Tyrosine Hydroxylase Expression in Type II Cochlear Afferents in Mice

Abstract

Acoustic information propagates from the ear to the brain via spiral ganglion neurons that innervate hair cells in the cochlea. These afferents include unmyelinated type II fibers that constitute 5 % of the total, the majority being myelinated type I neurons. Lack of specific genetic markers of type II afferents in the cochlea has been a roadblock in studying their functional role. Unexpectedly, type II afferents were visualized by reporter proteins induced by tyrosine hydroxylase (TH)-driven Cre recombinase. The present study was designed to determine whether TH-driven Cre recombinase (TH-2A-CreER) provides a selective and reliable tool for identification and genetic manipulation of type II rather than type I cochlear afferents. The “TH-2A-CreER neurons” radiated from the spiral lamina, crossed the tunnel of Corti, turned towards the base of the cochlea, and traveled beneath the rows of outer hair cells. Neither the processes nor the somata of TH-2A-CreER neurons were labeled by antibodies that specifically labeled type I afferents and medial efferents. TH-2A-CreER-positive processes partially co-labeled with antibodies to peripherin, a known marker of type II afferents. Individual TH-2A-CreER neurons gave off short branches contacting 7–25 outer hair cells (OHCs). Only a fraction of TH-2A-CreER boutons were associated with CtBP2-immunopositive ribbons. These results show that TH-2A-CreER provides a selective marker for type II versus type I afferents and can be used to describe the morphology and arborization pattern of type II cochlear afferents in the mouse cochlea.

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Processing Mechanisms in Hearing-Impaired Listeners: Evidence from Reaction Times and Sentence Interpretation.

Objective: The authors aimed to determine whether hearing impairment affects sentence comprehension beyond phoneme or word recognition (i.e., on the sentence level), and to distinguish grammatically induced processing difficulties in structurally complex sentences from perceptual difficulties associated with listening to degraded speech. Effects of hearing impairment or speech in noise were expected to reflect hearer-specific speech recognition difficulties. Any additional processing time caused by the sustained perceptual challenges across the sentence may either be independent of or interact with top-down processing mechanisms associated with grammatical sentence structure. Design: Forty-nine participants listened to canonical subject-initial or noncanonical object-initial sentences that were presented either in quiet or in noise. Twenty-four participants had mild-to-moderate hearing impairment and received hearing-loss-specific amplification. Twenty-five participants were age-matched peers with normal hearing status. Reaction times were measured on-line at syntactically critical processing points as well as two control points to capture differences in processing mechanisms. An off-line comprehension task served as an additional indicator of sentence (mis)interpretation, and enforced syntactic processing. Results: The authors found general effects of hearing impairment and speech in noise that negatively affected perceptual processing, and an effect of word order, where complex grammar locally caused processing difficulties for the noncanonical sentence structure. Listeners with hearing impairment were hardly affected by noise at the beginning of the sentence, but were affected markedly toward the end of the sentence, indicating a sustained perceptual effect of speech recognition. Comprehension of sentences with noncanonical word order was negatively affected by degraded signals even after sentence presentation. Conclusion: Hearing impairment adds perceptual processing load during sentence processing, but affects grammatical processing beyond the word level to the same degree as in normal hearing, with minor differences in processing mechanisms. The data contribute to our understanding of individual differences in speech perception and language understanding. The authors interpret their results within the ease of language understanding model. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Processing Mechanisms in Hearing-Impaired Listeners: Evidence from Reaction Times and Sentence Interpretation.

Objective: The authors aimed to determine whether hearing impairment affects sentence comprehension beyond phoneme or word recognition (i.e., on the sentence level), and to distinguish grammatically induced processing difficulties in structurally complex sentences from perceptual difficulties associated with listening to degraded speech. Effects of hearing impairment or speech in noise were expected to reflect hearer-specific speech recognition difficulties. Any additional processing time caused by the sustained perceptual challenges across the sentence may either be independent of or interact with top-down processing mechanisms associated with grammatical sentence structure. Design: Forty-nine participants listened to canonical subject-initial or noncanonical object-initial sentences that were presented either in quiet or in noise. Twenty-four participants had mild-to-moderate hearing impairment and received hearing-loss-specific amplification. Twenty-five participants were age-matched peers with normal hearing status. Reaction times were measured on-line at syntactically critical processing points as well as two control points to capture differences in processing mechanisms. An off-line comprehension task served as an additional indicator of sentence (mis)interpretation, and enforced syntactic processing. Results: The authors found general effects of hearing impairment and speech in noise that negatively affected perceptual processing, and an effect of word order, where complex grammar locally caused processing difficulties for the noncanonical sentence structure. Listeners with hearing impairment were hardly affected by noise at the beginning of the sentence, but were affected markedly toward the end of the sentence, indicating a sustained perceptual effect of speech recognition. Comprehension of sentences with noncanonical word order was negatively affected by degraded signals even after sentence presentation. Conclusion: Hearing impairment adds perceptual processing load during sentence processing, but affects grammatical processing beyond the word level to the same degree as in normal hearing, with minor differences in processing mechanisms. The data contribute to our understanding of individual differences in speech perception and language understanding. The authors interpret their results within the ease of language understanding model. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Processing Mechanisms in Hearing-Impaired Listeners: Evidence from Reaction Times and Sentence Interpretation.

Objective: The authors aimed to determine whether hearing impairment affects sentence comprehension beyond phoneme or word recognition (i.e., on the sentence level), and to distinguish grammatically induced processing difficulties in structurally complex sentences from perceptual difficulties associated with listening to degraded speech. Effects of hearing impairment or speech in noise were expected to reflect hearer-specific speech recognition difficulties. Any additional processing time caused by the sustained perceptual challenges across the sentence may either be independent of or interact with top-down processing mechanisms associated with grammatical sentence structure. Design: Forty-nine participants listened to canonical subject-initial or noncanonical object-initial sentences that were presented either in quiet or in noise. Twenty-four participants had mild-to-moderate hearing impairment and received hearing-loss-specific amplification. Twenty-five participants were age-matched peers with normal hearing status. Reaction times were measured on-line at syntactically critical processing points as well as two control points to capture differences in processing mechanisms. An off-line comprehension task served as an additional indicator of sentence (mis)interpretation, and enforced syntactic processing. Results: The authors found general effects of hearing impairment and speech in noise that negatively affected perceptual processing, and an effect of word order, where complex grammar locally caused processing difficulties for the noncanonical sentence structure. Listeners with hearing impairment were hardly affected by noise at the beginning of the sentence, but were affected markedly toward the end of the sentence, indicating a sustained perceptual effect of speech recognition. Comprehension of sentences with noncanonical word order was negatively affected by degraded signals even after sentence presentation. Conclusion: Hearing impairment adds perceptual processing load during sentence processing, but affects grammatical processing beyond the word level to the same degree as in normal hearing, with minor differences in processing mechanisms. The data contribute to our understanding of individual differences in speech perception and language understanding. The authors interpret their results within the ease of language understanding model. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Signia Expert Series: Speech-in-Noise Testing for Selection and Fitting of Hearing Aids: Worth the Effort?

In 2010, I conducted a survey at two audiology professional meetings, of 107 audiologists who routinely fit hearing aids. The purpose of the survey was to look at audiologists’ use of speech-in-noise testing in their clinical practice. This survey was given after I had conducted a talk on different speech-in-noise tests, so everyone who took the survey was familiar with the speech-in-noise tests that were listed in the survey.

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Signia Expert Series: Speech-in-Noise Testing for Selection and Fitting of Hearing Aids: Worth the Effort?

In 2010, I conducted a survey at two audiology professional meetings, of 107 audiologists who routinely fit hearing aids. The purpose of the survey was to look at audiologists’ use of speech-in-noise testing in their clinical practice. This survey was given after I had conducted a talk on different speech-in-noise tests, so everyone who took the survey was familiar with the speech-in-noise tests that were listed in the survey.

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Signia Expert Series: Speech-in-Noise Testing for Selection and Fitting of Hearing Aids: Worth the Effort?

In 2010, I conducted a survey at two audiology professional meetings, of 107 audiologists who routinely fit hearing aids. The purpose of the survey was to look at audiologists’ use of speech-in-noise testing in their clinical practice. This survey was given after I had conducted a talk on different speech-in-noise tests, so everyone who took the survey was familiar with the speech-in-noise tests that were listed in the survey.

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Ossicular Bone Damage and Hearing Loss in Rheumatoid Arthritis: A Correlated Functional and High Resolution Morphometric Study in Collagen-Induced Arthritic Mice

by Rensa Chen, Martin Schwander, Mary F. Barbe, Marion M. Chan

Globally, a body of comparative case-control studies suggests that rheumatoid arthritis (RA) patients are more prone to developing hearing loss (HL). However, experimental evidence that supports this hypothesis is still lacking because the human auditory organ is not readily accessible. The aim of this study was to determine the association between bone damage to the ossicles of the middle ear and HL, using a widely accepted murine model of collagen-induced arthritis (RA mice). Diarthrodial joints in the middle ear were examined with microcomputer tomography (microCT), and hearing function was assessed by auditory brainstem response (ABR). RA mice exhibited significantly decreased hearing sensitivity compared to age-matched controls. Additionally, a significant narrowing of the incudostapedial joint space and an increase in the porosity of the stapes were observed. The absolute latencies of all ABR waves were prolonged, but mean interpeak latencies were not statistically different. The observed bone defects in the middle ear that were accompanied by changes in ABR responses were consistent with conductive HL. This combination suggests that conductive impairment is at least part of the etiology of RA-induced HL in a murine model. Whether the inner ear sustains bone erosion or other pathology, and whether the cochlear nerve sustains pathology await subsequent studies. Considering the fact that certain anti-inflammatories are ototoxic in high doses, monitoring RA patients’ auditory function is advisable as part of the effort to ensure their well-being.

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Enhancing speech envelope by integrating hair-cell adaptation into cochlear implant processing

Publication date: Available online 30 September 2016
Source:Hearing Research
Author(s): Mahan Azadpour, Robert L. Smith
Cochlear implants (CIs) bypass some of the mechanisms that underlie normal neural behavior as occurs in acoustic hearing. One such neural mechanism is short-term adaptation, which has been proposed to have a significant role in speech perception. Acoustically-evoked neural adaptation has been mainly attributed to the depletion of neurotransmitter in the hair-cell to auditory-nerve synapse and is therefore not fully present in CI stimulation. This study evaluated a signal processing method that integrated a physiological model of hair-cell adaptation into CI speech processing. The linear high-pass adaptation model expanded the range of rapid variations of the electrical signal generated by the clinical processing strategy. Speech perception performance with the adaptation-based processing was compared to that of the clinical strategy in seven CI users. While there was large variability across subjects, the new processing improved sentence recognition and consonant identification scores in quiet in all the tested subjects with an average improvement of 8% and 6% respectively. Consonant recognition scores in babble noise were improved at the higher signal-to-noise ratios tested (10 and 6 dB) only. Information transfer analysis of consonant features showed significant improvements for manner and place of articulation features, but not for voicing. Enhancement of within-channel envelope cues was confirmed by consonant recognition results obtained with single-channel strategies that presented the overall amplitude envelope of the signal on a single active electrode. Adaptation-inspired envelope enhancement techniques can potentially improve perception of important speech features by CI users.



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Auditory steady-state responses as neural correlates of loudness growth

Publication date: Available online 29 September 2016
Source:Hearing Research
Author(s): Maaike Van Eeckhoutte, Jan Wouters, Tom Francart
The aim of this study was to find an objective estimate of individual, complete loudness growth functions based on auditory steady-state responses. Both normal-hearing and hearing-impaired listeners were involved in two behavioral loudness growth tasks and one EEG recording session. Behavioral loudness growth was measured with Absolute Magnitude Estimation and a Graphic Rating Scale with loudness categories. Stimuli were sinusoidally amplitude-modulated sinusoids with carrier frequencies of either 500 Hz or 2000 Hz, a modulation frequency of 40 Hz, a duration of 1 s, and presented at intensities encompassing the participants’ dynamic ranges. Auditory steady-state responses were evoked by the same stimuli using durations of at least 5 minutes. Results showed that there was a good correspondence between the relative growth of the auditory steady-state response amplitudes and the behavioral loudness growth responses for each participant of both groups of listeners. This demonstrates the potential for a more individual, objective, and automatic fitting of hearing aids in future clinical practice.



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Enhancing speech envelope by integrating hair-cell adaptation into cochlear implant processing

Publication date: Available online 30 September 2016
Source:Hearing Research
Author(s): Mahan Azadpour, Robert L. Smith
Cochlear implants (CIs) bypass some of the mechanisms that underlie normal neural behavior as occurs in acoustic hearing. One such neural mechanism is short-term adaptation, which has been proposed to have a significant role in speech perception. Acoustically-evoked neural adaptation has been mainly attributed to the depletion of neurotransmitter in the hair-cell to auditory-nerve synapse and is therefore not fully present in CI stimulation. This study evaluated a signal processing method that integrated a physiological model of hair-cell adaptation into CI speech processing. The linear high-pass adaptation model expanded the range of rapid variations of the electrical signal generated by the clinical processing strategy. Speech perception performance with the adaptation-based processing was compared to that of the clinical strategy in seven CI users. While there was large variability across subjects, the new processing improved sentence recognition and consonant identification scores in quiet in all the tested subjects with an average improvement of 8% and 6% respectively. Consonant recognition scores in babble noise were improved at the higher signal-to-noise ratios tested (10 and 6 dB) only. Information transfer analysis of consonant features showed significant improvements for manner and place of articulation features, but not for voicing. Enhancement of within-channel envelope cues was confirmed by consonant recognition results obtained with single-channel strategies that presented the overall amplitude envelope of the signal on a single active electrode. Adaptation-inspired envelope enhancement techniques can potentially improve perception of important speech features by CI users.



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Auditory steady-state responses as neural correlates of loudness growth

Publication date: Available online 29 September 2016
Source:Hearing Research
Author(s): Maaike Van Eeckhoutte, Jan Wouters, Tom Francart
The aim of this study was to find an objective estimate of individual, complete loudness growth functions based on auditory steady-state responses. Both normal-hearing and hearing-impaired listeners were involved in two behavioral loudness growth tasks and one EEG recording session. Behavioral loudness growth was measured with Absolute Magnitude Estimation and a Graphic Rating Scale with loudness categories. Stimuli were sinusoidally amplitude-modulated sinusoids with carrier frequencies of either 500 Hz or 2000 Hz, a modulation frequency of 40 Hz, a duration of 1 s, and presented at intensities encompassing the participants’ dynamic ranges. Auditory steady-state responses were evoked by the same stimuli using durations of at least 5 minutes. Results showed that there was a good correspondence between the relative growth of the auditory steady-state response amplitudes and the behavioral loudness growth responses for each participant of both groups of listeners. This demonstrates the potential for a more individual, objective, and automatic fitting of hearing aids in future clinical practice.



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Enhancing speech envelope by integrating hair-cell adaptation into cochlear implant processing

Publication date: Available online 30 September 2016
Source:Hearing Research
Author(s): Mahan Azadpour, Robert L. Smith
Cochlear implants (CIs) bypass some of the mechanisms that underlie normal neural behavior as occurs in acoustic hearing. One such neural mechanism is short-term adaptation, which has been proposed to have a significant role in speech perception. Acoustically-evoked neural adaptation has been mainly attributed to the depletion of neurotransmitter in the hair-cell to auditory-nerve synapse and is therefore not fully present in CI stimulation. This study evaluated a signal processing method that integrated a physiological model of hair-cell adaptation into CI speech processing. The linear high-pass adaptation model expanded the range of rapid variations of the electrical signal generated by the clinical processing strategy. Speech perception performance with the adaptation-based processing was compared to that of the clinical strategy in seven CI users. While there was large variability across subjects, the new processing improved sentence recognition and consonant identification scores in quiet in all the tested subjects with an average improvement of 8% and 6% respectively. Consonant recognition scores in babble noise were improved at the higher signal-to-noise ratios tested (10 and 6 dB) only. Information transfer analysis of consonant features showed significant improvements for manner and place of articulation features, but not for voicing. Enhancement of within-channel envelope cues was confirmed by consonant recognition results obtained with single-channel strategies that presented the overall amplitude envelope of the signal on a single active electrode. Adaptation-inspired envelope enhancement techniques can potentially improve perception of important speech features by CI users.



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Auditory steady-state responses as neural correlates of loudness growth

Publication date: Available online 29 September 2016
Source:Hearing Research
Author(s): Maaike Van Eeckhoutte, Jan Wouters, Tom Francart
The aim of this study was to find an objective estimate of individual, complete loudness growth functions based on auditory steady-state responses. Both normal-hearing and hearing-impaired listeners were involved in two behavioral loudness growth tasks and one EEG recording session. Behavioral loudness growth was measured with Absolute Magnitude Estimation and a Graphic Rating Scale with loudness categories. Stimuli were sinusoidally amplitude-modulated sinusoids with carrier frequencies of either 500 Hz or 2000 Hz, a modulation frequency of 40 Hz, a duration of 1 s, and presented at intensities encompassing the participants’ dynamic ranges. Auditory steady-state responses were evoked by the same stimuli using durations of at least 5 minutes. Results showed that there was a good correspondence between the relative growth of the auditory steady-state response amplitudes and the behavioral loudness growth responses for each participant of both groups of listeners. This demonstrates the potential for a more individual, objective, and automatic fitting of hearing aids in future clinical practice.



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Effects of belt speed on the body’s center of mass motion relative to the center of pressure during treadmill walking

Publication date: Available online 29 September 2016
Source:Gait & Posture
Author(s): Hsuan-Lun Lu, Tung-Wu Lu, Hsiu-Chen Lin, Hong-Jung Hsieh, Wing P. Chan
Treadmills are often used in clinical settings to improve walking balance control in patients with gait impairments. However, knowledge of the effects of belt speed on balance control remains incomplete. The current study determined such effects in terms of inclination angles (ia) and the rate of change (rcia) of the center of mass (com) motion relative to the center of pressure (cop) in twelve healthy adults at five belt speeds, including the subjects' preferred walking speed (pws), as measured using a motion capture system and an instrumented treadmill. The values of ias and rcias at key gait events and their average values over single-limb support (sls) and double-limb support (dls) were compared between speeds using one-way repeated measures analysis of variances. While the com-cop controls were different between sls and dls, they were inter-related to form an integrated whole. Among the belt speeds, the range of frontal ia during sls was smallest at the pws (p<0.05). With increasing speed, most variables of the sagittal ias and rcias, and of the frontal rcias during dls showed a linearly increasing trend (p<0.001). A linearly decreasing trend was found in the frontal ia at toe-off and in the average frontal rcia during sls (p<0.05). The pws appeared to be the best compromise between frontal stability during sls and smooth weight-transfer during dls. The current results provide useful baseline data for selecting speeds according to training needs, and may be helpful for developing protocols for gait retraining for patients with gait impairment.



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Perceiving slipperiness and grip: A meaningful relationship of the shoe-ground interface

Publication date: Available online 29 September 2016
Source:Gait & Posture
Author(s): Cédric Morio, Aurore Bourrelly, Lise Sissler, Nils Gueguen
The present study investigated the relationship between objective measurements of the available (CoFA), the utilized (CoFU) coefficient of friction and subjective perception of grip or slipperiness. It was hypothesized that significant correlations exist between the perception of grip or slip and the CoF during sports movement and that a minimum CoF was needed to ensure an optimal grip/slipperiness perception. Eighteen healthy active females performed forward and backward cutting tasks onto a forceplate. Six shoes and two floors were used to induce different grip conditions. Subjective ratings and CoFU were assessed for each shoe-floor combination, and mechanical CoFA was also measured in a specific test bed. Significant relationships (p<0.001) were found between grip, slipperiness ratings or CoFA with the CoFU (r=0.98, r=−0.97, r=0.88, respectively). Individual sensory thresholds of the minimum required CoFU were also determined using probit models between the CoFU and the grip acceptability. The mean threshold defined in the present study was 0.70±0.11. This meant that below this threshold, the grip perception was not acceptable, whereas above this threshold, the grip was felt good enough to perform the task. In conclusion, strong relationships between subjective perceptions and objective measurements of friction were found in sports-like movements. Moreover, a minimum friction requirement was defined for indoor dry shoe-floor conditions. The present study gives new insights of the shoe-floor interaction and outlines friction requirements for the manufacturers of sports floor or footwear.



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Effects of belt speed on the body’s center of mass motion relative to the center of pressure during treadmill walking

Publication date: Available online 29 September 2016
Source:Gait & Posture
Author(s): Hsuan-Lun Lu, Tung-Wu Lu, Hsiu-Chen Lin, Hong-Jung Hsieh, Wing P. Chan
Treadmills are often used in clinical settings to improve walking balance control in patients with gait impairments. However, knowledge of the effects of belt speed on balance control remains incomplete. The current study determined such effects in terms of inclination angles (ia) and the rate of change (rcia) of the center of mass (com) motion relative to the center of pressure (cop) in twelve healthy adults at five belt speeds, including the subjects' preferred walking speed (pws), as measured using a motion capture system and an instrumented treadmill. The values of ias and rcias at key gait events and their average values over single-limb support (sls) and double-limb support (dls) were compared between speeds using one-way repeated measures analysis of variances. While the com-cop controls were different between sls and dls, they were inter-related to form an integrated whole. Among the belt speeds, the range of frontal ia during sls was smallest at the pws (p<0.05). With increasing speed, most variables of the sagittal ias and rcias, and of the frontal rcias during dls showed a linearly increasing trend (p<0.001). A linearly decreasing trend was found in the frontal ia at toe-off and in the average frontal rcia during sls (p<0.05). The pws appeared to be the best compromise between frontal stability during sls and smooth weight-transfer during dls. The current results provide useful baseline data for selecting speeds according to training needs, and may be helpful for developing protocols for gait retraining for patients with gait impairment.



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Perceiving slipperiness and grip: A meaningful relationship of the shoe-ground interface

Publication date: Available online 29 September 2016
Source:Gait & Posture
Author(s): Cédric Morio, Aurore Bourrelly, Lise Sissler, Nils Gueguen
The present study investigated the relationship between objective measurements of the available (CoFA), the utilized (CoFU) coefficient of friction and subjective perception of grip or slipperiness. It was hypothesized that significant correlations exist between the perception of grip or slip and the CoF during sports movement and that a minimum CoF was needed to ensure an optimal grip/slipperiness perception. Eighteen healthy active females performed forward and backward cutting tasks onto a forceplate. Six shoes and two floors were used to induce different grip conditions. Subjective ratings and CoFU were assessed for each shoe-floor combination, and mechanical CoFA was also measured in a specific test bed. Significant relationships (p<0.001) were found between grip, slipperiness ratings or CoFA with the CoFU (r=0.98, r=−0.97, r=0.88, respectively). Individual sensory thresholds of the minimum required CoFU were also determined using probit models between the CoFU and the grip acceptability. The mean threshold defined in the present study was 0.70±0.11. This meant that below this threshold, the grip perception was not acceptable, whereas above this threshold, the grip was felt good enough to perform the task. In conclusion, strong relationships between subjective perceptions and objective measurements of friction were found in sports-like movements. Moreover, a minimum friction requirement was defined for indoor dry shoe-floor conditions. The present study gives new insights of the shoe-floor interaction and outlines friction requirements for the manufacturers of sports floor or footwear.



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Effects of belt speed on the body’s center of mass motion relative to the center of pressure during treadmill walking

Publication date: Available online 29 September 2016
Source:Gait & Posture
Author(s): Hsuan-Lun Lu, Tung-Wu Lu, Hsiu-Chen Lin, Hong-Jung Hsieh, Wing P. Chan
Treadmills are often used in clinical settings to improve walking balance control in patients with gait impairments. However, knowledge of the effects of belt speed on balance control remains incomplete. The current study determined such effects in terms of inclination angles (ia) and the rate of change (rcia) of the center of mass (com) motion relative to the center of pressure (cop) in twelve healthy adults at five belt speeds, including the subjects' preferred walking speed (pws), as measured using a motion capture system and an instrumented treadmill. The values of ias and rcias at key gait events and their average values over single-limb support (sls) and double-limb support (dls) were compared between speeds using one-way repeated measures analysis of variances. While the com-cop controls were different between sls and dls, they were inter-related to form an integrated whole. Among the belt speeds, the range of frontal ia during sls was smallest at the pws (p<0.05). With increasing speed, most variables of the sagittal ias and rcias, and of the frontal rcias during dls showed a linearly increasing trend (p<0.001). A linearly decreasing trend was found in the frontal ia at toe-off and in the average frontal rcia during sls (p<0.05). The pws appeared to be the best compromise between frontal stability during sls and smooth weight-transfer during dls. The current results provide useful baseline data for selecting speeds according to training needs, and may be helpful for developing protocols for gait retraining for patients with gait impairment.



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Perceiving slipperiness and grip: A meaningful relationship of the shoe-ground interface

Publication date: Available online 29 September 2016
Source:Gait & Posture
Author(s): Cédric Morio, Aurore Bourrelly, Lise Sissler, Nils Gueguen
The present study investigated the relationship between objective measurements of the available (CoFA), the utilized (CoFU) coefficient of friction and subjective perception of grip or slipperiness. It was hypothesized that significant correlations exist between the perception of grip or slip and the CoF during sports movement and that a minimum CoF was needed to ensure an optimal grip/slipperiness perception. Eighteen healthy active females performed forward and backward cutting tasks onto a forceplate. Six shoes and two floors were used to induce different grip conditions. Subjective ratings and CoFU were assessed for each shoe-floor combination, and mechanical CoFA was also measured in a specific test bed. Significant relationships (p<0.001) were found between grip, slipperiness ratings or CoFA with the CoFU (r=0.98, r=−0.97, r=0.88, respectively). Individual sensory thresholds of the minimum required CoFU were also determined using probit models between the CoFU and the grip acceptability. The mean threshold defined in the present study was 0.70±0.11. This meant that below this threshold, the grip perception was not acceptable, whereas above this threshold, the grip was felt good enough to perform the task. In conclusion, strong relationships between subjective perceptions and objective measurements of friction were found in sports-like movements. Moreover, a minimum friction requirement was defined for indoor dry shoe-floor conditions. The present study gives new insights of the shoe-floor interaction and outlines friction requirements for the manufacturers of sports floor or footwear.



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SPATA5 mutations cause a distinct autosomal recessive phenotype of intellectual disability, hypotonia and hearing loss.

Related Articles

SPATA5 mutations cause a distinct autosomal recessive phenotype of intellectual disability, hypotonia and hearing loss.

Orphanet J Rare Dis. 2016;11(1):130

Authors: Buchert R, Nesbitt AI, Tawamie H, Krantz ID, Medne L, Helbig I, Matalon DR, Reis A, Santani A, Sticht H, Abou Jamra R

Abstract
We examined an extended, consanguineous family with seven individuals with severe intellectual disability and microcephaly. Further symptoms were hearing loss, vision impairment, gastrointestinal disturbances, and slow and asymmetric waves in the EEG. Linkage analysis followed by exome sequencing revealed a homozygous variant in SPATA5 (c.1822_1824del; p.Asp608del), which segregates with the phenotype in the family. Molecular modelling suggested a deleterious effect of the identified alterations on the protein function. In an unrelated family, we identified compound heterozygous variants in SPATA5 (c.[2081G > A];[989_991delCAA]; p.[Gly694Glu];[.Thr330del]) in a further individual with global developmental delay, infantile spasms, profound dystonia, and sensorineural hearing loss. Molecular modelling suggested an impairment of protein function in the presence of both variants.SPATA5 is a member of the ATPase associated with diverse activities (AAA) protein family and was very recently reported in one publication to be mutated in individuals with intellectual disability, epilepsy and hearing loss. Our results describe new, probably pathogenic variants in SPATA5 that were identified in individuals with a comparable phenotype. We thus independently confirm that bi-allelic pathogenic variants in SPATA5 cause a syndromic form of intellectual disability, and we delineate its clinical presentation.

PMID: 27683084 [PubMed - as supplied by publisher]

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Gilles de la Tourette syndrome in a cohort of deaf people.

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Gilles de la Tourette syndrome in a cohort of deaf people.

Asian J Psychiatr. 2015 Oct;17:65-70

Authors: Robertson MM, Roberts S, Pillai S, Eapen V

Abstract
We present six patients with Gilles de la Tourette syndrome (TS) who are also deaf. TS has been observed previously, but rarely reported in deaf people, and to date, so called "unusual" phenomenology has been highlighted. TS occurs almost worldwide and in all cultures, and the clinical phenomenology is virtually identical. In our cohort of deaf patients (we suggest another culture) with TS, the phenomenology is the same as in hearing people, and as in all other cultures, with classic motor and vocal/phonic tics, as well as associated phenomena including echo-phenomena, pali-phenomena and rarer copro-phenomena. When "words" related to these phenomenon (e.g. echolalia, palilalia, coprolalia or mental coprolalia) are elicited in deaf people, they occur usually in British Sign Language (BSL): the more "basic" vocal/phonic tics such as throat clearing are the same phenomenologically as in hearing TS people. In our case series, there was a genetic predisposition to TS in all cases. We would argue that TS in deaf people is the same as TS in hearing people and in other cultures, highlighting the biological nature of the disorder.

PMID: 26216703 [PubMed - indexed for MEDLINE]

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Mobile Communication Devices, Ambient Noise, and Acoustic Voice Measures

Publication date: Available online 29 September 2016
Source:Journal of Voice
Author(s): Youri Maryn, Femke Ysenbaert, Andrzej Zarowski, Robby Vanspauwen
ObjectivesThe ability to move with mobile communication devices (MCDs; ie, smartphones and tablet computers) may induce differences in microphone-to-mouth positioning and use in noise-packed environments, and thus influence reliability of acoustic voice measurements. This study investigated differences in various acoustic voice measures between six recording equipments in backgrounds with low and increasing noise levels.MethodsOne chain of continuous speech and sustained vowel from 50 subjects with voice disorders (all separated by silence intervals) was radiated and re-recorded in an anechoic chamber with five MCDs and one high-quality recording system. These recordings were acquired in one condition without ambient noise and in four conditions with increased ambient noise. A total of 10 acoustic voice markers were obtained in the program Praat. Differences between MCDs and noise condition were assessed with Friedman repeated-measures test and posthoc Wilcoxon signed-rank tests, both for related samples, after Bonferroni correction.Results(1) Except median fundamental frequency and seven nonsignificant differences, MCD samples have significantly higher acoustic markers than clinical reference samples in minimal environmental noise. (2) Except median fundamental frequency, jitter local, and jitter rap, all acoustic measures on samples recorded with the reference system experienced significant influence from room noise levels.ConclusionsFundamental frequency is resistant to recording system, environmental noise, and their combination. All other measures, however, were impacted by both recording system and noise condition, and especially by their combination, often already in the reference/baseline condition without added ambient noise. Caution is therefore warranted regarding implementation of MCDs as clinical recording tools, particularly when applied for treatment outcomes assessments.



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Stimulation from Cochlear Implant Electrodes Assists with Recovery from Asymmetric Perceptual Tilt: Evidence from the Subjective Visual Vertical Test.

Stimulation from Cochlear Implant Electrodes Assists with Recovery from Asymmetric Perceptual Tilt: Evidence from the Subjective Visual Vertical Test.

Front Integr Neurosci. 2016;10:32

Authors: Gnanasegaram JJ, Parkes WJ, Cushing SL, McKnight CL, Papsin BC, Gordon KA

Abstract
Vestibular end organ impairment is highly prevalent in children who have sensorineural hearing loss (SNHL) rehabilitated with cochlear implants (CIs). As a result, spatial perception is likely to be impacted in this population. Of particular interest is the perception of visual vertical because it reflects a perceptual tilt in the roll axis and is sensitive to an imbalance in otolith function. The objectives of the present study were thus to identify abnormalities in perception of the vertical plane in children with SNHL and determine whether such abnormalities could be resolved with stimulation from the CI. Participants included 53 children (15.2 ± 4.0 years of age) with SNHL and vestibular loss, confirmed with vestibular evoked myogenic potential (VEMP) testing. Testing protocol was validated in a sample of nine young adults with normal hearing (28.8 ± 7.7 years). Perception of visual vertical was assessed using the static Subjective Visual Vertical (SVV) test performed with and without stimulation in the participants with cochleovestibular loss. Trains of electrical pulses were delivered by an electrode in the left and/or right ear. Asymmetric spatial orientation deficits were found in nearly half of the participants with CIs (24/53 [45%]). The abnormal perception in this cohort was exacerbated by visual tilts in the direction of their deficit. Electric pulse trains delivered using the CI shifted this abnormal perception towards center (i.e., normal; p = 0.007). Importantly, this benefit was realized regardless of which ear was stimulated. These results suggest a role for CI stimulation beyond the auditory system, in particular, for improving vestibular/balance function.

PMID: 27679562 [PubMed]

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Stimulation from Cochlear Implant Electrodes Assists with Recovery from Asymmetric Perceptual Tilt: Evidence from the Subjective Visual Vertical Test.

Stimulation from Cochlear Implant Electrodes Assists with Recovery from Asymmetric Perceptual Tilt: Evidence from the Subjective Visual Vertical Test.

Front Integr Neurosci. 2016;10:32

Authors: Gnanasegaram JJ, Parkes WJ, Cushing SL, McKnight CL, Papsin BC, Gordon KA

Abstract
Vestibular end organ impairment is highly prevalent in children who have sensorineural hearing loss (SNHL) rehabilitated with cochlear implants (CIs). As a result, spatial perception is likely to be impacted in this population. Of particular interest is the perception of visual vertical because it reflects a perceptual tilt in the roll axis and is sensitive to an imbalance in otolith function. The objectives of the present study were thus to identify abnormalities in perception of the vertical plane in children with SNHL and determine whether such abnormalities could be resolved with stimulation from the CI. Participants included 53 children (15.2 ± 4.0 years of age) with SNHL and vestibular loss, confirmed with vestibular evoked myogenic potential (VEMP) testing. Testing protocol was validated in a sample of nine young adults with normal hearing (28.8 ± 7.7 years). Perception of visual vertical was assessed using the static Subjective Visual Vertical (SVV) test performed with and without stimulation in the participants with cochleovestibular loss. Trains of electrical pulses were delivered by an electrode in the left and/or right ear. Asymmetric spatial orientation deficits were found in nearly half of the participants with CIs (24/53 [45%]). The abnormal perception in this cohort was exacerbated by visual tilts in the direction of their deficit. Electric pulse trains delivered using the CI shifted this abnormal perception towards center (i.e., normal; p = 0.007). Importantly, this benefit was realized regardless of which ear was stimulated. These results suggest a role for CI stimulation beyond the auditory system, in particular, for improving vestibular/balance function.

PMID: 27679562 [PubMed]

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GeneReviews(®)

Related Articles

GeneReviews(®)

Book. 1993

Authors: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, Bird TD, Ledbetter N, Mefford HC, Smith RJH, Stephens K

Abstract
CLINICAL CHARACTERISTICS: Xeroderma pigmentosum (XP) is characterized by: Sun sensitivity (severe sunburn with blistering, persistent erythema on minimal sun exposure in ~60% of affected individuals), with marked freckle-like pigmentation of the face before age two years in most affected individuals; Sunlight-induced ocular involvement (photophobia, keratitis, atrophy of the skin of the lids); Greatly increased risk of sunlight-induced cutaneous neoplasms (basal cell carcinoma, squamous cell carcinoma, melanoma). Approximately 25% of affected individuals have neurologic manifestations (acquired microcephaly, diminished or absent deep tendon stretch reflexes, progressive sensorineural hearing loss, and progressive cognitive impairment). The most common causes of death are skin cancer, neurologic degeneration, and internal cancer. The median age at death in persons with XP with neurodegeneration (29 years) was found to be younger than that in persons with XP without neurodegeneration (37 years).
DIAGNOSIS/TESTING: The diagnosis of XP is made on the basis of clinical findings and family history and/or by the identification of biallelic pathogenic variants in DDB2, ERCC1,ERCC2, ERCC3, ERCC4, ERCC5, POLH, XPA, or XPC.
MANAGEMENT: Treatment of manifestations: Small, premalignant skin lesions such as actinic keratoses can be treated by freezing with liquid nitrogen; larger areas can be treated with field treatments such as topical 5-fluorouracil or imiquimod. Rarely, therapeutic dermatome shaving or dermabrasion has been used; skin neoplasms can be treated (as in persons without XP) with electrodesiccation and curettage, or surgical excision; skin cancers that are recurrent or in locations at high risk for recurrence are best treated with Mohs micrographic surgery. Oral isotretinoin or acitretin can prevent new skin neoplasms but have many side effects. Neoplasms of the eyelids, conjunctiva, and cornea can be treated surgically; corneal transplantation may improve the visual impairment resulting from severe keratitis. Hearing loss may be treated with hearing aids. Prevention of primary manifestations: Avoid sun and other UV exposure to the skin and eyes; measurement of UV light with a light meter in an affected individual’s home, school, and/or work environment so that high levels of environmental UV can be identified and eliminated. Prevention of secondary complications: Dietary supplementation with oral vitamin D as needed. Surveillance: Skin examinations by a physician every three to 12 months; periodic routine eye and neurologic examinations and audiograms. Agents/circumstances to avoid: UV exposure from sunlight and artificial sources of UV radiation, cigarette smoke. Evaluation of relatives at risk: If family-specific pathogenic variants have been identified, molecular genetic testing of at-risk sibs can permit early diagnosis and rigorous sun protection from an early age. Pregnancy management: Systemic retinoids (isotretinoin, acitretin) may be used as skin cancer chemopreventive agents. These drugs are known to be teratogenic to a developing fetus and pose a high risk for birth defects. Women of reproductive age who are taking a systemic retinoid must use effective contraception and be monitored with regular pregnancy tests.
GENETIC COUNSELING: XP is inherited in an autosomal recessive manner. At conception, each sib of an affected individual has a 25% chance of being affected, a 50% chance of being an asymptomatic carrier, and a 25% chance of being unaffected and not a carrier. Once the pathogenic variants have been identified in an affected family member, carrier testing for at-risk family members and prenatal testing for pregnancies at increased risk are possible options.

PMID: 20301571

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Temporal Regularity Detection and Rate Discrimination in Cochlear-Implant Listeners

Abstract

Cochlear implants (CIs) convey fundamental-frequency information using primarily temporal cues. However, temporal pitch perception in CI users is weak and, when measured using rate discrimination tasks, deteriorates markedly as the rate increases beyond 300 pulses-per-second. Rate pitch may be weak because the electrical stimulation of the surviving neural population of the implant recipient may not allow accurate coding of inter-pulse time intervals. If so, this phenomenon should prevent listeners from detecting when a pulse train is physically temporally jittered. Performance in a jitter detection task was compared to that in a rate-pitch discrimination task. Stimuli were delivered using direct stimulation in cochlear implants, on a mid-array and an apical electrode, and at two different rates (100 and 300 pps). Average performance on both tasks was worse at the higher pulse rate and did not depend on electrode. However, there was a large variability across and within listeners that did not correlate between the two tasks, suggesting that rate-pitch judgement and regularity detection are to some extent limited by task-specific processes. Simulations with filtered pulse trains presented to NH listeners yielded broadly similar results, except that, for the rate discrimination task, the difference between performance with 100- and 300-pps base rates was smaller than observed for CI users.

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Minimal Hearing Loss: From a Failure-Based Approach to Evidence-Based Practice

Purpose

A representative sample of the literature on minimal hearing loss (MHL) was reviewed to provide evidence of challenges faced by children with MHL and to establish the need for evidence-based options for early intervention.

Method

Research articles published from 1950 to 2013 were searched in the Medline database using the keywords minimal hearing loss, unilateral hearing loss, and mild hearing loss. References cited in retrieved articles were also reviewed.

Results

In total, 69 articles contained relevant information about pediatric outcomes and/or intervention for unilateral hearing loss, 50 for mild hearing loss, and 6 for high-frequency hearing loss. Six challenges associated with MHL emerged, and 6 interventions were indicated. Evidence indicates that although some individuals may appear to have no observable speech-language or academic difficulties, others experience considerable difficulties. It also indicates that even though children with MHL may appear to catch up in some areas, difficulties in select domains continue into adulthood.

Conclusions

Evidence indicates significant risks associated with untreated MHL. Evidence also demonstrates the need for early intervention and identifies several appropriate intervention strategies; however, no single protocol is appropriate for all children. Therefore, families should be educated about the impact of MHL and about available interventions so that informed decisions can be made.

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Acoustic–Phonetic Versus Lexical Processing in Nonnative Listeners Differing in Their Dominant Language

Purpose

Nonnative listeners have difficulty recognizing English words due to underdeveloped acoustic–phonetic and/or lexical skills. The present study used Boothroyd and Nittrouer's (1988) j factor to tease apart these two components of word recognition.

Method

Participants included 15 native English and 29 native Russian listeners. Fourteen and 15 of the Russian listeners reported English (ED) and Russian (RD) to be their dominant language, respectively. Listeners were presented 119 consonant–vowel–consonant real and nonsense words in speech-spectrum noise at +6 dB SNR. Responses were scored for word and phoneme recognition, the logarithmic quotient of which yielded j.

Results

Word and phoneme recognition was comparable between native and ED listeners but poorer in RD listeners. Analysis of j indicated less effective use of lexical information in RD than in native and ED listeners. Lexical processing was strongly correlated with the length of residence in the United States.

Conclusions

Language background is important for nonnative word recognition. Lexical skills can be regarded as nativelike in ED nonnative listeners. Compromised word recognition in ED listeners is unlikely a result of poor lexical processing. Performance should be interpreted with caution for listeners dominant in their first language, whose word recognition is affected by both lexical and acoustic–phonetic factors.

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Use of Baby Isao Simulator and Standardized Parents in Hearing Screening and Parent Counseling Education

Purpose

The primary purpose of this study was to test the effect of the combined use of trained standardized parents and a baby simulator on students' hearing screening and parental counseling knowledge and skills.

Method

A one-group pretest-posttest quasi-experimental study design was used to assess self-ratings of confidence in knowledge and skills and satisfaction of the educational experience with standardized parents and a baby simulator. The mean age of the 14 audiology students participating in this study was 24.79 years (SD = 1.58). Participants completed a pre- and postevent questionnaire in which they rated their level of confidence for specific knowledge and skills. Six students (2 students in each scenario) volunteered to participate in the infant hearing screening and counseling scenarios, whereas others participated as observers. All participants participated in the briefing and debriefing sessions immediately before and after each of 3 scenarios. After the last scenario, participants were asked to complete a satisfaction survey of their learning experience using simulation and standardized parents.

Results

Overall, the pre- and post–simulation event questionnaire revealed a significant improvement in the participants' self-rated confidence levels regarding knowledge and skills. The mean difference between pre- and postevent scores was 0.52 (p SD = 0.30) based on a Likert scale, where 1 = not satisfied and 5 = very satisfied.

Conclusions

The results of this novel educational activity demonstrate the value of using infant hearing screening and parental counseling simulation sessions to enhance student learning. In addition, this study demonstrates the use of simulation and standardized parents as an important pedagogical tool for audiology students. Students experienced a high level of satisfaction with the learning experience.

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Mental Tasking and Caloric-Induced Vestibular Nystagmus Utilizing Videonystagmography

Purpose

The purpose of this study was to quantify the effects of mental tasking on measures of the caloric vestibulo-ocular reflex utilizing videonystagmography as the measurement technique.

Method

A within-subjects repeated-measures design was utilized. Sixteen healthy adults were evaluated (13 women, 3 men; ages 19–31 years). Each participant underwent bithermal caloric irrigation at 2 separate counterbalanced visits. At 1 visit mental tasking was utilized, whereas the other visit did not utilize mental tasking. The following outcomes were measured for each visit: peak slow-phase velocity (SPV), response duration, peak SPV latency, and eye blink artifact.

Results

No significant difference was seen for tasking versus no tasking with peak SPV, peak latency, or response duration. A significant difference was seen for the amount of eye blink artifact, with significantly more eye blinks present for the tasking condition.

Conclusions

Results could indicate mental tasking does not affect the important measure of SPV. Moreover, increased eye blink artifact with tasking could obscure the clinician's ability to read the nystagmograph. However, this investigation is limited to the healthy young adult population, and more studies should be performed to corroborate the presented evidence.

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Chosen Listening Levels for Music With and Without the Use of Hearing Aids

Purpose

The objective of this study was to describe chosen listening levels (CLLs) for recorded music for listeners with hearing loss in aided and unaided conditions.

Method

The study used a within-subject, repeated-measures design with 13 adult hearing-aid users. The music included rock and classical samples with different amounts of audio-industry compression limiting. CLL measurements were taken at ear level (i.e., at input to the hearing aid) and at the tympanic membrane.

Results

For aided listening, average CLLs were 69.3 dBA at the input to the hearing aid and 80.3 dBA at the tympanic membrane. For unaided listening, average CLLs were 76.9 dBA at the entrance to the ear canal and 77.1 dBA at the tympanic membrane. Although wide intersubject variability was observed, CLLs were not associated with audiometric thresholds. CLLs for rock music were higher than for classical music at the tympanic membrane, but no differences were observed between genres for ear-level CLLs. The amount of audio-industry compression had no significant effect on CLLs.

Conclusion

By describing the levels of recorded music chosen by hearing-aid users, this study provides a basis for ecologically valid testing conditions in clinical and laboratory settings.

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Survey on the Effectiveness of Dietary Supplements to Treat Tinnitus

Purpose

We surveyed the benefit of dietary supplements to treat tinnitus and reported adverse effects.

Method

A website was created for people with tinnitus to complete a variety of questions.

Results

The 1,788 subjects who responded to questionnaires came from 53 different countries; 413 (23.1%) reported taking supplements. No effect on tinnitus was reported in 70.7%, improvement in 19.0%, and worsening in 10.3%. Adverse effects were reported in 6% (n = 36), including bleeding, diarrhea, headache, and others. Supplements were reported to be helpful for sleep: melatonin (effect size, d = 1.228) and lipoflavonoid (d = 0.5244); emotional reactions: melatonin (d = 0.6138) and lipoflavonoid (d = 0.457); hearing: Ginkgo biloba (d = 0.3758); and concentration Ginkgo biloba (d = 0.3611). The positive, subjective reports should be interpreted cautiously; many might have reported a positive effect because they were committed to treatment and expected a benefit. Users of supplements were more likely to have loudness hyperacusis and to have a louder tinnitus.

Conclusions

The use of dietary supplements to treat tinnitus is common, particularly with Ginkgo biloba, lipoflavonoids, magnesium, melatonin, vitamin B12, and zinc. It is likely that some supplements will help with sleep for some patients. However, they are generally not effective, and many produced adverse effects. We concluded that dietary supplements should not be recommended to treat tinnitus but could have a positive outcome on tinnitus reactions in some people.

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Identifying and Prioritizing Diseases Important for Detection in Adult Hearing Health Care

Purpose

The purpose of this research note is to identify and prioritize diseases important for detection in adult hearing health care delivery systems.

Method

Through literature review and expert consultation, the authors identified 195 diseases likely to occur in adults complaining of hearing loss. Five neurotologists rated the importance of disease on 3 dimensions related to the necessity of detection prior to adult hearing aid fitting.

Results

Ratings of adverse health consequences, diagnostic difficulty, and presence of nonotologic symptoms associated with these diseases resulted in the identification of 104 diseases potentially important for detection prior to adult hearing aid fitting.

Conclusions

Current and evolving health care delivery systems, including direct-to-consumer sales, involve inconsistent means of disease detection vigilance prior to device fitting. The first steps in determining the safety of these different delivery methods are to identify and prioritize which diseases present the greatest risk for poor health outcomes and, thus, should be detected in hearing health care delivery systems. Here the authors have developed a novel multidimensional rating system to rank disease importance. The rankings can be used to evaluate the effectiveness of alternative detection methods and to inform public health policy. The authors are currently using this information to validate a consumer questionnaire designed to accurately identify when pre- fitting medical evaluations should be required for hearing aid patients.

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Efficiency of Melatonin as Compared to Pentobarbital for Audiometry Brainstem Response in Children With Associated Disorders

Purpose

Outpatient pediatric audiometry brainstem response (ABR) uses various techniques (no drug, hydroxyzine, pentobarbital, melatonin). The aim of this study was to evaluate the efficiency of melatonin as compared to pentobarbital in children with associated disorders.

Method

This was a retrospective study that took place in a tertiary care center. Eighty-three children (34 girls and 49 boys) had performed ABR under pentobarbital (GPent) or melatonin (GMel) between 2013 and 2014 and were included. All children had associated neurological or behavioral disorders or had failed a previous ABR using another technique. Success rate, defined as completed binaural investigation, delay, and duration of sleep (minutes), as well as side effects, were compared between GPent and GMel.

Results

There were 56 patients in GMel and 27 in GPent, with a mean age at test of 3 years and 10 months (1–13 years) and 4 years and 1 month (1–14.5 years), respectively. Success rate was 76.8% and 88.8%, respectively (p > .05), sleep duration was 23 and 153 min (p Conclusions

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Mandarin Lexical Tone Acquisition in Cochlear Implant Users With Prelingual Deafness: A Review

Purpose

The purpose of this review article is to synthesize evidence from the fields of developmental linguistics and cochlear implant technology relevant to the production and perception of Mandarin lexical tone in cochlear implant users with prelingual deafness. The aim of this review was to identify potential factors that determine outcomes for tonal-language speaking cochlear implant users and possible directions for further research.

Method

A computerized database search of MEDLINE, CINAHL, Academic Search Premier, Web of Science, and Google Scholar was undertaken in June and July 2014. Search terms used were lexical tone AND tonal language, speech development AND/OR speech production AND/OR speech perception AND cochlear implants, and pitch perception AND cochlear implants, anywhere in the title or abstract.

Conclusion

Despite the demonstrated limitations of pitch perception in cochlear implant users, there is some evidence that typical production and perception of lexical tone is possible by cochlear implant users with prelingual deafness. Further studies are required to determine the factors that contribute to better outcomes to inform rehabilitation processes for cochlear implant users in tonal-language environments.

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Minimal Hearing Loss: From a Failure-Based Approach to Evidence-Based Practice

Purpose

A representative sample of the literature on minimal hearing loss (MHL) was reviewed to provide evidence of challenges faced by children with MHL and to establish the need for evidence-based options for early intervention.

Method

Research articles published from 1950 to 2013 were searched in the Medline database using the keywords minimal hearing loss, unilateral hearing loss, and mild hearing loss. References cited in retrieved articles were also reviewed.

Results

In total, 69 articles contained relevant information about pediatric outcomes and/or intervention for unilateral hearing loss, 50 for mild hearing loss, and 6 for high-frequency hearing loss. Six challenges associated with MHL emerged, and 6 interventions were indicated. Evidence indicates that although some individuals may appear to have no observable speech-language or academic difficulties, others experience considerable difficulties. It also indicates that even though children with MHL may appear to catch up in some areas, difficulties in select domains continue into adulthood.

Conclusions

Evidence indicates significant risks associated with untreated MHL. Evidence also demonstrates the need for early intervention and identifies several appropriate intervention strategies; however, no single protocol is appropriate for all children. Therefore, families should be educated about the impact of MHL and about available interventions so that informed decisions can be made.

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Acoustic–Phonetic Versus Lexical Processing in Nonnative Listeners Differing in Their Dominant Language

Purpose

Nonnative listeners have difficulty recognizing English words due to underdeveloped acoustic–phonetic and/or lexical skills. The present study used Boothroyd and Nittrouer's (1988) j factor to tease apart these two components of word recognition.

Method

Participants included 15 native English and 29 native Russian listeners. Fourteen and 15 of the Russian listeners reported English (ED) and Russian (RD) to be their dominant language, respectively. Listeners were presented 119 consonant–vowel–consonant real and nonsense words in speech-spectrum noise at +6 dB SNR. Responses were scored for word and phoneme recognition, the logarithmic quotient of which yielded j.

Results

Word and phoneme recognition was comparable between native and ED listeners but poorer in RD listeners. Analysis of j indicated less effective use of lexical information in RD than in native and ED listeners. Lexical processing was strongly correlated with the length of residence in the United States.

Conclusions

Language background is important for nonnative word recognition. Lexical skills can be regarded as nativelike in ED nonnative listeners. Compromised word recognition in ED listeners is unlikely a result of poor lexical processing. Performance should be interpreted with caution for listeners dominant in their first language, whose word recognition is affected by both lexical and acoustic–phonetic factors.

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Use of Baby Isao Simulator and Standardized Parents in Hearing Screening and Parent Counseling Education

Purpose

The primary purpose of this study was to test the effect of the combined use of trained standardized parents and a baby simulator on students' hearing screening and parental counseling knowledge and skills.

Method

A one-group pretest-posttest quasi-experimental study design was used to assess self-ratings of confidence in knowledge and skills and satisfaction of the educational experience with standardized parents and a baby simulator. The mean age of the 14 audiology students participating in this study was 24.79 years (SD = 1.58). Participants completed a pre- and postevent questionnaire in which they rated their level of confidence for specific knowledge and skills. Six students (2 students in each scenario) volunteered to participate in the infant hearing screening and counseling scenarios, whereas others participated as observers. All participants participated in the briefing and debriefing sessions immediately before and after each of 3 scenarios. After the last scenario, participants were asked to complete a satisfaction survey of their learning experience using simulation and standardized parents.

Results

Overall, the pre- and post–simulation event questionnaire revealed a significant improvement in the participants' self-rated confidence levels regarding knowledge and skills. The mean difference between pre- and postevent scores was 0.52 (p SD = 0.30) based on a Likert scale, where 1 = not satisfied and 5 = very satisfied.

Conclusions

The results of this novel educational activity demonstrate the value of using infant hearing screening and parental counseling simulation sessions to enhance student learning. In addition, this study demonstrates the use of simulation and standardized parents as an important pedagogical tool for audiology students. Students experienced a high level of satisfaction with the learning experience.

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Mental Tasking and Caloric-Induced Vestibular Nystagmus Utilizing Videonystagmography

Purpose

The purpose of this study was to quantify the effects of mental tasking on measures of the caloric vestibulo-ocular reflex utilizing videonystagmography as the measurement technique.

Method

A within-subjects repeated-measures design was utilized. Sixteen healthy adults were evaluated (13 women, 3 men; ages 19–31 years). Each participant underwent bithermal caloric irrigation at 2 separate counterbalanced visits. At 1 visit mental tasking was utilized, whereas the other visit did not utilize mental tasking. The following outcomes were measured for each visit: peak slow-phase velocity (SPV), response duration, peak SPV latency, and eye blink artifact.

Results

No significant difference was seen for tasking versus no tasking with peak SPV, peak latency, or response duration. A significant difference was seen for the amount of eye blink artifact, with significantly more eye blinks present for the tasking condition.

Conclusions

Results could indicate mental tasking does not affect the important measure of SPV. Moreover, increased eye blink artifact with tasking could obscure the clinician's ability to read the nystagmograph. However, this investigation is limited to the healthy young adult population, and more studies should be performed to corroborate the presented evidence.

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Chosen Listening Levels for Music With and Without the Use of Hearing Aids

Purpose

The objective of this study was to describe chosen listening levels (CLLs) for recorded music for listeners with hearing loss in aided and unaided conditions.

Method

The study used a within-subject, repeated-measures design with 13 adult hearing-aid users. The music included rock and classical samples with different amounts of audio-industry compression limiting. CLL measurements were taken at ear level (i.e., at input to the hearing aid) and at the tympanic membrane.

Results

For aided listening, average CLLs were 69.3 dBA at the input to the hearing aid and 80.3 dBA at the tympanic membrane. For unaided listening, average CLLs were 76.9 dBA at the entrance to the ear canal and 77.1 dBA at the tympanic membrane. Although wide intersubject variability was observed, CLLs were not associated with audiometric thresholds. CLLs for rock music were higher than for classical music at the tympanic membrane, but no differences were observed between genres for ear-level CLLs. The amount of audio-industry compression had no significant effect on CLLs.

Conclusion

By describing the levels of recorded music chosen by hearing-aid users, this study provides a basis for ecologically valid testing conditions in clinical and laboratory settings.

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Survey on the Effectiveness of Dietary Supplements to Treat Tinnitus

Purpose

We surveyed the benefit of dietary supplements to treat tinnitus and reported adverse effects.

Method

A website was created for people with tinnitus to complete a variety of questions.

Results

The 1,788 subjects who responded to questionnaires came from 53 different countries; 413 (23.1%) reported taking supplements. No effect on tinnitus was reported in 70.7%, improvement in 19.0%, and worsening in 10.3%. Adverse effects were reported in 6% (n = 36), including bleeding, diarrhea, headache, and others. Supplements were reported to be helpful for sleep: melatonin (effect size, d = 1.228) and lipoflavonoid (d = 0.5244); emotional reactions: melatonin (d = 0.6138) and lipoflavonoid (d = 0.457); hearing: Ginkgo biloba (d = 0.3758); and concentration Ginkgo biloba (d = 0.3611). The positive, subjective reports should be interpreted cautiously; many might have reported a positive effect because they were committed to treatment and expected a benefit. Users of supplements were more likely to have loudness hyperacusis and to have a louder tinnitus.

Conclusions

The use of dietary supplements to treat tinnitus is common, particularly with Ginkgo biloba, lipoflavonoids, magnesium, melatonin, vitamin B12, and zinc. It is likely that some supplements will help with sleep for some patients. However, they are generally not effective, and many produced adverse effects. We concluded that dietary supplements should not be recommended to treat tinnitus but could have a positive outcome on tinnitus reactions in some people.

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Identifying and Prioritizing Diseases Important for Detection in Adult Hearing Health Care

Purpose

The purpose of this research note is to identify and prioritize diseases important for detection in adult hearing health care delivery systems.

Method

Through literature review and expert consultation, the authors identified 195 diseases likely to occur in adults complaining of hearing loss. Five neurotologists rated the importance of disease on 3 dimensions related to the necessity of detection prior to adult hearing aid fitting.

Results

Ratings of adverse health consequences, diagnostic difficulty, and presence of nonotologic symptoms associated with these diseases resulted in the identification of 104 diseases potentially important for detection prior to adult hearing aid fitting.

Conclusions

Current and evolving health care delivery systems, including direct-to-consumer sales, involve inconsistent means of disease detection vigilance prior to device fitting. The first steps in determining the safety of these different delivery methods are to identify and prioritize which diseases present the greatest risk for poor health outcomes and, thus, should be detected in hearing health care delivery systems. Here the authors have developed a novel multidimensional rating system to rank disease importance. The rankings can be used to evaluate the effectiveness of alternative detection methods and to inform public health policy. The authors are currently using this information to validate a consumer questionnaire designed to accurately identify when pre- fitting medical evaluations should be required for hearing aid patients.

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Efficiency of Melatonin as Compared to Pentobarbital for Audiometry Brainstem Response in Children With Associated Disorders

Purpose

Outpatient pediatric audiometry brainstem response (ABR) uses various techniques (no drug, hydroxyzine, pentobarbital, melatonin). The aim of this study was to evaluate the efficiency of melatonin as compared to pentobarbital in children with associated disorders.

Method

This was a retrospective study that took place in a tertiary care center. Eighty-three children (34 girls and 49 boys) had performed ABR under pentobarbital (GPent) or melatonin (GMel) between 2013 and 2014 and were included. All children had associated neurological or behavioral disorders or had failed a previous ABR using another technique. Success rate, defined as completed binaural investigation, delay, and duration of sleep (minutes), as well as side effects, were compared between GPent and GMel.

Results

There were 56 patients in GMel and 27 in GPent, with a mean age at test of 3 years and 10 months (1–13 years) and 4 years and 1 month (1–14.5 years), respectively. Success rate was 76.8% and 88.8%, respectively (p > .05), sleep duration was 23 and 153 min (p Conclusions

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Mandarin Lexical Tone Acquisition in Cochlear Implant Users With Prelingual Deafness: A Review

Purpose

The purpose of this review article is to synthesize evidence from the fields of developmental linguistics and cochlear implant technology relevant to the production and perception of Mandarin lexical tone in cochlear implant users with prelingual deafness. The aim of this review was to identify potential factors that determine outcomes for tonal-language speaking cochlear implant users and possible directions for further research.

Method

A computerized database search of MEDLINE, CINAHL, Academic Search Premier, Web of Science, and Google Scholar was undertaken in June and July 2014. Search terms used were lexical tone AND tonal language, speech development AND/OR speech production AND/OR speech perception AND cochlear implants, and pitch perception AND cochlear implants, anywhere in the title or abstract.

Conclusion

Despite the demonstrated limitations of pitch perception in cochlear implant users, there is some evidence that typical production and perception of lexical tone is possible by cochlear implant users with prelingual deafness. Further studies are required to determine the factors that contribute to better outcomes to inform rehabilitation processes for cochlear implant users in tonal-language environments.

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Minimal Hearing Loss: From a Failure-Based Approach to Evidence-Based Practice

Purpose

A representative sample of the literature on minimal hearing loss (MHL) was reviewed to provide evidence of challenges faced by children with MHL and to establish the need for evidence-based options for early intervention.

Method

Research articles published from 1950 to 2013 were searched in the Medline database using the keywords minimal hearing loss, unilateral hearing loss, and mild hearing loss. References cited in retrieved articles were also reviewed.

Results

In total, 69 articles contained relevant information about pediatric outcomes and/or intervention for unilateral hearing loss, 50 for mild hearing loss, and 6 for high-frequency hearing loss. Six challenges associated with MHL emerged, and 6 interventions were indicated. Evidence indicates that although some individuals may appear to have no observable speech-language or academic difficulties, others experience considerable difficulties. It also indicates that even though children with MHL may appear to catch up in some areas, difficulties in select domains continue into adulthood.

Conclusions

Evidence indicates significant risks associated with untreated MHL. Evidence also demonstrates the need for early intervention and identifies several appropriate intervention strategies; however, no single protocol is appropriate for all children. Therefore, families should be educated about the impact of MHL and about available interventions so that informed decisions can be made.

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Acoustic–Phonetic Versus Lexical Processing in Nonnative Listeners Differing in Their Dominant Language

Purpose

Nonnative listeners have difficulty recognizing English words due to underdeveloped acoustic–phonetic and/or lexical skills. The present study used Boothroyd and Nittrouer's (1988) j factor to tease apart these two components of word recognition.

Method

Participants included 15 native English and 29 native Russian listeners. Fourteen and 15 of the Russian listeners reported English (ED) and Russian (RD) to be their dominant language, respectively. Listeners were presented 119 consonant–vowel–consonant real and nonsense words in speech-spectrum noise at +6 dB SNR. Responses were scored for word and phoneme recognition, the logarithmic quotient of which yielded j.

Results

Word and phoneme recognition was comparable between native and ED listeners but poorer in RD listeners. Analysis of j indicated less effective use of lexical information in RD than in native and ED listeners. Lexical processing was strongly correlated with the length of residence in the United States.

Conclusions

Language background is important for nonnative word recognition. Lexical skills can be regarded as nativelike in ED nonnative listeners. Compromised word recognition in ED listeners is unlikely a result of poor lexical processing. Performance should be interpreted with caution for listeners dominant in their first language, whose word recognition is affected by both lexical and acoustic–phonetic factors.

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Use of Baby Isao Simulator and Standardized Parents in Hearing Screening and Parent Counseling Education

Purpose

The primary purpose of this study was to test the effect of the combined use of trained standardized parents and a baby simulator on students' hearing screening and parental counseling knowledge and skills.

Method

A one-group pretest-posttest quasi-experimental study design was used to assess self-ratings of confidence in knowledge and skills and satisfaction of the educational experience with standardized parents and a baby simulator. The mean age of the 14 audiology students participating in this study was 24.79 years (SD = 1.58). Participants completed a pre- and postevent questionnaire in which they rated their level of confidence for specific knowledge and skills. Six students (2 students in each scenario) volunteered to participate in the infant hearing screening and counseling scenarios, whereas others participated as observers. All participants participated in the briefing and debriefing sessions immediately before and after each of 3 scenarios. After the last scenario, participants were asked to complete a satisfaction survey of their learning experience using simulation and standardized parents.

Results

Overall, the pre- and post–simulation event questionnaire revealed a significant improvement in the participants' self-rated confidence levels regarding knowledge and skills. The mean difference between pre- and postevent scores was 0.52 (p SD = 0.30) based on a Likert scale, where 1 = not satisfied and 5 = very satisfied.

Conclusions

The results of this novel educational activity demonstrate the value of using infant hearing screening and parental counseling simulation sessions to enhance student learning. In addition, this study demonstrates the use of simulation and standardized parents as an important pedagogical tool for audiology students. Students experienced a high level of satisfaction with the learning experience.

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Mental Tasking and Caloric-Induced Vestibular Nystagmus Utilizing Videonystagmography

Purpose

The purpose of this study was to quantify the effects of mental tasking on measures of the caloric vestibulo-ocular reflex utilizing videonystagmography as the measurement technique.

Method

A within-subjects repeated-measures design was utilized. Sixteen healthy adults were evaluated (13 women, 3 men; ages 19–31 years). Each participant underwent bithermal caloric irrigation at 2 separate counterbalanced visits. At 1 visit mental tasking was utilized, whereas the other visit did not utilize mental tasking. The following outcomes were measured for each visit: peak slow-phase velocity (SPV), response duration, peak SPV latency, and eye blink artifact.

Results

No significant difference was seen for tasking versus no tasking with peak SPV, peak latency, or response duration. A significant difference was seen for the amount of eye blink artifact, with significantly more eye blinks present for the tasking condition.

Conclusions

Results could indicate mental tasking does not affect the important measure of SPV. Moreover, increased eye blink artifact with tasking could obscure the clinician's ability to read the nystagmograph. However, this investigation is limited to the healthy young adult population, and more studies should be performed to corroborate the presented evidence.

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Chosen Listening Levels for Music With and Without the Use of Hearing Aids

Purpose

The objective of this study was to describe chosen listening levels (CLLs) for recorded music for listeners with hearing loss in aided and unaided conditions.

Method

The study used a within-subject, repeated-measures design with 13 adult hearing-aid users. The music included rock and classical samples with different amounts of audio-industry compression limiting. CLL measurements were taken at ear level (i.e., at input to the hearing aid) and at the tympanic membrane.

Results

For aided listening, average CLLs were 69.3 dBA at the input to the hearing aid and 80.3 dBA at the tympanic membrane. For unaided listening, average CLLs were 76.9 dBA at the entrance to the ear canal and 77.1 dBA at the tympanic membrane. Although wide intersubject variability was observed, CLLs were not associated with audiometric thresholds. CLLs for rock music were higher than for classical music at the tympanic membrane, but no differences were observed between genres for ear-level CLLs. The amount of audio-industry compression had no significant effect on CLLs.

Conclusion

By describing the levels of recorded music chosen by hearing-aid users, this study provides a basis for ecologically valid testing conditions in clinical and laboratory settings.

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Survey on the Effectiveness of Dietary Supplements to Treat Tinnitus

Purpose

We surveyed the benefit of dietary supplements to treat tinnitus and reported adverse effects.

Method

A website was created for people with tinnitus to complete a variety of questions.

Results

The 1,788 subjects who responded to questionnaires came from 53 different countries; 413 (23.1%) reported taking supplements. No effect on tinnitus was reported in 70.7%, improvement in 19.0%, and worsening in 10.3%. Adverse effects were reported in 6% (n = 36), including bleeding, diarrhea, headache, and others. Supplements were reported to be helpful for sleep: melatonin (effect size, d = 1.228) and lipoflavonoid (d = 0.5244); emotional reactions: melatonin (d = 0.6138) and lipoflavonoid (d = 0.457); hearing: Ginkgo biloba (d = 0.3758); and concentration Ginkgo biloba (d = 0.3611). The positive, subjective reports should be interpreted cautiously; many might have reported a positive effect because they were committed to treatment and expected a benefit. Users of supplements were more likely to have loudness hyperacusis and to have a louder tinnitus.

Conclusions

The use of dietary supplements to treat tinnitus is common, particularly with Ginkgo biloba, lipoflavonoids, magnesium, melatonin, vitamin B12, and zinc. It is likely that some supplements will help with sleep for some patients. However, they are generally not effective, and many produced adverse effects. We concluded that dietary supplements should not be recommended to treat tinnitus but could have a positive outcome on tinnitus reactions in some people.

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Identifying and Prioritizing Diseases Important for Detection in Adult Hearing Health Care

Purpose

The purpose of this research note is to identify and prioritize diseases important for detection in adult hearing health care delivery systems.

Method

Through literature review and expert consultation, the authors identified 195 diseases likely to occur in adults complaining of hearing loss. Five neurotologists rated the importance of disease on 3 dimensions related to the necessity of detection prior to adult hearing aid fitting.

Results

Ratings of adverse health consequences, diagnostic difficulty, and presence of nonotologic symptoms associated with these diseases resulted in the identification of 104 diseases potentially important for detection prior to adult hearing aid fitting.

Conclusions

Current and evolving health care delivery systems, including direct-to-consumer sales, involve inconsistent means of disease detection vigilance prior to device fitting. The first steps in determining the safety of these different delivery methods are to identify and prioritize which diseases present the greatest risk for poor health outcomes and, thus, should be detected in hearing health care delivery systems. Here the authors have developed a novel multidimensional rating system to rank disease importance. The rankings can be used to evaluate the effectiveness of alternative detection methods and to inform public health policy. The authors are currently using this information to validate a consumer questionnaire designed to accurately identify when pre- fitting medical evaluations should be required for hearing aid patients.

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Efficiency of Melatonin as Compared to Pentobarbital for Audiometry Brainstem Response in Children With Associated Disorders

Purpose

Outpatient pediatric audiometry brainstem response (ABR) uses various techniques (no drug, hydroxyzine, pentobarbital, melatonin). The aim of this study was to evaluate the efficiency of melatonin as compared to pentobarbital in children with associated disorders.

Method

This was a retrospective study that took place in a tertiary care center. Eighty-three children (34 girls and 49 boys) had performed ABR under pentobarbital (GPent) or melatonin (GMel) between 2013 and 2014 and were included. All children had associated neurological or behavioral disorders or had failed a previous ABR using another technique. Success rate, defined as completed binaural investigation, delay, and duration of sleep (minutes), as well as side effects, were compared between GPent and GMel.

Results

There were 56 patients in GMel and 27 in GPent, with a mean age at test of 3 years and 10 months (1–13 years) and 4 years and 1 month (1–14.5 years), respectively. Success rate was 76.8% and 88.8%, respectively (p > .05), sleep duration was 23 and 153 min (p Conclusions

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Mandarin Lexical Tone Acquisition in Cochlear Implant Users With Prelingual Deafness: A Review

Purpose

The purpose of this review article is to synthesize evidence from the fields of developmental linguistics and cochlear implant technology relevant to the production and perception of Mandarin lexical tone in cochlear implant users with prelingual deafness. The aim of this review was to identify potential factors that determine outcomes for tonal-language speaking cochlear implant users and possible directions for further research.

Method

A computerized database search of MEDLINE, CINAHL, Academic Search Premier, Web of Science, and Google Scholar was undertaken in June and July 2014. Search terms used were lexical tone AND tonal language, speech development AND/OR speech production AND/OR speech perception AND cochlear implants, and pitch perception AND cochlear implants, anywhere in the title or abstract.

Conclusion

Despite the demonstrated limitations of pitch perception in cochlear implant users, there is some evidence that typical production and perception of lexical tone is possible by cochlear implant users with prelingual deafness. Further studies are required to determine the factors that contribute to better outcomes to inform rehabilitation processes for cochlear implant users in tonal-language environments.

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Biologically-variable rhythmic auditory cues are superior to isochronous cues in fostering natural gait variability in Parkinson’s disease

Publication date: Available online 28 September 2016
Source:Gait & Posture
Author(s): D.G. Dotov, S. Bayard, V. Cochen de Cock, C. Geny, V. Driss, G. Garrigue, B. Bardy, S. Dalla Bella
IntroductionRhythmic auditory cueing improves certain gait symptoms of Parkinson's disease (PD). Cues are typically stimuli or beats with a fixed inter-beat interval. We show that isochronous cueing has an unwanted side-effect in that it exacerbates one of the motor symptoms characteristic of advanced PD. Whereas the parameters of the stride cycle of healthy walkers and early patients possess a persistent correlation in time, or long-range correlation (LRC), isochronous cueing renders stride-to-stride variability random. Random stride cycle variability is also associated with reduced gait stability and lack of flexibility.MethodTo investigate how to prevent patients from acquiring a random stride cycle pattern, we tested rhythmic cueing which mimics the properties of variability found in healthy gait (biological variability). PD patients (n=19) and age-matched healthy participants (n=19) walked with three rhythmic cueing stimuli: isochronous, random variability, and with biological variability (LRC). Synchronization was not instructed.ResultsThe persistent correlation in gait was preserved only with stimuli with biological variability, equally for patients and controls (p's<.05). In contrast, cueing with isochronous or randomly varying inter-stimulus/beat intervals removed the LRC in the stride cycle. Notably, the individual's tendency to synchronize steps with beats determined the amount of negative effects of isochronous and random cues (p's<.05) but not the positive effect of biological variability.ConclusionStimulus variability and patients’ propensity to synchronize play a critical role in fostering healthier gait dynamics during cueing. The beneficial effects of biological variability provide useful guidelines for improving existing cueing treatments.



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