The Brain Activity Behind Tinnitus Uncovered

from Medical News Today.com

Tinnitus – hearing phantom sounds – affects millions of people, but because the physiological mechanisms behind the condition are largely unknown, treatment options are limited. Now research published in the online open access journal BMC Biology shows how a method that temporarily (usually for several seconds) reduces tinnitus in some patients links the condition to brain activity.

Galantamine in Frontotemporal Dementia and Primary Progressive Aphasia

from Dementia and Geriatric Cognitive Disorders

Background/Aims: The treatment of frontotemporal dementia (FTD) has been mainly symptomatic. Small randomized or open-label case control studies of neurotransmitters have been inconclusive. We tried galantamine in the 2 most common varieties of FTD. Method: Thirty-six behavioral variety FTD and primary progressive aphasia (PPA) patients were treated in an open-label period of 18 weeks and a randomized, placebo-controlled phase for 8 weeks with galantamine. The primary efficacy measures were the Frontal Behavioral Inventory, the Aphasia Quotient of the Western Aphasia Battery, the Clinical Global Impression of Severity and the Clinical Global Impression of Improvement. Results: No significant differences in behavior or language were found for the total group. A treatment effect (p = 0.009), in a subgroup of subjects with PPA in the global severity score, in favor of galantamine was detected in the placebo-controlled withdrawal phase but was not considered significant after correction for multiple comparisons. The language scores for the treated PPA group also remained stable compared to the placebo group, which showed deterioration. Conclusion: Galantamine is not effective in the behavioral variety of FTD, but a trend of efficacy is shown in the aphasic subgroup, which may be clinically significant. Galantamine appeared safe in FTD/PPA.

Influences on communicative development at 24 months of age: Child temperament, behaviour problems, and maternal factors

from Infant Behavior and Development

Within a longitudinal study using a large representative, community sample of infants recruited at mean age 8 months, we examined influences on infant communication development at 24 months, including child gender, shy temperament, behavioural and emotional problems, and several variables relating to maternal psychosocial health. On most developmental measures girls were in advance of boys and they also showed shyer temperament. Child gender, shy temperament and maternal psychosocial indices were associated with both vocabulary development as measured by the MacArthur-Bates Communicative Development Inventory (CDI), and communication and symbolic development assessed via the Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS) at 24 months. No prediction was found using scores at 8 or 12 months, although moderate stability between measures between 12 and 24 months was evident. Predictors of 24 month outcomes were all concurrently measured variables, and included temperamental shyness, but very little variance in communication outcomes was explained. Children whose mothers were experiencing clinical levels of depression and life difficulties reported more child behavioural problems.

Medical Implants: The Inside Story

from Medical News Today.com

Patients suffering from conditions such as stroke, blindness, deafness, incontinence, glaucoma or hydrocephalus will be the first to benefit from a range of new technologies and implantable medical devices developed by a pioneering European consortium of researchers, surgeons and technology companies.

Bilateral cochlear implants should be the standard for children with bilateral sensorineural deafness

from Current Opinion in Otolaryngology and Head and Neck Surgery

Purpose of review: Bilateral cochlear implants are provided to children in an attempt to establish binaural processing and allow hearing with greater ease. Arguments against implantation, which prevailed for many years, are countered by some of the findings reported over the past 1-2 years.

Recent findings: Behavioral and electrophysiological outcomes in children receiving cochlear implants suggest that two issues are most important when considering bilateral cochlear implants for any child: the duration of deafness prior to the first implantation affecting development of oral speech and language skills and the inter-stage interval (between implantation of the first and second ears) likely affecting development of binaural processing.

Summary: Based on the data reported to date, both the interval between onset of deafness and cochlear implantation and the interval between implantation of the first and second ears should be narrow in children. We recommend that simultaneous bilateral implantation be provided when possible and, if not, the inter-stage interval should be limited. We further recommend continued exploration of outcomes in children with longer inter-stage intervals with a view to defining a point at which bilateral cochlear implantation provides so little benefit that it is not cost-effective.

The Human Cricothyroid Muscle: Three Muscle Bellies and Their Innervation Patterns

from the Journal of Voice

We hypothesized that the phonatory and respiratory functions of the human cricothyroid (CT) muscle are subserved by separately controlled muscle bellies. In this work, 30 autopsied adult human hemilarynges were used to determine the neuromuscular organization of the CT muscle using microdissection, histology, and Sihler’s stain. The results showed that the human CT was composed of three bellies: rectus, oblique, and horizontal. External superior laryngeal nerve (ESLN) was found to enter into the CT muscle as a single trunk (37.5%) or multiple (two to five) branches (62.5%). Within the CT muscle, the ESLN gave off three to seven branches to innervate the rectus belly and one or two branches to supply the oblique and horizontal bellies, respectively. Notably, ESLN also gave off branches to innervate the ipsilateral thyroarytenoid muscle (46%) and subglottic mucosa (67%) or connect with the recurrent laryngeal nerve (25%). These findings suggest that the CT bellies appear to be functionally designed for different motor tasks. The data are also useful for further clarifying the functions of the CT bellies and the ESLN branches and for developing belly-based reinnervation procedures to treat laryngeal paralysis.

Predictions of Fundamental Frequency Changes During Phonation Based on A Biomechanical Model of the Vocal Fold Lamina Propria

from the Journal of Voice

This study examines the local and global changes of fundamental frequency (F0) during phonation and proposes a biomechanical model of predictions of F0 contours based on the mechanics of vibration of vocal fold lamina propria. The biomechanical model integrates the constitutive description of the tissue mechanical response with a structural model of beam vibration. The constitutive model accounts for the nonlinear and time-dependent response of the vocal fold cover and the vocal ligament. The structural model of the vocal fold lamina propria is based on a composite beam model with axial stress. Results show that local fluctuations such as F0 overshoots and undershoots can be characterized by the biomechanical model and might be related to the processes of stress relaxation of vocal fold tissues during length changes. The global changes of F0 declination in declarative sentence production can also be characterized by the model. Such F0 declination is partially attributed to the peak stress decay associated with stress relaxation of the vocal fold lamina propria and partially to neuromuscular control of the vocal fold length.

Laryngeal and Respiratory Behavior during Pitch Change in Professional Singers

from the Journal of Voice

The aim of this study was to examine the physiology of pitch change in terms of laryngeal and respiratory mechanisms in professional singers. Nine female professional singers were recruited to participate in the study. Videoendoscopic recordings of the participants producing one-octave ascending and descending scales were used as a basis to apply a ratio measurement of vocal fold length for each note produced on the scale. Simultaneous respiratory data using Respitrace were also collected. Questionnaires (Voice Handicap Index and Vocal Questionnaire) were used to obtain information about psychosocial aspects related to voice use. Two vocal fold lengthening patterns (static and dynamic) were observed with pitch change. Participants exhibiting a static pattern of vocal fold lengthening had fewer years of vocal training, exhibited a more variable use of vital capacity, and also began the singing task at a higher position in their vital capacity. The reverse was true for participants exhibiting a dynamic vocal fold pattern. These preliminary data indicate that the pattern of vocal fold lengthening exhibited by singers may be related to the number of years of training possessed. Furthermore, the data indicate that stability in one subsystem may result in variability in another, as shown by the interaction between the vocal fold and respiratory patterns.

Spontaneous Resolution of Hemorrhagic Polyps of the True Vocal Fold

from the Journal of Voice

Hemorrhagic polyps are the most common benign lesions surgically removed from the vocal folds. Although this modality does offer satisfactory results in most of the cases, there is a subset of polyps that seems to resolve with conservative therapy. This study was performed to examine this subset of polyps. Thirty-four consecutive subjects diagnosed with hemorrhagic polyps of the true vocal fold were retrospectively reviewed to determine the incidence of spontaneous resolution of the lesions with nonsurgical therapy. Sixteen subjects began conservative therapy, consisting of voice therapy and proper vocal hygiene, often while awaiting an optimal personal time for surgical intervention. Of these subjects, nine (56.3%) experienced a resolution of their lesion and symptoms without undergoing surgical therapy. Surgical removal of hemorrhagic polyps is often considered the standard of treatment for these benign lesions. However, these observations support a regimen of voice therapy and observation in select cases.

Voice Handicap in Singers

from the Journal of Voice

The study aimed to determine the differences in responses to the Voice Handicap Index (VHI-10) between singers and nonsingers and to evaluate the ranked order differences of the VHI-10 statements for both groups. The VHI-10 was modified to include statements related to the singing voice for comparison to the original VHI-10. Thirty-five nonsingers with documented voice disorders responded to the VHI-10. A second group, consisting of 35 singers with voice complaints, responded to the VHI-10 with three statements added specifically addressing the singing voice. Data from both groups were analyzed in terms of overall subject self-rating of voice handicap and the rank order of statements from least to most important. The difference between the mean VHI-10 for the singers and nonsingers was not statistically significant, thus, supporting the validity of the VHI-10. However, the 10 statements were ranked differently in terms of their importance by both groups. In addition, when three statements related specifically to the singing voice were substituted in the original VHI-10, the singers judged their voice problem to be more severe than when using the original VHI-10. The type of statements used to assess self-perception of voice handicap may be related to the subject population. Singers with voice problems do not rate their voices to be more handicapped than nonsingers unless statements related specifically to singing are included.

Voice Quality After Supracricoid Laryngectomy and Total Laryngectomy With Insertion of Voice Prosthesis

from the Journal of Voice

Vocal quality was analyzed in 20 subjects who underwent total laryngectomy with insertion of voice prosthesis (TL with VP) and in 10 subjects who underwent supracricoid laryngectomy (SCL). Acoustic analysis was carried out using Lingwaves and Praat, for sustained vowels and conversation to obtain the fundamental frequency (F0) and jitter parameters. Perceptual evaluations and self-assessment of voice impact on the quality of life were also performed. Results showed statistically significant differences between TL + VP and SCL individuals for the mean F0 during conversation, for Roughness, Grade of voice quality, and self-assessment of speech, with worst results in the SCL group.

Code-switching effects in bilingual word recognition: A masked priming study with event-related potentials

from Brain and Language

Two experiments tested language switching effects with bilingual participants in a priming paradigm with masked primes (duration of 50 ms in Experiment 1 and 100 ms in Experiment 2). Participants had to monitor target words for animal names, and ERPs were recorded to critical (non-animal) words in L1 and L2 primed by unrelated words from the same or the other language. Both experiments revealed language priming (switching) effects that depended on target language. For target words in L1, most of the language switch effect appeared in the N400 ERP component, with L2 primes generating a more negative going wave than L1 primes. For L2 target words, on the other hand, the effects of a language switch appeared mainly in an earlier ERP component (N250) peaking at approximately 250 ms post-target onset, and showing greater negativity following an L1 prime than an L2 prime. This is the first evidence for fast-acting language-switching effects occurring in the absence of overt task switching.

An introduction to the International Classification of Functioning, Disability and Health (ICF) for speech-language pathology: Its past, present and future

from the International Journal of Speech-Language Pathology

This paper provides a context for the remainder of this special issue on the International Classification of Functioning, Disability and Health (ICF) and speech-language pathology. It describes the ICF – its past, present and future in relation to the discipline of speech-language pathology. The history of the ICF is presented outlining the characteristics of previous versions of the ICF. In particular the changes to the terminology are described. The current status of the ICF is then depicted, with an emphasis on how the ICF has been operationalized in areas that affect speech-language pathology. The final section summarizes three challenges related to the application of the ICF in speech-language pathology: quickening its translation into clinical practice, developing better agreement on specific classifications relevant to the profession, and finally achieving a full roll out of the broad scope of the ICF in the profession.

Binaural jitter improves interaural time-difference sensitivity of cochlear implantees at high pulse rates

from the Proceedings of the National Academy of Sciences of the United States of America

Interaural time difference (ITD) arises whenever a sound outside of the median plane arrives at the two ears. There is evidence that ITD in the rapidly varying fine structure of a sound is most important for sound localization and for understanding speech in noise. Cochlear implants (CIs), neural prosthetic devices that restore hearing in the profoundly deaf, are increasingly implanted to both ears to provide implantees with the advantages of binaural hearing. CI listeners have been shown to be sensitive to fine structure ITD at low pulse rates, but their sensitivity declines at higher pulse rates that are required for speech coding. We hypothesize that this limitation in electric stimulation is at least partially due to binaural adaptation associated with periodic stimulation. Here, we show that introducing binaurally synchronized jitter in the stimulation timing causes large improvements in ITD sensitivity at higher pulse rates. Our experimental results demonstrate that a purely temporal trigger can cause recovery from binaural adaptation. Thus, binaurally jittered stimulation may improve several aspects of binaural hearing in bilateral recipients of neural auditory prostheses.

Oropharyngeal findings of endoscopic examination in swallowing disorders of neurological origin

from the European Archives of Oto-Rhino-Laryngology

Abstract  A study was carried out to examine the significance of anatomical and functional oropharyngeal findings in patients with neurological disorders as part of an endoscopic evaluation of swallowing. The study included 101 patients (60.2 years ± 16.35, 63 male = 62%, 38 female = 38%) with neurological disorders (cerebral infarct, head injury, hypoxia) presenting with dysphagia. Oropharyngeal findings from endoscopic examination of nine anatomical regions and ten functional tests were correlated with the results of a standardised endoscopic swallowing test. Anatomical changes were obtained in 30 (30%) patients; functional changes were obtained in 67 (66%) patients. No correlation between these changes and swallowing ability was found. “Start of swallow,” “leaking,” “residues” and “follow-up swallowing” did show a correlation with the results of the swallowing test. In addition, for swallowing tests with saliva, “follow-up swallowing” and “swallowing after coughing” also showed a correlation. Anatomical or functional endoscopic oropharyngeal examination changes alone did not influence swallowing ability in the mixed neurological group studied. Evaluation of swallowing ability requires a swallowing test with saliva and various test consistencies under normal conditions. Failure to swallow following coughing during swallowing tests with saliva can be used as a clinical indicator for aspiration.