Neural Mechanisms of Voluntary Control Over Hallucinations

自愿控制幻觉的神经机制

• 批准号: 10586487
• 负责人: Albert R Powers
• 金额: $ 83.75万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10586487
• 关键词: Acoustics; Automobile Driving; Behavioral; Belief; Biological Assay; Brain; Clinical; Cognitive; Cross-Sectional Studies; Development; Distress; Electroencephalography; Exertion; Exhibits; Goals; Hallucinations; Hearing; Image; Individual; Knowledge; Lead; Location; Loudness; Measures; Participant; Patients; Perception; Persons; Population; Process; Psychoses; Reporting; Route; Running; Symptoms; Translating; Translations; Update; Verbal Auditory Hallucinations; Voice; base; design; disability; experience; insight; neuromechanism; recruit; response; skills; suicidal risk; treatment strategy

Auditory verbal hallucinations (AVH) are among the most distressing symptoms in psychosis, and up to 30% of patients exhibit little to no response to current treatments. This is especially concerning given that the presence of hallucinations alone increases risk of suicide in patients with psychosis. One potential route toward development of new treatments for AVH is based on new evidence that many people with AVH never develop the need to seek treatment, despite the fact that AVH in treatment-seeking and non-treatment-seeking individuals tend to be similar in terms of low-level acoustic qualities such as loudness, duration, and location of voices. One particularly promising predictor comes from the fact that non-treatment-seeking voice-hearing populations consistently endorse a higher degree of control over their experiences than their treatmentseeking counterparts. Perhaps most strikingly, some individuals report an ability to fully control the onset and offset of their voices, which may make the experience of living with these voices significantly less disruptive and distressing. Moreover, new evidence indicates that voluntary inhibition of AVH may be developed in both treatment-seeking and non-treatment-seeking voice-hearers. Understanding the mechanisms specifically driving voluntary control over AVH could lead to new insights into potential treatment strategies to bolster these abilities. We and others have proposed hypotheses for how voluntary control of AVH might arise from cognitive inhibition, alterations in perceptual inference, or interactions between these processes. We propose to identify the mechanisms underlying inhibitory control of hallucinations. We will recruit 102 clinical and non-clinical voice-hearers with a range of control abilities for participation in a set of behavioral, imaging, and electrophysiological tasks designed to identify how voluntary control over voice-hearing occurs. Controlling for key confounds, we will relate our proposed measures to control abilities as measured on the newly-validated Yale Control Over Perceptual Experiences (COPE) Scale. We will also follow a subset of 60 of these participants over two years to identify predictors and correlates of changes in control abilities. To control for presence of hallucinations and psychosis, respectively, we will also recruit 51 matched healthy controls and 51 participants with psychosis but no voice-hearing to participate in the cross-sectional study. Principally, we hypothesize that exertion of control over AVH will result in: 1) activation of separable AVH- and control-related brain networks, the interaction between which will relate to abilities to exert control over AVH; 2) specific alterations in perception as demonstrated by the Conditioned Hallucinations task and EEG measures, corresponding to a decreased precision of perceptual priors, increased perceptual belief updating, or both; and 3) dual-task interference on the Think/No-Think task, an assay of cognitive inhibitory skills. Our goal is to translate the insights gained to new, mechanistically-informed treatments to enhance control over AVH.

听觉幻言（AVH）是最常见的幻听之一。 精神病症状令人痛苦，高达 30% 的患者对当前治疗几乎没有反应 治疗。鉴于仅幻觉的存在就会增加风险，这一点尤其令人担忧 精神病患者自杀的情况。开发新疗法的一条潜在途径 AVH 是基于新的证据表明许多 AVH 患者从未出现寻求治疗的需要， 尽管寻求治疗和未寻求治疗的个体的 AVH 往往相似 就低级声学质量而言，例如声音的响度、持续时间和位置。一 特别有希望的预测因素来自以下事实：非寻求治疗的声音听力 与寻求治疗相比，人们一致认可对自己的经历有更高程度的控制 同行。也许最引人注目的是，一些人报告说有能力完全控制 他们声音的开始和抵消，这可能会使与这些声音一起生活的体验变得显着 更少的破坏性和痛苦。此外，新的证据表明，自愿抑制 AVH 可能会 可以在寻求治疗和非寻求治疗的声音聆听者中得到发展。了解 专门驱动对 AVH 自愿控制的机制可能会带来对潜力的新见解 增强这些能力的治疗策略。我们和其他人提出了如何 AVH 的自愿控制可能源于认知抑制、知觉推理的改变或 这些过程之间的相互作用。我们建议确定抑制的机制 控制幻觉。我们将招募 102 名临床和非临床声音聆听者，他们具有一系列 参与一组设计的行为、成像和电生理任务的控制能力 确定对声音听觉的自愿控制是如何发生的。控制关键的混淆因素，我们将联系起来 我们提出的控制能力的措施是根据新验证的耶鲁控制能力来衡量的 感知体验（COPE）量表。我们还将在两年内跟踪其中 60 名参与者的子集 多年来确定控制能力变化的预测因素和相关性。控制存在 分别为幻觉和精神病，我们还将招募 51 名匹配的健康对照者和 51 名 患有精神病但没有声音听力的参与者参加横断面研究。主要是， 我们假设对 AVH 施加控制将导致：1）激活可分离的 AVH- 和 与控制相关的大脑网络，它们之间的相互作用将与施加控制的能力有关 AVH； 2) 条件性幻觉任务所证明的感知的具体改变以及 脑电图测量，对应于知觉先验精度的降低，知觉的增加 信念更新，或两者兼而有之； 3）对思考/不思考任务的双任务干扰，这是一种认知分析 抑制技能。我们的目标是将获得的见解转化为新的、基于机制的治疗方法 加强对 AVH 的控制。