Prevalence of neurocognitive and perceived speech deficits in patients with head and neck cancer before treatment: Associations with demographic, behavioral, and disease-related factors.

BACKGROUND: Neurocognition and speech, relevant domains in head and neck cancer (HNC), may be affected pretreatment. However, the prevalence of pretreatment deficits and their possible concurrent predictors are poorly understood. METHODS: Using an HNC prospective cohort (Netherlands Quality of Life and Biomedical Cohort Study, N ≥ 444) with a cross-sectional design, we investigated the estimated prevalence of pretreatment deficits and their relationship with selected demographic, behavioral, and disease-related factors. RESULTS: Using objective assessments, rates of moderate-to-severe neurocognitive deficit ranged between 4% and 8%. From patient-reported outcomes, 6.5% of patients reported high levels of cognitive failures and 46.1% reported speech deficits. Patient-reported speech functioning was worse in larynx compared to other subsites. Other nonspeech outcomes were unrelated to any variable. Patient-reported neurocognitive and speech functioning were modestly correlated, especially in the larynx group. CONCLUSIONS: These findings indicate that a subgroup of patients with HNC shows pretreatment deficits, possibly accentuated in the case of larynx tumors.

The Aftercare Survey: Assessment and intervention practices after brain tumor surgery in Europe.

Background: People with gliomas need specialized neurosurgical, neuro-oncological, psycho-oncological, and neuropsychological care. The role of language and cognitive recovery and rehabilitation in patients' well-being and resumption of work is crucial, but there are no clear guidelines for the ideal timing and character of assessments and interventions. The goal of the present work was to describe representative (neuro)psychological practices implemented after brain surgery in Europe. Methods: An online survey was addressed to professionals working with individuals after brain surgery. We inquired about the assessments and interventions and the involvement of caregivers. Additionally, we asked about recommendations for an ideal assessment and intervention plan. Results: Thirty-eight European centers completed the survey. Thirty of them offered at least one postsurgical (neuro)psychological assessment, mainly for language and cognition, especially during the early recovery stage and at long term. Twenty-eight of the participating centers offered postsurgical therapies. Patients who stand the highest chances of being included in evaluation and therapy postsurgically are those who underwent awake brain surgery, harbored a low-grade glioma, or showed poor recovery. Nearly half of the respondents offer support programs to caregivers, and all teams recommend them. Treatments differed between those offered to individuals with low-grade glioma vs those with high-grade glioma. The figure of caregiver is not yet fully recognized in the recovery phase. Conclusion: We stress the need for more complete rehabilitation plans, including the emotional and health-related aspects of recovery. In respondents' opinions, assessment and rehabilitation plans should also be individually tailored and goal-directed (eg, professional reinsertion).

Statistically comparing EEG/MEG waveforms through successive significant univariate tests: how bad can it be?

When making statistical comparisons, the temporal dimension of the EEG signal introduces problems. Guthrie and Buchwald (1991) proposed a formally correct statistical approach that deals with these problems: comparing waveforms by counting the number of successive significant univariate tests and then contrasting this number to a well-chosen critical value. However, in the literature, this method is often used inappropriately. Using real EEG data and Monte Carlo simulations, we examined the problems associated with the incorrect use of this approach under circumstances often encountered in the literature. Our results show inflated false-positive or false-negative rates depending on parameters of the data, including filtering. Our findings suggest that most applications of this method result in an inappropriate familywise error rate control. Solutions and alternative methods are discussed.

Withholding planned speech is reflected in synchronized beta-band oscillations.

When engaged in a conversation, speakers sometimes have to withhold a planned response, for example, before it is their turn to speak. In the present study, using magnetoencephalography (MEG) outside of a conversational setting, we investigate the oscillatory brain mechanisms involved in the process of withholding a planned verbal response until it is time to speak. Our participants viewed a sequence of four random consonant strings and one pseudoword, which they had to pronounce when the fifth string (the imperative stimulus) was presented. The pseudoword appeared either as the fourth or fifth stimulus in the sequence, creating two conditions. In the withhold condition, the pseudoword was the fourth string and the verbal response was withheld until the imperative stimulus was presented. In the control condition, the fifth string was the pseudoword, so no response was withheld. We compared oscillatory responses to the withhold relative to the control condition in the time period preceding speech. Alpha-beta power (8-30 Hz) decreased over occipital sensors in the withhold condition relative to the control condition. Source-level analysis indicated a posterior source (i.e., occipital cortex) associated with the alpha-beta power decreases. This occipital alpha-beta desynchronization likely reflects attentional allocation to the upcoming imperative stimulus. Moreover, beta (12-20 Hz) power increased over frontal sensors. Source-level analysis indicated a frontal source (i.e., middle and superior frontal gyri) associated with the beta-power increases. We interpret the frontal beta synchronization to reflect a mechanism aiding the maintenance of the current motor or cognitive state. Our results provide a window into a possible oscillatory mechanism implementing the ability of speakers to withhold a planned verbal response until they have to speak.