may induce beneficial brain plasticity. In our approach, patients perform a simple auditory target word detection task whilst their EEG was recorded. The constant decoding of these signals by machine learning models generates an individual and immediate brain-state-dependent feedback. It indicates to patients how well they accomplish the task during a training session, even if they are unable to speak. Results obtained from a proof-of-concept study with 10 stroke patients with mild to severe chronic aphasia (age range: 38–76 years) are remarkable. First, we found that the high-intensity training (30 h, 4 days per week) was feasible, despite a high-word presentation speed and unfavourable stroke-induced EEG signal characteristics. Second, the training induced a sustained recovery of aphasia, which generalized to multiple language aspects beyond the trained task. Specifically, all tested language assessments (Aachen Aphasia Test, Snodgrass & Vanderwart, Communicative Activity Log) showed significant medium to large improvements between pre- and post-training, with a standardized mean difference of 0.63 obtained for the Aachen Aphasia Test, and five patients categorized as non-aphasic at post-training assessment. Third, our data show that these language improvements were accompanied neither by significant changes in attention skills nor non-linguistic skills. Investigating possible modes of action of this brain–computer interface-based language training, neuroimaging data (EEG and resting-state functional MRI) indicates a training-induced faster word processing, a strengthened language network and a rebalancing between the language- and default mode networks.

Voice Hearing in Borderline Personality Disorder Across Perceptual, Subjective, and Neural Dimensions.

BackgroundAuditory verbal hallucinations (AVH) commonly occur in the context of borderline personality disorder (BPD) yet remain poorly understood. AVH are often perceived by patients with BPD as originating from inside the head and hence viewed clinically as “pseudohallucinations,” but they nevertheless have a detrimental impact on well-being.MethodsThe current study characterized perceptual, subjective, and neural expressions of AVH by using an auditory detection task, experience sampling and questionnaires, and functional neuroimaging, respectively.ResultsPerceptually, reported AVH correlated with a bias for reporting the presence of a voice in white noise. Subjectively, questionnaire measures indicated that AVH were significantly distressing and persecutory. In addition, AVH intensity, but not perceived origin (i.e., inside vs outside the head), was associated with greater concurrent anxiety. Neurally, fMRI of BPD participants demonstrated that, relative to imagining or listening to voices, periods of reported AVH induced greater blood oxygenation level–dependent activity in anterior cingulate and bilateral temporal cortices (regional substrates for language processing). AVH symptom severity was associated with weaker functional connectivity between anterior cingulate and bilateral insular cortices.ConclusionIn summary, our results indicate that AVH in participants with BPD are (1) underpinned by aberrant perceptual-cognitive mechanisms for signal detection, (2) experienced subjectively as persecutory and distressing, and (3) associated with distinct patterns of neural activity that inform proximal mechanistic understanding. Our findings are like analogous observations in patients with schizophrenia and validate the clinical significance of the AVH experience in BPD, often dismissed as “pseudohallucinations.” These highlight a need to reconsider this experience as a treatment priority.