Binaural Processing and Auditory Working Memory in Individuals with Tinnitus Having Normal Hearing Sensitivity.

BACKGROUND: Tinnitus is a sound perceived in the ears or head without any external or internal sound source. It can be hypothesized that the auditory processing at the different levels of the auditory pathway and working memory may get affected due to the additional sound contributed by tinnitus. The objective of our study is to evaluate binaural processes and working memory capacity in individual with tinnitus having normal hearing sensitivity. METHODS: The binaural interaction process was evaluated using the interaural time difference and interaural level difference. Similarly, the binaural integration process was assessed using the dichotic consonant-vowel test, and the working memory was assessed using the audio descending span test and Audio 2N-Back span test. Mann-Whitney U test was done to see the significant difference between the groups. RESULTS: The Mann-Whitney U test showed significantly poorer interaural level difference scores in the tinnitus group. Also, dichotic consonantvowel test scores and auditory working memory test scores were found to be significantly lower in individuals with tinnitus. CONCLUSION: The binaural processes, along with the working memory capacity, are found to be affected in an individual with tinnitus, which in turn may affect the speech perception ability of the individual.

Audiological Profiling and Rehabilitation Outcomes in a Child With Johanson-Blizzard Syndrome

Johanson Blizzard syndrome (JBS) is an autosomal recessive disorder that shows a multi-faceted impact on almost all body functions, including speech and hearing. This case presentation describes the comprehensive audiological and rehabilitative profile of an 8-year-old female child with JBS while correlating the test results to the physiological aspects of hearing. Case history revealed poor developmental motor skills, delayed speech and language development with hypothyroidism, and dysmorphic facial features including low bat ears, micrognathia, high arched palate, and hypoplasia of nasal alae. Conditioned pure-tone audiometric responses revealed profound hearing loss of cochlear origin in both ears, which was substantiated with bilateral A-type tympanogram in immittance evaluation. Otoacoustic emissions and auditory brain stem response were absent in both ears, consistent with the audiometric findings. Rehabilitation attempts with a cochlear implant and hearing aid in the opposite ears showed differential improvements, which were in harmony with the aided thresholds. The physiological basis for each finding and future implications are discussed.

Effects of Spatial Training Paradigms on Auditory Spatial Refinement in Normal-Hearing Listeners: A Comparative Study

Background and Objectives@#This study compared the effectiveness of two spatial training programs using real and virtual sound sources in refining spatial acuity skills in listeners with normal hearing. @*Subjects and Methods@#The study was conducted on two groups of 10 participants each; groups I and II underwent spatial training using real and virtual sound sources, respectively. The study was conducted in three phases: pre-training, training, and post-training phases. At the pre- and post-training phases, the spatial acuity of the participants was measured using real sound sources through the localization test, and virtual sound sources through the virtual acoustic space identification (VASI) test. The thresholds of interaural time difference (ITD) and interaural level difference (ILD) were also measured. In the training phase, Group I participants underwent localization training using loudspeakers in free field, while participants in Group II were subjected to virtual acoustic space (VAS) training using virtual sound sources from headphones. Both the training methods consisted of 5-8 sessions (20 min each) of systematically presented stimuli graded according to duration and back attenuation (for real source training) or number of VAS locations (for virtual source training). @*Results@#Results of independent t-scores comparing the spatial learning scores (pre vs. post-training) for each measure showed differences in performance between the two groups. Group II performed better than Group I on the VASI test, while the Group I out-performed Group II on the ITD. Both groups improved equally on the localization test and ILD. @*Conclusions@#Based on the present findings, we recommend the use of VAS training as it has practical implications due to its cost effectiveness, need for minimal equipment, and end user usefulness.

Effect of Levetiracetam on Cognition in Patients With Alzheimer Disease With and Without Epileptiform Activity: A Randomized Clinical Trial.

Importance: Network hyperexcitability may contribute to cognitive dysfunction in patients with Alzheimer disease (AD). Objective: To determine the ability of the antiseizure drug levetiracetam to improve cognition in persons with AD. Design, Setting, and Participants: The Levetiracetam for Alzheimer's Disease-Associated Network Hyperexcitability (LEV-AD) study was a phase 2a randomized double-blinded placebo-controlled crossover clinical trial of 34 adults with AD that was conducted at the University of California, San Francisco, and the University of Minnesota, Twin Cities, between October 16, 2014, and July 21, 2020. Participants were adults 80 years and younger who had a Mini-Mental State Examination score of 18 points or higher and/or a Clinical Dementia Rating score of less than 2 points. Screening included overnight video electroencephalography and a 1-hour resting magnetoencephalography examination. Interventions: Group A received placebo twice daily for 4 weeks followed by a 4-week washout period, then oral levetiracetam, 125 mg, twice daily for 4 weeks. Group B received treatment using the reverse sequence. Main Outcomes and Measures: The primary outcome was the ability of levetiracetam treatment to improve executive function (measured by the National Institutes of Health Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research [NIH-EXAMINER] composite score). Secondary outcomes were cognition (measured by the Stroop Color and Word Test [Stroop] interference naming subscale and the Alzheimer's Disease Assessment Scale-Cognitive Subscale) and disability. Exploratory outcomes included performance on a virtual route learning test and scores on cognitive and functional tests among participants with epileptiform activity. Results: Of 54 adults assessed for eligibility, 11 did not meet study criteria, and 9 declined to participate. A total of 34 adults (21 women [61.8%]; mean [SD] age, 62.3 [7.7] years) with AD were enrolled and randomized (17 participants to group A and 17 participants to group B). Thirteen participants (38.2%) were categorized as having epileptiform activity. In total, 28 participants (82.4%) completed the study, 10 of whom (35.7%) had epileptiform activity. Overall, treatment with levetiracetam did not change NIH-EXAMINER composite scores (mean difference vs placebo, 0.07 points; 95% CI, -0.18 to 0.32 points; P = .55) or secondary measures. However, among participants with epileptiform activity, levetiracetam treatment improved performance on the Stroop interference naming subscale (net improvement vs placebo, 7.4 points; 95% CI, 0.2-14.7 points; P = .046) and the virtual route learning test (t = 2.36; Cohen f2 = 0.11; P = .02). There were no treatment discontinuations because of adverse events. Conclusions and Relevance: In this randomized clinical trial, levetiracetam was well tolerated and, although it did not improve the primary outcome, in prespecified analysis, levetiracetam improved performance on spatial memory and executive function tasks in patients with AD and epileptiform activity. These exploratory findings warrant further assessment of antiseizure approaches in AD. Trial Registration: ClinicalTrials.gov Identifier: NCT02002819.

Musical Aptitude as a Variable in the Assessment of Working Memory and Selective Attention Tasks

Background and Objectives@#The influence of musical aptitude on cognitive test performance in musicians is a long-debated research question. Evidence points to the low performance of nonmusicians in visual and auditory cognitive tasks (working memory and attention) compared with musicians. This cannot be generalized to all nonmusicians, as a sub-group in this population can have innate musical abilities even without any formal musical training. The present study aimed to study the effect of musical aptitude on the working memory and selective attention. @*Subjects and Methods@#Three groups of 20 individuals each (a total of 60 participants), including trained-musicians, nonmusicians with good musical aptitude, and nonmusicians with low musical aptitude, participated in the present study. Cognitive-based visual (Flanker’s selective attention test) and auditory (working memory tests: backward digit span and operation span) tests were administered. @*Results@#MANOVA (followed by ANOVA) revealed a benefit of musicianship and musical aptitude on backward digit span and Flanker’s reaction time (p<0.05). Discriminant function analyses showed that the groups could be effectively (accuracy, 80%) segregated based on the backward digit span and Flanker’s selective attention test. Trained musicians and nonmusicians with good musical aptitude were distinguished as one cluster and nonmusicians with low musical aptitude formed another cluster, hinting the role of musical aptitude in working memory and selective attention. @*Conclusions@#Nonmusicians with good musical aptitude can have enhanced working memory and selective attention skills like musicians. Hence, caution is required when these individuals are included as controls in cognitive-based visual and auditory experiments.

Case Report: Early-Onset Behavioral Variant Frontotemporal Dementia in Patient With Retrotransposed Full-Length Transcript of Matrin-3 Variant 5.

Frontotemporal dementia (FTD) rarely occurs in individuals under the age of 30, and genetic causes of early-onset FTD are largely unknown. The current report follows a 27 year-old patient with no significant past medical history presenting with two years of progressive changes in behavior, rushed speech, verbal aggression, and social withdrawal. MRI and FDG-PET imaging of the brain revealed changes maximally in the frontal and temporal lobes, which along with the clinical features, are consistent with behavioral variant FTD. Next generation sequencing of a panel of 28 genes associated with dementia and amyotrophic lateral sclerosis (ALS) initially revealed a duplication of exon 15 in Matrin-3 (MATR3). Whole genome sequencing determined that this genetic anomaly was, in fact, a sequence corresponding with full-length MATR3 variant 5 inserted into chromosome 12, indicating retrotransposition from a messenger RNA intermediate. To our knowledge, this is a novel mutation of MATR3, as the majority of mutations in MATR3 linked to FTD-ALS are point mutations. Genomic DNA analysis revealed that this mutation is also present in one unaffected first-degree relative and one unaffected second-degree relative. This suggests that the mutation is either a disease-causing mutation with incomplete penetrance, which has been observed in heritable FTD, or a benign variant. Retrotransposons are not often implicated in neurodegenerative diseases; thus, it is crucial to clarify the potential role of this MATR3 variant 5 retrotransposition in early-onset FTD.