Planning Deficits in Children With Specific Language Impairment Are Reflected in Unnecessarily Awkward Grasps

Purpose

Specific language impairment (SLI) affects many children, but its symptomatology is still being characterized. An emerging view, which challenges the notion that SLI is specific to language, is that SLI may actually reflect a domain-general deficit in procedural learning. We explored an extension of this hypothesis that a core deficit in SLI involves a domain-general problem in planning.

Method

We used a dowel-transport task to study the extent to which 13 children with SLI and 14 typically developing (TD) controls (ages over both groups between 8;10 [years;months] and 12;11) would adopt initially awkward grasps that ensured comfortable final grasps when reaching out to move a dowel from 1 position to another (the end-state comfort effect). We predicted that children with SLI would be less likely to use end-state comfort grasps than would TD children.

Results

Contrary to our prediction, when awkward grasps were needed to ensure comfortable final grasps, participants with SLI showed the end-state comfort effect as often as the TD children did. Unexpectedly, however, in trials where awkward grasps were not needed for comfortable final grasps, the participants with SLI used more awkward grasps than did the TD participants after trials in which initial awkward grasps were needed.

Conclusion

We suggest that this perseverative behavior is indicative of a domain-general problem in planning in SLI.

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Grammar in Boys With Idiopathic Autism Spectrum Disorder and Boys With Fragile X Syndrome Plus Autism Spectrum Disorder

Purpose

Some boys with autism spectrum disorder (ASD) and boys with fragile X syndrome and a codiagnosis of ASD (FXS+ASD) have impairments in expressive grammatical abilities. The current study compared grammatical performance in these 2 groups of school-age boys.

Method

Thirty-seven boys similar on mean length of utterance participated in the current study (FXS: n = 19, ASD: n = 18). Participants completed an ASD assessment, nonverbal IQ testing, and conversation language samples. Convergent validity of a sentence imitation task with a norm-referenced assessment of grammar was examined in addition to divergent validity of the measures with nonverbal IQ and vocabulary comprehension and production.

Results

The boys with ASD outperformed the boys with FXS+ASD on the norm-referenced assessment of “be,” and effect sizes indicate that the boys with ASD had better performance on past tense probes on the sentence imitation task and “do” on the norm-referenced assessment. The two measures of grammar had good convergent validity except for copula and auxiliary “be” and “do.” Grammatical performance was not correlated with nonverbal IQ, and trends indicate a relationship between vocabulary and grammar.

Conclusions

Despite being similar on mean length of utterance, there were group differences on grammatical performance. The sentence imitation task had good convergent validity with a norm-referenced assessment of grammar for the third-person singular and past tense probes and therefore could be an inexpensive and valid tool to use clinically for these populations. Future research should continue to refine this task, particularly for the probes with high rates of unscorable responses (i.e., “be” and “do”).

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Planning Deficits in Children With Specific Language Impairment Are Reflected in Unnecessarily Awkward Grasps

Purpose

Specific language impairment (SLI) affects many children, but its symptomatology is still being characterized. An emerging view, which challenges the notion that SLI is specific to language, is that SLI may actually reflect a domain-general deficit in procedural learning. We explored an extension of this hypothesis that a core deficit in SLI involves a domain-general problem in planning.

Method

We used a dowel-transport task to study the extent to which 13 children with SLI and 14 typically developing (TD) controls (ages over both groups between 8;10 [years;months] and 12;11) would adopt initially awkward grasps that ensured comfortable final grasps when reaching out to move a dowel from 1 position to another (the end-state comfort effect). We predicted that children with SLI would be less likely to use end-state comfort grasps than would TD children.

Results

Contrary to our prediction, when awkward grasps were needed to ensure comfortable final grasps, participants with SLI showed the end-state comfort effect as often as the TD children did. Unexpectedly, however, in trials where awkward grasps were not needed for comfortable final grasps, the participants with SLI used more awkward grasps than did the TD participants after trials in which initial awkward grasps were needed.

Conclusion

We suggest that this perseverative behavior is indicative of a domain-general problem in planning in SLI.

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Grammar in Boys With Idiopathic Autism Spectrum Disorder and Boys With Fragile X Syndrome Plus Autism Spectrum Disorder

Purpose

Some boys with autism spectrum disorder (ASD) and boys with fragile X syndrome and a codiagnosis of ASD (FXS+ASD) have impairments in expressive grammatical abilities. The current study compared grammatical performance in these 2 groups of school-age boys.

Method

Thirty-seven boys similar on mean length of utterance participated in the current study (FXS: n = 19, ASD: n = 18). Participants completed an ASD assessment, nonverbal IQ testing, and conversation language samples. Convergent validity of a sentence imitation task with a norm-referenced assessment of grammar was examined in addition to divergent validity of the measures with nonverbal IQ and vocabulary comprehension and production.

Results

The boys with ASD outperformed the boys with FXS+ASD on the norm-referenced assessment of “be,” and effect sizes indicate that the boys with ASD had better performance on past tense probes on the sentence imitation task and “do” on the norm-referenced assessment. The two measures of grammar had good convergent validity except for copula and auxiliary “be” and “do.” Grammatical performance was not correlated with nonverbal IQ, and trends indicate a relationship between vocabulary and grammar.

Conclusions

Despite being similar on mean length of utterance, there were group differences on grammatical performance. The sentence imitation task had good convergent validity with a norm-referenced assessment of grammar for the third-person singular and past tense probes and therefore could be an inexpensive and valid tool to use clinically for these populations. Future research should continue to refine this task, particularly for the probes with high rates of unscorable responses (i.e., “be” and “do”).

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Planning Deficits in Children With Specific Language Impairment Are Reflected in Unnecessarily Awkward Grasps

Purpose

Specific language impairment (SLI) affects many children, but its symptomatology is still being characterized. An emerging view, which challenges the notion that SLI is specific to language, is that SLI may actually reflect a domain-general deficit in procedural learning. We explored an extension of this hypothesis that a core deficit in SLI involves a domain-general problem in planning.

Method

We used a dowel-transport task to study the extent to which 13 children with SLI and 14 typically developing (TD) controls (ages over both groups between 8;10 [years;months] and 12;11) would adopt initially awkward grasps that ensured comfortable final grasps when reaching out to move a dowel from 1 position to another (the end-state comfort effect). We predicted that children with SLI would be less likely to use end-state comfort grasps than would TD children.

Results

Contrary to our prediction, when awkward grasps were needed to ensure comfortable final grasps, participants with SLI showed the end-state comfort effect as often as the TD children did. Unexpectedly, however, in trials where awkward grasps were not needed for comfortable final grasps, the participants with SLI used more awkward grasps than did the TD participants after trials in which initial awkward grasps were needed.

Conclusion

We suggest that this perseverative behavior is indicative of a domain-general problem in planning in SLI.

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Grammar in Boys With Idiopathic Autism Spectrum Disorder and Boys With Fragile X Syndrome Plus Autism Spectrum Disorder

Purpose

Some boys with autism spectrum disorder (ASD) and boys with fragile X syndrome and a codiagnosis of ASD (FXS+ASD) have impairments in expressive grammatical abilities. The current study compared grammatical performance in these 2 groups of school-age boys.

Method

Thirty-seven boys similar on mean length of utterance participated in the current study (FXS: n = 19, ASD: n = 18). Participants completed an ASD assessment, nonverbal IQ testing, and conversation language samples. Convergent validity of a sentence imitation task with a norm-referenced assessment of grammar was examined in addition to divergent validity of the measures with nonverbal IQ and vocabulary comprehension and production.

Results

The boys with ASD outperformed the boys with FXS+ASD on the norm-referenced assessment of “be,” and effect sizes indicate that the boys with ASD had better performance on past tense probes on the sentence imitation task and “do” on the norm-referenced assessment. The two measures of grammar had good convergent validity except for copula and auxiliary “be” and “do.” Grammatical performance was not correlated with nonverbal IQ, and trends indicate a relationship between vocabulary and grammar.

Conclusions

Despite being similar on mean length of utterance, there were group differences on grammatical performance. The sentence imitation task had good convergent validity with a norm-referenced assessment of grammar for the third-person singular and past tense probes and therefore could be an inexpensive and valid tool to use clinically for these populations. Future research should continue to refine this task, particularly for the probes with high rates of unscorable responses (i.e., “be” and “do”).

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Objective measures for detecting the auditory brainstem response: comparisons of specificity, sensitivity and detection time

.


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Objective measures for detecting the auditory brainstem response: comparisons of specificity, sensitivity and detection time

.


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Objective measures for detecting the auditory brainstem response: comparisons of specificity, sensitivity and detection time

.


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Effects of cochlear synaptopathy on middle-ear muscle reflexes in unanesthetized mice

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): M.D. Valero, K.E. Hancock, S.F. Maison, M.C. Liberman
Cochlear synaptopathy, i.e. the loss of auditory-nerve connections with cochlear hair cells, is seen in aging, noise damage, and other types of acquired sensorineural hearing loss. Because the subset of auditory-nerve fibers with high thresholds and low spontaneous rates (SRs) is disproportionately affected, audiometric thresholds are relatively insensitive to this primary neural degeneration. Although, suprathreshold amplitudes of wave I of the auditory brainstem response (ABR) are attenuated in synaptopathic mice, there is not yet a robust diagnostic in humans. The middle-ear muscle reflex (MEMR) might be a sensitive metric (Valero et al., 2016), because low-SR fibers may be important drivers of the MEMR (Liberman and Kiang, 1984; Kobler et al., 1992). Here, to test the hypothesis that narrowband reflex elicitors can identify synaptopathic cochlear regions, we measured reflex growth functions in unanesthetized mice with varying degrees of noise-induced synaptopathy and in unexposed controls. To separate effects of the MEMR from those of the medial olivocochlear reflex, the other sound-evoked cochlear feedback loop, we used a mutant mouse strain with deletion of the acetylcholine receptor required for olivocochlear function. We demonstrate that the MEMR is normal when activated from non-synaptopathic cochlear regions and greatly weakened in synaptopathic regions and is a more sensitive indicator of moderate synaptopathy than the suprathreshold amplitude of ABR wave I.



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Addressing variability in the acoustic startle reflex for accurate gap detection assessment

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Ryan J. Longenecker, Inga Kristaponyte, Gregg L. Nelson, Jesse W. Young, Alexander V. Galazyuk
The acoustic startle reflex (ASR) is subject to substantial variability. This inherent variability consequently shapes the conclusions drawn from gap-induced prepulse inhibition of the acoustic startle reflex (GPIAS) assessments. Recent studies have cast doubt as to the efficacy of this methodology as it pertains to tinnitus assessment, partially, due to variability in and between data sets. The goal of this study was to examine the variance associated with several common data collection variables and data analyses with the aim to improve GPIAS reliability. To study this the GPIAS tests were conducted in adult male and female CBA/CaJ mice. Factors such as inter-trial interval, circadian rhythm, sex differences, and sensory adaptation were each evaluated. We then examined various data analysis factors which influence GPIAS assessment. Gap-induced facilitation, data processing options, and assessments of tinnitus were studied. We found that the startle reflex is highly variable in CBA/CaJ mice, but that this can be minimized by certain data collection factors. We also found that careful consideration of temporal fluctuations of the ASR and controlling for facilitation can lead to drastically divergent GPIAS results. Finally, we show that tinnitus decreases gap-induced inhibition of the acoustic startle reflex, but only for short gap durations. This study provides a guide for reducing variance in the GPIAS methodology – thereby improving the diagnostic power of the test.



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Paraquat initially damages cochlear support cells leading to anoikis-like hair cell death

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Jianhui Zhang, Hong Sun, Richard Salvi, Dalian Ding
Paraquat (PQ), one of the most widely used herbicides, is extremely dangerous because it generates the highly toxic superoxide radical. When paraquat was applied to cochlear organotypic cultures, it not only damaged the outer hair cells (OHCs) and inner hair cells (IHCs), but also caused dislocation of the hair cell rows. We hypothesized that the dislocation arose from damage to the support cells (SCs) that anchors hair cells within the epithelium. To test this hypothesis, rat postnatal cochlear cultures were treated with PQ. Shortly after PQ treatment, the rows of OHCs separated from one another and migrated radially away from IHCs suggesting loss of cell-cell adhesion that hold the hair cells in proper alignment. Hair cells dislocation was associated with extensive loss of SCs in the organ of Corti, loss of tympanic border cells (TBCs) beneath the basilar membrane, the early appearance of superoxide staining and caspase-8 labeling in SCs below the OHCs and disintegration of E-cadherin and β-catenin in the organ of Corti. Damage to the TBCs and SCs occurred prior to loss of OHC or IHC loss suggesting a form of detachment-induced apoptosis referred to as anoikis.



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Auditory and language outcomes in children with unilateral hearing loss

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Elizabeth M. Fitzpatrick, Isabelle Gaboury, Andrée Durieux-Smith, Doug Coyle, JoAnne Whittingham, Flora Nassrallah
ObjectivesChildren with unilateral hearing loss (UHL) are being diagnosed at younger ages because of newborn hearing screening. Historically, they have been considered at risk for difficulties in listening and language development. Little information is available on contemporary cohorts of children identified in the early months of life. We examined auditory and language acquisition outcomes in a contemporary cohort of early-identified children with UHL and compared their outcomes at preschool age with peers with mild bilateral loss and with normal hearing.DesignAs part of the Mild and Unilateral Hearing Loss in Children Study, we collected auditory and spoken language outcomes on children with unilateral, bilateral hearing loss and with normal hearing over a four-year period. This report provides a cross-sectional analysis of results at age 48 months. A total of 120 children (38 unilateral and 31 bilateral mild, 51 normal hearing) were enrolled in the study from 2010 to 2015. Children started the study at varying ages between 12 and 36 months of age and were followed until age 36–48 months. The median age of identification of hearing loss was 3.4 months (IQR: 2.0, 5.5) for unilateral and 3.6 months (IQR: 2.7, 5.9) for the mild bilateral group. Families completed an intake form at enrolment to provide baseline child and family-related characteristics. Data on amplification fitting and use were collected via parent questionnaires at each annual assessment interval. This study involved a range of auditory development and language measures. For this report, we focus on the end of follow-up results from two auditory development questionnaires and three standardized speech-language assessments. Assessments included in this report were completed at a median age of 47.8 months (IQR: 38.8, 48.5). Using ANOVA, we examined auditory and language outcomes in children with UHL and compared their scores to children with mild bilateral hearing loss and those with normal hearing.ResultsOn most measures, children with UHL performed poorer than those in the mild bilateral and normal hearing study groups. All children with hearing loss performed at lower levels compared to the normal hearing control group. However, mean standard scores for the normal hearing group in this study were above normative means for the language measures. In particular, children with UHL showed gaps compared to the normal hearing control group in functional auditory listening and in receptive and expressive language skills (three quarters of one standard deviation below) at age 48 months. Their performance in receptive vocabulary and speech production was not significantly different from that of their hearing peers (p < 0.001).ConclusionsEven when identified in the first months of life, children with UHL show a tendency to lag behind their normal hearing peers in functional auditory listening and in receptive and expressive language development.



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Effects of cochlear synaptopathy on middle-ear muscle reflexes in unanesthetized mice

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): M.D. Valero, K.E. Hancock, S.F. Maison, M.C. Liberman
Cochlear synaptopathy, i.e. the loss of auditory-nerve connections with cochlear hair cells, is seen in aging, noise damage, and other types of acquired sensorineural hearing loss. Because the subset of auditory-nerve fibers with high thresholds and low spontaneous rates (SRs) is disproportionately affected, audiometric thresholds are relatively insensitive to this primary neural degeneration. Although, suprathreshold amplitudes of wave I of the auditory brainstem response (ABR) are attenuated in synaptopathic mice, there is not yet a robust diagnostic in humans. The middle-ear muscle reflex (MEMR) might be a sensitive metric (Valero et al., 2016), because low-SR fibers may be important drivers of the MEMR (Liberman and Kiang, 1984; Kobler et al., 1992). Here, to test the hypothesis that narrowband reflex elicitors can identify synaptopathic cochlear regions, we measured reflex growth functions in unanesthetized mice with varying degrees of noise-induced synaptopathy and in unexposed controls. To separate effects of the MEMR from those of the medial olivocochlear reflex, the other sound-evoked cochlear feedback loop, we used a mutant mouse strain with deletion of the acetylcholine receptor required for olivocochlear function. We demonstrate that the MEMR is normal when activated from non-synaptopathic cochlear regions and greatly weakened in synaptopathic regions and is a more sensitive indicator of moderate synaptopathy than the suprathreshold amplitude of ABR wave I.



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Addressing variability in the acoustic startle reflex for accurate gap detection assessment

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Ryan J. Longenecker, Inga Kristaponyte, Gregg L. Nelson, Jesse W. Young, Alexander V. Galazyuk
The acoustic startle reflex (ASR) is subject to substantial variability. This inherent variability consequently shapes the conclusions drawn from gap-induced prepulse inhibition of the acoustic startle reflex (GPIAS) assessments. Recent studies have cast doubt as to the efficacy of this methodology as it pertains to tinnitus assessment, partially, due to variability in and between data sets. The goal of this study was to examine the variance associated with several common data collection variables and data analyses with the aim to improve GPIAS reliability. To study this the GPIAS tests were conducted in adult male and female CBA/CaJ mice. Factors such as inter-trial interval, circadian rhythm, sex differences, and sensory adaptation were each evaluated. We then examined various data analysis factors which influence GPIAS assessment. Gap-induced facilitation, data processing options, and assessments of tinnitus were studied. We found that the startle reflex is highly variable in CBA/CaJ mice, but that this can be minimized by certain data collection factors. We also found that careful consideration of temporal fluctuations of the ASR and controlling for facilitation can lead to drastically divergent GPIAS results. Finally, we show that tinnitus decreases gap-induced inhibition of the acoustic startle reflex, but only for short gap durations. This study provides a guide for reducing variance in the GPIAS methodology – thereby improving the diagnostic power of the test.



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Paraquat initially damages cochlear support cells leading to anoikis-like hair cell death

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Jianhui Zhang, Hong Sun, Richard Salvi, Dalian Ding
Paraquat (PQ), one of the most widely used herbicides, is extremely dangerous because it generates the highly toxic superoxide radical. When paraquat was applied to cochlear organotypic cultures, it not only damaged the outer hair cells (OHCs) and inner hair cells (IHCs), but also caused dislocation of the hair cell rows. We hypothesized that the dislocation arose from damage to the support cells (SCs) that anchors hair cells within the epithelium. To test this hypothesis, rat postnatal cochlear cultures were treated with PQ. Shortly after PQ treatment, the rows of OHCs separated from one another and migrated radially away from IHCs suggesting loss of cell-cell adhesion that hold the hair cells in proper alignment. Hair cells dislocation was associated with extensive loss of SCs in the organ of Corti, loss of tympanic border cells (TBCs) beneath the basilar membrane, the early appearance of superoxide staining and caspase-8 labeling in SCs below the OHCs and disintegration of E-cadherin and β-catenin in the organ of Corti. Damage to the TBCs and SCs occurred prior to loss of OHC or IHC loss suggesting a form of detachment-induced apoptosis referred to as anoikis.



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Auditory and language outcomes in children with unilateral hearing loss

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Elizabeth M. Fitzpatrick, Isabelle Gaboury, Andrée Durieux-Smith, Doug Coyle, JoAnne Whittingham, Flora Nassrallah
ObjectivesChildren with unilateral hearing loss (UHL) are being diagnosed at younger ages because of newborn hearing screening. Historically, they have been considered at risk for difficulties in listening and language development. Little information is available on contemporary cohorts of children identified in the early months of life. We examined auditory and language acquisition outcomes in a contemporary cohort of early-identified children with UHL and compared their outcomes at preschool age with peers with mild bilateral loss and with normal hearing.DesignAs part of the Mild and Unilateral Hearing Loss in Children Study, we collected auditory and spoken language outcomes on children with unilateral, bilateral hearing loss and with normal hearing over a four-year period. This report provides a cross-sectional analysis of results at age 48 months. A total of 120 children (38 unilateral and 31 bilateral mild, 51 normal hearing) were enrolled in the study from 2010 to 2015. Children started the study at varying ages between 12 and 36 months of age and were followed until age 36–48 months. The median age of identification of hearing loss was 3.4 months (IQR: 2.0, 5.5) for unilateral and 3.6 months (IQR: 2.7, 5.9) for the mild bilateral group. Families completed an intake form at enrolment to provide baseline child and family-related characteristics. Data on amplification fitting and use were collected via parent questionnaires at each annual assessment interval. This study involved a range of auditory development and language measures. For this report, we focus on the end of follow-up results from two auditory development questionnaires and three standardized speech-language assessments. Assessments included in this report were completed at a median age of 47.8 months (IQR: 38.8, 48.5). Using ANOVA, we examined auditory and language outcomes in children with UHL and compared their scores to children with mild bilateral hearing loss and those with normal hearing.ResultsOn most measures, children with UHL performed poorer than those in the mild bilateral and normal hearing study groups. All children with hearing loss performed at lower levels compared to the normal hearing control group. However, mean standard scores for the normal hearing group in this study were above normative means for the language measures. In particular, children with UHL showed gaps compared to the normal hearing control group in functional auditory listening and in receptive and expressive language skills (three quarters of one standard deviation below) at age 48 months. Their performance in receptive vocabulary and speech production was not significantly different from that of their hearing peers (p < 0.001).ConclusionsEven when identified in the first months of life, children with UHL show a tendency to lag behind their normal hearing peers in functional auditory listening and in receptive and expressive language development.



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The effect of positive sagittal spine balance and reconstruction surgery on standing balance

Publication date: Available online 13 March 2018
Source:Gait & Posture
Author(s): Pranitha Gottipati, Rebecca Stine, Aruna Ganju, Stefania Fatone
BackgroundPositive sagittal spine balance (PSSB) may adversely influence standing balance in individuals with degenerative spine diseases. PSSB is often corrected with the help of spinal reconstructive surgeries involving multiple vertebral units.Research QuestionThis study investigated the effect of PSSB and reconstructive surgery on postural sway as a measure of standing balance. The secondary goal of this study was to investigate the effect of reconstructive surgery on lower limb kinematics.MethodsSubjects who underwent spinal reconstructive surgery for correction of PSSB greater than or equal to 7 cm participated in this study. Postural sway data while standing quietly for 20 seconds on a force platform were analyzed pre-operatively, 6 and 24 months post-operatively.ResultsReconstructive surgery was successful in correcting PSSB in all individuals. There was a moderate correlation between PSSB and postural sway in the anterior-posterior (AP) direction before surgery (r = 0.58) and at 6–12 months post-surgery (r = 0.63). Reconstructive surgery had a significant main effect on postural sway in both the anterior-posterior (p < 0.009, F = 7.01) and medial-lateral directions (p < 0, F = 12.30). Reconstructive surgery also had a significant main effect on standing hip (p < 0, F = 17.01) and knee flexion (p < 0, F = 32.23).SignificanceThese results reveal that PSSB in persons with degenerative spinal conditions compromised postural balance, which improved after reconstructive surgery. Additionally, persons with PSSB adopted a crouch posture, which resolved after reconstructive surgery.



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The effect of positive sagittal spine balance and reconstruction surgery on standing balance

Publication date: Available online 13 March 2018
Source:Gait & Posture
Author(s): Pranitha Gottipati, Rebecca Stine, Aruna Ganju, Stefania Fatone
BackgroundPositive sagittal spine balance (PSSB) may adversely influence standing balance in individuals with degenerative spine diseases. PSSB is often corrected with the help of spinal reconstructive surgeries involving multiple vertebral units.Research QuestionThis study investigated the effect of PSSB and reconstructive surgery on postural sway as a measure of standing balance. The secondary goal of this study was to investigate the effect of reconstructive surgery on lower limb kinematics.MethodsSubjects who underwent spinal reconstructive surgery for correction of PSSB greater than or equal to 7 cm participated in this study. Postural sway data while standing quietly for 20 seconds on a force platform were analyzed pre-operatively, 6 and 24 months post-operatively.ResultsReconstructive surgery was successful in correcting PSSB in all individuals. There was a moderate correlation between PSSB and postural sway in the anterior-posterior (AP) direction before surgery (r = 0.58) and at 6–12 months post-surgery (r = 0.63). Reconstructive surgery had a significant main effect on postural sway in both the anterior-posterior (p < 0.009, F = 7.01) and medial-lateral directions (p < 0, F = 12.30). Reconstructive surgery also had a significant main effect on standing hip (p < 0, F = 17.01) and knee flexion (p < 0, F = 32.23).SignificanceThese results reveal that PSSB in persons with degenerative spinal conditions compromised postural balance, which improved after reconstructive surgery. Additionally, persons with PSSB adopted a crouch posture, which resolved after reconstructive surgery.



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The effect of positive sagittal spine balance and reconstruction surgery on standing balance

Publication date: Available online 13 March 2018
Source:Gait & Posture
Author(s): Pranitha Gottipati, Rebecca Stine, Aruna Ganju, Stefania Fatone
BackgroundPositive sagittal spine balance (PSSB) may adversely influence standing balance in individuals with degenerative spine diseases. PSSB is often corrected with the help of spinal reconstructive surgeries involving multiple vertebral units.Research QuestionThis study investigated the effect of PSSB and reconstructive surgery on postural sway as a measure of standing balance. The secondary goal of this study was to investigate the effect of reconstructive surgery on lower limb kinematics.MethodsSubjects who underwent spinal reconstructive surgery for correction of PSSB greater than or equal to 7 cm participated in this study. Postural sway data while standing quietly for 20 seconds on a force platform were analyzed pre-operatively, 6 and 24 months post-operatively.ResultsReconstructive surgery was successful in correcting PSSB in all individuals. There was a moderate correlation between PSSB and postural sway in the anterior-posterior (AP) direction before surgery (r = 0.58) and at 6–12 months post-surgery (r = 0.63). Reconstructive surgery had a significant main effect on postural sway in both the anterior-posterior (p < 0.009, F = 7.01) and medial-lateral directions (p < 0, F = 12.30). Reconstructive surgery also had a significant main effect on standing hip (p < 0, F = 17.01) and knee flexion (p < 0, F = 32.23).SignificanceThese results reveal that PSSB in persons with degenerative spinal conditions compromised postural balance, which improved after reconstructive surgery. Additionally, persons with PSSB adopted a crouch posture, which resolved after reconstructive surgery.



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Effects of cochlear synaptopathy on middle-ear muscle reflexes in unanesthetized mice

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): M.D. Valero, K.E. Hancock, S.F. Maison, M.C. Liberman
Cochlear synaptopathy, i.e. the loss of auditory-nerve connections with cochlear hair cells, is seen in aging, noise damage, and other types of acquired sensorineural hearing loss. Because the subset of auditory-nerve fibers with high thresholds and low spontaneous rates (SRs) is disproportionately affected, audiometric thresholds are relatively insensitive to this primary neural degeneration. Although, suprathreshold amplitudes of wave I of the auditory brainstem response (ABR) are attenuated in synaptopathic mice, there is not yet a robust diagnostic in humans. The middle-ear muscle reflex (MEMR) might be a sensitive metric (Valero et al., 2016), because low-SR fibers may be important drivers of the MEMR (Liberman and Kiang, 1984; Kobler et al., 1992). Here, to test the hypothesis that narrowband reflex elicitors can identify synaptopathic cochlear regions, we measured reflex growth functions in unanesthetized mice with varying degrees of noise-induced synaptopathy and in unexposed controls. To separate effects of the MEMR from those of the medial olivocochlear reflex, the other sound-evoked cochlear feedback loop, we used a mutant mouse strain with deletion of the acetylcholine receptor required for olivocochlear function. We demonstrate that the MEMR is normal when activated from non-synaptopathic cochlear regions and greatly weakened in synaptopathic regions and is a more sensitive indicator of moderate synaptopathy than the suprathreshold amplitude of ABR wave I.



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Addressing variability in the acoustic startle reflex for accurate gap detection assessment

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Ryan J. Longenecker, Inga Kristaponyte, Gregg L. Nelson, Jesse W. Young, Alexander V. Galazyuk
The acoustic startle reflex (ASR) is subject to substantial variability. This inherent variability consequently shapes the conclusions drawn from gap-induced prepulse inhibition of the acoustic startle reflex (GPIAS) assessments. Recent studies have cast doubt as to the efficacy of this methodology as it pertains to tinnitus assessment, partially, due to variability in and between data sets. The goal of this study was to examine the variance associated with several common data collection variables and data analyses with the aim to improve GPIAS reliability. To study this the GPIAS tests were conducted in adult male and female CBA/CaJ mice. Factors such as inter-trial interval, circadian rhythm, sex differences, and sensory adaptation were each evaluated. We then examined various data analysis factors which influence GPIAS assessment. Gap-induced facilitation, data processing options, and assessments of tinnitus were studied. We found that the startle reflex is highly variable in CBA/CaJ mice, but that this can be minimized by certain data collection factors. We also found that careful consideration of temporal fluctuations of the ASR and controlling for facilitation can lead to drastically divergent GPIAS results. Finally, we show that tinnitus decreases gap-induced inhibition of the acoustic startle reflex, but only for short gap durations. This study provides a guide for reducing variance in the GPIAS methodology – thereby improving the diagnostic power of the test.



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Paraquat initially damages cochlear support cells leading to anoikis-like hair cell death

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Jianhui Zhang, Hong Sun, Richard Salvi, Dalian Ding
Paraquat (PQ), one of the most widely used herbicides, is extremely dangerous because it generates the highly toxic superoxide radical. When paraquat was applied to cochlear organotypic cultures, it not only damaged the outer hair cells (OHCs) and inner hair cells (IHCs), but also caused dislocation of the hair cell rows. We hypothesized that the dislocation arose from damage to the support cells (SCs) that anchors hair cells within the epithelium. To test this hypothesis, rat postnatal cochlear cultures were treated with PQ. Shortly after PQ treatment, the rows of OHCs separated from one another and migrated radially away from IHCs suggesting loss of cell-cell adhesion that hold the hair cells in proper alignment. Hair cells dislocation was associated with extensive loss of SCs in the organ of Corti, loss of tympanic border cells (TBCs) beneath the basilar membrane, the early appearance of superoxide staining and caspase-8 labeling in SCs below the OHCs and disintegration of E-cadherin and β-catenin in the organ of Corti. Damage to the TBCs and SCs occurred prior to loss of OHC or IHC loss suggesting a form of detachment-induced apoptosis referred to as anoikis.



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Auditory and language outcomes in children with unilateral hearing loss

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Elizabeth M. Fitzpatrick, Isabelle Gaboury, Andrée Durieux-Smith, Doug Coyle, JoAnne Whittingham, Flora Nassrallah
ObjectivesChildren with unilateral hearing loss (UHL) are being diagnosed at younger ages because of newborn hearing screening. Historically, they have been considered at risk for difficulties in listening and language development. Little information is available on contemporary cohorts of children identified in the early months of life. We examined auditory and language acquisition outcomes in a contemporary cohort of early-identified children with UHL and compared their outcomes at preschool age with peers with mild bilateral loss and with normal hearing.DesignAs part of the Mild and Unilateral Hearing Loss in Children Study, we collected auditory and spoken language outcomes on children with unilateral, bilateral hearing loss and with normal hearing over a four-year period. This report provides a cross-sectional analysis of results at age 48 months. A total of 120 children (38 unilateral and 31 bilateral mild, 51 normal hearing) were enrolled in the study from 2010 to 2015. Children started the study at varying ages between 12 and 36 months of age and were followed until age 36–48 months. The median age of identification of hearing loss was 3.4 months (IQR: 2.0, 5.5) for unilateral and 3.6 months (IQR: 2.7, 5.9) for the mild bilateral group. Families completed an intake form at enrolment to provide baseline child and family-related characteristics. Data on amplification fitting and use were collected via parent questionnaires at each annual assessment interval. This study involved a range of auditory development and language measures. For this report, we focus on the end of follow-up results from two auditory development questionnaires and three standardized speech-language assessments. Assessments included in this report were completed at a median age of 47.8 months (IQR: 38.8, 48.5). Using ANOVA, we examined auditory and language outcomes in children with UHL and compared their scores to children with mild bilateral hearing loss and those with normal hearing.ResultsOn most measures, children with UHL performed poorer than those in the mild bilateral and normal hearing study groups. All children with hearing loss performed at lower levels compared to the normal hearing control group. However, mean standard scores for the normal hearing group in this study were above normative means for the language measures. In particular, children with UHL showed gaps compared to the normal hearing control group in functional auditory listening and in receptive and expressive language skills (three quarters of one standard deviation below) at age 48 months. Their performance in receptive vocabulary and speech production was not significantly different from that of their hearing peers (p < 0.001).ConclusionsEven when identified in the first months of life, children with UHL show a tendency to lag behind their normal hearing peers in functional auditory listening and in receptive and expressive language development.



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Effects of cochlear synaptopathy on middle-ear muscle reflexes in unanesthetized mice

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): M.D. Valero, K.E. Hancock, S.F. Maison, M.C. Liberman
Cochlear synaptopathy, i.e. the loss of auditory-nerve connections with cochlear hair cells, is seen in aging, noise damage, and other types of acquired sensorineural hearing loss. Because the subset of auditory-nerve fibers with high thresholds and low spontaneous rates (SRs) is disproportionately affected, audiometric thresholds are relatively insensitive to this primary neural degeneration. Although, suprathreshold amplitudes of wave I of the auditory brainstem response (ABR) are attenuated in synaptopathic mice, there is not yet a robust diagnostic in humans. The middle-ear muscle reflex (MEMR) might be a sensitive metric (Valero et al., 2016), because low-SR fibers may be important drivers of the MEMR (Liberman and Kiang, 1984; Kobler et al., 1992). Here, to test the hypothesis that narrowband reflex elicitors can identify synaptopathic cochlear regions, we measured reflex growth functions in unanesthetized mice with varying degrees of noise-induced synaptopathy and in unexposed controls. To separate effects of the MEMR from those of the medial olivocochlear reflex, the other sound-evoked cochlear feedback loop, we used a mutant mouse strain with deletion of the acetylcholine receptor required for olivocochlear function. We demonstrate that the MEMR is normal when activated from non-synaptopathic cochlear regions and greatly weakened in synaptopathic regions and is a more sensitive indicator of moderate synaptopathy than the suprathreshold amplitude of ABR wave I.



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Addressing variability in the acoustic startle reflex for accurate gap detection assessment

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Ryan J. Longenecker, Inga Kristaponyte, Gregg L. Nelson, Jesse W. Young, Alexander V. Galazyuk
The acoustic startle reflex (ASR) is subject to substantial variability. This inherent variability consequently shapes the conclusions drawn from gap-induced prepulse inhibition of the acoustic startle reflex (GPIAS) assessments. Recent studies have cast doubt as to the efficacy of this methodology as it pertains to tinnitus assessment, partially, due to variability in and between data sets. The goal of this study was to examine the variance associated with several common data collection variables and data analyses with the aim to improve GPIAS reliability. To study this the GPIAS tests were conducted in adult male and female CBA/CaJ mice. Factors such as inter-trial interval, circadian rhythm, sex differences, and sensory adaptation were each evaluated. We then examined various data analysis factors which influence GPIAS assessment. Gap-induced facilitation, data processing options, and assessments of tinnitus were studied. We found that the startle reflex is highly variable in CBA/CaJ mice, but that this can be minimized by certain data collection factors. We also found that careful consideration of temporal fluctuations of the ASR and controlling for facilitation can lead to drastically divergent GPIAS results. Finally, we show that tinnitus decreases gap-induced inhibition of the acoustic startle reflex, but only for short gap durations. This study provides a guide for reducing variance in the GPIAS methodology – thereby improving the diagnostic power of the test.



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Paraquat initially damages cochlear support cells leading to anoikis-like hair cell death

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Jianhui Zhang, Hong Sun, Richard Salvi, Dalian Ding
Paraquat (PQ), one of the most widely used herbicides, is extremely dangerous because it generates the highly toxic superoxide radical. When paraquat was applied to cochlear organotypic cultures, it not only damaged the outer hair cells (OHCs) and inner hair cells (IHCs), but also caused dislocation of the hair cell rows. We hypothesized that the dislocation arose from damage to the support cells (SCs) that anchors hair cells within the epithelium. To test this hypothesis, rat postnatal cochlear cultures were treated with PQ. Shortly after PQ treatment, the rows of OHCs separated from one another and migrated radially away from IHCs suggesting loss of cell-cell adhesion that hold the hair cells in proper alignment. Hair cells dislocation was associated with extensive loss of SCs in the organ of Corti, loss of tympanic border cells (TBCs) beneath the basilar membrane, the early appearance of superoxide staining and caspase-8 labeling in SCs below the OHCs and disintegration of E-cadherin and β-catenin in the organ of Corti. Damage to the TBCs and SCs occurred prior to loss of OHC or IHC loss suggesting a form of detachment-induced apoptosis referred to as anoikis.



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Auditory and language outcomes in children with unilateral hearing loss

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Elizabeth M. Fitzpatrick, Isabelle Gaboury, Andrée Durieux-Smith, Doug Coyle, JoAnne Whittingham, Flora Nassrallah
ObjectivesChildren with unilateral hearing loss (UHL) are being diagnosed at younger ages because of newborn hearing screening. Historically, they have been considered at risk for difficulties in listening and language development. Little information is available on contemporary cohorts of children identified in the early months of life. We examined auditory and language acquisition outcomes in a contemporary cohort of early-identified children with UHL and compared their outcomes at preschool age with peers with mild bilateral loss and with normal hearing.DesignAs part of the Mild and Unilateral Hearing Loss in Children Study, we collected auditory and spoken language outcomes on children with unilateral, bilateral hearing loss and with normal hearing over a four-year period. This report provides a cross-sectional analysis of results at age 48 months. A total of 120 children (38 unilateral and 31 bilateral mild, 51 normal hearing) were enrolled in the study from 2010 to 2015. Children started the study at varying ages between 12 and 36 months of age and were followed until age 36–48 months. The median age of identification of hearing loss was 3.4 months (IQR: 2.0, 5.5) for unilateral and 3.6 months (IQR: 2.7, 5.9) for the mild bilateral group. Families completed an intake form at enrolment to provide baseline child and family-related characteristics. Data on amplification fitting and use were collected via parent questionnaires at each annual assessment interval. This study involved a range of auditory development and language measures. For this report, we focus on the end of follow-up results from two auditory development questionnaires and three standardized speech-language assessments. Assessments included in this report were completed at a median age of 47.8 months (IQR: 38.8, 48.5). Using ANOVA, we examined auditory and language outcomes in children with UHL and compared their scores to children with mild bilateral hearing loss and those with normal hearing.ResultsOn most measures, children with UHL performed poorer than those in the mild bilateral and normal hearing study groups. All children with hearing loss performed at lower levels compared to the normal hearing control group. However, mean standard scores for the normal hearing group in this study were above normative means for the language measures. In particular, children with UHL showed gaps compared to the normal hearing control group in functional auditory listening and in receptive and expressive language skills (three quarters of one standard deviation below) at age 48 months. Their performance in receptive vocabulary and speech production was not significantly different from that of their hearing peers (p < 0.001).ConclusionsEven when identified in the first months of life, children with UHL show a tendency to lag behind their normal hearing peers in functional auditory listening and in receptive and expressive language development.



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Effects of cochlear synaptopathy on middle-ear muscle reflexes in unanesthetized mice

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): M.D. Valero, K.E. Hancock, S.F. Maison, M.C. Liberman
Cochlear synaptopathy, i.e. the loss of auditory-nerve connections with cochlear hair cells, is seen in aging, noise damage, and other types of acquired sensorineural hearing loss. Because the subset of auditory-nerve fibers with high thresholds and low spontaneous rates (SRs) is disproportionately affected, audiometric thresholds are relatively insensitive to this primary neural degeneration. Although, suprathreshold amplitudes of wave I of the auditory brainstem response (ABR) are attenuated in synaptopathic mice, there is not yet a robust diagnostic in humans. The middle-ear muscle reflex (MEMR) might be a sensitive metric (Valero et al., 2016), because low-SR fibers may be important drivers of the MEMR (Liberman and Kiang, 1984; Kobler et al., 1992). Here, to test the hypothesis that narrowband reflex elicitors can identify synaptopathic cochlear regions, we measured reflex growth functions in unanesthetized mice with varying degrees of noise-induced synaptopathy and in unexposed controls. To separate effects of the MEMR from those of the medial olivocochlear reflex, the other sound-evoked cochlear feedback loop, we used a mutant mouse strain with deletion of the acetylcholine receptor required for olivocochlear function. We demonstrate that the MEMR is normal when activated from non-synaptopathic cochlear regions and greatly weakened in synaptopathic regions and is a more sensitive indicator of moderate synaptopathy than the suprathreshold amplitude of ABR wave I.



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Addressing variability in the acoustic startle reflex for accurate gap detection assessment

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Ryan J. Longenecker, Inga Kristaponyte, Gregg L. Nelson, Jesse W. Young, Alexander V. Galazyuk
The acoustic startle reflex (ASR) is subject to substantial variability. This inherent variability consequently shapes the conclusions drawn from gap-induced prepulse inhibition of the acoustic startle reflex (GPIAS) assessments. Recent studies have cast doubt as to the efficacy of this methodology as it pertains to tinnitus assessment, partially, due to variability in and between data sets. The goal of this study was to examine the variance associated with several common data collection variables and data analyses with the aim to improve GPIAS reliability. To study this the GPIAS tests were conducted in adult male and female CBA/CaJ mice. Factors such as inter-trial interval, circadian rhythm, sex differences, and sensory adaptation were each evaluated. We then examined various data analysis factors which influence GPIAS assessment. Gap-induced facilitation, data processing options, and assessments of tinnitus were studied. We found that the startle reflex is highly variable in CBA/CaJ mice, but that this can be minimized by certain data collection factors. We also found that careful consideration of temporal fluctuations of the ASR and controlling for facilitation can lead to drastically divergent GPIAS results. Finally, we show that tinnitus decreases gap-induced inhibition of the acoustic startle reflex, but only for short gap durations. This study provides a guide for reducing variance in the GPIAS methodology – thereby improving the diagnostic power of the test.



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Paraquat initially damages cochlear support cells leading to anoikis-like hair cell death

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Jianhui Zhang, Hong Sun, Richard Salvi, Dalian Ding
Paraquat (PQ), one of the most widely used herbicides, is extremely dangerous because it generates the highly toxic superoxide radical. When paraquat was applied to cochlear organotypic cultures, it not only damaged the outer hair cells (OHCs) and inner hair cells (IHCs), but also caused dislocation of the hair cell rows. We hypothesized that the dislocation arose from damage to the support cells (SCs) that anchors hair cells within the epithelium. To test this hypothesis, rat postnatal cochlear cultures were treated with PQ. Shortly after PQ treatment, the rows of OHCs separated from one another and migrated radially away from IHCs suggesting loss of cell-cell adhesion that hold the hair cells in proper alignment. Hair cells dislocation was associated with extensive loss of SCs in the organ of Corti, loss of tympanic border cells (TBCs) beneath the basilar membrane, the early appearance of superoxide staining and caspase-8 labeling in SCs below the OHCs and disintegration of E-cadherin and β-catenin in the organ of Corti. Damage to the TBCs and SCs occurred prior to loss of OHC or IHC loss suggesting a form of detachment-induced apoptosis referred to as anoikis.



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Auditory and language outcomes in children with unilateral hearing loss

Publication date: Available online 13 March 2018
Source:Hearing Research
Author(s): Elizabeth M. Fitzpatrick, Isabelle Gaboury, Andrée Durieux-Smith, Doug Coyle, JoAnne Whittingham, Flora Nassrallah
ObjectivesChildren with unilateral hearing loss (UHL) are being diagnosed at younger ages because of newborn hearing screening. Historically, they have been considered at risk for difficulties in listening and language development. Little information is available on contemporary cohorts of children identified in the early months of life. We examined auditory and language acquisition outcomes in a contemporary cohort of early-identified children with UHL and compared their outcomes at preschool age with peers with mild bilateral loss and with normal hearing.DesignAs part of the Mild and Unilateral Hearing Loss in Children Study, we collected auditory and spoken language outcomes on children with unilateral, bilateral hearing loss and with normal hearing over a four-year period. This report provides a cross-sectional analysis of results at age 48 months. A total of 120 children (38 unilateral and 31 bilateral mild, 51 normal hearing) were enrolled in the study from 2010 to 2015. Children started the study at varying ages between 12 and 36 months of age and were followed until age 36–48 months. The median age of identification of hearing loss was 3.4 months (IQR: 2.0, 5.5) for unilateral and 3.6 months (IQR: 2.7, 5.9) for the mild bilateral group. Families completed an intake form at enrolment to provide baseline child and family-related characteristics. Data on amplification fitting and use were collected via parent questionnaires at each annual assessment interval. This study involved a range of auditory development and language measures. For this report, we focus on the end of follow-up results from two auditory development questionnaires and three standardized speech-language assessments. Assessments included in this report were completed at a median age of 47.8 months (IQR: 38.8, 48.5). Using ANOVA, we examined auditory and language outcomes in children with UHL and compared their scores to children with mild bilateral hearing loss and those with normal hearing.ResultsOn most measures, children with UHL performed poorer than those in the mild bilateral and normal hearing study groups. All children with hearing loss performed at lower levels compared to the normal hearing control group. However, mean standard scores for the normal hearing group in this study were above normative means for the language measures. In particular, children with UHL showed gaps compared to the normal hearing control group in functional auditory listening and in receptive and expressive language skills (three quarters of one standard deviation below) at age 48 months. Their performance in receptive vocabulary and speech production was not significantly different from that of their hearing peers (p < 0.001).ConclusionsEven when identified in the first months of life, children with UHL show a tendency to lag behind their normal hearing peers in functional auditory listening and in receptive and expressive language development.



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REPLY TO LETTER REGARDING "THE EFFECT OF HEARING AIDS AND COCHLEAR IMPLANTS ON BALANCE DURING GAIT".

REPLY TO LETTER REGARDING "THE EFFECT OF HEARING AIDS AND COCHLEAR IMPLANTS ON BALANCE DURING GAIT".

Otol Neurotol. 2018 Apr;39(4):519-520

Authors: Weaver TS, Shayman CS, Hullar TE

PMID: 29533343 [PubMed - in process]

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RESPONSE TO WEAVER TS, SHAYMAN CS, HULLER TE. THE EFFECT OF HEARING AIDS AND COCHLEAR IMPLANTS ON BALANCE DURING GAIT. OTOL NEUROTOL 2017;38: 1327-1332.

RESPONSE TO WEAVER TS, SHAYMAN CS, HULLER TE. THE EFFECT OF HEARING AIDS AND COCHLEAR IMPLANTS ON BALANCE DURING GAIT. OTOL NEUROTOL 2017;38: 1327-1332.

Otol Neurotol. 2018 Apr;39(4):518-519

Authors: Hallemans A, Herssens N, Mertens G, Van de Heyning P, Van Rompaey V

PMID: 29533342 [PubMed - in process]

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Wearable Smart System for Visually Impaired People.

Wearable Smart System for Visually Impaired People.

Sensors (Basel). 2018 Mar 13;18(3):

Authors: Ramadhan AJ

Abstract
In this paper, we present a wearable smart system to help visually impaired persons (VIPs) walk by themselves through the streets, navigate in public places, and seek assistance. The main components of the system are a microcontroller board, various sensors, cellular communication and GPS modules, and a solar panel. The system employs a set of sensors to track the path and alert the user of obstacles in front of them. The user is alerted by a sound emitted through a buzzer and by vibrations on the wrist, which is helpful when the user has hearing loss or is in a noisy environment. In addition, the system alerts people in the surroundings when the user stumbles over or requires assistance, and the alert, along with the system location, is sent as a phone message to registered mobile phones of family members and caregivers. In addition, the registered phones can be used to retrieve the system location whenever required and activate real-time tracking of the VIP. We tested the system prototype and verified its functionality and effectiveness. The proposed system has more features than other similar systems. We expect it to be a useful tool to improve the quality of life of VIPs.

PMID: 29533970 [PubMed - in process]

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REPLY TO LETTER REGARDING "THE EFFECT OF HEARING AIDS AND COCHLEAR IMPLANTS ON BALANCE DURING GAIT".

REPLY TO LETTER REGARDING "THE EFFECT OF HEARING AIDS AND COCHLEAR IMPLANTS ON BALANCE DURING GAIT".

Otol Neurotol. 2018 Apr;39(4):519-520

Authors: Weaver TS, Shayman CS, Hullar TE

PMID: 29533343 [PubMed - in process]

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via IFTTT

RESPONSE TO WEAVER TS, SHAYMAN CS, HULLER TE. THE EFFECT OF HEARING AIDS AND COCHLEAR IMPLANTS ON BALANCE DURING GAIT. OTOL NEUROTOL 2017;38: 1327-1332.

RESPONSE TO WEAVER TS, SHAYMAN CS, HULLER TE. THE EFFECT OF HEARING AIDS AND COCHLEAR IMPLANTS ON BALANCE DURING GAIT. OTOL NEUROTOL 2017;38: 1327-1332.

Otol Neurotol. 2018 Apr;39(4):518-519

Authors: Hallemans A, Herssens N, Mertens G, Van de Heyning P, Van Rompaey V

PMID: 29533342 [PubMed - in process]

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