Clinic and pathophysiology of false sensory perceptions in the scientific views of Viktor Kandinsky

Abstract

In the monograph «Kritische und klinische Betrachtungen im Gebiete der Sinnestäuschungen» (1885) and in its Russian version «On pseudohallucinations» (1890) V.Kh. Kandinsky was the first in the world to present a detailed differentiation of clinical forms of false sensory perceptions, specificating simple hallucinations, dream-like hallucinations and two varieties of pseudohallucinations. He set out descriptions of phenomena that resemble false perceptions, but are not them: unvoluntary speech, some forms of pathology of the ideation sphere, and pathology of the imaginary sphere. Several mental states described by the author later entered the psychiatric lexicon under new names: «speech-motor hallucinations» (Séglas), «delusion of the imagination» (Dupré and Logre), «autistic thinking» (Bleuler), «hypotonia of consciousness» (Berze), «oneiroid form of experience» (Mayer-Gross). Kandinsky supplemented clinical descriptions with an original pathophysiological hypothesis. The author believed that the thalamus, specific to each modality and multimodal cell groups of the sensory cortex, centers of abstract (symbolized) representations, and Broca’s center are involved in various configurations in the acts of sensory perception and the origin of the forms of his deceptions; the state of the frontal functions and the nature of the reflection of images of perception in consciousness are of paramount importance.The author illustrated his hypothesis with schemes of differentiated involvement of thalamocortical and transcortical networks. This article analyzes the reasons why Kandinsky’s hypothesis remained unknown to specialists until recently, and his descriptions of the forms of false sensory perceptions were taught in a distorted or simplified form. Despite the target testing of the hypothesis having never been carried out, all its main provisions are confirmed by the results of modern research. Russian psychiatrists successfully apply the systematics of hallucinations developed by Kandinsky in clinical practice. Remaining to this day the only clinical and pathophysiological hypothesis, Kandinsky´s clinical and pathophysiological hypothesis is extremely promising for studying the etiopathogenesis of mental illness and developing effective means of treating them.