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An EMG study of the lip muscles during covert auditory verbal hallucinations in schizophrenia

Abstract

Purpose: Auditory verbal hallucinations (AVHs) are speech perceptions in the absence of a external stimulation. An influential theoretical account of AVHs in schizophrenia claims that a deficit in inner speech monitoring would cause the verbal thoughts of the patient to be perceived as external voices. The account is based on a predictive control model, in which verbal self-monitoring is implemented. The aim of this study was to examine lip muscle activity during AVHs in schizophrenia patients, in order to check whether inner speech occurred. Methods: Lip muscle activity was recorded during covert AVHs (without articulation) and rest. Surface electromyography (EMG) was used on eleven schizophrenia patients. Results: Our results show an increase in EMG activity in the orbicularis oris inferior muscle, during covert AVHs relative to rest. This increase is not due to general muscular tension since there was no increase of muscular activity in the forearm muscle. Conclusion: This evidence that AVHs might be self-generated inner speech is discussed in the framework of a predictive control model. Further work is needed to better describe how the inner speech monitoring dysfunction occurs and how inner speech is controlled and monitored. This will help better understanding how AVHs occur

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