Audiologist-Guided Internet-Based Cognitive Behavior Therapy for Adults With Tinnitus in the United Kingdom: A Randomized Controlled Trial.

Objectives: Specialist tinnitus services are in high demand as a result of the negative effect tinnitus may have on quality of life. Additional clinically and cost-effective tinnitus management routes are needed. One potential route is providing Cognitive Behavioural Therapy for tinnitus via the Internet (iCBT). This study aimed to determine the efficacy of guided iCBT, using audiological support, on tinnitus distress and tinnitus-related comorbidities, in the United Kingdom. A further aim was to establish the stability of intervention effects 2-months postintervention. The hypothesis was that iCBT for tinnitus would be more effective at reducing tinnitus distress than weekly monitoring. Design: A randomized, delayed intervention efficacy trial, with a 2-month follow-up was implemented to evaluate the efficacy of iCBT in the United Kingdom. Participants were randomly assigned to the experimental (n = 73) or weekly monitoring control group (n = 73) after being stratified for tinnitus severity and age. After the experimental group completed the 8-week long iCBT intervention, the control group undertook the same intervention. Intervention effects were, therefore, evaluated in two independent groups at two time points. The primary outcome was a change in tinnitus distress between the groups as assessed by the Tinnitus Functional Index. Secondary assessment measures were included for insomnia, anxiety, depression, hearing disability, hyperacusis, cognitive failures, and satisfaction with life. These were completed at baseline, postintervention, and at a 2-month postintervention follow-up. Results: After undertaking the iCBT intervention, the experimental group had a greater reduction in tinnitus distress when compared with the control group. This reduction was statistically significant (Cohen's d = 0.7) and was clinically significant for 51% of the experimental group and 5% of the control group. This reduction was evident 4 weeks after commencing the iCBT intervention. Furthermore, the experimental group had a greater reduction in insomnia, depression, hyperacusis, cognitive failures, and a greater improvement in quality of life, as evidenced by the significant differences in these assessment measures postintervention. Results were maintained 2 months postintervention. Conclusions: Guided (using audiological support) iCBT for tinnitus resulted in statistically significant reductions in tinnitus distress and comorbidities (insomnia, depression, hyperacusis, cognitive failures) and a significant increase in quality of life. These effects remained stable at 2-months postintervention. Further trials to determine the longer term efficacy of iCBT to investigate predictors of outcome and to compare iCBT with standard clinical care in the United Kingdom are required. Registered at clinicaltrials.gov: NCT02370810 on 5/03/2015. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Audiologist-Guided Internet-Based Cognitive Behavior Therapy for Adults With Tinnitus in the United Kingdom: A Randomized Controlled Trial.

Objectives: Specialist tinnitus services are in high demand as a result of the negative effect tinnitus may have on quality of life. Additional clinically and cost-effective tinnitus management routes are needed. One potential route is providing Cognitive Behavioural Therapy for tinnitus via the Internet (iCBT). This study aimed to determine the efficacy of guided iCBT, using audiological support, on tinnitus distress and tinnitus-related comorbidities, in the United Kingdom. A further aim was to establish the stability of intervention effects 2-months postintervention. The hypothesis was that iCBT for tinnitus would be more effective at reducing tinnitus distress than weekly monitoring. Design: A randomized, delayed intervention efficacy trial, with a 2-month follow-up was implemented to evaluate the efficacy of iCBT in the United Kingdom. Participants were randomly assigned to the experimental (n = 73) or weekly monitoring control group (n = 73) after being stratified for tinnitus severity and age. After the experimental group completed the 8-week long iCBT intervention, the control group undertook the same intervention. Intervention effects were, therefore, evaluated in two independent groups at two time points. The primary outcome was a change in tinnitus distress between the groups as assessed by the Tinnitus Functional Index. Secondary assessment measures were included for insomnia, anxiety, depression, hearing disability, hyperacusis, cognitive failures, and satisfaction with life. These were completed at baseline, postintervention, and at a 2-month postintervention follow-up. Results: After undertaking the iCBT intervention, the experimental group had a greater reduction in tinnitus distress when compared with the control group. This reduction was statistically significant (Cohen's d = 0.7) and was clinically significant for 51% of the experimental group and 5% of the control group. This reduction was evident 4 weeks after commencing the iCBT intervention. Furthermore, the experimental group had a greater reduction in insomnia, depression, hyperacusis, cognitive failures, and a greater improvement in quality of life, as evidenced by the significant differences in these assessment measures postintervention. Results were maintained 2 months postintervention. Conclusions: Guided (using audiological support) iCBT for tinnitus resulted in statistically significant reductions in tinnitus distress and comorbidities (insomnia, depression, hyperacusis, cognitive failures) and a significant increase in quality of life. These effects remained stable at 2-months postintervention. Further trials to determine the longer term efficacy of iCBT to investigate predictors of outcome and to compare iCBT with standard clinical care in the United Kingdom are required. Registered at clinicaltrials.gov: NCT02370810 on 5/03/2015. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Audiologist-Guided Internet-Based Cognitive Behavior Therapy for Adults With Tinnitus in the United Kingdom: A Randomized Controlled Trial.

Objectives: Specialist tinnitus services are in high demand as a result of the negative effect tinnitus may have on quality of life. Additional clinically and cost-effective tinnitus management routes are needed. One potential route is providing Cognitive Behavioural Therapy for tinnitus via the Internet (iCBT). This study aimed to determine the efficacy of guided iCBT, using audiological support, on tinnitus distress and tinnitus-related comorbidities, in the United Kingdom. A further aim was to establish the stability of intervention effects 2-months postintervention. The hypothesis was that iCBT for tinnitus would be more effective at reducing tinnitus distress than weekly monitoring. Design: A randomized, delayed intervention efficacy trial, with a 2-month follow-up was implemented to evaluate the efficacy of iCBT in the United Kingdom. Participants were randomly assigned to the experimental (n = 73) or weekly monitoring control group (n = 73) after being stratified for tinnitus severity and age. After the experimental group completed the 8-week long iCBT intervention, the control group undertook the same intervention. Intervention effects were, therefore, evaluated in two independent groups at two time points. The primary outcome was a change in tinnitus distress between the groups as assessed by the Tinnitus Functional Index. Secondary assessment measures were included for insomnia, anxiety, depression, hearing disability, hyperacusis, cognitive failures, and satisfaction with life. These were completed at baseline, postintervention, and at a 2-month postintervention follow-up. Results: After undertaking the iCBT intervention, the experimental group had a greater reduction in tinnitus distress when compared with the control group. This reduction was statistically significant (Cohen's d = 0.7) and was clinically significant for 51% of the experimental group and 5% of the control group. This reduction was evident 4 weeks after commencing the iCBT intervention. Furthermore, the experimental group had a greater reduction in insomnia, depression, hyperacusis, cognitive failures, and a greater improvement in quality of life, as evidenced by the significant differences in these assessment measures postintervention. Results were maintained 2 months postintervention. Conclusions: Guided (using audiological support) iCBT for tinnitus resulted in statistically significant reductions in tinnitus distress and comorbidities (insomnia, depression, hyperacusis, cognitive failures) and a significant increase in quality of life. These effects remained stable at 2-months postintervention. Further trials to determine the longer term efficacy of iCBT to investigate predictors of outcome and to compare iCBT with standard clinical care in the United Kingdom are required. Registered at clinicaltrials.gov: NCT02370810 on 5/03/2015. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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A Method to Administer Agents to the Larynx in an Awake Large Animal

Purpose

This research note describes an adapted experimental methodology to administer an exogenous agent to the larynx and upper airway of awake animals. The exogenous agent could be a perturbation. In the current study, the agent was isotonic saline. Isotonic saline was selected because it is safe, of similar composition to extracellular fluid, and used in voice studies. The described approach allowed large animals such as pigs to be comfortably restrained without chemical sedation or anesthesia for extended periods while receiving the agent.

Method

Six Sinclair pigs were successfully trained with positive reinforcement to voluntarily enter and then be restrained in a Panepinto Sling. Once restrained, the pigs accepted a nose cone that delivered nebulized isotonic saline. This procedure was repeated 3 times per day for 20 days. At the end of the study, the larynx and airway tissues were excised and examined using histology and transmission electron microscopy.

Results

Pathology related to the procedure (i.e., nebulized inhaled isotonic saline or stress) was not identified in any examined tissues.

Conclusions

This methodology allowed for repeated application of exogenous agents to awake, unstressed animals. This method can be used repeatedly in the laboratory to test various therapeutics for safety, toxicity, and dosage. Future studies will specifically manipulate the type of agent to further our understanding of laryngeal pathobiology.

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Developing Appreciation for Sarcasm and Sarcastic Gossip: It Depends on Perspective

Background

Speakers use sarcasm to criticize others and to be funny; the indirectness of sarcasm protects the addressee's face (Brown & Levinson, 1987). Thus, appreciation of sarcasm depends on the ability to consider perspectives.

Purpose

We investigated development of this ability from late childhood into adulthood and examined effects of interpretive perspective and parties present.

Method

We presented 9- to 10-year-olds, 13- to 14-year-olds, and adults with sarcastic and literal remarks in three parties–present conditions: private evaluation, public evaluation, and gossip. Participants interpreted the speaker's attitude and humor from the addressee's perspective and, when appropriate, from the bystander's perspective.

Results

Children showed no influence of interpretive perspective or parties present on appreciation of the speaker's attitude or humor. Adolescents and adults, however, shifted their interpretations, judging that addressees have less favorable views of criticisms than bystanders. Further, adolescents and adults differed in their perceptions of the social functions of gossip, with adolescents showing more positive attitudes than adults toward sarcastic gossip.

Conclusions

We suggest that adults' disapproval of sarcastic gossip shows a deeper understanding of the utility of sarcasm's face-saving function. Thus, the ability to modulate appreciation of sarcasm according to interpretive perspective and parties present continues to develop in adolescence and into adulthood.

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Neural Indices of Semantic Processing in Early Childhood Distinguish Eventual Stuttering Persistence and Recovery

Purpose

Maturation of neural processes for language may lag in some children who stutter (CWS), and event-related potentials (ERPs) distinguish CWS who have recovered from those who have persisted. The current study explores whether ERPs indexing semantic processing may distinguish children who will eventually persist in stuttering (CWS-ePersisted) from those who will recover from stuttering (CWS-eRecovered).

Method

Fifty-six 5-year-old children with normal receptive language listened to naturally spoken sentences in a story context. ERP components elicited for semantic processing (N400, late positive component [LPC]) were compared for CWS-ePersisted, CWS-eRecovered, and children who do not stutter (CWNS).

Results

The N400 elicited by semantic violations had a more focal scalp distribution (left lateralized and less anterior) in the CWS-eRecovered compared with CWS-ePersisted. Although the LPC elicited in CWS-eRecovered and CWNS did not differ, the LPC elicited in the CWS-ePersisted was smaller in amplitude compared with that in CWNS.

Conclusions

ERPs elicited in 5-year-old CWS-eRecovered compared with CWS-ePersisted suggest that future recovery from stuttering may be associated with earlier maturation of semantic processes in the preschool years. Subtle differences in ERP indices offer a window into neural maturation processes for language and may help distinguish the course of stuttering development.

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A Method to Administer Agents to the Larynx in an Awake Large Animal

Purpose

This research note describes an adapted experimental methodology to administer an exogenous agent to the larynx and upper airway of awake animals. The exogenous agent could be a perturbation. In the current study, the agent was isotonic saline. Isotonic saline was selected because it is safe, of similar composition to extracellular fluid, and used in voice studies. The described approach allowed large animals such as pigs to be comfortably restrained without chemical sedation or anesthesia for extended periods while receiving the agent.

Method

Six Sinclair pigs were successfully trained with positive reinforcement to voluntarily enter and then be restrained in a Panepinto Sling. Once restrained, the pigs accepted a nose cone that delivered nebulized isotonic saline. This procedure was repeated 3 times per day for 20 days. At the end of the study, the larynx and airway tissues were excised and examined using histology and transmission electron microscopy.

Results

Pathology related to the procedure (i.e., nebulized inhaled isotonic saline or stress) was not identified in any examined tissues.

Conclusions

This methodology allowed for repeated application of exogenous agents to awake, unstressed animals. This method can be used repeatedly in the laboratory to test various therapeutics for safety, toxicity, and dosage. Future studies will specifically manipulate the type of agent to further our understanding of laryngeal pathobiology.

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Developing Appreciation for Sarcasm and Sarcastic Gossip: It Depends on Perspective

Background

Speakers use sarcasm to criticize others and to be funny; the indirectness of sarcasm protects the addressee's face (Brown & Levinson, 1987). Thus, appreciation of sarcasm depends on the ability to consider perspectives.

Purpose

We investigated development of this ability from late childhood into adulthood and examined effects of interpretive perspective and parties present.

Method

We presented 9- to 10-year-olds, 13- to 14-year-olds, and adults with sarcastic and literal remarks in three parties–present conditions: private evaluation, public evaluation, and gossip. Participants interpreted the speaker's attitude and humor from the addressee's perspective and, when appropriate, from the bystander's perspective.

Results

Children showed no influence of interpretive perspective or parties present on appreciation of the speaker's attitude or humor. Adolescents and adults, however, shifted their interpretations, judging that addressees have less favorable views of criticisms than bystanders. Further, adolescents and adults differed in their perceptions of the social functions of gossip, with adolescents showing more positive attitudes than adults toward sarcastic gossip.

Conclusions

We suggest that adults' disapproval of sarcastic gossip shows a deeper understanding of the utility of sarcasm's face-saving function. Thus, the ability to modulate appreciation of sarcasm according to interpretive perspective and parties present continues to develop in adolescence and into adulthood.

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Neural Indices of Semantic Processing in Early Childhood Distinguish Eventual Stuttering Persistence and Recovery

Purpose

Maturation of neural processes for language may lag in some children who stutter (CWS), and event-related potentials (ERPs) distinguish CWS who have recovered from those who have persisted. The current study explores whether ERPs indexing semantic processing may distinguish children who will eventually persist in stuttering (CWS-ePersisted) from those who will recover from stuttering (CWS-eRecovered).

Method

Fifty-six 5-year-old children with normal receptive language listened to naturally spoken sentences in a story context. ERP components elicited for semantic processing (N400, late positive component [LPC]) were compared for CWS-ePersisted, CWS-eRecovered, and children who do not stutter (CWNS).

Results

The N400 elicited by semantic violations had a more focal scalp distribution (left lateralized and less anterior) in the CWS-eRecovered compared with CWS-ePersisted. Although the LPC elicited in CWS-eRecovered and CWNS did not differ, the LPC elicited in the CWS-ePersisted was smaller in amplitude compared with that in CWNS.

Conclusions

ERPs elicited in 5-year-old CWS-eRecovered compared with CWS-ePersisted suggest that future recovery from stuttering may be associated with earlier maturation of semantic processes in the preschool years. Subtle differences in ERP indices offer a window into neural maturation processes for language and may help distinguish the course of stuttering development.

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A Method to Administer Agents to the Larynx in an Awake Large Animal

Purpose

This research note describes an adapted experimental methodology to administer an exogenous agent to the larynx and upper airway of awake animals. The exogenous agent could be a perturbation. In the current study, the agent was isotonic saline. Isotonic saline was selected because it is safe, of similar composition to extracellular fluid, and used in voice studies. The described approach allowed large animals such as pigs to be comfortably restrained without chemical sedation or anesthesia for extended periods while receiving the agent.

Method

Six Sinclair pigs were successfully trained with positive reinforcement to voluntarily enter and then be restrained in a Panepinto Sling. Once restrained, the pigs accepted a nose cone that delivered nebulized isotonic saline. This procedure was repeated 3 times per day for 20 days. At the end of the study, the larynx and airway tissues were excised and examined using histology and transmission electron microscopy.

Results

Pathology related to the procedure (i.e., nebulized inhaled isotonic saline or stress) was not identified in any examined tissues.

Conclusions

This methodology allowed for repeated application of exogenous agents to awake, unstressed animals. This method can be used repeatedly in the laboratory to test various therapeutics for safety, toxicity, and dosage. Future studies will specifically manipulate the type of agent to further our understanding of laryngeal pathobiology.

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Developing Appreciation for Sarcasm and Sarcastic Gossip: It Depends on Perspective

Background

Speakers use sarcasm to criticize others and to be funny; the indirectness of sarcasm protects the addressee's face (Brown & Levinson, 1987). Thus, appreciation of sarcasm depends on the ability to consider perspectives.

Purpose

We investigated development of this ability from late childhood into adulthood and examined effects of interpretive perspective and parties present.

Method

We presented 9- to 10-year-olds, 13- to 14-year-olds, and adults with sarcastic and literal remarks in three parties–present conditions: private evaluation, public evaluation, and gossip. Participants interpreted the speaker's attitude and humor from the addressee's perspective and, when appropriate, from the bystander's perspective.

Results

Children showed no influence of interpretive perspective or parties present on appreciation of the speaker's attitude or humor. Adolescents and adults, however, shifted their interpretations, judging that addressees have less favorable views of criticisms than bystanders. Further, adolescents and adults differed in their perceptions of the social functions of gossip, with adolescents showing more positive attitudes than adults toward sarcastic gossip.

Conclusions

We suggest that adults' disapproval of sarcastic gossip shows a deeper understanding of the utility of sarcasm's face-saving function. Thus, the ability to modulate appreciation of sarcasm according to interpretive perspective and parties present continues to develop in adolescence and into adulthood.

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Neural Indices of Semantic Processing in Early Childhood Distinguish Eventual Stuttering Persistence and Recovery

Purpose

Maturation of neural processes for language may lag in some children who stutter (CWS), and event-related potentials (ERPs) distinguish CWS who have recovered from those who have persisted. The current study explores whether ERPs indexing semantic processing may distinguish children who will eventually persist in stuttering (CWS-ePersisted) from those who will recover from stuttering (CWS-eRecovered).

Method

Fifty-six 5-year-old children with normal receptive language listened to naturally spoken sentences in a story context. ERP components elicited for semantic processing (N400, late positive component [LPC]) were compared for CWS-ePersisted, CWS-eRecovered, and children who do not stutter (CWNS).

Results

The N400 elicited by semantic violations had a more focal scalp distribution (left lateralized and less anterior) in the CWS-eRecovered compared with CWS-ePersisted. Although the LPC elicited in CWS-eRecovered and CWNS did not differ, the LPC elicited in the CWS-ePersisted was smaller in amplitude compared with that in CWNS.

Conclusions

ERPs elicited in 5-year-old CWS-eRecovered compared with CWS-ePersisted suggest that future recovery from stuttering may be associated with earlier maturation of semantic processes in the preschool years. Subtle differences in ERP indices offer a window into neural maturation processes for language and may help distinguish the course of stuttering development.

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Novel pregnancy-triggered episodes of CAPOS syndrome.

Related Articles

Novel pregnancy-triggered episodes of CAPOS syndrome.

Am J Med Genet A. 2017 Nov 01;:

Authors: Chang IJ, Adam MP, Jayadev S, Bird TD, Natarajan N, Glass IA

Abstract
Cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss (CAPOS) syndrome (OMIM# 601338) is a rare autosomal dominant disorder characterized by episodic, fever-induced ataxic encephalopathy in childhood with residual symptoms. All identified patients have the same heterozygous missense variant c.2452G>A (p.Glu818Lys) in the ATP1A3 gene, encoding Na(+) /K(+) ATPase α3. We describe a large CAPOS pedigree with three generations of affected members, the first ascertained in the United States. Deafness, optic atrophy, and pes cavus were present in all three members of the family evaluated. In addition, one of the affected individuals experienced markedly worsening features during her three pregnancies and in the immediate postpartum period, a potential element of the natural history of CAPOS previously unreported. We conclude that the triggering factors and clinical spectrum of pathogenic ATP1A3 variants may be broader than previously described. Targeted sequencing of ATP1A3 should be considered in any patient presenting with cerebellar ataxia triggered by febrile illness, or pregnancy and delivery, especially in the presence of sensorineural hearing loss, optic atrophy, pes cavus, or early childhood history of acute encephalopathic ataxia. Prophylactic administration of acetazolamide or flunarizine may prevent acute episodes of ataxia or mitigate neurologic symptoms, although their efficacies have not been well studied.

PMID: 29090527 [PubMed - as supplied by publisher]

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Static and dynamic balance of children and adolescents with sensorineural hearing loss.

Static and dynamic balance of children and adolescents with sensorineural hearing loss.

Einstein (Sao Paulo). 2017 Jul-Sep;15(3):262-268

Authors: Melo RS, Marinho SEDS, Freire MEA, Souza RA, Damasceno HAM, Raposo MCF

Abstract
OBJECTIVE: To assess the static and dynamic balance performance of students with normal hearing and with sensorineural hearing loss.
METHODS: A cross-sectional study assessing 96 students, 48 with normal hearing and 48 with sensorineural hearing loss of both sexes, aged 7 and 18 years. To evaluate static balance, Romberg, Romberg-Barré and Fournier tests were used; and for the dynamic balance, we applied the Unterberger test.
RESULTS: Hearing loss students showed more changes in static and dynamic balance as compared to normal hearing, in all tests used (p<0.001). The same difference was found when subjects were grouped by sex. For females, Romberg, Romberg-Barré, Fournier and Unterberger test p values were, respectively, p=0.004, p<0.001, p<0.001 and p=0.023; for males, the p values were p=0.009, p<0.001, p<0.001 and p=0.002, respectively. The same difference was observed when students were classified by age. For 7 to 10 years old students, the p values for Romberg, Romberg-Barré and Fournier tests were, respectively, p=0.007, p<0.001 and p=0.001; for those aged 11 and 14 years, the p values for Romberg, Romberg-Barré, Fournier and Unterberger tests were p=0.002, p<0.001, p<0.001 and p=0.015, respectively; and for those aged 15 and 18 years, the p values for Romberg-Barré, Fournier and Unterberger tests were, respectively, p=0.037, p<0.001 and p=0.037.
CONCLUSION: Hearing-loss students showed more changes in static and dynamic balance comparing to normal hearing of same sex and age groups.

PMID: 29091145 [PubMed - in process]

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Static and dynamic balance of children and adolescents with sensorineural hearing loss.

Static and dynamic balance of children and adolescents with sensorineural hearing loss.

Einstein (Sao Paulo). 2017 Jul-Sep;15(3):262-268

Authors: Melo RS, Marinho SEDS, Freire MEA, Souza RA, Damasceno HAM, Raposo MCF

Abstract
OBJECTIVE: To assess the static and dynamic balance performance of students with normal hearing and with sensorineural hearing loss.
METHODS: A cross-sectional study assessing 96 students, 48 with normal hearing and 48 with sensorineural hearing loss of both sexes, aged 7 and 18 years. To evaluate static balance, Romberg, Romberg-Barré and Fournier tests were used; and for the dynamic balance, we applied the Unterberger test.
RESULTS: Hearing loss students showed more changes in static and dynamic balance as compared to normal hearing, in all tests used (p<0.001). The same difference was found when subjects were grouped by sex. For females, Romberg, Romberg-Barré, Fournier and Unterberger test p values were, respectively, p=0.004, p<0.001, p<0.001 and p=0.023; for males, the p values were p=0.009, p<0.001, p<0.001 and p=0.002, respectively. The same difference was observed when students were classified by age. For 7 to 10 years old students, the p values for Romberg, Romberg-Barré and Fournier tests were, respectively, p=0.007, p<0.001 and p=0.001; for those aged 11 and 14 years, the p values for Romberg, Romberg-Barré, Fournier and Unterberger tests were p=0.002, p<0.001, p<0.001 and p=0.015, respectively; and for those aged 15 and 18 years, the p values for Romberg-Barré, Fournier and Unterberger tests were, respectively, p=0.037, p<0.001 and p=0.037.
CONCLUSION: Hearing-loss students showed more changes in static and dynamic balance comparing to normal hearing of same sex and age groups.

PMID: 29091145 [PubMed - in process]

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