Central auditory processing deficits in schizophrenia: Effects of auditory-based cognitive training.
Central auditory processing deficits in schizophrenia: Effects of auditory-based cognitive training.
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DOI：
10.1016/j.schres.2021.07.033
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发表时间：
2021-10
影响因子：
4.5
通讯作者：
Light, Gregory A.
中科院分区：
文献类型：
--
作者：
Molina, Juan L.;Joshi, Yash B.;Nungaray, John A.;Thomas, Michael L.;Sprock, Joyce;Clayson, Peter E.;Sanchez, Victoria A.;Attarha, Mouna;Biagianti, Bruno;Swerdlow, Neal R.;Light, Gregory A.
关键词：
感觉处理异常在精神分裂症（SZ）中很常见，并影响日常功能，例如在嘈杂环境中的言语感知。基于听觉的定向认知训练（TCT）是一种“自下而上”的认知补救干预，旨在提高低水平听觉信息处理的速度和准确性。然而，TCT对中枢听觉处理（CAP）的行为测量的影响以及CAP功能对SZ语言学习结果的作用尚不清楚。SZ（n=42）和健康受试者（CTL; n=18）进行了全面的临床，神经认知和听觉评估，包括听力灵敏度和语音识别测试（噪音中的单词（WIN），快速语音噪音（SIN））。SZ患者随机接受常规治疗（TAU）或30小时TCT + TAU，采用分层、平行设计。SZ患者在约10-12周后重复评估。患者在WIN（p<0.05，d=0.50）和SIN（p<0.01，d=0.63）中表现出CAP缺陷。相对于TAU，在TCT组中观察到治疗X时间对WIN的相互作用（p<0.05，d=0.74），但不是SIN辨别力。在背景范围内4 dB的具体增强推动了WIN性能的提高。基线CAP缺陷与TCT治疗30小时后语言学习能力的提高相关（p<0.01，d=1.28）。研究结果表明，密集的听觉训练提高了听觉处理和感知的保真度，使特定的CAP赤字“正常化”。此外，CAP赤字与语言学习的收益密切相关。可以想象，CAP措施不足的患者可能从TCT和其他针对SZ听觉功能障碍的干预措施中获益最多。
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. 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. Patients exhibited CAP deficits in WIN (p<0.05, d=0.50) and SIN (p<0.01, d=0.63). A treatment x 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. Baseline CAP deficits were associated with gains in verbal learning after 30-h of TCT (p<0.01, d=1.28). Findings demonstrate that intensive auditory training enhances the fidelity of auditory processing and perception, such that specific CAP deficits were ‘normalized’. Moreover, CAP deficits were robustly associated with verbal learning gains. 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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影响因子：
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