ReSound's Directional Philosophy

Dr. John Nelson: Today I will discuss how ReSound implements directional processing in our hearing aids. We know that directional hearing aids provide a significant benefit in laboratory settings. When conducting studies, we will typically place a listener in an audio sound booth in a controlled listening situation. An example of a controlled listening situation is where a speech signal comes from the front of the listener, and noise comes from the back. This setting does not represent a real-world situation. However, when we perform laboratory studies, we must control them so that we know what we are looking at and we can measure and evaluate the data. Therefore, when we obtain our results, we can go back and analyze what did or did not cause a directional benefit. Additionally, in a laboratory, the speech and noise may be spatially separated (i.e., they are not coming from the same direction). This is also a cue that allows directional hearing aids to work better, because they can focus in on different directions, being able to provide better audibility and better understanding from different situations.

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ReSound's Directional Philosophy

Dr. John Nelson: Today I will discuss how ReSound implements directional processing in our hearing aids. We know that directional hearing aids provide a significant benefit in laboratory settings. When conducting studies, we will typically place a listener in an audio sound booth in a controlled listening situation. An example of a controlled listening situation is where a speech signal comes from the front of the listener, and noise comes from the back. This setting does not represent a real-world situation. However, when we perform laboratory studies, we must control them so that we know what we are looking at and we can measure and evaluate the data. Therefore, when we obtain our results, we can go back and analyze what did or did not cause a directional benefit. Additionally, in a laboratory, the speech and noise may be spatially separated (i.e., they are not coming from the same direction). This is also a cue that allows directional hearing aids to work better, because they can focus in on different directions, being able to provide better audibility and better understanding from different situations.

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ReSound's Directional Philosophy

Dr. John Nelson: Today I will discuss how ReSound implements directional processing in our hearing aids. We know that directional hearing aids provide a significant benefit in laboratory settings. When conducting studies, we will typically place a listener in an audio sound booth in a controlled listening situation. An example of a controlled listening situation is where a speech signal comes from the front of the listener, and noise comes from the back. This setting does not represent a real-world situation. However, when we perform laboratory studies, we must control them so that we know what we are looking at and we can measure and evaluate the data. Therefore, when we obtain our results, we can go back and analyze what did or did not cause a directional benefit. Additionally, in a laboratory, the speech and noise may be spatially separated (i.e., they are not coming from the same direction). This is also a cue that allows directional hearing aids to work better, because they can focus in on different directions, being able to provide better audibility and better understanding from different situations.

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Symmetry in vertical ground reaction force is not related to walking and balance difficulties in people with multiple sclerosis

Publication date: Available online 16 April 2016
Source:Gait & Posture
Author(s): Alon Kalron
Analysis of vertical ground reaction force (GRF) symmetry may benefit people with multiple sclerosis (PwMS) since it can detect important differences in gait mechanics which have not previously been discussed in the related literature. Therefore, the primary objective of the current study was to determine whether symmetry of the vertical GRF during gait is associated with validated gait and balance tests in PwMS. Additionally, we examined whether the symmetry of the vertical GRF differs between MS fallers, non-fallers and between neurological disability levels. Gait and balance data were collected from 402 PwMS (249 women) with a mean age of 42.1 (S.D=14.1) years. Vertical GRF parameters were obtained using the Zebris FDM-T Treadmill (Zebris Medical GmbH, Germany). Clinical gait and balance tests included the 2 and 6-min Walk Test, Timed Up and Go Test, Timed 25 Foot Walk, Four Square Step Test, Multiple Sclerosis Walking Scale questionnaire, Modified Fatigue Impact Scale and the Falls Efficacy Scale International questionnaire. The vertical GRF symmetry index score of the total sample was 3.7 (SD=3.1). In terms of fall status, non-significant differences were observed between the fallers and non-faller groups and between the neurological disability subgroups. Non-significant correlation scores were found between the vertical GRF symmetry index, all clinical walking and balance tests and self-reported questionnaires. We suggest clinicians, especially those involved in physical rehabilitation, accord low priority to this gait phenomenon in the MS population.



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Development of gait performance and dynamic hip and knee joint loading after containment improving surgery in patients with Legg-Calvé-Perthes disease

Publication date: Available online 16 April 2016
Source:Gait & Posture
Author(s): Felix Stief, André Schmidt, Stefanie Adolf, Laura Kremer, Moamer Brkic, Andrea Meurer
Current surgery outcome evaluations in patients with Legg-Calvé-Perthes disease (LCPD) are usually based on static radiological changes. The aim of the present study was to assess the development of characteristic gait parameters and passive hip range of motion (ROM) measurements during the postoperative period up to healed stage of the femoral head represented by Stulberg classification. Twelve children (10 male, 2 female) with unilateral diagnosis of LCPD and 19 healthy control subjects at the same age participated in this prospective longitudinal study. Instrumented gait analysis was performed preoperatively, 13.4 (± 1.7), and 28.0 (± 4.4) months postoperatively. At final follow-up, the mean leg length of the involved side was reduced by 1.10 (± 0.53) cm compared to the non-involved side. In addition, a significant reduction in maximum knee flexion (-26%, p=0.037) and knee flexion/extension ROM (-26%, p=0.017) in stance was still present in the patient group compared to controls indicating a “stiff knee gait pattern”. In contrast, the sagittal plane hip parameters, the ipsilateral trunk lean toward the involved stance limb, and the knee and hip joint loading during gait normalized during the postoperative period. The results of the present study should motivate further exploration if patients with LCPD stiffen their knees to compensate for leg length discrepancy. Besides the standard radiological evaluation of the surgery outcome, instrumented gait analysis is a valuable method of recording functional deficits and early recognition of the need for physiotherapeutic treatment or insole supply in patients with LCPD.



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Symmetry in vertical ground reaction force is not related to walking and balance difficulties in people with multiple sclerosis

Publication date: Available online 16 April 2016
Source:Gait & Posture
Author(s): Alon Kalron
Analysis of vertical ground reaction force (GRF) symmetry may benefit people with multiple sclerosis (PwMS) since it can detect important differences in gait mechanics which have not previously been discussed in the related literature. Therefore, the primary objective of the current study was to determine whether symmetry of the vertical GRF during gait is associated with validated gait and balance tests in PwMS. Additionally, we examined whether the symmetry of the vertical GRF differs between MS fallers, non-fallers and between neurological disability levels. Gait and balance data were collected from 402 PwMS (249 women) with a mean age of 42.1 (S.D=14.1) years. Vertical GRF parameters were obtained using the Zebris FDM-T Treadmill (Zebris Medical GmbH, Germany). Clinical gait and balance tests included the 2 and 6-min Walk Test, Timed Up and Go Test, Timed 25 Foot Walk, Four Square Step Test, Multiple Sclerosis Walking Scale questionnaire, Modified Fatigue Impact Scale and the Falls Efficacy Scale International questionnaire. The vertical GRF symmetry index score of the total sample was 3.7 (SD=3.1). In terms of fall status, non-significant differences were observed between the fallers and non-faller groups and between the neurological disability subgroups. Non-significant correlation scores were found between the vertical GRF symmetry index, all clinical walking and balance tests and self-reported questionnaires. We suggest clinicians, especially those involved in physical rehabilitation, accord low priority to this gait phenomenon in the MS population.



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Development of gait performance and dynamic hip and knee joint loading after containment improving surgery in patients with Legg-Calvé-Perthes disease

Publication date: Available online 16 April 2016
Source:Gait & Posture
Author(s): Felix Stief, André Schmidt, Stefanie Adolf, Laura Kremer, Moamer Brkic, Andrea Meurer
Current surgery outcome evaluations in patients with Legg-Calvé-Perthes disease (LCPD) are usually based on static radiological changes. The aim of the present study was to assess the development of characteristic gait parameters and passive hip range of motion (ROM) measurements during the postoperative period up to healed stage of the femoral head represented by Stulberg classification. Twelve children (10 male, 2 female) with unilateral diagnosis of LCPD and 19 healthy control subjects at the same age participated in this prospective longitudinal study. Instrumented gait analysis was performed preoperatively, 13.4 (± 1.7), and 28.0 (± 4.4) months postoperatively. At final follow-up, the mean leg length of the involved side was reduced by 1.10 (± 0.53) cm compared to the non-involved side. In addition, a significant reduction in maximum knee flexion (-26%, p=0.037) and knee flexion/extension ROM (-26%, p=0.017) in stance was still present in the patient group compared to controls indicating a “stiff knee gait pattern”. In contrast, the sagittal plane hip parameters, the ipsilateral trunk lean toward the involved stance limb, and the knee and hip joint loading during gait normalized during the postoperative period. The results of the present study should motivate further exploration if patients with LCPD stiffen their knees to compensate for leg length discrepancy. Besides the standard radiological evaluation of the surgery outcome, instrumented gait analysis is a valuable method of recording functional deficits and early recognition of the need for physiotherapeutic treatment or insole supply in patients with LCPD.



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Symmetry in vertical ground reaction force is not related to walking and balance difficulties in people with multiple sclerosis

Publication date: Available online 16 April 2016
Source:Gait & Posture
Author(s): Alon Kalron
Analysis of vertical ground reaction force (GRF) symmetry may benefit people with multiple sclerosis (PwMS) since it can detect important differences in gait mechanics which have not previously been discussed in the related literature. Therefore, the primary objective of the current study was to determine whether symmetry of the vertical GRF during gait is associated with validated gait and balance tests in PwMS. Additionally, we examined whether the symmetry of the vertical GRF differs between MS fallers, non-fallers and between neurological disability levels. Gait and balance data were collected from 402 PwMS (249 women) with a mean age of 42.1 (S.D=14.1) years. Vertical GRF parameters were obtained using the Zebris FDM-T Treadmill (Zebris Medical GmbH, Germany). Clinical gait and balance tests included the 2 and 6-min Walk Test, Timed Up and Go Test, Timed 25 Foot Walk, Four Square Step Test, Multiple Sclerosis Walking Scale questionnaire, Modified Fatigue Impact Scale and the Falls Efficacy Scale International questionnaire. The vertical GRF symmetry index score of the total sample was 3.7 (SD=3.1). In terms of fall status, non-significant differences were observed between the fallers and non-faller groups and between the neurological disability subgroups. Non-significant correlation scores were found between the vertical GRF symmetry index, all clinical walking and balance tests and self-reported questionnaires. We suggest clinicians, especially those involved in physical rehabilitation, accord low priority to this gait phenomenon in the MS population.



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via IFTTT

Development of gait performance and dynamic hip and knee joint loading after containment improving surgery in patients with Legg-Calvé-Perthes disease

Publication date: Available online 16 April 2016
Source:Gait & Posture
Author(s): Felix Stief, André Schmidt, Stefanie Adolf, Laura Kremer, Moamer Brkic, Andrea Meurer
Current surgery outcome evaluations in patients with Legg-Calvé-Perthes disease (LCPD) are usually based on static radiological changes. The aim of the present study was to assess the development of characteristic gait parameters and passive hip range of motion (ROM) measurements during the postoperative period up to healed stage of the femoral head represented by Stulberg classification. Twelve children (10 male, 2 female) with unilateral diagnosis of LCPD and 19 healthy control subjects at the same age participated in this prospective longitudinal study. Instrumented gait analysis was performed preoperatively, 13.4 (± 1.7), and 28.0 (± 4.4) months postoperatively. At final follow-up, the mean leg length of the involved side was reduced by 1.10 (± 0.53) cm compared to the non-involved side. In addition, a significant reduction in maximum knee flexion (-26%, p=0.037) and knee flexion/extension ROM (-26%, p=0.017) in stance was still present in the patient group compared to controls indicating a “stiff knee gait pattern”. In contrast, the sagittal plane hip parameters, the ipsilateral trunk lean toward the involved stance limb, and the knee and hip joint loading during gait normalized during the postoperative period. The results of the present study should motivate further exploration if patients with LCPD stiffen their knees to compensate for leg length discrepancy. Besides the standard radiological evaluation of the surgery outcome, instrumented gait analysis is a valuable method of recording functional deficits and early recognition of the need for physiotherapeutic treatment or insole supply in patients with LCPD.



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Whole Exome Sequencing Reveals Homozygous Mutations in RAI1, OTOF, and SLC26A4 Genes Associated with Nonsyndromic Hearing Loss in Altaian Families (South Siberia)

by Alexander Y. Сhurbanov, Tatiana M. Karafet, Igor V. Morozov, Valeriia Yu. Mikhalskaia, Marina V. Zytsar, Alexander A. Bondar, Olga L. Posukh

Hearing loss (HL) is one of the most common sensorineural disorders and several dozen genes contribute to its pathogenesis. Establishing a genetic diagnosis of HL is of great importance for clinical evaluation of deaf patients and for estimating recurrence risks for their families. Efforts to identify genes responsible for HL have been challenged by high genetic heterogeneity and different ethnic-specific prevalence of inherited deafness. Here we present the utility of whole exome sequencing (WES) for identifying candidate causal variants for previously unexplained nonsyndromic HL of seven patients from four unrelated Altaian families (the Altai Republic, South Siberia). The WES analysis revealed homozygous missense mutations in three genes associated with HL. Mutation c.2168A>G (SLC26A4) was found in one family, a novel mutation c.1111G>C (OTOF) was revealed in another family, and mutation c.5254G>A (RAI1) was found in two families. Sanger sequencing was applied for screening of identified variants in an ethnically diverse cohort of other patients with HL (n = 116) and in Altaian controls (n = 120). Identified variants were found only in patients of Altaian ethnicity (n = 93). Several lines of evidences support the association of homozygosity for discovered variants c.5254G>A (RAI1), c.1111C>G (OTOF), and c.2168A>G (SLC26A4) with HL in Altaian patients. Local prevalence of identified variants implies possible founder effect in significant number of HL cases in indigenous population of the Altai region. Notably, this is the first reported instance of patients with RAI1 missense mutation whose HL is not accompanied by specific traits typical for Smith-Magenis syndrome. Presumed association of RAI1 gene variant c.5254G>A with isolated HL needs to be proved by further experimental studies.

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Central Nervous Activity upon Systemic Salicylate Application in Animals with Kanamycin-Induced Hearing Loss - A Manganese-Enhanced MRI (MEMRI) Study

by Moritz Gröschel, Romy Götze, Susanne Müller, Arne Ernst, Dietmar Basta

This study investigated the effect of systemic salicylate on central auditory and non-auditory structures in mice. Since cochlear hair cells are known to be one major target of salicylate, cochlear effects were reduced by using kanamycin to remove or impair hair cells. Neuronal brain activity was measured using the non-invasive manganese-enhanced magnetic resonance imaging technique. For all brain structures investigated, calcium-related neuronal activity was increased following systemic application of a sodium salicylate solution: probably due to neuronal hyperactivity. In addition, it was shown that the central effect of salicylate was not limited to the auditory system. A general alteration of calcium-related activity was indicated by an increase in manganese accumulation in the preoptic area of the anterior hypothalamus, as well as in the amygdala. The present data suggest that salicylate-induced activity changes in the auditory system differ from those shown in studies of noise trauma. Since salicylate action is reversible, central pharmacological effects of salicylate compared to those of (permanent) noise-induced hearing impairment and tinnitus might induce different pathophysiologies. These should therefore, be treated as different causes with the same symptoms.

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What is Menière's disease? A contemporary re-evaluation of endolymphatic hydrops.

What is Menière's disease? A contemporary re-evaluation of endolymphatic hydrops.

J Neurol. 2016 Apr;263(Suppl 1):71-81

Authors: Gürkov R, Pyykö I, Zou J, Kentala E

Abstract
Menière's disease is a chronic condition with a prevalence of 200-500 per 100,000 and characterized by episodic attacks of vertigo, fluctuating hearing loss, tinnitus, aural pressure and a progressive loss of audiovestibular functions. Over 150 years ago, Prosper Menière was the first to recognize the inner ear as the site of lesion for this clinical syndrome. Over 75 years ago, endolymphatic hydrops was discovered as the pathologic correlate of Menière's disease. However, this pathologic finding could be ascertained only in post-mortem histologic studies. Due to this diagnostic dilemma and the variable manifestation of the various audiovestibular symptoms, diagnostic classification systems based on clinical findings have been repeatedly modified and have not been uniformly used in scientific publications on Menière's disease. Furthermore, the higher level measures of impact on quality of life such as vitality and social participation have been neglected hitherto. Recent developments of high-resolution MR imaging of the inner ear have now enabled us to visualize in vivo endolymphatic hydrops in patients with suspected Menière's disease. In this review, we summarize the existing knowledge from temporal bone histologic studies and from the emerging evidence on imaging-based evaluation of patients with suspected Menière's disease. These indicate that endolymphatic hydrops is responsible not only for the full-blown clinical triad of simultaneous attacks of auditory and vestibular dysfunction, but also for other clinical presentations such as "vestibular" and "cochlear Menière's disease". As a consequence, we propose a new terminology which is based on symptomatic and imaging characteristics of these clinical entities to clarify and simplify their diagnostic classification.

PMID: 27083887 [PubMed - as supplied by publisher]

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Genetics of vestibular disorders: pathophysiological insights.

Genetics of vestibular disorders: pathophysiological insights.

J Neurol. 2016 Apr;263(Suppl 1):45-53

Authors: Frejo L, Giegling I, Teggi R, Lopez-Escamez JA, Rujescu D

Abstract
The two most common vestibular disorders are motion sickness and vestibular migraine, affecting 30 and 1-2 % of the population respectively. Both are related to migraine and show a familial trend. Bilateral vestibular hypofunction is a rare condition, and some of patients also present cerebellar ataxia and neuropathy. We present recent advances in the genetics of vestibular disorders with familial aggregation. The clinical heterogeneity observed in different relatives of the same families suggests a variable penetrance and the interaction of several genes in each family. Some Mendelian sensorineural hearing loss also exhibits vestibular dysfunction, including DFNA9, DFNA11, DFNA15 and DFNA28. However, the most relevant finding during the past years is the familial clustering observed in Meniere's disease. By using whole exome sequencing and combining bioinformatics tools, novel variants in DTNA and FAM136A genes have been identified in familial Meniere's disease, and this genomic strategy will facilitate the discovery of the genetic basis of familial vestibular disorders.

PMID: 27083884 [PubMed - as supplied by publisher]

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Genetics of vestibular disorders: pathophysiological insights.

Genetics of vestibular disorders: pathophysiological insights.

J Neurol. 2016 Apr;263(Suppl 1):45-53

Authors: Frejo L, Giegling I, Teggi R, Lopez-Escamez JA, Rujescu D

Abstract
The two most common vestibular disorders are motion sickness and vestibular migraine, affecting 30 and 1-2 % of the population respectively. Both are related to migraine and show a familial trend. Bilateral vestibular hypofunction is a rare condition, and some of patients also present cerebellar ataxia and neuropathy. We present recent advances in the genetics of vestibular disorders with familial aggregation. The clinical heterogeneity observed in different relatives of the same families suggests a variable penetrance and the interaction of several genes in each family. Some Mendelian sensorineural hearing loss also exhibits vestibular dysfunction, including DFNA9, DFNA11, DFNA15 and DFNA28. However, the most relevant finding during the past years is the familial clustering observed in Meniere's disease. By using whole exome sequencing and combining bioinformatics tools, novel variants in DTNA and FAM136A genes have been identified in familial Meniere's disease, and this genomic strategy will facilitate the discovery of the genetic basis of familial vestibular disorders.

PMID: 27083884 [PubMed - as supplied by publisher]

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What is Menière's disease? A contemporary re-evaluation of endolymphatic hydrops.

What is Menière's disease? A contemporary re-evaluation of endolymphatic hydrops.

J Neurol. 2016 Apr;263(Suppl 1):71-81

Authors: Gürkov R, Pyykö I, Zou J, Kentala E

Abstract
Menière's disease is a chronic condition with a prevalence of 200-500 per 100,000 and characterized by episodic attacks of vertigo, fluctuating hearing loss, tinnitus, aural pressure and a progressive loss of audiovestibular functions. Over 150 years ago, Prosper Menière was the first to recognize the inner ear as the site of lesion for this clinical syndrome. Over 75 years ago, endolymphatic hydrops was discovered as the pathologic correlate of Menière's disease. However, this pathologic finding could be ascertained only in post-mortem histologic studies. Due to this diagnostic dilemma and the variable manifestation of the various audiovestibular symptoms, diagnostic classification systems based on clinical findings have been repeatedly modified and have not been uniformly used in scientific publications on Menière's disease. Furthermore, the higher level measures of impact on quality of life such as vitality and social participation have been neglected hitherto. Recent developments of high-resolution MR imaging of the inner ear have now enabled us to visualize in vivo endolymphatic hydrops in patients with suspected Menière's disease. In this review, we summarize the existing knowledge from temporal bone histologic studies and from the emerging evidence on imaging-based evaluation of patients with suspected Menière's disease. These indicate that endolymphatic hydrops is responsible not only for the full-blown clinical triad of simultaneous attacks of auditory and vestibular dysfunction, but also for other clinical presentations such as "vestibular" and "cochlear Menière's disease". As a consequence, we propose a new terminology which is based on symptomatic and imaging characteristics of these clinical entities to clarify and simplify their diagnostic classification.

PMID: 27083887 [PubMed - as supplied by publisher]

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Genetics of vestibular disorders: pathophysiological insights.

Genetics of vestibular disorders: pathophysiological insights.

J Neurol. 2016 Apr;263(Suppl 1):45-53

Authors: Frejo L, Giegling I, Teggi R, Lopez-Escamez JA, Rujescu D

Abstract
The two most common vestibular disorders are motion sickness and vestibular migraine, affecting 30 and 1-2 % of the population respectively. Both are related to migraine and show a familial trend. Bilateral vestibular hypofunction is a rare condition, and some of patients also present cerebellar ataxia and neuropathy. We present recent advances in the genetics of vestibular disorders with familial aggregation. The clinical heterogeneity observed in different relatives of the same families suggests a variable penetrance and the interaction of several genes in each family. Some Mendelian sensorineural hearing loss also exhibits vestibular dysfunction, including DFNA9, DFNA11, DFNA15 and DFNA28. However, the most relevant finding during the past years is the familial clustering observed in Meniere's disease. By using whole exome sequencing and combining bioinformatics tools, novel variants in DTNA and FAM136A genes have been identified in familial Meniere's disease, and this genomic strategy will facilitate the discovery of the genetic basis of familial vestibular disorders.

PMID: 27083884 [PubMed - as supplied by publisher]

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