Relationship of imprecise corollary discharge in schizophrenia to auditory hallucinations.
BACKGROUND
A forward model of intended thoughts and actions prepares sensory cortex for sensations that are a consequence of those actions. Imprecision of the corollary discharge in schizophrenia may contribute to the misperception of inner experiences and thoughts as "voices" or auditory hallucinations.


OBJECTIVE
To assess the precision of the forward model in schizophrenia using the N100 component of the auditory event-related potential to speech that is altered or unaltered, in real time, as it is being spoken. To assess the relationship between auditory hallucinations and the imprecision of the corollary discharge.


METHODS
Prospective case-control study.


METHODS
Community mental health centers and Palo Alto Veterans Affairs Health Care System, Palo Alto, Calif.


METHODS
Twenty patients with schizophrenia and 17 sex- and age-matched healthy control subjects.


METHODS
N100 responses to auditory feedback, which was altered by pitch-shifting the self-voice, substituting an alien voice, or pitch-shifting the alien voice. On each trial, subjects judged whether feedback was "self," "other," or "unsure." Clinical ratings were used to assess severity of auditory hallucinations in patients.


RESULTS
In controls, N100 to unaltered self-voice feedback was dampened relative to N100 to altered self-voice or alien auditory feedback. This pattern was not seen in hallucinating patients. This imprecision correlated with the severity of hallucinations and with the percentage of misattribution errors.


CONCLUSIONS
These data support a connection between auditory verbal hallucinations and the imprecision of the corollary discharge heralding the sensory consequences of thoughts and actions.
Heinks-Maldonado
Theda H
TH
Department of Neuropsychology, Albert-Ludwigs-Universität, Freiburg, Germany.
Mathalon
Daniel H
DH
Houde
John F
JF
Gray
Max
M
Faustman
William O
WO
Ford
Judith M
JM
D000161:Acoustic Stimulation; D000328:Adult; D001303:Auditory Cortex / Q000503:physiopathology*; D016022:Case-Control Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005072:Evoked Potentials, Auditory / Q000502:physiology*; D005246:Feedback / Q000502:physiology*; D006212:Hallucinations / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D007600:Judgment / Q000502:physiology; D008297:Male; D008959:Models, Neurological; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D013060:Speech / Q000502:physiology*; D014705:Verbal Behavior / Q000502:physiology; D014831:Voice / Q000502:physiology