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Annals of Neurology Jul 2024Alice in Wonderland syndrome (AIWS) profoundly affects human perception of size and scale, particularly regarding one's own body and the environment. Its neuroanatomical...
OBJECTIVE
Alice in Wonderland syndrome (AIWS) profoundly affects human perception of size and scale, particularly regarding one's own body and the environment. Its neuroanatomical basis has remained elusive, partly because brain lesions causing AIWS can occur in different brain regions. Here, we aimed to determine if brain lesions causing AIWS map to a distributed brain network.
METHODS
A retrospective case-control study analyzing 37 cases of lesion-induced AIWS identified through systematic literature review was conducted. Using resting-state functional connectome data from 1,000 healthy individuals, the whole-brain connections of each lesion were estimated and contrasted with those from a control dataset comprising 1,073 lesions associated with 25 other neuropsychiatric syndromes. Additionally, connectivity findings from lesion-induced AIWS cases were compared with functional neuroimaging results from 5 non-lesional AIWS cases.
RESULTS
AIWS-associated lesions were located in various brain regions with minimal overlap (≤33%). However, the majority of lesions (≥85%) demonstrated shared connectivity to the right extrastriate body area, known to be selectively activated by viewing body part images, and the inferior parietal cortex, involved in size and scale judgements. This pattern was uniquely characteristic of AIWS when compared with other neuropsychiatric disorders (family-wise error-corrected p < 0.05) and consistent with functional neuroimaging observations in AIWS due to nonlesional causes (median correlation r = 0.56, interquartile range 0.24).
INTERPRETATION
AIWS-related perceptual distortions map to one common brain network, encompassing regions critical for body representation and size-scale processing. These findings lend insight into the neuroanatomical localization of higher-order perceptual functions, and may inform future therapeutic strategies for perceptual disorders. ANN NEUROL 2024.
PubMed: 38949221
DOI: 10.1002/ana.27015 -
Computational Psychiatry (Cambridge,... 2024Patients with anorexia nervosa (AN) typically hold altered beliefs about their body that they struggle to update, including global, prospective beliefs about their...
Patients with anorexia nervosa (AN) typically hold altered beliefs about their body that they struggle to update, including global, prospective beliefs about their ability to know and regulate their body and particularly their interoceptive states. While clinical questionnaire studies have provided ample evidence on the role of such beliefs in the onset, maintenance, and treatment of AN, psychophysical studies have typically focused on perceptual and 'local' beliefs. Across two experiments, we examined how women at the acute AN (N = 86) and post-acute AN state (N = 87), compared to matched healthy controls (N = 180) formed and updated their self-efficacy beliefs retrospectively (Experiment 1) and prospectively (Experiment 2) about their heartbeat counting abilities in an adapted heartbeat counting task. As preregistered, while AN patients did not differ from controls in interoceptive accuracy , they hold and maintain 'pessimistic' interoceptive, metacognitive self-efficacy beliefs after performance. Modelling using a simplified computational Bayesian learning framework showed that neither local evidence from performance, nor retrospective beliefs following that performance (that themselves were suboptimally updated) seem to be sufficient to counter and update pessimistic, self-efficacy beliefs in AN. AN patients showed lower learning rates than controls, revealing a tendency to base their posterior beliefs more on prior beliefs rather than prediction errors in both retrospective and prospective belief updating. Further explorations showed that while these differences in both explicit beliefs, and the latent mechanisms of belief updating, were not explained by general cognitive flexibility differences, they were explained by negative mood comorbidity, even after the acute stage of illness.
PubMed: 38948255
DOI: 10.5334/cpsy.109 -
Biological Psychiatry. Cognitive... Jun 2024'Voice-hearing' (VH) is a transdiagnostic experience that is common in trauma-related disorders (trauma-D). However, the neural substrates underlying trauma-related VH...
BACKGROUND
'Voice-hearing' (VH) is a transdiagnostic experience that is common in trauma-related disorders (trauma-D). However, the neural substrates underlying trauma-related VH remain largely unexplored. While auditory perceptual dysfunction is among the abnormalities implicated in schizophrenia VH, whether VH in trauma-D also involves auditory perceptual alterations is unknown.
METHODS
We investigated auditory cortex (AC)-related functional connectivity (FC) in n=65 women with trauma-D related to childhood abuse with varying severities of VH. Using a novel, computationally-driven and individual-specific method of functionally parcellating the brain, we calculated the FC of two distinct AC subregions-Heschl's gyrus (HG, corresponding to primary AC) and lateral superior temporal gyrus (lSTG, in non-primary AC)- with both the cerebrum and cerebellum. We then measured the association between VH severity and FC using leave-one-out cross validation within the cerebrum, and voxel-wise multiple regression analyses in the cerebellum.
RESULTS
We found that VH severity positively correlated with left lSTG-frontoparietal network FC, while it negatively correlated with FC between left lSTG and both cerebral and cerebellar representations of the default mode network. VH severity was not predicted by FC of left HG or right AC subregions.
CONCLUSIONS
Our findings point to altered interactions between auditory perceptual processing and higher-level processes related to self-reference and executive functioning. This is the first study to show alterations in auditory cortical connectivity in trauma-related VH. While VH in trauma-D appears to be mediated by brain networks that are also implicated in schizophrenia VH, the results suggest a unique mechanism that could distinguish VH in trauma-D.
PubMed: 38944384
DOI: 10.1016/j.bpsc.2024.06.009 -
NeuroImage Jun 2024The ability to perceive pain presents an interesting evolutionary advantage to adapt to an ever-changing environment. However, in the case of chronic pain (CP), pain...
The ability to perceive pain presents an interesting evolutionary advantage to adapt to an ever-changing environment. However, in the case of chronic pain (CP), pain perception hinders the capacity of the system to adapt to changing sensory environments. Similar to other chronic perceptual disorders, CP is also proposed to be a maladaptive compensation to aberrant sensory predictive processing. The local-global oddball paradigm relies on learning hierarchical rules and processing environmental irregularities at a local and global level. Prediction errors (PE) between actual and predicted input typically trigger an update of the forward model to limit the probability of encountering future PEs. It has been hypothesised that CP hinders forward model updating, reflected in increased local deviance and decreased global deviance. In the present study, we used the local-global paradigm to examine how CP influences hierarchical learning relative to healthy controls. As hypothesised, we observed that deviance in the stimulus characteristics evoked heightened local deviance and decreased global deviance of the stimulus-driven PE. This is also accompanied by respective changes in theta phase locking that is correlated with the subjective pain perception. Changes in the global deviant in the stimulus-driven-PE could also be explained by dampened attention-related responses. Changing the context of the auditory stimulus did not however show a difference in the context-driven PE. These findings suggest that CP is accompanied by maladaptive forward model updating where the constant presence of pain perception disrupts local deviance in non-nociceptive domains. Furthermore, we hypothesise that the auditory-processing based biomarker identified here could be a marker of domain-general dysfunction that could be confirmed by future research.
PubMed: 38942099
DOI: 10.1016/j.neuroimage.2024.120711 -
Journal of Speech, Language, and... Jun 2024This study aims at investigating the phonological development of the six guttural consonants of Jordanian Arabic, /χ/, /ʁ/, /ħ/, /ʕ/, /ʔ/, and /h/.
PURPOSE
This study aims at investigating the phonological development of the six guttural consonants of Jordanian Arabic, /χ/, /ʁ/, /ħ/, /ʕ/, /ʔ/, and /h/.
METHOD
An articulation test is designed to involve two tasks: picture naming and repetition. The test includes 54 words for picture naming and 18 words for repetition, representing all possible positions of the targeted guttural sounds. Samples are collected from 40 typically developing Ammani-Jordanian Arabic-speaking monolingual children, living in Amman, Jordan. Respondents are equally divided into eight age-related trajectories: 2-2;6, 2;6-3, 3-3;6, 3;6-4, 4-4;6, 4;6-5, 5-5;6, and 5;6-6 (years;months). No child with a history of hearing, speech, or vision disorders is included. The data are analyzed using , where the three developmental trajectories of production (customary, acquisition, and mastery) are determined for each guttural, and , addressed based on perceptual judgments, providing details of every mispronounced or deleted guttural.
RESULTS
The results show that /χ/, /ħ/, /ʕ/, and /ʔ/ are acquired before the age of 6 years, while /ʁ/ and /h/ are still not acquired by this age. Respondents use relatively variant alternatives for the mispronounced cognates, including guttural, nonguttural sounds, and vowel substitution. The /ʁ/ is the guttural with the highest number of alternatives, while /ʔ/ gets the least. The analysis also reveals patterns of guttural deletion, with variations across different guttural sounds and positions. Despite errors/deviations made, respondents score accuracy percentages that gradually increase in correlation with age. The guttural /ʁ/ starts with the lowest accuracy percentages, while /ʔ/ and /ħ/ start with the highest.
CONCLUSIONS
These findings illuminate on the developmental trajectory of guttural acquisition and enrich our understanding of children's evolving perception and production abilities. They offer valuable insights into the patterns of guttural sound production in Jordanian Arabic-speaking children, laying the groundwork for further research and the development of targeted assessment and intervention strategies to support phonological development in this population.
PubMed: 38941556
DOI: 10.1044/2024_JSLHR-23-00085 -
Journal of Clinical Psychology Jun 2024Personality disorders (PD) are based not just on maladaptive ideas about self and others, they also are grounded on embodied patterns of behaviors and reactions to...
Personality disorders (PD) are based not just on maladaptive ideas about self and others, they also are grounded on embodied patterns of behaviors and reactions to interpersonal stressors. There is growing interest in working with the body and through the body so to address automatisms that lead to suffering and dysfunctional social action. In this issue of the Journal of Clinical Psychology: In-Session the use of art and psychomotor therapies for these patients was explored by seven different clinical perspectives. Patients described presented with different PD and associated symptoms. The arts and psychomotor therapies deployed in personality disorder treatment are: (visual) art therapy, music therapy, drama therapy, dance (movement) therapy, and psychomotor therapy making psychotherapeutic use of the different modalities: art, music, play, role-play, performance, improvisation, dance, body awareness and movement. Interventions provide kinesthetic, sensory, perceptual, and symbolic opportunities to invite alternative modes of meaning-making, accessing own needs and wishes, and communicating them to others. In this commentary we summarize some of the different topics covered by the clinical-based papers, including working mechanisms of arts and psychomotor therapies, the importance of bottom-up emotion regulation processes, how to treat trauma in the presence of a PD, how to integrate art and psychomotor therapies in a fine-grained formulation and how to understand the process of change. Although there is a need for more empirical research, we hope this issue makes a solid case that clinicians can effectively include art and psychomotor therapies when treating the full range of PD.
PubMed: 38941072
DOI: 10.1002/jclp.23730 -
Behavioral Neuroscience Jun 2024In recent years, there have been significant advances in our understanding of the positive symptoms of schizophrenia, such as hallucinations and delusions. This progress... (Review)
Review
In recent years, there have been significant advances in our understanding of the positive symptoms of schizophrenia, such as hallucinations and delusions. This progress has been significantly aided by the use of associative learning-based approaches in human subjects and preclinical animal models. Here, we first review experimental research focusing on the abnormal processing of absent stimuli using three different conditioning phenomena: conditioned hallucinations, mediated conditioning, and trace conditioning. We then review studies investigating the ability to reduce focal processing of physically present but informationally redundant stimuli using habituation, latent inhibition, and blocking. The results of these different lines of research are then summarized within the framework of Wagner's (1981) standard operating procedures model, an associative learning model with explicit reference to the internal representations of both present and absent stimuli. Within this framework, the central deficit associated with positive symptoms can be described as a failure to suppress the focal processing of both absent stimuli and present but irrelevant stimuli. This can explain the wide range of results obtained in different experimental settings. Finally, we briefly discuss the role of the hippocampus and its interaction with dopaminergic transmission in the emergence of such abnormal stimulus representations and learning. Overall, we hope that the theoretical framework and empirical findings offered by the associative learning approach will continue to facilitate and integrate analyses of schizophrenia conducted at the psychological and behavioral levels on the one hand, and at the neural and molecular levels on the other, by serving as a useful interface between them. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Topics: Humans; Association Learning; Schizophrenia; Animals; Psychotic Disorders; Hallucinations; Schizophrenic Psychology; Conditioning, Classical; Hippocampus; Perception
PubMed: 38934921
DOI: 10.1037/bne0000599 -
The Behavioral and Brain Sciences Jun 2024Why have core knowledge? Standard answers typically emphasize the difficulty of learning core knowledge from experience, or the benefits it confers for learning about...
Why have core knowledge? Standard answers typically emphasize the difficulty of learning core knowledge from experience, or the benefits it confers for learning about the world. Here, we suggest a complementary reason: Core knowledge is critical for learning not just about the external world, but about the mind itself.
Topics: Humans; Illusions; Learning; Knowledge; Visual Perception
PubMed: 38934449
DOI: 10.1017/S0140525X23003205 -
Dementia & Neuropsychologia 2024The French composer, Maurice Ravel, at the peak of his career, showed signs of a progressive disorder that affected his ability to function with verbal and musical...
The French composer, Maurice Ravel, at the peak of his career, showed signs of a progressive disorder that affected his ability to function with verbal and musical language, as noted by the neurologist Théophile Alajouanine. The worsening of the disease led to a craniotomy, performed in 1937, which failed to reveal the cause of his illness, and he died shortly thereafter. A lack of post-mortem neuropathological evidence precluded a definitive diagnosis of the illness, which remained enigmatic. Speculations about the precise diagnosis of Ravel's neurological disease have been largely based on Alajouanine's observations, which included aphasia and amusia, mostly expressive, and ideomotor apraxia, while musical judgement, taste, and memory remained relatively intact, implying different neuroanatomical substrates. A possible subform of frontotemporal lobar degeneration complex was the diagnostic suggestion of many authors. His untimely death deprived the world of this remarkable musician, and the music that remained trapped in his mind.
PubMed: 38933078
DOI: 10.1590/1980-5764-DN-2023-0108 -
Scientific Reports Jun 2024Visual hallucinations in Lewy body disease (LBD) can be differentiated based on phenomenology into minor phenomena (MVH) and complex hallucinations (CVH). MVH include a...
Visual hallucinations in Lewy body disease (LBD) can be differentiated based on phenomenology into minor phenomena (MVH) and complex hallucinations (CVH). MVH include a variety of phenomena, such as illusions, presence and passage hallucinations occurring at early stages of LBD. The neural mechanisms of visual hallucinations are largely unknown. The hodotopic model posits that the hallucination state is due to abnormal activity in specialized visual areas, that occurs in the context of wider network connectivity alterations and that phenomenology of VH, including content and temporal characteristics, may help identify brain regions underpinning these phenomena. Here we investigated both the topological and hodological neural basis of visual hallucinations integrating grey and white matter imaging analyses. We studied LBD patients with VH and age matched healthy controls (HC). VH were assessed using a North-East-Visual-Hallucinations-Interview that captures phenomenological detail. Then we applied voxel-based morphometry and tract based spatial statistics approaches to identify grey and white matter changes. First, we compared LBD patients and HC. We found a reduced grey matter volume and a widespread damage of white tracts in LBD compared to HC. Then we tested the association between CVH and MVH and grey and white matter indices. We found that CVH duration was associated with decreased grey matter volume in the fusiform gyrus suggesting that LBD neurodegeneration-related abnormal activity in this area is responsible for CVH. An unexpected finding was that MVH severity was associated with a greater integrity of white matter tracts, specifically those connecting dorsal, ventral attention networks and visual areas. Our results suggest that networks underlying MVH need to be partly intact and functional for MVH experiences to occur, while CVH occur when cortical areas are damaged. The findings support the hodotopic view and the hypothesis that MVH and CVH relate to different neural mechanisms, with wider implications for the treatment of these symptoms in a clinical context.
Topics: Humans; Hallucinations; Lewy Body Disease; Gray Matter; Female; White Matter; Male; Aged; Magnetic Resonance Imaging; Aged, 80 and over; Case-Control Studies; Middle Aged
PubMed: 38926597
DOI: 10.1038/s41598-024-65536-w