Classification of musical hallucinations and the characters along with neural-molecular mechanisms of musical hallucinations associated with psychiatric disorders

BACKGROUND Musical hallucinations(MH)involve the false perception of music in the absence of external stimuli which links with different etiologies.The pathomechanisms of MH encompass various conditions.The etiological classification of MH is of particular importance and offers valuable insights to understand MH,and further to develop the effective treatment of MH.Over the recent decades,more MH cases have been reported,revealing newly identified medical and psychiatric causes of MH.Functional imaging studies reveal that MH activates a wide array of brain regions.An up-to-date analysis on MH,especially on MH comorbid psychiatric conditions is warranted.AIM To propose a new classification of MH;to study the age and gender differences of MH in mental disorders;and neuropathology of MH.METHODS Literatures searches were conducted using keywords such as“music hallucination,”“music hallucination and mental illness,”“music hallucination and gender difference,”and“music hallucination and psychiatric disease”in the databases of PubMed,Google Scholar,and Web of Science.MH cases were collected and categorized based on their etiologies.The t-test and ANOVA were employed(P<0.05)to compare the age differences of MH different etiological groups.Function neuroimaging studies of neural networks regulating MH and their possible molecular mechanisms were discussed.RESULTS Among the 357 yielded publications,294 MH cases were collected.The average age of MH cases was 67.9 years,with a predominance of females(66.8%females vs 33.2%males).MH was classified into eight groups based on their etiological mechanisms.Statistical analysis of MH cases indicates varying associations with psychiatric diagnoses.CONCLUSION We carried out a more comprehensive review of MH studies.For the first time according to our knowledge,we demonstrated the psychiatric conditions linked and/or associated with MH from statistical,biological and molecular point of view.

Face hallucination via compressive sensing

Face hallucination or super-resolution is an inverse problem which is underdetermined,and the compressive sensing(CS)theory provides an effective way of seeking inverse problem solutions.In this paper,a novel compressive sensing based face hallucination method is presented,which is comprised of three steps:dictionary learning、sparse coding and solving maximum a posteriori(MAP)formulation.In the first step,the K-SVD dictionary learning algorithm is adopted to obtain a dictionary which can sparsely represent high resolution(HR)face image patches.In the second step,we seek the sparsest representation for each low-resolution(LR)face image paches input using the learned dictionary,super resolution image blocks are obtained from the sparsest coefficients and dictionaries,which then are assembled into super-resolution(SR)image.Finally,MAP formulation is introduced to satisfy the consistency restrictive condition and obtain the higher quality HR images.The experimental results demonstrate that our approach can achieve better super-resolution faces compared with other state-of-the-art method.

An Analysis of Mystical Experience in Sophy' s Hysterical Hallucination in Darkness Visible

In William Golding' s Darkness Visible,Sophy' s experience of " hysterical hallucination" plays an important role in the the matic expression.They point directly to the evil nature of man.Although the specific content of hallucinations is different,they possess a common characteristic-mystical experience.They worth further research.This paper examines Sophy' s mystical experience in her hyster ical hallucination,so as to find out the functions of mystical experience and its influences on the novel' s thematic expression.

An Analysis of Hysterical Hallucination of Simon in Lord of the Flies

Golding gave hallucination to characters when they are suffering from hysteria.This paper researches the relation between Simon' s hysteria with hallucination and the revelation of the theme,and finds out that this clinical symptom turns to be the window for Golding to tell his theme.

Predicting outcomes using neural networks in the intensive care unit

Patients in intensive care units(ICUs)require rapid critical decision making.Modern ICUs are data rich,where information streams from diverse sources.Machine learning(ML)and neural networks(NN)can leverage the rich data for prognostication and clinical care.They can handle complex nonlinear relation-ships in medical data and have advantages over traditional predictive methods.A number of models are used:(1)Feedforward networks;and(2)Recurrent NN and convolutional NN to predict key outcomes such as mortality,length of stay in the ICU and the likelihood of complications.Current NN models exist in silos;their integration into clinical workflow requires greater transparency on data that are analyzed.Most models that are accurate enough for use in clinical care operate as‘black-boxes’in which the logic behind their decision making is opaque.Advan-ces have occurred to see through the opacity and peer into the processing of the black-box.In the near future ML is positioned to help in clinical decision making far beyond what is currently possible.Transparency is the first step toward vali-dation which is followed by clinical trust and adoption.In summary,NNs have the transformative ability to enhance predictive accuracy and improve patient management in ICUs.The concept should soon be turning into reality.

Prospects and perils of ChatGPT in diabetes

ChatGPT,a popular large language model developed by OpenAI,has the potential to transform the management of diabetes mellitus.It is a conversational artificial intelligence model trained on extensive datasets,although not specifically health-related.The development and core components of ChatGPT include neural networks and machine learning.Since the current model is not yet developed on diabetes-related datasets,it has limitations such as the risk of inaccuracies and the need for human supervision.Nevertheless,it has the potential to aid in patient engagement,medical education,and clinical decision support.In diabetes management,it can contribute to patient education,personalized dietary guidelines,and providing emotional support.Specifically,it is being tested in clinical scenarios such as assessment of obesity,screening for diabetic retinopathy,and provision of guidelines for the management of diabetic ketoacidosis.Ethical and legal considerations are essential before ChatGPT can be integrated into healthcare.Potential concerns relate to data privacy,accuracy of responses,and maintenance of the patient-doctor relationship.Ultimately,while ChatGPT and large language models hold immense potential to revolutionize diabetes care,one needs to weigh their limitations,ethical implications,and the need for human supervision.The integration promises a future of proactive,personalized,and patient-centric care in diabetes management.

Repetitive transcranial magnetic stimulation for hallucination in schizophrenia spectrum disorders A meta-analysis

OBJECTIVE： This study assessed the efficacy and tolerability of repetitive transcranial magnetic stimulation for treatment of auditory hallucination of patients with schizophrenia spectrum disorders. DATA SOURCES： Online literature retrieval was conducted using PubMed, ISI Web of Science, EMBASE, Medline and Cochrane Central Register of Controlled Trials databases from January 1985 to May 2012. Key words were ＂transcranial magnetic stimulation＂, ＂TMS＂, ＂repetitive tran- scranial magnetic stimulation＂, and ＂hallucination＂. STUDY SELECTION： Selected studies were randomized controlled trials assessing therapeutic ef- ficacy of repetitive transcranial magnetic stimulation for hallucination in patients with schizophrenia spectrum disorders. Experimental intervention was low-frequency repetitive transcranial magnetic stimulation in left temporoparietal cortex for treatment of auditory hallucination in schizophrenia spectrum disorders. Control groups received sham stimulation. MAIN OUTCOME MEASURES： The primary outcome was total scores of Auditory Hallucinations Rating Scale, Auditory Hallucination Subscale of Psychotic Symptom Rating Scale, Positive and Negative Symptom Scale-Auditory Hallucination item, and Hallucination Change Scale. Secondary outcomes included response rate, global mental state, adverse effects and cognitive function. RESULTS： Seventeen studies addressing repetitive transcranial magnetic stimulation for treatment of schizophrenia spectrum disorders were screened, with controls receiving sham stimulation. All data were completely effective, involving 398 patients. Overall mean weighted effect size for repeti- tive transcranial magnetic stimulation versus sham stimulation was statistically significant （MD = -0.42, 95%C/： -0.64 to -0.20, P = 0.000 2）. Patients receiving repetitive transcranial magnetic stimulation responded more frequently than sham stimulation （OR = 2.94, 95%C/： 1.39 to 6.24, P =0.005）. No significant differences were found between active repetitive transcranial magnetic stimulation and sham stimulation for positive or negative symptoms. Compared with sham stimulation, active repeti- tive transcranial magnetic stimulation had equivocal outcome in cognitive function and commonly caused headache and facial muscle twitching. CONCLUSION： Repetitive transcranial magnetic stimulation is a safe and effective treatment for auditory hallucination in schizophrenia spectrum disorders,

Abnormal Local Activity and Functional Dysconnectivity in Patients with Schizophrenia Having Auditory Verbal Hallucinations

Auditory verbal hallucination(AVH)is emphasized as a pathological hallmark of schizophrenia.Neuroimaging studies provide evidence linking AVH to overlapping functional abnormalities in distributed networks.However,no clear conclusion has still been reached.This study aimed to further explore the brain activity of patients with schizophrenia having AVH from both local activity(LA)and functional connectivity(FC)insights,while excluding confounding factors from other positive symptoms.A total of 42 patients with AVH(AVH patients group,APG),26 without AVH(non-AVH patients group,NPG),and 82 normal controls(NC)underwent resting-state functional magnetic resonance imaging(fMRI).LA measures,including regional homogeneity(ReHo)and fractional amplitude of low-frequency fluctuations(fALFF),and FC measures were evaluated to understand the neuroimaging mechanism of AVH.APG showed increased ReHo and fALFF in the bilateral putamen(Put)compared with NPG and NC.FC analysis(using bilateral putamen as seeds)revealed that all patients showed abnormal FC of multiple resting state network regions,including the anterior and post cingulate cortex,middle frontal gyrus,inferior parietal gyrus,and left angular gyrus.Interestingly,APG showed significantly decreased FC of insula extending to the superior temporal gyrus and inferior frontal gyrus compared with NPG and NC.The present findings suggested a significant correlation of abnormal LA and dysfunctional putamen-auditory cortical connectivity with the neuropathological mechanism of AVH,providing evidence for the functional disconnection hypothesis of schizophrenia.

Transcranial direct current stimulation for auditory verbal hallucinations:a systematic review of clinical trials

Transcranial direct current stimulation(tDCS)has been reportedly beneficial for different neurodegenerative disorders.tDCS has been reported as a potential adjunctive or alternative treatment for auditory verbal hallucination(AVH).This study aims to review the effects of tDCS on AVH in patients with schizophrenia through combining the evidence from randomized clinical trials(RCTs).The databases of PsycINFO(2000–2019),PubMed(2000–2019),EMBASE(2000–2019),CINAHL(2000–2019),Web of Science(2000–2019),and Scopus(2000–2019)were systematically searched.The clinical trials with RCT design were selected for final analysis.A total of nine RCTs were eligible and included in the review.Nine RCTs were included in the final analysis.Among them,six RCTs reported a significant reduction of AVH after repeated sessions of tDCS,whereas three RCTs did not show any advantage of active tDCS over sham tDCS.The current studies showed an overall decrease of approximately 28%of AVH after active tDCS and 10%after sham tDCS.The tDCS protocols targeting the sensorimotor frontal-parietal network showed greater treatment effects compared with the protocols targeting other regions.In this regard,cathodal tDCS over the left temporoparietal area showed inhibitory effects on AVHs.The most effective tDCS protocol on AVHs was twice-daily sessions(2 mA,20-minute duration)over 5 consecutive days(10 sessions)with the anode over the left dorsolateral prefrontal cortex and the cathode over the left temporal area.Some patient-specific and diseasespecific factors such as young age,nonsmoking status,and higher frequencies of AVHs seemed to be the predictors of treatment response.Taken together,the results of tDCS as an alternative treatment option for AVH show controversy among current literatures,since not all studies were positive.However,the studies targeting the same site of the brain showed that the tDCS could be a promising treatment option to reduce AVH.Further RCTs,with larger sample sizes,should be conducted to reach a conclusion on the efficacy of tDCS for AVH and to develop an effective therapeutic protocol for clinical setting.

Auditory hallucinations: A review of the ERC “VOICE” project

In this invited review I provide a selective overview of recent research on brain mechanisms and cognitive processes involved in auditory hallucinations. The review is focused on research carried out in the "VOICE" ERC Advanced Grant Project, funded by the European Research Council, but I also review and discuss the literature in general. Auditory hallucinations are suggested to be perceptual phenomena, with a neuronal origin in the speech perception areas in the temporal lobe. The phenomenology of auditory hallucinations is conceptualized along three domains, or dimensions; a perceptual dimension, experienced as someone speaking to the patient; a cognitive dimension, experienced as an inability to inhibit, or ignore the voices, and an emotional dimension, experienced as the "voices" having primarily a negative, or sinister, emotional tone. I will review cognitive, imaging, and neurochemistry data related to these dimensions, primarily the first two. The reviewed data are summarized in a model that sees auditory hallucinations as initiated from temporal lobe neuronal hyper-activation that draws attentional focus inward, and which is not inhibited due to frontal lobe hypo-activation. It is further suggested that this is maintained through abnormal glutamate and possibly gamma-amino-butyric-acid transmitter mediation, which could point towards new pathways for pharmacological treatment. A final section discusses new methods of acquiring quantitative data on the phenomenology and subjective experience of auditory hallucination that goes beyond standard interview questionnaires, by suggesting an iP hone/iP od app.

Cognitive behavioural therapy for auditory hallucinations in schizophrenia:A review

AIM To provide an updated of recent findings about efficacy of cognitive-behavior therapy(CBT) in reduction of command hallucinations.METHODS Pub Med/MEDLINE,Cochrane Library,the Cumulative Index to Nursing and Allied Health Literature,PsycI NFO,Clinical Trial.gov searches were performed using the keywords "hallucinations","behavioural therapy" and " cognitive therapy" in order to identify relevant articles published during the years of 2011 to 2016.No language limits were used.Studies conducted within control group,reviews,editorials,were excluded.Data on efficacy,acceptability and tolerability were extracted by three authors independently.Disagreements were resolved in a consensus meeting or by another reviewer.RESULTS A total of eight articles were eligible for inclusion.Two are randomized clinical trials(RCTs) and six are observational studies.The two RCTs included showed a greater efficacy of CBT compared to standard care on auditory hallucinations(AHs).Nevertheless,they considered different CBT models,particularly Treatment of Resistant Command Hallucinations and Cognitive Therapy for Command Hallucinations.As regards non RCT-studies,all papers included showed reduction on frequency and severity of AHs and distress related to them.However,the lack of content details within non-RCTs studies decreased their comparability.In terms of predictive variables,our findings show that negative symptoms at baseline appeared to be the strongest predictor of the treatment efficacy.Indeed,negative symptoms showed a significant negative correlation on outcome.CONCLUSION Although more conclusive studies are still needed,we found some preliminary evidence for the efficacy of CBT in the treatment of command hallucinations.

Multimodal morphometry and functional magnetic resonance imaging in schizophrenia and auditory hallucinations

AIM: To validate a multimodal [structural and functional magnetic resonance (MR)] approach as coincidence brain clusters are hypothesized to correlate with clinical severity of auditory hallucinations. METHODS: Twenty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (fourth edition, DSM-IV) criteria for schizophrenia and experiencing persistent hallucinations together with 28 healthy controls were evaluated with structural and functional MR imaging with an auditory paradigm designed to replicate those emotions related to the patients’ hallucinatory experiences. Coincidence maps were obtained by combining structural maps of gray matter reduction with emotional functional increased activation. Abnormal areas were correlated with the brief psychiatric rating scale (BPRS) and the psychotic symptom rating scale (PSYRATS) scales. RESULTS: The coincidence analysis showed areas with coexistence gray matter reductions and emotional activation in bilateral middle temporal and superior temporal gyri. Significant negative correlations between BPRS and PSYRATS scales were observed. BPRS scores were negatively correlated in the middle temporal gyrus (right) (t = 6.86, P = 0.001), while negative PSYRATS correlation affected regions in both the superior temporal gyrus (left) (t = 7.85, P = 0.001) and middle temporal gyrus (left) (t = 4.97, P = 0.002). CONCLUSION: Our data identify left superior and middle temporal gyri as relevant areas for the understanding of auditory hallucinations in schizophrenia. The use of multimodal approaches, sharing structural and functional information, may demonstrate areas specifically linked to the severity of auditory hallucinations.

40 Hz Auditory Steady State Response to Linguistic Features of Stimuli during Auditory Hallucinations

The auditory steady state response （ASSR） may reflect activity from different regions of the brain, depending on the modulation frequency used. In general, responses induced by low rates （_〈40 Hz） emanate mostly from central structures of the brain, and responses from high rates （〉80 Hz） emanate mostly from the peripheral auditory nerve or brainstem structures. Besides, it was reported that the gamma band ASSR （30-90 Hz） played an important role in working memory, speech understanding and recognition. This paper investigated the 40 Hz ASSR evoked by modulated speech and reversed speech. The speech was Chinese phrase voice, and the noise-like reversed speech was obtained by temporally reversing the speech. Both auditory stimuli were modulated with a frequency of 40 Hz. Ten healthy subjects and 5 patients with hallucination symptom participated in the experiment. Results showed re- duction in left auditory cortex response when healthy subjects listened to the reversed speech compared with the speech. In contrast, when the patients who experienced auditory hallucinations listened to the reversed speech, the auditory cortex of left hemispheric responded more actively. The ASSR results were consistent with the behavior results of patients. Therefore, the gamma band ASSR is expected to be helpful for rapid and objective diagnosis of hallucination in clinic.

Treatment of refractory auditory hallucinations in schizophrenia by rTMS: Positive impact of negative double blind controlled study

Background: Several studies reported on the effectiveness of 1 Hz repeated transcranial magnetic stimulation (rTMS) over the temporoparietal cortex (TPC) on refractory auditory hallucinations (AH) in schizophrenia but little is known about the long-term therapeutic effect of this tool. Aim: The aim of this study was to evaluate rTMS’ impact on auditory hallucinations (AH) and cognitive functions in patients with schizophrenia with a three-month follow-up. Methods: In a randomized double blind sham controlled study, 26 patients with refractory schizophrenia received 1 Hz rTMS applied on TPC for four weeks. rTMS was given to patients over one month with five rTMS sessions each week. Patients were evaluated via AHRS (Auditory Hallucination Rating Scale, Hoffman et al.), PANSS (Positive and Negative Syndrome Scale, Kay et al. 1988), and CGI (Clinical Global Impression) before treatment by rTMS every week during the first month, and every month until the third month. Results: Neither clinical nor cognitive differences were found between rTMS and placebo. Conclusion: 1 Hz rTMS using parameters mentioned above has no statistically significant effect on AH;although evidences about the potential benefit of rTMS in the treatment of AH negative results suggest the need for further studies in this area.

Knowledge domain and emerging trends in visual hallucination research:A scientometric analysis

BACKGROUND Visual hallucination(VH)refers to a spontaneous visual perception without corresponding external stimuli and often occurs in ophthalmological and neuropsychiatric disorders.It is associated with poor quality of life,and increased patient hospitalization and nursing home admission.To date,a scientometric analysis of research on VH is lacking.AIM To objectively summarize the features of VH research and gain insights into the emerging trends in research on VH.METHODS CiteSpace V was used in this article.Publication outputs,document types,geographic distributions,co-authorship status,research hotspots,and co-citation status were analyzed.A total of 2176 original articles and 465 reviews were included in the database downloaded from the Web of Science Core Collection.We selected the top 50 most cited or occurring articles or items to create a visualized network with a 1-year interval.In the document co-citation analysis stage,we performed clustering analysis on co-cited references,and log likelihood tests were used to name the clusters.RESULTS The results showed that most publications can be classified into neurology,sports,and ophthalmology studies.In addition,North America,Europe,Asia and Australia published the most documents.Some well-known authors have always had a leading role in this field;meanwhile,new authors keep emerging.A relatively stable cooperation has been formed among many authors.Furthermore,neuropsychiatric symptom and functional connectivity are the top hotspots.Research on VH in dementia with Lewy bodies and Parkinson’s disease(PD)have received much attention.Studies on VH in PD are likely to be the new emerging trends in the future,especially the mechanisms of VH.CONCLUSION Research on VH has formed a complete system.More large-scale clinical and indepth basic research are required to better understand the mechanisms underlying VH,which will contribute to our understanding of the pathophysiology and therapeutic options for VH.

Acute Normalization of Thyroxine Induced Hallucinations and Delusions

The association between disorders of thyroid function and psychiatric symptoms is well established. Generally, hypo-thyroidism is recognized as being able to induce psychotic symptoms. However, psychotic symptoms without affective and cognitive disturbances are rare in hyperthyroidism. We presented a patient with Graves’ disease who suffered from delusions and hallucinations without affective and cognitive disturbances following abrupt normalization of thyroid function. Furthermore, the patient was clinically and biochemically euthyroid when the psychotic symptoms developed. There was resolution of psychotic symptoms in this case. It is suggested that the abrupt change of thyroxine may cause susceptible individuals to become transient psychotic state.

Effectiveness of anti-psychiatric treatment on visual and haptic perceptual disorder for a patient with Alzheimer’s disease: A case report

BACKGROUND Perception is frequently impaired in patients with Alzheimer’s disease(AD).Several patients exhibit visual or haptic hallucinations.CASE SUMMARY A 71-year-old Chinese man presented with visual and haptic hallucinations he had been experiencing for 2 weeks.The clinical manifestations were the feeling of insects crawling and biting the limbs and geison.He looked for the insects while itching and scratching,which led to skin breakage on the limbs.He was treated with topical and anti-allergic drugs in several dermatology departments without any significant improvement.After admission,the patient was administered risperidone(0.5 mg)and duloxetine(2 mg/day).One week later,the dose of risperidone was increased to 2 mg/day,and that of duloxetine was increased to 60 mg/day.After 2 weeks of treatment,the patient’s sensation of insects crawling and biting disappeared,and his mood stabilized.CONCLUSION This patient manifested psychiatric behavioral symptoms caused by AD brain atrophy.It was important to re-evaluate the patient’s cognitive-psychological status when the patient repeatedly went to the hospital for treatment.Follow-up attention to cognitive function and the consideration of perceptual deficits as early manifestations of AD should be considered.

Legal and Ethical Perspectives on Artificial Intelligence

People are enormously nervous about Artificial Intelligence.Although many are constructive and want to move forward,many want more answers from a business perspective,a legal perspective,and an economic perspective.Just today,another class action lawsuit was filed in California.This paper will address concerns and hopefully help you understand Artificial Intelligence better.From these perspectives,you may decide how you feel and think about Artificial Intelligence based on the information presented in this paper and other research.

Challenges in the management of visual and tactile hallucinations in elderly people

This letter provides a concise review of the pertinent literature on visual and tactile hallucinations in elderly patients.The discussion addresses differential diagnoses and potential underlying mechanisms,as well as the psychopathology associated with tactile hallucinations,and emphasizes the necessity for invest-igation into the possibility of coexisting delusional infestation(parasitosis).These symptoms frequently manifest in patients with primary psychotic disorders,organic mental disorders,and substance use disorders.The proposed pathophy-siological mechanisms may involve dopaminergic imbalances and dysfunction of the striatal dopamine transporter.

Quantum Mechanical Postulates towards Realization of Artificial Wisdom on Incorporating Desire in Intelligence: A Hypothetical Study

This paper is a hypothetical study to present postulates to have mathematical formulation towards realization of artificial wisdom. On referring quantum mechanics (QM) a mathematical foundation of wisdom is being defined to have the wisdom machine that can work like creative human. Creation may be defined as the desire to have new. Wisdom is differentiated from intelligence on adding desire. Desire is defined as something more than need on encompassing knowledge of self and unbiased reasoning. Each component of desire has an embedded part that is defined as hallucination need (defined as wandering of mind around unreal, acting with attachments, having deluded mind with egoism, performing as foolish follower). This research is viewing wisdom as the tool-kit to realize the “Survival of the fittest.” That is wisdom allows developing own-self on desire base. QM allows probabilistic approximation of multiple interacting events. Human behavior and creativity is a product of multiple events occurring simultaneously and/or in cascade with mutual interferences. Quantum mechanical interpretation of human behavior may be possible on describing it with dual aspects of desire (conscious or the real need and unconscious or the hallucination need) and uncertainties in simultaneous measurement of them. This paper is presenting nine postulates. These postulates and more to develop in future research may make it possible to mathematically encode human wisdom of creativity, so that there may be artificial wisdom.