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Do patients with hallucinations imagine speech right?

Mario Altamura1, Giulia Prete2, Antonella Elia1

  • 1Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Foggia, Foggia, Italy.

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Summary

Auditory verbal hallucinations (AVHs) are linked to atypical brain activity. This study found that individuals experiencing AVHs, including those with schizophrenia and bipolar disorder, showed no ear advantage when imagining speech, unlike healthy controls.

Keywords:
Auditory hallucinationsAuditory imageryBipolar disorderLateralitySchizophrenia

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Cognitive Psychology

Background:

  • Auditory verbal hallucinations (AVHs) are often linked to altered speech perception lateralization.
  • Previous research suggests a weak Right Ear Advantage (REA) in verbal perception for patients with AVHs, implying left-hemispheric involvement.
  • The specific hemispheric lateralization of AVHs, particularly in verbal imagery, remains underexplored.

Purpose of the Study:

  • To investigate the hemispheric lateralization of auditory verbal imagery in patients experiencing AVHs.
  • To determine if the relationship between AVHs and hemispheric asymmetry extends to verbal imagery.
  • To explore whether this phenomenon is specific to schizophrenia or present in other psychotic disorders.

Main Methods:

  • Recruited participants: 29 schizophrenia patients with AVHs, 31 psychotic bipolar disorder patients with AVHs, 27 schizophrenia patients without AVHs, and 57 healthy controls.
  • Participants were instructed to imagine hearing a voice in one ear.
  • Assessed the Right Ear Advantage (REA) for auditory verbal imagery across all groups.

Main Results:

  • Healthy controls and non-hallucinating patients exhibited a typical REA for auditory imagery.
  • Patients with schizophrenia and psychotic bipolar disorder experiencing AVHs demonstrated no significant lateral bias in auditory verbal imagery.
  • These findings suggest a lack of hemispheric asymmetry for verbal imagery in individuals with AVHs.

Conclusions:

  • Atypical auditory verbal imagery is associated with AVHs, extending beyond perception to imagination.
  • The absence of lateral bias in verbal imagery may indicate disrupted inter-hemispheric connectivity.
  • This disruption could be a potential marker for predisposition to AVHs and is not exclusive to schizophrenia.