Monthly Archives: August 2007

Study finds some kids are being misdiagnosed with asthma

from EurekAlert.org

Vocal cord dysfunction (VCD) is the sudden, abnormal narrowing of the vocal cords during inhalation causing obstruction of the airflow, and is characterized by a noise that can mimic the sound of wheezing. A VCD attack can easily be mistaken for an asthma attack though it does not respond to asthma medications.

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Characteristics and reversibility of dementia in Normal Pressure Hydrocephalus

from Behavioural Neurology

Studies of the cognitive outcome after shunt insertion for treatment of Normal Pressure Hydrocephalus have reported widely mixed results. We prospectively studied performance of 60 patients with Normal Pressure Hydrocephalus on a comprehensive battery of neuropsychological tests before and after shunt surgery to determine which cognitive functions improve with shunt insertion. We also administered a subset of cognitive tests before and after temporary controlled drainage of cerebrospinal fluid to determine if change on this brief subset of tests after drainage could predict which patients would show cognitive improvement three to six months after shunt insertion. There was a significant improvement in learning, retention, and delayed recall of verbal memory three to six months after surgery (using paired t-tests). The majority (74%) of patients showed significant improvement (by at least one standard deviation) on at least one of the memory tests. Absence of improvement on verbal memory after temporary drainage of cerebrospinal fluid had a high negative predictive value for improvement on memory tests at 3–6 months after surgery (96%; p=0.0005). Also, the magnitude of improvement from Baseline to Post-Drainage on few specific tests of learning and recall significantly predicted the magnitude of improvement after shunt surgery on the same tests (r^{2}=0.32–0.58; p=0.04–0.001). Results indicate that testing before and after temporary drainage may be useful in predicting which patients are less likely to improve in memory with shunting.

NYU study points to lasting impact of mild hearing loss on neurological processes

from EurekAlert.org

Mild to moderate forms of hearing loss can have a lasting impact on the auditory cortex, according to findings by researchers at New York University’s Center for Neural Science. The study, which is the first to show central effects of mild hearing loss, appears in the latest issue of the Journal of Neuroscience.

Nigeria: Deaf Artisans Advocate National Policy on Deaf Rehabilitation

from AllAfrica.com

Deaf artisans are advocating for a national policy on deaf rehabilitation.

A statement signed by the executive chairman of the society, Mr. Ajakaiye Mohammad Sani and made available to City News yesterday, said lack of such policy brought about neglect of the deaf artisans which make them unemployable.

Mr. Ajakaiye stressed that their continual neglect by the federal government and the absence of such policy had created a vacuum which makes them irrelevant to the society.

Plasticity in high-order cognition: Evidence of dissociation in aphasia

from Behavioral and Brain Sciences

High-order constructs such as intelligence result from the interaction of numerous processing systems, one of which is language. However, in determining the role of language in intelligence, attention must be paid to evidence from lesion studies and, in particular, evidence of dissociation of functions where high-order cognition can be demonstrated in face of profound aphasia.

The Pars Interna/Media Anatomy and Histology in the Human Larynx

from Folia Phoniatrica et Logopaedica

The pars interna/media (PIM) is a small muscle found in the human larynx that has not been successfully described in contemporary literature on laryngeal structure. The objective of this study was to describe the PIM’s anatomy in detail. Thirteen human larynges obtained from postmortem examination were cleaned and preserved. Exposure of the PIM was through a lateral disarticulation of the cricothyroid joint and reflection of the cricothyroid muscle and the thyroid lamina. In the human, the PIM was found to be strap-like in form and to have two bellies with attachments to the medial surface of the thyroid cartilage at the root of the inferior horn and anteriosuperior cricoid arch. It appears to be innervated by a middle division, vestibular branch, of the internal superior laryngeal nerve. The average fiber diameter is 40 µm. Its type 1-to-type 2 fiber ratio places it within the range of other intrinsic laryngeal muscles. A muscle spindle was identified in medial bundle at the PIM’s thyroid attachment. Thyroid medial surface attachment is within few millimeters of the muscular process of the arytenoid cartilage. These data show that the PIM is a robust muscle and deserves attention anatomically. Its orientation within the thyroid and nonrecurrent laryngeal nerve innervations of the human PIM may place it in the vocal fold tensor group rather than the laryngeal sphincter group. It is possible the PIM reports on cricothyroid distance and right versus left cricothyroid joint stresses. Electromyographic examination of the PIM in the Rhesus larynx may help elucidate its physiology to elaborate its human physiology.

The Effects of Gated Speech on the Fluency of Speakers Who Stutter

from Folia Phoniatrica et Logopaedica

It is known that the speech of people who stutter improves when the speaker’s own vocalization is changed while the participant is speaking. One explanation of these effects is the disruptive rhythm hypothesis (DRH). The DRH maintains that the manipulated sound only needs to disturb timing to affect speech control. The experiment investigated whether speech that was gated on and off (interrupted) affected the speech control of speakers who stutter. Eight children who stutter read a passage when they heard their voice normally and when the speech was gated. Fluency was enhanced (fewer errors were made and time to read a set passage was reduced) when speech was interrupted in this way. The results support the DRH.

Subjective Burden in Mothers of Speech-Impaired Children

from Folia Phoniatrica et Logopaedica

Objective: Evaluation of perceived subjective burden in mothers of speech-impaired children against the presence or absence of an emotional disorder. Methods: 89 mothers (age 33;3 ± 5;5 years, range: 19;6-43;8 years) of 89 preschool children (23 girls, 66 boys, age: 3;9 ± 1;5 years, range: 1;6- 7;1 years) with specific speech impairment were investigated. German versions of the Hospital Anxiety and Depression Scale (HADS) and the Burden Scale for Family Caregivers (BSFC) were applied. Results: 11% of the mothers met criteria for a depressive disorder (normal controls: 2.5%; p = 0.008). Twenty-eight percent of the mothers met criteria for anxiety disorders (normal controls: 9.6%; p = 0.000). The HADS depression subscore and the BSFC correlate with r = 0.75. The HADS anxiety subscore and the BSFC correlate with r = 0.59. Conclusions: Results suggest the need for routine clinical assessment of mothers’ well-being when their children are affected by speech impairment.

Perceptual Voice Characteristics in Chronic Cough and Paradoxical Vocal Fold Movement

from Folia Phoniatrica et Logopaedica

Voice problems have been reported in chronic cough (CC) and paradoxical vocal fold movement (PVFM), however, there is a lack of a systematic description of voice characteristics in these conditions. This study examined the perceptual voice characteristics of 56 individuals with CC, 8 with PVFM and 55 with both CC and PVFM, compared to 25 people with muscle tension dysphonia (MTD) and 27 healthy controls. There was a high prevalence of abnormal voice quality in the CC and PVFM groups compared with healthy controls. More than one third of participants with CC and PVFM demonstrated strained, rough and/or breathy voices to a moderate or severe degree. The perceptual features in CC and PVFM were similar to those in MTD with greater severity evident in MTD. Possible mechanisms for abnormalities in voice quality include the presence of muscle tension and the frequency of coughing. These results have implications for the identification and management of voice disorders in CC and PVFM and suggest that clinicians should be alert to the incidence of voice abnormalities in these populations.

Early Phonological Development in Arabic Egyptian Children: 12-30 Months

from Folia Phoniatrica et Logopaedica

Phonological development is a dynamic process that operates on three levels: universal development, specific language development, and specific child development. An intricate relationship between the three factors delineates the course of acquisition of each child’s phonemic inventory. This study is designed to investigate the phonemic inventory and the phonological processes used by Arabic Egyptian children in order to evaluate cross-linguistic similarities and differences. Thirty Egyptian children with Cairene dialect, in the age period between 12 and 30 months, were included and divided into three groups, each covering a 6-month interval. A 1-hour tape recording for each child was done, followed by analysis of the phonemic inventory and phonological processes. Phonemic inventories showed universal similarities, with frequent occurrence of stops, nasals, and glides mostly in the form of bilabial and alveolar sounds. This is besides a specific tendency for early frequent production of laryngeal phonemes. Glottal replacement was found to be a common and naturally occurring phonological process, leading to frequent occurrence of glottal stop /U/ in the inventories of Egyptian children. The final position of the word showed the highest degree of correct phoneme production.

Cortical Auditory Evoked Potentials to Acoustic Changes in Speech Stimuli in Children

from Folia Phoniatrica et Logopaedica

Objective: To compare the maturation of speech-evoked N170 components of cortical auditory evoked potentials with that of tone-evoked N1 components. Patients and Methods: Cortical auditory evoked potentials to speech and tone stimuli were derived in 42 children from age 4 to 14 years. The N170 was derived from the difference curve of responses to monosyllabic words with initial consonant-to-vowel transitions and their intensity-equivalent noise signals. Results: The incidence of N1 increased from 71% below age 9 to 91% above, that of N170 tended to increase from 40 to 67% above. From age 9, adult-like morphologies of the difference waveforms were found and the time constants of N1 and N170 latency maturation were nearly identical. Conclusion: The N170 component is interpreted as a response to speech-specific acoustic changes such as the consonant-vowel transition. The late appearance of N170 indicates an electrophysiological correlate of speech perception that continues to develop into adolescence. Its clinical application, however, is limited due to the low incidence of N170.

Comfortable Effort Level in Young Children’s Speech

from Folia Phoniatrica et Logopaedica

The variability in comfortable effort level across experimental sessions as assessed by measures of speaking fundamental frequency (SFF) and vocal intensity (VI) has been reported for normal adult speakers. However, no such data are available for young children. The goal of this study was to determine the variability in SFF and VI seen in normally developing young children. Fifteen males and 14 females between the ages of 3 and 4 years were asked to repeat a vowel, a sentence, and four words at a comfortable speaking level on 3 separate days, each 1 week apart. SFF and VI were determined for each utterance. Statistical treatment of the data revealed that when combining all the data, there were no significant differences for mean SFF or VI across test sessions. However, the young females generally spoke with greater VI than young males. These results suggest that normal-speaking children at a very young age are, on the average, similar in the degree of variability to adults for SFF and VI across experimental sessions when asked to set their own level of output. These findings provide a baseline for the extent of variability in SFF and VI seen in normally developing young children.

Diagnostic Value of Nasometry – Representative Study of Patients with Cleft Palate and Normal Subjects

from Folia Phoniatrica et Logopaedica

In the rehabilitation of cleft palate patients the quality of spoken language represents one of the most important aspects of successful social integration. It is therefore necessary to direct special attention to phoniatric care and speech therapy following operative reconstruction. One of the main problems is the comparison of subjective and objective measures of the degree and type of nasal disorder. In an interdisciplinary project at the University of Jena nasometry was assessed. Due to a lack of norm values for German a representative sample for the calibration of cleft palate patients and normal subjects was collected. Speech was elicited using standardized and phonetically validated reading materials. Nasalance measurements were compared with judgements made by a group of trained listeners who were asked to assess voice quality (RBH) and nasality. A database containing nasalance values and acoustic signals from 120 subjects was built up. The results generally exhibited highly significant correlations between instrumental measurements and auditory judgements. Profiles of norm values for a phonetically and statistically reliable standard for German were obtained, which in turn can be used as a comparative basis for further studies. (Article in German)

A Patient With Bipolar Illness and Her Neuropsychological Signature

from Clinical Case Studies

This article describes a case study in which neuropsychological assessment was carried out on a 30-year-old, previously diagnosed, bipolar female to determine existence of specific deficits in cognitive function. The patient, whose mood cycles were 12 hours to 24 hours, was subsequently evaluated 8 hours per day for 5 consecutive days (a complete work week of neuropsychological assessment). Neuropsychological results showed motor slowing, right hemispheric dysfunctioning, and memory problems during depressive periods and attentional and executive problems during hypomanic and manic periods. The most normal performance was found during euthymic periods. In addition, left and right hemi visual neglect, aphasia, and sensorimotor problems were present across all mood states. Treatment implications are subsequently described.

Vestibular signal processing in a proprioceptively deafferented subject: The case of sitting posture

from BMC Neurology

Background

The vestibular system of the inner ear provides information about head translation/rotation in space and about the orientation of the head with respect to the gravitoinertial vector. It also largely contributes to the control of posture through vestibulospinal pathways. Testing an individual severely deprived of somatosensory information below the nose, we investigated if equilibrium can be maintained while seated on the sole basis of this information.

Results

Although she was unstable, the deafferented subject (DS) was able to remain seated with the eyes closed in the absence of feet, arm and back supports. However, with the head unconsciously rotated towards the left or right shoulder, the DS’s instability markedly increased. Small electrical stimulations of the vestibular apparatus produced large body tilts in the DS contrary to control subjects who did not show clear postural responses to the stimulations.

Conclusions

The results of the present experiment show that in the lack of vision and somatosensory information, vestibular signal processing allows the maintenance of an active sitting posture (i.e. without back or side rests). When head orientation changes with respect to the trunk, in the absence of vision, the lack of cervical information prevents the transformation of the head-centered vestibular information into a trunk-centered frame of reference of body motion. For the normal subjects, this latter frame of reference enables proper postural adjustments through vestibular signal processing, irrespectively of the orientation of the head with respect to the trunk.