Hallucinations, neuroplasticity, and prediction errors in schizophrenia
Open accessAbstract
Auditory hallucinations, a hallmark symptom of psychosis, are experienced by most people with a diagnosis of schizophrenia at some point in their illness. Auditory hallucinations can be understood as a failure in predictive coding, whereby abnormalities in sensory/perceptual processing combine with biased cognitive processes to result in a dampening of normal prediction error signaling. In this paper, we used a roving mismatch negativity (MMN) paradigm to optimize evaluation of prediction error signaling and short‐term neuroplasticity in 30 people with schizophrenia (n = 16 with and n = 14 without recent auditory hallucinations) and 20 healthy comparison participants. The recent hallucinations group exhibited an abnormal roving MMN profile [F(2,27) = 3.98, p = 0.03], significantly reduced prediction error signaling [t(28) = –2.25, p = 0.03], and a trend for diminished short‐term neuroplasticity [t(28) = 1.80, p = 0.08]. There were no statistically significant differences between the healthy comparison group and the combined schizophrenia group on any of the roving MMN indices. These findings are consistent with a predictive coding account of hallucinations in schizophrenia, which posits reduced prediction error signaling in those who are prone to hallucinations. These results also suggest that plasticity‐mediated formation and online updating of predictive coding models may also be disrupted in individuals with recent hallucinations.
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In SCZ, both negative and positive symptoms negatively correlate with flexibility and the ability to maintain the working memory trace.
“Clinically, both negative and positive symptoms were found to negatively correlate with flexibility and the ability to maintain the working memory trace (Leptourgos et al., 2022; McCleery et al., 2018).”
From Predictive coding in neuropsychiatric disorders: a systematic transdiagnostic review. (2025) · cites this paper as McCleery et al., 2018
The Results report that, within the schizophrenia group, overall psychiatric symptom scores were not significantly correlated with either repetition positivity or the memory trace effect. The paper does report a reduced memory trace effect in patients with recent hallucinations, but it does not establish the claimed negative correlations for both positive and negative symptoms. (LLM, conf=0.86)
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Experimental — accuracy not yet measuredSchizophrenia patients with recent auditory hallucinations showed reduced repetition effects compared to schizophrenia patients without recent auditory hallucinations.
“They found reduced repetition effects in schizophrenia patients with recent auditory hallucinations when compared to schizophrenia patients without recent auditory hallucinations (32).”
From A Predictive Coding Perspective on Mismatch Negativity Impairment in Schizophrenia (2020) · cites this paper as [32]
The Results section reports lower repetition positivity in schizophrenia patients with recent auditory hallucinations than in those without, but describes the difference as a tendency that was not statistically significant (p=0.08). The Discussion likewise calls it a tendency toward reduced short-term plasticity, so the unqualified claim overstates the finding. Page numbers are not available in our copy. (LLM, conf=0.88)
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BackgroundResultAuditory Mismatch Negativity Under Predictive Coding Framework and Its Role in Psychotic Disorders
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- Authors
- McCleery, A., Wynn, J. K., & Green, M. F.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- McCleery, Amanda
- Venue
- Scandinavian Journal of Psychology
- Publisher
- Wiley
- Published
- 2018-01-22
- Volume
- 59
- Issue
- 1
- Pages
- 41-48
- ISSN
- 0036-5564 (ISSN-L)
- 1467-9450
- PMC
- PMC5969574
- OpenAlex
- W2792321642
- Cited by
- 25
- References
- 43
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 1 · 2020: 5 · 2019: 1
- FWCI
- 1.37
- Type
- journal article
- Language
- en
- Update notices
- correction (2018-05-07)
- Open access
- green
- europepmc.org
- Locations
- Scandinavian Journal of Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (K23MH108829, T32MH096682)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- schizophrenia, auditory hallucinations, predictive coding, perceptual processing, psychosis
- MeSH terms
- Acoustic Stimulation, Adult, Brain, Electroencephalography, Female, Hallucinations, Humans, Male, Middle Aged, Neuronal Plasticity, Neuropsychological Tests, Schizophrenia, Schizophrenic Psychology
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