Exercise Science Principles and the Vocal Warm-up: Implications for Singing Voice Pedagogy

Publication date: Available online 19 May 2017
Source:Journal of Voice
Author(s): Matthew Hoch, Mary J. Sandage
Objectives/HypothesesPrinciples from exercise science literature were applied to singing warm-up pedagogy as a method for examining parallels between athletic and voice training. Analysis of the use of exercise principles in vocal warm-up should illuminate aspects of voice training that may be further developed in the future.Methods/DesignA selected canon of standard voice pedagogy texts and well-regarded warm-up methods were evaluated for use of exercise science principles for skill acquisition and fatigue resistance. Exercises were then categorized according to whether they were used for the purpose of skill acquisition (specificity), training up to tasks (overload), or detraining (reversibility).ResultsA preliminary review of well-established voice pedagogy programs reveals a strong bias toward the skill acquisition aspects of vocal warm-up, with little commentary on the fatigue management aspects. Further, the small number of vocalises examined that are not skill-acquisition oriented fall into a third “habilitative” category that likewise does not relate to overload but may play a role in offsetting reversibility.ConclusionsAlthough a systematic pedagogy for skill acquisition has emerged in the literature and practice of voice pedagogy, a parallel pedagogy for fatigue management has yet to be established. Identification of a systematic pedagogy for training up to specific singing genres and development of a singing maintenance program to avoid detraining may help the singer avoid injury.



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Transcutaneous Electrical Nerve Stimulation (TENS) and Laryngeal Manual Therapy (LMT): Immediate Effects in Women With Dysphonia

Publication date: Available online 19 May 2017
Source:Journal of Voice
Author(s): Mariana de Cásisa Macedo Conde, Larissa Thaís Donalonso Siqueira, José Eduardo Vendramini, Alcione Ghedini Brasolotto, Rinaldo Roberto de Jesus Guirro, Kelly Cristina Alves Silverio
PurposeThis study aimed to verify the immediate effect of low-frequency transcutaneous electrical nerve stimulation (TENS) and laryngeal manual therapy (LMT) in musculoskeletal pain, voice quality, and self-reported signs in women with dysphonia.MethodThirty women with behavioral dysphonia were randomly divided into the TENS group and the LMT group. All participants fulfilled the pain survey and had their voices recorded to posterior perceptual and acoustic analysis before and after intervention. The TENS group received a unique low-frequency TENS session (20 minutes). The LMT group received LMT (20 minutes) with soft and superficial massage in the sternocleidomastoid muscle, suprahyoid muscles, and larynx. Afterward, the volunteers reported their voice, larynx, breathing, and articulatory signs. Pre and post data were compared by parametric and nonparametric tests.ResultsAfter TENS, a decrease in pain intensity in the posterior or anterior region of the neck, shoulders, upper or lower back, and masseter was observed. After LMT, a decrease in pain intensity in the neck anterior region, shoulders, lower back, and temporal region was observed. Also, after TENS, there was an improvement in vowel /a/ instability; after LMT, there was a general improvement in voice quality, decrease in tension, and decrease in breathiness in speech. Positive voice and laryngeal signs were reported after TENS, and positive laryngeal signs and articulation were reported after LMT.ConclusionTENS and LMT may be used in voice treatment of women with behavioral dysphonia, and both may be considered important therapy resources that reduce musculoskeletal pain and cause positive laryngeal signs. Both TENS and LMT are able to partially improve voice quality, but TENS presented better results.



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Modeled auditory nerve responses to amplitude modulated cochlear implant stimulation

Publication date: Available online 19 May 2017
Source:Hearing Research
Author(s): M.J. van Gendt, J.J. Briaire, R.K. Kalkman, J.H.M. Frijns
Cochlear implants encode speech information by stimulating the auditory nerve with amplitude-modulated pulse trains. A computer model of the auditory nerve's response to electrical stimulation can be used to evaluate different approaches to improving CI patients' perception. In this paper a computationally efficient stochastic and adaptive auditory nerve model was used to investigate full nerve responses to amplitude-modulated electrical pulse trains. The model was validated for nerve responses to AM pulse trains via comparison with animal data. The influence of different parameters, such as adaptation and stochasticity, on long-term adaptation and modulation-following behavior was investigated. Responses to pulse trains with different pulse amplitudes, amplitude modulation frequencies, and modulation depths were modeled. Rate responses as well as period histograms, Vector Strength and the fundamental frequency were characterized in different time bins. The response alterations, including frequency following behavior, observed over the stimulus duration were similar to those seen in animal experiments. The tested model can be used to predict complete nerve responses to arbitrary input, and thus to different sound coding strategies.



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Modeled auditory nerve responses to amplitude modulated cochlear implant stimulation

Publication date: Available online 19 May 2017
Source:Hearing Research
Author(s): M.J. van Gendt, J.J. Briaire, R.K. Kalkman, J.H.M. Frijns
Cochlear implants encode speech information by stimulating the auditory nerve with amplitude-modulated pulse trains. A computer model of the auditory nerve's response to electrical stimulation can be used to evaluate different approaches to improving CI patients' perception. In this paper a computationally efficient stochastic and adaptive auditory nerve model was used to investigate full nerve responses to amplitude-modulated electrical pulse trains. The model was validated for nerve responses to AM pulse trains via comparison with animal data. The influence of different parameters, such as adaptation and stochasticity, on long-term adaptation and modulation-following behavior was investigated. Responses to pulse trains with different pulse amplitudes, amplitude modulation frequencies, and modulation depths were modeled. Rate responses as well as period histograms, Vector Strength and the fundamental frequency were characterized in different time bins. The response alterations, including frequency following behavior, observed over the stimulus duration were similar to those seen in animal experiments. The tested model can be used to predict complete nerve responses to arbitrary input, and thus to different sound coding strategies.



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Modeled auditory nerve responses to amplitude modulated cochlear implant stimulation

Publication date: Available online 19 May 2017
Source:Hearing Research
Author(s): M.J. van Gendt, J.J. Briaire, R.K. Kalkman, J.H.M. Frijns
Cochlear implants encode speech information by stimulating the auditory nerve with amplitude-modulated pulse trains. A computer model of the auditory nerve's response to electrical stimulation can be used to evaluate different approaches to improving CI patients' perception. In this paper a computationally efficient stochastic and adaptive auditory nerve model was used to investigate full nerve responses to amplitude-modulated electrical pulse trains. The model was validated for nerve responses to AM pulse trains via comparison with animal data. The influence of different parameters, such as adaptation and stochasticity, on long-term adaptation and modulation-following behavior was investigated. Responses to pulse trains with different pulse amplitudes, amplitude modulation frequencies, and modulation depths were modeled. Rate responses as well as period histograms, Vector Strength and the fundamental frequency were characterized in different time bins. The response alterations, including frequency following behavior, observed over the stimulus duration were similar to those seen in animal experiments. The tested model can be used to predict complete nerve responses to arbitrary input, and thus to different sound coding strategies.



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Modeled auditory nerve responses to amplitude modulated cochlear implant stimulation

Publication date: Available online 19 May 2017
Source:Hearing Research
Author(s): M.J. van Gendt, J.J. Briaire, R.K. Kalkman, J.H.M. Frijns
Cochlear implants encode speech information by stimulating the auditory nerve with amplitude-modulated pulse trains. A computer model of the auditory nerve's response to electrical stimulation can be used to evaluate different approaches to improving CI patients' perception. In this paper a computationally efficient stochastic and adaptive auditory nerve model was used to investigate full nerve responses to amplitude-modulated electrical pulse trains. The model was validated for nerve responses to AM pulse trains via comparison with animal data. The influence of different parameters, such as adaptation and stochasticity, on long-term adaptation and modulation-following behavior was investigated. Responses to pulse trains with different pulse amplitudes, amplitude modulation frequencies, and modulation depths were modeled. Rate responses as well as period histograms, Vector Strength and the fundamental frequency were characterized in different time bins. The response alterations, including frequency following behavior, observed over the stimulus duration were similar to those seen in animal experiments. The tested model can be used to predict complete nerve responses to arbitrary input, and thus to different sound coding strategies.



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Modeled auditory nerve responses to amplitude modulated cochlear implant stimulation

Publication date: Available online 19 May 2017
Source:Hearing Research
Author(s): M.J. van Gendt, J.J. Briaire, R.K. Kalkman, J.H.M. Frijns
Cochlear implants encode speech information by stimulating the auditory nerve with amplitude-modulated pulse trains. A computer model of the auditory nerve's response to electrical stimulation can be used to evaluate different approaches to improving CI patients' perception. In this paper a computationally efficient stochastic and adaptive auditory nerve model was used to investigate full nerve responses to amplitude-modulated electrical pulse trains. The model was validated for nerve responses to AM pulse trains via comparison with animal data. The influence of different parameters, such as adaptation and stochasticity, on long-term adaptation and modulation-following behavior was investigated. Responses to pulse trains with different pulse amplitudes, amplitude modulation frequencies, and modulation depths were modeled. Rate responses as well as period histograms, Vector Strength and the fundamental frequency were characterized in different time bins. The response alterations, including frequency following behavior, observed over the stimulus duration were similar to those seen in animal experiments. The tested model can be used to predict complete nerve responses to arbitrary input, and thus to different sound coding strategies.



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Safety Behaviors and Stuttering

Purpose

Those who are socially anxious may use safety behaviors during feared social interactions to prevent negative outcomes. Safety behaviors are associated with anxiety maintenance and poorer treatment outcomes because they prevent fear extinction. Social anxiety disorder is often comorbid with stuttering. Speech pathologists reported in a recent publication (Helgadottir, Menzies, Onslow, Packman, & O’Brian, 2014a) that they often recommended procedures for clients that could be safety behaviors. This study investigated the self-reported use of safety behaviors by adults who stutter.

Method

Participants were 133 adults who stutter enrolled in an online cognitive-behavior therapy program. Participants completed a questionnaire about their use of potential safety behaviors when anxious during social encounters. Correlations were computed between safety behaviors and pretreatment scores on measures of fear of negative evaluation and negative cognitions.

Results

Of 133 participants, 132 reported that they used safety behaviors. Many of the safety behaviors correlated with higher scores for fear of negative evaluation and negative cognitions.

Conclusions

Adults who stutter report using safety behaviors, and their use is associated with pretreatment fear of negative evaluation and unhelpful thoughts about stuttering. These results suggest that the negative effects of safety behaviors may extend to those who stutter, and further research is needed.

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Moving Triadic Gaze Intervention into Practice: Measuring Clinician Attitude and Implementation Fidelity

Purpose

This research investigated a first step in implementing the dynamic assessment (DA) component of Triadic Gaze Intervention (Olswang, Feuerstein, Pinder, & Dowden, 2013; Olswang et al., 2014), an evidence-based protocol for teaching early signals of communication to young children with physical disabilities. Clinician attitudes about adopting external evidence into practice and implementation fidelity in DA protocol delivery were examined following training.

Method

Seven early intervention clinicians from multiple disciplines were trained to deliver the four essential elements of the DA protocol: (a) provide communication opportunity, (b) recognize child's potentially communicative signal, (c) shape child's signal toward triadic gaze, and (d) reinforce with play. Clinician attitude regarding adopting evidence into practice was measured at baseline and follow-up, with the Evidence-Based Practice Attitude Scale (Aarons, 2004). Implementation fidelity in delivering the protocol was measured for adherence (accuracy) and competence (quality) during trial implementation.

Results

Clinicians' attitudes about trying new evidence that at first was perceived as incongruent with their practice improved over the course of the research. Clinicians demonstrated strong adherence to the DA protocol; however, competence varied across clinicians and appeared related to child performance.

Conclusions

The results provided insight into moving Triadic Gaze Intervention into practice and yielded valuable information regarding the implementation process, with implications for future research.

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Safety Behaviors and Stuttering

Purpose

Those who are socially anxious may use safety behaviors during feared social interactions to prevent negative outcomes. Safety behaviors are associated with anxiety maintenance and poorer treatment outcomes because they prevent fear extinction. Social anxiety disorder is often comorbid with stuttering. Speech pathologists reported in a recent publication (Helgadottir, Menzies, Onslow, Packman, & O’Brian, 2014a) that they often recommended procedures for clients that could be safety behaviors. This study investigated the self-reported use of safety behaviors by adults who stutter.

Method

Participants were 133 adults who stutter enrolled in an online cognitive-behavior therapy program. Participants completed a questionnaire about their use of potential safety behaviors when anxious during social encounters. Correlations were computed between safety behaviors and pretreatment scores on measures of fear of negative evaluation and negative cognitions.

Results

Of 133 participants, 132 reported that they used safety behaviors. Many of the safety behaviors correlated with higher scores for fear of negative evaluation and negative cognitions.

Conclusions

Adults who stutter report using safety behaviors, and their use is associated with pretreatment fear of negative evaluation and unhelpful thoughts about stuttering. These results suggest that the negative effects of safety behaviors may extend to those who stutter, and further research is needed.

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Moving Triadic Gaze Intervention into Practice: Measuring Clinician Attitude and Implementation Fidelity

Purpose

This research investigated a first step in implementing the dynamic assessment (DA) component of Triadic Gaze Intervention (Olswang, Feuerstein, Pinder, & Dowden, 2013; Olswang et al., 2014), an evidence-based protocol for teaching early signals of communication to young children with physical disabilities. Clinician attitudes about adopting external evidence into practice and implementation fidelity in DA protocol delivery were examined following training.

Method

Seven early intervention clinicians from multiple disciplines were trained to deliver the four essential elements of the DA protocol: (a) provide communication opportunity, (b) recognize child's potentially communicative signal, (c) shape child's signal toward triadic gaze, and (d) reinforce with play. Clinician attitude regarding adopting evidence into practice was measured at baseline and follow-up, with the Evidence-Based Practice Attitude Scale (Aarons, 2004). Implementation fidelity in delivering the protocol was measured for adherence (accuracy) and competence (quality) during trial implementation.

Results

Clinicians' attitudes about trying new evidence that at first was perceived as incongruent with their practice improved over the course of the research. Clinicians demonstrated strong adherence to the DA protocol; however, competence varied across clinicians and appeared related to child performance.

Conclusions

The results provided insight into moving Triadic Gaze Intervention into practice and yielded valuable information regarding the implementation process, with implications for future research.

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Safety Behaviors and Stuttering

Purpose

Those who are socially anxious may use safety behaviors during feared social interactions to prevent negative outcomes. Safety behaviors are associated with anxiety maintenance and poorer treatment outcomes because they prevent fear extinction. Social anxiety disorder is often comorbid with stuttering. Speech pathologists reported in a recent publication (Helgadottir, Menzies, Onslow, Packman, & O’Brian, 2014a) that they often recommended procedures for clients that could be safety behaviors. This study investigated the self-reported use of safety behaviors by adults who stutter.

Method

Participants were 133 adults who stutter enrolled in an online cognitive-behavior therapy program. Participants completed a questionnaire about their use of potential safety behaviors when anxious during social encounters. Correlations were computed between safety behaviors and pretreatment scores on measures of fear of negative evaluation and negative cognitions.

Results

Of 133 participants, 132 reported that they used safety behaviors. Many of the safety behaviors correlated with higher scores for fear of negative evaluation and negative cognitions.

Conclusions

Adults who stutter report using safety behaviors, and their use is associated with pretreatment fear of negative evaluation and unhelpful thoughts about stuttering. These results suggest that the negative effects of safety behaviors may extend to those who stutter, and further research is needed.

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Moving Triadic Gaze Intervention into Practice: Measuring Clinician Attitude and Implementation Fidelity

Purpose

This research investigated a first step in implementing the dynamic assessment (DA) component of Triadic Gaze Intervention (Olswang, Feuerstein, Pinder, & Dowden, 2013; Olswang et al., 2014), an evidence-based protocol for teaching early signals of communication to young children with physical disabilities. Clinician attitudes about adopting external evidence into practice and implementation fidelity in DA protocol delivery were examined following training.

Method

Seven early intervention clinicians from multiple disciplines were trained to deliver the four essential elements of the DA protocol: (a) provide communication opportunity, (b) recognize child's potentially communicative signal, (c) shape child's signal toward triadic gaze, and (d) reinforce with play. Clinician attitude regarding adopting evidence into practice was measured at baseline and follow-up, with the Evidence-Based Practice Attitude Scale (Aarons, 2004). Implementation fidelity in delivering the protocol was measured for adherence (accuracy) and competence (quality) during trial implementation.

Results

Clinicians' attitudes about trying new evidence that at first was perceived as incongruent with their practice improved over the course of the research. Clinicians demonstrated strong adherence to the DA protocol; however, competence varied across clinicians and appeared related to child performance.

Conclusions

The results provided insight into moving Triadic Gaze Intervention into practice and yielded valuable information regarding the implementation process, with implications for future research.

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Effect of Electrode Montage and Head Position on Air-Conducted Ocular Vestibular Evoked Myogenic Potential.

Effect of Electrode Montage and Head Position on Air-Conducted Ocular Vestibular Evoked Myogenic Potential.

Am J Audiol. 2017 May 16;:1-9

Authors: Makowiec K, McCaslin DL, Jacobson GP, Hatton K, Lee J

Abstract
Purpose: The purpose of this investigation was to identify the optimal recording parameters for evoking the ocular vestibular evoked myogenic potential (oVEMP) using air-conduction stimuli.
Method: Subjects were 17 otologically and neurologically intact adults (age: M = 24.18 years, SD = 1.91 years). The oVEMP responses were elicited using a 500-Hz tone burst air-conduction stimulus presented at an intensity of 95 dB nHL. The setting was a balance function laboratory that was part of a large tertiary care otology clinic.
Results: The oVEMP electrode montage and body position that yielded the largest oVEMP amplitude was the belly-tendon montage (Sandhu, George, & Rea, 2013), recorded with the subject in the sitting position. The N1 latency recorded with the belly-tendon montage was significantly shorter than that recorded for the infraorbital montage in both the sitting and supine positions.
Conclusion: The belly-tendon recording montage with the subject sitting yields significantly larger oVEMP amplitudes and shorter N1 latencies than do traditional bipolar infraorbital recordings.

PMID: 28520834 [PubMed - as supplied by publisher]

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The petrosal and bony labyrinth of Diplobune minor, an enigmatic Artiodactyla from the Oligocene of Western Europe.

Related Articles

The petrosal and bony labyrinth of Diplobune minor, an enigmatic Artiodactyla from the Oligocene of Western Europe.

J Morphol. 2017 May 17;:

Authors: Orliac MJ, Araújo R, Lihoreau F

Abstract
Anoplotheriinae are Paleogene European artiodactyls that present a unique postcranial morphology with a tridactyl autopodium and uncommon limb orientation. This peculiar morphology led to various hypotheses regarding anoplotheriine locomotion from semiaquatic to partly arboreal or partly bipedal. The petrosal bone, housing the organs of balance, and hearing, offers complementary information to postcranial morphology on the ecology of this uncommon artiodactyl. Here, we investigate the middle ear and bony labyrinth of the small anoplotheriine Diplobune minor based on four specimens from the Early Oligocene locality of Itardies (Quercy, France). A macroscopic study coupled with a μCT scan investigation of the petrosal anatomy provides novel information on the bony labyrinth, stapes, and innervation and vasculature of the inner ear of this enigmatic taxon. The petrosal of D. minor exhibits a mosaic of plesiomorphic characters and peculiar features that shed new light into the anatomy of this poorly studied taxon of an obscure taxonomic clade. We can confidently reject that D. minor was a semiaquatic species based on the petrosal morphology: presence of a large mastoid process and nonpachyostotic tegmen tympani do not support underwater hearing. On the other hand, the average semicircular canal radius points to a slow or medium slow agility for D. minor, and fully rejects it was a fast moving animal, which is congruent with its postcranial anatomy.

PMID: 28516487 [PubMed - as supplied by publisher]

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Effect of Electrode Montage and Head Position on Air-Conducted Ocular Vestibular Evoked Myogenic Potential.

Effect of Electrode Montage and Head Position on Air-Conducted Ocular Vestibular Evoked Myogenic Potential.

Am J Audiol. 2017 May 16;:1-9

Authors: Makowiec K, McCaslin DL, Jacobson GP, Hatton K, Lee J

Abstract
Purpose: The purpose of this investigation was to identify the optimal recording parameters for evoking the ocular vestibular evoked myogenic potential (oVEMP) using air-conduction stimuli.
Method: Subjects were 17 otologically and neurologically intact adults (age: M = 24.18 years, SD = 1.91 years). The oVEMP responses were elicited using a 500-Hz tone burst air-conduction stimulus presented at an intensity of 95 dB nHL. The setting was a balance function laboratory that was part of a large tertiary care otology clinic.
Results: The oVEMP electrode montage and body position that yielded the largest oVEMP amplitude was the belly-tendon montage (Sandhu, George, & Rea, 2013), recorded with the subject in the sitting position. The N1 latency recorded with the belly-tendon montage was significantly shorter than that recorded for the infraorbital montage in both the sitting and supine positions.
Conclusion: The belly-tendon recording montage with the subject sitting yields significantly larger oVEMP amplitudes and shorter N1 latencies than do traditional bipolar infraorbital recordings.

PMID: 28520834 [PubMed - as supplied by publisher]

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The petrosal and bony labyrinth of Diplobune minor, an enigmatic Artiodactyla from the Oligocene of Western Europe.

Related Articles

The petrosal and bony labyrinth of Diplobune minor, an enigmatic Artiodactyla from the Oligocene of Western Europe.

J Morphol. 2017 May 17;:

Authors: Orliac MJ, Araújo R, Lihoreau F

Abstract
Anoplotheriinae are Paleogene European artiodactyls that present a unique postcranial morphology with a tridactyl autopodium and uncommon limb orientation. This peculiar morphology led to various hypotheses regarding anoplotheriine locomotion from semiaquatic to partly arboreal or partly bipedal. The petrosal bone, housing the organs of balance, and hearing, offers complementary information to postcranial morphology on the ecology of this uncommon artiodactyl. Here, we investigate the middle ear and bony labyrinth of the small anoplotheriine Diplobune minor based on four specimens from the Early Oligocene locality of Itardies (Quercy, France). A macroscopic study coupled with a μCT scan investigation of the petrosal anatomy provides novel information on the bony labyrinth, stapes, and innervation and vasculature of the inner ear of this enigmatic taxon. The petrosal of D. minor exhibits a mosaic of plesiomorphic characters and peculiar features that shed new light into the anatomy of this poorly studied taxon of an obscure taxonomic clade. We can confidently reject that D. minor was a semiaquatic species based on the petrosal morphology: presence of a large mastoid process and nonpachyostotic tegmen tympani do not support underwater hearing. On the other hand, the average semicircular canal radius points to a slow or medium slow agility for D. minor, and fully rejects it was a fast moving animal, which is congruent with its postcranial anatomy.

PMID: 28516487 [PubMed - as supplied by publisher]

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Adaptive psychological structure in childhood hearing impairment: audiological correlations.

Adaptive psychological structure in childhood hearing impairment: audiological correlations.

Acta Otorhinolaryngol Ital. 2017 Jun;37(3):175-179

Authors: Serra A, Spinato G, Cocuzza S, Licciardello L, Pavone P, Maiolino L

Abstract
The present research deals with the clinical and social problems present during linguistic and cognitive development of deaf children. Currently, the development of Theory of Mind represents an important research field in deafness studies. These international studies highlighted a significant alteration in the development of Theory of Mind in deaf children compared to normal hearing children, especially in cases of congenital or preverbal hearing loss. In particular, the research focuses on the skills of deaf children in recognising emotions and desires, through both perceptive and cognitive methods, by evaluation of psycho-cognitive skills of children with severe hearing loss using a set of questions to be administered to hearing loss patients. The experiment was performed on a group composed of 10 children (5 males and 5 females) aged 4 to 9 years and 54 to 108 months, affected by bilateral congenital hearing loss (severe to total), or hearing loss that developed in preverbal children the year before entering elementary school, or during the fourth year of elementary school. The selection criteria were based on: audiologic evaluation, neuro-psychological tests administered to assess general, cognitive as well as praxis and perceptive abilities, and clinical observations performed to assess psychopathology using tests that assess development of both visual perceptive (Coloured Progressive Matrices) and graphic representational abilities (Test of Human Figure Drawings and the Family Drawing Test). The instrument "cognitive" was the "Deaf Children Series", arranged by us, that consists of a mental status examination (MSE) that evaluates: level of cognitive (knowledge-related) ability, emotional mood, and speech and thought patterns at the time of evaluation. Deaf children show a reduced responsiveness to the expressions of sadness on the perceptive side. Through the test, we observed a psychodynamic defense mechanism considering perceptive understanding performance. On the contrary, in normal hearing children, the emotion 'fear' is the most difficult to identify. Deaf children seem to be more susceptible to recognition of visual emotions. Furthermore, deaf children present significant problem-solving skills and emotional recognition skills, possibly as a result of their hearing impairment.

PMID: 28516959 [PubMed - in process]

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Medical Genetics Summaries

Medical Genetics Summaries

Book. 2012

Authors: Pratt V, McLeod H, Dean L, Malheiro A, Rubinstein W

Abstract
Gentamicin is an aminoglycoside antibiotic that is active against gram-negative bacteria. It is administered by injection to treat serious infections caused by susceptible strains of the following microorganisms: Pseudomonas aeruginosa, Proteus species, Escherichia coli, Klebsiella-Enterobacter-Serratia species, Citrobacter species and Staphylococcus species (1). Gentamicin may also be used topically to treat ophthalmic and dermatological infections. There are reports that a single injection of gentamicin may cause hearing loss in individuals who have a variant in the mitochondrial gene MT-RNR1, known as m.1555A>G. Hearing loss is bilateral, usually moderate to profound, and irreversible. Importantly, this occurs in genetically susceptible individuals even in cases where drug levels remain within the therapeutic range. Note that this effect is distinct from “dose-dependent ototoxicity” (damage to the inner ear), which can affect any individual, typically occurring after 5-7 days of aminoglycoside therapy (2). Currently, the FDA-approved drug label for gentamicin does not include a statement about m.1555A>G. However, an American College of Medical Genetics and Genomics (ACMG) guideline includes the following recommendation: “Single-gene testing may be warranted in cases in which the medical or family history, or presentation of the hearing loss, suggests a specific etiology. For example, testing for mitochondrial DNA mutations associated with aminoglycoside ototoxicity may be considered for individuals with a history of use of aminoglycoside antibiotics” (3, 4).

PMID: 28520359

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