Impact of baseline early auditory processing on response to cognitive remediation for schizophrenia

Medalia, Alice; Saperstein, Alice M.; Qian, Min; Javitt, Daniel C.

doi:10.1016/j.schres.2019.01.012

Cited by 32 publications

(19 citation statements)

References 33 publications

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“…Similarly, behaviourally defined EAP deficits have been shown to correlate significantly to deficits in auditory social cognition including AER and Sarcasm 13,15,32 . Most recently, it has been reported improvement in EAP during auditory training intercorrelates with improvement in Verbal Learning 33 or Attention/Vigilance 5 , consistent with results of this study.…”

Section: Discussionsupporting

confidence: 92%

Neural and functional correlates of impaired reading ability in schizophrenia

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Martı́nez

Sehatpour

et al. 2019

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Deficits in early auditory processing (EAP) are a core component of schizophrenia (SZ) and contribute significantly to impaired overall function. Here, we evaluate the potential contributions of EAP-related impairments in reading to functional capacity and outcome, relative to effects of auditory social cognitive and general neurocognitive dysfunction. Participants included 30-SZ and 28-controls of similar age, sex, and educational achievement. EAP was assessed using an auditory working memory (tone-matching) task. Phonological processing and reading Fluency were assessed using the Comprehensive Test of Phonological Processing and Woodcock-Johnson reading batteries, respectively. Auditory-related social cognition was assessed using measures of emotion/sarcasm recognition. Functional capacity and outcome were assessed using the UCSD Performance-based Skills Assessment and Specific Level of Functioning scale, respectively. fMRI resting-state functional-connectivity (rsFC) was used to evaluate potential underlying substrates. As predicted, SZ patients showed significant and interrelated deficits in both phonological processing (d = 0.74, p = 0.009) and reading fluency (d = 1.24, p < 0.00005). By contrast, single word reading (d = 0.35, p = 0.31) was intact. In SZ, deficits in EAP and phonological reading ability significantly predicted reduced functional capacity, but not functional outcome. By contrast, deficits in reading fluency significantly predicted impairments in both functional capacity and functional outcome. Moreover, deficits in reading fluency correlated with rsFC alterations among auditory thalamus, early auditory and auditory association regions. These findings indicate significant contributions of EAP deficits and functional connectivity changes in subcortical and early auditory regions to reductions in reading fluency, and of impaired reading ability to impaired functional outcome in SZ.

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Section: Discussionsupporting

confidence: 92%

Neural and functional correlates of impaired reading ability in schizophrenia

Dondé

Martı́nez

Sehatpour

et al. 2019

Sci Rep

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“…For example, in one study where EAP status was assessed before entering subjects into cognitive remediation, only SZ-EAP− subjects benefited significantly from auditory-based remediation. In these subjects, both EAP and verbal learning improved 49 . In parallel, in a recent study of transcranial direct current stimulation (tDCS) for auditory hallucinations, we observed significant benefit only in SZ-EAP+ patients 50 , suggesting that EAP− subjects may lack the functional substrates necessary for effective tDCS-based modulation of local connectivity.…”

Section: Discussionmentioning

confidence: 79%

Bimodal distribution of tone-matching deficits indicates discrete pathophysiological entities within the syndrome of schizophrenia

et al. 2019

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To date, no measures are available that permit differentiation of discrete, clinically distinct subtypes of schizophrenia (SZ) with potential differential underlying pathophysiologies. Over recent years, there has been increasing recognition that SZ is heterogeneously associated with deficits in early auditory processing (EAP), as demonstrated using clinically applicable tasks such as tone-matching task (TMT). Here, we pooled TMT performances across 310 SZ individuals and 219 healthy controls (HC), along with clinical, cognitive, and resting-state functional-connectivity MRI (rsFC-MRI) measures. In addition, TMT was measured in a group of 24 patients at symptomatic clinical high risk (CHR) for SZ and 24 age-matched HC (age range 7–27 years). We provide the first demonstration that the EAP deficits are bimodally distributed across SZ subjects ( P < 0.0001 vs. unimodal distribution), with one group showing entirely unimpaired TMT performance (SZ-EAP+), and a second showing an extremely large TMT impairment (SZ-EAP−), relative to both controls ( d = 2.1) and SZ-EAP+ patients ( d = 3.4). The SZ-EAP− group predominated among samples drawn from inpatient sites, showed higher levels of cognitive symptoms (PANSS), worse social cognition and a differential deficit in neurocognition (MATRICS battery), and reduced functional capacity. rsFC-MRI analyses showed significant reduction in SZ-EAP− relative to controls between subcortical and cortical auditory regions. As opposed to SZ, CHR patients showed intact EAP function. In HC age-matched to CHR, EAP ability was shown to increase across the age range of vulnerability preceding SZ onset. These results indicate that EAP measure segregates between discrete SZ subgroups. As TMT can be readily implemented within routine clinical settings, its use may be critical to account for the heterogeneity of clinical outcomes currently observed across SZ patients, as well as for pre-clinical detection and efficacious treatment selection.

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“…Improvements in higher order auditory processing gained through TCT in SZ are dependent on the severity of basic auditory deficits (150). Given that the MMN response to deviant sounds has also been shown to have a direct mediating effect on cognition and functional outcome in SZ patients (151), future research may want to examine the effects of pairing CBTv with TCT aimed at improving auditory discrimination as a potential optimal strategy that would benefit both AVH symptoms and cognitive and psychosocial functioning.…”

Section: Discussionmentioning

confidence: 99%

Change in the Neural Response to Auditory Deviance Following Cognitive Therapy for Hallucinations in Patients With Schizophrenia

et al. 2020

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Adjunctive psychotherapeutic approaches recommended for patients with schizophrenia (SZ) who are fully or partially resistant to pharmacotherapy have rarely utilized biomarkers to enhance the understanding of treatment-effective mechanisms. As SZ patients with persistent auditory verbal hallucinations (AVH) frequently evidence reduced neural responsiveness to external auditory stimulation, which may impact cognitive and functional outcomes, this study examined the effects of cognitive behavioral therapy for voices (CBTv) on clinical and AVH symptoms and the sensory processing of auditory deviants as measured with the electroencephalographically derived mismatch negativity (MMN) response. Twenty-four patients with SZ and AVH were randomly assigned to group CBTv treatment or a treatment as usual (TAU) condition. Patients in the group CBTv condition received treatment for 5 months while the matched control patients received TAU for the same period, followed by 5 months of group CBTv. Assessments were conducted at baseline and at the end of treatment. Although not showing consistent changes in the frequency of AVHs, CBTv (vs. TAU) improved patients' appraisal (p = 0.001) of and behavioral/emotional responses to AVHs, and increased both MMN generation (p = 0.001) and auditory cortex current density (p = 0.002) in response to tone pitch deviants. Improvements in AVH symptoms were correlated with change in pitch deviant MMN and current density in left primary auditory cortex. These findings of improved auditory information processing and symptom-response attributable to CBTv suggest potential clinical and functional benefits of psychotherapeutical approaches for patients with persistent AVHs.

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Impact of baseline early auditory processing on response to cognitive remediation for schizophrenia

Cited by 32 publications

References 33 publications

Neural and functional correlates of impaired reading ability in schizophrenia

Neural and functional correlates of impaired reading ability in schizophrenia

Bimodal distribution of tone-matching deficits indicates discrete pathophysiological entities within the syndrome of schizophrenia

Change in the Neural Response to Auditory Deviance Following Cognitive Therapy for Hallucinations in Patients With Schizophrenia

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