Corollary discharge dysfunction in schizophrenia: evidence for an elemental deficit.

Evidence is accumulating that schizophrenia is characterized by dysfunction of efference copy/corollary discharge mechanisms that normally allow us to unconsciously recognize and disregard sensations resulting from our own actions. This dysfunction may give rise to subtle but pervasive sensory/perceptual aberrations in schizophrenic patients, altering their experience of their own overt and covert actions, as well as their interactions with the environment. It may also contribute to symptoms such as hallucinations and delusions, and may disrupt the motivation to engage with people and in activities. We developed neurophysiological paradigms to study motor-sensory feed-forward processes, or efference copy/corollary discharge mechanisms, in the speech-auditory system, and showed these processes to be deficient in chronic schizophrenia. Specifically, we observed neural responses during talking that made evident the suppressive consequences of a successful corollary discharge mechanism. We also observed synchronous neural activity preceding talking that we believe reflects the efference copy in action. Recently, we extended this neurophysiological research to the somatosensory system, again finding evidence of deficient motor-sensory feed-forward processes in schizophrenia. If dysfunction of this elemental mechanism is reliable, valid, and not the result of antipsychotic medications, it might represent a major new class of electrophysiological measures sensitive to a fundamental and ubiquitous pathophysiological process in schizophrenia.