Auditory verbal hallucinations (AVH, ‘hearing voices’) are an important symptom of schizophrenia
but their biological basis is not well understood. One longstanding approach proposes that they
are perceptual in nature, specifcally that they refect spontaneous abnormal neuronal activity in
the auditory cortex, perhaps with additional ‘top down’ cognitive infuences. Functional imaging
studies employing the symptom capture technique—where activity when patients experience AVH is
compared to times ...
Auditory verbal hallucinations (AVH, ‘hearing voices’) are an important symptom of schizophrenia
but their biological basis is not well understood. One longstanding approach proposes that they
are perceptual in nature, specifcally that they refect spontaneous abnormal neuronal activity in
the auditory cortex, perhaps with additional ‘top down’ cognitive infuences. Functional imaging
studies employing the symptom capture technique—where activity when patients experience AVH is
compared to times when they do not—have had mixed fndings as to whether the auditory cortex is
activated. Here, using a novel variant of the symptom capture technique, we show that the experience
of AVH does not induce auditory cortex activation, even while real speech does, something that
efectively rules out all theories that propose a perceptual component to AVH. Instead, we fnd that
the experience of AVH activates language regions and/or regions that are engaged during verbal shortterm memory
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