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Neural correlates of the misattribution of speech in schizophrenia

Division of Psychological Medicine Section of Neuroimaging

STEVEN C. R. WILLIAMS, PhD

Department of Neuroimaging

MICHAEL J. BRAMMER, PhD

Brain Image Analysis Unit, Department of Biostatistics and Computing

LOUISE C. JOHNS, DClin and PHILIP K. McGUIRE, FRCPsych, MD, PhD

Institute of Psychiatry, London, UK

Correspondence: Paul Allen, Division of Psychological Medicine PO69, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, UK. Tel: +44(0)207 848 0514; Fax: +44(0)207 848 0287; email: p.allen{at}iop.kcl.ac.uk

Declaration of interest None.

Background The neurocognitive basis of auditory verbal hallucinations is unclear.

Aims To investigate whether people with a history of such hallucinations would misattribute their own speech as external and show differential activation in brain areas implicated in hallucinations compared with people without such hallucinations.

Method Participants underwent functional magnetic resonance imaging (fMRI) while listening to pre-recorded words. The source (self/non-self) and acoustic quality (undistorted/distorted) were varied across trials. Participants indicated whether the speech they heard was their own or that of another person. Twenty people with schizophrenia (auditory verbal hallucinations n=10, no hallucinations n=10) and healthy controls (n=11) were tested.

Results The hallucinator group made more external misattributions and showed altered activation in the superior temporal gyrus and anterior cingulate compared with both other groups.

Conclusions The misidentification of self-generated speech in patients with auditory verbal hallucinations is associated with functional abnormalities in the anterior cingulate and left temporal cortex. This may be related to impairment in the explicit evaluation of ambiguous auditory verbal stimuli.

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