New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY, USA.
New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian, New York, NY, USA.
Psychiatry Res. 2023 May;323:115152. doi: 10.1016/j.psychres.2023.115152. Epub 2023 Mar 7.
Early auditory processing (EAP) deficits are prevalent in schizophrenia and linked to disturbances in higher order cognition and daily functioning. Treatments that target EAP have the potential to drive downstream cognitive and functional improvements, but clinically feasible means to detect EAP impairment are lacking. This report describes the clinical feasibility and utility of using the Tone Matching (TM) Test to assess EAP in adults with schizophrenia. Clinicians were trained to administer the TM Test as part of a baseline cognitive battery to inform choice of cognitive remediation (CR) exercises. Only if the TM Test indicated EAP impairment, were the recommended CR exercises to include EAP training. Results indicated clinicians included the TM Test in all baseline assessments and identified 51.72% as EAP impaired. There were significant positive relationships between TM Test performance and cognitive summary scores, confirming instrumental validity. All clinicians found the TM Test useful for CR treatment planning. CR participants with impaired EAP spent significantly more training time on EAP exercises compared to CR participants with intact EAP (20.11% vs 3.32%). This study found that it is feasible to use the TM Test in community clinics and the test was perceived as clinically useful for personalizing treatment.
早期听觉处理 (EAP) 缺陷在精神分裂症中很常见,与高级认知和日常功能障碍有关。针对 EAP 的治疗方法有可能促进下游认知和功能的改善,但缺乏临床上可行的方法来检测 EAP 损伤。本报告描述了使用音调匹配 (TM) 测试评估精神分裂症成人 EAP 的临床可行性和实用性。临床医生接受了 TM 测试的培训,作为基线认知测试的一部分,以选择认知矫正 (CR) 练习。只有 TM 测试表明存在 EAP 损伤,才会推荐包括 EAP 训练的推荐 CR 练习。结果表明,临床医生将 TM 测试纳入了所有基线评估中,并确定了 51.72%的 EAP 受损。TM 测试表现与认知综合评分之间存在显著的正相关关系,证实了仪器的有效性。所有临床医生都认为 TM 测试对 CR 治疗计划有用。EAP 受损的 CR 参与者在 EAP 练习上花费的训练时间明显多于 EAP 正常的 CR 参与者 (20.11%对 3.32%)。这项研究发现,在社区诊所使用 TM 测试是可行的,并且该测试被认为对个性化治疗具有临床实用性。