Hallucination proneness alters sensory feedback processing in self-voice production

Abstract

Background: Sensory suppression occurs when hearing ones self-generated voice, as opposed to passively listening to ones own voice. Quality changes of sensory feedback to the self-generated voice can increase attentional control. These changes affect the self-other voice distinction and might lead to hearing non-existent voices in the absence of an external source (i.e., auditory verbal hallucinations (AVH)). However, it is unclear how changes in sensory feedback processing and attention allocation interact and how this interaction might relate to hallucination proneness (HP). Study Design: Participants varying in HP self-generated and passively listened to their voice that varied in emotional quality and certainty of recognition - 100% neutral, 60-40% neutral-angry, 50-50% neutral-angry, 40-60% neutral-angry, 100% angry, during EEG recordings. Study Results: The N1 auditory evoked potential was more suppressed for the self-generated than externally generated voices. Increased HP was associated with (i) an increased N1 response to the self- compared to externally generated voices, (ii) a reduced N1 response for angry compared to neutral voices, and (iii) a reduced N2 response to unexpected voice quality in sensory feedback (60-40% neutral-angry) compared to neutral voices. Conclusions: The current study highlights an association between increased HP and systematic changes of the emotional quality and certainty in sensory feedback processing (N1) and attentional control (N2) in self-voice production in a non-clinical population. Considering that voice hearers also display these changes, these findings support the continuum hypothesis. However, additional research is needed to validate this conclusion.

Exploring Neural Dynamics in Self-Voice Processing and Perception: Implications for Hallucination Proneness

“…Previous studies probing prediction of sensory feedback to the self-voice reported no N100 suppression effect in voice hearers with a psychotic disorder [106,107] whereas non-clinical voice hearers or high HP individuals showed a reversed N100 suppression effect [38,39,108]. These studies either used group differences [107] or hypothesized a linear relationship between HP and sensory feedback processing/attentional control, measured by the N100 suppression effect, using LMMs [39,108]. Future studies should consider that individuals on the postulated HP severity continuum (voice hearers with psychotic disorder, at high-risk of psychosis/prodromal and non-clinical voice hearers) may show a nonlinear relationship with the N100 suppression effect.…”

“…Furthermore, because of the small number of voice hearers with a psychotic disorder we were unable fully to explore the putative psychosis continuum. Previous studies probing prediction of sensory feedback to the self-voice reported no N100 suppression effect in voice hearers with a psychotic disorder [106,107] whereas non-clinical voice hearers or high HP individuals showed a reversed N100 suppression effect [38,39,108]. These studies either used group differences [107] or hypothesized a linear relationship between HP and sensory feedback processing/attentional control, measured by the N100 suppression effect, using LMMs [39,108].…”

The role of prediction and attention in phantom voice perception

“…Based on these aspects, it is likely that the perceptual discriminability among the five types of self-vocalizations varying in pleasure content used here might have been low. Further, using the same sample of participants and design but a selfvoice continuum from neutral to angry yielded a significant global N100 suppression effect (Duggirala et al, 2023). Hence, the question arises as to why similar effects did not emerge as a function of a continuum manipulation for positive vocal emotion expressions.…”

“…Participants in the current study did not exhibit a complete sense of ownership ("my voice or someone else's voice") and agency ("feeling associated with the sensory outcome of one's voluntary action") of their own 100% pleasure voice. The sense of ownership was lower for the 100% pleasure stimuli compared to the 100% angry self-voice ( (Herbert, Herbert, Ethofer, & Pauli, 2011;Yoshie & Haggard, 2013); supplementary figure 1C and supplementary figure 1C of Duggirala et al, 2023)).…”

“…Furthermore, because of the small number of voice hearers with a psychotic disorder we were unable fully to explore the putative psychosis continuum. Previous studies probing prediction of sensory feedback to the self-voice reported no N100 suppression effect in voice hearers with a psychotic disorder (Heinks-Maldonado et al, 2007;Heinks-Maldonado et al, 2006) whereas non-clinical voice hearers or high HP individuals showed a reversed N100 suppression effect (Duggirala et al, 2023;Pinheiro, Schwartze, Amorim, et al, 2020;Pinheiro et al, 2018). These studies either used group differences (Heinks-Maldonado et al, 2007) or hypothesized a linear relationship between HP and sensory feedback processing/attentional control, measured by the N100 suppression effect, using LMMs (Duggirala et al, 2023;Pinheiro et al, 2018).…”