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PubMed2002

Incidence of RBD and hallucination in patients affected by Parkinson's disease: 8-year follow-up.

We describe the 8-years follow-up of 80 patients affected by idiopathic, L-dopa-responsive Parkinson's disease. All patients were evaluated at baseline and during the follow-up with visual evoked potential, P300 event related potentials and polysomnography. The patients and their relatives compiled sleep and hallucination questionnaires. Statistical analysis was performed to evaluate if visual abnormalities, abnormal P300 recordings or sleep disturbances were linked to the development and hallucinations. Our results show that abnormal vision and abnormal P300 did not correlate with the incidence of hallucinations. However, the presence of REM sleep behavioral disorder (RBD) was significantly related to the development of hallucinations,independently of age, gender or duration of disease but dependent on the amount of dopaminoagonist treatment.

Age Factors↗
PubMed2005

Hallucinations in the general population.

Although hallucinations occur in a range of organic and psychiatric conditions, they are not invariably a sign of illness and also occur in "normal" individuals. Evidence indicates that psychotic hallucinations lie on a continuum with normal experiences, and many more people experience hallucinations than meet criteria for clinical psychosis. In addition to a symptomatic continuum between normal individuals and patients with psychosis, there is evidence that hallucinatory experiences in nonclinical and clinical samples may share the same underlying etiologic influences, including sociodemographic risk factors and neurocognitive mechanisms. Predictors of patient status include beliefs about hallucinations, negative mood, and perceived lack of control.

Brief Psychiatric Rating Scale↗
PubMed1987

Relationship of auditory hallucinations and paranoia to platelet MAO activity in schizophrenics: sex and race interactions.

Platelet monoamine oxidase (MAO) activity was determined in 37 female and 64 male patients with Research Diagnostic Criteria diagnoses of paranoid or undifferentiated schizophrenia, or schizoaffective disorder, mainly schizophrenic, and for 71 female and 65 male normal controls (NCs). Female NCs had significantly higher adjusted mean platelet MAO activity than male NCs and female, paranoid, nonhallucinating schizophrenics. Male NCs had significantly higher adjusted mean platelet MAO activity than male, paranoid, hallucinating schizophrenics. Examination of main and interactive effects of diagnostic subtype, presence/absence of auditory hallucinations, gender, and race within the group of schizophrenic patients revealed no statistically significant main effect but, rather, significant interactive effects of auditory hallucinations with gender, with diagnostic group and gender, and with diagnostic group and race in the prediction of platelet MAO activity. The interaction of diagnostic subtype with race and gender in the prediction of platelet MAO activity was also statistically significant. In general, significantly decreased platelet MAO activity was associated with both paranoid subtype and presence of auditory hallucinations in male and in black schizophrenics; and with paranoid subtype alone in white male schizophrenics. These interactive relationships with platelet MAO activity in schizophrenics may account for discrepancies in previous reports of the activity of this enzyme in schizophrenics, and are consistent with reduced platelet MAO activity in subgroups of schizophrenics.

Adult↗
PubMed1993

Lateral asymmetries in auditory acuity distinguish hallucinating from nonhallucinating schizophrenic patients.

Bilateral absolute auditory thresholds for frequencies ranging from 250 to 8000 Hz were examined on two occasions in schizophrenic patients and normal control subjects. Patients were classified as hallucinators and nonhallucinators on the basis of symptom ratings on both occasions. Previous evidence of better right than left ear acuity in schizophrenia was replicated but was found to characterize nonhallucinating patients only. Hallucinators showed no lateral asymmetry and inferior right ear acuity as compared with that in nonhallucinators. The results were reliable on retest. Brief Psychiatric Rating Scale scores of positive and negative symptoms in some cases differentiated hallucinators from nonhallucinators. The relationship of verbal hallucinations and right ear-left temporal lobe functions is discussed, together with complexities in cerebral laterality-syndrome relationships.

Adult↗
PubMed1992

Auditory hallucinations in women and men.

The total population of a community schizophrenia registry sample yielded information about the relative lifetime frequency of hallucinations in women and men. Whereas hallucinations in non-auditory modalities were equally distributed between the two sexes, auditory hallucinations were significantly more common in women. These results will be considered in relation to the existing literature on hallucinations and gender.

Adult↗
PubMed1994

Olfactory hallucinations and olfactory identification ability in patients with schizophrenia and other psychiatric disorders.

Olfactory identification ability and the prevalence of olfactory hallucinations were examined in 183 hospitalized patients from three diagnostic groups. One hundred and thirty-one patients with schizophrenia, 21 patients with major depression, 31 women with eating disorders along with 77 normal control subjects were examined using the University of Pennsylvania Smell Identification Test (UPSIT) and were questioned regarding the presence of olfactory hallucinations. Olfactory identification deficits were observed only in patients with schizophrenia. In contrast, olfactory hallucinations were reported by members of all psychiatric diagnostic categories (34.6% of patients with schizophrenia; 19% of depressed patients and 29% of eating disorders patients). For patients with schizophrenia, women were more likely to report olfactory hallucinations and had higher UPSIT scores than men.

Adolescent↗
PubMed2004

Interpretations of voices in patients with hallucinations and non-patient controls: a comparison and predictors of distress in patients.

BACKGROUND: This study tested the hypotheses that interpretations of voices will be associated with distress linked to auditory hallucinations, and that patients experiencing hallucinations will exhibit higher levels of negative interpretations in comparison with non-patients. METHOD: The Interpretation of Voices Inventory (British Journal of Clinical Psychology 41 (2002) 259) was administered to patients who met DSM-IV criteria for schizophrenia spectrum disorders with auditory hallucinations and non-patients. Patients were also assessed using a semi-structured interview to asses clinical dimensions of their voices. RESULTS: The results showed that people with psychosis who experience auditory hallucinations did exhibit higher levels of positive and negative interpretations of voices, in comparison to non-patients. Correlational analyses revealed that interpretations of voices were significantly associated with emotional, physical and cognitive characteristics of voices. Regression analyses demonstrated that physical characteristics of voices and metaphysical beliefs were significant predictors of emotional characteristics of voices. CONCLUSIONS: The theoretical and clinical implications of these findings are discussed.

Adult↗
PubMed2004

Polymorphisms of dopamine receptor and transporter genes and hallucinations in Parkinson's disease.

The authors conducted a case-control study of Parkinson's disease patients with and without visual hallucinations to investigate associations of the polymorphisms of the dopamine receptors D2 32806 C>T (Taq1A), D3 Ser9Gly and Msp1, D5 978T>C and dopamine transporter 3'-UTR 40 bp VNTR with visual hallucinations in Parkinson's disease. No significant differences were found between hallucinators and non-hallucinators in either the genotypic or allelic distributions. Our data suggest that the loci investigated here are not associated with the visual hallucinogenesis in Parkinson's disease.

Aged↗
PubMed2005

Segmented volumes of cerebrum and cerebellum in first episode schizophrenia with auditory hallucinations.

The volumes of cerebral and cerebellar regions were measured in first episode schizophrenic patients with (n = 17) and without (n = 8) auditory hallucinations. Magnetic resonance images of cerebral and cerebellar regions were segmented into gray and white fractions using an algorithm for semiautomated fuzzy tissue segmentation. They were defined by using the semiautomated Talairach atlas-based parcellation method. Patients with auditory hallucinations showed larger temporal white matter, frontal gray matter, and temporal gray matter volumes than patients without auditory hallucinations. These findings suggest that auditory hallucinations in schizophrenic patients may be associated with neuropathological abnormalities in frontal and temporal brain regions.

Adolescent↗
PubMed2005

EEG coherence measures during auditory hallucinations in schizophrenia.

We studied the change in EEG alpha-band average coherence between auditory hallucination (AH) and non-auditory hallucination (non-AH) states in seven auditory hallucinating schizophrenia patients. Four cortical regions were considered based on the existing dominant models for auditory hallucinations, the inner speech model and the central auditory processing deficit (CAPD) model. Coherences between electrodes located over Broca's area (BA 44/45) and Wernicke's area (BA 22/42) and between electrodes located over left-right temporal cortices were examined. There was no significant change observed in the coherence between Broca's and Wernicke's areas, but a significant increase was observed in coherence between the left and right superior temporal cortices during AHs compared with non-AHs, suggesting increased bilateral coherence between auditory cortical areas. Since coherence is a pairwise measure of functional correlation between regions, our findings suggest abnormally increased synchrony between the left and right auditory cortices during AHs in schizophrenia. Further, a significant increase in relative power was observed in the left, but not in the right auditory cortex during AHs. Thus our findings support the CAPD model and are consistent with that which postulate reduced prosodic processing during AHs.

Adult↗
PubMed2005

Low frequency repetitive transcranial magnetic stimulation improves source monitoring deficit in hallucinating patients with schizophrenia.

Auditory hallucinations have been associated with a disruption in monitoring one's own speech suggesting an autonoetic agnosia in schizophrenia. This deficit can be measured by a source monitoring task. Low frequency transcranial magnetic stimulations (rTMS) applied to the left temporoparietal cortex can inhibit cortical areas involved both in autonoetic agnosia (which means 'the inability to identify self-generated mental events') and in auditory hallucinations (AH) phenomena. Although improvements in AH have been repeatedly reported following rTMS treatment, effects on autonoetic agnosia measured by source monitoring have never been investigated. We aimed to investigate the relation between improvements in AH and source monitoring performance after rTMS treatment. Twenty four right-handed refractory schizophrenic patients with hallucinations randomly received sham or active 10.0001-Hz rTMS to the left temporoparietal cortex and performed 2 source monitoring tasks requiring discrimination between silent- and overt-reading words before and after rTMS sessions. Compared to sham, active rTMS significantly improved AH. Source monitoring performances and the improvements tended to correlate, which would support a specific relation between autonoetic agnosia and auditory hallucinations.

Adult↗
PubMed2005

Complex nocturnal visual hallucinations.

BACKGROUND AND PURPOSE: To describe the clinical features and associations of complex nocturnal visual hallucinations. PATIENTS AND METHODS: We identified 12 patients seen between 1997 and 2004 with complex nocturnal visual hallucinations. Charts were reviewed and data analyzed. RESULTS: Of the 12 patients, 11 were women. Vivid, silent, often distorted images of people and animals occurred after waking, disappearing with increased light. Idiopathic hypersomnia, beta blocker use, dementia with Lewy bodies, macular degeneration and anxiety were associated factors. The hallucinations appeared to be a primary parasomnia in four patients with anxiety being the only associated feature. CONCLUSIONS: Complex nocturnal visual hallucinations represent a well-defined syndrome with diverse causes which should be differentiated from other parasomnias causing arousals.

Adolescent↗
PubMed2000

Estrogen and visual hallucinations in a patient with Charles Bonnet syndrome.

PURPOSE: To describe the occurrence of visual hallucinations in a patient with Charles Bonnet syndrome associated with estrogen intake. METHOD: Case report. RESULTS: An 84-year-old woman with poor visual acuity secondary to bilateral, nonexudative, age-related macular degeneration had nonthreatening visual hallucinations 2 weeks after starting oral estrogen for osteoporosis. The estrogen was stopped, and the hallucinations subsided. The patient was given estrogen twice more and each time the hallucinations recurred. CONCLUSION: We report a case of Charles Bonnet syndrome associated with estrogen intake in an 84-year-old woman. Estrogen may have promoted release phenomena and triggered the hallucinatory episodes in our patient.

Aged↗
PubMed2003

The effects of focus of attention on attributional bias in patients experiencing auditory hallucinations.

Cognitive models suggest that auditory hallucinations occur as the result of internal events attributed to an external source. The present study represents an attempt to evaluate the source monitoring performance of people who experience auditory hallucinations, specifically in terms of the suggested links between source monitoring, emotionality of stimuli and self-focused attention. The source monitoring performance of a group of 30 patients with a diagnosis of a schizophrenia spectrum disorder who experience auditory hallucinations was compared following successful experimental manipulation of their attention, designed to increase and decrease their levels of self-focused attention. The inclusion of words previously rated as emotionally salient by schizophrenic patients assessed the effect of emotionality on source monitoring performance. This study demonstrated that participants' ratings of both internality and control of their responses to the word association task were lower in the external focus condition than the internal focus condition. Furthermore, it was found that ratings of internality and control were lower for responses to both positive and negative stimuli compared to responses to neutral stimuli, and the magnitude of these differences was amplified in the internal focus condition relative to the external focus condition. Focus of attention has a significant effect on source monitoring performance in people experiencing auditory hallucinations. The theoretical and clinical implications of these findings are discussed.

Adult↗
PubMed2001

Are auditory hallucinations the consequence of abnormal cerebral lateralization? A morphometric MRI study of the sylvian fissure and planum temporale.

BACKGROUND: Auditory verbal hallucinations (AVHs) are a characteristic feature of schizophrenia. Patients with schizophrenia have been found to have reduced volumes of a variety of brain structures as well as a reduction in right-left asymmetries, using postmortem and magnetic resonance imaging (MRI) measures. There is also evidence that patients with AVHs differ in these structural asymmetries, relative to those patients who do not hallucinate. The aim of this study was to examine whether patients with and without a prominent history of AVHs differ, both from each other and in comparison with normal subjects, in the asymmetry of the sylvian fissure (SF) and planum temporale (PT). METHODS: We recruited 74 DSM-IV male patients with schizophrenia (on the basis of their AVH history) and 32 matched normal control subjects. Thirty patients had no history of AVHs and 44 had a strong definitive history of AVHs. The SF length and PT area and volume were measured on a three-dimensional MRI spoiled GRASS volume sequence. Absolute measures and laterality coefficients were calculated. RESULTS: : All groups had the normal leftward asymmetry in both the SF and PT. Planum temporale volume and surface area and SF length were all larger in the left hemisphere. There were no significant differences in any measures between the two patient groups or between schizophrenic patients and control subjects. Greater leftward asymmetry of the SF correlated with hallucinations and thought disorder within the prominent hallucinator group. An association was found between handedness and brain size, but this did not interact with diagnosis. CONCLUSIONS: The results of this study do not confirm reports, based on smaller samples, of reduced structural asymmetries of either the SF or PT in schizophrenia, nor do they indicate a specific relationship to a propensity to experience AVHs. A modest correlation between leftward asymmetry of the SF and some positive symptomatology was found.

Adult↗
PubMed2004

[Hallucinations during treatment with hydrochloroquine].

INTRODUCTION: We report an unexpected cenesthetic hallucination-type neuropsychiatric side effect with hydrochloroquine (Plaquenil) in a patient treated for an erosive plantar lichen planus. OBSERVATION: A 75 year-old woman was hospitalized for a handicapping erosive plantar lichen. Treatment with hydrochloroquine (400 mg/day) was initiated, associated with topical corticosteroids and a short course of oral acorticosteroids (0.5 mg/kg/day of methylprednisolone). After 10 days of treatment, a short episode of temporo-spatial disorientation occurred, followed by a feeling of depersonalization and cenesthetic hallucinations with feelings in the body. These manifestations were preceded by nightmares. Hydrochloroquine was spontaneously stopped by the patient one week later and led to the progressive disappearance of the hallucinations and a return to a normal mental state within one month. Two and a half years later, no relapse of the psychiatric manifestations has been noted. DISCUSSION: Chloroquine and hydrochloroquine may be at the origin of severe psychosis-like psychiatric side effects. Such manifestations are exceptional, little known and principally described during treatment of malaria. The clinical presentation of the psychosis induced by synthetic ani-malarials is fairly homogeneous from one case to the next: onset in a patient without psychiatric past of manifestations such as delirium, hallucinations, maniac episodes or depression after an interval of a few hours to 40 days, usually regressing one week after suspension of the synthetic antimalarial. There is no relationship between the dose of synthetic anti-malarial administered and the onset of psychiatric problems. The triggering-off mechanism is unknown and appears to be an idiosyncratic reaction. Our case report draws the dermatologists' attention to the possibility of the occurrence of potentially severe psychiatric side effects.

Aged↗
PubMed1997

Do musical hallucinations always arise from the inner ear?

It has been known for some time that musical hallucinations occur in deaf patients. This has been ignored, as it has been believed that neurological and psychiatric causes predominate. However, despite specific appeals, no one with musical hallucinations and a lesion in the brain but not in the ear has been produced. The postulated otological basis is a hyperactive state of the ear, a slight endolymphatic hydrops or pre-Meniere's disease. The hallucinations probably develop out of rhythmic tinnitus. A review of all the very disparate states and diseases supposedly causing musical hallucinations shows that peripheral ear symptoms are always present. It therefore seems that they always have the same simple otological trigger.

Acoustic Stimulation↗
PubMed2001

Auditory verbal hallucinations and dysfunction of the neural substrates of speech.

OBJECTIVE: to evaluate the neural substrate of auditory verbal hallucinations (AVH), the correlation between AVH and subvocal speech (hereafter SVS), and the relationship between speech and AVH. METHOD: we reviewed the papers found by an electronic literature search on hallucinations and speech. The review was extended to the papers cited in these publications and to classical works. RESULTS: there is no conclusive evidence of structural abnormality of the speech perception area in hallucinating schizophrenic patients. However there is evidence of electrophysiological abnormalities of the auditory and speech perception cortices. Functional imaging data are inconsistent, yet point to the left superior temporal gyrus as one of the neural substrates for AVH. There is also evidence that SVS could accompany the experience of AVH. CONCLUSION: there is evidence that dysfunction of brain areas responsible for speech generation is a fundamental mechanism for generating AVH in schizophrenia. It results in a secondary activation of Wernicke's area (speech perception) and Broca's area (speech expression). The first leading to the experience of hallucinations, and the second, eventually, gives rise to a variable degree of vocal muscle activity detectable by EMG, and/or faint vocalizations detectable by sensitive microphones placed at proximity of the larynx. Direct stimulation or disease of Wernicke's area produces AVH without SVS.

Brain↗