Cited by 245Hallucinations in medical conditionsSchizophrenia research and treatmentMental Health and Psychiatry

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Quantitative Meta-Analysis on State and Trait Aspects of Auditory Verbal Hallucinations in Schizophrenia

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Kuhn, S., Gallinat, J.·2012·Schizophrenia Bulletin

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Abstract

Auditory verbal hallucinations (AVHs) have a high prevalence in schizophrenic patients. An array of studies have explored the neural correlates of AVHs by means of functional neuroimaging and have associated AVHs with diverse brain regions, some of which have been shown to be involved in speech generation, speech perception, and auditory stimulus processing. We divided these studies into "state" studies comparing periods of presence and absence of AVHs within-subject and "trait" studies comparing patients experiencing AVHs with patients without AVHs or healthy controls during tasks with verbal material. We set out to test the internal consistency and possible dissociations of the neural correlates of AVHs. We used activation likelihood estimation to perform quantitative meta-analyses on brain regions reported in state and trait studies on AVHs to assess significant concordance across studies. State studies were associated with activation in bilateral inferior frontal gyrus, bilateral postcentral gyrus, and left parietal operculum. Trait studies on the other hand showed convergence of decreases in hallucinating subjects in left superior temporal gyrus, left middle temporal gyrus, anterior cingulate cortex, and left premotor cortex activity. Based on the clear dissociation of brain regions that show convergence across state in comparison to trait studies, we conclude that the state of experiencing AVHs is primarily related brain regions that have been implicated in speech production ie, Broca's area, whereas the general trait that makes humans prone to AVHs seems to be related to brain areas involved in auditory stimuli processing and speech perception, ie, auditory cortex.

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Hypersensitivity to passive voice hearing in hallucination proneness
Johnson, J. F., Belyk, M., Schwartze, M., Pinheiro, A. P., & Kotz, S. A. (2022) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2022.859731 · Cited by 3
“Moreover, patients with chronic hallucinations can experience spontaneous AVH during scanning (Jardri et al., 2011; Kühn and Gallinat, 2012; van Lutterveld et al., 2013; Zmigrod et al., 2016), which may even be unintentionally elicited by tasks (e.”
Background
Auditory Verbal Hallucinations in Schizophrenia: A Model for Aberrant Self-consciousness
John, J. P., Parekh, P., Halahalli, H. N., Menon, S., & Kutty, B. M. (2017) · Springer eBooks · doi:10.1007/978-981-10-5777-9_8 · Cited by 1
Decreased Broca-left supplementary motor area connectivity underlying auditory verbal hallucination: A resting-state NIRS study
Huang, Z., Ma, Y., Wang, J., Song, Y., Zhang, J., Ye, Z., Ouyang, D., Ke, D., Cao, D., & Dong, W. (2026) · Translational Psychiatry · doi:10.1038/s41398-026-03839-4 · Cited by 1
“Early task-based and symptom-capture studies demonstrated that multiple large-scale networks are implicated in AVH, most prominently the Default Mode Network (DMN), Salience Network (SN), and auditory – language network [19, 20], re ﬂ ecting state-level neural activity when AVH is present.”
Precentral Gyrus Connectivity in Auditory Verbal Hallucinations: A Resting-State Functional MRI Study
Zaykova, V., Popova, F., Kandilarova, S., & Stoyanov, D. (2025) · ALPHA PSYCHIATRY · doi:10.31083/ap45829 · Cited by 1
“These observations suggest that the motor cortex undergoes aberrant activations in response to button presses during the presence of AVH [18].”
Inner speech and the neurobiology of psychosis
Skipper, J. I., Lametti, D., & Green, D. W. (2025) · bioRxiv · doi:10.1101/2025.08.22.671634 · Cited by 1
Exploring the Links between Functional Activation and Hallucination Proneness.
Alotaibi, A. M., Alosaimi, M. H., Orfali, R. S., Alshanawani, M., Bentall, R., & Meyer, G. (2025) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2025.111424 · Cited by 1
Common and unique white matter fractional anisotropy patterns in patients with schizophrenia with medication-resistant auditory verbal hallucinations: a retrospective tract-based spatial statistics study
Zhuo, C., Li, C., Ma, X.-Y., Li, R.-L., Chen, X.-M., Li, Y.-C., Zhang, Q.-Y., Yang, L.-X., & Wang, L.-N. (2025) · Schizophrenia · doi:10.1038/s41537-025-00597-y · Cited by 1
“Hence, further studies are needed to examine the effects of FA changes in the CC on the bilateral neural activity associated with AVHs in medication-resistant and treatable patients 52,77,78,82 – 86 .”
Imagerie cérébrale fonctionnelle de l'hallucination ou comment voir ce que les hallucinés entendent
Jardri, R., & Thomas, P. (2012) · L information psychiatrique · doi:10.1684/ipe.2012.0995
Dysconnectivity in Hallucinations
Ćurĉić‐Blake, B., Houenou, J., & Jardri, R. (2018) · Springer eBooks · doi:10.1007/978-3-319-75124-5_10 · Cited by 3
Hallucinations
Bujarski, K., & Sperling, M. R. (2012) · Springer: New York · doi:10.1007/978-1-4614-0959-5 · Cited by 1
NeuroMark dFNC: Transferable Dynamic-State Templates for Subject-Specific and Frequency-Resolved Chronnectomics
Esfahani, M., Seraji, M., Salem, S., Jensen, K. M., Fu, Z.-N., Adalı, T., Wang, Y.-P., & Calhoun, V. (2026) · bioRxiv · doi:10.64898/2026.10.12.758630
“Clinically, such disruptions and connectivity patterns may be relevant to hallucinations, disorganized thought, attentional instability, and cognitive dysfunction [60, 61, 62, 63].”
Neural encoding of auditory processing in schizophrenia
Vuyyuru, L. R., & Raju, A. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1893300
“Coordinate-based meta-analyses (Jardri et al., 2011; Kühn and Gallinat, 2012) converge on a bilateral fronto-temporal network including the inferior frontal gyrus, superior and middle temporal gyri, insula, and inferior parietal lobule.”
Structural alterations in early auditory cortex in borderline personality disorder with auditory verbal hallucinations
Prieult, Y. L., Otte, M., Schmitgen, M. M., Koç, M. İ., Tech, C., & Wolf, R. C. (2026) · Brain Structure and Function · doi:10.1007/s00429-026-03162-0
“MTG abnormalities affect semantic processing, shaping the linguistic content of hallucinations (Binder et al. 2009; Kühn and Gallinat 2012).”
Distinct neural mechanisms underlying hallucination experience and exposure to its externalised virtual representation
Fortier, A., Dumais, A., Athanassiou, M., Hudon, A., Stip, É., & Potvin, S. (2026) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2026.2690065
“This outcome was consistent with findings of meta-analyses of hallucinations captures studies and more recent studies (Jardri et al. 2011; Kühn and Gallinat 2012; Thoma et al. 2016; Zmigrod et al. 2016; Fovet et al. 2022).”
Validation of the Arabic‐Language Version of the Laune‐Slade Hallucinations Scale‐Extended (LSHS‐E) in Young General Population Adults
Fekih-Romdhane, F., Marrakchi, S., Laranjeira, C., Ghrissi, F., Cheour, M., el Haj, M., & Hallit, S. (2026) · Early Intervention in Psychiatry · doi:10.1111/eip.70172
“In clinical populations, hallucinations may be influenced by factors such as antipsychotic medication and hospitalization (Kühn and Gallinat 2012).”
Free-water imaging in subcortical gray matter in schizophrenia patients with persistent auditory verbal hallucinations.
Li, J.-G., He, J., Ren, H., Li, Z.-C., Ma, X.-Q., Yuan, L., Ouyang, L., Liao, A.-J., Peng, H., He, Y., et al. (2024) · Schizophrenia Research · doi:10.1016/j.schres.2024.10.028
Positive relation between arcuate fasciculus white matter fiber structure and severity of auditory hallucinations: A DTI tractography studyPreprint
Falkenberg, L. E., Westerhausen, R., Johnsen, E., Kroken, R., Løberg, E., Bereśniewicz, J., Kazimierczak, K., Kompus, K., Ersland, L., & Hugdahl, K. (2019) · bioRxiv · doi:10.1101/784942
Translating Neurocognitive Models of Auditory Verbal Hallucinations in Schizophrenia into Novel Therapeutic Interventions
Orlov, N. D., Garrison, J. R., & Allen, P. (2018) · Springer eBooks · doi:10.1007/978-3-319-75124-5_11 · Cited by 1
“Whilst elevated neural activity in the auditory cortex is likely to underpin the perceptual qualities of AVH, a number of other ‘non-sensory’ brain regions have also been implicated in AVH including the prefrontal and premotor cortex (PFC), medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC) and paracingu…”
Background
Temporal functional connectomics in schizophrenia and healthy controls
Chen, B., & Li, X. (2017) · IEEE International Conference on Systems, Man and Cybernetics · doi:10.1109/smc.2017.8123054
“An array of studies have supported the neural correlates of AVHs by means of functional neuroimaging and associated AVHs with diverse brain regions, some of which have been shown to be involved in speech generation, speech perception, and auditory stimulus processing [38], [39], [40].”
Background
White Matter Microstructure Alterations in Schizophrenia With Auditory Verbal Hallucination: Diffusion Tensor Imaging Study
Sung, M., Jung, J., Song, K., Jung, T., & Lee, H. (2024) · Journal of Korean Neuropsychiatric Association · doi:10.4306/jknpa.2024.63.1.76
Intrinsic oscillations of auditory networks in schizophrenia and bipolar disorder
Atagün, M. I., Akin, B., Algın, O., Şıkoğlu, E., Can, S., Kaymak, S. U., Çayköylü, A., Moore, C., Phillips, M., & Öngür, D. (2019) · Dusunen Adam The Journal of Psychiatry and Neurological Sciences · doi:10.14744/dajpns.2019.00002
“As auditory hallucinations typically emerge at rest, it has been shown that the correlation of the brain activity shows that resting-state functional connectivity abnormalities of the auditory cortices are significantly higher in hallucinating patients, in comparison to nonhallucinating patients with schizophrenia (21…”
Result
Schizophrenia and Functional Imaging
Pauly, K., & Moessnang, C. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-801829-3.00025-2

Authors: Kuhn, S., & Gallinat, J.
Affiliations: St. Hedwig-Krankenhaus (DE)
Venue: Schizophrenia Bulletin
Publisher: Oxford University Press (OUP)
Published: 2010-12-22
Volume: 38
Issue: 4
Pages: 779-786
ISSN: 0586-7614 (ISSN-L)
1745-1701
DOI: 10.1093/schbul/sbq152
PMC: PMC3406531
OpenAlex: W2159319538
Cited by: 245
References: 53
Citations by year: 2026: 5 · 2025: 11 · 2024: 77 · 2023: 11 · 2022: 13 · 2021: 13 · 2020: 12 · 2019: 10 · 2018: 9 · 2017: 18 · 2016: 18 · 2015: 10 · 2014: 8 · 2013: 12 · 2012: 13
FWCI: 0.70
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Schizophrenia Bulletin (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
Max Planck Institute for Plasma Physics (submittedVersion)
MPG.PuRe (Max Planck Society) (submittedVersion)
Funders: Bristol-Myers Squibb
Eli Lilly and Company
AstraZeneca
Bundesministerium für Bildung und Forschung (01GS08159)
Fonds Wetenschappelijk Onderzoek
Vlaamse regering
Cilag
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, schizophrenia
MeSH terms: Auditory Perception, Brain, Frontal Lobe, Gyrus Cinguli, Hallucinations, Humans, Magnetic Resonance Imaging, Parietal Lobe, Schizophrenia, Speech Perception, Temporal Lobe, Positron-Emission Tomography, Functional Neuroimaging

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Quantitative Meta-Analysis on State and Trait Aspects of Auditory Verbal Hallucinations in Schizophrenia

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