Fatigue is common in patients with chronic pain, but the neural underpinning of this symptom is still poorly understood. In this study, we aimed to investigate resting state connectivity correlates of pain and fatigue in patients with chronic pain. Twenty-four women with chronic pain, and 22 age-matched healthy controls underwent resting state functional magnetic resonance imaging (fMRI), performed a 20-min fatiguing attention task, and underwent an additional resting state fMRI examination. Patients with chronic pain reported a higher degree of both fatigue (p < 0.001) and pain (p < 0.001) than healthy controls. Significant group differences in connectivity to the lateral visual network, the salience network, the auditory network, the executive control network, and especially in regions within the default mode network were detected before the task. After the task, these differences were no longer statistically detectable, and only differences in connectivity between the basal ganglia network and the prefrontal areas between groups were observed. While differences in functional connectivity related to pain were present before performance of the task, only differences related to fatigue were found after the task. This finding indicates that processing of fatigue might overshadow processing of pain after performance of a fatiguing attention task in patients with chronic pain.

Research on spatial neglect predominantly focuses on the visual domain, often conceptualising cross-modal spatial cueing as a potential means to ameliorate visuospatial performance. As spatial neglect can affect multiple sensory modalities, it is unclear how patients with different profiles (e.g., those with visual neglect only versus those with additional auditory neglect) respond to these cues. This study thus investigated the effects of cross-modal spatial cueing in spatial neglect, considering the role of auditory spatial impairment. A total of 60 participants were included, comprising 40 right-hemispheric stroke patients presenting with (V+) or without (V-) visual neglect and 20 healthy controls. Based on the performance in an auditory spatial localisation task, V+ patients were subdivided into those with visual neglect only (V+A-) and those with additional auditory neglect (V+A+). Participants completed a visual search task comprising four cueing conditions: congruent, incongruent, mono sound (i.e., a binaural tone with no spatial properties), and no sound. Voxel-based lesion-symptom mapping (VLSM) was conducted to identify neural correlates of impaired auditory localisation. Critically, only V+A- patients benefited from congruent auditory cues, whereas V+A+ patients did not. Across participants, higher auditory localisation accuracy significantly correlated with faster search durations in the congruent condition. VLSM revealed that poorer auditory localisation performance was associated with lesions involving the first and second branches of the right superior longitudinal fasciculus. These findings suggest that the efficacy of auditory cueing in spatial neglect depends on the sensory modalities affected, necessitating multimodal assessments to devise individualised rehabilitation strategies.

The presentation of a rarely occurring auditory stimulus that contains a silent interval (or gap) among a sequence of frequently occurring stimuli that do not contain a gap can elicit a negative-going event-related potential known as the deviant-related negativity (DRN). This study investigated how the temporal position of the gap (i.e., temporal distance from stimulus onset) influences DRN amplitude using a novel multideviant paradigm. Seventeen young adults were presented with a sequence in which six gap deviants alternated with a standard stimulus. The standard stimulus was a 500-ms duration white noise burst. The deviants were constructed by inserting a gap in six different temporal positions, ranging from 15 to 400 ms after stimulus onset. In different conditions, gap duration was either 10 or 30 ms. Participants were also presented with single-deviant sequences in which the gap occurred at 100 or 300 ms. The amplitude of the DRN was larger for 30 ms than for 10-ms duration gaps; however, it was much reduced for gaps occurring at 300 or 400 ms after stimulus onset. There was no significant difference in DRN amplitude between the multideviant and single-deviant paradigms. These results confirm the hypothesis that auditory integration occurs within a limited temporal window of less than 300 ms. Moreover, the multideviant paradigm elicited DRN responses of comparable amplitude to those in the single-deviant paradigm, highlighting its potential as an efficient tool for assessing temporal processing.

Attention-deficit hyperactivity disorder (ADHD) is an increasingly recognized yet under-addressed challenge within the medical profession, affecting medical students and physicians (including residents and faculty). While current literature emphasizes high rates of depression, anxiety, and burnout in these groups, ADHD - despite its persistence into adulthood and its impact on academic, clinical, and interpersonal functioning - receives comparatively less attention. Reported ADHD prevalence among medical students, residents, and practicing physicians varies widely and may be underestimated due to stigma, underreporting, and diagnostic bias. Untreated ADHD can hinder academic performance, impede residency matching, threaten patient care, and worsen mental health. In prior work, we introduced the 5-Minute Video Summary (5MVS), a multisensory, five-minute physician-narrated video that distills a scientific article's key findings while also commenting on strengths and limitations using varied visuals and vocal delivery to support attention and retention. The present manuscript conceptually extends this ADHD-supportive, technology-enabled approach "upstream" to the foundational task the 5MVS depends on: completing the initial reading of scientific literature. We introduce "Record and Read" (R&R), a self-implemented strategy that leverages auditory reinforcement and the production effect. Learners record themselves reading an article aloud, then listen to the recording while following along and highlighting salient points. R&R is intended to reduce procrastination, increase sustained engagement, and improve comprehension for medical students and physicians with ADHD, potentially offering flexibility and independence, though technological access and stamina demands may pose barriers. While we propose R&R as a complementary tool for medical students and physicians with ADHD to promote both engagement with full-text articles and efficient consolidation, this approach has yet to be systematically studied via pilot, acceptability, or feasibility testing - underscoring its need for empirical evaluation.

Creutzfeldt-Jakob disease is a rare prion disorder that may present with rapidly progressive neurological and neuropsychiatric deterioration, making early diagnosis challenging. We report the case of a 55-year-old woman admitted for rapidly progressive balance impairment evolving over three months, associated with dysarthria, upper-limb dystonia, visual and auditory hallucinations, progressive loss of autonomy, mutism, refusal of oral intake, and myoclonus involving the face and limbs. A history of a similar neurological disorder in her mother was reported. Routine cerebrospinal fluid (CSF) analysis was unremarkable, onconeural antibody testing was negative, and cerebrospinal fluid 14-3-3 protein was negative. Electroencephalography showed slowing with short pseudo-periodic activity over the right hemisphere. Repeat brain magnetic resonance imaging demonstrated bilateral asymmetric cortical diffusion restriction, more marked in the right frontoparietotemporal region and the left parieto-occipital cortex, associated with the involvement of the right caudate and lentiform nuclei and the left caudate nucleus. There was no pathological enhancement, hemorrhage, or thalamic involvement. Based on the rapidly progressive neurological course, myoclonus, extrapyramidal signs, suggestive electroencephalographic abnormalities, and characteristic cortical-basal ganglia diffusion restriction, a diagnosis of probable Creutzfeldt-Jakob disease was favored. This case highlights the diagnostic value of diffusion-weighted magnetic resonance imaging in suspected prion disease, especially when cerebrospinal fluid 14-3-3 protein is negative, and emphasizes the importance of considering a possible familial background when a similar disorder is reported in a first-degree relative.

During face-to-face interactions, overt non-verbal cues from conversational partners can reflect the quality of the conversation. Here, we investigated the impact of specific visual non-verbal cues (i.e., facial expressions of confusion, approaching movements towards the speaker), on the speakers' acoustic-phonetic adaptations typically employed to enhance clarity (i.e., speech rate, voice intensity, and pitch). Participants read sentences to a listener seated in a separate room and visible through a head-mounted display. Crucially, no auditory feedback was provided. Unknown to participants, the listener was a confederate whose behavior was pre-recorded in silence using a 360° video camera. The confederate simulated three different levels of listening effort: easy, medium, and hard. After each trial, participants rated the estimated listening effort and comprehension of the confederate, as well as their own speaking effort. In Experiment 1 (N = 22), participants were told their voice was transmitted with varying background noise levels, providing a rationale for potential listener difficulties. In Experiment 2 (N = 12), no mention of background noise was made, to further isolate the effects of visual cues. In both experiments, participants adjusted their speech to the seen listener's behavior. Experiment 1 showed adaptations across all measured parameters, and significant modulations persisted for most parameters in Experiment 2. These adaptations were already present in the earliest phase of exposure to the visual effort cues and remained stable across the mini-block, suggesting a rapid and highly sensitive monitoring mechanism. These findings indicate that visible non-verbal cues of listening effort can elicit acoustic-phonetic adaptations, even in the absence of acoustic feedback or explicit communicative signals, highlighting their role in regulating communication and maintaining speech clarity.

Isolating relevant sounds in the auditory stream is a crucial feat accomplished by human infants and a pivotal ability for language acquisition. It is therefore reasonable to postulate the existence of early mechanisms that reorient attention toward salient acoustic stimuli. Previous studies suggest that infants tend to allocate more attention to consonant sounds because they resemble human vocalizations. However, systematic evidence on the neural processes underlying consonance tuning in newborns is still scarce. Here, we investigate newborns' learning of auditory regularities by computing mismatch responses (MMRs) and the trial-by-trial correlation between the neural signal and Bayesian surprise (a theoretical measure of learning). We present 22 healthy newborns (40.4 ± 15.8 h) with a roving paradigm (a pseudorandom sequence of deviant and standard events), composed of either consonant or dissonant sounds, while we record their electroencephalogram. Our results show that 1) newborns exhibit a neural encoding of auditory regularities for all sound types (consonant and dissonant), as demonstrated by the presence of MMRs and significant correlation of the neural signal with Bayesian surprise; 2) consonant and dissonant sounds elicited MMRs of opposite polarities, with consonant auditory stimulation evoking negative responses, reminiscent of adult-like MMRs. Overall, our findings suggest that newborns display a dedicated perceptual learning mechanism for consonance. We speculate that this mechanism might represent an evolutionarily acquired process to detect and learn novel auditory stimuli with acoustic features resembling human vocalizations.

Recent advances in eye-tracking technologies have fostered growing interest in their integration with acoustic research for investigating auditory perception and human behavioral responses. This study presents a structured literature review of recent developments at the intersection of eye tracking and acoustics, with the aim of analyzing how eye-movement data can support the interpretation of auditory events, spatial listening behaviors, and multimodal human-environment interactions. The reviewed studies were organized into four main research areas focusing on the application of eye-tracking in acoustics: sound source localization and identification, sound event detection and classification, acoustic sensing and multimodal systems, and soundscape and perceptual acoustic studies. The analysis indicates that eye-movement patterns can provide useful indicators of auditory attention and perceptual processes, particularly when combined with complementary physiological, visual, and acoustic sensing modalities. Furthermore, recent methodological advances, including real-time processing, machine learning algorithms, and sensor fusion techniques, have contributed to improving the robustness and accuracy of multimodal data analysis. Nevertheless, the review also highlights several limitations in current research, such as the lack of standardized experimental protocols, inter-individual variability, and susceptibility to environmental noise and external interference. Finally, future research perspectives are discussed, emphasizing the development of standardized and adaptive multimodal frameworks for human behavior modeling and intelligent acoustic monitoring systems.

Background/Objectives: Auditory neuropathy is a form of hearing loss marked by preserved outer hair cell function and abnormal or absent auditory brainstem responses. Monogenic causes play a significant role in its aetiology. This systematic review aims to identify the genetic causes of auditory neuropathy reported in the literature and to determine the diagnostic yield of genetic testing in affected individuals. Methods: A systematic search of MEDLINE, Embase, and PubMed was conducted. Studies were included if participants had a diagnosis of auditory neuropathy and if genetic testing results were reported with variant interpretation based on American College of Medical Genetics and Genomics criteria. Results/Discussion: Twenty-nine studies involving 441 children and adults with auditory neuropathy were included. Overall, 21 different genes and 136 pathogenic and likely pathogenic variants were found to be causative of auditory neuropathy, with both syndromic and non-syndromic presentations. Variants in OTOF were the most common cause, responsible for 59% of all genetic diagnoses found. A genetic diagnosis was confirmed in 195 of 362 individuals who underwent genetic testing, resulting in a diagnostic yield of 54%. After adjusting for study bias and new gene associations with AN, the diagnostic yield was 31%. Conclusions: This review identifies gene and variant-level associations with auditory neuropathy that enhance our understanding of the condition. It highlights the high diagnostic yield of genetic testing in auditory neuropathy which supports consideration of genetic testing early in the diagnostic pathway. A genetic diagnosis may support precision-based approaches to treatment, including cochlear implants and participation in gene therapy trials.