Verification and validation are objective and subjective measurements of hearing aid function. Many studies have provided rationales for performing these measurements as necessary for hearing aid practitioners to prov...Verification and validation are objective and subjective measurements of hearing aid function. Many studies have provided rationales for performing these measurements as necessary for hearing aid practitioners to provide the highest level of care. Several researchers have suggested that completing these measurements as part of routine clinical care will reduce the number of return visits, reduce the number of aids returned for credit, and increase patient satisfaction. The purpose of this review article is to provide background, method and rationale for practitioners to use these measurements to improve their practice of hearing healthcare.展开更多
Background/purpose:With increasing accessibility to the Internet,patients frequently use the Internet for hearing healthcare information.No study has examined the information about hearing loss available in the Mandar...Background/purpose:With increasing accessibility to the Internet,patients frequently use the Internet for hearing healthcare information.No study has examined the information about hearing loss available in the Mandarin language on online video-sharing platforms.The study’s primary purpose is to investigate the content,source,understandability,and actionability of hearing loss information in the Mandarin language’s one hundred most popular online videos.Method:In this project,publicly accessible online videos were analyzed.One hundred of the most popular Mandarin-language videos about hearing loss were identified(51 videos on YouTube and 49 on the Bilibili video-sharing platform).They were manually coded for different popularity metrics,sources,and content.Each video was also rated using the Patient Education Materials Assessment Tool for Audiovisual Materials(PEMAT-AV)to measure the understandability and actionability scores.Results:The video sources were classified as either media(n=36),professional(n=39),or consumer(n=25).The videos covered various topics,including symptoms,consequences,and treatment of hearing loss.Overall,videos attained adequate understandability scores(mean=73.6%)but low(mean=43.4%)actionability scores.Conclusions:While existing online content related to hearing loss is quite diverse and largely understandable,those videos provide limited actionable information.Hearing healthcare professionals,media,and content creators can help patients better understand their conditions and make educated hearing healthcare decisions by focusing on the actionability information in their online videos.展开更多
Confounding effect is a critical issue in clinical research of otolaryngology because it can distort the research's conclusion. In this review, we introduce the definition of confounding effect, the methods of ver...Confounding effect is a critical issue in clinical research of otolaryngology because it can distort the research's conclusion. In this review, we introduce the definition of confounding effect, the methods of verifying and controlling the effect. Confounding effect can be prevented by research's design, and adjusted by data analysis. Clinicians would be aware and cautious about confounding effect in their research. They would be able to set up a research's design in which appropriate methods have been applied to prevent this effect.They would know how to adjust confounding effect after data collection. It is important to remember that sometimes it is impossible to eliminate confounding effect completely, and statistical method is not a master key. Solid research knowledge and critical thinking of our brain are the most important in controlling confounding effect.展开更多
The purpose of this study was to develop and evaluate the effects of visual materials (labeled pictures and a preference sorting template) on the ability to increase the convergence (agreement) of responses by persons...The purpose of this study was to develop and evaluate the effects of visual materials (labeled pictures and a preference sorting template) on the ability to increase the convergence (agreement) of responses by persons with dementia and their nursing assistants on a Preference Assessment Questionnaire that contained 25 items related to Quality of Life (QoL). A total of 33 nursing assistants participated;54% were native English speakers and 46% were non-native English speakers. Thirty-seven residents with dementia were randomly assigned to either the treatment condition, a 10-min preference card sorting task (VoiceMyChoice?;VMC) which reflected the items and content of the Preference Assessment Questionnaire, or a control condition consisting of a 10-min card matching activity using the materials from VMC. Before and after the treatment or the control session, residents and their assigned NA were administered the Preference Assessment Questionnaire;one week later, these procedures were repeated to assess consistency in responding and improved convergence between dyad members’ responses over time. Results revealed that convergence scores between members of NA-Resident dyads increased significantly after the use of VMC for both the English and non-native English dyads, but not in the control condition. VMC has the potential to enable persons with dementia to communicate personal choices and for their caregivers of various linguistic and/or cultural backgrounds to understand them better.展开更多
The public’s attitudes can affect the experience of stuttering of people who stutter.This study investigated the attitudes held by the public about people who stutter in China.A web-based written survey with closed a...The public’s attitudes can affect the experience of stuttering of people who stutter.This study investigated the attitudes held by the public about people who stutter in China.A web-based written survey with closed and open-ended questions was implemented to develop a rich understanding.One hundred and two respondents in 26 provinces and 3 municipalities provided comments on people who stutter in their life aspects such as personality,speech,social life,work,life participation,education,dating and marriage,capability,and communication skills.The predominantly negative attitudes towards the overall domains were identified.Attitudes to people who stutter varied according to the different sources of knowledge.Familiarity with people who stutter might reduce stereotypes.However,knowledge from the media might aggravate stereotypes.Implications and future research orientation were also discussed.展开更多
Smoothed cepstral peak prominence(CPPs)is a measurement of the distance from the prominent cepstral peak to the linear regression line directly beneath it.Variations of CPPs data acquisition and analysis lead to the c...Smoothed cepstral peak prominence(CPPs)is a measurement of the distance from the prominent cepstral peak to the linear regression line directly beneath it.Variations of CPPs data acquisition and analysis lead to the complexity of the clinical cut-off values,and there are no agreeable values for a specific voice disorder,such as hypokinetic dysarthria associated with Parkinson’s disease(PD).This study examined the CPPs in people with hypokinetic dysarthria associated with PD compared with healthy participants.Results demonstrated significant differences in speech tasks of sustained vowel and connected speech,with CPPs of connected speech more sensitive to dysphonia and gender difference in PD participants.Males in PD participants presented higher CPPs for sustained vowels and lower CPPs for connected speech than females.It is implied that a consistent clinical application protocol is necessary,and multiple acoustic measures are needed to ensure the accuracy of clinical decisions.展开更多
In this article,the mechanism of inheritance behind inherited hearing loss and genetic susceptibilityin noise-induced hearing loss are reviewed.Conventional treatments for sensorineural hearing loss(SNHL),i.e.hearing ...In this article,the mechanism of inheritance behind inherited hearing loss and genetic susceptibilityin noise-induced hearing loss are reviewed.Conventional treatments for sensorineural hearing loss(SNHL),i.e.hearing aid and cochlear implant,are effective for some cases,but not without limitations.For example,they provide little benefit for patients of profound SNHL or neural hearing loss,especially when the hearing loss is in poor dynamic range and with low frequency resolution.We emphasize the most recent evidence-based treatment in this field,which includes gene therapy and allotransplantation of stem cells.Their promising results have shown that they might be options of treatment for profound SNHL and neural hearing loss.Although some treatments are still at the experimental stage,it is helpful to be aware of the novel therapies and endeavour to explore the feasibility of their clinical application.展开更多
Electrically evoked compound action potential(e CAP) amplitudes elicited at suprathreshold levels were assessed as a measure of the effectiveness of cochlear implant(CI) stimulation. Twenty-one individuals participate...Electrically evoked compound action potential(e CAP) amplitudes elicited at suprathreshold levels were assessed as a measure of the effectiveness of cochlear implant(CI) stimulation. Twenty-one individuals participated; one was excluded due to facial stimulation during e CAP testing. For each participant, e CAPs were elicited with stimulation from seven electrodes near the upper limit of the individual's electrical dynamic range. A reduced-channel CI program was created using those same seven electrodes, and participants performed a vowel discrimination task. Consistent with previous reports, e CAP amplitudes varied across tested electrodes; the profiles were unique to each individual. In 6subjects(30%), e CAP amplitude variability was partially explained by the impedance of the recording electrode. The remaining amplitude variability within subjects, and the variability observed across subjects could not be explained by recording electrode impedance. This implies that other underlying factors, such as variations in neural status across the array, are responsible. Across-site mean e CAP amplitude was significantly correlated with vowel discrimination scores(r^2= 0.56). A single e CAP amplitude measured from the middle of the array was also significantly correlated with vowel discrimination, but the correlation was weaker(r^2= 0.37), though not statistically different from the acrosssite mean. Normalizing each e CAP amplitude by its associated recording electrode impedance did not improve the correlation with vowel discrimination(r^2= 0.52). Further work is needed to assess whether combining e CAP amplitude with other measures of the electrode-neural interface and/or with more central measures of auditory function provides a more complete picture of auditory function in CI recipients.展开更多
Alport syndrome is an X-linked syndrome that results in nephritis, renal failure, sensorineural hearing loss, and eye deficits. As a result of sensorineural hearing loss, these individuals are likely to experience dif...Alport syndrome is an X-linked syndrome that results in nephritis, renal failure, sensorineural hearing loss, and eye deficits. As a result of sensorineural hearing loss, these individuals are likely to experience difficulties in the area of speech and language. While studies in the past have examined the speech and language characteristics of children with syndromic sensorineural hearing loss, to our knowledge there are no previous studies to have documented the speech and language characteristics of these children on a long-term basis. The current study addresses this limitation by reporting speech, language, hearing, and function of twin brothers with X-linked Alport syndrome across a seven-year period.Information was collected by examining the medical records of the participants as well as through a verbal interview with the participants' guardian. Results revealed that the participants' hearing abilities gradually deteriorated over the seven-year period which affected their speech and language development as well. The kidney function tests revealed significant presence of hematuria(blood in the urine) as well as proteinuria(protein in the urine) suggesting chronic kidney dysfunction. This longitudinal study demonstrates the functional relationship between the kidneys and the cochlea, although they appear to be independent of one another. As individuals with Alport syndrome exhibit systemic complications, interdisciplinary collaboration is essential among health care providers including audiologists, speech-language pathologists,nephrologists, and ophthalmologist to promote evidence-based practice.展开更多
Objective Taste impairment is prevalent among post-laryngectomy head and neck cancer survivors. Previous studies report resolution of taste changes after treatment. This study aimed to determine the taste function of ...Objective Taste impairment is prevalent among post-laryngectomy head and neck cancer survivors. Previous studies report resolution of taste changes after treatment. This study aimed to determine the taste function of post-laryngectomy head and neck cancer survivors and examine associations with dietary intake and malnutrition status. Materials and Methods Six participants (5 males and 1 female) were tested in their ability to identify solutions of the five basic tastes of bitter (caffeine), salty (sodium chloride), sour (citric acid), sweet (sucrose), and umami (monosodium glutamate) at three different concentrations in triplicate. Participants completed a 24-hour dietary recall to determine dietary intake, and were screened for positive markers of malnutrition. Results Participants had a mean time of 17?10.8 years since treatment. At the lowest concentration, 33.3% of participants identified bitter, 16.7% salty, 16.7% sour, 0% sweet, and 0% umami. No participants presented positive features of malnutrition, though 83.3% of participants’reported energy intake below recommendations. Positive correlations were found between energy intake and correct identification scores for sour at medium (P=0.003) and low (P=0.01) concentrations and for umami at low concentration (P=0.03). Conclusions As evidenced by a lack of malnutrition features and maintenance of weight status, adaptation in taste function appears to occur in post-laryngectomy head and neck cancer survivors. Interventions for taste impairment through stimulation of salivation by sour or umami taste may prevent alterations in dietary intake and maximize quality of life in this population. Further research is required to understand post-treatment taste impairment and recovery.展开更多
Introduction: The absence of vertigo during the caloric test, despite a robust response, has been suggested to represent a central vestibular system phenomenon. The purpose of this investigation was to determine the p...Introduction: The absence of vertigo during the caloric test, despite a robust response, has been suggested to represent a central vestibular system phenomenon. The purpose of this investigation was to determine the prevalence of absent caloric-induced vertigo perception in an unselected group of patients and to assess possible predicting variables.Methods: Prospective investigation of 92 unselected patients who underwent caloric testing. Inclusion criteria were that each patient generate a maximum slow phase velocity(maxSPV) > 15 deg/sec and a caloric asymmetry of≤10%. Following the caloric, patients were asked, "Did you have any sensation of motion?"Results: Results showed 75% of patients reported motion with a mean age of 56.51 years compared to a mean age of 66.55 in the 25% of patients reporting an absence of motion. A logistic regression was performed and the overall model was statistically significant accounting for 29% of the variance in caloric perception. The significant predictor variables were patient age and maxSPV of the caloric response. The effect size for both variables was small with an odds ratio of.9 for maxSPV and 1.06 for age.Conclusions: The current investigation showed that both age and maxSPV of the caloric response were significant predictors of vertigo perception during the caloric exam. However, the association between age and caloric perception is not conclusive. Although there is evidence to suggest that these findings represent age-related changes in the central processing of vestibular system stimulation, there are additional unmeasured factors that influence the perception of caloric-induced vertigo.展开更多
Background: This study aimed to compare the neurophysiological responses to sound in adults with hypersensitivity compared to adults without hypersensitivity, and correlate the daily-life experiences to the neurophysi...Background: This study aimed to compare the neurophysiological responses to sound in adults with hypersensitivity compared to adults without hypersensitivity, and correlate the daily-life experiences to the neurophysiological manifestations. Material and Methods: The Adolescent/Adult Sensory Profile (AASP) was administered to 27 adults, separated by their cut-off scores. Differences in neurophysiological responses were measured by N1-P2 Event-Related Potentials (ERP) in response to auditory changes in frequency and intensity. Reactions to daily sounds were measured by the hyperacusis questionnaire. Correlations between AASP, hyperacusis questionnaire, and ERP were measured. Results: The basic ability to detect a change in stimuli manifested in N1 waveform was not significantly different. However, participants with hypersensitivity presented a stronger P2 response and a higher hyperacusis score. Daily expressions of auditory hypersensitivity correlated (p = 0.05 - p = 0.01) with larger ERP responses. Conclusions: Auditory hypersensitivity as reflected in daily scenarios is evident in neurophysiological manifestations measured by ERPs. Understanding the relationship between the neural mechanisms of auditory hyper-ensitivity and its daily expressions, may optimize participation and wellbeing for people with hypersensitivity.展开更多
Introduction: Parkinson’s Disease (PD) is a devastating neurodegenerative disease that significantly influences motor performance. Recent studies suggest expressive language deficits may also exist among individuals ...Introduction: Parkinson’s Disease (PD) is a devastating neurodegenerative disease that significantly influences motor performance. Recent studies suggest expressive language deficits may also exist among individuals with PD even though the condition is primarily known for changes in motor skills. The purpose of this pilot study was to examine the influence of early stage PD on global coherence or the ability to maintain consistency of a theme or topic. Methods: Discourse samples were collected from eleven individuals with PD and compared to eleven matched controls to examine measures of global coherence. Two-minute speech samples describing a “typical day” were transcribed and rated on mean global coherence and percentage high global coherence. Results: Greater declines in global coherence were observed among individuals with PD, however, comparisons of both mean global coherence ratings and percentage high global coherence were not statistically significant between the two groups. A significant downward linear trend was observed for both mean global coherence ratings and percentage high coherence among all participants indicating decreases in global coherence over time. Conclusion: Approaches to the study of global coherence as a measure of expressive language performance should consider the temporal changes especially among neurological conditions known to reduce expressive language ability.展开更多
Background:Many disease-specific factors such as muscular weakness,increased muscle stiffness,varying postural strategies,and changes in postural reflexes have been shown to lead to postural instability and fall risk ...Background:Many disease-specific factors such as muscular weakness,increased muscle stiffness,varying postural strategies,and changes in postural reflexes have been shown to lead to postural instability and fall risk in people with Parkinson's disease(PD).Recently,analytical techniques,inspired by the dynamical systems perspective on movement control and coordination,have been used to examine the mechanisms underlying the dynamics of postural declines and the emergence of postural instabilities in people with PD.Methods:A wavelet-based technique was used to identify limit cycle oscillations(LCOs) in the anterior–posterior(AP) postural sway of people with mild PD(n = 10) compared to age-matched controls(n = 10).Participants stood on a foam and on a rigid surface while completing a dual task(speaking).Results:There was no significant difference in the root mean square of center of pressure between groups.Three out of 10 participants with PD demonstrated LCOs on the foam surface,while none in the control group demonstrated LCOs.An inverted pendulum model of bipedal stance was used to demonstrate that LCOs occur due to disease-specific changes associated with PD:time-delay and neuromuscular feedback gain.Conclusion:Overall,the LCO analysis and mathematical model appear to capture the subtle postural instabilities associated with mild PD.In addition,these findings provide insights into the mechanisms that lead to the emergence of unstable posture in patients with PD.展开更多
Introduction: Superior semicircular canal dehiscence(SCD) remains difficult to diagnose despite advances in high-resolution computed tomography(HRCT) imaging. We hypothesize possible associations between gross tempora...Introduction: Superior semicircular canal dehiscence(SCD) remains difficult to diagnose despite advances in high-resolution computed tomography(HRCT) imaging. We hypothesize possible associations between gross temporal bone anatomy and sub-millimeter pathology of the semicircular canals, which may supplement imaging and clinical suspicion. This pilot study investigates differences in gross temporal bone anatomic parameters between temporal bones with and without SCD.Methods: Records were reviewed for 18 patients referred to an otology clinic complaining of dizziness with normal caloric stimulation results indicative of non-vestibular findings. Eleven patients had normal temporal bone anatomy while seven had SCD. Three-dimensional reconstruction of every patient's temporal bone anatomy was created from patient-specific computational tomography images. Surface area(SA),volume(V), and SA to V ratios(SA:V) were computed across temporal bone anatomical parameters.Results: SCD temporal bones have significantly smaller V, and larger temporal bone SA. Mean(±SD) V was 21,484 ± 3,921 mm^3 in temporal bones without SCD and 16,343 ± 34,471 mm^3 for those with SCD. Their respective SA were 13,733 ± 1,603 mm^2 and 18,073 ± 3,002 mm^2.Temporal bone airspaces and lateral semicircular canals did not demonstrate significant differences where SCD was and was not present. Plots of MV_(warm)response against computed SCD temporal bone anatomic parameters(SA, V and SA:V) showed moderate to strong correlations:temporal bone SA:V(r= 0.64), temporal bone airspace V(r= 0.60), temporal bone airspace SA(r= 0.55), LSCC SA(r= 0.51), and LSCC-toTM Distance(r= 0.65).Conclusions: This analysis demonstrated that SCD is associated with decreased temporal bone volume and density. The defect in SCD does not appear to influence caloric responses.展开更多
In vivo implantation of microelectrodes opens the door to studying neural circuits and restoring damaged neural pathways through direct electrical stimulation and recording.Although some neuroprostheses have achieved ...In vivo implantation of microelectrodes opens the door to studying neural circuits and restoring damaged neural pathways through direct electrical stimulation and recording.Although some neuroprostheses have achieved clinical success,electrode material properties,inflammatory response,and glial scar formation at the electrode-tissue interfaces affect performance and sustainability.Those challenges can be addressed by improving some of the materials’mechanical,physical,chemical,and electrical properties.This paper reviews materials and designs of current microelectrodes and discusses perspectives to advance neuroprosthetics performance.展开更多
文摘Verification and validation are objective and subjective measurements of hearing aid function. Many studies have provided rationales for performing these measurements as necessary for hearing aid practitioners to provide the highest level of care. Several researchers have suggested that completing these measurements as part of routine clinical care will reduce the number of return visits, reduce the number of aids returned for credit, and increase patient satisfaction. The purpose of this review article is to provide background, method and rationale for practitioners to use these measurements to improve their practice of hearing healthcare.
文摘Background/purpose:With increasing accessibility to the Internet,patients frequently use the Internet for hearing healthcare information.No study has examined the information about hearing loss available in the Mandarin language on online video-sharing platforms.The study’s primary purpose is to investigate the content,source,understandability,and actionability of hearing loss information in the Mandarin language’s one hundred most popular online videos.Method:In this project,publicly accessible online videos were analyzed.One hundred of the most popular Mandarin-language videos about hearing loss were identified(51 videos on YouTube and 49 on the Bilibili video-sharing platform).They were manually coded for different popularity metrics,sources,and content.Each video was also rated using the Patient Education Materials Assessment Tool for Audiovisual Materials(PEMAT-AV)to measure the understandability and actionability scores.Results:The video sources were classified as either media(n=36),professional(n=39),or consumer(n=25).The videos covered various topics,including symptoms,consequences,and treatment of hearing loss.Overall,videos attained adequate understandability scores(mean=73.6%)but low(mean=43.4%)actionability scores.Conclusions:While existing online content related to hearing loss is quite diverse and largely understandable,those videos provide limited actionable information.Hearing healthcare professionals,media,and content creators can help patients better understand their conditions and make educated hearing healthcare decisions by focusing on the actionability information in their online videos.
文摘Confounding effect is a critical issue in clinical research of otolaryngology because it can distort the research's conclusion. In this review, we introduce the definition of confounding effect, the methods of verifying and controlling the effect. Confounding effect can be prevented by research's design, and adjusted by data analysis. Clinicians would be aware and cautious about confounding effect in their research. They would be able to set up a research's design in which appropriate methods have been applied to prevent this effect.They would know how to adjust confounding effect after data collection. It is important to remember that sometimes it is impossible to eliminate confounding effect completely, and statistical method is not a master key. Solid research knowledge and critical thinking of our brain are the most important in controlling confounding effect.
文摘The purpose of this study was to develop and evaluate the effects of visual materials (labeled pictures and a preference sorting template) on the ability to increase the convergence (agreement) of responses by persons with dementia and their nursing assistants on a Preference Assessment Questionnaire that contained 25 items related to Quality of Life (QoL). A total of 33 nursing assistants participated;54% were native English speakers and 46% were non-native English speakers. Thirty-seven residents with dementia were randomly assigned to either the treatment condition, a 10-min preference card sorting task (VoiceMyChoice?;VMC) which reflected the items and content of the Preference Assessment Questionnaire, or a control condition consisting of a 10-min card matching activity using the materials from VMC. Before and after the treatment or the control session, residents and their assigned NA were administered the Preference Assessment Questionnaire;one week later, these procedures were repeated to assess consistency in responding and improved convergence between dyad members’ responses over time. Results revealed that convergence scores between members of NA-Resident dyads increased significantly after the use of VMC for both the English and non-native English dyads, but not in the control condition. VMC has the potential to enable persons with dementia to communicate personal choices and for their caregivers of various linguistic and/or cultural backgrounds to understand them better.
文摘The public’s attitudes can affect the experience of stuttering of people who stutter.This study investigated the attitudes held by the public about people who stutter in China.A web-based written survey with closed and open-ended questions was implemented to develop a rich understanding.One hundred and two respondents in 26 provinces and 3 municipalities provided comments on people who stutter in their life aspects such as personality,speech,social life,work,life participation,education,dating and marriage,capability,and communication skills.The predominantly negative attitudes towards the overall domains were identified.Attitudes to people who stutter varied according to the different sources of knowledge.Familiarity with people who stutter might reduce stereotypes.However,knowledge from the media might aggravate stereotypes.Implications and future research orientation were also discussed.
文摘Smoothed cepstral peak prominence(CPPs)is a measurement of the distance from the prominent cepstral peak to the linear regression line directly beneath it.Variations of CPPs data acquisition and analysis lead to the complexity of the clinical cut-off values,and there are no agreeable values for a specific voice disorder,such as hypokinetic dysarthria associated with Parkinson’s disease(PD).This study examined the CPPs in people with hypokinetic dysarthria associated with PD compared with healthy participants.Results demonstrated significant differences in speech tasks of sustained vowel and connected speech,with CPPs of connected speech more sensitive to dysphonia and gender difference in PD participants.Males in PD participants presented higher CPPs for sustained vowels and lower CPPs for connected speech than females.It is implied that a consistent clinical application protocol is necessary,and multiple acoustic measures are needed to ensure the accuracy of clinical decisions.
文摘In this article,the mechanism of inheritance behind inherited hearing loss and genetic susceptibilityin noise-induced hearing loss are reviewed.Conventional treatments for sensorineural hearing loss(SNHL),i.e.hearing aid and cochlear implant,are effective for some cases,but not without limitations.For example,they provide little benefit for patients of profound SNHL or neural hearing loss,especially when the hearing loss is in poor dynamic range and with low frequency resolution.We emphasize the most recent evidence-based treatment in this field,which includes gene therapy and allotransplantation of stem cells.Their promising results have shown that they might be options of treatment for profound SNHL and neural hearing loss.Although some treatments are still at the experimental stage,it is helpful to be aware of the novel therapies and endeavour to explore the feasibility of their clinical application.
基金supported by the National Institutes of Health, National Institute on Deafness and Other Communication Disorders under the following grants awarded to the University of Iowa: F31DC013202, P50DC000242, and R01DC012082funded in part by the University of Iowa Department of Communication Sciences and Disorders
文摘Electrically evoked compound action potential(e CAP) amplitudes elicited at suprathreshold levels were assessed as a measure of the effectiveness of cochlear implant(CI) stimulation. Twenty-one individuals participated; one was excluded due to facial stimulation during e CAP testing. For each participant, e CAPs were elicited with stimulation from seven electrodes near the upper limit of the individual's electrical dynamic range. A reduced-channel CI program was created using those same seven electrodes, and participants performed a vowel discrimination task. Consistent with previous reports, e CAP amplitudes varied across tested electrodes; the profiles were unique to each individual. In 6subjects(30%), e CAP amplitude variability was partially explained by the impedance of the recording electrode. The remaining amplitude variability within subjects, and the variability observed across subjects could not be explained by recording electrode impedance. This implies that other underlying factors, such as variations in neural status across the array, are responsible. Across-site mean e CAP amplitude was significantly correlated with vowel discrimination scores(r^2= 0.56). A single e CAP amplitude measured from the middle of the array was also significantly correlated with vowel discrimination, but the correlation was weaker(r^2= 0.37), though not statistically different from the acrosssite mean. Normalizing each e CAP amplitude by its associated recording electrode impedance did not improve the correlation with vowel discrimination(r^2= 0.52). Further work is needed to assess whether combining e CAP amplitude with other measures of the electrode-neural interface and/or with more central measures of auditory function provides a more complete picture of auditory function in CI recipients.
文摘Alport syndrome is an X-linked syndrome that results in nephritis, renal failure, sensorineural hearing loss, and eye deficits. As a result of sensorineural hearing loss, these individuals are likely to experience difficulties in the area of speech and language. While studies in the past have examined the speech and language characteristics of children with syndromic sensorineural hearing loss, to our knowledge there are no previous studies to have documented the speech and language characteristics of these children on a long-term basis. The current study addresses this limitation by reporting speech, language, hearing, and function of twin brothers with X-linked Alport syndrome across a seven-year period.Information was collected by examining the medical records of the participants as well as through a verbal interview with the participants' guardian. Results revealed that the participants' hearing abilities gradually deteriorated over the seven-year period which affected their speech and language development as well. The kidney function tests revealed significant presence of hematuria(blood in the urine) as well as proteinuria(protein in the urine) suggesting chronic kidney dysfunction. This longitudinal study demonstrates the functional relationship between the kidneys and the cochlea, although they appear to be independent of one another. As individuals with Alport syndrome exhibit systemic complications, interdisciplinary collaboration is essential among health care providers including audiologists, speech-language pathologists,nephrologists, and ophthalmologist to promote evidence-based practice.
文摘Objective Taste impairment is prevalent among post-laryngectomy head and neck cancer survivors. Previous studies report resolution of taste changes after treatment. This study aimed to determine the taste function of post-laryngectomy head and neck cancer survivors and examine associations with dietary intake and malnutrition status. Materials and Methods Six participants (5 males and 1 female) were tested in their ability to identify solutions of the five basic tastes of bitter (caffeine), salty (sodium chloride), sour (citric acid), sweet (sucrose), and umami (monosodium glutamate) at three different concentrations in triplicate. Participants completed a 24-hour dietary recall to determine dietary intake, and were screened for positive markers of malnutrition. Results Participants had a mean time of 17?10.8 years since treatment. At the lowest concentration, 33.3% of participants identified bitter, 16.7% salty, 16.7% sour, 0% sweet, and 0% umami. No participants presented positive features of malnutrition, though 83.3% of participants’reported energy intake below recommendations. Positive correlations were found between energy intake and correct identification scores for sour at medium (P=0.003) and low (P=0.01) concentrations and for umami at low concentration (P=0.03). Conclusions As evidenced by a lack of malnutrition features and maintenance of weight status, adaptation in taste function appears to occur in post-laryngectomy head and neck cancer survivors. Interventions for taste impairment through stimulation of salivation by sour or umami taste may prevent alterations in dietary intake and maximize quality of life in this population. Further research is required to understand post-treatment taste impairment and recovery.
文摘Introduction: The absence of vertigo during the caloric test, despite a robust response, has been suggested to represent a central vestibular system phenomenon. The purpose of this investigation was to determine the prevalence of absent caloric-induced vertigo perception in an unselected group of patients and to assess possible predicting variables.Methods: Prospective investigation of 92 unselected patients who underwent caloric testing. Inclusion criteria were that each patient generate a maximum slow phase velocity(maxSPV) > 15 deg/sec and a caloric asymmetry of≤10%. Following the caloric, patients were asked, "Did you have any sensation of motion?"Results: Results showed 75% of patients reported motion with a mean age of 56.51 years compared to a mean age of 66.55 in the 25% of patients reporting an absence of motion. A logistic regression was performed and the overall model was statistically significant accounting for 29% of the variance in caloric perception. The significant predictor variables were patient age and maxSPV of the caloric response. The effect size for both variables was small with an odds ratio of.9 for maxSPV and 1.06 for age.Conclusions: The current investigation showed that both age and maxSPV of the caloric response were significant predictors of vertigo perception during the caloric exam. However, the association between age and caloric perception is not conclusive. Although there is evidence to suggest that these findings represent age-related changes in the central processing of vestibular system stimulation, there are additional unmeasured factors that influence the perception of caloric-induced vertigo.
文摘Background: This study aimed to compare the neurophysiological responses to sound in adults with hypersensitivity compared to adults without hypersensitivity, and correlate the daily-life experiences to the neurophysiological manifestations. Material and Methods: The Adolescent/Adult Sensory Profile (AASP) was administered to 27 adults, separated by their cut-off scores. Differences in neurophysiological responses were measured by N1-P2 Event-Related Potentials (ERP) in response to auditory changes in frequency and intensity. Reactions to daily sounds were measured by the hyperacusis questionnaire. Correlations between AASP, hyperacusis questionnaire, and ERP were measured. Results: The basic ability to detect a change in stimuli manifested in N1 waveform was not significantly different. However, participants with hypersensitivity presented a stronger P2 response and a higher hyperacusis score. Daily expressions of auditory hypersensitivity correlated (p = 0.05 - p = 0.01) with larger ERP responses. Conclusions: Auditory hypersensitivity as reflected in daily scenarios is evident in neurophysiological manifestations measured by ERPs. Understanding the relationship between the neural mechanisms of auditory hyper-ensitivity and its daily expressions, may optimize participation and wellbeing for people with hypersensitivity.
文摘Introduction: Parkinson’s Disease (PD) is a devastating neurodegenerative disease that significantly influences motor performance. Recent studies suggest expressive language deficits may also exist among individuals with PD even though the condition is primarily known for changes in motor skills. The purpose of this pilot study was to examine the influence of early stage PD on global coherence or the ability to maintain consistency of a theme or topic. Methods: Discourse samples were collected from eleven individuals with PD and compared to eleven matched controls to examine measures of global coherence. Two-minute speech samples describing a “typical day” were transcribed and rated on mean global coherence and percentage high global coherence. Results: Greater declines in global coherence were observed among individuals with PD, however, comparisons of both mean global coherence ratings and percentage high global coherence were not statistically significant between the two groups. A significant downward linear trend was observed for both mean global coherence ratings and percentage high coherence among all participants indicating decreases in global coherence over time. Conclusion: Approaches to the study of global coherence as a measure of expressive language performance should consider the temporal changes especially among neurological conditions known to reduce expressive language ability.
基金the National Science Foundation for partial financial support for this project provided through the grant CMMI-1300632Purdue University for partial financial support for this project through a Research Incentive Grant
文摘Background:Many disease-specific factors such as muscular weakness,increased muscle stiffness,varying postural strategies,and changes in postural reflexes have been shown to lead to postural instability and fall risk in people with Parkinson's disease(PD).Recently,analytical techniques,inspired by the dynamical systems perspective on movement control and coordination,have been used to examine the mechanisms underlying the dynamics of postural declines and the emergence of postural instabilities in people with PD.Methods:A wavelet-based technique was used to identify limit cycle oscillations(LCOs) in the anterior–posterior(AP) postural sway of people with mild PD(n = 10) compared to age-matched controls(n = 10).Participants stood on a foam and on a rigid surface while completing a dual task(speaking).Results:There was no significant difference in the root mean square of center of pressure between groups.Three out of 10 participants with PD demonstrated LCOs on the foam surface,while none in the control group demonstrated LCOs.An inverted pendulum model of bipedal stance was used to demonstrate that LCOs occur due to disease-specific changes associated with PD:time-delay and neuromuscular feedback gain.Conclusion:Overall,the LCO analysis and mathematical model appear to capture the subtle postural instabilities associated with mild PD.In addition,these findings provide insights into the mechanisms that lead to the emergence of unstable posture in patients with PD.
基金supported in part by the National Institutes of Health (United States of America) under Award Numbers 5T32DC013018-03 and TL1TR001116
文摘Introduction: Superior semicircular canal dehiscence(SCD) remains difficult to diagnose despite advances in high-resolution computed tomography(HRCT) imaging. We hypothesize possible associations between gross temporal bone anatomy and sub-millimeter pathology of the semicircular canals, which may supplement imaging and clinical suspicion. This pilot study investigates differences in gross temporal bone anatomic parameters between temporal bones with and without SCD.Methods: Records were reviewed for 18 patients referred to an otology clinic complaining of dizziness with normal caloric stimulation results indicative of non-vestibular findings. Eleven patients had normal temporal bone anatomy while seven had SCD. Three-dimensional reconstruction of every patient's temporal bone anatomy was created from patient-specific computational tomography images. Surface area(SA),volume(V), and SA to V ratios(SA:V) were computed across temporal bone anatomical parameters.Results: SCD temporal bones have significantly smaller V, and larger temporal bone SA. Mean(±SD) V was 21,484 ± 3,921 mm^3 in temporal bones without SCD and 16,343 ± 34,471 mm^3 for those with SCD. Their respective SA were 13,733 ± 1,603 mm^2 and 18,073 ± 3,002 mm^2.Temporal bone airspaces and lateral semicircular canals did not demonstrate significant differences where SCD was and was not present. Plots of MV_(warm)response against computed SCD temporal bone anatomic parameters(SA, V and SA:V) showed moderate to strong correlations:temporal bone SA:V(r= 0.64), temporal bone airspace V(r= 0.60), temporal bone airspace SA(r= 0.55), LSCC SA(r= 0.51), and LSCC-toTM Distance(r= 0.65).Conclusions: This analysis demonstrated that SCD is associated with decreased temporal bone volume and density. The defect in SCD does not appear to influence caloric responses.
基金funded through the NIH by grant R01DC018666 at Northwestern University.
文摘In vivo implantation of microelectrodes opens the door to studying neural circuits and restoring damaged neural pathways through direct electrical stimulation and recording.Although some neuroprostheses have achieved clinical success,electrode material properties,inflammatory response,and glial scar formation at the electrode-tissue interfaces affect performance and sustainability.Those challenges can be addressed by improving some of the materials’mechanical,physical,chemical,and electrical properties.This paper reviews materials and designs of current microelectrodes and discusses perspectives to advance neuroprosthetics performance.
