This is consistent with fMRI research showing that superior temporal cortical regions show high levels of activation both during AVHs ( Allen et al., 2008 Jardri et al., 2011) and purposely generated inner speech ( Simons et al., 2010). Evidence from cognitive psychology suggests that individuals with a diagnosis of schizophrenia who experience AVHs, compared to individuals with the same diagnosis who do not experience AVHs, and to healthy controls, are more likely to misattribute self-generated speech in source memory tasks ( Stephane et al., 2010) or signal detection tasks ( Bentall and Slade, 1985 Brookwell et al., 2013). Recent attempts to provide novel treatment options for individuals experiencing AVHs have accordingly attempted to use neurostimulation techniques to selectively decrease activity in temporal cortical regions, with a moderate degree of success ( Hoffman et al., 2005, 2013 Slotema et al., 2013).ĪVHs have been theoretically linked to atypical functioning of inner speech processes, with the most prominent model suggesting that atypical self-monitoring or reality monitoring may lead to a lack of agency over self-generated language processes ( Frith, 1992 Jones and Fernyhough, 2007).
Evidence from cognitive neuroscience suggests that AVHs are accompanied by high levels of activation in, among other areas, the superior temporal gyrus, particularly in the left hemisphere ( Allen et al., 2008 Jardri et al., 2011). They are commonly associated with a diagnosis of schizophrenia, but also occur in other psychiatric diagnoses such as bipolar disorder and post-traumatic stress disorder ( Larøi et al., 2012), as well as in individuals with no psychiatric diagnosis ( Beavan et al., 2011 Johns et al., 2014). Technical issues surrounding the use of neurostimulation as a treatment option are discussed (including methods to localize the targeted cortical area, and the state-dependent effects of brain stimulation), as are issues surrounding the acceptability of neurostimulation for adolescent populations and individuals who experience qualitatively different types of AVH.Īuditory verbal hallucinations (AVHs) are the experience of hearing a voice in the absence of any speaker ( Aleman and Larøi, 2008). Here, we provide a brief overview of cognitive models and neurostimulation paradigms associated with treatment of AVHs, and discuss techniques that could be explored in the future to improve the efficacy of treatment, including alternating current and random noise stimulation. Some evidence suggests that the therapeutic effect of neurostimulation on AVHs may result from modulation of cortical areas involved in the ability to monitor the source of self-generated information. Results from recent attempts to treat AVHs with neurostimulation (rTMS or tDCS) to the left temporoparietal junction have not been conclusive, but suggest that it may be a promising treatment option for some individuals.
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