Δευτέρα 6 Μαρτίου 2017

Editorial Board

Publication date: March 2017
Source:Gait & Posture, Volume 53





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Ringing Ear Frequency

Tinnitus, the uncomfortable hearing condition that causes a constant droning, buzzing or ringing in heads of sufferers, received its own week of awareness in the United States and in the United Kingdom from February 6 to February 12.

In an article published by The Guardian during Tinnitus Awareness Week, a research effort at the University of Leicester was reported to be falling short of expectations despite its innovative approach to treatment. The strategy in question involves flashing lights of different colors over a series of therapeutic sessions. The idea is to occupy certain neurological functions so that patients do not engage the brain cells that assimilate and identify sound as it increases ringing ear frequency.

The excitability of certain brain functions is one of the many theories behind what medical researchers believe may be the root causes of tinnitus. Unfortunately, the researchers at the University of Leicester are not seeing much progress from the use of colored lights.

Determination of Ringing Ear Frequency

A tinnitus treatment method that is showing more promise than the aforementioned flashing lights involves the measurement of ringing ear frequency. This practical method can be enacted with the assistance of a smartphone or tablet, a web-based application and a pair of headphones.

AudioNotch is an online app that creates specific sounds according to the frequency heard or experienced by tinnitus patients. The guiding principle of this treatment method is based on research conducted at the Westfalian Wilhelms-University in Germany; the approach is called customized notched music, and it aims to reduce the loudness of the tinnitus sounds.

The use of notched and filtered sound to treat tinnitus patients has gone through peer review processes. This treatment method has shown to be substantially effective for many patients. The simplicity of the method is an important aspect of treatment since it involves three steps:

1 – Using the AudioNotch web application to determine the frequency of tinnitus sounds.

2 – Create a therapeutic sound by either uploading music or choosing from a digital audio library. The therapy is customized based on the previous step.

3 – Patients should listen to their customized notch sounds for one hour on a daily basis. Many patients will notice an improvement and will experience relief after a few days.

It is important to note that AudioNotch is for patients whose tinnitus condition is caused by noise exposure and not by secondary effects such as infections or reactions to certain medications.



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A Cross-Language Study of Laryngeal-Oral Coordination Across Varying Prosodic and Syllable-Structure Conditions

Purpose
The purpose of this study is to use prosodic and syllable-structure variation to probe the underlying representation of laryngeal kinematics in languages traditionally considered to differ in voicing typology (German vs. Dutch and French).
Method
Transillumination and videofiberendoscopic filming were used to investigate the devoicing gesture in German, Dutch, and French for material that compared, first, a strong versus weak prosodic condition and, second, singletons versus clusters (stop + /r/ and /l/).
Results
The results showed strengthening of the devoicing gesture in the strong prosodic condition and in the segmental context stop + /r/ for German and French but not for Dutch. In terms of timing (duration of oral occlusion, voice onset time, timing of peak glottal opening relative to stop release), French was intermediate between German and Dutch.
Conclusions
(a) The representation of French voiceless plosives requires an active specification for glottal spreading just as in German. (b) Static features are not well suited to capturing cross-language differences in voicing typology and changes in voicing specification over time.

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Late Talkers: A Population-Based Study of Risk Factors and School Readiness Consequences

Purpose
This study was designed to (a) identify sociodemographic, pregnancy and birth, family health, and parenting and child care risk factors for being a late talker at 24 months of age; (b) determine whether late talkers continue to have low vocabulary at 48 months; and (c) investigate whether being a late talker plays a unique role in children's school readiness at 60 months.
Method
We analyzed data from the Early Childhood Longitudinal Study, a population-based sample of 9,600 children. Data were gathered when the children were 9, 24, 48, and 60 months old.
Results
The risk of being a late talker at 24 months was significantly associated with being a boy, lower socioeconomic status, being a nonsingleton, older maternal age at birth, moderately low birth weight, lower quality parenting, receipt of day care for less than 10 hr/week, and attention problems. Being a late talker increased children's risk of having low vocabulary at 48 months and low school readiness at 60 months. Family socioeconomic status had the largest and most profound effect on children's school readiness.
Conclusions
Limited vocabulary knowledge at 24 and 48 months is uniquely predictive of later school readiness. Young children with low vocabularies require additional supports prior to school entry.

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Measuring Sound-Processor Threshold Levels for Pediatric Cochlear Implant Recipients Using Conditioned Play Audiometry via Telepractice

Purpose
This study evaluated the use of telepractice for measuring cochlear implant (CI) behavioral threshold (T) levels in children using conditioned play audiometry (CPA). The goals were to determine whether (a) T levels measured via telepractice were not significantly different from those obtained in person, (b) response probability differed between remote and in-person conditions, and (c) the remote visit required more time than the in-person condition.
Method
An ABBA design (A, in-person; B, remote) was split across 2 visits. Nineteen children aged 2.6–7.1 years participated. T levels were measured using CPA for 3 electrodes per session. A “hit” rate was calculated to determine whether the likelihood of obtaining responses differed between conditions. Test time was compared across conditions. A questionnaire was administered to assess parent/caregiver attitudes about telepractice.
Results
Results indicated no significant difference in T levels between conditions. Hit rates were not significantly different between in-person and remote conditions (98% vs. 97%, respectively). Test time was similar between conditions. Questionnaire results revealed that 100% of caregivers would use telepractice for CI appointments either some or all of the time.
Conclusion
Telepractice is a viable option for routine pediatric programming appointments for children using CPA to set behavioral thresholds.

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Semantic Processing of Sentences in Preschoolers With Specific Language Impairment: Evidence From the N400 Effect

Purpose
Given the complexity of sentence processing and the specific problems that children with specific language impairment (SLI) experience, we investigated the time course and characteristics of semantic processing at the sentence level in Dutch preschoolers with SLI.
Method
We measured N400 responses to semantically congruent and incongruent spoken sentences (e.g., “My father is eating an apple/*blanket”) in a group of 37 Dutch preschoolers with SLI and in a group of 25 typically developing (TD) peers. We compared the time course and amplitude of the N400 effect between the two groups.
Results
The TD group showed a strong posterior N400 effect in time windows 300–500 ms and 500–800 ms. In contrast, the SLI group demonstrated only a reliable N400 effect in the later time window, 500–800 ms, and did not show a stronger presence at posterior electrodes.
Conclusion
The findings suggest that the neuronal processing of semantic information at sentence level is atypical in preschoolers with SLI compared with TD children.

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Nonadjacent Dependency Learning in Cantonese-Speaking Children With and Without a History of Specific Language Impairment

Purpose
This study investigated nonadjacent dependency learning in Cantonese-speaking children with and without a history of specific language impairment (SLI) in an artificial linguistic context.
Method
Sixteen Cantonese-speaking children with a history of SLI and 16 Cantonese-speaking children with typical language development (TLD) were tested with a nonadjacent dependency learning task using artificial languages that mimic Cantonese.
Results
Children with TLD performed above chance and were able to discriminate between trained and untrained nonadjacent dependencies. However, children with a history of SLI performed at chance and were not able to differentiate trained versus untrained nonadjacent dependencies.
Conclusions
These findings, together with previous findings from English-speaking adults and adolescents with language impairments, suggest that individuals with atypical language development, regardless of age, diagnostic status, language, and culture, show difficulties in learning nonadjacent dependencies. This study provides evidence for early impairments to statistical learning in individuals with atypical language development.

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Increased Response to Altered Auditory Feedback in Dyslexia: A Weaker Sensorimotor Magnet Implied in the Phonological Deficit

Purpose
The purpose of this study was to examine whether developmental dyslexia (DD) is characterized by deficiencies in speech sensory and motor feedforward and feedback mechanisms, which are involved in the modulation of phonological representations.
Method
A total of 42 adult native speakers of Dutch (22 adults with DD; 20 participants who were typically reading controls) were asked to produce /bep/ while the first formant (F1) of the /e/ was not altered (baseline), increased (ramp), held at maximal perturbation (hold), and not altered again (after-effect). The F1 of the produced utterance was measured for each trial and used for statistical analyses. The measured F1s produced during each phase were entered in a linear mixed-effects model.
Results
Participants with DD adapted more strongly during the ramp phase and returned to baseline to a lesser extent when feedback was back to normal (after-effect phase) when compared with the typically reading group. In this study, a faster deviation from baseline during the ramp phase, a stronger adaptation response during the hold phase, and a slower return to baseline during the after-effect phase were associated with poorer reading and phonological abilities.
Conclusion
The data of the current study are consistent with the notion that the phonological deficit in DD is associated with a weaker sensorimotor magnet for phonological representations.

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A Cross-Language Study of Laryngeal-Oral Coordination Across Varying Prosodic and Syllable-Structure Conditions

Purpose
The purpose of this study is to use prosodic and syllable-structure variation to probe the underlying representation of laryngeal kinematics in languages traditionally considered to differ in voicing typology (German vs. Dutch and French).
Method
Transillumination and videofiberendoscopic filming were used to investigate the devoicing gesture in German, Dutch, and French for material that compared, first, a strong versus weak prosodic condition and, second, singletons versus clusters (stop + /r/ and /l/).
Results
The results showed strengthening of the devoicing gesture in the strong prosodic condition and in the segmental context stop + /r/ for German and French but not for Dutch. In terms of timing (duration of oral occlusion, voice onset time, timing of peak glottal opening relative to stop release), French was intermediate between German and Dutch.
Conclusions
(a) The representation of French voiceless plosives requires an active specification for glottal spreading just as in German. (b) Static features are not well suited to capturing cross-language differences in voicing typology and changes in voicing specification over time.

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Late Talkers: A Population-Based Study of Risk Factors and School Readiness Consequences

Purpose
This study was designed to (a) identify sociodemographic, pregnancy and birth, family health, and parenting and child care risk factors for being a late talker at 24 months of age; (b) determine whether late talkers continue to have low vocabulary at 48 months; and (c) investigate whether being a late talker plays a unique role in children's school readiness at 60 months.
Method
We analyzed data from the Early Childhood Longitudinal Study, a population-based sample of 9,600 children. Data were gathered when the children were 9, 24, 48, and 60 months old.
Results
The risk of being a late talker at 24 months was significantly associated with being a boy, lower socioeconomic status, being a nonsingleton, older maternal age at birth, moderately low birth weight, lower quality parenting, receipt of day care for less than 10 hr/week, and attention problems. Being a late talker increased children's risk of having low vocabulary at 48 months and low school readiness at 60 months. Family socioeconomic status had the largest and most profound effect on children's school readiness.
Conclusions
Limited vocabulary knowledge at 24 and 48 months is uniquely predictive of later school readiness. Young children with low vocabularies require additional supports prior to school entry.

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Measuring Sound-Processor Threshold Levels for Pediatric Cochlear Implant Recipients Using Conditioned Play Audiometry via Telepractice

Purpose
This study evaluated the use of telepractice for measuring cochlear implant (CI) behavioral threshold (T) levels in children using conditioned play audiometry (CPA). The goals were to determine whether (a) T levels measured via telepractice were not significantly different from those obtained in person, (b) response probability differed between remote and in-person conditions, and (c) the remote visit required more time than the in-person condition.
Method
An ABBA design (A, in-person; B, remote) was split across 2 visits. Nineteen children aged 2.6–7.1 years participated. T levels were measured using CPA for 3 electrodes per session. A “hit” rate was calculated to determine whether the likelihood of obtaining responses differed between conditions. Test time was compared across conditions. A questionnaire was administered to assess parent/caregiver attitudes about telepractice.
Results
Results indicated no significant difference in T levels between conditions. Hit rates were not significantly different between in-person and remote conditions (98% vs. 97%, respectively). Test time was similar between conditions. Questionnaire results revealed that 100% of caregivers would use telepractice for CI appointments either some or all of the time.
Conclusion
Telepractice is a viable option for routine pediatric programming appointments for children using CPA to set behavioral thresholds.

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Semantic Processing of Sentences in Preschoolers With Specific Language Impairment: Evidence From the N400 Effect

Purpose
Given the complexity of sentence processing and the specific problems that children with specific language impairment (SLI) experience, we investigated the time course and characteristics of semantic processing at the sentence level in Dutch preschoolers with SLI.
Method
We measured N400 responses to semantically congruent and incongruent spoken sentences (e.g., “My father is eating an apple/*blanket”) in a group of 37 Dutch preschoolers with SLI and in a group of 25 typically developing (TD) peers. We compared the time course and amplitude of the N400 effect between the two groups.
Results
The TD group showed a strong posterior N400 effect in time windows 300–500 ms and 500–800 ms. In contrast, the SLI group demonstrated only a reliable N400 effect in the later time window, 500–800 ms, and did not show a stronger presence at posterior electrodes.
Conclusion
The findings suggest that the neuronal processing of semantic information at sentence level is atypical in preschoolers with SLI compared with TD children.

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Nonadjacent Dependency Learning in Cantonese-Speaking Children With and Without a History of Specific Language Impairment

Purpose
This study investigated nonadjacent dependency learning in Cantonese-speaking children with and without a history of specific language impairment (SLI) in an artificial linguistic context.
Method
Sixteen Cantonese-speaking children with a history of SLI and 16 Cantonese-speaking children with typical language development (TLD) were tested with a nonadjacent dependency learning task using artificial languages that mimic Cantonese.
Results
Children with TLD performed above chance and were able to discriminate between trained and untrained nonadjacent dependencies. However, children with a history of SLI performed at chance and were not able to differentiate trained versus untrained nonadjacent dependencies.
Conclusions
These findings, together with previous findings from English-speaking adults and adolescents with language impairments, suggest that individuals with atypical language development, regardless of age, diagnostic status, language, and culture, show difficulties in learning nonadjacent dependencies. This study provides evidence for early impairments to statistical learning in individuals with atypical language development.

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Increased Response to Altered Auditory Feedback in Dyslexia: A Weaker Sensorimotor Magnet Implied in the Phonological Deficit

Purpose
The purpose of this study was to examine whether developmental dyslexia (DD) is characterized by deficiencies in speech sensory and motor feedforward and feedback mechanisms, which are involved in the modulation of phonological representations.
Method
A total of 42 adult native speakers of Dutch (22 adults with DD; 20 participants who were typically reading controls) were asked to produce /bep/ while the first formant (F1) of the /e/ was not altered (baseline), increased (ramp), held at maximal perturbation (hold), and not altered again (after-effect). The F1 of the produced utterance was measured for each trial and used for statistical analyses. The measured F1s produced during each phase were entered in a linear mixed-effects model.
Results
Participants with DD adapted more strongly during the ramp phase and returned to baseline to a lesser extent when feedback was back to normal (after-effect phase) when compared with the typically reading group. In this study, a faster deviation from baseline during the ramp phase, a stronger adaptation response during the hold phase, and a slower return to baseline during the after-effect phase were associated with poorer reading and phonological abilities.
Conclusion
The data of the current study are consistent with the notion that the phonological deficit in DD is associated with a weaker sensorimotor magnet for phonological representations.

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A Cross-Language Study of Laryngeal-Oral Coordination Across Varying Prosodic and Syllable-Structure Conditions

Purpose
The purpose of this study is to use prosodic and syllable-structure variation to probe the underlying representation of laryngeal kinematics in languages traditionally considered to differ in voicing typology (German vs. Dutch and French).
Method
Transillumination and videofiberendoscopic filming were used to investigate the devoicing gesture in German, Dutch, and French for material that compared, first, a strong versus weak prosodic condition and, second, singletons versus clusters (stop + /r/ and /l/).
Results
The results showed strengthening of the devoicing gesture in the strong prosodic condition and in the segmental context stop + /r/ for German and French but not for Dutch. In terms of timing (duration of oral occlusion, voice onset time, timing of peak glottal opening relative to stop release), French was intermediate between German and Dutch.
Conclusions
(a) The representation of French voiceless plosives requires an active specification for glottal spreading just as in German. (b) Static features are not well suited to capturing cross-language differences in voicing typology and changes in voicing specification over time.

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Late Talkers: A Population-Based Study of Risk Factors and School Readiness Consequences

Purpose
This study was designed to (a) identify sociodemographic, pregnancy and birth, family health, and parenting and child care risk factors for being a late talker at 24 months of age; (b) determine whether late talkers continue to have low vocabulary at 48 months; and (c) investigate whether being a late talker plays a unique role in children's school readiness at 60 months.
Method
We analyzed data from the Early Childhood Longitudinal Study, a population-based sample of 9,600 children. Data were gathered when the children were 9, 24, 48, and 60 months old.
Results
The risk of being a late talker at 24 months was significantly associated with being a boy, lower socioeconomic status, being a nonsingleton, older maternal age at birth, moderately low birth weight, lower quality parenting, receipt of day care for less than 10 hr/week, and attention problems. Being a late talker increased children's risk of having low vocabulary at 48 months and low school readiness at 60 months. Family socioeconomic status had the largest and most profound effect on children's school readiness.
Conclusions
Limited vocabulary knowledge at 24 and 48 months is uniquely predictive of later school readiness. Young children with low vocabularies require additional supports prior to school entry.

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Measuring Sound-Processor Threshold Levels for Pediatric Cochlear Implant Recipients Using Conditioned Play Audiometry via Telepractice

Purpose
This study evaluated the use of telepractice for measuring cochlear implant (CI) behavioral threshold (T) levels in children using conditioned play audiometry (CPA). The goals were to determine whether (a) T levels measured via telepractice were not significantly different from those obtained in person, (b) response probability differed between remote and in-person conditions, and (c) the remote visit required more time than the in-person condition.
Method
An ABBA design (A, in-person; B, remote) was split across 2 visits. Nineteen children aged 2.6–7.1 years participated. T levels were measured using CPA for 3 electrodes per session. A “hit” rate was calculated to determine whether the likelihood of obtaining responses differed between conditions. Test time was compared across conditions. A questionnaire was administered to assess parent/caregiver attitudes about telepractice.
Results
Results indicated no significant difference in T levels between conditions. Hit rates were not significantly different between in-person and remote conditions (98% vs. 97%, respectively). Test time was similar between conditions. Questionnaire results revealed that 100% of caregivers would use telepractice for CI appointments either some or all of the time.
Conclusion
Telepractice is a viable option for routine pediatric programming appointments for children using CPA to set behavioral thresholds.

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Semantic Processing of Sentences in Preschoolers With Specific Language Impairment: Evidence From the N400 Effect

Purpose
Given the complexity of sentence processing and the specific problems that children with specific language impairment (SLI) experience, we investigated the time course and characteristics of semantic processing at the sentence level in Dutch preschoolers with SLI.
Method
We measured N400 responses to semantically congruent and incongruent spoken sentences (e.g., “My father is eating an apple/*blanket”) in a group of 37 Dutch preschoolers with SLI and in a group of 25 typically developing (TD) peers. We compared the time course and amplitude of the N400 effect between the two groups.
Results
The TD group showed a strong posterior N400 effect in time windows 300–500 ms and 500–800 ms. In contrast, the SLI group demonstrated only a reliable N400 effect in the later time window, 500–800 ms, and did not show a stronger presence at posterior electrodes.
Conclusion
The findings suggest that the neuronal processing of semantic information at sentence level is atypical in preschoolers with SLI compared with TD children.

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Nonadjacent Dependency Learning in Cantonese-Speaking Children With and Without a History of Specific Language Impairment

Purpose
This study investigated nonadjacent dependency learning in Cantonese-speaking children with and without a history of specific language impairment (SLI) in an artificial linguistic context.
Method
Sixteen Cantonese-speaking children with a history of SLI and 16 Cantonese-speaking children with typical language development (TLD) were tested with a nonadjacent dependency learning task using artificial languages that mimic Cantonese.
Results
Children with TLD performed above chance and were able to discriminate between trained and untrained nonadjacent dependencies. However, children with a history of SLI performed at chance and were not able to differentiate trained versus untrained nonadjacent dependencies.
Conclusions
These findings, together with previous findings from English-speaking adults and adolescents with language impairments, suggest that individuals with atypical language development, regardless of age, diagnostic status, language, and culture, show difficulties in learning nonadjacent dependencies. This study provides evidence for early impairments to statistical learning in individuals with atypical language development.

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Increased Response to Altered Auditory Feedback in Dyslexia: A Weaker Sensorimotor Magnet Implied in the Phonological Deficit

Purpose
The purpose of this study was to examine whether developmental dyslexia (DD) is characterized by deficiencies in speech sensory and motor feedforward and feedback mechanisms, which are involved in the modulation of phonological representations.
Method
A total of 42 adult native speakers of Dutch (22 adults with DD; 20 participants who were typically reading controls) were asked to produce /bep/ while the first formant (F1) of the /e/ was not altered (baseline), increased (ramp), held at maximal perturbation (hold), and not altered again (after-effect). The F1 of the produced utterance was measured for each trial and used for statistical analyses. The measured F1s produced during each phase were entered in a linear mixed-effects model.
Results
Participants with DD adapted more strongly during the ramp phase and returned to baseline to a lesser extent when feedback was back to normal (after-effect phase) when compared with the typically reading group. In this study, a faster deviation from baseline during the ramp phase, a stronger adaptation response during the hold phase, and a slower return to baseline during the after-effect phase were associated with poorer reading and phonological abilities.
Conclusion
The data of the current study are consistent with the notion that the phonological deficit in DD is associated with a weaker sensorimotor magnet for phonological representations.

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Allicin protects against cisplatin-induced vestibular dysfunction by inhibiting the apoptotic pathway.

Allicin protects against cisplatin-induced vestibular dysfunction by inhibiting the apoptotic pathway.

Eur J Pharmacol. 2017 Mar 01;:

Authors: Wu X, Cai J, Li X, Li H, Li J, Bai X, Liu W, Han Y, Xu L, Zhang D, Wang H, Fan Z

Abstract
Cisplatin is an anticancer drug that causes the impairment of inner ear function as side effects, including hearing loss and balance dysfunction. The purpose of this study was to investigate the effects of allicin against cisplatin-induced vestibular dysfunction in mice and to make clear the mechanism underlying the protective effects of allicin on oto-vestibulotoxicity. Mice intraperitoneally injected with cisplatin exhibited vestibular dysfunction in swimming test, which agreed with impairment in vestibule. However, these impairments were significantly prevented by pre-treatment with allicin. Allicin markedly reduced cisplatin-activated expression of cleaved-caspase-3 in hair cells and vascular layer cells of utricule, saccule and ampulla, but also decreased AIF nuclear translocation of hair cells in utricule, saccule and ampulla. These results showed that allicin played an effective role in protecting vestibular dysfunction induced by cisplatin via inhibiting caspase-dependent and caspase-independent apoptotic pathways. Therefore, allicin may be useful in preventing oto-vestibulotoxicity mediated by cisplatin.

PMID: 28259711 [PubMed - as supplied by publisher]



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Allicin protects against cisplatin-induced vestibular dysfunction by inhibiting the apoptotic pathway.

Allicin protects against cisplatin-induced vestibular dysfunction by inhibiting the apoptotic pathway.

Eur J Pharmacol. 2017 Mar 01;:

Authors: Wu X, Cai J, Li X, Li H, Li J, Bai X, Liu W, Han Y, Xu L, Zhang D, Wang H, Fan Z

Abstract
Cisplatin is an anticancer drug that causes the impairment of inner ear function as side effects, including hearing loss and balance dysfunction. The purpose of this study was to investigate the effects of allicin against cisplatin-induced vestibular dysfunction in mice and to make clear the mechanism underlying the protective effects of allicin on oto-vestibulotoxicity. Mice intraperitoneally injected with cisplatin exhibited vestibular dysfunction in swimming test, which agreed with impairment in vestibule. However, these impairments were significantly prevented by pre-treatment with allicin. Allicin markedly reduced cisplatin-activated expression of cleaved-caspase-3 in hair cells and vascular layer cells of utricule, saccule and ampulla, but also decreased AIF nuclear translocation of hair cells in utricule, saccule and ampulla. These results showed that allicin played an effective role in protecting vestibular dysfunction induced by cisplatin via inhibiting caspase-dependent and caspase-independent apoptotic pathways. Therefore, allicin may be useful in preventing oto-vestibulotoxicity mediated by cisplatin.

PMID: 28259711 [PubMed - as supplied by publisher]



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Cochlear implant effectiveness in postlingual single-sided deaf individuals: what’s the point?

.


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Cochlear implant effectiveness in postlingual single-sided deaf individuals: what’s the point?

.


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Cochlear implant effectiveness in postlingual single-sided deaf individuals: what’s the point?

.


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Number of people in US with hearing loss expected to nearly double in coming decades

In a study published online by JAMA Otolaryngology-Head & Neck Surgery, Adele M. Goman, Ph.D., of Johns Hopkins University, Baltimore, Md., and colleagues used U.S.

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Number of people in US with hearing loss expected to nearly double in coming decades

In a study published online by JAMA Otolaryngology-Head & Neck Surgery, Adele M. Goman, Ph.D., of Johns Hopkins University, Baltimore, Md., and colleagues used U.S.

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Number of people in US with hearing loss expected to nearly double in coming decades

In a study published online by JAMA Otolaryngology-Head & Neck Surgery, Adele M. Goman, Ph.D., of Johns Hopkins University, Baltimore, Md., and colleagues used U.S.

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