Why do some people with schizophrenia 'hear voices'?

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Photo by Mario Heller on Unsplash
Photo by Mario Heller on Unsplash

When people with schizophrenia and other mental disorders ‘hear voices’, this could be due to abnormalities in two brain processes, according to international researchers. The team measured the brain waves of 20 patients with schizophrenia with auditory hallucinations (hearing voices), and 20 patients with schizophrenia who have never experienced such hallucinations. They found that people who hear voices have a “broken” corollary discharge, where the brain suppresses the sound of the person’s own voice when they speak. They also found a ‘noisy’ efference copy, a dysfunction which makes the brain hear these sounds more intensely than they should. These two processes likely contribute to auditory hallucinations, and could be a target for future treatments, according to the researchers.

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From: PLOS

Peer-reviewed Experimental study People

What happens in the brain when a person with schizophrenia “hears voices”?

New study used brain scans of people with and without auditory hallucinations to model the brain networks that may be involved

Auditory hallucinations are likely the result of abnormalities in two brain processes: a “broken” corollary discharge that fails to suppress self-generated sounds, and a “noisy” efference copy that makes the brain hear these sounds more intensely than it should. That is the conclusion of a new study published October 3rd in the open-access journal PLOS Biology by Xing Tian, of New York University Shanghai, China, and colleagues.

Patients with certain mental disorders, including schizophrenia, often hear voices in the absence of sound. Patients may fail to distinguish between their own thoughts and external voices, resulting in a reduced ability to recognize thoughts as self-generated. In the new study, researchers carried out electroencephalogram (EEG) experiments measuring the brain waves of twenty patients diagnosed with schizophrenia with auditory hallucinations and twenty patients diagnosed with schizophrenia who had never experienced such hallucinations.

In general, when people are preparing to speak, their brains send a signal known as “corollary discharge” that suppresses the sound of their own voice. However, the new study showed that when patients with auditory hallucinations were preparing to speak a syllable, their brains not only failed to suppress these internal sounds, but had an enhanced “efference copy” response to internal sounds other than the planned syllable.

The authors conclude that impairments in these two processes likely contribute to auditory hallucinations and that targeting them in the future could lead to new treatments for such hallucinations.

The authors add, “People who suffer from auditory hallucinations can ‘hear’ sounds without external stimuli. A new study suggests that impaired functional connections between motor and auditory systems in the brain mediate the loss of ability to distinguish fancy from reality.”

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PLOS Biology
Research:Paper
Organisation/s: NYU Shanghai, China
Funder: This study was supported by the National Natural Science Foundation of China 32071099 and 32271101 (https://www.nsfc.gov.cn/), Natural Science Foundation of Shanghai 20ZR1472100 (https://svc.stcsm.sh.gov.cn/), Program of Introducing Talents of Discipline to Universities, Base B16018 to X.T., East China Normal University (ECNU) Academic Innovation Promotion Program for Excellent Doctoral Students YBNLTS2019-026 (http://www.yjsy.ecnu.edu.cn/ ) and China Postdoctoral Foundation under Grant Number 2024M752047 (https://www.chinapostdoctor.org.cn/bshjjh/) to F.Y. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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