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Jain S, Kothari S, V S R, H S HK, Jain C. The Relationship Between Auditory and Cognitive Processing Abilities in Children With Specific Learning Disorders. Am J Audiol 2024; 33:824-837. [PMID: 38959167 DOI: 10.1044/2024_aja-24-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024] Open
Abstract
PURPOSE Specific learning disorder (SLD) refers to a pattern of learning difficulties characterized by problems with reading, writing, or mathematics that are not solely due to intellectual disabilities, sensory deficits, or other neurological or medical conditions. It is a neurodevelopmental disorder that affects the processing and organizing of information. Auditory and cognitive processing is affected in most children with SLD, although to a varying degree. However, it is still unclear whether there exists any relationship between auditory and cognitive processing disorders in children with SLD. METHOD We tested 1,259 children, of whom 77 were diagnosed as SLD and 30 age- and gender-matched typically developing (TD) children were selected. Auditory processing abilities were assessed for auditory discrimination, pattern perception, closure, temporal processing, binaural integration, and separation using standardized tests and procedures. Cognitive processing was measured using working memory, short-term memory, and attention tasks. RESULTS The test data of the TD children were taken as the norm. Based on the normative range, children with SLD were divided into those with auditory processing disorder (APD; n = 31) and those without APD (n = 46). A regression model highlighted a robust positive relationship between APD and cognitive processing, particularly pronounced in SLD with APD children. The results are discussed, supporting the information-processing theory of learning disability and highlighting a complex loop between auditory and cognitive deficits in children with SLD. CONCLUSIONS The findings underscore the critical role of both auditory and cognitive abilities in children with SLD. Tailoring the intervention to break the loop is recommended, which may improve learning abilities more effectively.
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Affiliation(s)
- Saransh Jain
- Department of Prevention of Communication Disorders, All India Institute of Speech and Hearing, Mysuru, India
| | - Siddharth Kothari
- Department of Speech-Language Pathology, Dr. S.R. Chandrasekhar Institute of Speech and Hearing, Bengaluru, India
| | - Rohith V S
- Aanvi Hearing Solutions Private Limited, Bengaluru, India
| | - Harshan Kumar H S
- Department of Speech-Language Pathology, JSS Institute of Speech and Hearing, Mysuru, India
| | - Chandni Jain
- Department of Audiology, All India Institute of Speech and Hearing, Mysuru, India
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Molina JL, Joshi YB, Nungaray JA, Sprock J, Attarha M, Biagianti B, Thomas ML, Swerdlow NR, Light GA. Early auditory processing abnormalities alter individual learning trajectories and sensitivity to computerized cognitive training in schizophrenia. Psychol Med 2024; 54:2669-2676. [PMID: 38587021 DOI: 10.1017/s0033291724000783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
BACKGROUND Auditory system plasticity is a promising target for neuromodulation, cognitive rehabilitation and therapeutic development in schizophrenia (SZ). Auditory-based targeted cognitive training (TCT) is a 'bottom up' intervention designed to enhance the speed and accuracy of auditory information processing, which has been shown to improve neurocognition in certain SZ patients. However, the dynamics of TCT learning as a function of training exercises and their impact on neurocognitive functioning and therapeutic outcomes are unknown. METHODS Forty subjects (SZ, n = 21; healthy subjects (HS), n = 19) underwent comprehensive clinical, cognitive, and auditory assessments, including measurements of auditory processing speed (APS) at baseline and after 1-h of TCT. SZ patients additionally completed 30-hours of TCT and repeated assessments ~10-12 weeks later. RESULTS SZ patients were deficient in APS at baseline (d = 0.96, p < 0.005) relative to HS. After 1-h of TCT, analyses revealed significant main effects of diagnosis (d = 1.75, p = 0.002) and time (d = 1.04, p < 0.001), and a diagnosis × time interaction (d = 0.85, p = 0.02) on APS. APS learning effects were robust after 1-h in SZ patients (d = 1.47, p < 0.001) and persisted throughout the 30-h of training. Baseline APS was associated with verbal learning gains after 30-h of TCT (r = 0.51, p = 0.02) in SZ. CONCLUSIONS TCT learning metrics may have prognostic utility and aid in the prospective identification of individuals likely to benefit from TCT. Future experimental medicine studies may advance predictive algorithms that enhance TCT-related clinical, cognitive and functional outcomes.
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Affiliation(s)
- Juan L Molina
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Yash B Joshi
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - John A Nungaray
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Joyce Sprock
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Mouna Attarha
- Department of R&D, Posit Science Corporation, San Francisco, CA, USA
| | - Bruno Biagianti
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Neal R Swerdlow
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Gregory A Light
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
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Fivel L, Mondino M, Brunelin J, Haesebaert F. Basic auditory processing and its relationship with symptoms in patients with schizophrenia: A systematic review. Psychiatry Res 2023; 323:115144. [PMID: 36940586 DOI: 10.1016/j.psychres.2023.115144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/09/2023] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
Processing of basic auditory features, one of the earliest stages of auditory perception, has been the focus of considerable investigations in schizophrenia. Although numerous studies have shown abnormalities in pitch perception in schizophrenia, other basic auditory features such as intensity, duration, and sound localization have been less explored. Additionally, the relationship between basic auditory features and symptom severity shows inconsistent results, preventing concrete conclusions. Our aim was to present a comprehensive overview of basic auditory processing in schizophrenia and its relationship with symptoms. We conducted a systematic review according to the PRISMA guidelines. PubMed, Embase, and PsycINFO databases were searched for studies exploring auditory perception in schizophrenia compared to controls, with at least one behavioral task investigating basic auditory processing using pure tones. Forty-one studies were included. The majority investigated pitch processing while the others investigated intensity, duration and sound localization. The results revealed that patients have a significant deficit in the processing of all basic auditory features. Although the search for a relationship with symptoms was limited, auditory hallucinations experience appears to have an impact on basic auditory processing. Further research may examine correlations with clinical symptoms to explore the performance of patient subgroups and possibly implement remediation strategies.
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Affiliation(s)
- Laure Fivel
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France
| | - Marine Mondino
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France.
| | - Jerome Brunelin
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France
| | - Frédéric Haesebaert
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, PSYR2, Bron F-69500, France; Centre Hospitalier Le Vinatier, 95 Boulevard Pinel, Bron F-69500, France
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Swerdlow NR, Bhakta SG, Talledo J, Benster L, Kotz J, Vinogradov S, Molina JL, Light GA. Auditory discrimination and frequency modulation learning in schizophrenia patients: amphetamine within-subject dose response and time course. Psychol Med 2023; 53:140-148. [PMID: 33849683 PMCID: PMC8514598 DOI: 10.1017/s0033291721001239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/11/2021] [Accepted: 03/17/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Auditory frequency modulation learning ('auditory learning') is a key component of targeted cognitive training (TCT) for schizophrenia. TCT can be effective in enhancing neurocognition and function in schizophrenia, but such gains require significant time and effort and elude many patients. METHODS As a strategy to increase and/or accelerate TCT-induced clinical gains, we tested the dose- and time-course effects of the pro-attentional drug, amphetamine (AMPH; placebo, 2.5, 5 or 10 mg po; within-subject double-blind, order balanced) on auditory learning in schizophrenia patients [n = 32; M:F = 19:13; age 42.0 years (24-55)]. To understand predictors and/or mechanisms of AMPH-enhanced TCT, we also measured auditory fidelity (words-in-noise (WIN), quick speech-in-noise (QuickSIN)) and neurocognition (MATRICS comprehensive cognitive battery (MCCB)). Some measures were also acquired from age-matched healthy subjects (drug free; n = 10; M:F = 5:5). RESULTS Patients exhibited expected deficits in neurocognition. WIN and QuickSIN performance at low signal intensities was impaired in patients with low v. high MCCB attention/vigilance (A/V) scores; these deficits were corrected by AMPH, maximally at 2.5-5 mg (d's = 0.79-1.29). AMPH also enhanced auditory learning, with maximal effects at 5 mg (d = 0.93), and comparable effects 60 and 210 min post pill. 'Pro-learning' effects of AMPH and AMPH-induced gains in auditory fidelity were most evident in patients with low MCCB A/V scores. CONCLUSIONS These findings advance our understanding of the impact of pro-attentional interventions on auditory information processing and suggest dose- and time-course parameters for studies that assess the ability of AMPH to enhance the clinical benefits of TCT in schizophrenia patients.
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Affiliation(s)
- Neal R. Swerdlow
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Savita G. Bhakta
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Jo Talledo
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Lindsay Benster
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Juliana Kotz
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Sophia Vinogradov
- Department of Psychiatry, School of Medicine, University of Minnesota, USA
| | - Juan L. Molina
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
| | - Gregory A. Light
- Department of Psychiatry, School of Medicine, University of California, San Diego, USA
- VISN-22 Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
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de Bustamante Simas ML, Dos Santos NRM, Lacerda AM. Auditory perceptual discomfort and low-hearing tolerance in the first episode psychosis. PSICOLOGIA, REFLEXAO E CRITICA : REVISTA SEMESTRAL DO DEPARTAMENTO DE PSICOLOGIA DA UFRGS 2022; 35:20. [PMID: 35819653 PMCID: PMC9276868 DOI: 10.1186/s41155-022-00224-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/10/2022] [Indexed: 11/10/2022]
Abstract
Awareness of perceptual and sensory changes that might occur in visual, auditory, proprioception, and other senses, in the early stages towards the First Episode Psychosis (FEP), and their subsequent sensorial evolution as the disturb progresses deeper into an acute episode, might be a key element for interrupting the process. In the present study, we investigated hearing discomfort/tolerance to 16 given sound streams. Sixteen people diagnosed with FEP, participated in the experiment. Sixteen frequency sweeps varying in modulation envelopes (sawtooth, sine), order (ascending, descending), duration (4s, 8s), and range (50–8000 Hz, 2–8 kHz) were presented randomly, but always in the same sequence, to FEP and healthy controls (HC). The level of discomfort was estimated by the participant by making a mark across a continuous line whose extremes read “nothing bad” (left) and “too bad” (right). Results showed that ascending sine pure frequency sweeps (p < 0.01) and descending sine pure frequencies sweeps (p < 0.01) caused the maximum discomfort in FEP. Other variables also showed differences between FEP and HC, and FEP were always more intolerant to such pure frequency sweeps than HC. We conclude that this might be useful for very early assessment of people at risk, people with FEP, and people with schizophrenia.
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Affiliation(s)
- Maria Lúcia de Bustamante Simas
- Laboratório de Percepção Visual, Programa da Pós Graduação em Psicologia, Departamento de Psicologia, Centro de Filosofia e Ciências Humanas, Universidade Federal de Pernambuco, Av da Arquitetura s/n CFCH 9º Andar, Recife, PE, CEP.: 50740-550, Brasil.
| | - Naianna Ribeiro Mocelin Dos Santos
- Laboratório de Percepção Visual, Programa da Pós Graduação em Psicologia, Departamento de Psicologia, Centro de Filosofia e Ciências Humanas, Universidade Federal de Pernambuco, Av da Arquitetura s/n CFCH 9º Andar, Recife, PE, CEP.: 50740-550, Brasil
| | - Aline Mendes Lacerda
- Laboratório de Percepção Visual, Programa da Pós Graduação em Psicologia, Departamento de Psicologia, Centro de Filosofia e Ciências Humanas, Universidade Federal de Pernambuco, Av da Arquitetura s/n CFCH 9º Andar, Recife, PE, CEP.: 50740-550, Brasil
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Psychologically Informed Practice in Audiological Rehabilitation: Audiologist Perceived Barriers, Facilitators, and Preparedness. Ear Hear 2022; 43:1853-1865. [DOI: 10.1097/aud.0000000000001257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Central auditory processing deficits in schizophrenia: Effects of auditory-based cognitive training. Schizophr Res 2021; 236:135-141. [PMID: 34500174 PMCID: PMC9259506 DOI: 10.1016/j.schres.2021.07.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/23/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sensory processing abnormalities are common in schizophrenia (SZ) and impact everyday functions, such as speech perception in noisy environments. Auditory-based targeted cognitive training (TCT) is a "bottom up" cognitive remediation intervention designed to enhance the speed and accuracy of low-level auditory information processing. However, the effects of TCT on behavioral measures of central auditory processing (CAP) and the role of CAP function on verbal learning outcomes in SZ are unknown. METHODS SZ (n = 42) and healthy subjects (CTL; n = 18) underwent comprehensive clinical, neurocognitive, and auditory assessments, including tests of hearing sensitivity and speech recognition (Words-in-Noise (WIN), Quick Speech-in-Noise (SIN)). SZ patients were randomized to receive either treatment-as-usual (TAU); or 30-h of TCT + TAU using a stratified, parallel design. SZ patients repeated assessments ~10-12 weeks later. RESULTS Patients exhibited deficits in both WIN (p < 0.05, d = 0.50) and SIN (p < 0.01, d = 0.63). A treatment × time interaction on WIN (p < 0.05, d = 0.74), but not SIN discriminability, was seen in the TCT group relative to TAU. Specific enhancements in the 4-dB over background range drove gains in WIN performance. Moreover, SZ patients with greater CAP deficits experienced robust gains in verbal learning after 30-h of TCT relative to SZ patients without CAP impairment (p < 0.01, d = 1.28). CONCLUSION Findings demonstrate that intensive auditory training enhances the fidelity of auditory processing and perception, such that specific CAP deficits were 'normalized' and were predictive of gains in verbal learning after TCT. It is conceivable that patients with deficiencies in CAP measures may benefit most from TCT and other interventions targeting auditory dysfunction in SZ.
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Implications for Early Diagnosis and Treatment in Schizophrenia Due to Correlation between Auditory Perceptual Deficits and Cognitive Impairment. J Clin Med 2021; 10:jcm10194557. [PMID: 34640571 PMCID: PMC8509531 DOI: 10.3390/jcm10194557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
It is indicated that auditory perception deficits are present in schizophrenia and related to formal thought disorder. The purpose of the present study was to investigate the association of auditory deficits with cognitive impairment in schizophrenia. An experimental group of 50 schizophrenia patients completed a battery of auditory processing evaluation and a neuropsychological battery of tests. Correlations between neuropsychological battery scores and auditory processing scores were examined. Cognitive impairment was correlated with auditory processing deficits in schizophrenia patients. All neuropsychological test scores were significantly correlated with at least one auditory processing test score. Our findings support the coexistence of auditory processing disorder, severe cognitive impairment, and formal thought disorder in a subgroup of schizophrenia patients. This may have important implications in schizophrenia research, as well as in early diagnosis and nonpharmacological treatment of the disorder.
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Musiek FE, Morris S, Ichiba K, Clark L, Davidson AJ. Auditory Hallucinations: An Audiological Horizon? J Am Acad Audiol 2021; 32:195-210. [PMID: 34062609 DOI: 10.1055/s-0041-1722989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Interesting data and theories have emerged regarding auditory hallucinations (AHs) in patients with schizophrenia. The possibility that these patients may have changes in the anatomy of the auditory cortex and/or subcortical structures of the central auditory nervous system and present with deficits on audiological tests is important information to the audiology community. However, it seems clear that, in general, audiologists are not sufficiently aware of these findings. PURPOSE There are two main purposes of this article: (1) to educate audiologists about AHs related to schizophrenia and related issues, and (2) to encourage audiologists and hearing scientists to become involved in the evaluation and research of AHs. This fascinating disorder is one in which audiologists/hearing scientists are well suited to make a significant contribution. RESEARCH DESIGN A review and synthesis of the literature was conducted. Relevant literature was identified through PubMed, Google Scholar, as well as independent book chapters and article searches. Keywords driving the searches were AHs, auditory illusions, verbal and musical hallucinations, schizophrenia, and central auditory disorders. Given the currency of the topic, the information collected was primarily between 1990 and 2020. STUDY SAMPLE The review is organized around categorization, prevalence, models, mechanisms, anatomy, pathophysiology, and audiological correlates related to AHs. DATA COLLECTION AND ANALYSIS Searches were conducted using well-known search engines and manual searches by each author. This information on AHs was then analyzed collectively by the authors for useful background and relevance, as well as important for the field of audiology. RESULTS Several anatomical, physiological, and functional imaging studies have shown compromise of the auditory cortex in those with schizophrenia and AHs. Potentially related to this, are studies that demonstrated sub-par performance on behavioral audiologic measures for this unique clinical population. These findings align well with the kind of hearing disorder for which audiologists are well-trained to make significant contributions. CONCLUSION Neurobiological and audiological evidence is accumulating on patients with schizophrenia and AH potentially rendering it as both an auditory and psychiatric disorder. Audiologists should consider expanding their horizon and playing a role in the clinical investigation of this disorder.
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Affiliation(s)
- Frank E Musiek
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, Arizona
| | - Sarah Morris
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, Arizona
| | - Kayla Ichiba
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, Arizona
| | - Liza Clark
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson, Arizona
| | - Alyssa J Davidson
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
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Koerner TK, A. Papesh M, Gallun FJ. A Questionnaire Survey of Current Rehabilitation Practices for Adults With Normal Hearing Sensitivity Who Experience Auditory Difficulties. Am J Audiol 2020; 29:738-761. [PMID: 32966118 DOI: 10.1044/2020_aja-20-00027] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Purpose A questionnaire survey was conducted to collect information from clinical audiologists about rehabilitation options for adult patients who report significant auditory difficulties despite having normal or near-normal hearing sensitivity. This work aimed to provide more information about what audiologists are currently doing in the clinic to manage auditory difficulties in this patient population and their views on the efficacy of recommended rehabilitation methods. Method A questionnaire survey containing multiple-choice and open-ended questions was developed and disseminated online. Invitations to participate were delivered via e-mail listservs and through business cards provided at annual audiology conferences. All responses were anonymous at the time of data collection. Results Responses were collected from 209 participants. The majority of participants reported seeing at least one normal-hearing patient per month who reported significant communication difficulties. However, few respondents indicated that their location had specific protocols for the treatment of these patients. Counseling was reported as the most frequent rehabilitation method, but results revealed that audiologists across various work settings are also successfully starting to fit patients with mild-gain hearing aids. Responses indicated that patient compliance with computer-based auditory training methods was regarded as low, with patients generally preferring device-based rehabilitation options. Conclusions Results from this questionnaire survey strongly suggest that audiologists frequently see normal-hearing patients who report auditory difficulties, but that few clinicians are equipped with established protocols for diagnosis and management. While many feel that mild-gain hearing aids provide considerable benefit for these patients, very little research has been conducted to date to support the use of hearing aids or other rehabilitation options for this unique patient population. This study reveals the critical need for additional research to establish evidence-based practice guidelines that will empower clinicians to provide a high level of clinical care and effective rehabilitation strategies to these patients.
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Affiliation(s)
- Tess K. Koerner
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
| | - Melissa A. Papesh
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Frederick J. Gallun
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland
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Swerdlow NR, Bhakta SG, Talledo J, Kotz J, Roberts BZ, Clifford RE, Thomas ML, Joshi YB, Molina JL, Light GA. Memantine effects on auditory discrimination and training in schizophrenia patients. Neuropsychopharmacology 2020; 45:2180-2188. [PMID: 32961542 PMCID: PMC7784956 DOI: 10.1038/s41386-020-00865-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 12/16/2022]
Abstract
The uncompetitive low-affinity NMDA receptor antagonist, memantine, acutely increases electrophysiological measures of auditory information processing in both healthy subjects (HS) and patients with schizophrenia. Memantine effects on functional measures of auditory discrimination performance and learning are not known; conceivably, beneficial effects on these measures might suggest a role for memantine in augmenting the cognitive and functional impact of auditory targeted cognitive training (TCT). Here, carefully characterized HS (n = 20) and schizophrenia patients (n = 22) were tested in measures of auditory discrimination performance (words-in-noise (WIN), quick speech-in-noise (QuickSIN), gaps-in-noise) and auditory frequency modulation learning (a component of TCT) on 2 days about a week apart, after ingesting either placebo or 20 mg memantine po, in a double-blind, within-subject cross-over random order design. Memantine modestly enhanced functional measures of auditory discrimination in both schizophrenia patients (WIN) and HS (WIN and QuickSIN), as well as auditory frequency modulation learning in schizophrenia patients. These findings converge with a growing literature showing that memantine can enhance a range of metrics of auditory function. These properties could contribute to the apparent benefits of memantine as an adjunctive treatment in schizophrenia, and suggest that memantine might augment learning and potentially clinical gains from auditory-based TCT.
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Affiliation(s)
- Neal R. Swerdlow
- grid.266100.30000 0001 2107 4242Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA
| | - Savita G. Bhakta
- grid.266100.30000 0001 2107 4242Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA
| | - Jo Talledo
- grid.266100.30000 0001 2107 4242Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA
| | - Juliana Kotz
- grid.266100.30000 0001 2107 4242Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA
| | - Benjamin Z. Roberts
- grid.266100.30000 0001 2107 4242Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA
| | - Royce Ellen Clifford
- grid.266100.30000 0001 2107 4242Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA
| | - Michael L. Thomas
- grid.47894.360000 0004 1936 8083Department of Psychology, Colorado State University, Fort Collins, CO USA
| | - Yash B. Joshi
- grid.266100.30000 0001 2107 4242Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA ,grid.410371.00000 0004 0419 2708VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA USA
| | - Juan L. Molina
- grid.266100.30000 0001 2107 4242Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA
| | - Gregory A. Light
- grid.266100.30000 0001 2107 4242Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, CA USA ,grid.410371.00000 0004 0419 2708VISN-22 Mental Illness, Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA USA
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Moschopoulos N, Nimatoudis I, Kaprinis S, Sidiras C, Iliadou V. Auditory processing disorder may be present in schizophrenia and it is highly correlated with formal thought disorder. Psychiatry Res 2020; 291:113222. [PMID: 32562936 DOI: 10.1016/j.psychres.2020.113222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 12/17/2022]
Abstract
The present study investigates the presence of Auditory Processing Disorder (APD) in schizophrenia and its association with symptomatology, especially Formal Thought Disorder (FTD). 50 patients with schizophrenia and 25 matched healthy controls completed a battery of three auditory processing tests. Positive and Negative Syndrome Scale (PANSS) and Thought, Language and Communication (TLC) scale were used to assess clinical symptoms. The patient group was divided into two subgroups, according to FTD severity. Auditory processing performance of the control group and the patient group was evaluated. Correlations between auditory processing scores and TLC scores, as well as auditory processing scores and PANSS scores were examined. Most of the patients, especially those with FTD, had auditory deficits that can be classified as APD. Patients showed impaired performance compared to controls in all tests. Total severity and specific factors of FTD, as well as other clinical symptoms and symptom categories were correlated with auditory processing performance. We provided evidence that APD may be present in schizophrenia and that FTD, as well as other clinical symptoms are associated with auditory processing deficits. There are important clinical implications for non-pharmacological interventions and early diagnosis of schizophrenia.
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Affiliation(s)
- Nikolaos Moschopoulos
- Clinical Psychoacoustics Lab, 3rd Psychiatry Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Ioannis Nimatoudis
- Clinical Psychoacoustics Lab, 3rd Psychiatry Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stergios Kaprinis
- 2nd Psychiatry Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Sidiras
- Clinical Psychoacoustics Lab, 3rd Psychiatry Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki Iliadou
- Clinical Psychoacoustics Lab, 3rd Psychiatry Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Moschopoulos NP, Nimatoudis I, Kaprinis S, Iliadou V. Behavioral assessment of auditory processing deficits in schizophrenia: Literature review and suggestions for future research. Scand J Psychol 2018; 60:116-127. [DOI: 10.1111/sjop.12514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/12/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Nikolaos P. Moschopoulos
- Clinical Psychoacoustics Lab; 3rd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Ioannis Nimatoudis
- Clinical Psychoacoustics Lab; 3rd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Stergios Kaprinis
- 2nd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Vasiliki Iliadou
- Clinical Psychoacoustics Lab; 3rd Psychiatry Department; Aristotle University of Thessaloniki; Thessaloniki Greece
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Iliadou VV, Weihing J, Chermak GD, Bamiou DE. Otoacoustic emission suppression in children diagnosed with central auditory processing disorder and speech in noise perception deficits. Int J Pediatr Otorhinolaryngol 2018; 111:39-46. [PMID: 29958612 DOI: 10.1016/j.ijporl.2018.05.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/21/2018] [Accepted: 05/22/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The present study was designed to test the hypothesis that medial olivocochlear system functionality is associated with speech recognition in babble performance in children diagnosed with central auditory processing disorder. METHOD Children diagnosed with central auditory processing disorder who specifically demonstrated speech in noise deficits were compared to children diagnosed with central auditory processing disorder without these deficits. Suppression effects were examined across 15 time intervals to examine variability. Analysis of right and left ear suppression was performed separately to evaluate laterality. STUDY SAMPLE 52 children diagnosed with central auditory processing disorder, aged 6-14 years were divided into normal or abnormal groups based on SinB performance in each ear. Cut-off value was set at SNR = 1.33 dB. Transient otoacoustic emissions suppression was measured. RESULTS The abnormal Speech in Babble Right Ear group showed significant negative correlations with suppression levels for 7 of the 15 time intervals measured. No significant correlations with SinBR performance were observed for the remaining time intervals, as was the case for the typically evaluated R8-18 time interval and the Speech in Babble Left Ear. CONCLUSIONS Results indicate that suppression is influenced by the time window analysed, and ear tested, and is associated with speech recognition in babble performance in children with central auditory processing disorder.
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Affiliation(s)
| | - Jeffrey Weihing
- Department of Otolaryngology - Head and Neck Surgery - and Communicative Disorders, University of Louisville, Louisville, KY, United States
| | - Gail D Chermak
- Department of Speech and Hearing Sciences, Elson S. Floyd College of Medicine, Washington State University Health Sciences, Spokane, WA, United States
| | - Doris Eva Bamiou
- Neuro-Otology Department, University College London Hospitals NHS Trust, United Kingdom; University College London Ear Institute, United Kingdom
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Aase I, Kompus K, Gisselgård J, Joa I, Johannessen JO, Brønnick K. Language Lateralization and Auditory Attention Impairment in Young Adults at Ultra-High Risk for Psychosis: A Dichotic Listening Study. Front Psychol 2018; 9:608. [PMID: 29755393 PMCID: PMC5934990 DOI: 10.3389/fpsyg.2018.00608] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 04/10/2018] [Indexed: 12/11/2022] Open
Abstract
Objectives: Impaired attention and language functions are common in psychosis, but have been less explored in subjects with ultra-high risk for psychosis (UHR). The aim of the study was to investigate differences in language lateralization and auditory attention in UHR subjects compared to healthy controls with a dichotic listening paradigm. In addition, symptoms from The Structural Interview for Prodromal Syndromes (SIPS) were explored in relation to performance on dichotic listening. Methods: The UHR subjects (n = 46, female = 28, mean age = 17.9) were compared to a group of healthy controls (n = 40, female = 20, mean age = 16.8). A split-plot repeated measures analysis of covariance was conducted with group as between-subjects factor and attention conditions (non-forced, forced-right, forced-left) and side (right ear, left ear) as repeated measures factors (2×3×2 design) using gender, age and handedness as covariates. SIPS symptoms were subjected to Spearman’s r correlations with laterality indexes and attentional gain in each ear. Results: There was a statistically significant three-way interaction of group (UHR, healthy controls) × forced condition (non-forced, forced-right, forced-left) × side (right ear, left ear), p = 0.048. The effect was due to an interaction between group × side in the forced-left condition. There were no significant differences between UHR subjects and healthy controls in the non-forced condition. Right ear gain correlated with “Perceptual abnormalities/Hallucinations” (P4), r = 0.486, p = 0.001. Conclusion: UHR subjects demonstrated impairment in top-down attentional mechanisms, but showed no language lateralization abnormalities. Impairment in top-down attentional mechanisms are frequently reported from dichotic listening studies in patients with schizophrenia. Higher levels of perceptual abnormalities and hallucinatory experiences were associated with enhanced report from the right ear in the forced-right condition.
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Affiliation(s)
- Ingvild Aase
- Centre for Clinical Research in Psychosis (TIPS), Stavanger University Hospital, Stavanger, Norway.,Institute of Health, Faculty of Social Science, University of Stavanger, Stavanger, Norway
| | - Kristiina Kompus
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jens Gisselgård
- Centre for Clinical Research in Psychosis (TIPS), Stavanger University Hospital, Stavanger, Norway
| | - Inge Joa
- Centre for Clinical Research in Psychosis (TIPS), Stavanger University Hospital, Stavanger, Norway.,Institute of Health, Faculty of Social Science, University of Stavanger, Stavanger, Norway
| | - Jan O Johannessen
- Centre for Clinical Research in Psychosis (TIPS), Stavanger University Hospital, Stavanger, Norway.,Institute of Health, Faculty of Social Science, University of Stavanger, Stavanger, Norway
| | - Kolbjørn Brønnick
- Centre for Clinical Research in Psychosis (TIPS), Stavanger University Hospital, Stavanger, Norway.,Institute of Health, Faculty of Social Science, University of Stavanger, Stavanger, Norway
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Abdul Wahab NA, Zakaria MN, Abdul Rahman AH, Sidek D, Wahab S. Listening to Sentences in Noise: Revealing Binaural Hearing Challenges in Patients with Schizophrenia. Psychiatry Investig 2017; 14:786-794. [PMID: 29209382 PMCID: PMC5714720 DOI: 10.4306/pi.2017.14.6.786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 12/23/2016] [Accepted: 03/19/2017] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE The present, case-control, study investigates binaural hearing performance in schizophrenia patients towards sentences presented in quiet and noise. METHODS Participants were twenty-one healthy controls and sixteen schizophrenia patients with normal peripheral auditory functions. The binaural hearing was examined in four listening conditions by using the Malay version of hearing in noise test. The syntactically and semantically correct sentences were presented via headphones to the randomly selected subjects. In each condition, the adaptively obtained reception thresholds for speech (RTS) were used to determine RTS noise composite and spatial release from masking. RESULTS Schizophrenia patients demonstrated significantly higher mean RTS value relative to healthy controls (p=0.018). The large effect size found in three listening conditions, i.e., in quiet (d=1.07), noise right (d=0.88) and noise composite (d=0.90) indicates statistically significant difference between the groups. However, noise front and noise left conditions show medium (d=0.61) and small (d=0.50) effect size respectively. No statistical difference between groups was noted in regards to spatial release from masking on right (p=0.305) and left (p=0.970) ear. CONCLUSION The present findings suggest an abnormal unilateral auditory processing in central auditory pathway in schizophrenia patients. Future studies to explore the role of binaural and spatial auditory processing were recommended.
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Affiliation(s)
- Noor Alaudin Abdul Wahab
- Audiology Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Audiology Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd. Normani Zakaria
- Audiology Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Abdul Hamid Abdul Rahman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Dinsuhaimi Sidek
- Department of Otorhinolaryngology, School of Medicine, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Suzaily Wahab
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Chermak GD, Bamiou DE, Vivian Iliadou V, Musiek FE. Practical guidelines to minimise language and cognitive confounds in the diagnosis of CAPD: a brief tutorial. Int J Audiol 2017. [PMID: 28635503 DOI: 10.1080/14992027.2017.1284351] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To provide audiologists with strategies to minimise confounding cognitive and language processing variables and accurately diagnose central auditory processing disorder (CAPD). DESIGN Tutorial. STUDY SAMPLE None. RESULTS Strategies are reviewed to minimise confounding cognitive and language processing variables and accurately diagnose CAPD. CONCLUSIONS Differential diagnosis is exceedingly important and can be quite challenging. Distinguishing between two or more conditions presenting with similar symptoms or attributes requires multidisciplinary, comprehensive assessment. To ensure appropriate interventions, the audiologist is a member of the multidisciplinary team responsible for determining whether there is an auditory component to other presenting deficits or whether one condition is responsible for the symptoms seen in another. Choice of tests should be guided both by the symptoms of the affected individual, as established in an in-depth interview and case history, the individual's age and primary language, and by the specific deficits reported to be associated with specific clinical presentations. Knowing which tests are available, their strengths and limitations, the processes assessed, task and response requirements, and the areas of the central auditory nervous system (CANS) to which each test is most sensitive provides the audiologist with critical information to assist in the differential diagnostic process.
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Affiliation(s)
- Gail D Chermak
- a Department of Speech and Hearing Sciences, Elson S. Floyd College of Medicine , Washington State University Health Sciences Spokane , Spokane , WA , USA
| | | | - Vasiliki Vivian Iliadou
- c Clinical Psychoacoustics Lab, 3rd Psychiatric Department , Neuroscience Sector, Medical School, Aristotle University of Thessaloniki , Thessaloniki , Greece , and
| | - Frank E Musiek
- d Neuroaudiology Lab , University of Arizona , Tucson , AZ , USA
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Abdul Wahab NA, Wahab S, Abdul Rahman AH, Sidek D, Zakaria MN. The Hyperactivity of Efferent Auditory System in Patients with Schizophrenia: A Transient Evoked Otoacoustic Emissions Study. Psychiatry Investig 2016; 13:82-8. [PMID: 26766950 PMCID: PMC4701690 DOI: 10.4306/pi.2016.13.1.82] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/18/2015] [Accepted: 05/30/2015] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Electrophysiological studies, which are mostly focused on afferent pathway, have proven that auditory processing deficits exist in patients with schizophrenia. Nevertheless, reports on the suppressive effect of efferent auditory pathway on cochlear outer hair cells among schizophrenia patients are limited. The present, case-control, study examined the contralateral suppression of transient evoked otoacoustic emissions (TEOAEs) in patients with schizophrenia. METHODS Participants were twenty-three healthy controls and sixteen schizophrenia patients with normal hearing, middle ear and cochlear outer hair cells function. Absolute non-linear and linear TEOAEs were measured in both ears by delivering clicks stimuli at 80 dB SPL and 60 dB SPL respectively. Subsequently, contralateral suppression was determined by subtracting the absolute TEOAEs response obtained at 60 dBpe SPL during the absence and presence of contralateral white noise delivered at 65 dB HL. No attention tasks were conducted during measurements. RESULTS We found no significant difference in absolute TEOAEs responses at 80 dB SPL, in either diagnosis or ear groups (p>0.05). However, the overall contralateral suppression was significantly larger in schizophrenia patients (p<0.05). Specifically, patients with schizophrenia demonstrated significantly increased right ear contralateral suppression compared to healthy control (p<0.05). CONCLUSION The present findings suggest increased inhibitory effect of efferent auditory pathway especially on the right cochlear outer hair cells. Further studies to investigate increased suppressive effects are crucial to expand the current understanding of auditory hallucination mechanisms in schizophrenia patients.
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Affiliation(s)
- Noor Alaudin Abdul Wahab
- Audiology Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Audiology Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Wilayah Persekutuan, Malaysia
| | - Suzaily Wahab
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Wilayah Persekutuan, Malaysia
| | - Abdul Hamid Abdul Rahman
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Wilayah Persekutuan, Malaysia
| | - Dinsuhaimi Sidek
- Department of Otorhinolaryngology, School of Medicine, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohd. Normani Zakaria
- Audiology Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Iliadou VV, Bamiou DE, Chermak GD, Nimatoudis I. Comparison of two tests of auditory temporal resolution in children with central auditory processing disorder, adults with psychosis, and adult professional musicians. Int J Audiol 2014; 53:507-13. [PMID: 24801531 DOI: 10.3109/14992027.2014.900576] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Evaluate auditory temporal resolution threshold outcomes across three different populations. DESIGN Two commercially available tests of auditory gap detection (Random gap detection (RGDT) test, and Gaps-in-noise (GIN) test) were administered to all participants. STUDY SAMPLE Adult professional musicians (APM) (N = 11, age range 28-61 years); children with central auditory processing disorder (CAPD) (N = 22, age range 7.5-17 years); and first episode psychosis patients (FEP) (N = 17, age range 18-48 years). RESULTS It was not possible to calculate a threshold for the RGDT for 13 of 22 children with CAPD and for 7 of 17 adults with FEP due to response inconsistency. Analysis of variance (ANOVA) excluding cases that produced inconsistent RGDT results showed that only RGDT thresholds differed across groups (F = 8.73, p = 0.001). Three t-tests comparing test means within group revealed statistically significant differences between the gap detection thresholds obtained with the RGDT vs. the GIN for each group. No significant correlations were seen between RGDT and GIN. CONCLUSION Lower/better gap detection thresholds and smaller standard deviations were obtained using the GIN in all three groups. Lack of correlation between the two tests suggests that they may measure different processes.
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