The role of the primary auditory cortex in the neural mechanism of auditory verbal hallucinations
Kristiina Kompus1*, Liv E. Falkenberg1, Josef J. Bless1, Erik Johnsen2,3, Rune A. Kroken2, Bodil Kråkvik4, Frank Larøi5, Else-Marie Løberg1,2, Einar Vedul-Kjelsås4,6, René Westerhausen1,2 and Kenneth Hugdahl1,2,7
1Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
2Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
3Department of Clinical Medicine, Section Psychiatry, University of Bergen, Bergen, Norway
4Division of Psychiatry, Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway
5Department of Psychology, University of Liège, Liège, Belgium
6Department of Neuroscience, Faculty of Medicine, NTNU, Trondheim, Norway
7Department of Radiology, Haukeland University Hospital, Bergen, Norway
Auditory verbal hallucinations (AVHs) are a subjective experience of “hearing voices” in the absence of corresponding physical stimulation in the environment. The most remarkable feature of AVHs is their perceptual quality, that is, the experience is subjectively often as vivid as hearing an actual voice, as opposed to mental imagery or auditory memories. This has lead to propositions that dysregulation of the primary auditory cortex (PAC) is a crucial component of the neural mechanism of AVHs. One possible mechanism by which the PAC could give rise to the experience of hallucinations is aberrant patterns of neuronal activity whereby the PAC is overly sensitive to activation arising from internal processing, while being less responsive to external stimulation. In this paper, we review recent research relevant to the role of the PAC in the generation of AVHs. We present new data from a functional magnetic resonance imaging (fMRI) study, examining the responsivity of the left and right PAC to parametrical modulation of the intensity of auditory verbal stimulation, and corresponding attentional top-down control in non-clinical participants with AVHs, and non-clinical participants with no AVHs. Non-clinical hallucinators showed reduced activation to speech sounds but intact attentional modulation in the right PAC. Additionally, we present data from a group of schizophrenia patients with AVHs, who do not show attentional modulation of left or right PAC. The context-appropriate modulation of the PAC may be a protective factor in non-clinical hallucinations.
Keywords: auditory verbal hallucinations, primary auditory cortex, non-clinical, schizophrenia, auditory attention
Citation: Kompus K, Falkenberg LE, Bless JJ, Johnsen E, Kroken RA, Kråkvik B, Larøi F, Løberg E-M, Vedul-Kjelsås E, Westerhausen R and Hugdahl K (2013) The role of the primary auditory cortex in the neural mechanism of auditory verbal hallucinations. Front. Hum. Neurosci. 7:144. doi: 10.3389/fnhum.2013.00144
Received: 29 January 2013; Accepted: 02 April 2013;
Published online: 24 April 2013.
Kelly M. J. Diederen, University of Cambridge, UK
Giuliana Lucci, IRCCS Santa Lucia of Rome, Italy
Renaud Jardri, University Medical Centre of Lille, France
Alexander M. Rapp, University of Tuebingen, Germany
Copyright © 2013 Kompus, Falkenberg, Bless, Johnsen, Kroken, Kråkvik, Larøi, Løberg, Vedul-Kjelsås, Westerhausen and Hugdahl. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in other forums, provided the original authors and source are credited and subject to any copyright notices concerning any third-party graphics etc.
*Correspondence: Kristiina Kompus, Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, N-5009 Bergen, Norway. e-mail: firstname.lastname@example.org