Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury

by Michael E. Hoffer, Mikhaylo Szczupak, Alexander Kiderman, James Crawford, Sara Murphy, Kathryn Marshall, Constanza Pelusso, Carey Balaban

Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications.

from #Audiology via xlomafota13 on Inoreader http://ift.tt/1JAuRx6
via IFTTT

Effect of calendar age on physical performance: A comparison of standard clinical measures with instrumented measures in middle-aged to older adults

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): M. Stijntjes, C.G.M. Meskers, A.J.M. de Craen, R.C. van Lummel, S.M. Rispens, P.E. Slagboom, A.B. Maier
BackgroundDecline in physical performance is highly prevalent during aging. Identification of sensitive markers of age-related changes in physical performance is important for early detection, development of therapeutic strategies and insight into underlying mechanisms. We studied the association of calendar age and familial longevity with standard clinical and instrumented measures of physical performance in a cohort of healthy middle-aged to older adults.MethodsCross-sectional analysis within the Leiden Longevity Study consisting of offspring of nonagenarian siblings and their partners (n=300, mean age (SD) 65.3 (6.7) years). Standard clinical measures were 25-meter walking speed and total duration of the chair stand test (CST). Instrumented measures were determined using a body fixed sensor. Dependence of physical performance on calendar age and familial longevity (offspring versus partner status) was analyzed using linear and logistic regression, respectively, adjusted for gender and height.ResultsHigher calendar age was associated with slower walking speed and longer duration of the CST (standardized β (95% CI) −.024 (−.042; −.006) and .035 (.014;.056), respectively). Instrumented measures showed similar effect sizes with strongest associations for gait stability and symmetry in mediolateral direction and for the extension and flexion phase of sit-to-stand and stand-to-sit transfers, respectively. No differences were observed between offspring of nonagenarian siblings and their partners.ConclusionsStandard clinical and instrumented measures of physical performance are associated with similar effect size to age-related changes in physical performance observable from middle age. The potential added value of instrumented measures for understanding underlying mechanisms requires further attention.



from #Audiology via ola Kala on Inoreader http://ift.tt/1OTC9hR
via IFTTT

Threat-induced changes in attention during tests of static and anticipatory postural control

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): Martin Zaback, Mark G. Carpenter, Allan L. Adkin
Postural threat, manipulated through changes in surface height, influences postural control. Evidence suggests changes in attention may contribute to this relationship. However, limited research has explored where and how attention is reallocated when threatened. The primary aim of this study was to describe changes in attention when presented with a postural threat, while a secondary aim was to explore associations between changes in attention and postural control. Eighty-two healthy young adults completed tests of static (quiet standing) and anticipatory (rise to toes) postural control under threatening and non-threatening conditions. Participants completed an open-ended questionnaire after each postural task which asked them to list what they thought about or directed their attention toward. Each item listed was assigned a percentage value reflecting how much attention it occupied. Exit interviews were completed to help confirm where attention was directed. Five attention categories were identified: movement processes, threat-relevant stimuli, self-regulatory strategies, task objectives, and task-irrelevant information. For both postural tasks, the percentage values and number of items listed for movement processes, threat-relevant stimuli, and self-regulatory strategies increased under threatening compared to non-threatening conditions, while the percentage values and number of items listed for task objectives and task-irrelevant information decreased. Changes in attention related to movement processes and self-regulatory strategies were associated with changes in static postural control, while changes in attention related to threat-relevant stimuli were associated with changes in anticipatory postural control. These results suggest that threat-induced changes in attention are multidimensional and contribute to changes in postural control.



from #Audiology via ola Kala on Inoreader http://ift.tt/1OTC7qb
via IFTTT

Biomechanical and perceived differences between overground and treadmill walking in children with cerebral palsy

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): Taeyou Jung, Yumi Kim, Luke E. Kelly, Mark F. Abel
The treadmill is widely used as an instrument for gait training and analysis. The primary purpose of this study was to compare biomechanical variables between overground and treadmill walking in children with cerebral palsy (CP). Perceived differences between the two walking modes were also investigated by comparing self-selected walking speeds. Twenty children with CP performed both overground and treadmill walking at a matched speed for biomechanical comparison using a 3-D motion analysis system. In addition, they were asked to select comfortable and fastest walking speeds under each walking condition to compare perceived differences. Significant differences in spatiotemporal variables were found including higher cadence and shorter stride length during treadmill walking at a matched speed (for all, P<.003). The comparison of joint kinematics demonstrated significant differences between overground and treadmill walking, which showed increases in peak angles of ankle dorsi-flexion, knee flexion/extension, and hip flexion (for all, P<.001), increases in ankle and hip excursions and a decrease in pelvic rotation excursion while walking on treadmill (for all, P<.002). Comparison of perceived difference revealed that children with CP chose significantly slower speeds when asked to select their comfortable and fastest walking speeds on the treadmill as compared to overground (for both, P<.001). Our results suggest that these biomechanical and perceived differences should be considered when using a treadmill for gait intervention or assessment.



from #Audiology via ola Kala on Inoreader http://ift.tt/1UEL8Bw
via IFTTT

Effect of calendar age on physical performance: A comparison of standard clinical measures with instrumented measures in middle-aged to older adults

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): M. Stijntjes, C.G.M. Meskers, A.J.M. de Craen, R.C. van Lummel, S.M. Rispens, P.E. Slagboom, A.B. Maier
BackgroundDecline in physical performance is highly prevalent during aging. Identification of sensitive markers of age-related changes in physical performance is important for early detection, development of therapeutic strategies and insight into underlying mechanisms. We studied the association of calendar age and familial longevity with standard clinical and instrumented measures of physical performance in a cohort of healthy middle-aged to older adults.MethodsCross-sectional analysis within the Leiden Longevity Study consisting of offspring of nonagenarian siblings and their partners (n=300, mean age (SD) 65.3 (6.7) years). Standard clinical measures were 25-meter walking speed and total duration of the chair stand test (CST). Instrumented measures were determined using a body fixed sensor. Dependence of physical performance on calendar age and familial longevity (offspring versus partner status) was analyzed using linear and logistic regression, respectively, adjusted for gender and height.ResultsHigher calendar age was associated with slower walking speed and longer duration of the CST (standardized β (95% CI) −.024 (−.042; −.006) and .035 (.014;.056), respectively). Instrumented measures showed similar effect sizes with strongest associations for gait stability and symmetry in mediolateral direction and for the extension and flexion phase of sit-to-stand and stand-to-sit transfers, respectively. No differences were observed between offspring of nonagenarian siblings and their partners.ConclusionsStandard clinical and instrumented measures of physical performance are associated with similar effect size to age-related changes in physical performance observable from middle age. The potential added value of instrumented measures for understanding underlying mechanisms requires further attention.



from #Audiology via ola Kala on Inoreader http://ift.tt/1OTC9hR
via IFTTT

Threat-induced changes in attention during tests of static and anticipatory postural control

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): Martin Zaback, Mark G. Carpenter, Allan L. Adkin
Postural threat, manipulated through changes in surface height, influences postural control. Evidence suggests changes in attention may contribute to this relationship. However, limited research has explored where and how attention is reallocated when threatened. The primary aim of this study was to describe changes in attention when presented with a postural threat, while a secondary aim was to explore associations between changes in attention and postural control. Eighty-two healthy young adults completed tests of static (quiet standing) and anticipatory (rise to toes) postural control under threatening and non-threatening conditions. Participants completed an open-ended questionnaire after each postural task which asked them to list what they thought about or directed their attention toward. Each item listed was assigned a percentage value reflecting how much attention it occupied. Exit interviews were completed to help confirm where attention was directed. Five attention categories were identified: movement processes, threat-relevant stimuli, self-regulatory strategies, task objectives, and task-irrelevant information. For both postural tasks, the percentage values and number of items listed for movement processes, threat-relevant stimuli, and self-regulatory strategies increased under threatening compared to non-threatening conditions, while the percentage values and number of items listed for task objectives and task-irrelevant information decreased. Changes in attention related to movement processes and self-regulatory strategies were associated with changes in static postural control, while changes in attention related to threat-relevant stimuli were associated with changes in anticipatory postural control. These results suggest that threat-induced changes in attention are multidimensional and contribute to changes in postural control.



from #Audiology via ola Kala on Inoreader http://ift.tt/1OTC7qb
via IFTTT

Biomechanical and perceived differences between overground and treadmill walking in children with cerebral palsy

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): Taeyou Jung, Yumi Kim, Luke E. Kelly, Mark F. Abel
The treadmill is widely used as an instrument for gait training and analysis. The primary purpose of this study was to compare biomechanical variables between overground and treadmill walking in children with cerebral palsy (CP). Perceived differences between the two walking modes were also investigated by comparing self-selected walking speeds. Twenty children with CP performed both overground and treadmill walking at a matched speed for biomechanical comparison using a 3-D motion analysis system. In addition, they were asked to select comfortable and fastest walking speeds under each walking condition to compare perceived differences. Significant differences in spatiotemporal variables were found including higher cadence and shorter stride length during treadmill walking at a matched speed (for all, P<.003). The comparison of joint kinematics demonstrated significant differences between overground and treadmill walking, which showed increases in peak angles of ankle dorsi-flexion, knee flexion/extension, and hip flexion (for all, P<.001), increases in ankle and hip excursions and a decrease in pelvic rotation excursion while walking on treadmill (for all, P<.002). Comparison of perceived difference revealed that children with CP chose significantly slower speeds when asked to select their comfortable and fastest walking speeds on the treadmill as compared to overground (for both, P<.001). Our results suggest that these biomechanical and perceived differences should be considered when using a treadmill for gait intervention or assessment.



from #Audiology via ola Kala on Inoreader http://ift.tt/1UEL8Bw
via IFTTT

Effect of calendar age on physical performance: A comparison of standard clinical measures with instrumented measures in middle-aged to older adults

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): M. Stijntjes, C.G.M. Meskers, A.J.M. de Craen, R.C. van Lummel, S.M. Rispens, P.E. Slagboom, A.B. Maier
BackgroundDecline in physical performance is highly prevalent during aging. Identification of sensitive markers of age-related changes in physical performance is important for early detection, development of therapeutic strategies and insight into underlying mechanisms. We studied the association of calendar age and familial longevity with standard clinical and instrumented measures of physical performance in a cohort of healthy middle-aged to older adults.MethodsCross-sectional analysis within the Leiden Longevity Study consisting of offspring of nonagenarian siblings and their partners (n=300, mean age (SD) 65.3 (6.7) years). Standard clinical measures were 25-meter walking speed and total duration of the chair stand test (CST). Instrumented measures were determined using a body fixed sensor. Dependence of physical performance on calendar age and familial longevity (offspring versus partner status) was analyzed using linear and logistic regression, respectively, adjusted for gender and height.ResultsHigher calendar age was associated with slower walking speed and longer duration of the CST (standardized β (95% CI) −.024 (−.042; −.006) and .035 (.014;.056), respectively). Instrumented measures showed similar effect sizes with strongest associations for gait stability and symmetry in mediolateral direction and for the extension and flexion phase of sit-to-stand and stand-to-sit transfers, respectively. No differences were observed between offspring of nonagenarian siblings and their partners.ConclusionsStandard clinical and instrumented measures of physical performance are associated with similar effect size to age-related changes in physical performance observable from middle age. The potential added value of instrumented measures for understanding underlying mechanisms requires further attention.



from #Audiology via xlomafota13 on Inoreader http://ift.tt/1OTC9hR
via IFTTT

Threat-induced changes in attention during tests of static and anticipatory postural control

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): Martin Zaback, Mark G. Carpenter, Allan L. Adkin
Postural threat, manipulated through changes in surface height, influences postural control. Evidence suggests changes in attention may contribute to this relationship. However, limited research has explored where and how attention is reallocated when threatened. The primary aim of this study was to describe changes in attention when presented with a postural threat, while a secondary aim was to explore associations between changes in attention and postural control. Eighty-two healthy young adults completed tests of static (quiet standing) and anticipatory (rise to toes) postural control under threatening and non-threatening conditions. Participants completed an open-ended questionnaire after each postural task which asked them to list what they thought about or directed their attention toward. Each item listed was assigned a percentage value reflecting how much attention it occupied. Exit interviews were completed to help confirm where attention was directed. Five attention categories were identified: movement processes, threat-relevant stimuli, self-regulatory strategies, task objectives, and task-irrelevant information. For both postural tasks, the percentage values and number of items listed for movement processes, threat-relevant stimuli, and self-regulatory strategies increased under threatening compared to non-threatening conditions, while the percentage values and number of items listed for task objectives and task-irrelevant information decreased. Changes in attention related to movement processes and self-regulatory strategies were associated with changes in static postural control, while changes in attention related to threat-relevant stimuli were associated with changes in anticipatory postural control. These results suggest that threat-induced changes in attention are multidimensional and contribute to changes in postural control.



from #Audiology via xlomafota13 on Inoreader http://ift.tt/1OTC7qb
via IFTTT

Biomechanical and perceived differences between overground and treadmill walking in children with cerebral palsy

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): Taeyou Jung, Yumi Kim, Luke E. Kelly, Mark F. Abel
The treadmill is widely used as an instrument for gait training and analysis. The primary purpose of this study was to compare biomechanical variables between overground and treadmill walking in children with cerebral palsy (CP). Perceived differences between the two walking modes were also investigated by comparing self-selected walking speeds. Twenty children with CP performed both overground and treadmill walking at a matched speed for biomechanical comparison using a 3-D motion analysis system. In addition, they were asked to select comfortable and fastest walking speeds under each walking condition to compare perceived differences. Significant differences in spatiotemporal variables were found including higher cadence and shorter stride length during treadmill walking at a matched speed (for all, P<.003). The comparison of joint kinematics demonstrated significant differences between overground and treadmill walking, which showed increases in peak angles of ankle dorsi-flexion, knee flexion/extension, and hip flexion (for all, P<.001), increases in ankle and hip excursions and a decrease in pelvic rotation excursion while walking on treadmill (for all, P<.002). Comparison of perceived difference revealed that children with CP chose significantly slower speeds when asked to select their comfortable and fastest walking speeds on the treadmill as compared to overground (for both, P<.001). Our results suggest that these biomechanical and perceived differences should be considered when using a treadmill for gait intervention or assessment.



from #Audiology via xlomafota13 on Inoreader http://ift.tt/1UEL8Bw
via IFTTT

Selective processing of auditory evoked responses with iterative-randomized stimulation and averaging: A strategy for evaluating the time-invariant assumption

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): Joaquin T. Valderrama, Angel de la Torre, Carlos Medina, Jose C. Segura, A. Roger D. Thornton
The recording of auditory evoked potentials (AEPs) at fast rates allows the study of neural adaptation, improves accuracy in estimating hearing threshold and may help diagnosing certain pathologies. Stimulation sequences used to record AEPs at fast rates require to be designed with a certain jitter, i.e., not periodical. Some authors believe that stimuli from wide-jittered sequences may evoke auditory responses of different morphology, and therefore, the time-invariant assumption would not be accomplished. This paper describes a methodology that can be used to analyze the time-invariant assumption in jittered stimulation sequences. The proposed method [Split-IRSA] is based on an extended version of the iterative randomized stimulation and averaging (IRSA) technique, including selective processing of sweeps according to a predefined criterion. The fundamentals, the mathematical basis and relevant implementation guidelines of this technique are presented in this paper. The results of this study show that Split-IRSA presents an adequate performance and that both fast and slow mechanisms of adaptation influence the evoked-response morphology, thus both mechanisms should be considered when time-invariance is assumed. The significance of these findings is discussed.



from #Audiology via xlomafota13 on Inoreader http://ift.tt/1IVIGGf
via IFTTT

Auditory and visual 3D virtual reality therapy as a new treatment for chronic subjective tinnitus: results of a randomized controlled trial

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): D. Malinvaud, A. Londero, R. Niarra, Ph Peignard, O. Warusfel, I. Viaud-Delmon, G. Chatellier, P. Bonfils
BackgroundSubjective tinnitus (ST) is a frequent audiologic condition that still requires effective treatment. This study aimed at evaluating two therapeutic approaches: Virtual Reality (VR) immersion in auditory and visual 3D environments and Cognitive Behaviour Therapy (CBT).Methodsthis open, randomized and therapeutic equivalence trial used bilateral testing of VR versus CBT. Adult patients displaying unilateral or predominantly unilateral ST, and fulfilling inclusion criteria were included after giving their written informed consent. We measured the different therapeutic effect by comparing the mean scores of validated questionnaires and visual analog scales, pre and post protocol. Equivalence was established if both strategies did not differ for more than a predetermined limit. We used univariate and multivariate analysis adjusted on baseline values to assess treatment efficacy. In addition of this trial, purely exploratory comparison to a waiting list group (WL) was provided.ResultsBetween August, 2009 and November, 2011, 148 of 162 screened patients were enrolled (VR n = 61, CBT n = 58, WL n = 29). These groups did not differ at baseline for demographic data. Three month after the end of the treatment, we didn’t find any difference between VR and CBT groups either for tinnitus severity (p=0.99) or tinnitus handicap (p=0.36).ConclusionVR appears to be at least as effective as CBT in unilateral ST patients.



from #Audiology via xlomafota13 on Inoreader http://ift.tt/1TLfgel
via IFTTT

Reduction in Spread of Excitation from Current Focusing at Multiple Cochlear Locations in Cochlear Implant Users

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): Monica Padilla, David M. Landsberger
Channel interaction from a broad spread of excitation is likely to be a limiting factor in performance by cochlear implant users. Although partial tripolar stimulation has been shown to reduce spread of excitation, the magnitude of the reduction is highly variable across subjects. Because the reduction in spread of excitation is typically only measured at one electrode for a given subject, the degree of variability across cochlear locations is unknown. The first goal of the present study was to determine if the reduction in spread of excitation observed from partial tripolar current focusing systematically varies across the cochlea. The second goal was to measure the variability in reduction of spread of excitation relative to monopolar stimulation across the cochlea. The third goal was to expand upon previous results that suggest that scaling of verbal descriptors can be used to predict the reduction in spread of excitation, by increasing the limited number of sites previously evaluated and verify the relationships remain with the larger dataset. The spread of excitation for monopolar and partial tripolar stimulation was measured at 5 cochlear locations using a psychophysical forward masking task. Results of the present study suggest that although partial tripolar stimulation typically reduces spread of excitation, the degree of reduction in spread of excitation was found to be highly variable and no effect of cochlear location was found. Additionally, subjective scaling of certain verbal descriptors (Clean/Dirty, Pure/Noisy) correlated with the reduction in spread of excitation suggesting sound quality scaling might be used as a quick clinical estimate of channels providing a reduction in spread of excitation. This quick scaling technique might help clinicians determine which patients would be most likely to benefit from a focused strategy.



from #Audiology via xlomafota13 on Inoreader http://ift.tt/1TLfcvg
via IFTTT

Selective processing of auditory evoked responses with iterative-randomized stimulation and averaging: A strategy for evaluating the time-invariant assumption

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): Joaquin T. Valderrama, Angel de la Torre, Carlos Medina, Jose C. Segura, A. Roger D. Thornton
The recording of auditory evoked potentials (AEPs) at fast rates allows the study of neural adaptation, improves accuracy in estimating hearing threshold and may help diagnosing certain pathologies. Stimulation sequences used to record AEPs at fast rates require to be designed with a certain jitter, i.e., not periodical. Some authors believe that stimuli from wide-jittered sequences may evoke auditory responses of different morphology, and therefore, the time-invariant assumption would not be accomplished. This paper describes a methodology that can be used to analyze the time-invariant assumption in jittered stimulation sequences. The proposed method [Split-IRSA] is based on an extended version of the iterative randomized stimulation and averaging (IRSA) technique, including selective processing of sweeps according to a predefined criterion. The fundamentals, the mathematical basis and relevant implementation guidelines of this technique are presented in this paper. The results of this study show that Split-IRSA presents an adequate performance and that both fast and slow mechanisms of adaptation influence the evoked-response morphology, thus both mechanisms should be considered when time-invariance is assumed. The significance of these findings is discussed.



from #Audiology via ola Kala on Inoreader http://ift.tt/1IVIGGf
via IFTTT

Auditory and visual 3D virtual reality therapy as a new treatment for chronic subjective tinnitus: results of a randomized controlled trial

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): D. Malinvaud, A. Londero, R. Niarra, Ph Peignard, O. Warusfel, I. Viaud-Delmon, G. Chatellier, P. Bonfils
BackgroundSubjective tinnitus (ST) is a frequent audiologic condition that still requires effective treatment. This study aimed at evaluating two therapeutic approaches: Virtual Reality (VR) immersion in auditory and visual 3D environments and Cognitive Behaviour Therapy (CBT).Methodsthis open, randomized and therapeutic equivalence trial used bilateral testing of VR versus CBT. Adult patients displaying unilateral or predominantly unilateral ST, and fulfilling inclusion criteria were included after giving their written informed consent. We measured the different therapeutic effect by comparing the mean scores of validated questionnaires and visual analog scales, pre and post protocol. Equivalence was established if both strategies did not differ for more than a predetermined limit. We used univariate and multivariate analysis adjusted on baseline values to assess treatment efficacy. In addition of this trial, purely exploratory comparison to a waiting list group (WL) was provided.ResultsBetween August, 2009 and November, 2011, 148 of 162 screened patients were enrolled (VR n = 61, CBT n = 58, WL n = 29). These groups did not differ at baseline for demographic data. Three month after the end of the treatment, we didn’t find any difference between VR and CBT groups either for tinnitus severity (p=0.99) or tinnitus handicap (p=0.36).ConclusionVR appears to be at least as effective as CBT in unilateral ST patients.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TLfgel
via IFTTT

Reduction in Spread of Excitation from Current Focusing at Multiple Cochlear Locations in Cochlear Implant Users

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): Monica Padilla, David M. Landsberger
Channel interaction from a broad spread of excitation is likely to be a limiting factor in performance by cochlear implant users. Although partial tripolar stimulation has been shown to reduce spread of excitation, the magnitude of the reduction is highly variable across subjects. Because the reduction in spread of excitation is typically only measured at one electrode for a given subject, the degree of variability across cochlear locations is unknown. The first goal of the present study was to determine if the reduction in spread of excitation observed from partial tripolar current focusing systematically varies across the cochlea. The second goal was to measure the variability in reduction of spread of excitation relative to monopolar stimulation across the cochlea. The third goal was to expand upon previous results that suggest that scaling of verbal descriptors can be used to predict the reduction in spread of excitation, by increasing the limited number of sites previously evaluated and verify the relationships remain with the larger dataset. The spread of excitation for monopolar and partial tripolar stimulation was measured at 5 cochlear locations using a psychophysical forward masking task. Results of the present study suggest that although partial tripolar stimulation typically reduces spread of excitation, the degree of reduction in spread of excitation was found to be highly variable and no effect of cochlear location was found. Additionally, subjective scaling of certain verbal descriptors (Clean/Dirty, Pure/Noisy) correlated with the reduction in spread of excitation suggesting sound quality scaling might be used as a quick clinical estimate of channels providing a reduction in spread of excitation. This quick scaling technique might help clinicians determine which patients would be most likely to benefit from a focused strategy.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TLfcvg
via IFTTT

Selective processing of auditory evoked responses with iterative-randomized stimulation and averaging: A strategy for evaluating the time-invariant assumption

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): Joaquin T. Valderrama, Angel de la Torre, Carlos Medina, Jose C. Segura, A. Roger D. Thornton
The recording of auditory evoked potentials (AEPs) at fast rates allows the study of neural adaptation, improves accuracy in estimating hearing threshold and may help diagnosing certain pathologies. Stimulation sequences used to record AEPs at fast rates require to be designed with a certain jitter, i.e., not periodical. Some authors believe that stimuli from wide-jittered sequences may evoke auditory responses of different morphology, and therefore, the time-invariant assumption would not be accomplished. This paper describes a methodology that can be used to analyze the time-invariant assumption in jittered stimulation sequences. The proposed method [Split-IRSA] is based on an extended version of the iterative randomized stimulation and averaging (IRSA) technique, including selective processing of sweeps according to a predefined criterion. The fundamentals, the mathematical basis and relevant implementation guidelines of this technique are presented in this paper. The results of this study show that Split-IRSA presents an adequate performance and that both fast and slow mechanisms of adaptation influence the evoked-response morphology, thus both mechanisms should be considered when time-invariance is assumed. The significance of these findings is discussed.



from #Audiology via ola Kala on Inoreader http://ift.tt/1IVIGGf
via IFTTT

Auditory and visual 3D virtual reality therapy as a new treatment for chronic subjective tinnitus: results of a randomized controlled trial

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): D. Malinvaud, A. Londero, R. Niarra, Ph Peignard, O. Warusfel, I. Viaud-Delmon, G. Chatellier, P. Bonfils
BackgroundSubjective tinnitus (ST) is a frequent audiologic condition that still requires effective treatment. This study aimed at evaluating two therapeutic approaches: Virtual Reality (VR) immersion in auditory and visual 3D environments and Cognitive Behaviour Therapy (CBT).Methodsthis open, randomized and therapeutic equivalence trial used bilateral testing of VR versus CBT. Adult patients displaying unilateral or predominantly unilateral ST, and fulfilling inclusion criteria were included after giving their written informed consent. We measured the different therapeutic effect by comparing the mean scores of validated questionnaires and visual analog scales, pre and post protocol. Equivalence was established if both strategies did not differ for more than a predetermined limit. We used univariate and multivariate analysis adjusted on baseline values to assess treatment efficacy. In addition of this trial, purely exploratory comparison to a waiting list group (WL) was provided.ResultsBetween August, 2009 and November, 2011, 148 of 162 screened patients were enrolled (VR n = 61, CBT n = 58, WL n = 29). These groups did not differ at baseline for demographic data. Three month after the end of the treatment, we didn’t find any difference between VR and CBT groups either for tinnitus severity (p=0.99) or tinnitus handicap (p=0.36).ConclusionVR appears to be at least as effective as CBT in unilateral ST patients.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TLfgel
via IFTTT

Reduction in Spread of Excitation from Current Focusing at Multiple Cochlear Locations in Cochlear Implant Users

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): Monica Padilla, David M. Landsberger
Channel interaction from a broad spread of excitation is likely to be a limiting factor in performance by cochlear implant users. Although partial tripolar stimulation has been shown to reduce spread of excitation, the magnitude of the reduction is highly variable across subjects. Because the reduction in spread of excitation is typically only measured at one electrode for a given subject, the degree of variability across cochlear locations is unknown. The first goal of the present study was to determine if the reduction in spread of excitation observed from partial tripolar current focusing systematically varies across the cochlea. The second goal was to measure the variability in reduction of spread of excitation relative to monopolar stimulation across the cochlea. The third goal was to expand upon previous results that suggest that scaling of verbal descriptors can be used to predict the reduction in spread of excitation, by increasing the limited number of sites previously evaluated and verify the relationships remain with the larger dataset. The spread of excitation for monopolar and partial tripolar stimulation was measured at 5 cochlear locations using a psychophysical forward masking task. Results of the present study suggest that although partial tripolar stimulation typically reduces spread of excitation, the degree of reduction in spread of excitation was found to be highly variable and no effect of cochlear location was found. Additionally, subjective scaling of certain verbal descriptors (Clean/Dirty, Pure/Noisy) correlated with the reduction in spread of excitation suggesting sound quality scaling might be used as a quick clinical estimate of channels providing a reduction in spread of excitation. This quick scaling technique might help clinicians determine which patients would be most likely to benefit from a focused strategy.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TLfcvg
via IFTTT

Selective processing of auditory evoked responses with iterative-randomized stimulation and averaging: A strategy for evaluating the time-invariant assumption

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): Joaquin T. Valderrama, Angel de la Torre, Carlos Medina, Jose C. Segura, A. Roger D. Thornton
The recording of auditory evoked potentials (AEPs) at fast rates allows the study of neural adaptation, improves accuracy in estimating hearing threshold and may help diagnosing certain pathologies. Stimulation sequences used to record AEPs at fast rates require to be designed with a certain jitter, i.e., not periodical. Some authors believe that stimuli from wide-jittered sequences may evoke auditory responses of different morphology, and therefore, the time-invariant assumption would not be accomplished. This paper describes a methodology that can be used to analyze the time-invariant assumption in jittered stimulation sequences. The proposed method [Split-IRSA] is based on an extended version of the iterative randomized stimulation and averaging (IRSA) technique, including selective processing of sweeps according to a predefined criterion. The fundamentals, the mathematical basis and relevant implementation guidelines of this technique are presented in this paper. The results of this study show that Split-IRSA presents an adequate performance and that both fast and slow mechanisms of adaptation influence the evoked-response morphology, thus both mechanisms should be considered when time-invariance is assumed. The significance of these findings is discussed.



from #Audiology via ola Kala on Inoreader http://ift.tt/1IVIGGf
via IFTTT

Auditory and visual 3D virtual reality therapy as a new treatment for chronic subjective tinnitus: results of a randomized controlled trial

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): D. Malinvaud, A. Londero, R. Niarra, Ph Peignard, O. Warusfel, I. Viaud-Delmon, G. Chatellier, P. Bonfils
BackgroundSubjective tinnitus (ST) is a frequent audiologic condition that still requires effective treatment. This study aimed at evaluating two therapeutic approaches: Virtual Reality (VR) immersion in auditory and visual 3D environments and Cognitive Behaviour Therapy (CBT).Methodsthis open, randomized and therapeutic equivalence trial used bilateral testing of VR versus CBT. Adult patients displaying unilateral or predominantly unilateral ST, and fulfilling inclusion criteria were included after giving their written informed consent. We measured the different therapeutic effect by comparing the mean scores of validated questionnaires and visual analog scales, pre and post protocol. Equivalence was established if both strategies did not differ for more than a predetermined limit. We used univariate and multivariate analysis adjusted on baseline values to assess treatment efficacy. In addition of this trial, purely exploratory comparison to a waiting list group (WL) was provided.ResultsBetween August, 2009 and November, 2011, 148 of 162 screened patients were enrolled (VR n = 61, CBT n = 58, WL n = 29). These groups did not differ at baseline for demographic data. Three month after the end of the treatment, we didn’t find any difference between VR and CBT groups either for tinnitus severity (p=0.99) or tinnitus handicap (p=0.36).ConclusionVR appears to be at least as effective as CBT in unilateral ST patients.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TLfgel
via IFTTT

Reduction in Spread of Excitation from Current Focusing at Multiple Cochlear Locations in Cochlear Implant Users

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): Monica Padilla, David M. Landsberger
Channel interaction from a broad spread of excitation is likely to be a limiting factor in performance by cochlear implant users. Although partial tripolar stimulation has been shown to reduce spread of excitation, the magnitude of the reduction is highly variable across subjects. Because the reduction in spread of excitation is typically only measured at one electrode for a given subject, the degree of variability across cochlear locations is unknown. The first goal of the present study was to determine if the reduction in spread of excitation observed from partial tripolar current focusing systematically varies across the cochlea. The second goal was to measure the variability in reduction of spread of excitation relative to monopolar stimulation across the cochlea. The third goal was to expand upon previous results that suggest that scaling of verbal descriptors can be used to predict the reduction in spread of excitation, by increasing the limited number of sites previously evaluated and verify the relationships remain with the larger dataset. The spread of excitation for monopolar and partial tripolar stimulation was measured at 5 cochlear locations using a psychophysical forward masking task. Results of the present study suggest that although partial tripolar stimulation typically reduces spread of excitation, the degree of reduction in spread of excitation was found to be highly variable and no effect of cochlear location was found. Additionally, subjective scaling of certain verbal descriptors (Clean/Dirty, Pure/Noisy) correlated with the reduction in spread of excitation suggesting sound quality scaling might be used as a quick clinical estimate of channels providing a reduction in spread of excitation. This quick scaling technique might help clinicians determine which patients would be most likely to benefit from a focused strategy.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TLfcvg
via IFTTT

Selective processing of auditory evoked responses with iterative-randomized stimulation and averaging: A strategy for evaluating the time-invariant assumption

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): Joaquin T. Valderrama, Angel de la Torre, Carlos Medina, Jose C. Segura, A. Roger D. Thornton
The recording of auditory evoked potentials (AEPs) at fast rates allows the study of neural adaptation, improves accuracy in estimating hearing threshold and may help diagnosing certain pathologies. Stimulation sequences used to record AEPs at fast rates require to be designed with a certain jitter, i.e., not periodical. Some authors believe that stimuli from wide-jittered sequences may evoke auditory responses of different morphology, and therefore, the time-invariant assumption would not be accomplished. This paper describes a methodology that can be used to analyze the time-invariant assumption in jittered stimulation sequences. The proposed method [Split-IRSA] is based on an extended version of the iterative randomized stimulation and averaging (IRSA) technique, including selective processing of sweeps according to a predefined criterion. The fundamentals, the mathematical basis and relevant implementation guidelines of this technique are presented in this paper. The results of this study show that Split-IRSA presents an adequate performance and that both fast and slow mechanisms of adaptation influence the evoked-response morphology, thus both mechanisms should be considered when time-invariance is assumed. The significance of these findings is discussed.



from #Audiology via ola Kala on Inoreader http://ift.tt/1IVIGGf
via IFTTT

Auditory and visual 3D virtual reality therapy as a new treatment for chronic subjective tinnitus: results of a randomized controlled trial

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): D. Malinvaud, A. Londero, R. Niarra, Ph Peignard, O. Warusfel, I. Viaud-Delmon, G. Chatellier, P. Bonfils
BackgroundSubjective tinnitus (ST) is a frequent audiologic condition that still requires effective treatment. This study aimed at evaluating two therapeutic approaches: Virtual Reality (VR) immersion in auditory and visual 3D environments and Cognitive Behaviour Therapy (CBT).Methodsthis open, randomized and therapeutic equivalence trial used bilateral testing of VR versus CBT. Adult patients displaying unilateral or predominantly unilateral ST, and fulfilling inclusion criteria were included after giving their written informed consent. We measured the different therapeutic effect by comparing the mean scores of validated questionnaires and visual analog scales, pre and post protocol. Equivalence was established if both strategies did not differ for more than a predetermined limit. We used univariate and multivariate analysis adjusted on baseline values to assess treatment efficacy. In addition of this trial, purely exploratory comparison to a waiting list group (WL) was provided.ResultsBetween August, 2009 and November, 2011, 148 of 162 screened patients were enrolled (VR n = 61, CBT n = 58, WL n = 29). These groups did not differ at baseline for demographic data. Three month after the end of the treatment, we didn’t find any difference between VR and CBT groups either for tinnitus severity (p=0.99) or tinnitus handicap (p=0.36).ConclusionVR appears to be at least as effective as CBT in unilateral ST patients.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TLfgel
via IFTTT

Reduction in Spread of Excitation from Current Focusing at Multiple Cochlear Locations in Cochlear Implant Users

Publication date: Available online 8 January 2016
Source:Hearing Research
Author(s): Monica Padilla, David M. Landsberger
Channel interaction from a broad spread of excitation is likely to be a limiting factor in performance by cochlear implant users. Although partial tripolar stimulation has been shown to reduce spread of excitation, the magnitude of the reduction is highly variable across subjects. Because the reduction in spread of excitation is typically only measured at one electrode for a given subject, the degree of variability across cochlear locations is unknown. The first goal of the present study was to determine if the reduction in spread of excitation observed from partial tripolar current focusing systematically varies across the cochlea. The second goal was to measure the variability in reduction of spread of excitation relative to monopolar stimulation across the cochlea. The third goal was to expand upon previous results that suggest that scaling of verbal descriptors can be used to predict the reduction in spread of excitation, by increasing the limited number of sites previously evaluated and verify the relationships remain with the larger dataset. The spread of excitation for monopolar and partial tripolar stimulation was measured at 5 cochlear locations using a psychophysical forward masking task. Results of the present study suggest that although partial tripolar stimulation typically reduces spread of excitation, the degree of reduction in spread of excitation was found to be highly variable and no effect of cochlear location was found. Additionally, subjective scaling of certain verbal descriptors (Clean/Dirty, Pure/Noisy) correlated with the reduction in spread of excitation suggesting sound quality scaling might be used as a quick clinical estimate of channels providing a reduction in spread of excitation. This quick scaling technique might help clinicians determine which patients would be most likely to benefit from a focused strategy.



from #Audiology via ola Kala on Inoreader http://ift.tt/1TLfcvg
via IFTTT