Cited by 177Schizophrenia research and treatmentVisual perception and processing mechanismsHallucinations in medical conditions

What visual illusions teach us about schizophrenia

Open access
Notredame, Charles-Edouard, Pins, Delphine, Deneve, Sophie, Jardri, Renaud·2014·Frontiers in Integrative Neuroscience

Abstract

Illusion, namely a mismatch between the objective and perceived properties of an object present in the environment, is a common feature of visual perception, both in normal and pathological conditions. This makes illusion a valuable tool with which to explore normal perception and its impairments. Although still debated, the hypothesis of a modified, and typically diminished, susceptibility to illusions in schizophrenia patients is supported by a growing number of studies. The current paper aimed to review how illusions have been used to explore and reveal the core features of visual perception in schizophrenia from a psychophysical, neurophysiological and functional point of view. We propose an integration of these findings into a common hierarchical Bayesian inference framework. The Bayesian formalism considers perception as the optimal combination between sensory evidence and prior knowledge, thereby highlighting the interweaving of perceptions and beliefs. Notably, it offers a holistic and convincing explanation for the perceptual changes observed in schizophrenia that might be ideally tested using illusory paradigms, as well as potential paths to explore neural mechanisms. Implications for psychopathology (in terms of positive symptoms, subjective experience or behavior disruptions) are critically discussed.

AI snapshot

Written from the paper’s full text.

TL;DR

This review argues that schizophrenia is often associated with diminished susceptibility to visual illusions, interpreted as an overweighting of sensory evidence relative to prior knowledge within a hierarchical Bayesian framework. It proposes circular inference as a unifying account linking altered visual perception to hallucinations and delusions.

Key findings

  • A growing number of studies support reduced susceptibility to visual illusions in schizophrenia; Dakin et al. (2005) found the contrast-contrast effect was diminished in schizophrenia (n=15) compared with healthy and psychiatric controls (n=20), with patients more accurate in contrast discrimination. Replications and extensions include surround suppression, binocular depth inversion, apparent motion, and motion-induced blindness.
  • Resistance to illusions has been linked to positive symptoms: Keane et al. (2013) found resistance to binocular depth inversion positively correlated with need for structured treatment and positive symptoms; Sanders et al. (2013) found apparent motion illusion strength inversely correlated with delusional belief conviction. However, other studies found no or only weak relationships.
  • Neurophysiological evidence includes reduced visual cortex GABA in schizophrenia (Yoon et al., 2010), with lower GABA correlating with less biased contrast discrimination despite misleading context; Dima et al. (2009, 2010) reported reversed effective connectivity patterns (predominance of feedforward modulation) in patients during the hollow-mask illusion.
  • Bayesian integration via predictive coding and circular inference models explains symptoms through imbalance between prior and sensory evidence; circular inference predicts either overweighting of sensory evidence (lower illusion susceptibility) or prior knowledge (higher illusion susceptibility) depending on impaired upward or downward loops. Visual hallucinations have a point prevalence of 27% in the psychosis spectrum (Waters et al., 2014), and schizophrenia affects approximately 1% of the general population (McGrath et al., 2008).

Methods

  • Narrative review of published visual illusion experiments in schizophrenia and pro-psychotic states, with findings summarized in Table 2; no new empirical data or meta-analysis are reported.
  • Reviewed paradigms include surround suppression, binocular depth inversion, apparent motion, motion-induced blindness, three-flash, contour detection, and spatial frame illusions, in patients with schizophrenia, first-episode psychosis, prodromal states, bipolar/major depression, substance or sleep-deprivation models, and controls.
  • Main analysis is qualitative synthesis and theoretical integration into hierarchical Bayesian inference, including predictive coding and circular inference frameworks.

Limitations

  • Stated: findings are heterogeneous; negative or nuanced results often involve surround-suppression illusions, which may be affected by methodological issues and covariates; lack of statistical power may explain some studies; the conflict between Bayesian hypotheses (over- vs under-weighted prediction errors) is unresolved, and neurophysiological causes remain unclear.
  • Stated: the paper calls for more rigorous methodology, precise classifications, and conceptual definitions.
  • Evident from text: as a narrative review, it does not describe a systematic search strategy, inclusion criteria, or formal quality appraisal; many cited studies have small samples (e.g., n=7–38 in several paradigms), and clinical correlations are inconsistent across studies.

Model-written summary. Check it against the paper before relying on it.

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Registry

Crossref · 10.3389/fnint.2014.00063

Cites

91 of 91 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 104 cited sources checked · 0 supported · 0 flagged

  • Interpretationreasoning

    Attempts to localize the specific disruption responsible for the pattern of sensitivity to VIs in schizophrenia using the structural approach led to apparent contradictions.

    “However, these attempts led to apparent contradictions.”
    Quote in the paperSubstantial claim
  • Interpretationreasoning

    These findings suggest a perceptual process different in nature compared to the one observed in the general population, rather than the classical cognitive deficit-model.

    “Rather than the classical cognitive deficit-model proposed in schizophrenia, these findings suggest a perceptual process different in nature compared to the one observed in the general population.”
    Quote in the paperSubstantial claim
  • Premisecitation

    Dakin's findings of decreased susceptibility to context-based illusions in schizophrenia were replicated using the same type of context-based illusion paradigms.

    “Dakin's findings were notably replicated using the same type of context-based illusion paradigms (Uhlhaas et al., 2004; Tadin et al., 2006; Chen et al., 2008)”
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  • Premisecitation

    Dakin et al. (2005) found that schizophrenia patients were significantly less biased by the surroundings and more accurate in contrast discrimination compared with healthy and psychiatric controls.

    “By manipulating the reference-contrast, the authors noticed that the patients who suffered from schizophrenia were significantly less biased by the surroundings and were thus more accurate in contrast discrimination compared with the healthy and psychiatric controls.”
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    • cites Dakin et al., 2005 source

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  • Premisecitation

    Norton et al. (2008) reported that the Three-flash illusion peaked at a longer inter-stimulus interval in patients with schizophrenia compared with healthy controls.

    “The authors reported the illusion peaked to a longer inter-stimulus interval when presented to patients with schizophrenia compared with healthy controls.”
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    Premisecitation

    Some authors have argued that the impairment of gain control is a robust and significant property of visual processing in schizophrenia, and may even consider it a core feature of the disorder.

    “Some authors have argued, in line with the findings that stem from the study of VIs, that the impairment of gain control is a robust and significant property of visual processing in schizophrenia, and may even consider it a core feature of the disorder (Robol et al., 2013; Tibber et al., 2013).”
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    Premisecitation

    Yang et al. and Tibber et al. hypothesized that pre-cortical stages of the visual system, in which luminance is supposed to be processed, were spared, thereby contradicting Norton's conclusions.

    “Thus, these authors hypothesized that the pre-cortical stages of the visual system, in which luminance is supposed to be processed, were spared, thereby contradicting Norton's conclusions.”
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    Premisecitation

    Yang et al. (2012) and Tibber et al. (2013) found that luminance context processing was similar in patients and controls, whereas the strength of illusions was inferior in patients for other psychophysical parameters (e.g., contrast, orientation, size or motion).

    “Yang et al. (2012) and Tibber et al. (2013) found that luminance context processing was similar, whereas the strength of the illusions was inferior in patients for the other psychophysical parameters (e.g., contrast, orientation, size or motion).”
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    Interpretationreasoning

    VIs pinpoint the limits of purely anatomoclinical or linear causal models and underline the complexity and specificity of visual perception in schizophrenia.

    “VIs, although polymorphic, pinpoint the limits of purely anatomoclinical or linear causal models and underline, in contrast, the complexity and specificity of visual perception in schizophrenia.”
    Quote in the paperNot a substantial claim
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    Premisenone given

    Many VIs refer to a basic perceptual phenomenon called the context or surround suppression effect, which can be conceptualized as a form of gain control.

    “Although not always labeled as such, many VIs refer to a basic perceptual phenomenon called the context or surround suppression effect, which can be conceptualized as a form of gain control.”
    Quote in the paperNot a substantial claim
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    Premisecitation

    Perceptual organization can be viewed as relying on two main fundamental mechanisms: gain control and integration, both of which could be impaired in schizophrenia.

    “According to Butler et al. (2008) this phenomenon of perceptual organization can be viewed as relying on two main fundamental mechanisms: gain control and integration, both of which could be impaired in schizophrenia.”
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    Premisecitation

    Norton et al. argued that the temporal alteration in the Three-flash illusion may rely on a faulty sensory-integration within the very first stages of the visual stream.

    “They argued that this temporal alteration may rely on a faulty sensory-integration within the very first stages of the visual stream.”
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    Interpretationreasoning

    Increased performance in patients on VI tasks cannot be attributed to general task difficulty, a lack of attention or motivation, or a disease-related global deficit.

    “From a methodological point of view, increased performance in patients cannot be attributed to general task difficulty, a lack of attention or motivation or to a disease-related global deficit.”
    Quote in the paperSubstantial claim
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    Interpretationnone given

    The surround-suppression paradigm appears exposed to specific methodological issues and covariates that may be imputed in the results.

    “This paradigm appears exposed to specific methodological issues and covariates that may be imputed in the results”
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    Premisecitation

    Over-trusted sensory signals become over-salient and unpredictable; they could be transmitted up the hierarchy, but no adjustments could fully resolve the aberrancy.

    “Artificially over-trusted, sensory signals become over-salient and unpredictable. They could be transmitted up the hierarchy, but no adjustments could fully resolve the aberrancy (Fletcher and Frith, 2008).”
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    • cites Fletcher and Frith, 2008 source

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    • The authors state this as an assumption: In Predictive Coding, the prior and the likelihood have a Gaussian distribution.
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    Premisecitation

    Chen et al. (2008) proposed that context interaction impairment in schizophrenia may be better accounted for by alterations of surround inhibition rather than surround facilitation.

    “The authors proposed that context interaction impairment in schizophrenia may be better accounted for by alterations of surround inhibition rather than surround facilitation.”
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    • cites Chen et al., 2008 source

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    Interpretationreasoning

    If both descending and climbing loops are impaired, both sensory evidence and prior knowledge are reverberated and over-counted, resulting in an overconfident but not biased inferred belief in the Predictive Coding framework.

    “If both descending and climbing loops are impaired (A), both sensory evidence and prior knowledge are reverberated and over counted (multiplication of the pink and violet arrows). In the Predictive coding framework, this results in an overconfident (narrowing of the posterior distribution) but not biased (unchanged K) inferred belief.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
    • The authors state this as an assumption: In Predictive Coding, the prior and the likelihood have a Gaussian distribution.
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    Premisecitation

    Visual perception plays an important role in the psychopathology of schizophrenia and constitutes a unique way to explore the underlying mechanisms of reality construction.

    “several authors have defended the idea that visual perception plays an important role in the psychopathology of schizophrenia (Butler and Javitt, 2005), and constitutes a unique way to explore the underlying mechanisms of reality construction (Silverstein and Keane, 2011).”
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    • The authors state this as an assumption: Perception is closely interwoven with other high-level functions such as belief genesis or reasoning.
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    Premisenone given

    In Bayesian accounts, positive symptoms of schizophrenia are imputed to an imbalance in the relative weight or precision attributed to the prior and sensory evidence, causing false inferences.

    “By relying on the Bayesian formalism, authors typically impute the positive symptoms of schizophrenia to an imbalance in the relative weight or precision attributed to the prior and sensory evidence, which, in turn, causes false inferences.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: Sensory inputs are inherently ambiguous.
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    Premisecitation

    The Müller-Lyer illusion can be explained by internalized rules of perspective leading an individual to compute the line flanked with converging fins as if it were further away, so its shorter appearance conflicts with the actual identical size of the two lines.

    “According to this author, the internalized rules of perspective (i.e., prior knowledge) lead an individual to compute the line flanked with converging fins as if it were further away. Consequently, the line's shorter appearance conflicts with the actual identical size of the two lines.”
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    Premisenone given

    VIs are an illustration of the perceptual system's ability to bind and group visual elements into coherent patterns, which leads to a meaningful representation.

    “VIs are an illustration of the perceptual system's ability to bind and group visual elements into coherent patterns, which leads to a meaningful representation.”
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    Premisecitation

    Predictive Coding and Circular Inference frameworks are algorithmically similar and may essentially differ in the type of variables considered.

    “Importantly, despite conceptual differences, these frameworks are algorithmically similar and may essentially differ in the type of variables considered (e.g., binary vs. continuous, see Jardri and Deneve, 2013).”
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    Premisenone given

    The physiological existence of VIs suggests that deceiving perception paradoxically requires the integrity of the different subcomponents of the visual system.

    “The physiological existence of VIs suggests that deceiving perception paradoxically requires the integrity of the different subcomponents of the visual system.”
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    Premisecitation

    Gain control of neural responses is achieved through a combination of intrinsic neuronal properties, lateral interactions and feedback modulations.

    “Gain control of neural responses is achieved through a combination of intrinsic neuronal properties, lateral interactions and feedback modulations (Must et al., 2004).”
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    Premisecitation

    Some evidence suggests that surround suppression and its impairment depends on several variables, such as the contrast and the time of presentation, which counters an absolute independent process.

    “Some evidence suggests that surround suppression and its impairment depends on several variables, such as the contrast (previously discussed) and the time of presentation (Calvert and Harris, 1988; Bressan and Kramer, 2013), which counters an absolute independent process.”
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    Interpretationreasoning

    The bias toward prior knowledge in the Hollow mask illusion is better understood as an optimal inference combining bottom-up and top-down information, supporting adaptation in a noisy environment.

    “However, rather than a perceptual error, this bias is better understood as the consequence of inferences that optimally combine bottom-up and top-down information (see Boxes 1, 3), which supports the best adaptation in a noisy environment.”
    Quote in the paperSubstantial claim
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    Interpretationreasoning

    This disturbance from large-scale dysconnectivity would result in aberrant concept formation, delusions, and hallucinations.

    “This disturbance would result in aberrant concept formation, delusions, and hallucinations.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A lack of statistical power is a major cause of concern in neuroscience and may be imputed for several studies.

    “even if a lack of statistical power is a major cause of concern in neuroscience and may be imputed for several studies (Button et al., 2013)”
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    Premisecitation

    In healthy controls, a model with connectivity modulation from higher-level areas to V1 better accounted for data, whereas in schizophrenia patients DCM revealed a reverse pattern with predominance of feedforward modulation.

    “While a model that places connectivity modulation from the higher-level areas to the primary visual cortex (i.e., V1) better accounted for healthy control data, the DCM revealed a reverse pattern in schizophrenia patients (i.e., the predominance of the feedforward modulation).”
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    Premisecitation

    Some authors have argued that excessively precise prior expectations, corresponding to a smaller-than-normal gain for prediction errors, better account for hallucinatory experiences.

    “However, in opposition to a theory of over salient sensory evidence, some authors have argued that excessively precise prior expectations, which correspond to a smaller-than-normal gain for prediction errors, better account for hallucinatory experiences.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
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    • cites Chambon et al., 2011 source

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    • cites Schmack et al., 2013 source

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    • The authors state this as an assumption: In Predictive Coding, the prior and the likelihood have a Gaussian distribution.
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    Interpretationreasoning

    Depending on which loops are mostly impaired, the Circular Inference model predicts that either sensory information or priors will dominate the final percept.

    “Depending on which loops are mostly impaired, the model predicts that either sensory information or priors will dominate the final percept.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given

    The conflict between contradictory hypotheses about prediction error gain (larger or smaller than normal, over-trusted prior or over-counted sensory evidence) has never been fully resolved, making experimental testing difficult.

    “Note that the conflict between apparently contradictory hypotheses (gains of prediction errors larger than normal or smaller than normal, over-trusted prior or over-counted sensory evidence) has never been fully resolved, which renders the experimental testing of these theories extremely difficult.”
    Quote in the paperNot a substantial claim
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    Interpretationreasoning

    Even when facing weak or non-existent sensory evidence, circular propagation generates strong perceptual beliefs, so hallucinations occur where nothing relevant should have been inferred.

    “Even when facing weak or non-existent sensory evidence, the circular propagation generates strong perceptual beliefs: hallucinations occur where nothing relevant should have been inferred.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
  • May combine two claims.

    Interpretationreasoning

    Circular inference introduces spurious correlations between sensory and prior messages that are non-existent in the real world, leading to learning and consolidation of unshakable but false causal relationships and delusional belief systems.

    “In the same way, circular inference introduces spurious correlations between sensory (feedforward) and prior (feedback) messages that are non-existent in the real world. This leads to the learning and consolidation of “unshakable” (but false) causal relationships, resulting in delusional belief systems.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
  • May combine two claims.

    Interpretationreasoning

    A deficit in control of downward loops would predict over-confidence in prior knowledge and higher susceptibility to perceptual illusions.

    “Vice-versa, a deficit in the control of downward loops (e.g., prior expectations that activate lower levels and are misinterpreted as sensory information when they are reverberated back up the hierarchy) would predict an over-confidence in the prior knowledge and a higher susceptibility to perceptual illusions.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
  • May combine two claims.

    Premisecitation

    In the Circular Inference model, excitatory/inhibitory imbalance renders the system unable to avoid circular propagation of beliefs: bottom-up sensory evidence is reverberated back down as prior information and combined with itself, and prior expectations can generate fake sensory representations that reinforce prior expectations.

    “In their model, Jardri and Denève showed how excitatory/inhibitory imbalance renders the system unable to avoid circular propagation of beliefs: bottom-up sensory evidence are reverberated back down as if they were prior information (upward loops), and thus combined with themselves until weak sensory inputs or meaningless coincidences are attributed to highly trusted high-level interpretations.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Jardri and Deneve, 2013

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    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Several authors have related auditory hallucinations to an over-saliency of inner speech, considered a covert motor action, which is misattributed to an alien source.

    “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).”
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    • The authors state this as an assumption: In Predictive Coding, the prior and the likelihood have a Gaussian distribution.
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    Interpretationreasoning

    Asymmetrically impairing the inhibitory loops biases the inferential system in two opposite ways that both may generate the same aspecific perceptual phenomenon.

    “Thus, asymmetrically impairing the inhibitory loops biases the inferential system in two opposite ways that both may generate the same aspecific perceptual phenomenon.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
  • May combine two claims.

    Interpretationreasoning

    A deficit in control of upward loops would cause over-confidence in sensory evidence and lower susceptibility to perceptual illusions.

    “Indeed, a deficit in the control of upward loops (e.g., sensory evidence that reaches a high level representation and is then misinterpreted as prior knowledge when it is reverberated back down) would cause an over-confidence in sensory evidence and a lower susceptibility to perceptual illusions.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
  • May combine two claims.

    Premisecitation

    Systemic administration of a GABAA agonist (lorazepam) lengthens percept durations and decreases switch rates.

    “More importantly, the authors then experimentally confirmed these predictions by observing, after the systemic administration of a GABAA agonist (lorazepam), a lengthening of the percept durations and a decrease in the switch rates (Van Loon et al., 2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Van Loon et al., 2013 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    The neurophysiological processes that cause the inferential imbalance remain unclear.

    “Finally, the neurophysiological processes that cause this imbalance remain unclear.”
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    Interpretationnone given

    The effects of circular inference are aggravated by an asymmetric impairment predominantly affecting either the upward or downward loops.

    “This would be aggravated by an asymmetric impairment predominantly affecting either the upward or downward loops.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
  • May combine two claims.

    Interpretationreasoning

    If the impairment only affects climbing loops, sensory evidence but not prior knowledge is reverberated; the prediction error is emphasized and the inferred belief is biased toward sensory evidence.

    “In contrast, when the impairment only affects climbing loops (B), sensory evidence, but not prior knowledge, is reverberated. The prediction error is emphasized (K is too large), and the inferred belief is biased toward sensory evidence.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
    • The authors state this as an assumption: In Predictive Coding, the prior and the likelihood have a Gaussian distribution.
  • May combine two claims.

    Premisecitation

    In cortical networks, excitatory-inhibitory balance is tightly maintained and appears affected in schizophrenia.

    “Indeed such balance is tightly maintained in cortical networks, and appears to be affected in schizophrenia (O'Donnell, 2011).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites O'Donnell, 2011 source

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    Interpretationcitation

    When facing a visual illusion, controls show top-down counter-balancing, whereas schizophrenia patients exhibit strengthening of bottom-up processes that prevent them from perceiving the illusory effect.

    “When facing a VI (i.e., a complex perceptual task), a tendency toward a top-down counter-balancing is observed in controls, whereas patients who suffer from schizophrenia exhibit a strengthening of the bottom-up processes that prevent them from perceiving the illusory effect.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Patients with schizophrenia failed to correct for the inverted Hollow Mask to a more plausible interpretation, which can be explained by an underweighting of prior knowledge during perceptual inferences.

    “The fact that patients with schizophrenia failed to correct for the inverted Hollow Mask to a more plausible (or predictable) interpretation can also be explained by an underweighting of prior knowledge during perceptual inferences (Schmeider et al., 1996; Schneider et al., 2002; Koethe et al., 2009).”
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    • cites Schneider et al., 2002 source

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    • cites Koethe et al., 2009 source

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  • Probably not a substantial claim: may not pass S1 (asserted). May combine two claims.

    Premisecitation

    According to the excessively precise prior hypothesis, perception distances itself from sensory stimuli and becomes dependent on prior knowledge, so one would only perceive what one is expecting to perceive.

    “According to this hypothesis, perception distances itself from the sensory stimuli and becomes dependent on prior knowledge of the world (Friston, 2005b; Chambon et al., 2011; Schmack et al., 2013); thus, one would only perceive what one is expecting to perceive.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Friston, 2005b

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    • cites Chambon et al., 2011 source

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    • cites Schmack et al., 2013 source

      Not checked in the free run.

    • The authors state this as an assumption: In Predictive Coding, the prior and the likelihood have a Gaussian distribution.
  • May combine two claims.

    Interpretationreasoning

    If the inhibitory disequilibrium disfavors descending loops, only prior knowledge is over-counted; the prediction error is minimized and the posterior is biased toward expectations.

    “If, in contrast, the inhibitory disequilibrium disfavors the descending loops (C), only the prior knowledge is over counted because of its reverberation. The prediction error is then minimized (K is too small), and the resulting posterior is biased toward expectations.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
    • The authors state this as an assumption: In Predictive Coding, the prior and the likelihood have a Gaussian distribution.
  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    A disrupted inferential system may fail to attenuate the sensory consequences of self-generated acts; the resulting overweighed prediction error drives otherwise silent percepts into awareness, which is then misattributed to an external agent.

    “Conversely, a disrupted inferential system may fail to attenuate the sensory consequences of self-generated acts. Artificially overweighed, the resulting prediction error would then drive otherwise silent percepts to emerge into awareness. The only way to account for this unusual experience is then to misattribute it to an external agent.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: In Predictive Coding, the prior and the likelihood have a Gaussian distribution.
  • May combine two claims.

    Interpretationreasoning

    Psychotic manifestations can be understood as resulting from circular inferences, which cause overconfidence, surinterpretations of weak sensory data, and dissociations between high-level and low-level representations.

    “Psychotic manifestations can be understood as resulting from such circular inferences, which cause overconfidence, surinterpretations of weak sensory data and dissociations between high-level and low-level representations.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.
    • Rests on an assumption: Long-range connections in the brain are overwhelmingly excitatory.
  • Probably not a substantial claim: may not pass S4 (based).

    Study design and conductnone given

    Frequent methodological issues, such as inter-group comparability, have made findings on the links between visual illusion sensitivity and clinical features difficult to interpret.

    “Despite an abundant literature dealing with this matter, frequent methodological issues (e.g., inter-group comparability) have made the findings difficult to interpret.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Adult patients with schizophrenia are more concerned by auditory compared with visual hallucinations.

    “Importantly, while VIs provide a privileged access to the visual hallucinatory modality, readers should note that adult patients who suffer from schizophrenia are more concerned by auditory compared with visual hallucinations (Mueser et al., 1990; Blom, 2010).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Mueser et al., 1990 source

      Not checked in the free run.

    • cites Blom, 2010 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    An asymmetric impairment in the excitatory-inhibitory balance, consisting of overweighting prior information relative to sensory evidence caused by insufficient inhibitory control of downward loops, could explain the concomitant increase in hallucinations and illusions in Parkinson's disease.

    “asymmetric impairment in the excitatory-inhibitory balance (i.e., an overweighting of prior information relative to the sensory evidence, which is caused by an insufficient inhibitory control of downward loops). This impairment could explain the concomitant increase in hallucinations and illusions in Parkinson's disease (as could the Predictive Coding model).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    The opposite profile of asymmetric circular belief propagation, selective impairment of upward loops, predicts opposite increased vulnerability to visual illusions but similar symptoms.

    “Interestingly, the opposite profile of asymmetric circular belief propagation (selective impairment of upward loops) predicts opposite (increased) vulnerability to VIs but similar symptoms.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    Resistance to visual illusions is not a specific perceptual property of schizophrenia and is not an endophenotypic marker for psychosis in general.

    “Thus, these converging clues prompt one to refute the idea that resistance to VIs is a specific perceptual property of schizophrenia and, hence, an endophenotypic marker for psychosis in general.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    Under the Circular Inference model, aberrant experiences in schizophrenia may be understood as immersion in a world dominated by sensory evidence, while top-down influences lose their organizing and structuring potential.

    “Considering the Circular Inference model, aberrant experiences in schizophrenia may be understood as an immersion in a world dominated by sensory evidence, while top-down influences lose their organizing and structuring potential.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Some authors found no or only weak relationships between visual illusions and psychopathology.

    “While some authors found no or only weak relationships between VIs and psychopathology (Koethe et al., 2006, 2009; Tibber et al., 2013; Yang et al., 2013)”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Koethe et al., 2006, 2009

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Tibber et al., 2013 source

      Not checked in the free run.

    • cites Yang et al., 2013 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In Parkinson's disease, one quarter of patients suffer from visual hallucinations and visual misperceptions.

    “This tendency is noteworthy in the case of Parkinson's disease, in which one quarter of patients suffer from visual hallucinations and visual misperceptions (Diederich et al., 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Diederich et al., 2009 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Visual hallucinations in schizophrenia have a substantial point prevalence of 27%.

    “The authors reported visual hallucinations with a substantial point prevalence of 27% (Waters et al., 2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Waters et al., 2014 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    According to the hypothesis, more weight attributed to sensory evidence, due to a spontaneous or induced variable disequilibrium in the excitatory-to-inhibitory balance, predicts less proneness to visual illusions and greater vulnerability to delusional beliefs and hallucinations.

    “According to this hypothesis, the more weight that is attributed to sensory evidence (because of a spontaneous or induced variable disequilibrium in the excitatory-to-inhibitory balance), the less prone the subject is to VIs, and the more vulnerable he will be to delusional beliefs and hallucinations.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationreasoning

    An overweighting of sensory evidence may explain both hallucinations and reduced susceptibility to visual illusions in schizophrenia.

    “We effectively illustrated how an overweighting of sensory evidence may explain both hallucinations and the reduced susceptibility to VIs in schizophrenia.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    Hallucinations would only emerge when facing highly uncertain and normally irrelevant sensory information.

    “Hallucinations would only emerge when facing highly uncertain (and normally irrelevant) sensory information.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: During the vast majority of daily life situations, patients resolve the moderate ambiguity of environmental stimuli through strong and unambiguous percepts but with weakened links and coherence between perceptual elements.
  • May combine two claims.

    Premisecitation

    Studies comparing schizophrenia with bipolar or major depressive disorder found that the latter two groups were normally sensitive to Binocular depth inversion and Contrast modulation, significantly different from schizophrenia patients.

    “studies that directly compared patients who suffered from schizophrenia with patients who suffered from bipolar or major depressive disorders found that the latter two groups were normally sensitive to Binocular depth inversion (Schneider et al., 2002; Koethe et al., 2009; Wang et al., 2013) and Contrast modulation (Dakin et al., 2005; Yang et al., 2013), which was significantly different from the”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Schneider et al., 2002 source

      Not checked in the free run.

    • cites Koethe et al., 2009 source

      Not checked in the free run.

    • cites Wang et al., 2013 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    This proposal may account for the gradual increase in susceptibility to visual illusions that accompanies the progressive emergence of misperceptions in some psychiatric or neurological conditions, such as Parkinson's disease.

    “This proposal may account for the gradual increase in susceptibility to VIs that accompanies the progressive emergence of misperceptions in some psychiatric or neurological conditions, such as Parkinson's disease (see also Section Visual Illusions, Bayes and Psychotic Symptoms).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    The Bayesian framework predicts that false inferences provide heuristic value to vulnerability to illusions, which can be considered an indirect but valuable access to global neural processing in schizophrenia.

    “provide an heuristic value to the vulnerability to illusions, which can be considered an indirect but valuable access to the global neural processing in this disorder.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    This phenomenon can also be explained by the lack of prior influence on saliency.

    “This phenomenon can also be explained by the lack of prior influence on saliency.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Using a probabilistic generative model, Brown et al. predicted that a failure in attenuating sensory proprioceptive evidence led to delusional ideas regarding agency and decreased susceptibility to the Force-matching illusion.

    “Using a probabilistic generative model, the authors predicted that a failure in attenuating sensory proprioceptive evidence led to the emergence of delusional ideas regarding agency (the ability to correctly identify oneself as the cause of one's own actions), as well as a decreased susceptibility to the Force-matching illusion.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Brown et al. (2013) source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    These findings are in accordance with previous experimental reports of resistance to visual illusions in schizophrenia but extend the observation to multisensory perception.

    “These findings are in accordance with previous experimental reports of resistance to VIs in schizophrenia but extend this observation to multisensory perception.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Shergill et al. indicated that schizophrenia patients were more accurate than controls when matching an externally applied force, revealing a failure in the normal sensory attenuation mechanism.

    “The authors indicated that patients who suffered from schizophrenia were more accurate compared with controls when matching the externally applied force, which revealed a failure in the normal sensory attenuation mechanism.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Shergill et al., 2005 source

      Not checked in the free run.

64 of 64
  • The authors state this as an assumption.

    Perception is closely interwoven with other high-level functions such as belief genesis or reasoning.

    “In line with the assumption that perception is closely interwoven with other high-level functions (such as belief genesis or reasoning; Fletcher and Frith, 2008)”
  • The authors state this as an assumption.

    The Bayesian formalism considers perception as the optimal combination between sensory evidence and prior knowledge.

    “The Bayesian formalism considers perception as the optimal combination between sensory evidence and prior knowledge, thereby highlighting the interweaving of perceptions and beliefs.”
  • The authors state this as an assumption.

    Sensory inputs are inherently ambiguous.

    “Bayesian models set uncertainty and belief as the core features of perception by considering sensory inputs as inherently ambiguous.”
  • The authors state this as an assumption.

    In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction, and this requires equally strong inhibitory loops to cancel excitatory feedforward/feedback loops.

    “To properly compute the probability of perceptual variables, the prior and likelihood must be multiplied only once. In the brain's hierarchy, top-down and bottom-up beliefs should be propagated only once in each direction (see figure above). This can be achieved if equally strong inhibitory loops exist to cancel excitatory feedforward/feedback loops (green and black units).”
  • The paper relies on this without support.

    Long-range connections in the brain are overwhelmingly excitatory.

    “Since long-range connections in the brain are overwhelmingly excitatory, these two types of messages would be reverberated endlessly through feed-forward/feedback excitatory loops if they were not controlled, and kept in check, by the presence of equivalently strong inhibitory loops.”
  • The authors state this as an assumption.

    In Predictive Coding, the prior and the likelihood have a Gaussian distribution.

    “Predictive coding applies the Bayes rule while assuming that the prior and the likelihood have a Gaussian distribution.”
  • The authors state this as an assumption.

    During the vast majority of daily life situations, patients resolve the moderate ambiguity of environmental stimuli through strong and unambiguous percepts but with weakened links and coherence between perceptual elements.

    “Although the hypothesis requires further investigation, we can assume that during the vast majority of daily life situations, patients resolve the moderate ambiguity of the environmental stimuli through strong and unambiguous percepts but with weakened links and coherence between perceptual elements (links typically implicitly driven by prior knowledge).”
  • The paper relies on this without support.

    The necessity to adapt to highly ambiguous situations is not permanent.

    “Importantly, because the necessity to adapt to highly ambiguous situations is not permanent, this may also account for the intermittent nature of hallucinations (Jardri et al., 2013).”
  • The paper relies on this without support.

    When ambiguity is particularly strong, visual illusions represent an extreme perceptual task.

    “When the ambiguity is particularly strong, VIs represent an extreme perceptual task.”
9 of 9

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Psychosis has been associated with a decreased influence of stimulus predictability on brain responses, such as N400, P300, and MMN.

    “a decreased influence of stimulus predictability on brain responses (e.g. N400, P300, MMN; but see (62));”

    From The Predictive Coding Account of Psychosis (2018) · cites this paper as [61]

    In “Visual illusions, bayes and psychotic symptoms” (page unavailable), the paper reports electrophysiological evidence of reduced top-down influence during a visual-illusion task in schizophrenia. That supports the general idea that expectations can have less influence on neural processing, but our copy does not report decreased predictability effects on N400, P300, or MMN responses specifically. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • Psychosis has been associated with a loss of cortico-thalamic connectivity.

    “and a loss of cortico-thalamic connectivity (for reviews see (59, 61)).”

    From The Predictive Coding Account of Psychosis (2018) · cites this paper as [61]

    The Introduction (page unavailable) describes schizophrenia as involving a possible large-scale dysconnectivity syndrome linked to delusions and hallucinations. It does not identify a loss of cortico-thalamic connectivity; searches for cortico-thalamic and thalamic connectivity returned no passage establishing that specific connection. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • Individuals with schizophrenia have been found to be less susceptible to visual illusions.

    “One example of evidence for this model is that individuals with schizophrenia have been found to be less susceptible to visual illusions (Notredame, Pins, Deneve, & Jardri, 2014).”

    From The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review (2015) · cites this paper as Notredame, Pins, Deneve, & Jardri, 2014

  • Psychosis has been associated with a failure to attenuate sensory consequences of self-generated actions.

    “a failure to attenuate sensory consequences of self-generated actions;”

    From The Predictive Coding Account of Psychosis (2018) · cites this paper as [61]

  • Psychosis has been associated with a greater resistance to visual illusions, which rely on prior beliefs for their effects.

    “For example, psychosis has been associated with a greater resistance to visual illusions (which rely on prior beliefs for their effects);”

    From The Predictive Coding Account of Psychosis (2018) · cites this paper as [61]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Claimed schizophrenia-bipolar contrast difference conflicts with Yang et al. table entry

    Major

    The discussion cites Yang et al. (2013) in support of a significant contrast-modulation difference between schizophrenia and bipolar groups. Table 2 says that study found no difference among bipolar, schizophrenia and control groups for any task.

  • Silverstein symptom correlation is given opposite directions

    Major

    The discussion lists Silverstein et al. (2013) as finding an inverse correlation between illusion sensitivity and positive symptoms, whereas Table 2 reports a positive correlation between positive symptoms and context sensitivity.

  • Chen et al. is called a replication despite the opposite result

    Minor

    The text cites Chen et al. (2008) as replicating Dakin's diminished contextual bias, but Table 2 reports greater surround-induced bias in Chen's patients.

  • Claimed reductions across visual parameters conflict with table results

    Minor

    The text attributes reduced illusion strength for orientation and motion to the Yang and Tibber studies. Table 2 reports no patient-control difference for orientation in either study or for motion in Yang et al. (2012).

  • Upward-loop impairment is assigned opposite effects on illusion susceptibility

    Minor

    The model discussion predicts that impaired control of upward loops lowers susceptibility to illusions. The clinical-implications section instead says selective impairment of upward loops predicts increased vulnerability.

5 of 5

Cites

Flagged first, then by citations

1 of the 92 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Gregory, 1973, The confounded eye, 49
  2. Müller-Lyer, 1889, Optische urteilstäuschungen, Arch. Für Anat. Physiol. Physiol. Abt, 2, 263
  3. Ponzo, 1910, Intorno ad alcune illusioni nel campo delle sensazioni tattili, sull'illusione di Aristotele e fenomeni analoghi, Arch. Für Gesamte Psychol, 16, 307

Cited by

Sorted by citations

Authors
Notredame, C.-E., Pins, D., Deneve, S., & Jardri, R.
Affiliations
  • Université Lille Nord de France (FR)
  • Inserm (FR)
Venue
Frontiers in Integrative Neuroscience
Published
2014-08-12
Volume
8
Pages
63-63
ISSN
1662-5145 (ISSN-L)
OpenAlex
W2049841753
Cited by
177
References
92
Citations by year
2026: 15 · 2025: 8 · 2024: 17 · 2023: 17 · 2022: 16 · 2021: 10 · 2020: 17 · 2019: 11 · 2018: 17 · 2017: 19 · 2016: 13 · 2015: 14 · 2014: 3
FWCI
2.26
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Frontiers in Integrative Neuroscience (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • HAL (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Visual perception and processing mechanisms
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
Keywords
optical illusions, schizophrenia, visual perception, Bayesian inference, perceptual priors, perceptual belief, positive symptoms, subjective experience, neural mechanisms of perception

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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