Objectives: Among the many advantages of binaural hearing are the abilities to localize sounds in space and to attend to one sound in the presence of many sounds. Binaural hearing provides benefits for all listeners, but it may be especially critical for military personnel who must maintain situational awareness in complex tactical environments with multiple speech and noise sources. There is concern that Military Service Members who have been exposed to one or more high-intensity blasts during their tour of duty may have difficulty with binaural and spatial ability due to degradation in auditory and cognitive processes. The primary objective of this study was to assess the ability of blast-exposed Military Service Members to localize speech sounds in quiet and in multisource environments with one or two competing talkers. Design: Participants were presented with one, two, or three topic-related (e.g., sports, food, travel) sentences under headphones and required to attend to, and then locate the source of, the sentence pertaining to a prespecified target topic within a virtual space. The listener’s head position was monitored by a head-mounted tracking device that continuously updated the apparent spatial location of the target and competing speech sounds as the subject turned within the virtual space. Measurements of auditory localization ability included mean absolute error in locating the source of the target sentence, the time it took to locate the target sentence within 30 degrees, target/competitor confusion errors, response time, and cumulative head motion. Twenty-one blast-exposed Active-Duty or Veteran Military Service Members (blast-exposed group) and 33 non-blast-exposed Service Members and beneficiaries (control group) were evaluated. Results: In general, the blast-exposed group performed as well as the control group if the task involved localizing the source of a single speech target. However, if the task involved two or three simultaneous talkers, localization ability was compromised for some participants in the blast-exposed group. Blast-exposed participants were less accurate in their localization responses and required more exploratory head movements to find the location of the target talker. Conclusions: Results suggest that blast-exposed participants have more difficulty than non-blast-exposed participants in localizing sounds in complex acoustic environments. This apparent deficit in spatial hearing ability highlights the need to develop new diagnostic tests using complex listening tasks that involve multiple sound sources that require speech segregation and comprehension. Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government. ACKNOWLEDGMENTS: This article is dedicated to Dr. R. (Steve) Ackley (1946-2013), Chair, Department of Speech, Hearing, and Language Sciences at Gallaudet University. He served as an advisor to the first author, L. Kubli. Dr. Ackley provided guidance, patience, humor, and support to complete the research study. He was an admirable mentor and friend who is missed dearly. The research was supported by a grant (D61I10J826) from the Defense Medical Research and Development Program. The authors have no conflicts of interest to disclose. Address for correspondence: Lina R. Kubli, 810 Vermont Avenue, NW (10P9R), Washington DC, 20420, USA. E-mail: lina.kubli@va.gov Received August 19, 2016; accepted September 26, 2017. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Παρασκευή 29 Δεκεμβρίου 2017
Effects of Amplification on Neural Phase Locking, Amplitude, and Latency to a Speech Syllable
Objective: Older adults often have trouble adjusting to hearing aids when they start wearing them for the first time. Probe microphone measurements verify appropriate levels of amplification up to the tympanic membrane. Little is known, however, about the effects of amplification on auditory-evoked responses to speech stimuli during initial hearing aid use. The present study assesses the effects of amplification on neural encoding of a speech signal in older adults using hearing aids for the first time. It was hypothesized that amplification results in improved stimulus encoding (higher amplitudes, improved phase locking, and earlier latencies), with greater effects for the regions of the signal that are less audible. Design: Thirty-seven adults, aged 60 to 85 years with mild to severe sensorineural hearing loss and no prior hearing aid use, were bilaterally fit with Widex Dream 440 receiver-in-the-ear hearing aids. Probe microphone measures were used to adjust the gain of the hearing aids and verify the fitting. Unaided and aided frequency-following responses and cortical auditory-evoked potentials to the stimulus /ga/ were recorded in sound field over the course of 2 days for three conditions: 65 dB SPL and 80 dB SPL in quiet, and 80 dB SPL in six-talker babble (+10 signal to noise ratio). Results: Responses from midbrain were analyzed in the time regions corresponding to the consonant transition (18 to 68 ms) and the steady state vowel (68 to 170 ms). Generally, amplification increased phase locking and amplitude and decreased latency for the region and presentation conditions that had lower stimulus amplitudes—the transition region and 65 dB SPL level. Responses from cortex showed decreased latency for P1, but an unexpected decrease in N1 amplitude. Previous studies have demonstrated an exaggerated cortical representation of speech in older adults compared to younger adults, possibly because of an increase in neural resources necessary to encode the signal. Therefore, a decrease in N1 amplitude with amplification and with increased presentation level may suggest that amplification decreases the neural resources necessary for cortical encoding. Conclusion: Increased phase locking and amplitude and decreased latency in midbrain suggest that amplification may improve neural representation of the speech signal in new hearing aid users. The improvement with amplification was also found in cortex, and, in particular, decreased P1 latencies and lower N1 amplitudes may indicate greater neural efficiency. Further investigations will evaluate changes in subcortical and cortical responses during the first 6 months of hearing aid use. ACKNOWLEDGMENTS: We thank Francis Kuk, Widex USA, for feedback on the project, and Widex USA, Inc. for providing hearing aids and participant funds and providing KEMAR measurements. We also thank Dr. Richard Wilson for providing the six-talker babble used in the noise presentation condition. We also acknowledge Lauren Evans, Arielle Abrams, Alyson Schapiro, Andrea Kaplanges, Alanna Schloss, and other lab members for their help with data collection and analysis. S.A. designed the experiment; K.J., C.F., A.P., and S.A. collected and analyzed the data; and K.J., C.F., A.P., and S.A. wrote the article. We have no conflict of interest to report. This study was funded by University of Maryland’s Department of Hearing and Speech Sciences, the Hearing Health Foundation, NIH-NIDCD Grant T32DC000046, and Widex USA, Inc. who provided hearing aids for the duration of the study and contributed to subject compensation. Address for correspondence: Samira Anderson, Department of Hearing and Speech Sciences, 0100 Lefrak Hall, 7251 Preinkert Drive, College Park, MD 20742, USA. E-mail: sander22@umd.edu Received May 14, 2016; accepted November 5, 2017. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
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The Reliability and Validity of "Dokuz Eylül University Meniere's Disease Disability Scale".
The Reliability and Validity of "Dokuz Eylül University Meniere's Disease Disability Scale".
J Int Adv Otol. 2017 Dec 14;:
Authors: Mutlu B, Kırkım G, Mungan Durankaya S, Gürkan S, Başokçu TO, Güneri EA
Abstract
OBJECTIVE: Ménière's Disease (MD) is a chronic, non-life threatening inner ear disease, with attacks of disabling vertigo, progressive hearing loss, and tinnitus as the major symptoms. All three symptoms, separately or in combination, cause great distress and have a considerable impact on the quality of life of the patients. The aims of this study were to develop a disease-specific quality of life survey for patients with MD and to analyze the relationships between the audiovestibular findings and the survey.
MATERIALS AND METHODS: Following Ear-Nose-Throat examination and audiovestibular tests, the Dokuz Eylül University Meniere's Disease Disability Scale (DEU-MDDS) and Turkish version of the Dizziness Handicap Inventory (DHI-T) were administered to 93 patients with definite MD. Reliability and validity analyses of the scale were performed.
RESULTS: There were 45 (48.4%) male and 48 (51.6%) female patients and the mean age was 48.9±12.1 years. Cronbach's alpha was 0.92 and intraclass correlation coefficients of the DEU-MMDS were significant (p<0.001). Results of the Goodness of Fit Statistics showed that the expression levels of the items were high and the correlation coefficients of each item with the scale were sufficient. There was a statistically significant correlation between DHI-T scores and MDDS. DEU-MDDS was not related to the vestibular tests, age or gender (p>0.05).
CONCLUSION: The MDDS is a valid and reliable scale as a disease-specific quality of life questionnaire for patients with MD.
PMID: 29283101 [PubMed - as supplied by publisher]
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Amiodarone-associated bilateral vestibulopathy.
| Related Articles |
Amiodarone-associated bilateral vestibulopathy.
Eur Arch Otorhinolaryngol. 2017 Dec 27;:
Authors: Gürkov R, Manzari L, Blödow A, Wenzel A, Pavlovic D, Luis L
Abstract
BACKGROUND: Bilateral vestibulopathy (BVP) is a debilitating disorder characterized by the hypofunction of both vestibular end organs or nerves. The most frequent identifiable causes of BVP are ototoxic drug effects, infectious and autoimmune disorders. The majority of cases, however, remain idiopathic.
METHODS: Medical records of patients diagnosed with idiopathic BVP were examined in five dizziness clinics.
RESULTS: We identified 126 patients with "idiopathic" BVP. Out of these, 15 patients had a history of Amiodarone treatment before the diagnosis of BVP, resulting in a 12% prevalence.
CONCLUSION: The present report supports the hypothesis that Amiodarone can cause BVP. Vestibular examination in patients taking Amiodarone and suffering from balance-related symptoms are recommended, to recognize this adverse effect as early as possible and allow for an informed judgement on a potential dose reduction or withdrawal for recovery of the vestibular function.
PMID: 29282523 [PubMed - as supplied by publisher]
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The Reliability and Validity of "Dokuz Eylül University Meniere's Disease Disability Scale".
The Reliability and Validity of "Dokuz Eylül University Meniere's Disease Disability Scale".
J Int Adv Otol. 2017 Dec 14;:
Authors: Mutlu B, Kırkım G, Mungan Durankaya S, Gürkan S, Başokçu TO, Güneri EA
Abstract
OBJECTIVE: Ménière's Disease (MD) is a chronic, non-life threatening inner ear disease, with attacks of disabling vertigo, progressive hearing loss, and tinnitus as the major symptoms. All three symptoms, separately or in combination, cause great distress and have a considerable impact on the quality of life of the patients. The aims of this study were to develop a disease-specific quality of life survey for patients with MD and to analyze the relationships between the audiovestibular findings and the survey.
MATERIALS AND METHODS: Following Ear-Nose-Throat examination and audiovestibular tests, the Dokuz Eylül University Meniere's Disease Disability Scale (DEU-MDDS) and Turkish version of the Dizziness Handicap Inventory (DHI-T) were administered to 93 patients with definite MD. Reliability and validity analyses of the scale were performed.
RESULTS: There were 45 (48.4%) male and 48 (51.6%) female patients and the mean age was 48.9±12.1 years. Cronbach's alpha was 0.92 and intraclass correlation coefficients of the DEU-MMDS were significant (p<0.001). Results of the Goodness of Fit Statistics showed that the expression levels of the items were high and the correlation coefficients of each item with the scale were sufficient. There was a statistically significant correlation between DHI-T scores and MDDS. DEU-MDDS was not related to the vestibular tests, age or gender (p>0.05).
CONCLUSION: The MDDS is a valid and reliable scale as a disease-specific quality of life questionnaire for patients with MD.
PMID: 29283101 [PubMed - as supplied by publisher]
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Amiodarone-associated bilateral vestibulopathy.
| Related Articles |
Amiodarone-associated bilateral vestibulopathy.
Eur Arch Otorhinolaryngol. 2017 Dec 27;:
Authors: Gürkov R, Manzari L, Blödow A, Wenzel A, Pavlovic D, Luis L
Abstract
BACKGROUND: Bilateral vestibulopathy (BVP) is a debilitating disorder characterized by the hypofunction of both vestibular end organs or nerves. The most frequent identifiable causes of BVP are ototoxic drug effects, infectious and autoimmune disorders. The majority of cases, however, remain idiopathic.
METHODS: Medical records of patients diagnosed with idiopathic BVP were examined in five dizziness clinics.
RESULTS: We identified 126 patients with "idiopathic" BVP. Out of these, 15 patients had a history of Amiodarone treatment before the diagnosis of BVP, resulting in a 12% prevalence.
CONCLUSION: The present report supports the hypothesis that Amiodarone can cause BVP. Vestibular examination in patients taking Amiodarone and suffering from balance-related symptoms are recommended, to recognize this adverse effect as early as possible and allow for an informed judgement on a potential dose reduction or withdrawal for recovery of the vestibular function.
PMID: 29282523 [PubMed - as supplied by publisher]
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Πέμπτη 28 Δεκεμβρίου 2017
Evaluation of the Supraglottic and Subglottic Activities Including Acoustic Assessment of the Opera-Chant Singers
Source:Journal of Voice
Author(s): Emine Petekkaya, Ahmet Hilmi Yücel, Özgür Sürmelioğlu
Opera and chant singers learn to effectively use aerodynamic components by breathing exercises during their education. Aerodynamic components, including subglottic air pressure and airflow, deteriorate in voice disorders. This study aimed to evaluate the changes in aerodynamic parameters and supraglottic structures of men and women with different vocal registers who are in an opera and chant education program. Vocal acoustic characteristics, aerodynamic components, and supraglottic structures were evaluated in 40 opera and chant art branch students. The majority of female students were sopranos, and the male students were baritone or tenor vocalists. The acoustic analyses revealed that the mean fundamental frequency was 152.33 Hz in the males and 218.77 Hz in the females. The estimated mean subglottal pressures were similar in females (14.99 cmH2O) and in males (14.48 cmH2O). Estimated mean airflow rates were also similar in both groups. The supraglottic structure compression analyses revealed partial anterior-posterior compressions in 2 tenors and 2 sopranos, and false vocal fold compression in 2 sopranos. Opera music is sung in high-pitched sounds. Attempts to sing high-pitched notes and frequently using register transitions overstrain the vocal structures. This intense muscular effort eventually traumatizes the vocal structures and causes supraglottic activity.
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