Auditory Hallucinations and the Brain’s Resting-State Networks: Findings and Methodological Observations

Resting-state brain networks may help explain hallucinations across different sensory modalities and populations. This report from the International Consortium on Hallucination Research reviews evidence linking resting-state alterations to auditory hallucinations, finding connectivity differences in left-hemisphere auditory and language regions, plus atypical interactions of the default mode network with networks for cognitive control and salience. Similar patterns appear in visual hallucinations, suggesting both domain-general and modality-specific network changes. However, high methodological heterogeneity across studies limits direct comparisons. The authors offer recommendations for future research on resting-state connectivity and hallucinations.

Study at a glance

Abstract

In recent years, there has been increasing interest in the potential for alterations to the brain's resting-state networks (RSNs) to explain various kinds of psychopathology. RSNs provide an intriguing new explanatory framework for hallucinations, which can occur in different modalities and population groups, but which remain poorly understood. This collaboration from the International Consortium on Hallucination Research (ICHR) reports on the evidence linking resting-state alterations to auditory hallucinations (AH) and provides a critical appraisal of the methodological approaches used in this area. In the report, we describe findings from resting connectivity fMRI in AH (in schizophrenia and nonclinical individuals) and compare them with findings from neurophysiological research, structural MRI, and research on visual hallucinations (VH). In AH, various studies show resting connectivity differences in left-hemisphere auditory and language regions, as well as atypical interaction of the default mode network and RSNs linked to cognitive control and salience. As the latter are also evident in studies of VH, this points to a domain-general mechanism for hallucinations alongside modality-specific changes to RSNs in different sensory regions. However, we also observed high methodological heterogeneity in the current literature, affecting the ability to make clear comparisons between studies. To address this, we provide some methodological recommendations and options for future research on the resting state and hallucinations.