Impaired functional double dissociation in motor-to-sensory transformation mediates aberrant predictive coding in auditory verbal hallucinations
Abstract
Auditory verbal hallucinations (AVHs), the experience of hearing voices in the absence of corresponding external stimuli, are widely attributed to failures of self-monitoring. However, theoretical models and empirical investigations have primarily localized the underlying dysfunction to abnormalities within auditory cortices. Recent studies have revealed that the motor system exerts predictive regulation over auditory processing, suggesting that AVHs are not merely an abnormal auditory processing but also involve distinct, functionally dissociable impairments in motor-to-sensory transformation. How these impairments dynamically manifest in motor-to-sensory neural circuits remains unclear. This review synthesizes recent findings on the functional interactions between motor and sensory systems and proposes a hierarchical neurobiological framework for predictive coding in AVHs across two dimensions: temporal precision and spatial circuit architecture. In the temporal dimension, mismatches between motor-based predictions and sensory feedback disrupt the precision of predictive coding and Bayesian inference, giving rise to three forms of predictive dysfunction: excessively weak predictive signals, excessively strong predictive signals, and impaired predictive updating. In the spatial dimension, we characterize the spatiotemporal disintegration of the frontal-temporal-thalamic circuit underlying AVHs, focusing on both circuit-level disruption and hierarchical computational…
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