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A functional neuroanatomy of hallucinations in schizophrenia
Abstract
Hallucinations, perceptions in the absence of external stimuli, are prominent among the core symptoms of schizophrenia. The neural correlates of these brief, involuntary experiences are not well understood, and have not been imaged selectively. We have used new positron emission tomography (PET) methods to study the brain state associated with the occurrence of hallucinations in six schizophrenic patients. Here we present a group study of five patients with classic auditory verbal hallucinations despite medication, demonstrating activations in subcortical nuclei (thalamic, striatal), limbic structures (especially hippocampus), and paralimbic regions (parahippocampal and cingulate gyri, as well as orbitofrontal cortex). We also present a case study of a unique, drug-naive patient with visual as well as auditory verbal hallucinations, demonstrating activations in visual and auditory/linguistic association cortices as part of a distributed cortical-subcortical network. Activity in deep brain structures, identified with group analysis, may generate or modulate hallucinations, and the particular neocortical regions entrained in individual patients may affect their specific perceptual content. The interaction of these distributed neural systems provides a biological basis for the bizarre reports of schizophrenic patients.
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“AVHs are often accompanied by activation of the speech and language perception areas in the left hemisphere”
From Auditory verbal hallucinations as atypical inner speech monitoring, and the potential of neurostimulation as a treatment option (2013) · cites this paper as Silbersweig et al., 1995
In the citing paper
“The first two were in the putamen and thalamus, which are involved in initiating and organizing language representations ordinarily (56–58), and have been shown to be activated coincident with AVH occurrences in two reports (26,59).”
From Elevated functional connectivity along a corticostriatal loop and the mechanism of auditory/verbal hallucinations in patients with schizophrenia (2011) · cites this paper as [59]
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“…approach is to try to explain how such conscious states can arise, for instance by appealing to an inappropriate activation of face processing or vestibular neural circuits, as can indeed be observed by brain-imaging methods during hallucinations (Ffytche et al., 1998; Silbersweig et al., 1995).”
BackgroundLefaucheur, J.-P., André-Obadia, N., Antal, A., Ayache, S. S., Baeken, C., Benninger, D. H., Cantello, R. M., Cincotta, M., de Carvalho, M., De Ridder, D., et al. (2014) · Clinical Neurophysiology · doi:10.1016/j.clinph.2014.05.021 · Cited by 2,119
“During auditory hallucinations, brain areas involved in the perception of speech (primary auditory cortex and associative areas of language in the left hemisphere) show pathological hyperactivity, as determined by neuroimaging studies (Silbersweig et al., 1995; Shergill et al., 2000).”
Basal ganglia and cerebellar loops: motor and cognitive circuits
Middleton, F. (2000) · Brain Research Reviews · doi:10.1016/s0165-0173(99)00040-5 · Cited by 1,940
Metadata
- Authors
- Silbersweig, D. A., Stern, E., Frith, C., Cahill, C., Holmes, A., Grootoonk, S., Seaward, J., McKenna, P., Chua, S. E., Schnorr, L., Jones, T., & Frackowiak, R. S. J.
- Affiliations
- Hammersmith Hospital (GB)
- Fulbourn Hospital (GB)
- Venue
- Nature
- Published
- 1995-11
- Volume
- 378
- Issue
- 6553
- Pages
- 176-179
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- OpenAlex
- W1969273085
- Cited by
- 906
- References
- 30
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 14 · 2023: 15 · 2022: 20 · 2021: 22 · 2020: 13 · 2019: 18 · 2018: 21 · 2017: 24 · 2016: 27 · 2015: 17 · 2014: 27 · 2013: 25 · 2012: 30
- FWCI
- 19.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- 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
- hallucinations, schizophrenia, auditory verbal hallucinations, visual hallucinations, neural correlates, thalamus, striatum, hippocampus, parahippocampal gyrus, cingulate gyrus, orbitofrontal cortex, cortical-subcortical networks
- MeSH terms
- Adult, Brain, Cerebrovascular Circulation, Hallucinations, Humans, Male, Schizophrenia, Tomography, Emission-Computed
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