Monthly Archives: September 2009
What Influences Literacy Outcome in Children With Speech Sound Disorder?
Conclusions: Results support previous literature findings that SSD history predicts literacy difficulties and that the association is strongest for SSD + language impairment (LI). Magnitude of phonological impairment alone did not determine literacy outcome, as predicted by the core phonological deficit hypothesis. Instead, consistent with a multiple deficit approach, phonological deficits appeared to interact with other cognitive factors in literacy development.
Cortical Activation during a Pitch Discrimination Task in Tinnitus Patients and Controls – An fMRI Study
Chronic subjective tinnitus has been associated with aberrant activation of cortical areas involved in the perception of auditory information. This leads to the hypothesis that neural correlates of altered auditory perception may be found in tinnitus patients using functional magnetic resonance imaging. To study brain activation patterns due to acoustic stimulation in a pitch discrimination task, 6 tinnitus patients and 6 age-matched controls were investigated. Tones were presented binaurally at 5 beeps/s with three different frequencies in a block design. Using Statistical Parametrical Mapping, we found activation of secondary auditory areas in both groups. Furthermore, controls showed activation of the right-hemispheric anterior insula, whereas the middle frontal gyrus, putamen and left-hemispheric insula were activated in tinnitus patients. In the between-group analysis, activation of the caudate nucleus, superior frontal gyrus (Brodmann area 8) and cingular cortex was more pronounced in patients than in controls suggesting the perception of auditory inputs in a more emotional context in our patient group compared to controls.
Patient Perceptions of Voice Therapy Adherence
Patient perspectives of behavioral voice therapy, including perspectives of treatment adherence, have not been formally documented. Because treatment adherence is, to a large extent, determined by patient beliefs, assessment of patient perspectives is integral to the study of adherence. Fifteen patients who had undergone at least two sessions of direct voice therapy for a variety of voice disorders/complaints were interviewed about their perspectives on voice therapy, with a particular focus on adherence. Interviews were transcribed and analyzed for content according to qualitative methods. Three common content themes emerged from the transcripts: Voice Therapy is Hard, Make it Happen, and The Match Matters. Findings were compared with reports of patient experiences in other behavioral interventions, such as diet and exercise, and related to existing theoretical models of behavior change and therapeutic process. This study yields information toward the development of scales to measure adherence-related constructs and strategies to improve treatment adherence in voice therapy.
from the Journal of Voice
The Relationship Between the Glottic Configuration After Frontolateral Laryngectomy and the Acoustic Voice Analysis
The relative measurement of the anterior commissure synechia (S) is a crucial factor worsening voice quality and the perceptual analysis score has a strong correlation to the synechia’s impact. The aim of this study is to correlate the laryngeal configuration regarding the anterior commissure synechia and its relationship with the acoustic vocal parameters. Fifteen male patients underwent frontolateral partial vertical laryngectomy and reconstruction with bipedicle sternohyoid muscle flap for the treatment of T1b/T2 glottic cancer. The patients were free of disease, and the evaluation was performed after a minimum postoperative period of 12 months. Measurements of the anterior commissure synechia and the free border of both the preserved and the reconstructed vocal folds were simultaneously performed with the acoustic analysis of the voice. We calculated the mathematical proportion between the midsagital dimension of the synechia of the anterior commissure and the measurement of the free border of the intermembranous region of each vocal fold—the preserved one and that reconstructed with the bipedicle sternohyoid muscle flap. The acoustic evaluation showed an important increase in the fundamental frequency, and the values of all parameters were changed regardless of the anterior commissure synechia findings. These results suggest that the acoustic voice parameters are always changed because of the aperiodic pattern regardless of the anterior commissure synechia findings.
from the Journal of Voice
The neural response to changing semantic and perceptual complexity during language processing
Speech comprehension involves processing at different levels of analysis, such as acoustic, phonetic, and lexical. We investigated neural responses to manipulating the difficulty of processing at two of these levels. Twelve subjects underwent positron emission tomographic scanning while making decisions based upon the semantic relatedness between heard nouns. We manipulated perceptual difficulty by presenting either clear or acoustically degraded speech, and semantic difficulty by varying the degree of semantic relatedness between words. Increasing perceptual difficulty was associated with greater activation of the left superior temporal gyrus, an auditory-perceptual region involved in speech processing. Increasing semantic difficulty was associated with reduced activity in both superior temporal gyri and increased activity within the left angular gyrus, a heteromodal region involved in accessing word meaning. Comparing across all the conditions, we also observed increased activation within the left inferior prefrontal cortex as the complexity of language processing increased. These results demonstrate a flexible system for language processing, where activity within distinct parts of the network is modulated as processing demands change. Hum Brain Mapp, 2009. © 2009 Wiley-Liss, Inc.
from Human Brain Mapping
Does the Middle Temporal Area Carry Vestibular Signals Related to Self-Motion?
Recent studies have described vestibular responses in the dorsal medial superior temporal area (MSTd), a region of extrastriate visual cortex thought to be involved in self-motion perception. The pathways by which vestibular signals are conveyed to area MSTd are currently unclear, and one possibility is that vestibular signals are already present in areas that are known to provide visual inputs to MSTd. Thus, we examined whether selective vestibular responses are exhibited by single neurons in the middle temporal area (MT), a visual motion-sensitive region that projects heavily to area MSTd. We compared responses in MT and MSTd to three-dimensional rotational and translational stimuli that were either presented using a motion platform (vestibular condition) or simulated using optic flow (visual condition). When monkeys fixated a visual target generated by a projector, half of MT cells (and most MSTd neurons) showed significant tuning during the vestibular rotation condition. However, when the fixation target was generated by a laser in a dark room, most MT neurons lost their vestibular tuning whereas most MSTd neurons retained their selectivity. Similar results were obtained for free viewing in darkness. Our findings indicate that MT neurons do not show genuine vestibular responses to self-motion; rather, their tuning in the vestibular rotation condition can be explained by retinal slip due to a residual vestibulo-ocular reflex. Thus, the robust vestibular signals observed in area MSTd do not arise through inputs from area MT.
from the Journal of Neuroscience
EU to set volume limits on MP3 players to limit risk of hearing loss
The EU says it will draft new technical standards to limit the volume of mobile music players.
from Medbroadcast.com
A Web Services–Based Distributed System with Browser–Client Architecture to Promote Tele-audiology Assessment
The purpose of this research was to extend applications of the Internet and other telecommunication means to the assessment of hearing. The newly developed distributed system consists primarily of an application server and its database, and Web services under browser–server architecture to support remote hearing assessment. A pilot study was conducted: three independent audiologists assessed hearing of 25 subjects using testing approaches with different data communication configurations. Analysis of the results demonstrated the feasibility of replacing conventional “face-to-face” tests with the remote hearing tests using the distributed system. Because of its distributed architecture, the present system supports a new service model and separates technical maintenance and clinical services. Consequently, the system shows great potential
Conference Offers Hope for People With Dysphagia
Thirst and dehydration are common complaints for people with dysphagia – a disorder that affects a person’s ability to swallow normally. But local health care providers recently learned about an option that helps patients with dysphagia quench their thirst and improve their quality of life.
Over 100 speech-language pathologists visited the UT Dallas Callier Center for Communication Disorders on Sept. 19 to learn about the Frazier Water Protocol, a management program that allows patients with dysphagia to drink water.
Kathy Panther, speech-language pathologist and rehab director for the Frazier Rehab Institute in Louisville, Ky., was the featured speaker.
Does the Middle Temporal Area Carry Vestibular Signals Related to Self-Motion?
Recent studies have described vestibular responses in the dorsal medial superior temporal area (MSTd), a region of extrastriate visual cortex thought to be involved in self-motion perception. The pathways by which vestibular signals are conveyed to area MSTd are currently unclear, and one possibility is that vestibular signals are already present in areas that are known to provide visual inputs to MSTd. Thus, we examined whether selective vestibular responses are exhibited by single neurons in the middle temporal area (MT), a visual motion-sensitive region that projects heavily to area MSTd. We compared responses in MT and MSTd to three-dimensional rotational and translational stimuli that were either presented using a motion platform (vestibular condition) or simulated using optic flow (visual condition). When monkeys fixated a visual target generated by a projector, half of MT cells (and most MSTd neurons) showed significant tuning during the vestibular rotation condition. However, when the fixation target was generated by a laser in a dark room, most MT neurons lost their vestibular tuning whereas most MSTd neurons retained their selectivity. Similar results were obtained for free viewing in darkness. Our findings indicate that MT neurons do not show genuine vestibular responses to self-motion; rather, their tuning in the vestibular rotation condition can be explained by retinal slip due to a residual vestibulo-ocular reflex. Thus, the robust vestibular signals observed in area MSTd do not arise through inputs from area MT.
from the Journal of Neuroscience
Generalized and Symptom-Specific Insight in Behavioral Variant Frontotemporal Dementia and Primary Progressive Aphasia
Behavioral variant frontotemporal dementia (FTD) and primary progressive aphasia (PPA) are related dementias with different presenting symptoms but with increasing symptom overlap as they progress. Loss of insight is associated with early behavioral variant FTD, but not PPA. This study used the Frontal Behavioral Inventory to compare patient and caregiver concepts of symptom presence and severity. Patients with behavioral variant FTD were found to have worse insight overall than PPA patients. However, the PPA group showed reduced insight into behavioral symptoms, and the behavioral variant FTD groups had intact insight into some language symptoms. Theoretical and clinical implications are discussed.
from the Journal of Neurosphysiology
Quantification of tympanic membrane elasticity parameters from in situ point indentation measurements: validation and preliminary study
Correct quantitative parameters to describe tympanic membrane elasticity are an important input for realistic modeling of middle ear mechanics. In the past, several attempts have been made to determine tympanic membrane elasticity from tensile experiments on cut-out strips. The strains and stresses in such experiments may be far out of the physiologically relevant range and the elasticity parameters are only partially determined. We developed a setup to determine tympanic membrane elasticity in situ, using a combination of point micro-indentation and Moiré profilometry. The measuring method was tested on latex phantom models of the tympanic membrane, and our results show that the correct parameters can be determined. These parameters were calculated by finite element simulation of the indentation experiment and parameter optimization routines.
When the apparatus was used for rabbit tympanic membranes, Moiré profilometry showed that there is no measurable displacement of the manubrium during the small indentations. This result greatly simplifies boundary conditions, as we may regard both the annulus and the manubrium as fixed without having to rely on fixation interventions. The technique allows us to determine linear elastic material parameters of a tympanic membrane in situ. In this way our method takes into account the complex geometry of the membrane, and parameters are obtained in a physiologically relevant range of strain.
from Hearing Research
Acoustic analysis of the tremulous voice: assessing the utility of the correlation dimension and perturbation parameters
Acoustic analysis may provide a useful means to quantitatively characterize the tremulous voice. Signals were obtained from 25 subjects with diagnoses of either Parkinson’s disease or vocal polyps exhibiting vocal tremor. These were compared to signals from 24 subjects with normal voices. Signals were analyzed via correlation dimension and several parameters from the Multi-Dimensional Voice Program (MDVP): percent jitter, percent shimmer, amplitude tremor intensity index (ATRI), frequency tremor intensity index (FTRI), amplitude tremor frequency (Fatr), and fundamental frequency tremor frequency (Fftr). No significant difference was found between the tremor and control groups for ATRI and Fatr. Percent jitter, percent shimmer, FTRI, Fftr, and correlation dimension values were found to be significantly higher in the tremor group than in the control group. We conclude that these parameters may have utility for the clinical quantification of tremor severity and treatment effects.
from the Journal of Communication Disorders
Cochlear abnormalities associated with enlarged vestibular aqueduct anomaly
Objectives
The objective of this study is to examine the correlation between enlarged vestibular aqueduct (EVA) anomaly and other inner ear anomalies such as cochlear dysplasia, vestibulocochlear dysplasia and modiolar hypoplasia.
Methods
Retrospective chart review, with institutional review board approval, of patients with EVA who received treatment at Primary Children’s Medical Center or University Hospital at the University of Utah, between 1997 and 2006. Review of radiographs was done to evaluate for the presence of EVA and other inner ear anomalies.
Results
Twenty patients (40 ears) were included in the study, 17 patients had bilateral EVA and three patients had unilateral EVA. There were 10 females and 10 males. The average age of all patients at the time of initial diagnosis was 1.7 years (0–6 years). Thirty-seven ears were shown to have EVA (92.5%). Of those ears with EVA, 29 (78.4%) had one or more inner ear anomalies. Twenty-three (62.2%) ears had cochlear dysplasia, six (16.2%) had vestibulocochlear dysplasia, and 18 (48.7%) had modiolar hypoplasia.
Conclusions
Using small field of view, thin section CT and/or MR imaging, cochleovestibular abnormalities are commonly identified in association with EVA.
from the International Journal of Pediatric Otorhinolaryngology
The prelexical development in children implanted by 16 months compared with normal hearing children
Objective
Few studies exist which document the early speech development of German-speaking children or German-speaking children who are deaf and using cochlear implants. The current study aims to: (1) document the pre-canonical and canonical speech development of German-speaking children who are deaf and receive cochlear implants by the age of 16 months and (2) compare these children’s results with those of children with normal hearing.
Design
This longitudinal study included 5 German-speaking children with normal hearing and 5 with sensorineural deafness. All children from the deaf group received hearing amplification before cochlear implantation, received their first implant by 16 months of age, and became bilateral implant users by 31 months of age. The pre-canonical and canonical vocalisations of each child were recorded on video- and audiotapes in a semi-standardised playing situation every 4 weeks over a span of 1 year. In the cochlear implant group, the recording started 4–5 days postoperatively (first implant); in the normal hearing group it began between the ages of 4 and 5 months. The video and audio recordings were analysed using EUDICO Linguistic Annotator version 2.4 (Nijmegen, The Netherlands) and International Phonetic Alphabet transcription.
Results
Both groups showed individual patterns of babbling acquisition, though the groups’ patterns of acquisition were similar when analysed for consonant manner and place. Some children started with plosives and others, with nasals, but all acquired fricatives and laterals next. Onset of canonical babbling for children in the cochlear implant group began 0–4 months after first fitting of the first device, while children from the normal hearing group demonstrated an onset of canonical babbling between 4 and 9 months of age.
Conclusion
Our results show that deaf children who receive cochlear implants at an early age are capable of reaching the canonical babbling milestone in a shorter time than children with normal hearing typically do and that their consonant phoneme acquisition follows a similar sequence to normal hearing peers’. These results are consistent with the literature indicating that early identification and intervention are important for allowing children with cochlear implants the opportunity to catch up to hearing peers.
from the International Journal of Pediatric Otorhinolaryngology
