The latest medical research on Otology Neurotology
The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about otology neurotology gathered by our medical AI research bot.
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Request AccessCognitive rehabilitation effects on grey matter volume and Go-NoGo activity in progressive multiple sclerosis: results from the CogEx trial.
Neurology, Neurosurgery and PsychiatryNCT03679468.
Participants were randomised to: 'CR plus EX', 'CR plus sham EX (EX-S)', 'EX plus sham CR (CR-S)' and 'CR-S plus EX-S' and attended 12-week intervention. All subjects performed physical/cognitive assessments at baseline, week 12 and 6 months post intervention (month 9). All MRI substudy participants underwent volumetric MRI and fMRI (Go-NoGo task).
104 PMS enrolled at four sites participated in the CogEx MRI substudy; 84 (81%) had valid volumetric MRI and valid fMRI. Week 12/month 9 cognitive performances did not differ among interventions; however, 25-62% of the patients showed Symbol Digit Modalities Test improvements. Normalised cortical grey matter volume (NcGMV) changes at week 12 versus baseline were heterogeneous among interventions (p=0.05); this was mainly driven by increased NcGMV in 'CR plus EX-S' (p=0.02). Groups performing CR (ie, 'CR plus EX' and 'CR plus EX-S') exhibited increased NcGMV over time, especially in the frontal (p=0.01), parietal (p=0.04) and temporal (p=0.04) lobes, while those performing CR-S exhibited NcGMV decrease (p=0.008). In CR groups, increased NcGMV (r=0.36, p=0.01) at week 12 versus baseline correlated with increased California Verbal Learning Test (CVLT)-II scores. 'CR plus EX-S' patients exhibited Go-NoGo activity increase (p<0.05, corrected) at week 12 versus baseline in bilateral insula.
In PMS, CR modulated grey matter (GM) volume and insular activity. The association of GM and CVLT-II changes suggests GM plasticity contributes to cognitive improvements.
Early loss of spiral ganglion neurons in the auditory system after noise trauma.
Audiology and Neuro-OtologyNoise-induced hearing loss (NIHL) is one of the most frequent recognized occupational diseases. The time course of the involved pathologies is still under investigation. Several studies have demonstrated an acute damage of the sensory tissue, but only few experiments investigated the degeneration of (type I) spiral ganglion neurons (SGN), representing the primary neurons in the auditory system. The aim of the present study was to investigate the time course of SGN degeneration within a 7-day period after traumatic noise exposure starting immediately after trauma.
Young adult normal hearing mice were noise exposed for 3 hours with a broadband noise (5 - 20 kHz) at 115 dB SPL. Auditory threshold shift was measured by auditory brainstem recordings (ABR) and SGN densities were analyzed at different time points during the first week after acoustic trauma.
Significant reduction of SGN densities was detected and is accompanied by a significant hearing loss. Degeneration starts within hours after the applied trauma, further progressing within days post-exposure.
Early neurodegeneration in the auditory periphery seems to be induced by direct overstimulation of the auditory nerve fibers. SGN loss is supposed to be a result of inflammatory responses and neural deprivation, leading to permanent hearing loss and auditory processing deficits.
Comparison of the audiological knowledge of three chatbots - ChatGPT, Bing Chat, and Bard.
Audiology and Neuro-OtologyThe purpose of this study was to evaluate three chatbots - OpenAI ChatGPT, Microsoft Bing Chat (currently Copilot), and Google Bard (currently Gemini) - in terms of their responses to a defined set of audiological questions.
Each chatbot was presented with the same 10 questions. The authors rated the responses on a Likert scale ranging from 1 to 5. Additional features, such as the number of inaccuracies or errors and the provision of references, were also examined.
Most responses given by all three chatbots were rated as satisfactory or better. However all chatbots generated at least a few errors or inaccuracies. ChatGPT achieved the highest overall score, while Bard was the worst. Bard was also the only chatbot unable to provide a response to one of the questions. ChatGPT was the only chatbot that did not provide information about its sources.
Chatbots are an intriguing tool that can be used to access basic information in a specialized area like audiology. Nevertheless, one needs to be careful, as correct information is not infrequently mixed in with errors that are hard to pick up unless the user is well versed in the field.
The Effect of Bimodal Hearing on Post-Operative Quality of Life.
Audiology and Neuro-OtologyTo examine how bimodal stimulation affects quality of life (QOL) during the post operative period following cochlear implantation (CI). This data could potentially provide evidence to encourage more bimodal candidates to continue hearing aid (HA) use after CI.
In this prospective study, patients completed preoperative, and 1-, 3- and 6-months post-activation QOL surveys on listening effort, speech perception, sound quality/localization, and hearing handicap. 15 HA users who were candidates for contralateral CI completed the study (mean age 65.6 years).
Patients used both devices a median rate of 97%, 97% and 98% of the time at 1, 3, and 6 months respectively. On average, patients' hearing handicap score decreased by 16% at 1 month, 36% at 3 months, and 30% at 6 months. Patients' listening effort scores decreased by a mean of 10.8% at 1 month, 12.6% at 3 months and 18.7% at 6 months. Localization improved by 24.3% at 1 month and remained steady. There was no significant improvement in sound quality scores.
Bimodal listeners should expect QOL to improve, and listening effort and localization is generally optimized using CI and HA compared to CI alone. Some scores improved at earlier time points than others, suggesting bimodal auditory skills may develop at different rates.
Speech comprehension by cochlear implant users assessed with evoked potentials and response times.
Audiology and Neuro-OtologyCochlear implant (CI) users differ greatly in their rehabilitation outcomes, including speech understanding in noise. This variability may be related to brain changes associated with intact senses recruiting cortical areas from stimulation-deprived senses. Numerous studies have demonstrated such cross-modal reorganization in individuals with untreated hearing loss. How it is affected by regular use of hearing devices remains unclear, however. To shed light on this, the current study measured cortical responses reflecting comprehension abilities in experienced CI users and normal-hearing controls.
Using multichannel electroencephalography, we tested CI users who had used their devices for at least 12 months and closely matched controls (N = 2 × 13). Cortical responses reflecting comprehension abilities - the N400 and late positive complex (LPC) components - were evoked using congruent and incongruent digit-triplet stimuli. The participants' task was to assess digit-triplet congruency by means of timed button presses. All measurements were performed in speech-shaped noise 15 dB above individually measured speech recognition thresholds. Three stimulus presentation modes were used: auditory-only, visual-only, and visual-then-auditory.
The analyses revealed no group differences in the N400 and LPC responses. In terms of response times, the CI users were slower and differentially affected by the three stimulus presentation modes relative to the controls.
Compared to normal-hearing controls, experienced CI users may need more time to comprehend speech in noise. Response times can serve as a proxy for speech comprehension by CI users.
Contribution of basal ganglia activity to REM sleep disorder in Parkinson's disease.
Neurology, Neurosurgery and PsychiatryRapid eye movement (REM) sleep behaviour disorder (RBD) is one of the most common sleep problems and represents a key prodromal marker in Parkinson's disease (PD). It remains unclear whether and how basal ganglia nuclei, structures that are directly involved in the pathology of PD, are implicated in the occurrence of RBD.
Here, in parallel with whole-night video polysomnography, we recorded local field potentials from two major basal ganglia structures, the globus pallidus internus and subthalamic nucleus, in two cohorts of patients with PD who had varied severity of RBD. Basal ganglia oscillatory patterns during RBD and REM sleep without atonia were analysed and compared with another age-matched cohort of patients with dystonia that served as controls.
We found that beta power in both basal ganglia nuclei was specifically elevated during REM sleep without atonia in patients with PD, but not in dystonia. Basal ganglia beta power during REM sleep positively correlated with the extent of atonia loss, with beta elevation preceding the activation of chin electromyogram activities by ~200 ms. The connectivity between basal ganglia beta power and chin muscular activities during REM sleep was significantly correlated with the clinical severity of RBD in PD.
These findings support that basal ganglia activities are associated with if not directly contribute to the occurrence of RBD in PD. Our study expands the understanding of the role basal ganglia played in RBD and may foster improved therapies for RBD by interrupting the basal ganglia-muscular communication during REM sleep in PD.
Italian fast speech reception threshold test, a new method to investigate adults auditory impairment in noise.
Audiology and Neuro-OtologyPurpose of our study is to compare two competing methods of performing bisyllabic words speech audiometry for the detection of the 50% speech reception threshold in noise (SRT50).
Classic method is performed submitting multiple words lists at fixed signal to noise ratio. A newer Fast method - Italian Fast Speech Reception Threshold 50 (IFastSRT50) - is performed by means of a program software with a single list of bisyllabic words and noise intensity shifting.
Means comparison between SRT50 Classic and IFastSRT50 shows a slight significant correlation (r=0.263; p=0.044) and a wide significant difference: SRT50 Classic=-2.763dB (SD=4.1) and IFastSRT50=-7.803dB (SD=2.1) (P < 0.0001). There is high difference between test execution time means (SRT50 Classic=11min, IFastSRT50 =2min; P < 0.0001). Correlation between test results and execution times was higher in for SRT50 Classic than IFastSRT50.
IFastSRT50 test is a reliable method to quickly investigate signal to noise ratio needed to obtain 50% of recognition scores with bisyllabic words, it allows less execution time than SRT50 Classic method and can avoid patients fatigue and other limitations of different speech discrimination tests in noise as sentences based ones.
Association between COPD and hearing loss with impaired speech recognition: a cross-sectional study.
Audiology and Neuro-OtologyStudies have identified a greater risk of sensory neural hearing loss in individuals with COPD compared to healthy individuals, but it is unclear whether they are at increased risk of hearing loss with impaired speech recognition. The aim of this study was to assess whether COPD is associated with hearing loss that affects speech recognition.
This is a case-control study. We screened individuals from health facilities in the municipality of Jundiai. We enrolled a test group of individuals with COPD and an age-matched control group composed of individuals with asthma. The selected individuals attended an appointment with a chest physician, responded questionnaires and underwent tonal and speech audiometry. Adjusted binary logistic regression analysis evaluated whether COPD was associated with reduced speech recognition.
We enrolled 36 individuals with COPD and 72 with asthma. Individuals with COPD were more likely to have a reduced speech recognition compared to asthmatic individuals [Reduced recognition of three-syllable words: adjusted OR 3.72, 95 CI (1.38 - 10.02)] [Reduced recognition of monosyllable words: adjusted OR 4.74, 95 CI (1.52 - 14.76)].
We conclude that individuals with COPD from primary and secondary healthcare facilities have at least 38% greater risk of hearing loss with reduced speech recognition compared to an age-matched control group of individuals with asthma recruited from the same facilities. We recommend that longitudinal studies evaluate whether regular screening could contribute to the prevention or early treatment of hearing loss in individuals with moderate-severe COPD.
Measuring the acoustic reflex through the tympanic membrane.
Audiology and Neuro-OtologyThe acoustic reflex is the active response of the middle ear to loud sounds, altering the mechanical transfer function of the acoustic energy into the inner ear. Our goal is to observe the effect of the acoustic reflex on the tympanic membrane by identifying a significant nonlinear increase in membrane oscillations.
By using interferometric spectrally encoded endoscopy we record the membrane oscillations over time in response to a loud, 200-ms-long acoustic stimulus.
A gradual reflex activation is measured between approximately 40 and 100 ms, manifested as a linear 42% increase in the umbo oscillation amplitude.
The measured oscillations correlate well with those expected from a mechanical model of a damped harmonic oscillator, and the results of this work demonstrate the potential of interferometric spectrally encoded endoscopy to observe unique dynamical processes in the tympanic membrane and in the middle ear.
Utricular Dysfunction and Hearing Impairment Affect Spatial Navigation in Community-dwelling Healthy Adults: Analysis from the Baltimore Longitudinal Study of Aging.
Audiology and Neuro-OtologySpatial navigation, the ability to move through one's environment, is a complex skill utilized in everyday life. The effects of specific vestibular end-organ deficits and hearing impairments on spatial navigation have received little to no attention. We hypothesized that hearing impairment adversely affects spatial navigation and that bi-modal impairments (vestibular and hearing) further impair navigation ability.
Data from 182 participants in the Baltimore Longitudinal Study of Aging who had interpretable results for the video head impulse test (vHIT), cervical (cVEMP) and ocular (oVEMP) vestibular evoked myogenic potentials, audiometric testing, and the triangle completion test (TCT) were retrospectively analyzed. Multiple linear regression, controlling for age, sex, and cognition, was employed to identify predictors of TCT performance in terms of end-point error, angle deviation, and distance walked.
oVEMP abnormalities were associated with larger end-point error (p=0.008) and larger angle deviation (p=0.002) but were not associated with distance walked (p=0.392). Abnormalities on cVEMP and vHIT were not associated with distance walked (p=0.835, p=0.300), end-point error (p=0.256, p=0.808), or angle deviation (p=0.192, p=0.966). Compared with normal hearing adults, hearing impaired adults walked a shorter distance during the TCT (p=0.049) but had similar end-point error (p=0.302) and angle deviation (p=0.466). There was no interaction between vestibular and hearing function for predicting spatial navigation ability.
In this cohort analysis, utricular dysfunction and hearing impairment were associated with poorer spatial navigation performance. We postulate that hearing impairment negatively affects one's ability to use real-time, intrinsic auditory cues and/or prior experience to guide navigation.
The Directional Effects of Marker Frequencies on Across-Channel Temporal Gap-Detection Tasks: An Experimental Study.
Audiology and Neuro-OtologyGap detection tests are crucial clinical tools for identifying auditory processing disorders that result from abnormalities in the central auditory nervous system. These tests assess the ability to resolve temporal information in sounds, which aids in the diagnosis of auditory temporal processing issues. This study explores the directional effects of marker frequencies on gap detection tasks with respect to the conditions of long and short frequency disparity (separation).
We measured the gap detection thresholds (GDTs) using four across-channel narrowband noise conditions (1-2, 2-1, 1-4, and 4-1 kHz). A within-subject study design involved 29 healthy individuals with normal hearing. Stimuli were presented monaurally using headphones routed via a calibrated audiometer.
The condition with long frequency disparity and a low leading frequency (1-4 kHz) exhibited higher GDTs compared to the other across-channel conditions. However, we did not observe this effect in the other condition with long frequency disparity and a high leading frequency (4-1 kHz), which did not show significant differences from the two conditions with short frequency disparity.
The study findings suggest that the combined effects of the spectral characteristics of the gap markers, including frequency disparity and order of presentation, influence the temporal resolution ability of auditory gap detection. Clinicians evaluating a patient suspected to have central auditory disorders should recognize that the across-channel GDTs may not consistently increase as the frequency separation between the markers increases.
Evaluation of the Vestibulo-ocular Reflex Using the Video Head Impulse Test in Patients with Unilateral Chronic Otitis Media.
Audiology and Neuro-OtologyTo evaluate the vestibulo-ocular reflex (VOR) using the video head impulse test (vHIT) as a vestibular function assessment method in patients with unilateral chronic otitis media (COM).
Twenty-eight patients with unilateral COM scheduled for middle ear surgery, including 12 males and 16 females with a mean age of 54.5 years, successfully underwent preoperative vHIT. vHIT variables, including VOR gain, VOR gain asymmetry, and the incidence of corrective saccades, were compared between the ipsilesional and contralesional ears.
Ten (35.7%) patients reported varying degrees of disequilibrium or lightheadedness. The VOR gain in the ipsilesional and contralesional ears were 1.01 ± 0.10 and 1.04 ± 0.11, 0.97 ± 0.12 and 0.94 ± 0.13, and 0.97 ± 0.13 and 1.04 ± 0.15 in the horizontal canal (HC), anterior canal (AC), and posterior canal (PC), respectively. The average VOR gains in the ipsilesional ears were within the predefined range of normal values; however, the gains in HC and PC significantly decreased compared with those in contralesional ears (p=0.038 in HC and p=0.015 in PC). The prevalence of corrective saccades, including overt and/or covert saccades, did not differ significantly between the two ears.
This study assessed the pathophysiology of the inner ear affected by chronic middle ear infection by quantitatively comparing the VOR using vHIT. It demonstrated that vHIT can be a practical assessment of vestibular function in patients with COM.
