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2015 ; 48
(6
): 376-85
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Ketamine-Induced Hallucinations
#MMPMID26361209
Powers AR 3rd
; Gancsos MG
; Finn ES
; Morgan PT
; Corlett PR
Psychopathology
2015[]; 48
(6
): 376-85
PMID26361209
show ga
BACKGROUND: Ketamine, the NMDA glutamate receptor antagonist drug, is
increasingly employed as an experimental model of psychosis in healthy
volunteers. At subanesthetic doses, it safely and reversibly causes delusion-like
ideas, amotivation and perceptual disruptions reminiscent of the aberrant
salience experiences that characterize first-episode psychosis. However, auditory
verbal hallucinations, a hallmark symptom of schizophrenia, have not been
reported consistently in healthy volunteers even at high doses of ketamine.
SAMPLING AND METHODS: Here we present data from a set of healthy participants who
received moderately dosed, placebo-controlled ketamine infusions in the reduced
stimulation environment of the magnetic resonance imaging (MRI) scanner. We
highlight the phenomenological experiences of 3 participants who experienced
particularly vivid hallucinations. RESULTS: Participants in this series reported
auditory verbal and musical hallucinations at a ketamine dose that does not
induce auditory hallucination outside of the scanner. CONCLUSIONS: We interpret
the observation of ketamine-induced auditory verbal hallucinations in the context
of the reduced perceptual environment of the MRI scanner and offer an explanation
grounded in predictive coding models of perception and psychosis - the brain
fills in expected perceptual inputs, and it does so more in situations of altered
perceptual input. The altered perceptual input of the MRI scanner creates a
mismatch between top-down perceptual expectations and the heightened bottom-up
signals induced by ketamine. Such circumstances induce aberrant percepts,
including musical and auditory verbal hallucinations. We suggest that these
circumstances might represent a useful experimental model of auditory verbal
hallucinations and highlight the impact of ambient sensory stimuli on
psychopathology.