Abstract
<p>Auditory verbal hallucinations (AVHs), the experience of hearing voices in the absence of external stimuli, are widely attributed to a failure in self-monitoring. However, models and empirical investigations have primarily focused on localizing the dysfunction to the pathology of auditory cortices. Recent studies have revealed that the motor system can exerts predictive regulation over auditory processing, suggesting that AVHs are not merely an abnormal auditory process but involve distinct, functionally dissociable impairments in motor-to-sensory transformation. How the impairments manifest dynamically in motor-to-sensory neural circuits remain unclear. This review synthesizes recent findings on the functional relations between motor and sensory systems and proposes a hierarchical neurobiological organization framework of predictive coding in AVHs across two dimensions — temporal precision and spatial circuit architecture. In the temporal dimension, a mismatch between motor-based prediction and sensory feedback disrupts the precision of predictive coding and Bayesian inference, leading to three aspects of deficits — overly weak predictive intensity, overly strong predictive intensity and defective predictive updating. In the spatial dimension, we characterize the spatiotemporal dynamic disintegration of the frontal-temporal-thalamic circuit underlying AVHs, examining both its structural disorganization and hierarchical computational misalignment between prediction and perceptual signals. By explicitly linking the temporal precision of predictive coding to the spatial architecture of sensorimotor circuits, this review aims to provide a unified mechanistic account that bridges cognitive, computational, and clinical perspectives of AVHs.</p>