Coding of consonant-vowel transition in children with central auditory processing disorder: an electrophysiological study.

INTRODUCTION: Acoustic change complex (ACC) is an important tool to investigate the encoding of the acoustic property of speech signals in various populations. However, there is a limited number of research papers that have explored the usefulness of ACC as a tool to study the neural encoding of consonant-vowel (CV) transition in children with central auditory processing disorder (CAPD). Thus, the present study aims to investigate the utility of ACC as an objective tool to study the neural representation of consonant-vowel (CV) transition in children with CAPD. METHODS: Twenty children diagnosed having CAPD and 20 normal counterparts in the age range of 8-14 years were the participants. The ACC was acquired using naturally produced CV syllable /sa/ with a duration of 380 ms. RESULTS: Latency of N1' and P2' was found to be prolonged in children with CAPD compared to normal counterparts, whereas the amplitude of N1' and P2' did not show any significant difference. Scalp topography showed significantly different activation patterns for children with and without CAPD. CONCLUSION: Prolonged latencies of ACC indicated poor encoding of CV transition in children with CAPD. The difference in scalp topography might be because of the involvement of additional brain areas for the neural discrimination task in children with CAPD.

Effect of acoustic features on discrimination ability in individuals with auditory neuropathy spectrum disorder: an electrophysiological and behavioral study.

PURPOSE: The present study aimed to investigate the discrimination ability for acoustic cues in individuals with auditory neuropathy spectrum disorder (ANSD) using both behavioral and neural measures and to compare the result with normal hearing individuals. METHODS: Four naturally produced syllables /ba/, /da/, /ma/ and /pa/ were used to study discrimination skills. They were combined in pairs such that the two syllables differ in acoustic features, that is place (/ba/-/da/), manner (/ba/-/ma/) and voicing (/ba/-/pa/) cues. Thirty individuals with ANSD and 30 individuals with normal hearing sensitivity were the participants. Syllable discrimination skill was assessed using behavioral (reaction time, sensitivity and D-prime) and neural (P300) measures. RESULTS: There was prolongation in latency and reduction in amplitude of P300 in individuals with ANSD compared to individuals with normal hearing sensitivity. Individuals with ANSD showed better discrimination skill for stimulus pairs differing in the manner followed by place and the least perceived was voicing information. CONCLUSION: Discrimination ability of individuals with ANSD is found to be affected as evident on behavioral and neural measures. The discrimination ability varies with acoustic features of speech.

Cortical processing of speech in individuals with auditory neuropathy spectrum disorder.

OBJECTIVE: Auditory neuropathy spectrum disorder (ANSD) is a condition where cochlear amplification function (involving outer hair cells) is normal but neural conduction in the auditory pathway is disordered. This study was done to investigate the cortical representation of speech in individuals with ANSD and to compare it with the individuals with normal hearing. DESIGN: Forty-five participants including 21 individuals with ANSD and 24 individuals with normal hearing were considered for the study. Individuals with ANSD had hearing thresholds ranging from normal hearing to moderate hearing loss. Auditory cortical evoked potentials-through odd ball paradigm-were recorded using 64 electrodes placed on the scalp for /ba/-/da/ stimulus. Onset cortical responses were also recorded in repetitive paradigm using /da/ stimuli. Sensitivity and reaction time required to identify the oddball stimuli were also obtained. RESULT: Behavioural results indicated that individuals in ANSD group had significantly lower sensitivity and longer reaction times compared to individuals with normal hearing sensitivity. Reliable P300 could be elicited in both the groups. However, a significant difference in scalp topographies was observed between the two groups in both repetitive and oddball paradigms. Source localization using local auto regressive analyses revealed that activations were more diffuses in individuals with ANSD when compared to individuals with normal hearing sensitivity. CONCLUSION: Results indicated that the brain networks and regions activated in individuals with ANSD during detection and discrimination of speech sounds are different from normal hearing individuals. In general, normal hearing individuals showed more focused activations while in individuals with ANSD activations were diffused.

Efficacy of cervical and ocular vestibular-evoked myogenic potentials in evaluation of benign paroxysmal positional vertigo of posterior semicircular canal.

Benign paroxysmal positional vertigo (BPPV) constitutes a major proportion of the population with peripheral vestibulopathies. Although the freely floating otoconia within the semicircular canals is responsible for the symptoms of BPPV, the source of the otoconia debris is mainly believed to be the otolith organs. Therefore, the pathology in either or both the otolith organs appears a logical proposition. Cervical and ocular vestibular-evoked myogenic potentials (cVEMP and oVEMP), being the tests for functional integrity of the otolith organs, appear promising for investigating otolith involvement in BPPV. While recent evidences are suggestive of equivocal findings for cVEMP, there are only a few studies on oVEMP. Additionally, both these potentials have never been explored in the same set of individuals with BPPV. Therefore, the present study aimed to evaluate the functional integrity of the otolith organs through cVEMP and oVEMP in individuals with posterior canal BPPV. Thirty-one individuals with unilateral posterior canal BPPV and 31 age- and gender-matched healthy controls underwent 500 Hz tone-burst-evoked cVEMP and oVEMP. The results demonstrated no significant group difference on any of the cVEMP parameters (p > 0.05). A similar trend was noticed for the latency-related parameters of oVEMP. However, the peak-to-peak amplitude was significantly smaller in the affected ears of individuals with BPPV than their unaffected ears and the ears of healthy controls (p < 0.05). The BPPV group showed significantly higher inter-aural amplitude difference ratio than the healthy controls (p < 0.05). Further, the sensitivity and specificity of oVEMP were also found to be far superior to those of cVEMP. Thus, the outcome of the present study revealed involvement of utricle rather than saccule in posterior canal BPPV, and therefore, oVEMP appears to be better suited to clinical investigation than cVEMP in individuals with posterior canal BPPV.

Speech Perception in Quiet and in the Presence of Noise in Children with Autism Spectrum Disorder: A Behavioral Study.

Signal-to-noise ratio (SNR) is one of the important parameters to be considered for the effective perception of speech. Many researchers indicate that children with autism spectrum disorder (ASD) have reduced capacity to integrate sensory information across different modalities and show speech understanding difficulty in the presence of background speech or noise. So, this present study was undertaken with the aimed to evaluate and compare the speech perception ability in quiet and in the presence of noise for children with and without ASD and also to compare across different noise conditions. Speech perception in noise was measured for 15 children with ASD and 15 age-matched children without ASD in the age range of 8 to 12 years. The stimulus includes standardized bisyllabic and trisyllabic Kannada words in quiet and at different SNR conditions. The result showed that children with ASD had poor performance in all the listening conditions (quiet, speech babble, and speech noise) and the syllable conditions (bisyllables and trisyllables) compared to children without ASD. When compared across quiet and different SNR conditions for individuals with ASD, the result showed the best performance in quiet conditions followed by different SNR conditions. The performance deteriorated with a decrease in SNR for both groups. Children with ASD showed poor performance in quiet and in the presence of noise compared to children without ASD. Speech perception evaluation in the presence of noise provides a more reliable predictor of the communication difficulty faced by children with ASD than evaluating only in quiet conditions.

COVID-19 Vaccination and Sudden Sensorineural Hearing Loss: A Case Study.

This article highlights a client with sensorineural hearing loss reported after 2 days of 2nd dose of COVID-19 vaccination. The audiological evaluations suggest unilateral hearing loss which recovered after the treatment. This article focuses on spreading awareness about the complications after vaccination and the importance of treatment.

Balance Problem in Individuals with Normal Hearing Across Age Groups - A Behavioural Study.

Purpose: This study was done to find the hidden balance problem in individuals across age groups using perceptual measure (Dizziness Index of Impairment in Activities of Daily Living Scale questionnaire, DII-ADL) and vestibulospinal-cerebellar function tests (Sharpened Romberg test, Fukuda stepping test, Tandem gait test, and Finger-to-nose test). Methods: A total of 150 individuals in three age groups, young adults (20-40 years), middle-aged adults (40-60 years), and older adults (> 60 years) were considered. All the individuals had normal hearing sensitivity with no reported perceptual balance issues. DII-ADL questionnaire, Sharpened Romberg test, Fukuda stepping test, Tandem gait test, and Finger-to-nose test were administered to all the participants. Results: Balance disturbances were observed in all three age groups. The symptoms and test findings showed increased abnormality with the increase in age. DII-ADL questionnaire suggests older adults have more difficulty performing activities of daily living than young and middle-aged adults. The sharpened Romberg test result showed a moderate negative correlation and the Fukuda stepping test showed a moderate positive correlation with the sections of the DII-ADL questionnaire. Conclusion: Individuals of any age can have difficulty performing activities of daily living even though they do not have evident balance disorder perceptually. Thus there is a need to spread awareness among professionals and emphasize the need for screening individuals across age groups for balance disturbances. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-022-03459-6.

Is Working Memory Compromised in Individuals with Sensorineural Hearing Loss with Auditory Neural Origin?

The study aimed to investigate the working memory and speech recognition in noise from individuals with Sensori Neural Hearing Loss (SNHL) with and without auditory neuropathy spectrum disorder (ANSD). The purpose of assessing working memory recommends for a potential intervention program to perceive speech. Twenty participants in the age range of 16-44 years, diagnosed as having mild to moderate SNHL were recruited for the study. The participants were divided into two groups based on the presence and absence of ANSD (10 in each group). The visual working memory was assessed in all the participants using the Operation Span Test, Reading Span Test and Visual Backward Test. Speech perception ability was assessed using the SNR 50 test. There was no significant difference between the scores of Operation Span, Reading Span, and Visual Backward Span for individuals with SNHL with and without ANSD. There was a significant difference between the scores of SNR 50 for individuals with SNHL with and without ANSD. The visual working memory in individuals with and without ANSD is similar. Speech perception in noise is significantly affected in ANSD than SNHL without ANSD. Thus, it is recommended to use speech reading, which utilizes visual working memory to interpret the message, as previous studies have reported that individuals with ANSD show limited benefit in auditory mode of rehabilitation alone.

Auditory and Vestibular Functioning in Individuals with Type-2 Diabetes Mellitus: A Systematic Review.

Introduction Diabetes mellitus is a metabolic disease associated with a rise in the level of blood glucose. Individuals with diabetes mellitus are more likely to develop hearing loss, tinnitus, and dizziness due to macro- and microvascular complications. The extent to which auditory and vestibular functions are impaired in individuals with type-2 diabetes mellitus is still under debate. Objective To systematically review studies focusing on auditory and vestibular functions in individuals with type-2 diabetes mellitus. Data Synthesis A search was conducted in the PubMed, MedlinePlus, Ingenta Connect and Google Scholar databases for articles published until June 2019. A total of 15,980 articles were primarily retrieved, 33 of which were shortlisted based on the inclusion criteria set by the investigators for the systematic review. Out of 33 full-length articles, 26 evaluated the functioning of the auditory system, while 7 evaluated the functioning of the vestibular system. Most studies related to auditory functioning reported a significant effect of type-2 diabetes mellitus on the peripheral auditory system, whereas studies on vestibular functioning reported no significant effect of diabetes mellitus on the functioning of the peripheral vestibular end-organ. Conclusion Overall, the results of various audiological and peripheral vestibular tests reveal distinctive peripheral and/or central auditory and vestibular end-organ impairments in individuals with type-2 diabetes mellitus.

Balance Assessment of Children with Sensorineural Hearing Loss.

This study aimed to assess the balance function in children with sensorineural hearing loss (SNHL) using different tests to assess vestibulospinal pathway and tests to assess vestibular system and to compare the result obtained with those of children with normal hearing sensitivity. Detailed balance assessment was done for 15 children with severe to profound SNHL and 15 children with normal hearing sensitivity in the age range of 6-10 years. The audiological evaluation included pure-tone audiometry, speech audiometry, immittance evaluation, otoacoustic emission, vestibular evoked myogenic potential (cervical VEMP and ocular VEMP), and tests to assess vestibulospinal pathway and cerebellar function, such as Romberg test, Fukuda stepping test, Tandem gait test, and Finger-to-nose test. cVEMP and oVEMP were absent in 8 ears (27%) of a total of 30 ears with SNHL. Statistical analysis shows no significant difference between latency and amplitude of cVEMP peaks and latency of oVEMP peaks across groups. Significant reduction of oVEMP peaks amplitude was seen in children with SNHL compared to children with normal hearing. Fukuda stepping test showed an abnormal response in 2 children with SNHL (13%) and one child could not perform tandem gait test (7%). Children with SNHL showed an evident abnormality on the balance assessment test results. The abnormal function of the vestibular system and the vestibulospinal pathway can compromise the child's motor development and thus needs investigation early in life.

Effect of Quiet and Noise on P300 Response in Individuals with Auditory Neuropathy Spectrum Disorder.

Introduction Auditory neuropathy spectrum disorder (ANSD) is a clinical condition in which individuals have normal cochlear responses and abnormal neural responses. There is a lack of evidence in the literature regarding the neural discrimination skill in individuals with ANSD, especially when the signal is presented in the presence of noise. Objectives The present study was performed with the aim to investigate auditory discrimination skill, in quiet and in the presence of noise, in individuals with ANSD and to compare the findings with normal-hearing individuals. Methods A total of 30 individuals with normal hearing sensitivity and 30 individuals with ANSD in the age range of 15 to 55 years old, with the mean age of 27.86 years old, were the participants. P300 response was recorded from both groups using syllable pairs /ba/-/da/ in oddball paradigm and the syllable /da/ in repetitive paradigm in quiet and at +10 dB signal-to-noise ratio (SNR). Results There was significant prolongation in latency and reaction time, and reduction in amplitude of P300 response and sensitivity in both groups with the addition of noise. The topographic pattern analysis showed activation of the central-parietal-occipital region of the brain in individuals with ANSD, whereas activation of the central-parietal region was observed in individuals with normal hearing. The activation was more diffused in individuals with ANSD compared with that of individuals with normal hearing. Conclusion The individuals with ANSD showed a significantly more adverse effect of noise on the neural discrimination skill than the normal counterpart.

Pattern Perception in Quiet and at Different Signal to Noise Ratio in Children with Learning Disability.

OBJECTIVES: This study aimed to assess pattern perception at different signal-to-noise ratio (SNR) in children with learning disability (LD) and typically developing children. The first objective of this study was to estimate the identification scores in quiet and at different SNR (0 dB SNR and -5 dB SNR) in children with LD and to compare the result with the typically developing children. The second objective of the study was to estimate identification scores for words differing in syllable length (monosyllable, bisyllable, and trisyllable) for both the groups of children with LD and typically developing children and to compare the result for both the groups. MATERIALS AND METHODS: Participants included 60 children including 40 typically developing children and 20 children with LD in the age range 7-11 years. Speech perception was assessed using words varying in syllable length (monosyllables, bisyllables, and trisyllables), and was tested in quiet and at different SNR (0 dB SNR and -5 dB SNR). RESULTS: Compared to typically developing children, perception was affected in children with LD. For children with LD, the perception was best in quiet condition and was least at -5 dB SNR. Trisyllables showed the best result followed by bisyllables and monosyllables. CONCLUSION: Children with LD showed poor pattern perception compared to typically developing children. SNR had a significant effect on the performance of children with LD. The length of the stimuli also had an effect on the perception in children with LD.

Speech Perception in Quiet and in Noise Condition in Individuals with Auditory Neuropathy Spectrum Disorder.

OBJECTIVE: The study investigated the effect of noise on syllable perception in individuals with Auditory Neuropathy Spectrum Disorder (ANSD) and compared that with the normal hearing individuals. MATERIALS AND METHODS: A total of 54 participants were considered, out of which 26 individuals were diagnosed with ANSD and 28 with normal hearing sensitivity. Syllable identification and discrimination were assessed in both the groups in quiet as well as +10 dB SNR. RESULTS: All the individuals with ANSD performed poorer on syllable identification and syllable discrimination tasks compared to individuals with normal hearing. Information transfer and d-prime analyses revealed that noise affects the perception of voicing information in individuals with ANSD compared to place and manner information. Among the consonants tested, /pa/ was more resistant to noise. CONCLUSION: Noise had deleterious effects on speech perception in individuals with ANSD. Low-frequency information appears to be more susceptible to the effects of noise in individuals with ANSD.

Auditory and Vestibular Functioning in Individuals with Type-2 Diabetes Mellitus: A Systematic Review

Abstract Introduction Diabetes mellitus is a metabolic disease associated with a rise in the level of blood glucose. Individuals with diabetes mellitus are more likely to develop hearing loss, tinnitus, and dizziness due to macro- and microvascular complications. The extent to which auditory and vestibular functions are impaired in individuals with type-2 diabetes mellitus is still under debate. Objective To systematically review studies focusing on auditory and vestibular functions in individuals with type-2 diabetes mellitus. Data Synthesis A search was conducted in the PubMed, MedlinePlus, Ingenta Connect and Google Scholar databases for articles published until June 2019. A total of 15,980 articles were primarily retrieved, 33 of which were shortlisted based on the inclusion criteria set by the investigators for the systematic review. Out of 33 full-length articles, 26 evaluated the functioning of the auditory system, while 7 evaluated the functioning of the vestibular system. Most studies related to auditory functioning reported a significant effect of type-2 diabetes mellitus on the peripheral auditory system, whereas studies on vestibular functioning reported no significant effect of diabetes mellitus on the functioning of the peripheral vestibular end-organ. Conclusion Overall, the results of various audiological and peripheral vestibular tests reveal distinctive peripheral and/or central auditory and vestibular end-organ impairments in individuals with type-2 diabetes mellitus.

Effect of Quiet and Noise on P300 Response in Individuals with Auditory Neuropathy Spectrum Disorder

Abstract Introduction Auditory neuropathy spectrum disorder (ANSD) is a clinical condition in which individuals have normal cochlear responses and abnormal neural responses. There is a lack of evidence in the literature regarding the neural discrimination skill in individuals with ANSD, especially when the signal is presented in the presence of noise. Objectives The present study was performed with the aim to investigate auditory discrimination skill, in quiet and in the presence of noise, in individuals with ANSD and to compare the findings with normal-hearing individuals. Methods A total of 30 individuals with normal hearing sensitivity and 30 individuals with ANSD in the age range of 15 to 55 years old, with the mean age of 27.86 years old, were the participants. P300 response was recorded from both groups using syllable pairs /ba/-/da/ in oddball paradigm and the syllable /da/ in repetitive paradigm in quiet and at +10 dB signal-to-noise ratio (SNR). Results There was significant prolongation in latency and reaction time, and reduction in amplitude of P300 response and sensitivity in both groups with the addition of noise. The topographic pattern analysis showed activation of the central-parietal-occipital region of the brain in individuals with ANSD, whereas activation of the central-parietal region was observed in individuals with normal hearing. The activation was more diffused in individuals with ANSD compared with that of individuals with normal hearing. Conclusion The individuals with ANSD showed a significantly more adverse effect of noise on the neural discrimination skill than the normal counterpart.

The effect of rise/fall time of 500 Hz short tone bursts on cervical vestibular evoked myogenic potential.

BACKGROUND: Cervical vestibular evoked myogenic potential (cVEMP) is a biphasic potential recorded from the Sternocleidomastoid muscle in response to loud acoustic stimulation and assesses the intactness of the Sacculocolic pathway. The literature on clinical utility of cVEMP has been growing rapidly, though not without inconsistencies despite involving alike population. A close scrutiny of the methods across such studies revealed an inconsistent use of stimulus parameters; especially rise/fall times (RFTs). However the effect of RFTs on cVEMP has been largely unexplored. OBJECTIVE: The study aimed at exploring the effect of varying RFTs on cVEMP and obtaining optimum RFT to enable reliable recording of cVEMPs. METHODS: The cVEMPs were recorded from both ears of 30 healthy individuals with normal audio-vestibular system using 500 Hz short tone-bursts (STBs) at 95 dB nHL and varying the RFTs from 1 to 8 ms at all integer values. RESULTS: There was significant prolongation of latencies with increasing RFTs (p< 0.05). The largest amplitudes were obtained for 2 to 3 ms RFTs, though significantly smaller amplitude was obtained only for 8 ms RFT (p< 0.05), thereby rendering 8 ms RFT unfit for cVEMP recording. The 1 ms RFT produced smallest variability across individuals and would also result in lesser duration of exposure to loud sound. CONCLUSIONS: The RFT of 1 ms of 500 Hz STBs are optimum for recording cVEMPs. This is owing to large amplitudes and least variability demonstrated for this RFT.