Plasticity in auditory categorization is supported by differential engagement of the auditory-linguistic network.

To construct our perceptual world, the brain categorizes variable sensory cues into behaviorally-relevant groupings. Categorical representations are apparent within a distributed fronto-temporo-parietal brain network but how this neural circuitry is shaped by experience remains undefined. Here, we asked whether speech and music categories might be formed within different auditory-linguistic brain regions depending on listeners' auditory expertise. We recorded EEG in highly skilled (musicians) vs. less experienced (nonmusicians) perceivers as they rapidly categorized speech and musical sounds. Musicians showed perceptual enhancements across domains, yet source EEG data revealed a double dissociation in the neurobiological mechanisms supporting categorization between groups. Whereas musicians coded categories in primary auditory cortex (PAC), nonmusicians recruited non-auditory regions (e.g., inferior frontal gyrus, IFG) to generate category-level information. Functional connectivity confirmed nonmusicians' increased left IFG involvement reflects stronger routing of signal from PAC directed to IFG, presumably because sensory coding is insufficient to construct categories in less experienced listeners. Our findings establish auditory experience modulates specific engagement and inter-regional communication in the auditory-linguistic network supporting categorical perception. Whereas early canonical PAC representations are sufficient to generate categories in highly trained ears, less experienced perceivers broadcast information downstream to higher-order linguistic brain areas (IFG) to construct abstract sound labels.

Parent-child communication surrounding genetic testing for Li-Fraumeni syndrome: Living under the cloud of cancer.

BACKGROUND: Advances in the application of genetic technologies reveal a growing number of heritable disorders associated with an increased risk to develop cancer during childhood. As genetic testing is increasingly employed in the clinical setting, it is essential to understand whether parents communicate with their children about test results and to elucidate the factors that influence the content and outcomes of these conversations. METHODS: Semistructured interviews were conducted with 14 parents whose children tested positive for Li-Fraumeni syndrome (LFS). Semantic content analysis was performed on transcribed interviews, focusing on questions related to parent-child conversations about the genetic testing process and disclosure of positive test results. RESULTS: All parents emphasized the importance of involving children in conversations about LFS. The majority (93%) identified as being part of "cancer families" in which prior experiences with cancer created opportunities for communication. While all had spoken with their children about cancer, only seven (50%) specifically disclosed to their children that they had tested positive for LFS. The most common reason cited for nondisclosure at the time of this study was the young age of the children. CONCLUSION: Parents of children with LFS desire open conversations about genetic testing and cancer risk. These conversations are challenging yet essential to enable child understanding of genetic risk status and enhance compliance with health-promoting and cancer surveillance measures. Development of age-appropriate educational materials and novel clinical models to facilitate parent-child conversations about genetic test results and risk status for cancer are needed.

Parent perspectives and preferences for strategies regarding nonsedated MRI scans in a pediatric oncology population.

PURPOSE: Children with cancer frequently require MRI scans for clinical purposes. Sedation with general anesthesia (GA) is often used to promote compliance, reduce motion, and alleviate anxiety. The use of GA for MRI scans is costly in terms of time, personnel, and medications. In addition, prominent risks are associated with anesthesia exposure in patients with complex medical conditions. Successful behavioral interventions have been implemented in clinical research settings to promote scan success and compliance. To our knowledge, parent/caregiver acceptability of behavioral interventions to promote nonsedated MRI has not been systematically investigated in a medically complex population. As a first step toward developing a protocol-based intervention to promote nonsedated scanning, we conducted a survey to explore parental perspectives regarding acceptability of nonsedated scanning and to gain information regarding preference for specific behavioral interventions to facilitate nonsedated MRI exams. METHODS: Parents or guardians of 101 patients diagnosed with childhood cancer participated in a semi-structured survey via telephone. The sample was stratified by age group (8-12 years; 13-18 years), gender, and diagnosis (solid tumor (ST), brain tumor (BT), and acute lymphoblastic leukemia (ALL)). RESULTS: The majority of parents indicated that nonsedated MRI scans would be acceptable. Reduced anesthesia exposure was the most frequently identified benefit, followed by decreased irritability post-MRI scan, and shorter appointment time. Challenges included fear of movement and noise during scans and change in routine, with parents of younger children and those with a history of sedated exams identifying more challenges. Behavioral intervention preference differed by patient age and gender; however, education was ranked as most preferred overall. CONCLUSION: Parents of children treated for cancer consider behavior interventions to promote nonsedated scanning as acceptable. Patient characteristics should be considered when tailoring behavioral interventions. Results can inform future studies of behavioral interventions to promote nonsedated MRI scans. Future research should also investigate the risks associated with failed exams, both in terms of patient medical care and cost effectiveness.

In-home salivary melatonin collection: Methodology for children and adolescents.

In-home salivary collection quality and adherence to a prescribed collection methodology for evaluation of dim light melatonin onset (DLMO) is unknown in children. Primary aims of this study were to 1) describe a novel family centered methodology for in-home salivary collection; 2) determine the acceptance and feasibility of this methodology; 3) measure adherence to collection instructions; and 4) identify patterns between participants' age and quality of samples collected. After receiving instructional handouts from the study team, families utilized in-home salivary melatonin collection. Participants (N = 64) included 39 children (21 female, mean age 9.5 ± 1.61 years) and 25 adolescents (11 female, mean age 15.9 ± 2.12 years) with craniopharyngioma. Participants were 90% adherent to collection schedule, and 89% of the samples collected were of sufficient quantity and quality, with no differences found between age (child vs. adolescent) and melatonin sample quantity and quality. In-home saliva collection provides an acceptable and feasible method to collect salivary melatonin and biomarkers in children and adolescents.

Attentional modulation and domain-specificity underlying the neural organization of auditory categorical perception.

Categorical perception (CP) is highly evident in audition when listeners' perception of speech sounds abruptly shifts identity despite equidistant changes in stimulus acoustics. While CP is an inherent property of speech perception, how (if) it is expressed in other auditory modalities (e.g., music) is less clear. Moreover, prior neuroimaging studies have been equivocal on whether attentional engagement is necessary for the brain to categorically organize sound. To address these questions, we recorded neuroelectric brain responses [event-related potentials (ERPs)] from listeners as they rapidly categorized sounds along a speech and music continuum (active task) or during passive listening. Behaviorally, listeners' achieved sharper psychometric functions and faster identification for speech than musical stimuli, which was perceived in a continuous mode. Behavioral results coincided with stronger ERP differentiation between prototypical and ambiguous tokens (i.e., categorical processing) for speech but not for music. Neural correlates of CP were only observed when listeners actively attended to the auditory signal. These findings were corroborated by brain-behavior associations; changes in neural activity predicted more successful CP (psychometric slopes) for active but not passively evoked ERPs. Our results demonstrate auditory categorization is influenced by attention (active > passive) and is stronger for more familiar/overlearned stimulus domains (speech > music). In contrast to previous studies examining highly trained listeners (i.e., musicians), we infer that (i) CP skills are largely domain-specific and do not generalize to stimuli for which a listener has no immediate experience and (ii) categorical neural processing requires active engagement with the auditory stimulus.