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Alonso-Sanchez MF, Z-Rivera L, Otero M, Portal J, Cavieres Á, Alfaro-Faccio P. Aberrant brain language network in schizophrenia spectrum disorder: a systematic review of its relation to language signs beyond symptoms. Front Psychiatry 2024; 15:1244694. [PMID: 39026525 PMCID: PMC11254709 DOI: 10.3389/fpsyt.2024.1244694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/07/2024] [Indexed: 07/20/2024] Open
Abstract
Background Language disturbances are a core feature of schizophrenia, often studied as a formal thought disorder. The neurobiology of language in schizophrenia has been addressed within the same framework, that language and thought are equivalents considering symptoms and not signs. This review aims to systematically examine published peer-reviewed studies that employed neuroimaging techniques to investigate aberrant brain-language networks in individuals with schizophrenia in relation to linguistic signs. Methods We employed a language model for automatic data extraction. We selected our studies according to the PRISMA recommendations, and we conducted the quality assessment of the selected studies according to the STROBE guidance. Results We analyzed the findings from 37 studies, categorizing them based on patient characteristics, brain measures, and language task types. The inferior frontal gyrus (IFG) and superior temporal gyrus (STG) exhibited the most significant differences among these studies and paradigms. Conclusions We propose guidelines for future research in this field based on our analysis. It is crucial to investigate larger networks involved in language processing, and language models with brain metrics must be integrated to enhance our understanding of the relationship between language and brain abnormalities in schizophrenia.
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Affiliation(s)
- María F. Alonso-Sanchez
- Escuela de Fonoaudiología, Centro de Investigación del Desarrollo en Cognición y Lenguaje (CIDCL), Facultad de Medicina, Universidad de Valparaíso, Viña del Mar, Chile
| | - Lucía Z-Rivera
- Advanced Center for Electrical and Electronic Engineering (AC3E), Universidad Técnica Federico Santa María, Valparaíso, Chile
| | - Mónica Otero
- Facultad de Ingeniería, Arquitectura y Diseño, Universidad San Sebastián, Santiago de Chile, Chile
- Centro BASAL Ciencia & Vida, Universidad San Sebastián, Santiago de Chile, Chile
| | - Jorge Portal
- Advanced Center for Electrical and Electronic Engineering (AC3E), Universidad Técnica Federico Santa María, Valparaíso, Chile
- Departamento de Electrónica, Univeridad Técnica Federico Santa María (USM), Valparaíso, Chile
| | - Álvaro Cavieres
- Departamento de Psiquiatría, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Pedro Alfaro-Faccio
- Instituto de Literatura y Ciencias del Lenguaje, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
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Yasa Kostas R, Kostas K, MacPherson SE, Wolters MK. Semantic verbal fluency in native speakers of Turkish: a systematic review of category use, scoring metrics and normative data in healthy individuals. J Clin Exp Neuropsychol 2024; 46:272-301. [PMID: 38904178 DOI: 10.1080/13803395.2024.2331827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 03/07/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION Semantic verbal fluency (SVF) is a widely used measure of frontal executive function and access to semantic memory. SVF scoring metrics include the number of unique words generated, perseverations, intrusions, semantic cluster size and switching between clusters, and scores vary depending on the language the test is administered in. In this paper, we review the existing normative data for Turkish, the main metrics used for scoring SVF data in Turkish, and the most frequently used categories. METHOD We conducted a systematic review of peer-reviewed papers using Medline, EMBASE, PsycInfo, Web of Science, and two Turkish databases, TR-Dizin and Yok-Tez. Included papers contained data on the SVF performance of healthy adult native speakers of Turkish, and reported the categories used. Versions of the SVF that required participants to alternate categories were excluded. We extracted and tabulated demographics, descriptions of groups, metrics used, categories used, and sources of normative data. Studies were assessed for level of detail in reporting findings. RESULTS 1400 studies were retrieved. After deduplication, abstract, full text screening, and merging of theses with their published versions, 121 studies were included. 114 studies used the semantic category "animal", followed by first names (N = 14, 12%). All studies reported word count. More complex measures were rare (perseverations: N = 12, 10%, clustering and switching: N = 5, 4%). Four of seven normative studies reported only word count, two also measured perseverations, and one reported category violations and perseverations. Two normative studies were published in English. CONCLUSIONS There is a lack of normative Turkish SVF data with more complex metrics, such as clustering and switching, and a lack of normative data published in English. Given the size of the Turkish diaspora, normative SVF data should include monolingual and bilingual speakers. Limitations include a restriction to key English and Turkish databases.
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Affiliation(s)
| | - Kahraman Kostas
- Department of Computer Science, Heriot-Watt University, Edinburgh, UK
| | - Sarah E MacPherson
- Human Cognitive Neuroscience, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Maria K Wolters
- School of Informatics, University of Edinburgh, Edinburgh, UK
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Nour MM, McNamee DC, Liu Y, Dolan RJ. Trajectories through semantic spaces in schizophrenia and the relationship to ripple bursts. Proc Natl Acad Sci U S A 2023; 120:e2305290120. [PMID: 37816054 PMCID: PMC10589662 DOI: 10.1073/pnas.2305290120] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/31/2023] [Indexed: 10/12/2023] Open
Abstract
Human cognition is underpinned by structured internal representations that encode relationships between entities in the world (cognitive maps). Clinical features of schizophrenia-from thought disorder to delusions-are proposed to reflect disorganization in such conceptual representations. Schizophrenia is also linked to abnormalities in neural processes that support cognitive map representations, including hippocampal replay and high-frequency ripple oscillations. Here, we report a computational assay of semantically guided conceptual sampling and exploit this to test a hypothesis that people with schizophrenia (PScz) exhibit abnormalities in semantically guided cognition that relate to hippocampal replay and ripples. Fifty-two participants [26 PScz (13 unmedicated) and 26 age-, gender-, and intelligence quotient (IQ)-matched nonclinical controls] completed a category- and letter-verbal fluency task, followed by a magnetoencephalography (MEG) scan involving a separate sequence-learning task. We used a pretrained word embedding model of semantic similarity, coupled to a computational model of word selection, to quantify the degree to which each participant's verbal behavior was guided by semantic similarity. Using MEG, we indexed neural replay and ripple power in a post-task rest session. Across all participants, word selection was strongly influenced by semantic similarity. The strength of this influence showed sensitivity to task demands (category > letter fluency) and predicted performance. In line with our hypothesis, the influence of semantic similarity on behavior was reduced in schizophrenia relative to controls, predicted negative psychotic symptoms, and correlated with an MEG signature of hippocampal ripple power (but not replay). The findings bridge a gap between phenomenological and neurocomputational accounts of schizophrenia.
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Affiliation(s)
- Matthew M. Nour
- Department of Psychiatry, University of Oxford, OxfordOX3 7JX, United Kingdom
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, LondonWC1B 5EH, United Kingdom
| | - Daniel C. McNamee
- Champalimaud Research, Centre for the Unknown, 1400-038Lisbon, Portugal
| | - Yunzhe Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing100875, China
- Chinese Institute for Brain Research, Beijing102206, China
| | - Raymond J. Dolan
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, LondonWC1B 5EH, United Kingdom
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing100875, China
- Wellcome Centre for Human Neuroimaging, University College London, LondonWC1N 3AR, United Kingdom
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Holmlund TB, Chandler C, Foltz PW, Diaz-Asper C, Cohen AS, Rodriguez Z, Elvevåg B. Towards a temporospatial framework for measurements of disorganization in speech using semantic vectors. Schizophr Res 2023; 259:71-79. [PMID: 36372683 DOI: 10.1016/j.schres.2022.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 11/11/2022]
Abstract
Incoherent speech in schizophrenia has long been described as the mind making "leaps" of large distances between thoughts and ideas. Such a view seems intuitive, and for almost two decades, attempts to operationalize these conceptual "leaps" in spoken word meanings have used language-based embedding spaces. An embedding space represents meaning of words as numerical vectors where a greater proximity between word vectors represents more shared meaning. However, there are limitations with word vector-based operationalizations of coherence which can limit their appeal and utility in clinical practice. First, the use of esoteric word embeddings can be conceptually hard to grasp, and this is complicated by several different operationalizations of incoherent speech. This problem can be overcome by a better visualization of methods. Second, temporal information from the act of speaking has been largely neglected since models have been built using written text, yet speech is spoken in real time. This issue can be resolved by leveraging time stamped transcripts of speech. Third, contextual information - namely the situation of where something is spoken - has often only been inferred and never explicitly modeled. Addressing this situational issue opens up new possibilities for models with increased temporal resolution and contextual relevance. In this paper, direct visualizations of semantic distances are used to enable the inspection of examples of incoherent speech. Some common operationalizations of incoherence are illustrated, and suggestions are made for how temporal and spatial contextual information can be integrated in future implementations of measures of incoherence.
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Affiliation(s)
- Terje B Holmlund
- Department of Clinical Medicine, University of Tromsø - the Arctic University of Norway, Tromsø, Norway.
| | - Chelsea Chandler
- Institute of Cognitive Science, University of Colorado Boulder, United States of America
| | - Peter W Foltz
- Institute of Cognitive Science, University of Colorado Boulder, United States of America
| | | | - Alex S Cohen
- Department of Psychology, Louisiana State University, United States of America; Center for Computation and Technology, Louisiana State University, United States of America
| | - Zachary Rodriguez
- Department of Psychology, Louisiana State University, United States of America; Center for Computation and Technology, Louisiana State University, United States of America
| | - Brita Elvevåg
- Department of Clinical Medicine, University of Tromsø - the Arctic University of Norway, Tromsø, Norway; Norwegian Center for eHealth Research, University Hospital of North Norway, Tromsø, Norway
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Foltz PW, Chandler C, Diaz-Asper C, Cohen AS, Rodriguez Z, Holmlund TB, Elvevåg B. Reflections on the nature of measurement in language-based automated assessments of patients' mental state and cognitive function. Schizophr Res 2023; 259:127-139. [PMID: 36153250 DOI: 10.1016/j.schres.2022.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 11/23/2022]
Abstract
Modern advances in computational language processing methods have enabled new approaches to the measurement of mental processes. However, the field has primarily focused on model accuracy in predicting performance on a task or a diagnostic category. Instead the field should be more focused on determining which computational analyses align best with the targeted neurocognitive/psychological functions that we want to assess. In this paper we reflect on two decades of experience with the application of language-based assessment to patients' mental state and cognitive function by addressing the questions of what we are measuring, how it should be measured and why we are measuring the phenomena. We address the questions by advocating for a principled framework for aligning computational models to the constructs being assessed and the tasks being used, as well as defining how those constructs relate to patient clinical states. We further examine the assumptions that go into the computational models and the effects that model design decisions may have on the accuracy, bias and generalizability of models for assessing clinical states. Finally, we describe how this principled approach can further the goal of transitioning language-based computational assessments to part of clinical practice while gaining the trust of critical stakeholders.
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Affiliation(s)
- Peter W Foltz
- Institute of Cognitive Science, University of Colorado Boulder, United States of America.
| | - Chelsea Chandler
- Institute of Cognitive Science, University of Colorado Boulder, United States of America; Department of Computer Science, University of Colorado Boulder, United States of America
| | | | - Alex S Cohen
- Department of Psychology, Louisiana State University, United States of America; Center for Computation and Technology, Louisiana State University, United States of America
| | - Zachary Rodriguez
- Department of Psychology, Louisiana State University, United States of America; Center for Computation and Technology, Louisiana State University, United States of America
| | - Terje B Holmlund
- Department of Clinical Medicine, University of Tromsø - the Arctic University of Norway, Tromsø, Norway
| | - Brita Elvevåg
- Department of Clinical Medicine, University of Tromsø - the Arctic University of Norway, Tromsø, Norway; Norwegian Centre for eHealth Research, University Hospital of North Norway, Tromsø, Norway.
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Hui CLM, See SHW, Chiu TC, Pintos AS, Kroyer JM, Suen YN, Lee EHM, Chan SKW, Chang WC, Elvevåg B, Chen EYH. What Drives Animal Fluency Performance in Cantonese-Speaking Chinese Patients with Adult-Onset Psychosis? Brain Sci 2023; 13:brainsci13030372. [PMID: 36979182 PMCID: PMC10046392 DOI: 10.3390/brainsci13030372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Among the numerous studies investigating semantic factors associated with functioning in psychotic patients, most have been conducted on western populations. By contrast, the current cross-sectional study involved native Cantonese-speaking Chinese participants. Using the category fluency task, we compared performance between patients and healthy participants and examined clinical and sociodemographic correlates. First-episode psychosis patients (n = 356) and gender- and age-matched healthy participants (n = 35) were asked to generate as many ‘animals’ as they could in a minute. As expected, patients generated fewer correct responses (an average of 15.5 vs. 22.9 words), generated fewer clusters (an average of 3.7 vs. 5.4 thematically grouped nouns), switched less between clusters (on average 8.0 vs. 11.9 switches) and, interestingly, produced a larger percentage of Chinese zodiac animals than healthy participants (an average of 37.7 vs. 24.2). However, these significant group differences in the clusters and switches disappeared when the overall word production was controlled for. Within patients, education was the strongest predictor of category fluency performance (namely the number of correct responses, clusters, and switches). The findings suggest that an overall slowness in patients may account for the group differences in category fluency performance rather than any specific abnormality per se.
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Affiliation(s)
- Christy Lai-Ming Hui
- Department of Psychiatry, School of Clinical Medicine, University of Hong Kong, Hong Kong, China
- Correspondence: ; Tel.: +852-2255-3064; Fax: +852-2855-1345
| | - Sally Hiu-Wah See
- Department of Psychiatry, School of Clinical Medicine, University of Hong Kong, Hong Kong, China
| | - Tsz-Ching Chiu
- Department of Psychiatry, School of Clinical Medicine, University of Hong Kong, Hong Kong, China
| | - Andrea Stephanie Pintos
- Department of Psychiatry, School of Clinical Medicine, University of Hong Kong, Hong Kong, China
| | - Johanna M. Kroyer
- Department of Psychiatry, School of Clinical Medicine, University of Hong Kong, Hong Kong, China
| | - Yi-Nam Suen
- Department of Psychiatry, School of Clinical Medicine, University of Hong Kong, Hong Kong, China
| | - Edwin Ho-Ming Lee
- Department of Psychiatry, School of Clinical Medicine, University of Hong Kong, Hong Kong, China
| | - Sherry Kit-Wa Chan
- Department of Psychiatry, School of Clinical Medicine, University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Wing-Chung Chang
- Department of Psychiatry, School of Clinical Medicine, University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Brita Elvevåg
- Department of Clinical Medicine, University of Tromsø—The Arctic University of Norway, 9037 Tromsø, Norway
| | - Eric Yu-Hai Chen
- Department of Psychiatry, School of Clinical Medicine, University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
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The Role of Silence in Verbal Fluency Tasks - A New Approach for the Detection of Mild Cognitive Impairment. J Int Neuropsychol Soc 2023; 29:46-58. [PMID: 35067261 DOI: 10.1017/s1355617721001454] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Most recordings of verbal fluency tasks include substantial amounts of task-irrelevant content that could provide clinically valuable information for the detection of mild cognitive impairment (MCI). We developed a method for the analysis of verbal fluency, focusing not on the task-relevant words but on the silent segments, the hesitations, and the irrelevant utterances found in the voice recordings. METHODS Phonemic ('k', 't', 'a') and semantic (animals, food items, actions) verbal fluency data were collected from healthy control (HC; n = 25; Mage = 67.32) and MCI (n = 25; Mage = 71.72) participants. After manual annotation of the voice samples, 10 temporal parameters were computed based on the silent and the task-irrelevant segments. Traditional fluency measures, based on word count (correct words, errors, repetitions) were also employed in order to compare the outcome of the two methods. RESULTS Two silence-based parameters (the number of silent pauses and the average length of silent pauses) and the average word transition time differed significantly between the two groups in the case of all three semantic fluency tasks. Subsequent receiver operating characteristic (ROC) analysis showed that these three temporal parameters had classification abilities similar to the traditional measure of counting correct words. CONCLUSION In our approach for verbal fluency analysis, silence-related parameters displayed classification ability similar to the most widely used traditional fluency measure. Based on these results, an automated tool using voiced-unvoiced segmentation may be developed enabling swift and cost-effective verbal fluency-based MCI screening.
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Cohen AS, Rodriguez Z, Warren KK, Cowan T, Masucci MD, Edvard Granrud O, Holmlund TB, Chandler C, Foltz PW, Strauss GP. Natural Language Processing and Psychosis: On the Need for Comprehensive Psychometric Evaluation. Schizophr Bull 2022; 48:939-948. [PMID: 35738008 PMCID: PMC9434462 DOI: 10.1093/schbul/sbac051] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND HYPOTHESIS Despite decades of "proof of concept" findings supporting the use of Natural Language Processing (NLP) in psychosis research, clinical implementation has been slow. One obstacle reflects the lack of comprehensive psychometric evaluation of these measures. There is overwhelming evidence that criterion and content validity can be achieved for many purposes, particularly using machine learning procedures. However, there has been very little evaluation of test-retest reliability, divergent validity (sufficient to address concerns of a "generalized deficit"), and potential biases from demographics and other individual differences. STUDY DESIGN This article highlights these concerns in development of an NLP measure for tracking clinically rated paranoia from video "selfies" recorded from smartphone devices. Patients with schizophrenia or bipolar disorder were recruited and tracked over a week-long epoch. A small NLP-based feature set from 499 language samples were modeled on clinically rated paranoia using regularized regression. STUDY RESULTS While test-retest reliability was high, criterion, and convergent/divergent validity were only achieved when considering moderating variables, notably whether a patient was away from home, around strangers, or alone at the time of the recording. Moreover, there were systematic racial and sex biases in the model, in part, reflecting whether patients submitted videos when they were away from home, around strangers, or alone. CONCLUSIONS Advancing NLP measures for psychosis will require deliberate consideration of test-retest reliability, divergent validity, systematic biases and the potential role of moderators. In our example, a comprehensive psychometric evaluation revealed clear strengths and weaknesses that can be systematically addressed in future research.
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Affiliation(s)
- Alex S Cohen
- Louisiana State University, Department of Psychology, Baton Rouge, LA, USA
- Louisiana State University, Center for Computation and Technology, Baton Rouge, LA, USA
| | - Zachary Rodriguez
- Louisiana State University, Department of Psychology, Baton Rouge, LA, USA
- Louisiana State University, Center for Computation and Technology, Baton Rouge, LA, USA
| | - Kiara K Warren
- Louisiana State University, Department of Psychology, Baton Rouge, LA, USA
| | - Tovah Cowan
- Louisiana State University, Department of Psychology, Baton Rouge, LA, USA
| | - Michael D Masucci
- Louisiana State University, Department of Psychology, Baton Rouge, LA, USA
| | - Ole Edvard Granrud
- Louisiana State University, Department of Psychology, Baton Rouge, LA, USA
| | - Terje B Holmlund
- University of Tromsø—The Arctic University of Norway, Tromso, Norway
| | - Chelsea Chandler
- University of Colorado, Institute of Cognitive Science, Boulder, CO, USA
- University of Colorado, Department of Computer Science, Boulder, CO, USA
| | - Peter W Foltz
- University of Colorado, Institute of Cognitive Science, Boulder, CO, USA
- University of Colorado, Department of Computer Science, Boulder, CO, USA
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Diaz-Asper C, Chandler C, Turner RS, Reynolds B, Elvevåg B. Increasing access to cognitive screening in the elderly: applying natural language processing methods to speech collected over the telephone. Cortex 2022; 156:26-38. [DOI: 10.1016/j.cortex.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/10/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
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Lundin NB, Jones MN, Myers EJ, Breier A, Minor KS. Semantic and phonetic similarity of verbal fluency responses in early-stage psychosis. Psychiatry Res 2022; 309:114404. [PMID: 35066310 PMCID: PMC8863651 DOI: 10.1016/j.psychres.2022.114404] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 01/12/2022] [Accepted: 01/15/2022] [Indexed: 11/16/2022]
Abstract
Linguistic abnormalities can emerge early in the course of psychotic illness. Computational tools that quantify similarity of responses in standardized language-based tasks such as the verbal fluency test could efficiently characterize the nature and functional correlates of these disturbances. Participants with early-stage psychosis (n=20) and demographically matched controls without a psychiatric diagnosis (n=20) performed category and letter verbal fluency. Semantic similarity was measured via predicted context co-occurrence in a large text corpus using Word2Vec. Phonetic similarity was measured via edit distance using the VFClust tool. Responses were designated as clusters (related items) or switches (transitions to less related items) using similarity-based thresholds. Results revealed that participants with early-stage psychosis compared to controls had lower fluency scores, lower cluster-related semantic similarity, and fewer switches; mean cluster size and phonetic similarity did not differ by group. Lower fluency semantic similarity was correlated with greater speech disorganization (Communication Disturbances Index), although more strongly in controls, and correlated with poorer social functioning (Global Functioning: Social), primarily in the psychosis group. Findings suggest that search for semantically related words may be impaired soon after psychosis onset. Future work is warranted to investigate the impact of language disturbances on social functioning over the course of psychotic illness.
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Affiliation(s)
- Nancy B. Lundin
- Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University, Bloomington, IN, USA; Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Michael N. Jones
- Department of Psychological and Brain Sciences and Cognitive Science Program, Indiana University, Bloomington, IN, USA
| | - Evan J. Myers
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Alan Breier
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA; Eskenazi Midtown Prevention and Recovery Center for Early Psychosis, Indianapolis, IN, USA.
| | - Kyle S. Minor
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA; Eskenazi Midtown Prevention and Recovery Center for Early Psychosis, Indianapolis, IN, USA
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Itaguchi Y, Castro-Chavira SA, Waterloo K, Johnsen SH, Rodríguez-Aranda C. Evaluation of Error Production in Animal Fluency and Its Relationship to Frontal Tracts in Normal Aging and Mild Alzheimer's Disease: A Combined LDA and Time-Course Analysis Investigation. Front Aging Neurosci 2022; 13:710938. [PMID: 35095462 PMCID: PMC8790484 DOI: 10.3389/fnagi.2021.710938] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Semantic verbal fluency (VF), assessed by animal category, is a task widely used for early detection of dementia. A feature not regularly assessed is the occurrence of errors such as perseverations and intrusions. So far, no investigation has analyzed the how and when of error occurrence during semantic VF in aging populations, together with their possible neural correlates. The present study aims to address the issue using a combined methodology based on latent Dirichlet allocation (LDA) analysis for word classification together with a time-course analysis identifying exact time of errors' occurrence. LDA is a modeling technique that discloses hidden semantic structures based on a given corpus of documents. We evaluated a sample of 66 participants divided into a healthy young group (n = 24), healthy older adult group (n = 23), and group of patients with mild Alzheimer's disease (AD) (n = 19). We performed DTI analyses to evaluate the white matter integrity of three frontal tracts purportedly underlying error commission: anterior thalamic radiation, frontal aslant tract, and uncinate fasciculus. Contrasts of DTI metrics were performed on the older groups who were further classified into high-error rate and low-error rate subgroups. Results demonstrated a unique deployment of error commission in the patient group characterized by high incidence of intrusions in the first 15 s and higher rate of perseverations toward the end of the trial. Healthy groups predominantly showed very low incidence of perseverations. The DTI analyses revealed that the patients with AD committing high-error rate presented significantly more degenerated frontal tracts in the left hemisphere. Thus, our findings demonstrated that the appearance of intrusions, together with left hemisphere degeneration of frontal tracts, is a pathognomic trait of mild AD. Furthermore, our data suggest that the error commission of patients with AD arises from executive and working memory impairments related partly to deteriorated left frontal tracts.
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Affiliation(s)
| | | | - Knut Waterloo
- Department of Psychology, UiT The Artic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital North Norway, Tromsø, Norway
| | - Stein Harald Johnsen
- Department of Neurology, University Hospital North Norway, Tromsø, Norway
- Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Artic University of Norway, Tromsø, Norway
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Ku BS, Pauselli L, Covington MA, Compton MT. Computational linguistic analysis applied to a semantic fluency task: A replication among first-episode psychosis patients with and without derailment and tangentiality. Psychiatry Res 2021; 304:114105. [PMID: 34298424 PMCID: PMC8719331 DOI: 10.1016/j.psychres.2021.114105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 12/01/2022]
Abstract
Automated tools do not yet exist to measure formal thought disorder, including derailment and tangentiality, both of which can be subjectively rated using the Scale for the Assessment of Positive Symptoms after a clinical research interview. CoVec, a new automated tool, measures the semantic similarity among words averaged in a five- and ten-word window (Coherence-5 and Coherence-10, respectively). One prior report demonstrated that this tool was able to differentiate between patients with those types of thought disorder and patients without them (and controls). Here, we attempted a replication of the initial findings using data from a different sample of patients hospitalized for initial evaluation of first-episode psychosis. Participants were administered a semantic fluency task and the animal lists were analyzed with CoVec. In this study, we partially replicated the prior findings, showing that first-episode patients with derailment had significantly lower Coherence-5 and Coherence-10 compared with patients without derailment. Further research is warranted on this and other highly reliable and objective methods of detecting formal thought disorder through simple assessments such as semantic fluency tasks.
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Affiliation(s)
- Benson S. Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Luca Pauselli
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Morningside/West Hospital Center, New York, NY, USA
| | | | - Michael T. Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA,Corresponding author: Michael T. Compton, M.D., M.P.H., New York State Psychiatric Institute, 722 W. 168 Street, Room R249, New York, NY 10032. Tel: 646-774-8476.
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13
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Le TP, Moscardini E, Cowan T, Elvevåg B, Holmlund TB, Foltz PW, Tucker RP, Schwartz EK, Cohen AS. Predicting self-injurious thoughts in daily life using ambulatory assessment of state cognition. J Psychiatr Res 2021; 138:335-341. [PMID: 33895607 DOI: 10.1016/j.jpsychires.2021.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 03/17/2021] [Accepted: 04/08/2021] [Indexed: 01/22/2023]
Abstract
Self-injurious thoughts (SITs) fluctuate considerably from moment to moment. As such, "static" and temporally stable predictors (e.g., demographic variables, prior history) are suboptimal in predicting imminent SITs. This concern is particularly true for "online" cognitive abilities, which are important for understanding SITs, but are typically measured using tests selected for temporal stability. Advances in ambulatory assessments (i.e., real-time assessment in a naturalistic environment) allow for measuring cognition with improved temporal resolution. The present study measured relationships between "state" cognitive performance, measured using an ambulatory-based Trail Making Test, and SITs. Self-reported state hope and social connectedness was also measured. Data were collected using a specially designed mobile application (administered 4x/week up to 28 days) in substance use inpatients (N = 99). Consistent with prior literature, state hope and social connectedness was significantly associated with state SITs. Importantly, poorer state cognitive performance also significantly predicted state SITs, independent of hallmark static and state self-report risk variables. These findings highlight the potential importance of "online" cognition to predict SITs. Ambulatory recording reflects an efficient, sensitive, and ecological valid methodology for evaluating subjective and objectives predictors of imminent SITs.
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Affiliation(s)
- Thanh P Le
- Department of Psychology, Louisiana State University, USA.
| | | | - Tovah Cowan
- Department of Psychology, Louisiana State University, USA
| | - Brita Elvevåg
- Department of Clinical Medicine, University of Tromsø - the Arctic University of Norway, Norway; The Norwegian Centre for eHealth Research, University Hospital of North Norway, Norway
| | - Terje B Holmlund
- Department of Clinical Medicine, University of Tromsø - the Arctic University of Norway, Norway
| | - Peter W Foltz
- Institue of Cognitive Science, University of Colorado Boulder, USA
| | | | | | - Alex S Cohen
- Department of Psychology, Louisiana State University, USA
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14
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Chandler C, Holmlund TB, Foltz PW, Cohen AS, Elvevåg B. Extending the usefulness of the verbal memory test: The promise of machine learning. Psychiatry Res 2021; 297:113743. [PMID: 33529873 DOI: 10.1016/j.psychres.2021.113743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 01/16/2021] [Indexed: 11/29/2022]
Abstract
The evaluation of verbal memory is a core component of neuropsychological assessment in a wide range of clinical and research settings. Leveraging story recall to assay neurocognitive function could be made more useful if it were possible to administer frequently (i.e., would allow for the collection of more patient data over time) and automatically assess the recalls with machine learning methods. In the present study, we evaluated a novel story recall test with 24 parallel forms that was deployed using smart devices in 94 psychiatric inpatients and 80 nonpatient adults. Machine learning and vector-based natural language processing methods were employed to automate test scoring, and performance using these methods was evaluated in their incremental validity, criterion validity (i.e., convergence with trained human raters), and parallel forms reliability. Our results suggest moderate to high consistency across the parallel forms, high convergence with human raters (r values ~ 0.89), and high incremental validity for discriminating between groups. While much work remains, the present findings are critical for implementing an automated, neuropsychological test deployable using remote technologies across multiple and frequent administrations.
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Affiliation(s)
- Chelsea Chandler
- Department of Computer Science, University of Colorado Boulder, CO, USA; Institute of Cognitive Science, University of Colorado Boulder, CO, USA.
| | - Terje B Holmlund
- Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Norway
| | - Peter W Foltz
- Institute of Cognitive Science, University of Colorado Boulder, CO, USA; Pearson, CO, USA
| | - Alex S Cohen
- Department of Psychology, Louisiana State University, LA, USA
| | - Brita Elvevåg
- Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Norway; Norwegian Centre for eHealth Research, University Hospital of North Norway, Tromsø, Norway.
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15
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Zohdi H, Scholkmann F, Wolf U. Individual Differences in Hemodynamic Responses Measured on the Head Due to a Long-Term Stimulation Involving Colored Light Exposure and a Cognitive Task: A SPA-fNIRS Study. Brain Sci 2021; 11:54. [PMID: 33466405 PMCID: PMC7824905 DOI: 10.3390/brainsci11010054] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/20/2020] [Accepted: 12/30/2020] [Indexed: 12/11/2022] Open
Abstract
When brain activity is measured by neuroimaging, the canonical hemodynamic response (increase in oxygenated hemoglobin ([O2Hb]) and decrease in deoxygenated hemoglobin ([HHb]) is not always seen in every subject. The reason for this intersubject-variability of the responses is still not completely understood. This study is performed with 32 healthy subjects, using the systemic physiology augmented functional near-infrared spectroscopy (SPA-fNIRS) approach. We investigate the intersubject variability of hemodynamic and systemic physiological responses, due to a verbal fluency task (VFT) under colored light exposure (CLE; blue and red). Five and seven different hemodynamic response patterns were detected in the subgroup analysis of the blue and red light exposure, respectively. We also found that arterial oxygen saturation and mean arterial pressure were positively correlated with [O2Hb] at the prefrontal cortex during the CLE-VFT independent of the color of light and classification of the subjects. Our study finds that there is substantial intersubject-variability of cerebral hemodynamic responses, which is partially explained by subject-specific systemic physiological changes induced by the CLE-VFT. This means that both subgroup analyses and the additional assessment of systemic physiology are of crucial importance to achieve a comprehensive understanding of the effects of a CLE-VFT on human subjects.
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Affiliation(s)
- Hamoon Zohdi
- Institute of Complementary and Integrative Medicine, University of Bern, 3012 Bern, Switzerland; (H.Z.); (F.S.)
| | - Felix Scholkmann
- Institute of Complementary and Integrative Medicine, University of Bern, 3012 Bern, Switzerland; (H.Z.); (F.S.)
- Biomedical Optics Research Laboratory, Neonatology Research, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Ursula Wolf
- Institute of Complementary and Integrative Medicine, University of Bern, 3012 Bern, Switzerland; (H.Z.); (F.S.)
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16
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Cohen AS, Cox CR, Tucker RP, Mitchell KR, Schwartz EK, Le TP, Foltz PW, Holmlund TB, Elvevåg B. Validating Biobehavioral Technologies for Use in Clinical Psychiatry. Front Psychiatry 2021; 12:503323. [PMID: 34177631 PMCID: PMC8225932 DOI: 10.3389/fpsyt.2021.503323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/11/2021] [Indexed: 11/14/2022] Open
Abstract
The last decade has witnessed the development of sophisticated biobehavioral and genetic, ambulatory, and other measures that promise unprecedented insight into psychiatric disorders. As yet, clinical sciences have struggled with implementing these objective measures and they have yet to move beyond "proof of concept." In part, this struggle reflects a traditional, and conceptually flawed, application of traditional psychometrics (i.e., reliability and validity) for evaluating them. This paper focuses on "resolution," concerning the degree to which changes in a signal can be detected and quantified, which is central to measurement evaluation in informatics, engineering, computational and biomedical sciences. We define and discuss resolution in terms of traditional reliability and validity evaluation for psychiatric measures, then highlight its importance in a study using acoustic features to predict self-injurious thoughts/behaviors (SITB). This study involved tracking natural language and self-reported symptoms in 124 psychiatric patients: (a) over 5-14 recording sessions, collected using a smart phone application, and (b) during a clinical interview. Importantly, the scope of these measures varied as a function of time (minutes, weeks) and spatial setting (i.e., smart phone vs. interview). Regarding reliability, acoustic features were temporally unstable until we specified the level of temporal/spatial resolution. Regarding validity, accuracy based on machine learning of acoustic features predicting SITB varied as a function of resolution. High accuracy was achieved (i.e., ~87%), but only when the acoustic and SITB measures were "temporally-matched" in resolution was the model generalizable to new data. Unlocking the potential of biobehavioral technologies for clinical psychiatry will require careful consideration of resolution.
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Affiliation(s)
- Alex S Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States.,Center for Computation and Technology Louisiana State University, Baton Rouge, LA, United States
| | - Christopher R Cox
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Kyle R Mitchell
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Elana K Schwartz
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Thanh P Le
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Peter W Foltz
- Department of Psychology, University of Colorado, Boulder, CO, United States
| | - Terje B Holmlund
- Department of Clinical Medicine, University of Tromsø-The Arctic University of Norway, Tromsø, Norway
| | - Brita Elvevåg
- Department of Clinical Medicine, University of Tromsø-The Arctic University of Norway, Tromsø, Norway.,The Norwegian Center for eHealth Research, University Hospital of North Norway, Tromsø, Norway
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17
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Diaz-Asper C, Chandler C, Turner RS, Reynolds B, Elvevåg B. Acceptability of collecting speech samples from the elderly via the telephone. Digit Health 2021; 7:20552076211002103. [PMID: 33953936 PMCID: PMC8056560 DOI: 10.1177/20552076211002103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/17/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE There is a critical need to develop rapid, inexpensive and easily accessible screening tools for mild cognitive impairment (MCI) and Alzheimer's disease (AD). We report on the efficacy of collecting speech via the telephone to subsequently develop sensitive metrics that may be used as potential biomarkers by leveraging natural language processing methods. METHODS Ninety-one older individuals who were cognitively unimpaired or diagnosed with MCI or AD participated from home in an audio-recorded telephone interview, which included a standard cognitive screening tool, and the collection of speech samples. In this paper we address six questions of interest: (1) Will elderly people agree to participate in a recorded telephone interview? (2) Will they complete it? (3) Will they judge it an acceptable approach? (4) Will the speech that is collected over the telephone be of a good quality? (5) Will the speech be intelligible to human raters? (6) Will transcriptions produced by automated speech recognition accurately reflect the speech produced? RESULTS Participants readily agreed to participate in the telephone interview, completed it in its entirety, and rated the approach as acceptable. Good quality speech was produced for further analyses to be applied, and almost all recorded words were intelligible for human transcription. Not surprisingly, human transcription outperformed off the shelf automated speech recognition software, but further investigation into automated speech recognition shows promise for its usability in future work. CONCLUSION Our findings demonstrate that collecting speech samples from elderly individuals via the telephone is well tolerated, practical, and inexpensive, and produces good quality data for uses such as natural language processing.
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Affiliation(s)
| | - Chelsea Chandler
- Department of Computer Science, University of Colorado Boulder, CO, USA
| | - R Scott Turner
- Department of Neurology, Georgetown University, Washington, DC, USA
| | - Brigid Reynolds
- Department of Neurology, Georgetown University, Washington, DC, USA
| | - Brita Elvevåg
- Department of Clinical Medicine, University of Tromsø, Tromsø- the Arctic University of Norway, Norway
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18
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A Dynamic Method, Analysis, and Model of Short-Term Memory for Serial Order with Clinical Applications. Psychiatry Res 2020; 294:113494. [PMID: 33217720 DOI: 10.1016/j.psychres.2020.113494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/29/2020] [Indexed: 11/23/2022]
Abstract
This study examined the robustness of a traditional memory task when moved out of controlled traditional settings. A letter recall task was designed to be self-administered via a smart-device which assessed recall by participants' writing their responses on the device. This enabled collection of both the letter recalled and the timing of this recall such that the temporal dynamics could be examined. Participants were patients with mental illness (n=71) and healthy volunteers (n=103). Temporal dynamics were examined using a new mechanism that measured memory retrieval time precisely. Data were analyzed for accuracy, time and their relationships. The classic memory phenomena and associated effects were replicated. In terms of temporal dynamics, this is the first demonstration of primacy and recency effects in time domain variables, as well as phonological similarity effects as evident by the inverted U-shaped curves in time. The speed of short-term memory processes affects accuracy, error types and timing. The robustness of these memory effects and new approach to temporal dynamics suggest this framework may be suitable for clinical applications, notably for the long-term monitoring of cognition in patients with mental illness.
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19
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Holmlund TB, Diaz-Asper C, Elvevåg B. The reality of doing things with (thousands of) words in applied research and clinical settings: A commentary on Clarke et al. (2020). Cortex 2020; 136:150-156. [PMID: 33023751 DOI: 10.1016/j.cortex.2020.08.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/19/2020] [Accepted: 08/22/2020] [Indexed: 11/25/2022]
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20
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Le TP, Lucas HD, Schwartz EK, Mitchell KR, Cohen AS. Frontal alpha asymmetry in schizotypy: electrophysiological evidence for motivational dysfunction. Cogn Neuropsychiatry 2020; 25:371-386. [PMID: 32873177 DOI: 10.1080/13546805.2020.1813096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction: Schizotypy is defined as personality traits reflecting an underlying risk for schizophrenia-spectrum disorders. As yet, there is a dearth of suitable objective markers for measuring schizotypy. Frontal alpha asymmetry, characterised by reduced left versus right frontal region activity, reflects trait-like diminished approach-related systems and has been found in schizophrenia. Methods: The present study used electroencephalography (EEG) recorded on a consumer-grade mobile headset to examine asymmetric resting-state frontal alpha, beta, and gamma power within the multidimensional schizotypy (e.g. positive, negative, disorganised) during a three-minute "eyes closed" resting period in college undergraduates (n=49). Results: Findings suggest that schizotypy was exclusively related to reduced left versus right-lateralised power in the alpha frequency (8.1-12.9 Hz., R2= .16). Follow-up analysis suggested that positive schizotypy was uniquely associated with increased right alpha activity, indicating increased withdrawal motivation. Conclusions: Frontal asymmetry is a possible ecologically valid objective marker for schizotypy that may be detectable using easily accessible, consumer-grade technology.
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Affiliation(s)
- Thanh P Le
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Heather D Lucas
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Elana K Schwartz
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Kyle R Mitchell
- Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), La Jolla, CA, USA
| | - Alex S Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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21
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Lundin NB, Todd PM, Jones MN, Avery JE, O'Donnell BF, Hetrick WP. Semantic Search in Psychosis: Modeling Local Exploitation and Global Exploration. SCHIZOPHRENIA BULLETIN OPEN 2020; 1:sgaa011. [PMID: 32803160 PMCID: PMC7418865 DOI: 10.1093/schizbullopen/sgaa011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Impairments in category verbal fluency task (VFT) performance have been widely documented in psychosis. These deficits may be due to disturbed “cognitive foraging” in semantic space, in terms of altered salience of cues that influence individuals to search locally within a subcategory of semantically related responses (“clustering”) or globally between subcategories (“switching”). To test this, we conducted a study in which individuals with schizophrenia (n = 21), schizotypal personality traits (n = 25), and healthy controls (n = 40) performed VFT with “animals” as the category. Distributional semantic model Word2Vec computed cosine-based similarities between words according to their statistical usage in a large text corpus. We then applied a validated foraging-based search model to these similarity values to obtain salience indices of frequency-based global search cues and similarity-based local cues. Analyses examined whether diagnosis predicted VFT performance, search strategies, cue salience, and the time taken to switch between vs search within clusters. Compared to control and schizotypal groups, individuals with schizophrenia produced fewer words, switched less, and exhibited higher global cue salience, indicating a selection of more common words when switching to new clusters. Global cue salience negatively associated with vocabulary ability in controls and processing speed in schizophrenia. Lastly, individuals with schizophrenia took a similar amount of time to switch to new clusters compared to control and schizotypal groups but took longer to transition between words within clusters. Findings of altered local exploitation and global exploration through semantic memory provide preliminary evidence of aberrant cognitive foraging in schizophrenia.
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Affiliation(s)
- Nancy B Lundin
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN.,Program in Neuroscience, Indiana University, Bloomington, IN
| | - Peter M Todd
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN.,Cognitive Science Program, Indiana University, Bloomington, IN
| | - Michael N Jones
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN.,Cognitive Science Program, Indiana University, Bloomington, IN
| | - Johnathan E Avery
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN.,Cognitive Science Program, Indiana University, Bloomington, IN
| | - Brian F O'Donnell
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN.,Program in Neuroscience, Indiana University, Bloomington, IN.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - William P Hetrick
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN.,Program in Neuroscience, Indiana University, Bloomington, IN.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
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22
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Holmlund TB, Chandler C, Foltz PW, Cohen AS, Cheng J, Bernstein JC, Rosenfeld EP, Elvevåg B. Applying speech technologies to assess verbal memory in patients with serious mental illness. NPJ Digit Med 2020; 3:33. [PMID: 32195368 PMCID: PMC7066153 DOI: 10.1038/s41746-020-0241-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/13/2020] [Indexed: 12/21/2022] Open
Abstract
Verbal memory deficits are some of the most profound neurocognitive deficits associated with schizophrenia and serious mental illness in general. As yet, their measurement in clinical settings is limited to traditional tests that allow for limited administrations and require substantial resources to deploy and score. Therefore, we developed a digital ambulatory verbal memory test with automated scoring, and repeated self-administration via smart devices. One hundred and four adults participated, comprising 25 patients with serious mental illness and 79 healthy volunteers. The study design was successful with high quality speech recordings produced to 92% of prompts (Patients: 86%, Healthy: 96%). The story recalls were both transcribed and scored by humans, and scores generated using natural language processing on transcriptions were comparable to human ratings (R = 0.83, within the range of human-to-human correlations of R = 0.73-0.89). A fully automated approach that scored transcripts generated by automatic speech recognition produced comparable and accurate scores (R = 0.82), with very high correlation to scores derived from human transcripts (R = 0.99). This study demonstrates the viability of leveraging speech technologies to facilitate the frequent assessment of verbal memory for clinical monitoring purposes in psychiatry.
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Affiliation(s)
| | | | - Peter W. Foltz
- University of Colorado Boulder, Boulder, CO USA
- Pearson PLC, London, England
| | | | - Jian Cheng
- Analytic Measures Inc, Palo Alto, CA USA
| | | | | | - Brita Elvevåg
- UiT The Arctic University of Norway, Tromsø, Norway
- Norwegian Centre for eHealth Research, Tromsø, Norway
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23
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Le TP, Cowan T, Schwartz EK, Elvevåg B, Holmlund TB, Foltz PW, Barkus E, Cohen AS. The importance of loneliness in psychotic-like symptoms: Data from three studies. Psychiatry Res 2019; 282:112625. [PMID: 31662188 DOI: 10.1016/j.psychres.2019.112625] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 12/26/2022]
Abstract
Poor social connection or loneliness is a prominent feature of schizotypy and may exacerbate psychosis risk. Previous studies have examined the inter-relationships between loneliness and psychosis risk, but critically, they have largely been conducted in non-clinical samples or exclusively used laboratory questionnaires with limited consideration of the heterogeneity within schizotypy (i.e., positive, negative, disorganized factors). The present study examined links between loneliness and psychotic-like symptoms across the dimensions of schizotypy through cross-sectional, laboratory-based questionnaires (Study 1; N = 160), ambulatory assessment (Study 2; N = 118) in undergraduates, and ambulatory assessment in inpatients in a substance abuse treatment program (Study 3; N = 48). Trait positive schizotypy consistently predicted cross-sectional and state psychotic-like symptoms. Loneliness, assessed via cross-sectional and ambulatory means, was largely linked with psychotic-like symptoms. Importantly, psychotic-like symptoms were dynamic: psychotic-like symptoms largely increased with loneliness in individuals with elevated positive and disorganized schizotypal traits, though there were some inconsistency related to disorganized schizotypy and state psychotic-like symptoms. Negative schizotypy and loneliness did not significantly interact to predict psychotic-like symptoms, suggesting specificity to positive schizotypy. Ambulatory approaches provide the opportunity for ecologically valid identification of risk states across psychopathology, thus informing early intervention.
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Affiliation(s)
- Thanh P Le
- Department of Psychology, Louisiana State University, United States.
| | - Tovah Cowan
- Department of Psychology, Louisiana State University, United States
| | - Elana K Schwartz
- Department of Psychology, Louisiana State University, United States
| | - Brita Elvevåg
- Department of Clinical Medicine, University of Tromsø - the Arctic University of Norway, Norway; The Norwegian Centre for eHealth Research, University Hospital of North Norway, Norway
| | - Terje B Holmlund
- Department of Clinical Medicine, University of Tromsø - the Arctic University of Norway, Norway
| | - Peter W Foltz
- Institute of Cognitive Science, University of Colorado, United States
| | - Emma Barkus
- School of Psychology, University of Wollongong, United States
| | - Alex S Cohen
- Department of Psychology, Louisiana State University, United States
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