Trends in ototoxicity monitoring among cisplatin-treated patients with cancer.

PURPOSE: This study aims to characterize patterns in ototoxicity monitoring and identify potential barriers to audiologic follow-up. METHODS: We performed a single-institution retrospective cohort study on adult (≥ 18 years old) cancer patients treated with cisplatin from January 2014 to September 2021. Our primary outcomes were rates of baseline and post-treatment audiograms at the following time points: 3, 6, 12, and greater than 12 months. Time-to-event analyses were performed to describe additional insights to ototoxicity monitoring patterns. RESULTS: Nine hundred fifty-five patients with cancer were included for analysis. The most common primary cancer sites were head and neck (64%), followed by cervical (24%). Three hundred seventy-three patients (39%) underwent baseline audiometric assessment, 38 patients (4%) received audiologic evaluation during chemotherapy, and 346 patients (36%) obtained at least one post-treatment audiogram. Audiologic follow-up was greatest within 3 months of completing chemotherapy (26%), but this tapered dramatically to less than 10% at every other post-treatment time point. Patients with head and neck cancer achieved higher rates of audiologic follow-up at every time point than patients with non-head and neck cancer except for during treatment. CONCLUSIONS: Ototoxicity monitoring is an inconsistent practice, particularly during chemotherapy and for long-term surveillance of hearing loss. Patients with non-head and neck cancer may be at increased risk for loss of audiologic follow-up. IMPLICATIONS FOR CANCER SURVIVORS: Cisplatin ototoxicity is a common occurrence that can be effectively managed with auditory rehabilitation. Therefore, referrals to audiology and counseling on treatment-related ototoxicity are recommended throughout chemotherapy and cancer survivorship.

The temporal, spatial, and frequency dimensions of neural oscillations associated with verbal working memory.

Cognitive operations engage neural generators oscillating at different frequencies distributed in time and space. Accordingly, oscillatory activity detected by magnetoencephalography (MEG)/electroencephalography (EEG) should be analyzed along frequency, time, and spatial dimensions. MEG data were obtained from 19 healthy individuals while performing a modified Sternberg paradigm. The stimuli were letters, which constituted words or pronounceable nonwords. We applied tridimensional analysis of oscillations and also computed event-related fields (ERFs) in areas where significant changes in oscillatory activity were observed. Verbal working memory for visual verbal stimuli was associated with oscillatory interplay between the bilateral occipital lobes and the left frontoparietotemporal areas. Spatially stable occipital desynchrony was noted during information encoding, while a left hemisphere desynchronization, increasing in amplitude and spatial extent over time, was observed during information encoding and maintenance. No ERF changes were detected during information maintenance. Oscillatory activity associated with verbal working memory is consistent with the above hypothesis. These findings underscore the importance of multidimensional evaluation of oscillations. The findings also indicate that combining electrophysiological methods increase the chance of signal detection.

Evaluation of inner-outer space distinction and verbal hallucinations in schizophrenia.

INTRODUCTION: Verbal hallucinations could result from attributing one's own inner speech to another. Inner speech is usually experienced in inner space, whereas hallucinations are often experienced in outer space. To clarify this paradox, we investigated schizophrenia patients' ability to distinguish between speech experienced in inner space, and speech experienced in outer space. METHODS: 32 schizophrenia patients and 26 matched healthy controls underwent a two-stage experiment. First, they read sentences aloud or silently. Afterwards, they were required to distinguish between the sentences read aloud (experienced in outer space), the sentences read silently (experienced in inner space), and new sentences not previously read (no space coding). The sentences were in the first, second, or third person in equal proportions. Linear mixed models were used to investigate the effects of group, sentence location, pronoun, and hallucinations status. RESULTS: Schizophrenia patients were similar to controls in recognition capacity of sentences without space coding. They exhibited both inner-outer and outer-inner space confusion (they confused silently read sentences for sentences read aloud, and vice versa). Patients who experienced hallucinations inside their head were more likely to have outer-inner space bias. CONCLUSIONS: For speech generated by one's own brain, schizophrenia patients have bidirectional failure of inner-outer space distinction (inner-outer and outer-inner space biases); this might explain why hallucinations (abnormal inner speech) could be experienced in outer space. Furthermore, the direction of inner-outer space indistinction could determine the spatial location of the experienced hallucinations (inside or outside the head).

Neural oscillations associated with the primacy and recency effects of verbal working memory.

For sequential information, the first (primacy) and last (recency) items are better remembered than items in the middle of the sequence. The cognitive operations and neural correlates for the primacy and recency effects are unclear. In this paper, we investigate brain oscillations associated with these effects. MEG recordings were obtained on 19 subjects performing a modified Sternberg paradigm. Correlation analyses were performed between brain oscillatory activity and primacy and recency indices. Oscillatory activity during information maintenance, not encoding, was correlated with the primacy and recency effects. The primacy effect was associated with occipital post-desynchrony, and temporal post-synchrony. The recency effect was associated with parietal and temporal desynchrony. Differences were also observed according to the maintenance strategy. These data indicate that the primacy and recency effects are related to different neural, and likely cognitive, operations that are dependant on the strategy for information maintenance.

Classification of schizophrenia with spectro-temporo-spatial MEG patterns in working memory.

OBJECTIVE: To investigate whether temporo-spatial patterns of brain oscillations extracted from multichannel magnetoencephalogram (MEG) recordings in a working memory task can be used successfully as a biometric marker to discriminate between healthy control subjects and patients with schizophrenia. METHODS: Five letters appearing sequentially on a screen had to be memorized. The letters constituted a word in one condition and a pronounceable non-word in the other. Power changes of 248 channel MEG data were extracted in frequency sub-bands and a two-step filter and search algorithm was used to select informative features that discriminated patients and controls. RESULTS: The discrimination between patients and controls was greater in the word condition than in the non-word condition. Furthermore, in the word condition, the most discriminant patterns were extracted in delta (1-4 Hz), alpha (12-16 Hz) and beta (16-24 Hz) frequency bands. These features were located in the left dorso-frontal, occipital and left fronto-temporal, respectively. CONCLUSION: The analysis of the oscillatory patterns of MEG recordings in the working memory task provided a high level of correct classification of patients and controls. SIGNIFICANCE: We show, using a newly developed algorithm, that the temporo-spatial patterns of brain oscillations can be used as biometric marker that discriminate schizophrenia patients and healthy controls.

Temporospatial characterization of brain oscillations (TSCBO) associated with subprocesses of verbal working memory in schizophrenia.

The studies of the neural correlates of verbal working memory in schizophrenia are somewhat inconsistent. This could be related to experimental paradigms that engage differentially working memory components or methodological limitations in terms of characterization of brain activity. Magnetoencephalographic recordings were obtained on 10 schizophrenia patients and 11 healthy controls while performing a modified Sternberg paradigm to investigate subprocesses of verbal working memory. A new method for temporospatial characterization of brain oscillations was applied to whole head recordings and a 1-48 Hz frequency range. Patients differed from controls in event-related synchronization/desynchronization (ERS/ERD) patterns during the encode phase, the mid-maintain phase, and the end of the maintain phase. During the encode phase, patients did not show 1-4 Hz ERS in the left anterior frontal and left parietal lobes. In the mid-maintain phase, the left anterior frontal and left parietal lobes 1-4 Hz ERS, and the bilateral occipital lobes 8-32 Hz ERS were not observed in patients. At the end of the maintain phase, patients did not exhibit 12-48 Hz ERD in the left frontal and parietal lobes. The behavioral data showed reduced primacy effect In schizophrenia, the encode and maintain subprocesses were associated with less ERS and less ERD, respectively. These ERS/ERD abnormalities had specificity in terms of frequency and spatial location. Less ERD reflects reduced complexity of the neural activity, while reduced ERS reflects failure of the neural systems to resume idle state. The impaired primacy effect appears related to specific ERS/ERD patterns in the encode and maintain phases.

Empirical evaluation of language disorder in schizophrenia.

OBJECTIVE: Studies of the content of speech and of verbal hallucinations in schizophrenia point to dysfunction at multiple levels of language. In this study, we empirically evaluated language processes. METHODS: We examined the performance of 22 schizophrenia patients and 11 healthy control subjects with procedures designed to explore the sublexical, lexical, semantic, syntactic and discourse levels of language processing. RESULTS: Schizophrenia patients exhibit impairment in the recognition of incorrect, but not correct, linguistic stimuli at all but the sublexical level of language processing. The patients were not impaired in the recognition of nonlinguistic stimuli. CONCLUSION: This language-specific differential impairment could explain speech abnormalities in schizophrenia. The nonrecognition of incorrect linguistic information would prevent patients from correcting the abnormal speech they may occasionally produce. A model of decreased power of linguistic computations (reduced number of operations) adequately accounts for this differential impairment.

Computerized binary scale of auditory speech hallucinations (cbSASH).

BACKGROUND: Evidence indicates that the neuropathology of auditory verbal hallucinations (AVH) varies according to their phenomenological characteristics. Therefore, AVH should be subgrouped accordingly in hallucinations research. As evaluation of these characteristics depends entirely on the patient report, obtaining measurement of the reliability of these reports is crucial. METHOD: A computerized binary scale of auditory speech hallucinations (cbSASH) was developed to evaluate the phenomenology of AVH. It includes two subscales (inconsistency and malingering) to assess the reliability of the patient report. The cbSASH was administered along with MMPI-2, a general psychopathology scale, which includes similar validity subscales. Thirty-four psychotic patients with history of AVH were enrolled in this study. RESULTS: The scores on the inconsistency and malingering subscales of the cbSASH were correlated with the scores on the corresponding validity subscales in the MMPI-2. The combination of the malingering and inconsistency subscales provided robust measures of the reliability and ability of the patients' descriptions of their hallucinations. CONCLUSION: The cbSASH provides a reliable and comprehensive evaluation of the phenomenology of AVH. Consequently, it is possible to subgroup patients according to the characteristics of their hallucinations. This refinement of AVH phenotypes could reduce the noise and inconsistency noted in AVH and psychosis research.