Audiology by Alexandros G. Sfakianakis: 03/28/18

Τετάρτη 28 Μαρτίου 2018

Comparison of Subjective and Objective Measures of Hearing, Auditory Processing, and Cognition Among Older Adults With and Without Mild Cognitive Impairment

Purpose

The aims of the study were to compare the Cognitive Self-Report Questionnaire (CSRQ; Spina, Ruff, & Mahncke, 2006) Hearing and Cognitive subscale ratings among older adults with and without probable mild cognitive impairment (MCI) and to examine whether self-report, as measured by the CSRQ, is associated with objective measures of hearing, auditory processing, and cognition.

Method

Data analyses included 97 older adults of ages 61–91 years. Participants completed the CSRQ self-report measure as well as a battery of objective measures, including pure-tone audiometry, degraded speech understanding, temporal processing, and memory.

Results

Older adults with probable MCI rated their cognitive abilities more poorly than those without MCI (p = .002), but ratings of hearing and auditory abilities did not differ between the two groups (p = .912). Age and CSRQ Hearing subscale ratings explained a significant proportion of variance in objective measures of hearing and degraded speech understanding (R ² = .39, p < .001). Age, sex, mental status, and CSRQ Cognition subscale ratings explained a significant proportion of variance in objective memory performance (R ² = .55, p < .001).

Conclusions

Taken together, these results suggest that the CSRQ is an appropriate self-report measure of hearing, cognition, and some aspects of auditory processing for older adults with and without probable MCI.

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Comparison of Subjective and Objective Measures of Hearing, Auditory Processing, and Cognition Among Older Adults With and Without Mild Cognitive Impairment

Purpose

Method

Results

Conclusions

Comparison of Subjective and Objective Measures of Hearing, Auditory Processing, and Cognition Among Older Adults With and Without Mild Cognitive Impairment

Purpose

Method

Results

Conclusions

Taken together, these results suggest that the CSRQ is an appropriate self-report measure of hearing, cognition, and some aspects of auditory processing for older adults with and without probable MCI.

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tACS-mediated modulation of the auditory steady-state response as seen with MEG

Publication date: Available online 28 March 2018
Source:Hearing Research
Author(s): Petteri Hyvärinen, Dawoon Choi, Gianpaolo Demarchi, Antti A. Aarnisalo, Nathan Weisz
BackgroundPrevious studies have shown that transcranial electrical stimulation can be successfully applied during simultaneous MEG measurements. In particular, using beamforming they have established that changes of stimulus induced as well as evoked activity can be inspected during transcranial alternating current stimulation (tACS).Objective/Hypothesis: We studied tACS-mediated changes of the auditory steady-state response (ASSR), hypothesizing that—due to the putatively inhibitory role of alpha oscillations—these evoked responses would be diminished.MethodsWe compared ASSRs in conditions with and without 12-Hz and 6.5-Hz sinusoidal 1.5 mA tACS, applied bilaterally over temporal areas. Source-level activity was estimated using a linearly constrained minimum variance beamformer and compared across tACS conditions using paired t-tests following a condition-internal normalization procedure.ConclusionsBy separating the electrical and auditory stimulation to non-overlapping parts of the frequency spectrum, we were able to compare auditory-evoked steady-state activity across tACS conditions. We observed a significant decrease in normalized ASSR power in the 12-Hz tACS condition, illustrating that tACS could induce immediate changes in auditory evoked activity. This study sets a methodology to further interrogate the causal roles of oscillatory dynamics in auditory cortices, as well as suggests perspectives for employing tACS in clinical contexts.

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tACS-mediated modulation of the auditory steady-state response as seen with MEG

Laryngeal Manifestations of Inflammatory Bowel Disease

Publication date: Available online 28 March 2018
Source:Journal of Voice
Author(s): Elke Loos, Peter Lemkens, Vincent Vander Poorten, Evelien Humblet, Griet Laureyns
BackgroundLaryngeal involvement in inflammatory bowel disease is rare. Only 12 cases of laryngeal involvement in Crohn disease have been reported until now. Moreover, only one case of laryngeal manifestations in ulcerative colitis has been reported so far.Materials and MethodsIn this article, we present a patient with ulcerative colitis, who consulted our ear, nose, and throat (ENT) clinic with laryngeal complaints. Furthermore, a review of current literature was performed.ResultsA concise overview of this rare extraintestinal manifestation and other ENT manifestations of inflammatory bowel diseases is provided.ConclusionsLaryngeal manifestations in inflammatory bowel disease are very rare, but these manifestations should be known by the otorhinolaryngologist.

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The Use of Vibrotactile Feedback During Dual-Task Standing Balance Conditions in People With Unilateral Vestibular Hypofunction

Hypothesis: People with unilateral vestibular hypofunction (UVH) would have increased postural sway and slower reaction times while using vibrotactile feedback (VTF) during dual-task conditions compared with age-matched controls. Background: VTF has been shown to improve real-time balance performance in persons with vestibular disorders. Future use of this technology outside of the laboratory environment as a real-time balance aid requires that using VTF during dual-tasking scenarios be studied. Method: Nine people with UVH and nine age-matched controls participated in a study focused on assessing the effects of a secondary cognitive task and sensory integration conditions on the root-mean-square of center of pressure (RMS COP) while using VTF. Reaction times from the secondary cognitive task were used to assess the effects of VTF, and sensory integration conditions on the attention required to perform the task. Results: The results showed that there was no group difference between individuals with UVH and age-matched controls on balance performance while using VTF during dual-task conditions. Using VTF significantly degraded the reaction time performance in both groups, and the participants with UVH had slower reaction times compared with controls. Conclusion: People with UVH showed the ability to use VTF to control balance during dual-task conditions, but more attentional resources were needed to perform the secondary cognitive tasks while using VTF. Address correspondence and reprint requests to Chia-Cheng Lin, P.T., Ph.D., M.S., Department of Physical Therapy, East Carolina University, Health Sciences Building, 2405D, Mail Stop 668, Greenville, NC 27834; E-mail: linch14@ecu.edu This material is based upon work supported by the National Science Foundation CAREER program under Grant No. RAPD-0846471 to K.H.S. and the National Institute on Deafness and Other Communication Disorders under Grant no. 5R21-DC-012410–02 to K.H.S. and S.L.W. The authors disclose no conflicts of interest. Copyright © 2018 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

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RECONSTRUCTION OF THE CANAL WALL IN TYMPANOPLASTY FOR CHOLESTEATOMA WITH TITANIUM SHEETING

No abstract available

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Burkitt Lymphoma of the Temporal Bone

No abstract available

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Prevention of Otic Barotrauma in Aviation: A Systematic Review

Objective: To conduct a systematic review of the published evidence relating to the prevention of otic barotrauma in aviation. In particular, this review sought to identify procedures, techniques, devices, and medications for the prevention of otic barotrauma as well as evaluate the evidence relating to their efficacy. Data Sources: Ten databases including Embase, MEDLINE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched using the full historical range. Study Selection: English language articles including more than or equal to five participants or cases were included. Outcomes of interest were reduced severity or the successful prevention of otic barotrauma in participants undergoing gradual changes in pressure during air travel or its simulation. Data Extraction: Articles and data were extracted and analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses and other international guidelines. Conclusions: This review highlights the lack of published evidence relating to what is a significant and increasingly common problem in otology. There is level 1 evidence that supports the efficacy of oral pseudoephedrine (120 mg) in preventing otic barotrauma in adults. However, oral pseudoephedrine (1 mg/kg) does not appear to be effective in children. There is insufficient evidence to support the efficacy of either nasal balloon inflation or pressure-equalizing ear plugs for the prevention of otic barotrauma. A recently reported, novel technique for insertion of temporary tympanostomy tubes is promising but requires further evaluation. Address correspondence and reprint requests to Peter Ryan, BMed, c/o Dr Nicholas Jufas, Department of Otolaryngology and Head and Neck Surgery, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; E-mail: peter.john.ryan@gmail.com Financial disclosure: No funding or other support received. The authors disclose no conflicts of interest. Copyright © 2018 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

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tACS-mediated modulation of the auditory steady-state response as seen with MEG

Publication date: Available online 28 March 2018
Source:Hearing Research
Author(s): Petteri Hyvärinen, Dawoon Choi, Gianpaolo Demarchi, Antti A. Aarnisalo, Nathan Weisz
BackgroundPrevious studies have shown that transcranial electrical stimulation can be successfully applied during simultaneous MEG measurements. In particular, using beamforming they have established that changes of stimulus induced as well as evoked activity can be inspected during transcranial alternating current stimulation (tACS).Objective/Hypothesis: We studied tACS-mediated changes of the auditory steady-state response (ASSR), hypothesizing that—due to the putatively inhibitory role of alpha oscillations—these evoked responses would be diminished.MethodsWe compared ASSRs in conditions with and without 12-Hz and 6.5-Hz sinusoidal 1.5 mA tACS, applied bilaterally over temporal areas. Source-level activity was estimated using a linearly constrained minimum variance beamformer and compared across tACS conditions using paired t-tests following a condition-internal normalization procedure.ConclusionsBy separating the electrical and auditory stimulation to non-overlapping parts of the frequency spectrum, we were able to compare auditory-evoked steady-state activity across tACS conditions. We observed a significant decrease in normalized ASSR power in the 12-Hz tACS condition, illustrating that tACS could induce immediate changes in auditory evoked activity. This study sets a methodology to further interrogate the causal roles of oscillatory dynamics in auditory cortices, as well as suggests perspectives for employing tACS in clinical contexts.

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Hearing Loss May Increase Accident Risks

People with hearing problems may have a higher risk of getting into accidents, says a recent study published in JAMA Otolaryngology-Head and Neck Surgery. Data from the National Health Interview Survey (NHIS), collected from 232.2 million U.S. adults from 2007 to 2015, showed that respondents who had "a lot of trouble" hearing were twice as likely to be hurt.

Accidental or unintentional injuries have led to 30.6 million emergency department visits in the United States, according to the CDC National Center for Health Statistics. Meanwhile, over 37.5 million American aged 18 and over suffer from different forms of hearing difficulty. Understanding the link between the accidental injury and hearing loss is key to reduce risks and incidences, including deaths.

In the NHIS survey, respondents were asked to describe their hearing status and were given the following options: excellent, good, a little trouble, moderate trouble, a lot of trouble, and deaf. The researchers did a cross-sectional analysis of the responses and tracked injuries that were related to work, leisure, and activities like sports and driving. Accidental injuries were found in 2.8 percent of survey respondents; the most prevalent injuries were work- and leisure-related.

With the observational study’s design, the researchers could not intervene nor control natural differences that could further explain the findings. The researchers noted that self-reporting was admittedly one of the study limitations. Nonetheless, they concluded that improved public awareness of hearing health and proper screening is important to reduce the risk of accidental injuries.

Notably, study author Hossein Mahboubi, MD, MPH, of University of California, Irvine, wrote about the gaps in hearing loss referral and evaluation in the March 2018 issue of The Hearing Journal, and stressed the need for increased hearing health awareness.

Published: 3/28/2018 11:53:00 AM

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Hearing Loss May Increase Accident Risks

Published: 3/28/2018 11:53:00 AM

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Hearing Loss May Increase Accident Risks

Published: 3/28/2018 11:53:00 AM

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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

No abstract available

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Facial Nerve Trauma: A Call for Minimum Reporting Guidelines

No abstract available

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Can Fat-plug Myringoplasty Be a Good Alternative to Formal Myringoplasty? A Systematic Review and Meta-analysis

Objective: This study reviewed available literature to evaluate the success rate of fat myringoplasty compared with methods using other graft materials and suggests proper indications for this procedure. Data Sources: Studies reporting the success rate of fat myringoplasty were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases for studies published from database inception to 2017. Study Selection: The following terms were used for the literature search: (“Fat” OR “Adipose”) and (“Myringoplasty” OR “Tympanoplasty”). Data Extraction: Eight case series reported the data of perforation size and audiologic results. The success rate varied according to the perforation size with a cutoff value of 3 to 5 mm in length or 30% of the total tympanic membrane area. The success rate in anterior perforation was lower than that in other sites, ranging from 76.7 and 85.2% to 84.5 and 91.7%, respectively. The meta-analysis was performed on 10 articles. The overall success rate in fat myringoplasty and paper patch technique was not significantly different, while the success rate of fat myringoplasty was lower than that for the conventional myringoplasty technique using fascia or perichondrium (OR 0.63, 95% CI 0.49–0.80). Hyaluronic acid showed a significantly higher success rate than fat myringoplasty (90.1% versus 69.9%) (OR 0.20, 95% CI 0.09–0.46). Conclusions: The success rate of fat myringoplasty may be associated with the perforation site and size. The success rate of fat myringoplasty was equivalent to that of the paper patch but inferior to a conventional method using perichondrium or fascia.

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A Relationship Between Blood Levels of Otolin-1 and Vitamin D

Objective: Low vitamin D levels have been associated with and could play a role in the pathogenesis of idiopathic benign paroxysmal positional vertigo (iBPPV). Since otoconia degeneration contributes to iBPPV and a lack of vitamin D may impact otoconia structure and integrity, we proposed a negative association between vitamin D levels and levels of a proposed circulatory biomarker for otolithic degeneration, otolin-1. Study Design: Cross-sectional clinical study. Setting: Clinical research center. Patients: Seventy-nine men and women ranging in age from 22 to 95 years old without known vertigo. Interventions: Diagnostic. Main Outcome Measures: Blood levels of 25-OH vitamin D and otolin-1. Results: Previously, we had reported higher otolin-1 levels in older age groups. The majority of the subjects (83%) had vitamin D levels that were below 40 ng/ml. Vitamin D level was lowest in the young and increased with age before declining in subjects 70 years of age and older (p = 0.005). There was a negative correlation between vitamin D and otolin-1 levels of subjects over 70 (r = −0.36, p = 0.036). Conclusion: Our results demonstrate a relationship between vitamin D and otolin-1. The majority of our subjects had abnormally low vitamin D levels, but only those over 70 years of age showed a negative correlation with high otolin-1 levels. We postulate that a seasonal drop in vitamin D may not be sufficient for otoconia fragmentation and ultimately iBPPV, rather, chronically low vitamin D maybe required to induce otoconia degeneration.

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Tablet-based Screening for Hearing Loss: Feasibility of Testing in Nonspecialty Locations

Objective: To determine the feasibility of audiometric screening with tablet-based applications in typical clinic locations: examination room and clinic waiting area. Study Design: A randomized prospective study. Setting: Tertiary referral center. Patients: Participants included 107 adult patients referred for audiometric testing to assess hearing loss. Intervention: Each patient completed standard audiometry testing and one of three tablet-based audiometric applications that included pure-tone air conduction testing. The tablet-based audiometric testing was completed in a quiet examination room and a clinic waiting area using noise-cancellation headphones. A 5-question patient satisfaction survey was completed at the end of the testing. Main Outcome Measure: Thresholds at each frequency were compared with those obtained from tablet-based audiometric applications in a quiet examination room and clinic waiting area. Sensitivity and specificity of each tablet-based audiogram in detecting a hearing loss at each frequency was determined. Results: All three tablet-based audiometric applications were user-friendly for hearing screening. However, one application was shown to be feasible and the most accurate of the three tested with 92% of thresholds within 10 dB of conventional audiometry across all test conditions. This application had a sensitivity of 96 to 100% and specificity of 72 to 85% for identifying a hearing loss in each frequency tested. Variability was noted among applications between testing in a quiet clinic room and testing in the clinic waiting area. Patients showed no preference for either conventional audiometry or the tablet-based device. Conclusion: Tablet-based audiometric applications can be used to screen for hearing loss in typical clinic locations. This tool does not replace standard audiometry testing but allows for screening for hearing disorders when appropriate and in settings without access to audiometric equipment.

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RE.: THE PAPER “IMPACT OF COCHLEAR IMPLANTATION ON COGNITIVE FUNCTIONS OF OLDER ADULTS PILOT TEST RESULTS,” RECENTLY PUBLISHED IN OTOLOGY & NEUROTOLOGY (38:E289–E295_2017)

No abstract available

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Right Ear Advantage of Speech Audiometry in Single-sided Deafness

Background: Postlingual single-sided deafness (SSD) is defined as normal hearing in one ear and severely impaired hearing in the other ear. A right ear advantage and dominance of the left hemisphere are well established findings in individuals with normal hearing and speech processing. Therefore, it seems plausible that a right ear advantage would exist in patients with SSD. Methods: The audiometric database was searched to identify patients with SSD. Results from the German monosyllabic Freiburg word test and four-syllabic number test in quiet were evaluated. Results of right-sided SSD were compared with left-sided SSD. Statistical calculations were done with the Mann–Whitney U test. Results: Four hundred and six patients with SSD were identified, 182 with right-sided and 224 with left-sided SSD. The two groups had similar pure-tone thresholds without significant differences. All test parameters of speech audiometry had better values for right ears (SSD left) when compared with left ears (SSD right). Statistically significant results (p

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American Otological Society Preliminary Program

No abstract available

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Picosecond Infrared Laser (PIRL) Application in Stapes Surgery—First Experience in Human Temporal Bones

Objective: Using a contact-free laser technique for stapedotomy reduces the risk of mechanical damage of the stapes footplate. However, the risk of inner ear dysfunction due to thermal, acoustic, or direct damage has still not been solved. The objective of this study was to describe the first experiences in footplate perforation in cadaver tissue performed by the novel Picosecond-Infrared-Laser (PIRL), allowing a tissue preserving ablation. Patients and Intervention: Three human cadaver stapes were perforated using a fiber-coupled PIRL. The results were compared with footplate perforations performed with clinically applied Er:YAG laser. Therefore, two different laser energies for the Er:YAG laser (30 and 60 mJ) were used for footplate perforation of three human cadaver stapes each. Main Outcome Measure: Comparisons were made using histology and environmental scanning electron microscopy (ESEM) analysis. Results: The perforations performed by the PIRL (total energy: 640–1070 mJ) revealed a precise cutting edge with an intact trabecular bone structure and no considerable signs of coagulation. Using the Er:YAG-Laser with a pulse energy of 30 mJ (total energy: 450–600 mJ), a perforation only in the center of the ablation zone was possible, whereas with a pulse energy of 60 mJ (total energy: of 195–260 mJ) the whole ablation zone was perforated. For both energies, the cutting edge appeared irregular with trabecular structure of the bone only be conjecturable and signs of superficial carbonization. Conclusion: The microscopic results following stapes footplate perforation suggest a superiority of the PIRL in comparison to the Er:YAG laser regarding the precision and tissue preserving ablation.

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Does Hospital Volume Affect Outcomes in Patients Undergoing Vestibular Schwannoma Surgery?

Objective: To determine the effect of hospital surgical case volume on the outcomes of vestibular schwannoma surgery. Study Design: Retrospective case review. Setting: University HealthSystem Consortium member hospitals (includes nearly every US academic medical center). Patients: Three thousand six hundred ninety-seven patients who underwent vestibular schwannoma resection over a 3-year timespan (2012–2015) grouped by race, age, comorbidities, payer, and sex. Intervention: Surgical resection of vestibular schwannoma. Main Outcome Measures: Morbidity and mortality following vestibular schwannoma excision are compared by hospital volume (low, medium, and high) including deciles. Results: There was significantly longer length of stay (p ≤ 0.005) among groups with low-volume hospitals followed by medium-volume hospitals and high-volume hospitals. Low-volume hospitals had a significantly higher rate of complications including stroke, aspiration, and respiratory failure (p ≤ 0.0175). Patient characteristics of age, sex, sex, and baseline comorbidities were similar between hospital groups. However, patients at high-volume hospitals were more likely to be Caucasian (83.1%, p = 0.0001) and have private insurance (76.7%, p

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Bilateral Cochlear Implantation Versus Bimodal Hearing in Patients With Functional Residual Hearing: A Within-subjects Comparison of Audiologic Performance and Quality of Life

Objective: Evaluate performance and quality of life changes after sequential bilateral cochlear implantation in patients with preoperative residual hearing functioning in a bimodal hearing configuration. Study Design: Retrospective analysis using within-subjects repeated measures design. Setting: Tertiary otologic center. Patients: Twenty-two adult patients with bilateral sensorineural hearing loss who used bimodal hearing before second cochlear implant (CI) meeting the following criteria: 1) preoperative residual hearing (≤80 dB HL at 250 Hz) in the ear to be implanted, 2) implantation with current CI technology (2013–2016), 3) consonant-nucleus-consonant (CNC) speech recognition testing in the bimodal condition preoperatively and bilateral CI condition postoperatively. Intervention: Cochlear implantation. Main Outcome Measures: CNC and AzBio sentence scores in quiet and noise (+5 SNR). Subjective measures of communication difficulty and sound quality were also administered. Results: Twenty-two patients (mean 64 yr, 68% men) were included. At an average follow-up of 11.8 months, CNC scores in the bilateral CI condition (mean 63%, standard deviation [SD] = 22) were significantly better than preoperative bimodal scores with repeated measures analysis (mean 55%, SD = 22) (p = 0.03). AzBio scores in quiet were also higher with bilateral CI (mean 76%, SD = 24) compared with bimodal listening (mean 69%, SD = 29) (p = 0.0007). Global abbreviated profile of hearing aid benefit (APHAB) and overall speech, spatial, and qualities of hearing (SSQ) scores exhibited significant improvement following bilateral implantation (p = 0.006 for both analyses). Conclusions: For patients using a bimodal hearing configuration with substantial residual hearing in the non-CI ear, bilateral cochlear implantation yields improved audiologic performance and better subjective quality of life, irrespective of the ability to preserve acoustic hearing during the second sided implantation.

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Serum Methylarginines and Hearing Loss in a Population-based Cohort of Older Adults

Objective: Age-related hearing loss is associated with endothelial dysfunction and increased cardiovascular risk, suggesting a vascular etiology. Methylarginines are endogenous nitric oxide synthase inhibitors that cause endothelial dysfunction and increase cardiovascular disease risk. This study is the first to examine the hypothesis that higher serum concentrations of methylarginines are associated with greater hearing loss prevalence. Study Design/Patients: Cross-sectional audiometric data on hearing levels, and serum methylarginines were collected from a population-based sample of 630 older community-dwelling adults. Results: Linear regression analysis showed a statistically significant association between higher serum concentrations of asymmetric dimethylarginine (ADMA) and L-arginine and greater degrees of hearing loss for males, particularly over 75 years. Higher body mass index and previous history of stroke were also associated with hearing loss. For females, ADMA concentration was not associated with hearing loss, but higher serum L-arginine concentrations were associated with reduced hearing loss prevalence in older females. Antihypertensive medication use was also associated with reduced hearing loss prevalence. LDL cholesterol and previous myocardial infarction were associated with greater hearing loss. Conclusion: This study showed a significant association between serum concentrations of ADMA and hearing loss for males, consistent with the association between endothelial dysfunction and hearing loss. The opposite effect of L-arginine on hearing loss in males versus females might reflect a different role of this precursor toward nitric oxide versus methylated arginines synthesis. These findings are potentially clinically significant if the association between ADMA and hearing loss is causal, as serum methylarginine levels are modifiable through pharmacotherapeutic/lifestyle interventions.

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Hearing Restoration in Cochlear Nerve Deficiency: the Choice Between Cochlear Implant or Auditory Brainstem Implant, a Meta-analysis

Objective: To answer the dilemma clinician's face when deciding between cochlear implant (CI) and auditory brainstem implant (ABI) treatment options in patients with cochlear nerve deficiency (CND). Study Design: Case study supplemented with literature review and meta-analysis. Setting: Tertiary referral center. Patient(s): Child with CHARGE syndrome and congenital deafness. Intervention(s): ABI as there was no benefit after bilateral cochlear implantation. Main Outcome Measures: Speech and language development, quality of life. Results: In one ear the cochleovestibular nerve was present on magnetic resonance imaging (MRI) without preoperative ABR responses. In the contra lateral ear the nerve could not be identified, despite present ABR responses. Nevertheless, there was no positive outcome with CI. The patient had improved speech and language and quality of life with ABI. Of the 108 patients with CND and CI identified in the literature review, 25% attained open-set speech perception, 34% attained closed-set speech perception, and 41% detected sounds or less. The appearance of the cochlear nerve on MRI was a useful predictor of success, with cochlear nerve aplasia on MRI associated with a smaller chance of a positive outcome post cochlear implantation compared with patients with cochlear nerve hypoplasia. Conclusion: Although patients with (apparent) cochlear nerve aplasia are less likely to benefit from CI, CI before ABI is supported as some patients attain closed or open-set levels of speech perception after cochlear implantation.

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PREVALENCE OF POTENTIAL HYBRID AND CONVENTIONAL COCHLEAR IMPLANT CANDIDATES BASED ON AUDIOMETRIC PROFILE

No abstract available

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A Mid-scala Cochlear Implant Electrode Design Achieves a Stable Post-surgical Position in the Cochlea of Patients Over Time—A Prospective Observational Study

Introduction: Cochlear implant (CI) electrode design impacts the clinical performance of patients. Stability and the occurrence of electrode array migration, which is the postoperative movement of the electrode array, were investigated using a mid-scalar electrode array and postoperative image analysis. Methods: A prospective observational study was conducted. A mid-scalar electrode was surgically placed using a mastoidectomy, followed by a posterior tympanotomy and an extended round-window or cochleostomy insertion. A few days after surgery and 3 months later Cone Beam Computed Tomography (CBCT) was performed. The two different CBCT's were fused, and the differences between the electrode positions in three dimensions were calculated (the migration). A migration greater than 0.5 mm was deemed clinically relevant. Results: Fourteen subjects participated. The mid-scalar electrode migrated in one patient (7%). This did not lead to the extrusion of an electrode contact. The mean migration of every individual electrode contact in all patients was 0.36 mm (95% confidence interval 0.22–0.50 mm), which approximates to the estimated measurement error of the CBCT technique. Conclusion: A mid-scalar electrode array achieves a stable position in the cochlea in a small but representative group of patients. The methods applied in this work can be used for providing postoperative feedback for surgeons and for benchmarking electrode designs.

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Case of a Rare “White Epidermoid Tumor” Involving the Cerebellopontine Angle

No abstract available

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Speech Perception in Quiet and Noise With an Off the Ear CI Processor Enabling Adaptive Microphone Directionality

Objective: To investigate the impact of the wearing position of an off-the-ear-processor (OTE) on speech perception in quiet and noise. Patients: The study group consisted of 16 adult subjects with bilateral severe-to-profound sensorineural hearing loss, 2 of them unilaterally, and 14 bilaterally provided with cochlear implants. Main Outcome Measures: Speech perception in quiet and noise was measured for frontal presentation with the recipients behind-the-ear processor CP810 or CP910 and the OTE processor Kanso (Cochlear Limited, Sydney, Australia). Additionally, speech performance in noise with the OTE for spatially separated signal and noise sources was assessed. Results: The recipients showed monosyllabic word recognition scores in quiet between 65 and 95% and speech reception thresholds in noise between 2.4 and −5.5 dB SNR with the OTE. For frontal presentation of speech and noise, application of the adaptive directional microphone (Beam) yielded a slight median decrement of 0.6 dB for the speech reception threshold compared with standard directionality. However, huge median improvements, ranging from −3.7 to −11.6 dB, for the three tested conditions with spatially separated sources (S0NIL, S0NCL, S0N180) were observed. Conclusion: The beamforming algorithm in the investigated OTE processor provides similar benefits as described in previous studies for behind-the-ear processors in conditions with spatially separated speech and noise sources. Adaptive microphone directionality can be successfully implemented in an OTE processor. The OTE processor's potential to increase usability, comfort, and cosmetics might not be compromised by a deterioration of speech performance.

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Gregory J. Matz, M.D.: Obituary

No abstract available

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Early Fitting in Cochlear Implantation: Benefits and Limits

Objective: Evaluation of a shortened delay time between surgical placement of the cochlear implant (CI) device and processor activation to less than 8 days (early CI fitting). Assessment of benefits and limits of early fitting in terms of medical, technical, audiological, and subjective outcome. Study Design: Prospective. Setting: Tertiary referral center. Patients: Forty-one patients scheduled for cochlear implant surgery divided into early fit (EF, n = 21) and control group (CG, n = 19). Main Outcome Measures: Questionnaires were used to evaluate technical, medical, and subjective outcomes associated with early fitting. Additional, electrode impedance and speech recognition scores were measured. These data, collected preoperative, at first activation and after 3 months were compared with the CG with standard fitting. Results: The medical and audiological status of the EF subjects allowed early fitting in nearly all patients (20/21). Evidence of pain, delayed wound healing, or other compromises was equal in both study groups. Speech recognition scores show comparable development over time for EF and CG. Average electrode impedance was significantly higher in the CG at first activation. Conclusions: Early fitting of the sound processor is feasible and did not compromise wound healing or generates additional pain. During the first month following surgery, reduction of wound swelling can be expected. Hence, regular inspection of magnet strength is recommended at follow-ups. Over all, early activation of their CI device was highly appreciated by nearly all patients.

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Electrocochleography Results in Patients With Bilateral Vestibular Paresis and Sound- or Pressure-Induced Horizontal Nystagmus

Objective: To describe the electrocochleography (ECochG) findings in patients with bilateral vestibular paresis and sound- and/or pressure-induced horizontal nystagmus. Design: Retrospective case series. Setting: Tertiary care center. Patients: Three adult patients with bilateral vestibular paresis and sound- and/or pressure-induced horizontal nystagmus were evaluated from 2012 to 2016. Main Outcome Measure: All patients underwent ECochG, vestibular evoked myogenic potential (VEMP) testing, bithermal caloric testing, rotary chair testing, audiometric testing, and temporal bone computed tomography (CT). For ECochG, the summating potential (SP) to action potential (AP) ratio was determined. Results: All patients had normal temporal bone CT, reduced caloric responses bilaterally, decreased gain on rotary chair, and abnormal ECochG. For two subjects, the SP/AP was elevated bilaterally. One subject had unilateral SP/AP elevation. Cervical VEMPs were present in all subjects, but at reduced thresholds in two subjects. Conclusion: SP/AP elevation was found in all three patients with the syndrome of bilateral vestibular paresis and/or sound- or pressure-induced horizontal nystagmus. As the etiology of this syndrome remains unclear, understanding the basis for abnormal ECochG may shed insight into the pathophysiology of this condition.

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Trunk Motion Visual Feedback During Walking Improves Dynamic Balance in Older Adults: Assessor Blinded Randomized Controlled Trial

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Eric Anson, Lei Ma, Tippawan Meetam, Elizabeth Thompson, Rathore Roshita, Victoria Dean, John Jeka
BackgroundVirtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes.Research Question: To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems.Methods40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3x/week for 4 weeks in 2 minute bouts separated by a seated rest. The control group was instructed to look at a stationary bulls-eye target while the experimental group also saw a moving cursor superimposed on the stationary bulls-eye that represented VFB of their walking trunk motion. The experimental group was instructed to keep the cursor in the center of the bulls-eye. Somatosensory (monofilaments and joint position testing) and vestibular function (canal specific clinical head impulses) was evaluated prior to intervention. Balance and mobility were tested before and after the intervention using Berg Balance Test, BESTest, mini-BESTest, and Six Minute Walk.ResultsThere were no significant differences between groups before the intervention. The experimental group significantly improved on the BESTest (p = 0.031) and the mini-BEST (p = 0.019). The control group did not improve significantly on any measure. Individuals with more profound sensory impairments had a larger improvement on dynamic balance subtests of the BESTest.SignificanceOlder adults with self-reported balance problems improve their dynamic balance after training using trunk motion VFB treadmill walking. Individuals with worse sensory function may benefit more from trunk motion VFB during walking than individuals with intact sensory function.

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Identifying balance impairments in people with Parkinson’s disease using video and wearable sensors

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Emma Stack, Veena Agarwal, Rachel King, Malcolm Burnett, Fatemeh Tahavori, Balazs Janko, William Harwin, Ann Ashburn, Dorit Kunkel
BackgroundFalls and near falls are common among people with Parkinson's (PwP). To date, most wearable sensor research focussed on fall detection, few studies explored if wearable sensors can detect instability.Research questionCan instability (caution or near-falls) be detected using wearable sensors in comparison to video analysis?MethodsTwenty-four people (aged 60–86) with and without Parkinson's were recruited from community groups. Movements (e.g. walking, turning, transfers and reaching) were observed in the gait laboratory and/or at home; recorded using clinical measures, video and five wearable sensors (attached on the waist, ankles and wrists). After defining ‘caution’ and ‘instability’, two researchers evaluated video data and a third the raw wearable sensor data; blinded to each other’s evaluations. Agreement between video and sensor data was calculated on stability, timing, step count and strategy.ResultsData was available for 117 performances: 82 (70%) appeared stable on video. Ratings agreed in 86/117 cases (74%). Highest agreement was noted for chair transfer, timed up and go test and 3 m walks. Video analysts noted caution (slow, contained movements, safety-enhancing postures and concentration) and/or instability (saving reactions, stopping after stumbling or veering) in 40/134 performances (30%): raw wearable sensor data identified 16/35 performances rated cautious or unstable (sensitivity 46%) and 70/82 rated stable (specificity 85%). There was a 54% chance that a performance identified from wearable sensors as cautious/unstable was so; rising to 80% for stable movements.SignificanceAgreement between wearable sensor and video data suggested that wearable sensors can detect subtle instability and near-falls. Caution and instability were observed in nearly a third of performances, suggesting that simple, mildly challenging actions, with clearly defined start- and end-points, may be most amenable to monitoring during free-living at home. Using the genuine near-falls recorded, work continues to automatically detect subtle instability using algorithms.

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Regulation of quasi-joint stiffness by combination of activation of ankle muscles in midstances during gait in patients with hemiparesis

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Yusuke Sekiguchi, Takayuki Muraki, Dai Owaki, Keita Honda, Shin-Ichi Izumi
BackgroundThe regulation of ankle joint stiffness by combination of activation of plantarflexor and dorsiflexor during gait has not been investigated in patients with hemiparesis. The objective of the present study was to examine the relationship between combination of activation of ankle muscles and quasi-joint stiffness (QJS) during the stance phase of gait.MethodsThe activation of the medial head of the gastrocnemius (MG), soleus, and tibialis anterior, gait parameters were collected from 19 patients with hemiparesis due to stroke and from 12 healthy controls using a three-dimensional motion analysis system. The indexes of reciprocal activation and coactivation were calculated from the ratio of plantarflexor to dorsiflexor activation and magnitude of coactivation (MC), which is computed by multiplying an index of simultaneous activation of ankle muscles by plantarflexor activation.ResultsQJS was significantly correlated with MC of MG on the paretic side, whereas it correlated with the ratio of MG (r = 0.63, p < 0.05) in healthy controls and the ratio of MG (r = 0.67, p < 0.05) and soleus (r = 0.61, p < 0.05) on the non-paretic side in midstance. Furthermore, QJS on the paretic side was lower than that on the non-paretic side and in healthy controls (p < 0.05).Significance: Our findings support that the regulation of QJS in midstance by reciprocal activation is altered on the paretic side, whereas it may be regulated by reciprocal activation and enhanced by relatively high activity of plantarflexor on the non-paretic side and in healthy controls.

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Treadmill walking reduces pre-frontal activation in patients with Parkinson's disease

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Pablo Cornejo Thumm, Inbal Maidan, Marina Brozgol, Shiran Shustak, Eran Gazit, Shirley Shema Shiratzki, Hagar Bernad-Elazari, Yoav Beck, Nir Giladi, Jeffrey M. Hausdorff, Anat Mirelman
BackgroundAmong patients with Parkinson’s disease (PD), gait is typically disturbed and less automatic. These gait changes are associated with impaired rhythmicity and increased prefrontal activation, presumably in an attempt to compensate for reduced automaticity.Research questionWe investigated whether during treadmill walking, when the pace is determined and fixed, prefrontal activation in patients with PD is lower, as compared to over-ground walking.MethodsTwenty patients with PD (age: 69.8 ± 6.5 yrs.; MoCA: 26.9 ± 2.4; disease duration: 7.9 ± 4.2 yrs) walked at a self-selected walking speed over-ground and on a treadmill. A wireless functional near infrared spectroscopy (fNIRS) system measured prefrontal lobe activation, i.e., oxygenated hemoglobin (Hb02) in the pre-frontal area. Gait was evaluated using 3D-accelerometers attached to the lower back and ankles (Opal™, APDM). Dynamic gait stability was assessed using the maximum Lyapunov exponent to investigate automaticity of the walking pattern.ResultsHb02 was lower during treadmill walking than during over-ground walking (p = 0.001). Gait stability was greater on the treadmill, compared to over-ground walking, in both the anteroposterior and medio-lateral axes (p<0.001).SignificanceThese findings support the notion that when gait is externally paced, prefrontal lobe activation is reduced in patients with PD, perhaps reflecting a reduced need for compensatory cognitive mechanisms.

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Comparison of segmental analysis and sacral marker methods for determining the center of mass during level and slope walking

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Bora Jeong, Chang-Yong Ko, Yunhee Chang, Jeicheong Ryu, Gyoosuk Kim
BackgroundA human’s center of mass (COM) is a widely used parameter in both clinical and practical applications. The segmental analysis method for determining the COM is considered the gold standard but is difficult to apply in a real environment.Research questionThe purpose of this study was to confirm the efficacy of an alternative COM determination method—the sacral marker method—by comparing segmental analysis and sacral marker method results in three dimensions during level or slope walking.MethodsTen healthy young subjects (age = 24.0 ± 4.5 yr, height = 174.5 ± 5.9 cm, and weight = 66.9 ± 9.4 kg) participated in the study. Each participant was monitored using a Helen Hayes full-body marker set and asked to walk on level and sloped (7°) terrain. The markers’ trajectories were subsequently recorded. Each participant’s COM was determined using segmental analysis and sacral marker methods via calculation and direct measurement, respectively.ResultsComparative results indicated no significant differences (p > 0.05) between the segmental analysis and sacral marker method results for the COM displacement, velocity, or acceleration in the fore-aft and vertical directions. Conversely, significant differences (p < 0.05) between the two methods were observed for the COM displacement and acceleration in the medial-lateral direction, suggesting kinematic differences.SignificanceBased on this latter finding, caution should be exercised when determining COM kinematics using the sacral marker method.

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Impact of motor fluctuations on real-life gait in Parkinson’s patients

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Ana Lígia Silva de Lima, Luc J.W. Evers, Tim Hahn, Nienke M. de Vries, Margaret Daeschler, Babak Boroojerdi, Dolors Terricabras, Max A. Little, Bastiaan R. Bloem, Marjan J. Faber
Backgroundpeople with PD (PWP) have an increased risk of becoming inactive. Wearable sensors can provide insights into daily physical activity and walking patterns.Research questions(1) is the severity of motor fluctuations associated with sensor-derived average daily walking quantity? (2) is the severity of motor fluctuations associated with the amount of change in sensor-derived walking quantity after levodopa intake?Methods304 Dutch PWP from the Parkinson@Home study were included. At baseline, all participants received a clinical examination. During the follow-up period (median: 97 days; 25-Interquartile range-IQR: 91 days, 75-IQR: 188 days), participants used the Fox Wearable Companion app and streamed smartwatch accelerometer data to a cloud platform. The first research question was assessed by linear regression on the sensor-derived mean time spent walking/day with the severity of fluctuations (MDS-UPDRS item 4.4) as independent variable, controlled for age and MDS-UPDRS part-III score. The second research question was assessed by linear regression on the sensor-derived mean post-levodopa walking quantity, with the sensor-derived mean pre-levodopa walking quantity and severity of fluctuations as independent variables, controlled for mean time spent walking per day, age and MDS-UPDRS part-III score.ResultsPWP spent most time walking between 8am and 1pm, summing up to 72 ± 39 (mean ± standard deviation) minutes of walking/day. The severity of motor fluctuations did not influence the mean time spent walking (B = 2.4 ± 1.9, p = 0.20), but higher age (B = −1.3 ± 0.3, p = < 0.001) and greater severity of motor symptoms (B = −0.6 ± 0.2, p < 0.001) was associated with less time spent walking (F(3,216) = 14.6, p<.001, R² =.17). The severity of fluctuations was not associated with the amount of change in time spent walking in relation to levodopa intake in any part of the day.SignificanceAnalysis of sensor-derived gait quantity suggests that the severity of motor fluctuations is not associated with changes in real-life walking patterns in mildly to moderate affected PWP.

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Trunk Motion Visual Feedback During Walking Improves Dynamic Balance in Older Adults: Assessor Blinded Randomized Controlled Trial

Identifying balance impairments in people with Parkinson’s disease using video and wearable sensors

Regulation of quasi-joint stiffness by combination of activation of ankle muscles in midstances during gait in patients with hemiparesis

Treadmill walking reduces pre-frontal activation in patients with Parkinson's disease

Comparison of segmental analysis and sacral marker methods for determining the center of mass during level and slope walking

Impact of motor fluctuations on real-life gait in Parkinson’s patients

Trunk Motion Visual Feedback During Walking Improves Dynamic Balance in Older Adults: Assessor Blinded Randomized Controlled Trial

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Eric Anson, Lei Ma, Tippawan Meetam, Elizabeth Thompson, Rathore Roshita, Victoria Dean, John Jeka
BackgroundVirtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes.Research Question: To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems.Methods40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3x/week for 4 weeks in 2 minute bouts separated by a seated rest. The control group was instructed to look at a stationary bulls-eye target while the experimental group also saw a moving cursor superimposed on the stationary bulls-eye that represented VFB of their walking trunk motion. The experimental group was instructed to keep the cursor in the center of the bulls-eye. Somatosensory (monofilaments and joint position testing) and vestibular function (canal specific clinical head impulses) was evaluated prior to intervention. Balance and mobility were tested before and after the intervention using Berg Balance Test, BESTest, mini-BESTest, and Six Minute Walk.ResultsThere were no significant differences between groups before the intervention. The experimental group significantly improved on the BESTest (p = 0.031) and the mini-BEST (p = 0.019). The control group did not improve significantly on any measure. Individuals with more profound sensory impairments had a larger improvement on dynamic balance subtests of the BESTest.SignificanceOlder adults with self-reported balance problems improve their dynamic balance after training using trunk motion VFB treadmill walking. Individuals with worse sensory function may benefit more from trunk motion VFB during walking than individuals with intact sensory function.

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Identifying balance impairments in people with Parkinson’s disease using video and wearable sensors

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Emma Stack, Veena Agarwal, Rachel King, Malcolm Burnett, Fatemeh Tahavori, Balazs Janko, William Harwin, Ann Ashburn, Dorit Kunkel
BackgroundFalls and near falls are common among people with Parkinson's (PwP). To date, most wearable sensor research focussed on fall detection, few studies explored if wearable sensors can detect instability.Research questionCan instability (caution or near-falls) be detected using wearable sensors in comparison to video analysis?MethodsTwenty-four people (aged 60–86) with and without Parkinson's were recruited from community groups. Movements (e.g. walking, turning, transfers and reaching) were observed in the gait laboratory and/or at home; recorded using clinical measures, video and five wearable sensors (attached on the waist, ankles and wrists). After defining ‘caution’ and ‘instability’, two researchers evaluated video data and a third the raw wearable sensor data; blinded to each other’s evaluations. Agreement between video and sensor data was calculated on stability, timing, step count and strategy.ResultsData was available for 117 performances: 82 (70%) appeared stable on video. Ratings agreed in 86/117 cases (74%). Highest agreement was noted for chair transfer, timed up and go test and 3 m walks. Video analysts noted caution (slow, contained movements, safety-enhancing postures and concentration) and/or instability (saving reactions, stopping after stumbling or veering) in 40/134 performances (30%): raw wearable sensor data identified 16/35 performances rated cautious or unstable (sensitivity 46%) and 70/82 rated stable (specificity 85%). There was a 54% chance that a performance identified from wearable sensors as cautious/unstable was so; rising to 80% for stable movements.SignificanceAgreement between wearable sensor and video data suggested that wearable sensors can detect subtle instability and near-falls. Caution and instability were observed in nearly a third of performances, suggesting that simple, mildly challenging actions, with clearly defined start- and end-points, may be most amenable to monitoring during free-living at home. Using the genuine near-falls recorded, work continues to automatically detect subtle instability using algorithms.

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Regulation of quasi-joint stiffness by combination of activation of ankle muscles in midstances during gait in patients with hemiparesis

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Yusuke Sekiguchi, Takayuki Muraki, Dai Owaki, Keita Honda, Shin-Ichi Izumi
BackgroundThe regulation of ankle joint stiffness by combination of activation of plantarflexor and dorsiflexor during gait has not been investigated in patients with hemiparesis. The objective of the present study was to examine the relationship between combination of activation of ankle muscles and quasi-joint stiffness (QJS) during the stance phase of gait.MethodsThe activation of the medial head of the gastrocnemius (MG), soleus, and tibialis anterior, gait parameters were collected from 19 patients with hemiparesis due to stroke and from 12 healthy controls using a three-dimensional motion analysis system. The indexes of reciprocal activation and coactivation were calculated from the ratio of plantarflexor to dorsiflexor activation and magnitude of coactivation (MC), which is computed by multiplying an index of simultaneous activation of ankle muscles by plantarflexor activation.ResultsQJS was significantly correlated with MC of MG on the paretic side, whereas it correlated with the ratio of MG (r = 0.63, p < 0.05) in healthy controls and the ratio of MG (r = 0.67, p < 0.05) and soleus (r = 0.61, p < 0.05) on the non-paretic side in midstance. Furthermore, QJS on the paretic side was lower than that on the non-paretic side and in healthy controls (p < 0.05).Significance: Our findings support that the regulation of QJS in midstance by reciprocal activation is altered on the paretic side, whereas it may be regulated by reciprocal activation and enhanced by relatively high activity of plantarflexor on the non-paretic side and in healthy controls.

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Treadmill walking reduces pre-frontal activation in patients with Parkinson's disease

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Pablo Cornejo Thumm, Inbal Maidan, Marina Brozgol, Shiran Shustak, Eran Gazit, Shirley Shema Shiratzki, Hagar Bernad-Elazari, Yoav Beck, Nir Giladi, Jeffrey M. Hausdorff, Anat Mirelman
BackgroundAmong patients with Parkinson’s disease (PD), gait is typically disturbed and less automatic. These gait changes are associated with impaired rhythmicity and increased prefrontal activation, presumably in an attempt to compensate for reduced automaticity.Research questionWe investigated whether during treadmill walking, when the pace is determined and fixed, prefrontal activation in patients with PD is lower, as compared to over-ground walking.MethodsTwenty patients with PD (age: 69.8 ± 6.5 yrs.; MoCA: 26.9 ± 2.4; disease duration: 7.9 ± 4.2 yrs) walked at a self-selected walking speed over-ground and on a treadmill. A wireless functional near infrared spectroscopy (fNIRS) system measured prefrontal lobe activation, i.e., oxygenated hemoglobin (Hb02) in the pre-frontal area. Gait was evaluated using 3D-accelerometers attached to the lower back and ankles (Opal™, APDM). Dynamic gait stability was assessed using the maximum Lyapunov exponent to investigate automaticity of the walking pattern.ResultsHb02 was lower during treadmill walking than during over-ground walking (p = 0.001). Gait stability was greater on the treadmill, compared to over-ground walking, in both the anteroposterior and medio-lateral axes (p<0.001).SignificanceThese findings support the notion that when gait is externally paced, prefrontal lobe activation is reduced in patients with PD, perhaps reflecting a reduced need for compensatory cognitive mechanisms.

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Comparison of segmental analysis and sacral marker methods for determining the center of mass during level and slope walking

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Bora Jeong, Chang-Yong Ko, Yunhee Chang, Jeicheong Ryu, Gyoosuk Kim
BackgroundA human’s center of mass (COM) is a widely used parameter in both clinical and practical applications. The segmental analysis method for determining the COM is considered the gold standard but is difficult to apply in a real environment.Research questionThe purpose of this study was to confirm the efficacy of an alternative COM determination method—the sacral marker method—by comparing segmental analysis and sacral marker method results in three dimensions during level or slope walking.MethodsTen healthy young subjects (age = 24.0 ± 4.5 yr, height = 174.5 ± 5.9 cm, and weight = 66.9 ± 9.4 kg) participated in the study. Each participant was monitored using a Helen Hayes full-body marker set and asked to walk on level and sloped (7°) terrain. The markers’ trajectories were subsequently recorded. Each participant’s COM was determined using segmental analysis and sacral marker methods via calculation and direct measurement, respectively.ResultsComparative results indicated no significant differences (p > 0.05) between the segmental analysis and sacral marker method results for the COM displacement, velocity, or acceleration in the fore-aft and vertical directions. Conversely, significant differences (p < 0.05) between the two methods were observed for the COM displacement and acceleration in the medial-lateral direction, suggesting kinematic differences.SignificanceBased on this latter finding, caution should be exercised when determining COM kinematics using the sacral marker method.

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Impact of motor fluctuations on real-life gait in Parkinson’s patients

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Ana Lígia Silva de Lima, Luc J.W. Evers, Tim Hahn, Nienke M. de Vries, Margaret Daeschler, Babak Boroojerdi, Dolors Terricabras, Max A. Little, Bastiaan R. Bloem, Marjan J. Faber
Backgroundpeople with PD (PWP) have an increased risk of becoming inactive. Wearable sensors can provide insights into daily physical activity and walking patterns.Research questions(1) is the severity of motor fluctuations associated with sensor-derived average daily walking quantity? (2) is the severity of motor fluctuations associated with the amount of change in sensor-derived walking quantity after levodopa intake?Methods304 Dutch PWP from the Parkinson@Home study were included. At baseline, all participants received a clinical examination. During the follow-up period (median: 97 days; 25-Interquartile range-IQR: 91 days, 75-IQR: 188 days), participants used the Fox Wearable Companion app and streamed smartwatch accelerometer data to a cloud platform. The first research question was assessed by linear regression on the sensor-derived mean time spent walking/day with the severity of fluctuations (MDS-UPDRS item 4.4) as independent variable, controlled for age and MDS-UPDRS part-III score. The second research question was assessed by linear regression on the sensor-derived mean post-levodopa walking quantity, with the sensor-derived mean pre-levodopa walking quantity and severity of fluctuations as independent variables, controlled for mean time spent walking per day, age and MDS-UPDRS part-III score.ResultsPWP spent most time walking between 8am and 1pm, summing up to 72 ± 39 (mean ± standard deviation) minutes of walking/day. The severity of motor fluctuations did not influence the mean time spent walking (B = 2.4 ± 1.9, p = 0.20), but higher age (B = −1.3 ± 0.3, p = < 0.001) and greater severity of motor symptoms (B = −0.6 ± 0.2, p < 0.001) was associated with less time spent walking (F(3,216) = 14.6, p<.001, R² =.17). The severity of fluctuations was not associated with the amount of change in time spent walking in relation to levodopa intake in any part of the day.SignificanceAnalysis of sensor-derived gait quantity suggests that the severity of motor fluctuations is not associated with changes in real-life walking patterns in mildly to moderate affected PWP.

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Fine structure of the canal neuromasts of the lateral line system in the adult zebrafish.

Fine structure of the canal neuromasts of the lateral line system in the adult zebrafish.

Anat Histol Embryol. 2018 Mar 26;:

Authors: Laurà R, Abbate F, Germanà GP, Montalbano G, Germanà A, Levanti M

Abstract
The mechanosensory lateral line system of fish is responsible for several functions such as balance, hearing, and orientation in water flow and is formed by neuromast receptor organs distributed on head, trunk and tail. Superficial and canal neuromasts can be distinguished for localization and morphological differences. Several information is present regarding the superficial neuromasts of zebrafish and other teleosts especially during larval and juvenile stages, while not as numerous data are so far available about the ultrastructural characteristics of the canal neuromasts in adult zebrafish. Therefore, the aim of this study was to investigate by transmission electron microscopy the ultrastructural aspects of cells present in the canal neuromasts. Besides the typical cellular aspects of the neuromast, different cellular types of hair cells were observed that could be identified as developing hair cells during the physiological turnover. The knowledge of the observed cellular types of the canal neuromasts and their origin could give a contribution to studies carried out on adult zebrafish used as model in neurological and non-neurological damages, such as deafness and vestibular disorders.

PMID: 29582454 [PubMed - as supplied by publisher]

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Πληροφορίες

Τετάρτη 28 Μαρτίου 2018