The auditory evoked-gamma response and its relation with the N1m.

Publication date: Available online 22 February 2017
Source:Hearing Research
Author(s): Caroline Witton, Mark A. Eckert, Ian M. Stanford, Lauren E. Gascoyne, Paul L. Furlong, Siân F. Worthen, Arjan Hillebrand
This study explored the patterns of oscillatory activity that underpin the N1m auditory evoked response. Evoked gamma activity is a small and relatively rarely-reported component of the auditory evoked response, and the objective of this work was to determine how this component relates to the larger and more prolonged changes in lower frequency bands. An event-related beamformer analysis of MEG data from monaural click stimulation was used to reconstruct volumetric images and virtual electrode time series. Group analysis of localisations showed that activity in the gamma band originated from a source that was more medial than those for activity in the theta-to-beta band, and virtual-electrode analysis showed that the source of the gamma activity could be statistically dissociated from the lower-frequency response.These findings are in accordance with separate functional roles for the activity in each frequency band, and provide evidence that the oscillatory activity that underpins the auditory evoked response may contain important information about the physiological basis of the macroscopic signals recorded by MEG in response to auditory stimulation.



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The auditory evoked-gamma response and its relation with the N1m.

Publication date: Available online 22 February 2017
Source:Hearing Research
Author(s): Caroline Witton, Mark A. Eckert, Ian M. Stanford, Lauren E. Gascoyne, Paul L. Furlong, Siân F. Worthen, Arjan Hillebrand
This study explored the patterns of oscillatory activity that underpin the N1m auditory evoked response. Evoked gamma activity is a small and relatively rarely-reported component of the auditory evoked response, and the objective of this work was to determine how this component relates to the larger and more prolonged changes in lower frequency bands. An event-related beamformer analysis of MEG data from monaural click stimulation was used to reconstruct volumetric images and virtual electrode time series. Group analysis of localisations showed that activity in the gamma band originated from a source that was more medial than those for activity in the theta-to-beta band, and virtual-electrode analysis showed that the source of the gamma activity could be statistically dissociated from the lower-frequency response.These findings are in accordance with separate functional roles for the activity in each frequency band, and provide evidence that the oscillatory activity that underpins the auditory evoked response may contain important information about the physiological basis of the macroscopic signals recorded by MEG in response to auditory stimulation.



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The auditory evoked-gamma response and its relation with the N1m.

Publication date: Available online 22 February 2017
Source:Hearing Research
Author(s): Caroline Witton, Mark A. Eckert, Ian M. Stanford, Lauren E. Gascoyne, Paul L. Furlong, Siân F. Worthen, Arjan Hillebrand
This study explored the patterns of oscillatory activity that underpin the N1m auditory evoked response. Evoked gamma activity is a small and relatively rarely-reported component of the auditory evoked response, and the objective of this work was to determine how this component relates to the larger and more prolonged changes in lower frequency bands. An event-related beamformer analysis of MEG data from monaural click stimulation was used to reconstruct volumetric images and virtual electrode time series. Group analysis of localisations showed that activity in the gamma band originated from a source that was more medial than those for activity in the theta-to-beta band, and virtual-electrode analysis showed that the source of the gamma activity could be statistically dissociated from the lower-frequency response.These findings are in accordance with separate functional roles for the activity in each frequency band, and provide evidence that the oscillatory activity that underpins the auditory evoked response may contain important information about the physiological basis of the macroscopic signals recorded by MEG in response to auditory stimulation.



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A Study Regarding Temporomandibular Disorders (TMD) Has Implications for Audiologists

Sampaio and colleagues in a recently-published article evaluated the prevalence of and relationship between several factors on temporomandibular disorders (TMD). These authors define TMD “as a cluster of disorders characterized by pain in the preauricular area, masticatory muscles and temporomandibular joint (TMJ), limitation or deviations in the mandibular range of motion, and clicking of the TMJ during the mandibular function.”

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Bilateral otoneurological pathology: To operate or not?

Related Articles

Bilateral otoneurological pathology: To operate or not?

Cochlear Implants Int. 2017 Feb 20;:1-4

Authors: Khosla S, Elliot M, Donnelly N

Abstract
OBJECTIVE: To illustrate our experience when managing a complex patient with potentially life-threatening bilateral otological disease facing multisensory compromise including complete loss of audiovestibular function and visual disturbance Clinical presentation: A 67 year old lady, presented with a large left vestibular schwannoma and extensive right cholesteatoma encircling the otic capsule. She underwent translabyrinthine resection of the vestibular schwannoma, resulting in profound sensorineural hearing loss, vestibular hypofunction and corneal scarring following an initial temporary facial palsy. Due to the extent of the disease and good right-sided bone conduction thresholds, the cholesteatoma was managed conservatively utilising a bone-anchored-hearing-aid with regular review by the Skull-Base team. However, following acute deterioration in hearing and disease extension threatening right facial nerve function, the decision was taken for surgical intervention with a view to staged cochlear implantation (CI).
INTERVENTION: Our patient underwent right lateral petrousectomy, total osseous labyrinthectomy, and implantation of an intracochlear 'dummy' with blind sac closure of the external auditory canal. Recovery was excellent with no further deterioration in balance and no loss of facial nerve function. CI occurred 3 months post-operatively with good functional outcome.
CONCLUSION: We present the management of bilateral complex otoneurological disease with significant risk of multisensory compromise. Size of the left vestibular schwannoma necessitated surgical resection with resultant loss of ipsilateral audiovestibular function. Due to residual right audiovestibular function and the risks of surgery, the extensive right cholesteatoma was managed conservatively until disease progression necessitated surgical intervention. Subsequently it was possible to restore access to open-set speech with a right CI.

PMID: 28218014 [PubMed - as supplied by publisher]

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Bilateral otoneurological pathology: To operate or not?

Related Articles

Bilateral otoneurological pathology: To operate or not?

Cochlear Implants Int. 2017 Feb 20;:1-4

Authors: Khosla S, Elliot M, Donnelly N

Abstract
OBJECTIVE: To illustrate our experience when managing a complex patient with potentially life-threatening bilateral otological disease facing multisensory compromise including complete loss of audiovestibular function and visual disturbance Clinical presentation: A 67 year old lady, presented with a large left vestibular schwannoma and extensive right cholesteatoma encircling the otic capsule. She underwent translabyrinthine resection of the vestibular schwannoma, resulting in profound sensorineural hearing loss, vestibular hypofunction and corneal scarring following an initial temporary facial palsy. Due to the extent of the disease and good right-sided bone conduction thresholds, the cholesteatoma was managed conservatively utilising a bone-anchored-hearing-aid with regular review by the Skull-Base team. However, following acute deterioration in hearing and disease extension threatening right facial nerve function, the decision was taken for surgical intervention with a view to staged cochlear implantation (CI).
INTERVENTION: Our patient underwent right lateral petrousectomy, total osseous labyrinthectomy, and implantation of an intracochlear 'dummy' with blind sac closure of the external auditory canal. Recovery was excellent with no further deterioration in balance and no loss of facial nerve function. CI occurred 3 months post-operatively with good functional outcome.
CONCLUSION: We present the management of bilateral complex otoneurological disease with significant risk of multisensory compromise. Size of the left vestibular schwannoma necessitated surgical resection with resultant loss of ipsilateral audiovestibular function. Due to residual right audiovestibular function and the risks of surgery, the extensive right cholesteatoma was managed conservatively until disease progression necessitated surgical intervention. Subsequently it was possible to restore access to open-set speech with a right CI.

PMID: 28218014 [PubMed - as supplied by publisher]

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Gait biomechanics following lower extremity trauma: amputation vs. reconstruction

Publication date: Available online 21 February 2017
Source:Gait & Posture
Author(s): Elizabeth Russell Esposito, Daniel J. Stinner, John R. Fergason, Jason M. Wilken
BackgroundSurgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive.PurposeTo compare gait biomechanics after lower limb reconstruction and transtibial amputation.MethodsTwenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length. Lower extremity joint angles, moments, and powers, and ground reaction forces were analyzed on the affected limb of patients and right limb of able-bodied individuals. ANOVA with Tukeys post-hoc tests determined differences among groups and post-hoc paired t-tests with Bonferroni-Holm corrections determined differences between limbs.ResultsThe ankle, knee, and hip exhibited significant kinematic differences between amputated, reconstructed and able-bodied limbs. The reconstruction group exhibited less ankle power and range of motion while the amputee group exhibited lower knee flexor and extensor moments and power generation.ConclusionGait deficiencies were more pronounced at the ankle following limb reconstruction with orthosis use and at the knee following transtibial amputation with prosthesis use. Although both groups in the cohorts tested can replicate many key aspects of normative gait mechanics, some deficiencies still persist. These results add to the growing body of literature comparing amputation and limb reconstruction and provide information to inform the patient on functional expectations should either procedure be considered.



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Roussouly’s Sagittal Spino-Pelvic Morphotypes as Determinants of Gait in Asymptomatic Adult Subjects

Publication date: Available online 22 February 2017
Source:Gait & Posture
Author(s): Ziad Bakouny, Ayman Assi, Abir Massaad, Elie Saghbini, Virginie Lafage, Wafa Skalli, Ismat Ghanem, Gaby Kreichati
Sagittal alignment is known to greatly vary between asymptomatic adult subjects; however, there are no studies on the possible effect of these differences on gait. The aim of this study is to investigate whether asymptomatic adults with different Roussouly sagittal alignment morphotypes walk differently. Ninety-one asymptomatic young adults (46M & 45W), aged 21.6±2.2years underwent 3D gait analysis and full body biplanar X-rays with three-dimensional (3D) reconstructions of their spines and pelvises and generation of sagittal alignment parameters. Subjects were divided according to Roussouly’s sagittal alignment classification. Sagittal alignment and kinematic parameters were compared between Roussouly types. 17 subjects were classified as type 2, 47 as type 3, 26 as type 4 but only 1 as type 1. Type 2 subjects had significantly more mean pelvic retroversion (less mean pelvic tilt) during gait compared to type 3 and 4 subjects (type 2: 8.2°; type 3:11.2°, type 4: 11.3°) and significantly larger ROM pelvic obliquity compared to type 4 subjects (type 2: 11.0°; type 4: 9.1°). Type 2 subjects also had significantly larger maximal hip extension during stance compared to subjects of types 3 and 4 (type 2: −11.9°; type 3: −8.8°; type 4: −7.9°) and a larger ROM of ankle plantar/dorsiflexion compared to type 4 subjects (type 2: 31.1°; type 4: 27.9°). Subjects with type 2 sagittal alignment were shown to have a gait pattern involving both increased hip extension and pelvic retroversion which could predispose to posterior femoroacetabular impingement and consequently osteoarthritis.



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Gait biomechanics following lower extremity trauma: amputation vs. reconstruction

Publication date: Available online 21 February 2017
Source:Gait & Posture
Author(s): Elizabeth Russell Esposito, Daniel J. Stinner, John R. Fergason, Jason M. Wilken
BackgroundSurgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive.PurposeTo compare gait biomechanics after lower limb reconstruction and transtibial amputation.MethodsTwenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length. Lower extremity joint angles, moments, and powers, and ground reaction forces were analyzed on the affected limb of patients and right limb of able-bodied individuals. ANOVA with Tukeys post-hoc tests determined differences among groups and post-hoc paired t-tests with Bonferroni-Holm corrections determined differences between limbs.ResultsThe ankle, knee, and hip exhibited significant kinematic differences between amputated, reconstructed and able-bodied limbs. The reconstruction group exhibited less ankle power and range of motion while the amputee group exhibited lower knee flexor and extensor moments and power generation.ConclusionGait deficiencies were more pronounced at the ankle following limb reconstruction with orthosis use and at the knee following transtibial amputation with prosthesis use. Although both groups in the cohorts tested can replicate many key aspects of normative gait mechanics, some deficiencies still persist. These results add to the growing body of literature comparing amputation and limb reconstruction and provide information to inform the patient on functional expectations should either procedure be considered.



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Roussouly’s Sagittal Spino-Pelvic Morphotypes as Determinants of Gait in Asymptomatic Adult Subjects

Publication date: Available online 22 February 2017
Source:Gait & Posture
Author(s): Ziad Bakouny, Ayman Assi, Abir Massaad, Elie Saghbini, Virginie Lafage, Wafa Skalli, Ismat Ghanem, Gaby Kreichati
Sagittal alignment is known to greatly vary between asymptomatic adult subjects; however, there are no studies on the possible effect of these differences on gait. The aim of this study is to investigate whether asymptomatic adults with different Roussouly sagittal alignment morphotypes walk differently. Ninety-one asymptomatic young adults (46M & 45W), aged 21.6±2.2years underwent 3D gait analysis and full body biplanar X-rays with three-dimensional (3D) reconstructions of their spines and pelvises and generation of sagittal alignment parameters. Subjects were divided according to Roussouly’s sagittal alignment classification. Sagittal alignment and kinematic parameters were compared between Roussouly types. 17 subjects were classified as type 2, 47 as type 3, 26 as type 4 but only 1 as type 1. Type 2 subjects had significantly more mean pelvic retroversion (less mean pelvic tilt) during gait compared to type 3 and 4 subjects (type 2: 8.2°; type 3:11.2°, type 4: 11.3°) and significantly larger ROM pelvic obliquity compared to type 4 subjects (type 2: 11.0°; type 4: 9.1°). Type 2 subjects also had significantly larger maximal hip extension during stance compared to subjects of types 3 and 4 (type 2: −11.9°; type 3: −8.8°; type 4: −7.9°) and a larger ROM of ankle plantar/dorsiflexion compared to type 4 subjects (type 2: 31.1°; type 4: 27.9°). Subjects with type 2 sagittal alignment were shown to have a gait pattern involving both increased hip extension and pelvic retroversion which could predispose to posterior femoroacetabular impingement and consequently osteoarthritis.



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Gait biomechanics following lower extremity trauma: amputation vs. reconstruction

Publication date: Available online 21 February 2017
Source:Gait & Posture
Author(s): Elizabeth Russell Esposito, Daniel J. Stinner, John R. Fergason, Jason M. Wilken
BackgroundSurgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive.PurposeTo compare gait biomechanics after lower limb reconstruction and transtibial amputation.MethodsTwenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length. Lower extremity joint angles, moments, and powers, and ground reaction forces were analyzed on the affected limb of patients and right limb of able-bodied individuals. ANOVA with Tukeys post-hoc tests determined differences among groups and post-hoc paired t-tests with Bonferroni-Holm corrections determined differences between limbs.ResultsThe ankle, knee, and hip exhibited significant kinematic differences between amputated, reconstructed and able-bodied limbs. The reconstruction group exhibited less ankle power and range of motion while the amputee group exhibited lower knee flexor and extensor moments and power generation.ConclusionGait deficiencies were more pronounced at the ankle following limb reconstruction with orthosis use and at the knee following transtibial amputation with prosthesis use. Although both groups in the cohorts tested can replicate many key aspects of normative gait mechanics, some deficiencies still persist. These results add to the growing body of literature comparing amputation and limb reconstruction and provide information to inform the patient on functional expectations should either procedure be considered.



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Roussouly’s Sagittal Spino-Pelvic Morphotypes as Determinants of Gait in Asymptomatic Adult Subjects

Publication date: Available online 22 February 2017
Source:Gait & Posture
Author(s): Ziad Bakouny, Ayman Assi, Abir Massaad, Elie Saghbini, Virginie Lafage, Wafa Skalli, Ismat Ghanem, Gaby Kreichati
Sagittal alignment is known to greatly vary between asymptomatic adult subjects; however, there are no studies on the possible effect of these differences on gait. The aim of this study is to investigate whether asymptomatic adults with different Roussouly sagittal alignment morphotypes walk differently. Ninety-one asymptomatic young adults (46M & 45W), aged 21.6±2.2years underwent 3D gait analysis and full body biplanar X-rays with three-dimensional (3D) reconstructions of their spines and pelvises and generation of sagittal alignment parameters. Subjects were divided according to Roussouly’s sagittal alignment classification. Sagittal alignment and kinematic parameters were compared between Roussouly types. 17 subjects were classified as type 2, 47 as type 3, 26 as type 4 but only 1 as type 1. Type 2 subjects had significantly more mean pelvic retroversion (less mean pelvic tilt) during gait compared to type 3 and 4 subjects (type 2: 8.2°; type 3:11.2°, type 4: 11.3°) and significantly larger ROM pelvic obliquity compared to type 4 subjects (type 2: 11.0°; type 4: 9.1°). Type 2 subjects also had significantly larger maximal hip extension during stance compared to subjects of types 3 and 4 (type 2: −11.9°; type 3: −8.8°; type 4: −7.9°) and a larger ROM of ankle plantar/dorsiflexion compared to type 4 subjects (type 2: 31.1°; type 4: 27.9°). Subjects with type 2 sagittal alignment were shown to have a gait pattern involving both increased hip extension and pelvic retroversion which could predispose to posterior femoroacetabular impingement and consequently osteoarthritis.



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Life Lessons on Hearing Loss.

Related Articles

Life Lessons on Hearing Loss.

Fam Med. 2017 Feb;49(2):146-147

Authors: Trelease-Bell A

PMID: 28218944 [PubMed - in process]

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Program Sustainability: Hearing Loss and Tinnitus Prevention in American Indian Communities.

Related Articles

Program Sustainability: Hearing Loss and Tinnitus Prevention in American Indian Communities.

Am J Prev Med. 2017 Mar;52(3S3):S268-S270

Authors: Martin WH, Sobel JL, Griest SE, Howarth LC, Becker TM

Abstract
INTRODUCTION: An important goal of any health promotion effort is to have it maintained in delivery and effectiveness over time. The purpose of this study was to establish a community-based noise-induced hearing loss and tinnitus prevention program in three different types of American Indian communities and evaluate them for evidence of long-term sustainability.
METHODS: The target population was fourth- and fifth-grade students from three different models of American Indian communities. The evidenced-based Dangerous Decibels(®) program was adapted to include local media, classroom education, family and community outreach, and web-based activities. Sustainability was attempted by promoting funding stability, political support, partnerships, organizational capacity, program adaptation, program evaluation, communications, public health impacts, and strategic planning.
RESULTS: Currently, there is evidence suggesting that the hearing health promotion program is self-sustaining in all three American Indian communities. The intervention was effective at changing knowledge, attitudes, beliefs, and behaviors in the target population, but program adoption and self-sustenance faced challenges that required patience, persistence, and creativity by the program team. Components of the intervention continue to be delivered by local members of each community.
CONCLUSIONS: Critical factors that led to self-sustaining programs included approval of community leaders and engagement of community members in the design, administration, and evaluation of the effort; use of a well-developed, evidence-based intervention; and high-level training of local participants who could confidently and effectively continue delivering the program following a gradual transition to independence.

PMID: 28215378 [PubMed - in process]

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