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.

听觉言语幻觉（AVH）是最大的 精神病的痛苦症状，多达30％的患者对当前的反应几乎没有反应 治疗。考虑到仅存在幻觉就会增加风险，这尤其令人担忧 精神病患者自杀。开发新疗法的潜在途径 AVH基于新的证据，表明许多患有AVH的人从未培养过寻求治疗的需求， 尽管事实上，在寻求治疗和寻求治疗的个人中，AVH往往相似 就低级声学品质而言，例如响度，持续时间和声音的位置。一 特别有前途的预测因子来自以下事实 人口一贯认可对他们的经验的控制程度，而不是他们的治疗方法 同行。也许最引人注目的是，有些人报告了完全控制的能力 他们的声音发作和抵消，这可能会使与这些声音的生活经历显着 较少的破坏性和痛苦。此外，新的证据表明对AVH的自愿抑制可能 可以在寻求治疗和非治疗的语音听觉中发展。了解 专门驱动对AVH的自愿控制的机制可能会导致对潜力的新见解 加强这些能力的治疗策略。我们和其他人提出了关于如何 对AVH的自愿控制可能是由于认知抑制，感知推断的改变或 这些过程之间的相互作用。我们建议确定抑制性的机制 控制幻觉。我们将招募102个临床和非临床语音听力，范围 参与一组行为，成像和电生理任务的控制能力 确定对语音听力的自愿控制是如何发生的。控制关键混杂，我们将联系 我们提出的控制能力的措施，如新近验证的耶鲁大学控制 感知体验（COPE）量表。我们还将遵循两个参与者的一个子集 确定控制能力变化的预测因素和相关性的年份。控制存在 幻觉和精神病，我们还将招募51个匹配的健康对照和51个 精神病的参与者，但没有声音听力参加横断面研究。主要是 我们假设对AVH的控制施加会导致：1）激活可分离的AVH和 与控制相关的大脑网络，其之间的相互作用将与能力有关控制的能力 avh; 2）有条件幻觉任务和 脑电图测量，对应于感知先验的精度降低，增加了感知 信念更新，或两者兼而有之； 3）双任务干扰思维/无思想任务，一种认知的测定 抑制技能。我们的目标是将获得的见解转化为新的，机械化的治疗方法 增强对AVH的控制。