Mismatch Negativity and Ear Laterality in Alzheimer's Disease and in Mild Cognitive Impairment

The Importance of Subjective Cognitive Decline Recognition and the Potential of Molecular and Neurophysiological Biomarkers-A Systematic Review

Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are early stages of Alzheimer's disease (AD). Neurophysiological markers such as electroencephalography (EEG) and event-related potential (ERP) are emerging as alternatives to traditional molecular and imaging markers. This paper aimed to review the literature on EEG and ERP markers in individuals with SCD. We analysed 30 studies that met our criteria, with 17 focusing on resting-state or cognitive task EEG, 11 on ERPs, and two on both EEG and ERP parameters. Typical spectral changes were indicative of EEG rhythm slowing and were associated with faster clinical progression, lower education levels, and abnormal cerebrospinal fluid biomarkers profiles. Some studies found no difference in ERP components between SCD subjects, controls, or MCI, while others reported lower amplitudes in the SCD group compared to controls. Further research is needed to explore the prognostic value of EEG and ERP in relation to molecular markers in individuals with SCD.

Altered mismatch response of inferior parietal lobule in amnestic mild cognitive impairment: A magnetoencephalographic study

Background

Mismatch negativity (MMN) reflects the functional integrity of sensory memory function. With the advantages of independence of individual's focused attention and behavioral cooperation, this neurophysiological signal is particularly suitable for investigating elderly with cognitive decline such as amnestic mild cognitive impairment (aMCI). However, the existing results remain substantially inconsistent whether these patients show deficits of MMN. In order to reconcile the previous disputes, the present study used magnetoencephalography combined with distributed source imaging methods to determine the source‐level magnetic mismatch negativity (MMNm) in aMCI.

Methods

A total of 26 healthy controls (HC) and 26 patients with aMCI underwent an auditory oddball paradigm during the MEG recordings. MMNm amplitudes and latencies in the bilateral superior temporal gyrus, inferior frontal gyrus, and inferior parietal lobule (IPL) were compared between HC and aMCI groups. The correlations of MMNm responses with performance of auditory/verbal memory tests were examined. Finally, MMNm and its combination with verbal/auditory memory tests were submitted to receiver operating characteristic (ROC) curve analysis.

Results

Compared to HC, patients with aMCI showed significantly delayed MMNm latencies in the IPL. Among the patients with aMCI, longer MMNm latencies of left IPL were associated with lower scores of Chinese Version Verbal Learning Test (CVVLT). The ROC curve analysis revealed that the combination of MMNm latencies of left IPL and CVVLT scores yielded a moderate accuracy in the discrimination of aMCI from HC at an individual level.

Conclusions

Our data suggest dysfunctional MMNm in patients with aMCI, particularly in the IPL.

Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review

BACKGROUND

Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed.

OBJECTIVE

To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs.

METHODS

Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O'Malley's scoping review and appraisal process was followed.

RESULTS

There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs.

CONCLUSION

Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.

The Neuronal Basis of Predictive Coding Along the Auditory Pathway: From the Subcortical Roots to Cortical Deviance Detection

In this review, we attempt to integrate the empirical evidence regarding stimulus-specific adaptation (SSA) and mismatch negativity (MMN) under a predictive coding perspective (also known as Bayesian or hierarchical-inference model). We propose a renewed methodology for SSA study, which enables a further decomposition of deviance detection into repetition suppression and prediction error, thanks to the use of two controls previously introduced in MMN research: the many-standards and the cascade sequences. Focusing on data obtained with cellular recordings, we explain how deviance detection and prediction error are generated throughout hierarchical levels of processing, following two vectors of increasing computational complexity and abstraction along the auditory neuraxis: from subcortical toward cortical stations and from lemniscal toward nonlemniscal divisions. Then, we delve into the particular characteristics and contributions of subcortical and cortical structures to this generative mechanism of hierarchical inference, analyzing what is known about the role of neuromodulation and local microcircuitry in the emergence of mismatch signals. Finally, we describe how SSA and MMN are occurring at similar time frame and cortical locations, and both are affected by the manipulation of N-methyl- D-aspartate receptors. We conclude that there is enough empirical evidence to consider SSA and MMN, respectively, as the microscopic and macroscopic manifestations of the same physiological mechanism of deviance detection in the auditory cortex. Hence, the development of a common theoretical framework for SSA and MMN is all the more recommendable for future studies. In this regard, we suggest a shared nomenclature based on the predictive coding interpretation of deviance detection.