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Abnormal monitoring of inner speech: a physiological basis for auditory hallucinations
Abstract
Auditory verbal hallucinations ("voices") are thought to arise from a disorder of inner speech (thinking in words). We examined the neural correlates of tasks which involve inner speech in subjects with schizophrenia who hear voices (hallucinators), subjects with schizophrenia who do not (nonhallucinators), and normal controls. There were no differences between hallucinators and controls in regional cerebral blood flow during thinking in sentences. However, when imagining sentences being spoken in another person's voice--which entails both the generation and monitoring of inner speech--hallucinators had a normal left frontal response, but reduced activation in the left middle temporal gyrus and the rostral supplementary motor area, regions which were activated by both normal subjects and nonhallucinators (p < 0.001). These findings suggest that a predisposition to verbal hallucinations is associated with a failure to activate areas concerned with the monitoring of inner speech.
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“Methods of eliciting inner speech have typically involved either subvocal recitation (e.g. covertly repeating ‘You are a x’ in response to a cue; McGuire et al., 1995) or prompting participants to make phonological judgements about words using inner speech (such as which syllable to stress in pronunciation; Aleman et al., 2005).”
From The brain's conversation with itself: neural substrates of dialogic inner speech (2016) · cites this paper as McGuire et al., 1995
In the citing paper
“Such studies have been conducted since the earliest days of neuroimaging (McGuire et al., 1995), and have been driven primarily by an interest in the possible role of inner speech in the experience of auditory verbal hallucinations (see Adult Psychopathology), although neuroimaging research on verbal working memory (e.g., Marvel & Desmond, 2010) and imagery for speech (Tian & Poeppel, 2010) has”
From Inner Speech: Development, Cognitive Functions, Phenomenology, and Neurobiology (2015) · cites this paper as McGuire et al., 1995
In the citing paper
“Several authors have also related auditory hallucinations to an over-saliency of the inner speech (considered a covert motor action), which is misattributed to an alien source (McGuire et al., 1995; Allen et al., 2007; Moseley et al., 2013).”
From What visual illusions teach us about schizophrenia (2014) · cites this paper as McGuire et al., 1995
In the citing paper
“an early neuroimaging study found no difference in brain activation between hallucinating patients and healthy controls during inner speech (McGuire et al., 1995).”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as McGuire et al., 1995
In the citing paper
“Currently, most studies rely on asking participants to repeat sentences to themselves (e.g. McGuire et al., 1995) or requiring participants to count syllables (e.g. Aziz-Zadeh et al., 2005).”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as McGuire et al., 1995
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Behrendt, R., & Whittingham, M. (2005) · Psychopathology · doi:10.1159/000089662 · Cited by 1
Parekh, P., John, J. P., Menon, S., Halahalli, H. N., & Kutty, B. M. (2016) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/062992 · Cited by 1
Using neurophysiological techniques to study auditory hallucinations in schizophrenia
Ford, J. M., & Mathalon, D. H. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511642197.019 · Cited by 1
“Cognitive Dysmetria” in Schizophrenia
Kéri, S., & Janka, Z. (2000) · American Journal of Psychiatry · doi:10.1176/ajp.157.4.662 · Cited by 1
Metadata
- Authors
- McGuire, P. K., David, A. S., Murray, R. M., Frackowiak, R. S. J., Frith, C. D., Wright, I., & Silbersweig, D. A.
- Affiliations
- Hammersmith Hospital (GB)
- Weill Cornell Medical Center (US)
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1995-09
- Volume
- 346
- Issue
- 8975
- Pages
- 596-600
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W1994899805
- Cited by
- 349
- References
- 32
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 8 · 2021: 11 · 2020: 9 · 2019: 23 · 2018: 8 · 2017: 8 · 2016: 9 · 2015: 12 · 2014: 12 · 2013: 12 · 2012: 19
- FWCI
- 7.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Wellcome Trust
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- auditory verbal hallucinations, inner speech, schizophrenia, neural correlates, regional cerebral blood flow, left middle temporal gyrus, supplementary motor area, sentence generation, frontal lobe activation
- MeSH terms
- Adult, Auditory Perceptual Disorders, Cerebrovascular Circulation, Hallucinations, Humans, Male, Schizophrenia, Speech Perception, Tomography, Emission-Computed
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