|
1
|
Wang J, He F, Shepherd DA, Li S, Lange K, Sung V, Morgan A, Kerr JA, Saffery R, Wake M. Polygenic Risk Scores and Hearing Loss Phenotypes in Children. JAMA Otolaryngol Head Neck Surg 2024:2825856. [PMID: 39509092 PMCID: PMC11544553 DOI: 10.1001/jamaoto.2024.3659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 08/30/2024] [Indexed: 11/15/2024]
Abstract
Importance Monogenic causes of childhood hearing loss are well established, as are polygenic risk contributions to age-related hearing loss. However, an untested possibility is that polygenic risk scores (PRS) also contribute to childhood hearing loss of all severities, alongside environmental and/or monogenic causes. Objective To examine the association between a PRS for adult hearing loss and childhood hearing loss phenotypes. Design, Setting, and Participants This cross-sectional study used a unique population-based dataset spanning normal hearing to profound loss, combining 2 contemporaneous population cohorts in Australia. This included the Child Health CheckPoint, a national population-based cross-sectional study nested within the Longitudinal Study of Australian Children, and the Victorian Childhood Hearing Longitudinal Databank (VicCHILD), a statewide population-based longitudinal data bank open to every child with congenital hearing loss in Victoria, Australia. The analysis took place from March to August 2023. Exposures Genotype data were generated from saliva- or blood-derived DNA using global single-nucleotide variations arrays. Based on genotype data, PRS was computed using published UK Biobank genome-wide association study results for self-reported hearing difficulty in individuals aged 40 to 69 years. Main Outcomes and Measures Hearing outcomes were classified by laterality (bilateral, unilateral), severity (mild, moderate, severe or worse) and types (sensorineural, conductive, mixed, auditory neuropathy, atresia). Analyses included multinominal logistic regressions of PRS with hearing outcomes. Results Overall, 1488 CheckPoint study children (49.8% boys, aged 11-12 years) and 527 VicCHILD study children (55.2% boys, aged 0-13 years) with hearing and genotype data were included. A 1-SD increment in PRS was associated with higher odds of mild (odds ratio [OR], 1.3; 95% CI, 1.0-1.6), moderate (OR, 5.1; 95% CI, 3.2-8.1), and severe or worse (OR, 5.3; 95% CI, 3.9-7.3) unilateral hearing loss compared with normal hearing. Similarly, the PRS was associated with increased odds of mild, moderate, and severe or worse bilateral hearing loss (per-SD ORs, 3.9-6.6) and all hearing loss types (per-SD ORs, 8.5-10.6). Conclusions and Relevance In this cross-sectional study, a PRS initially developed for adult hearing difficulty was associated with wide-ranging childhood hearing loss phenotypes, partly explaining hearing phenotype variations despite shared genetic and environmental factors (eg, preterm birth). Large-scale studies with objectively defined hearing phenotypes are crucial for refining PRS and predicting high-risk children.
Collapse
Affiliation(s)
- Jing Wang
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Fan He
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University
- Centre for Cancer Research, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Daisy A. Shepherd
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Shuai Li
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Katherine Lange
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Valerie Sung
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Community Child Health, Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Angela Morgan
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, Victoria, Australia
- Speech Pathology Department, Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Jessica A. Kerr
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard Saffery
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics & The Liggins Institute, The University of Auckland, Grafton, Auckland, New Zealand
| |
Collapse
|
|
2
|
Cavendish J, Goebel LJ. Musical Hallucinations in an Elderly Female With Hearing Loss. Cureus 2024; 16:e72992. [PMID: 39634986 PMCID: PMC11616730 DOI: 10.7759/cureus.72992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2024] [Indexed: 12/07/2024] Open
Abstract
Musical hallucinations (MH) are rare auditory phenomena in which patients perceive music without a known source. Risk factors for MH include hearing loss, older age, female gender, epilepsy, and certain medications. This case report details the presentation, diagnosis, and treatment of an 82-year-old woman who developed MH following the onset of hearing loss. Despite treatment attempts with gabapentin, quetiapine, and donepezil, the symptoms persisted, demonstrating the difficulty in treating this condition.
Collapse
Affiliation(s)
- Jacqueline Cavendish
- Internal Medicine, Joan C. Edwards School of Medicine at Marshall University, Huntington, USA
| | - Lynne J Goebel
- Internal Medicine and Geriatrics, Joan C. Edwards School of Medicine at Marshall University, Huntington, USA
| |
Collapse
|
|
3
|
Lian X, Song W, Si TM, Lian NZ. Classification of musical hallucinations and the characters along with neural-molecular mechanisms of musical hallucinations associated with psychiatric disorders. World J Psychiatry 2024; 14:1386-1396. [PMID: 39319238 PMCID: PMC11417650 DOI: 10.5498/wjp.v14.i9.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 08/15/2024] [Accepted: 08/22/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Musical hallucinations (MH) involve the false perception of music in the absence of external stimuli which links with different etiologies. The pathomechanisms of MH encompass various conditions. The etiological classification of MH is of particular importance and offers valuable insights to understand MH, and further to develop the effective treatment of MH. Over the recent decades, more MH cases have been reported, revealing newly identified medical and psychiatric causes of MH. Functional imaging studies reveal that MH activates a wide array of brain regions. An up-to-date analysis on MH, especially on MH comorbid psychiatric conditions is warranted. AIM To propose a new classification of MH; to study the age and gender differences of MH in mental disorders; and neuropathology of MH. METHODS Literatures searches were conducted using keywords such as "music hallucination," "music hallucination and mental illness," "music hallucination and gender difference," and "music hallucination and psychiatric disease" in the databases of PubMed, Google Scholar, and Web of Science. MH cases were collected and categorized based on their etiologies. The t-test and ANOVA were employed (P < 0.05) to compare the age differences of MH different etiological groups. Function neuroimaging studies of neural networks regulating MH and their possible molecular mechanisms were discussed. RESULTS Among the 357 yielded publications, 294 MH cases were collected. The average age of MH cases was 67.9 years, with a predominance of females (66.8% females vs 33.2% males). MH was classified into eight groups based on their etiological mechanisms. Statistical analysis of MH cases indicates varying associations with psychiatric diagnoses. CONCLUSION We carried out a more comprehensive review of MH studies. For the first time according to our knowledge, we demonstrated the psychiatric conditions linked and/or associated with MH from statistical, biological and molecular point of view.
Collapse
Affiliation(s)
- Xin Lian
- Department of Radiology and Biomedical Imaging, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China
| | - Wei Song
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton L8S 4L8, ON, Canada
| | - Tian-Mei Si
- Department of Psychopharmacology, Peking University Sixth Hospital, Beijing 100191, China
| | - Naomi Zheng Lian
- Department of Psychiatry, Hartford HealthCare, St Vincent’s Medical Center, Westport, CT 06088, United States
| |
Collapse
|
|
4
|
Wang J, Liu M, Sung V, Lycett K, Grobler A, Burgner D, Wong TY, Wake M. Associations of Retinal Vessel Caliber With Hearing Status in Childhood and Midlife: A Cross-Generational Population-Based Study. JAMA Otolaryngol Head Neck Surg 2021; 146:323-330. [PMID: 31999311 DOI: 10.1001/jamaoto.2019.4484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance Microvascular phenotypes, which can be assessed using retinal imaging, may be informative about the life course pathogenesis of hearing loss. Objective To investigate whether differences in retinal vessel caliber (specifically wider venules and narrower arterioles) are associated with hearing threshold and hearing loss in mid-childhood and midlife. Design, Setting, and Participants A population-based cross-sectional study (Child Health CheckPoint) was nested within the Longitudinal Study of Australian Children. A total of 1281 children and 1255 attending parents were assessed using retinal microvasculature and air conduction audiometry data at a main assessment center in 7 large cities in Australia. Main Outcomes and Measures Air conduction audiometry was used to calculate the high Fletcher index (mean threshold of 1, 2, and 4 kHz), and bilateral hearing loss was defined as a high Fletcher index greater than 15 dB hearing level in the better-hearing ear. Retinal arteriolar and venular caliber were measured from fundus photographs using validated computer-based software. Linear and logistic regression quantified the associations of retinal vessel caliber with hearing threshold and hearing loss, respectively. Results Of the 1281 included children (mean age, 11.4 years; 49.1% boys), the mean (SD) high Fletcher index was 7.9 (5.8) dB hearing level. Of the 1255 included adults (mean age, 43.8 years; 86.6% women), the mean (SD) high Fletcher index was 13.0 (6.8) dB hearing level; 109 of 1281 children (8.5%) and 328 of 1255 adults (26.1%) had hearing loss. In adults, each 1-SD (18.6-μm) wider retinal venular caliber (worse) was associated with higher (worse) hearing threshold at lower individual frequencies (eg, 2 kHz: β = 0.63; 95% CI, 0.10-1.17) and overall high Fletcher index (eg, 2 kHz: β = 0.52; 95% CI, 0.07-0.96), as well as a 1.20-fold (95% CI, 1.03-1.40) higher odds of hearing loss. In children, patterns of venular associations were similar but smaller and less certain. Narrower retinal arteriolar caliber (worse) was associated with a 1.16-fold (95% CI, 1.00-1.37) higher odds of hearing loss in adults (per 1-SD [14.0-μm] narrower arteriolar caliber) but not in children. Conclusions and Relevance Adverse retinal microvascular characteristics are associated with hearing loss by midlife, with venular associations possibly emerging by age 11 to 12 years. Microvascular health may contribute to the pathogenesis of hearing loss across the life course, warranting replication and mechanistic studies to inform causal inference and prevention efforts.
Collapse
Affiliation(s)
- Jing Wang
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Mengjiao Liu
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Valerie Sung
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Department of General Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Kate Lycett
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Centre for Social and Early Emotional Development, Deakin University, Melbourne, Victoria, Australia
| | - Anneke Grobler
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - David Burgner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Department of General Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-National University of Singapore Medical School, Singapore
| | - Melissa Wake
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
|
5
|
Spontaneous brain activity underlying auditory hallucinations in the hearing-impaired. Cortex 2021; 136:1-13. [PMID: 33450598 DOI: 10.1016/j.cortex.2020.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/09/2020] [Accepted: 12/05/2020] [Indexed: 11/22/2022]
Abstract
Auditory hallucinations, the perception of a sound without a corresponding source, are common in people with hearing impairment. Two forms can be distinguished: simple (i.e., tinnitus) and complex hallucinations (speech and music). Little is known about the precise mechanisms underlying these types of hallucinations. Here we tested the assumption that spontaneous activity in the auditory pathways, following deafferentation, underlies these hallucinations and is related to their phenomenology. By extracting (fractional) Amplitude of Low Frequency Fluctuation [(f)ALFF] scores from resting state fMRI of 18 hearing impaired patients with complex hallucinations (voices or music), 18 hearing impaired patients with simple hallucinations (tinnitus or murmuring), and 20 controls with normal hearing, we investigated differences in spontaneous brain activity between these groups. Spontaneous activity in the anterior and posterior cingulate cortex of hearing-impaired groups was significantly higher than in the controls. The group with complex hallucinations showed elevated activity in the bilateral temporal cortex including Wernicke's area, while spontaneous activity of the group with simple hallucinations was mainly located in the cerebellum. These results suggest a decrease in error monitoring in both hearing-impaired groups. Spontaneous activity of language-related areas only in complex hallucinations suggests that the manifestation of the spontaneous activity represents the phenomenology of the hallucination. The link between cerebellar activity and simple hallucinations, such as tinnitus, is new and may have consequences for treatment.
Collapse
|
|
6
|
Schutte MJL, Linszen MMJ, Marschall TM, Ffytche DH, Koops S, van Dellen E, Heringa SM, Slooter AJC, Teunisse R, van den Heuvel OA, Lemstra AW, Foncke EMJ, Slotema CW, de Jong J, Rossell SL, Sommer IEC. Hallucinations and other psychotic experiences across diagnoses: A comparison of phenomenological features. Psychiatry Res 2020; 292:113314. [PMID: 32731082 DOI: 10.1016/j.psychres.2020.113314] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/15/2020] [Accepted: 07/19/2020] [Indexed: 01/19/2023]
Abstract
Although psychotic experiences are prevalent across many psychiatric, neurological, and medical disorders, investigation of these symptoms has largely been restricted to diagnostic categories. This study aims to examine phenomenological similarities and differences across a range of diagnoses. We assessed frequency, severity and phenomenology of psychotic experiences in 350 outpatients including; participants with schizophrenia spectrum disorders, hearing impairment, Parkinson's disease, Lewy Body Dementia, Alzheimer's disease, visual impairment, posttraumatic stress disorder, borderline personality disorder, and participants with recent major surgery. Psychotic phenomena were explored between these groups using the Questionnaire for Psychotic Experiences (QPE). Participants with major psychiatric disorders reported a combination of several psychotic experiences, and more severe experiences compared to all other disorders. Participants with recent major surgery or visual impairment experienced isolated visual hallucinations. Participants with hearing impairment reported isolated auditory hallucinations, whereas the neurodegenerative disorders reported visual hallucinations, occasionally in combination with hallucinations in another modality or delusions. The phenomenology between neurodegenerative disorders, and within major psychiatric disorders showed many similarities. Our findings indicate that the phenomenology of psychotic experiences is not diagnosis specific, but may rather point to the existence of various subtypes across diagnoses. These subtypes could have a different underlying etiology requiring specific treatment.
Collapse
Affiliation(s)
- Maya J L Schutte
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, the Netherlands
| | - Mascha M J Linszen
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, the Netherlands
| | - Theresa M Marschall
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, the Netherlands.
| | - Dominic H Ffytche
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sanne Koops
- Department of Neurology, University Medical Center Utrecht & Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Edwin van Dellen
- Department of Psychiatry, University Medical Center Utrecht & Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Sophie M Heringa
- Department of Psychiatry, University Medical Center Utrecht & Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Arjen J C Slooter
- Department of Intensive Care Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rob Teunisse
- Department of Geriatric Psychiatry, Dimence, Deventer, the Netherlands
| | - Odile A van den Heuvel
- Department of Psychiatry and Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, the Netherlands
| | - Afina W Lemstra
- Department of Neurology, VU university medical center, Amsterdam, the Netherlands
| | - Elisabeth M J Foncke
- Department of Neurology, VU university medical center, Amsterdam, the Netherlands
| | | | - Joop de Jong
- Parnassia Psychiatric Institute, The Hague, the Netherlands
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University & Voices Clinic, Monash Alfred Psychiatry Research Centre, Melbourne, Australia
| | - Iris E C Sommer
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
|
7
|
Wang J, Sung V, Carew P, Liu RS, Burgner D, Wake M. Inflammation and hearing status in mid-childhood and mid-life: a population-based cross-sectional study. Int J Epidemiol 2020; 48:1556-1566. [PMID: 30815675 DOI: 10.1093/ije/dyz023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Lifelong inflammation - known to be associated with many non-communicable diseases - has not been thoroughly investigated in hearing. We aimed to determine if glycoprotein A (GlycA), a novel biomarker of chronic inflammation, is associated with hearing acuity in mid-childhood and mid-life. METHODS Population-based cross-sectional study within the Longitudinal Study of Australian Children with plasma GlycA and audiometry data (1169 children and 1316 parents). We calculated high Fletcher Index (mean threshold across 1, 2 and 4 kHz), defining hearing loss as threshold >15 decibel hearing level (dB HL) (better ear). Linear/logistic regression quantified associations of GlycA with hearing threshold/loss. RESULTS Mean [standard deviation (SD)] high Fletcher Indices (dB HL) were 8.0 (5.7) for children and 13.1 (6.9) for adults, with 8.7% and 26.1% respectively showing hearing loss. 1-SD rise in GlycA (children 0.13 mmol/L, adults 0.17 mmol/L) predicted higher hearing thresholds for the lower individual frequencies [1 kHz: children β 0.8, 95% confidence interval (CI) 0.3-1.3; adults β 0.8, 95% CI 0.2-1.4]. This same pattern was evident for the high Fletcher Index (children β 0.7, 95% CI 0.3-1.1; adults β 0.8, 95% CI 0.3-1.4). This translated into 1-SD rise in GlycA predicting adult hearing loss [odds ratio (OR) 1.2, 95% CI 1.0-1.5] with similar but attenuated patterns in children. CONCLUSIONS GlycA is associated with poorer hearing by mid-childhood. This potentially reframes hearing loss as a life-course condition with inflammatory antecedents common to other non-communicable diseases. Replication and mechanistic studies could inform causal inference and early prevention efforts.
Collapse
Affiliation(s)
- Jing Wang
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Valerie Sung
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Department of General Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Peter Carew
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, Victoria, Australia
| | - Richard S Liu
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Department of General Medicine, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.,Department of Paediatrics & The Liggins Institute, The University of Auckland, Grafton, Auckland, New Zealand
| |
Collapse
|
|
8
|
Abstract
PURPOSE OF REVIEW The association between hallucinations and sensory loss, especially vision- and hearing-impairment, has been firmly established over the past years. The deafferentation theory, a decrease of the threshold for activation in the brain and the consequential imbalance between excitatory and inhibitory brain networks, is hypothesized to underly this relationship. Here we review the studies investigating this theory with a focus on the most recent literature to better understand the contribution of sensory loss to hallucinations. RECENT FINDINGS A large cross-sectional study has recently confirmed the relationship between auditory impairment and deafferentation. However, the underlying mechanisms of deafferentation are still under debate, with hyperexcitability and deviations in bottom-up and top-down processes being the most likely explanations. Social isolation following sensory impairment increases the risk for hallucinations. Better knowledge and awareness about the contribution of deafferentation and loneliness would benefit diagnosis and treatment of hallucinations. SUMMARY Studies imply activity in higher order areas, corresponding to the functional mapping of sensory system, and a general state of higher excitability as neurobiological explanation. Auditory deafferentation, tinnitus and other auditory hallucinations, likely lie on a continuum. Social isolation mediates psychotic symptoms in sensory-impaired individuals. Currently, there is no standard treatment for deafferentation hallucinations.
Collapse
|
|
9
|
Musical Ear Syndrome and Cochlear Explantation: Case Report and Proposal for a Theoretical Framework. Otol Neurotol 2019; 40:e962-e965. [PMID: 31577637 DOI: 10.1097/mao.0000000000002408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To report an unusual case of musical ear syndrome, and to present a theoretical framework for this condition, merging information from the presented case and from former case reports. PATIENT A 67-year-old semi-professional musician, who underwent bilateral cochlear implantation and experienced musical ear syndrome, i.e., hearing music, where none was present. INTERVENTIONS Cochlear implantation with a bilateral cochlear implant, and cochlear explantation 17 months later. MAIN OUTCOME MEASURE Report of presence or absence of musical ear syndrome by the patient. RESULTS Musical ear syndrome started 1 day after implantation. It ceased immediately after cochlear explantation, but reappeared 3 months later. CONCLUSIONS Several types of factors seem to determine whether a musical ear syndrome is present or not. We propose to differentiate between triggers, modifiers, and conditions, which determine a base vulnerability. Vulnerability seems to be increased by auditory deprivation and by habitual retrieval of music from memory. Cochlear implantation or explantation seems to act as triggers. The proposed framework may help to stimulate reporting of more potentially relevant factors in future case reports on musical ear syndrome, and ultimately to help to understand this condition better.
Collapse
|
|
10
|
Smith J, Wang J, Grobler AC, Lange K, Clifford SA, Wake M. Hearing, speech reception, vocabulary and language: population epidemiology and concordance in Australian children aged 11 to 12 years and their parents. BMJ Open 2019; 9:85-94. [PMID: 31273019 PMCID: PMC6624023 DOI: 10.1136/bmjopen-2018-023196] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To describe the epidemiology and parent-child concordance of hearing, speech reception, vocabulary and language in Australian parent-child dyads at child age 11 to 12 years. DESIGN Population-based cross-sectional study (Child Health CheckPoint) nested within the Longitudinal Study of Australian Children. SETTING Assessment centres in seven Australian cities and eight regional towns or home visits around Australia, February 2015 to March 2016. PARTICIPANTS Of all participating CheckPoint families (n=1874), 1516 children (50% female) and 1520 parents (87% mothers, mean age 43.8 years) undertook at least one of four measurements of hearing and language. OUTCOME MEASURES Hearing threshold (better ear mean of 1, 2 and 4 kHz) from pure-tone audiometry, speech reception threshold, receptive vocabulary, expressive and receptive languages using a sentence repetition task. Parent-child concordance was examined using Pearson's correlation coefficients and adjusted linear regression models. Survey weights and methods accounted for Longitudinal Study of Australian Children's complex sampling and stratification. RESULTS Children had a similar speech reception threshold to parents (children mean -14.3, SD 2.4; parents -14.9, SD 3.2 dB) but better hearing acuity (children 8.3, SD 6.3; parents 13.4, SD 7.0 decibels hearing level). Standardised sentence repetition scores were similar (children 9.8, SD 2.9; parents 9.1, SD 3.3) but, as expected, parents had superior receptive vocabularies. Parent-child correlations were higher for the cognitively-based language measures (vocabulary 0.31, 95% CI 0.26 to 0.36; sentence repetition 0.29, 95% CI 0.24 to 0.34) than the auditory measures (hearing 0.18, 95% CI 0.13 to 0.23; speech reception threshold 0.18, 95% CI 0.13 to 0.22). Mother-child and father-child concordances were similar for all measures. CONCLUSIONS We provide population reference values for multiple measures spanning auditory and verbal communication systems in children and mid-life adults. Concordance values aligned with previous twin studies and offspring studies in adults, in keeping with polygenic heritability that is modest for audition but around 60% for language by late childhood.
Collapse
Affiliation(s)
- Julia Smith
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Jing Wang
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Katherine Lange
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Susan A Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
|
11
|
Wang J, Sung V, Carew P, Burt RA, Liu M, Wang Y, Afandi A, Wake M. Prevalence of Childhood Hearing Loss and Secular Trends: A Systematic Review and Meta-Analysis. Acad Pediatr 2019; 19:504-514. [PMID: 30872125 DOI: 10.1016/j.acap.2019.01.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 01/13/2019] [Accepted: 01/25/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Better epidemiologic information on childhood hearing loss would inform research priorities and efforts to prevent its progression. OBJECTIVES To estimate prevalence and secular trends in children's hearing loss. DATA SOURCES We searched MEDLINE and Embase from January 1996 to August 2017. STUDY ELIGIBILITY CRITERIA We included epidemiologic studies in English reporting hearing loss prevalence. STUDY APPRAISAL AND SYNTHESIS METHODS The modified Leboeuf-Yde and Lauritsen tool was used to assess methodological quality. Meta-analyses combined study-specific estimates using random-effects models. PARTICIPANTS Children 0 to 18 years of age. RESULTS Among 88 eligible studies, 43.2% included audiometric measurement of speech frequencies. In meta-analyses, pooled prevalence estimates of slight or worse bilateral speech frequency losses >15 decibels hearing level (dB HL) were 13.1% (95% confidence interval [CI], 10.0-17.0). Using progressively more stringent cutpoints, pooled prevalence estimates were 8.1% (95% CI, 1.3-19.8) with >20 dB HL, 2.2% (95% CI, 1.4-3.0) with >25 dB HL, 1.8% (95% CI, 0.4-4.1) with >30 dB HL, and 0.9% (95% CI, 0.1-2.6) with >40 dB HL. Also, 8.9% (95% CI, 6.4-12.3) had likely sensorineural losses >15 dB HL in 1 or both ears, and 1.2% (95% CI, 0.5-2.1) had self-reported hearing loss. From 1990 to 2010, the prevalence of losses >15 dB HL in 1 or both ears rose substantially (all P for trend <.001). LIMITATIONS The studies had high heterogeneity and offered limited information for hearing loss types and secular trend. CONCLUSIONS AND IMPLICATIONS Childhood slight or worse hearing loss is prevalent and may be increasing. Advances in understanding hearing loss trajectories, causes, and prevention would require international repositories and longitudinal studies with audiometric data beginning in childhood. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO 2016 CRD42016034148.
Collapse
Affiliation(s)
- Jing Wang
- Murdoch Children's Research Institute (J Wang, V Sung, P Carew, RA Burt, M Liu, Y Wang, and M Wake); Department of Paediatrics (J Wang, V Sung, RA Burt, M Liu, Y Wang, and M Wake)
| | - Valerie Sung
- Murdoch Children's Research Institute (J Wang, V Sung, P Carew, RA Burt, M Liu, Y Wang, and M Wake); Department of General Medicine (V Sung), Royal Children's Hospital; Department of Paediatrics (J Wang, V Sung, RA Burt, M Liu, Y Wang, and M Wake)
| | - Peter Carew
- Murdoch Children's Research Institute (J Wang, V Sung, P Carew, RA Burt, M Liu, Y Wang, and M Wake); Department of Audiology and Speech Pathology (P Carew), The University of Melbourne, Parkville, Victoria, Australia
| | - Rachel A Burt
- Murdoch Children's Research Institute (J Wang, V Sung, P Carew, RA Burt, M Liu, Y Wang, and M Wake); Department of Paediatrics (J Wang, V Sung, RA Burt, M Liu, Y Wang, and M Wake)
| | - Mengjiao Liu
- Murdoch Children's Research Institute (J Wang, V Sung, P Carew, RA Burt, M Liu, Y Wang, and M Wake); Department of Paediatrics (J Wang, V Sung, RA Burt, M Liu, Y Wang, and M Wake)
| | - Yichao Wang
- Murdoch Children's Research Institute (J Wang, V Sung, P Carew, RA Burt, M Liu, Y Wang, and M Wake)
| | - Aflah Afandi
- Kulliyyah of Allied Health Sciences (A Afandi), International Islamic University Malaysia, Kuantan, Pahang, Malaysia
| | - Melissa Wake
- Murdoch Children's Research Institute (J Wang, V Sung, P Carew, RA Burt, M Liu, Y Wang, and M Wake); Department of Paediatrics (J Wang, V Sung, RA Burt, M Liu, Y Wang, and M Wake); Department of Paediatrics and The Liggins Institute (M Wake), The University of Auckland, Grafton, Auckland, New Zealand.
| |
Collapse
|
|
12
|
Linszen MMJ, van Zanten GA, Teunisse RJ, Brouwer RM, Scheltens P, Sommer IE. Auditory hallucinations in adults with hearing impairment: a large prevalence study. Psychol Med 2019; 49:132-139. [PMID: 29554989 DOI: 10.1017/s0033291718000594] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Similar to visual hallucinations in visually impaired patients, auditory hallucinations are often suggested to occur in adults with hearing impairment. However, research on this association is limited. This observational, cross-sectional study tested whether auditory hallucinations are associated with hearing impairment, by assessing their prevalence in an adult population with various degrees of objectified hearing impairment. METHODS Hallucination presence was determined in 1007 subjects aged 18-92, who were referred for audiometric testing to the Department of ENT-Audiology, University Medical Center Utrecht, the Netherlands. The presence and severity of hearing impairment were calculated using mean air conduction thresholds from the most recent pure tone audiometry. RESULTS Out of 829 participants with hearing impairment, 16.2% (n = 134) had experienced auditory hallucinations in the past 4 weeks; significantly more than the non-impaired group [5.8%; n = 10/173; p < 0.001, odds ratio 3.2 (95% confidence interval 1.6-6.2)]. Prevalence of auditory hallucinations significantly increased with categorized severity of impairment, with rates up to 24% in the most profoundly impaired group (p < 0.001). The corrected odds of hallucination presence increased 1.02 times for each dB of impairment in the best ear. Auditory hallucinations mostly consisted of voices (51%), music (36%), and doorbells or telephones (24%). CONCLUSIONS Our findings reveal that auditory hallucinations are common among patients with hearing impairment, and increase with impairment severity. Although more research on potential confounding factors is necessary, clinicians should be aware of this phenomenon, by inquiring after hallucinations in hearing-impaired patients and, conversely, assessing hearing impairment in patients with auditory hallucinations, since it may be a treatable factor.
Collapse
Affiliation(s)
- M M J Linszen
- Department of Psychiatry and Brain Center Rudolf Magnus,University Medical Center Utrecht,Utrecht University,Utrecht,The Netherlands
| | - G A van Zanten
- Department of Otorhinolaryngology and Head & Neck Surgery and Brain Center Rudolf Magnus,University Medical Center Utrecht,Utrecht University,Utrecht,The Netherlands
| | - R J Teunisse
- Department of Geriatric Psychiatry,Dimence, Deventer,The Netherlands
| | - R M Brouwer
- Department of Psychiatry and Brain Center Rudolf Magnus,University Medical Center Utrecht,Utrecht University,Utrecht,The Netherlands
| | - P Scheltens
- Alzheimer Center and Department of Neurology,Neuroscience Campus Amsterdam,VU University Medical Center,Amsterdam,The Netherlands
| | - I E Sommer
- Department of Psychiatry and Brain Center Rudolf Magnus,University Medical Center Utrecht,Utrecht University,Utrecht,The Netherlands
| |
Collapse
|
|
13
|
Abstract
Musical hallucinations (MHs) are relatively uncommon phenomena sometimes encountered in older patients, especially older women. They usually involve popular, overlearned music, either entire songs or repetitive snippets. While MHs are most commonly associated with hearing loss, they may occur in a variety of psychiatric, neurologic, and iatrogenic conditions. We report a 91-year-old man whose MHs were causally related to the antidepressant mirtazapine. Although mirtazapine is generally well tolerated, it may rarely cause MHs or other psychotic symptoms.
Collapse
|
|
14
|
Moseley P, Alderson-Day B, Kumar S, Fernyhough C. Musical hallucinations, musical imagery, and earworms: A new phenomenological survey. Conscious Cogn 2018; 65:83-94. [PMID: 30077016 PMCID: PMC6204882 DOI: 10.1016/j.concog.2018.07.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/26/2018] [Accepted: 07/19/2018] [Indexed: 12/04/2022]
Abstract
We conducted a phenomenological survey comparing musical hallucinations to other inner music. MH were more likely to be reported as externally located than other experiences. MH were less controllable and less familiar than imagery or earworms. MH were less likely to include lyrical content than other forms of inner music. Individuals with higher levels of musical expertise were less likely to report MH. Musical hallucinations (MH) account for a significant proportion of auditory hallucinations, but there is a relative lack of research into their phenomenology. In contrast, much research has focused on other forms of internally generated musical experience, such as earworms (involuntary and repetitive inner music), showing that they can vary in perceived control, repetitiveness, and in their effect on mood. We conducted a large online survey (N = 270), including 44 participants with MH, asking participants to rate imagery, earworms, or MH on several variables. MH were reported as occurring less frequently, with less controllability, less lyrical content, and lower familiarity, than other forms of inner music. MH were also less likely to be reported by participants with higher levels of musical expertise. The findings are outlined in relation to other forms of hallucinatory experience and inner music, and their implications for psychological models of hallucinations discussed.
Collapse
Affiliation(s)
- Peter Moseley
- Psychology Department, Durham University, South Road, Durham DH1 3LE, United Kingdom; School of Psychology, University of Central Lancashire, Marsh Lane, Preston PR1 2HE, United Kingdom.
| | - Ben Alderson-Day
- Psychology Department, Durham University, South Road, Durham DH1 3LE, United Kingdom
| | - Sukhbinder Kumar
- Institute of Neuroscience, Newcastle University, Newcastle NE1 7RU, United Kingdom
| | - Charles Fernyhough
- Psychology Department, Durham University, South Road, Durham DH1 3LE, United Kingdom
| |
Collapse
|
|
15
|
Wang J, le Clercq CMP, Sung V, Carew P, Liu RS, Mensah FK, Burt RA, Gold L, Wake M. Cross-sectional epidemiology of hearing loss in Australian children aged 11-12 years old and 25-year secular trends. Arch Dis Child 2018; 103:579-585. [PMID: 29386180 DOI: 10.1136/archdischild-2017-313505] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 12/08/2017] [Accepted: 12/24/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVE In a national study of Australian children aged 11-12 years old, we examined the (1) prevalence and characteristics of hearing loss, (2) its demographic risk factors and (3) evidence for secular increases since 1990. METHODS This is a cross-sectional CheckPoint wave within the Longitudinal Study of Australian Children. 1485 children (49.8% retention; 49.7% boys) underwent air-conduction audiometry. Aim 1: hearing loss (≥16 decibels hearing level (dB HL)) was defined in four ways to enable prior/future comparisons: high Fletcher Index (mean of 1, 2 and 4 kHz; primary outcome relevant to speech perception), four-frequency (1, 2, 4 and 8 kHz), lower frequency (1 and 2 kHz) and higher frequency (4 and 8 kHz); aim 2: logistic regression of hearing loss by age, gender and disadvantage index; and aim 3: P for trend examining CheckPoint and reported prevalence in studies arranged by date since 1990. RESULTS For high Fletcher Index, the prevalence of bilateral and unilateral hearing loss ≥16 dB HL was 9.3% and 13.3%, respectively. Slight losses (16-25 dB HL) were more prevalent than mild or greater (≥26 dB HL) losses (bilateral 8.5% vs 0.8%; unilateral 12.5% vs 0.9%), and lower frequency more prevalent than higher frequency losses (bilateral 11.0% vs 6.9%; unilateral 15.4% vs 11.5%). Demographic characteristics did not convincingly predict hearing loss. Prevalence of bilateral/unilateral lower and higher frequency losses ≥16 dB HL has risen since 1990 (all P for trend <0.001). CONCLUSIONS AND RELEVANCE Childhood hearing loss is prevalent and has risen since 1990. Future research should investigate the causes, course and impact of these changes.
Collapse
Affiliation(s)
- Jing Wang
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Carlijn M P le Clercq
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Otolaryngology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Valerie Sung
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter Carew
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Richard S Liu
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Fiona K Mensah
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rachel A Burt
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,The HEARing Cooperative Research Centre, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Gold
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,School of Health and Social Development, Deakin University, Geelong, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The Liggins Institute, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
|
16
|
Badcock JC, Dehon H, Larøi F. Hallucinations in Healthy Older Adults: An Overview of the Literature and Perspectives for Future Research. Front Psychol 2017; 8:1134. [PMID: 28736541 PMCID: PMC5500657 DOI: 10.3389/fpsyg.2017.01134] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 06/21/2017] [Indexed: 12/22/2022] Open
Abstract
KEY POINTS
➢ Studies suggest a substantial minority of healthy older adults have hallucinatory experiences, in line with existing evidence on hallucinations in other age groups, though it is still unclear if hallucination prevalence increases or declines with age in older cohorts. ➢ Stigma attached to both hallucinations and ageing leads to considerable under-reporting of these experiences in healthy older adults and may negatively bias how professionals, family members, and the public respond. ➢ Why and when hallucinations in healthy older adults remit, persist, or progress to other clinical disorders remains poorly understood. ➢ Current evidence points to a range of factors associated with hallucinations in older adults including decline in sensory or cognitive functioning, poor sleep, and psychosocial stressors (e.g., social isolation, loneliness, and bereavement), highlighting the need for accurate assessment and tailored interventions. Hallucinations, though common in youth and younger adults, are not the preserve of these age groups. Accumulating evidence shows that hallucinatory experiences are also present at surprisingly high rates in healthy older adults in the general community. Furthermore, stigma and misunderstanding of hallucinations, together with ageism, may lead to under-reporting of these experiences by older adults, and misdiagnosis or mismanagement by health and mental health practitioners. Consequently, improved public and professional knowledge is needed about the nature and significance of hallucinations with advancing age. The purpose of this review is to provide a comprehensive overview, and critical analysis, of research on the prevalence, psychosocial, and neurobiological factors associated with hallucinations in people aged 60 years and over. To the best of our knowledge, this is the first review of its kind in the literature. The evidence supports a dynamic conceptualization of hallucinations, in which the emergence of hallucinations is viewed as a balance between the sensory, cognitive, or social impairments accompanying advancing age and the degree to which compensatory processes elicited by these impairments are successful. We briefly summarize the implications of the literature for aged care services and interventions, and stress that far more studies are needed in this important field of research.
Collapse
Affiliation(s)
- Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western AustraliaPerth, WA, Australia.,Australia and Perth Voices Clinic, Murdoch University Child and Adult Psychology Service, Murdoch UniversityMurdoch, WA, Australia
| | - Hedwige Dehon
- Psychology and Neuroscience of Cognition Research Unit, University of LiegeLiege, Belgium
| | - Frank Larøi
- Psychology and Neuroscience of Cognition Research Unit, University of LiegeLiege, Belgium.,Department of Biological and Medical Psychology, University of BergenBergen, Norway.,NORMENT - Norwegian Centre of Excellence for Mental Disorders Research, University of OsloOslo, Norway
| |
Collapse
|
|
17
|
Gandhi R, Narang P, Lippmann S. Are Musical and Auditory Hallucinations Related? PSYCHOSOMATICS 2016; 57:442-3. [PMID: 27283253 DOI: 10.1016/j.psym.2016.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 03/07/2016] [Accepted: 03/07/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Raghu Gandhi
- Psychiatry Residency Program, Hennepin County Medical Center, Minneapolis, MN
| | - Puneet Narang
- University of Minnesota, Minneapolis, MN; Regions Hospital, St. Paul, MN.
| | | |
Collapse
|
|
18
|
Abstract
There are a number of auditory symptom syndromes that can develop without an organic basis. Some of these, such as nonorganic hearing loss, affect populations similar to those presenting with functional somatosensory and motor symptoms, while others, such as musical hallucination, affect populations with a significantly different demographic and require different treatment strategies. Many of these conditions owe their origin to measurably abnormal peripheral sensory pathology or brain network activity, but their pathological impact is often due, at least in part, to overamplification of the salience of these phenomena. For each syndrome, this chapter briefly outlines a definition, demographics, investigations, putative mechanisms, and treatment strategies. Consideration is given to what extent they can be considered to have a functional basis. Treatments are in many cases pragmatic and rudimentary, needing more work to be done in integrating insights from behavioral and cognitive psychology to auditory neuroscience. The audiology literature has historically equated the term functional with malingering, although this perception is, thankfully, slowly changing. These disorders transcend the disciplines of audiology, otorhinolaryngology, neurology and psychiatry, and a multidisciplinary approach is often rewarding.
Collapse
|
|
19
|
Increased risk of psychosis in patients with hearing impairment: Review and meta-analyses. Neurosci Biobehav Rev 2015; 62:1-20. [PMID: 26743858 DOI: 10.1016/j.neubiorev.2015.12.012] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/24/2015] [Accepted: 12/24/2015] [Indexed: 12/12/2022]
Abstract
Several studies suggest hearing impairment as a risk factor for psychosis. Hearing impairment is highly prevalent and potentially reversible, as it can be easily diagnosed and sometimes improved. Insight in the association between hearing impairment and psychosis can therefore contribute to prevention of psychosis. This paper provides meta-analyses of all epidemiologic evidence on the association between hearing impairment and psychosis and summarizes mechanisms that potentially underlie this relationship. Meta-analyses showed an increased risk of hearing impairment on all psychosis outcomes, such as hallucinations (OR 1.40(95%CI 1.18-1.65; n=227,005)), delusions (OR 1.55(95%CI 1.36-1.78; n=250,470)), psychotic symptoms (OR 2.23(95%CI 1.83-2.72; n=229,647) and delirium (OR 2.67(95%CI 2.05-3.48; n=12,432). Early exposure to hearing impairment elevated the risk of later development of schizophrenia (OR 3.15(95%CI 1.25-7.95; n=50,490)). Potential mechanisms underlying this association include loneliness, diminished theory of mind, disturbances of source monitoring and top-down processing and deafferentiation. Early assessment and treatment of hearing impairment in patients with (high risk of) psychosis may be essential in psychosis treatment and prevention.
Collapse
|
|
20
|
Coebergh JAF, Lauw RF, Bots R, Sommer IEC, Blom JD. Musical hallucinations: review of treatment effects. Front Psychol 2015; 6:814. [PMID: 26136708 PMCID: PMC4468361 DOI: 10.3389/fpsyg.2015.00814] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/28/2015] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Despite an increased scientific interest in musical hallucinations over the past 25 years, treatment protocols are still lacking. This may well be due to the fact that musical hallucinations have multiple causes, and that published cases are relatively rare. OBJECTIVE To review the effects of published treatment methods for musical hallucinations. METHODS A literature search yielded 175 articles discussing a total number of 516 cases, of which 147 articles discussed treatment in 276 individuals. We analyzed the treatment results in relation to the etiological factor considered responsible for the mediation of the musical hallucinations, i.e., idiopathic/hypoacusis, psychiatric disorder, brain lesion, and other pathology, epilepsy or intoxication/pharmacology. RESULTS Musical hallucinations can disappear without intervention. When hallucinations are bearable, patients can be reassured without any other treatment. However, in other patients musical hallucinations are so disturbing that treatment is indicated. Distinct etiological groups appear to respond differently to treatment. In the hypoacusis group, treating the hearing impairment can yield significant improvement and coping strategies (e.g., more acoustic stimulation) are frequently helpful. Pharmacological treatment methods can also be successful, with antidepressants being possibly more helpful than antiepileptics (which are still better than antipsychotics). The limited use of acetylcholinesterase inhibitors has looked promising. Musical hallucinations occurring as part of a psychiatric disorder tend to respond well to psychopharmacological treatments targeting the underlying disorder. Musical hallucinations experienced in the context of brain injuries and epilepsy tend to respond well to antiepileptics, but their natural course is often benign, irrespective of any pharmacological treatment. When intoxication/pharmacology is the main etiological factor, it is important to stop or switch the causative substance or medication. CONCLUSION Treatments for musical hallucinations tend to yield favorable results when they target the main etiological factor of these phenomena. There is a need to establish the natural course of musical hallucinations, their response to non-pharmacological treatments, and their effects on the patient's quality of life. There is also a need to standardize the assessment of treatment responses, and document long-term follow up.
Collapse
Affiliation(s)
- Jan A. F. Coebergh
- Department of Neurology, Haga HospitalThe Hague, Netherlands
- Department of Neurology, Ashford/St. Peter's HospitalChertsey, UK
- Department of Neurology, St. George's HospitalLondon, UK
| | - R. F. Lauw
- Parnassia Psychiatric InstituteThe Hague, Netherlands
| | - R. Bots
- ‘S Heeren LooNoordwijk, Netherlands
| | - I. E. C. Sommer
- Department of Psychiatry, University Medical Center UtrechtUtrecht, Netherlands
- Brain Centre Rudolf MagnusUtrecht, Netherlands
| | - J. D. Blom
- Parnassia Psychiatric InstituteThe Hague, Netherlands
- Department of Psychiatry, University of GroningenGroningen, Netherlands
| |
Collapse
|
|
21
|
Blom JD, Coebergh JAF, Lauw R, Sommer IEC. Musical hallucinations treated with acetylcholinesterase inhibitors. Front Psychiatry 2015; 6:46. [PMID: 25904872 PMCID: PMC4387860 DOI: 10.3389/fpsyt.2015.00046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 03/18/2015] [Indexed: 11/21/2022] Open
Abstract
Musical hallucinations are relatively rare auditory percepts which, due to their intrusive nature and the accompanying fear of impending mental decline, tend to cause significant distress and impairment. Although their etiology and pathophysiology appear to be heterogeneous and no evidence-based treatment methods are available, case reports indicate that acetylcholinesterase inhibitors may yield positive results in patients with comorbid hearing loss. We present two female patients (aged 76 and 78 years) both of whom suffered from hearing impairment and practically incessant musical hallucinations. Both patients were successfully treated with the acetylcholinesterase inhibitor rivastigmine. Based on these two case descriptions and an overview of studies describing the use of acetylcholinesterase inhibitors in similar patients, we discuss possible mechanisms and propose further research on the use of acetylcholinesterase inhibitors for musical hallucinations experienced in concordance with hearing loss.
Collapse
Affiliation(s)
- Jan Dirk Blom
- Parnassia Psychiatric Institute , The Hague , Netherlands ; Department of Psychiatry, University of Groningen , Groningen , Netherlands
| | - Jan Adriaan F Coebergh
- Department of Neurology, Ashford and St. Peter's Hospitals , Chertsey , UK ; Department of Neurology, St. George's Hospital , London , UK
| | - René Lauw
- Parnassia Psychiatric Institute , The Hague , Netherlands
| | - Iris E C Sommer
- Department of Psychiatry, University Medical Center Utrecht , Utrecht , Netherlands ; Rudolf Magnus Institute of Neuroscience , Utrecht , Netherlands
| |
Collapse
|
|
22
|
Sommer IE, Roze CM, Linszen MMJ, Somers M, van Zanten GA. Hearing loss; the neglected risk factor for psychosis. Schizophr Res 2014; 158:266-7. [PMID: 25096542 DOI: 10.1016/j.schres.2014.07.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 07/14/2014] [Accepted: 07/15/2014] [Indexed: 10/24/2022]
Affiliation(s)
- I E Sommer
- Psychiatry Department UMCU Utrecht and Brain Center Rudolf Magnus, Heidelberglaan 100, Utrecht, The Netherlands.
| | - C M Roze
- GGZ ProPersona, Mental Health Care Centre for Hearing Disabled, Willy Brandtlaan 20, Ede, The Netherlands
| | - M M J Linszen
- Psychiatry Department UMCU Utrecht and Brain Center Rudolf Magnus, Heidelberglaan 100, Utrecht, The Netherlands
| | - M Somers
- Psychiatry Department UMCU Utrecht and Brain Center Rudolf Magnus, Heidelberglaan 100, Utrecht, The Netherlands
| | - G A van Zanten
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, The Netherlands
| |
Collapse
|
|
23
|
Güçlü O, Senormancı O, Güçlü DG, Konkan R. Musical hallucinations of an unidentified melody. Gen Hosp Psychiatry 2013; 35:e7-8. [PMID: 23347456 DOI: 10.1016/j.genhosppsych.2012.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Revised: 12/13/2012] [Accepted: 12/17/2012] [Indexed: 11/25/2022]
Affiliation(s)
- Oya Güçlü
- Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul, Turkey
| | | | | | | |
Collapse
|