[Acute psychotic productivity in cerebral imaging]. / Akute psychotische Produktivität in der zerebralen Bildgebung1.

Regional cerebral blood flow (rCBF) was analysed in 24 neuroleptically never treated schizophrenics by 99m-Tc-HMPAO-SPECT. Psychopathological symptoms (PANSS) were correlated with rCBF-measures using multidimensional scaling (MDS). Highest degrees of correlation were found for ideas of grandiosity and formal thought disorders compared to different regions of interest (ROIs). An adynamic cluster was defined by basic symptoms which showed signs of deficiency. This cluster was by the highest degree correlated with a cluster defined by rCBF compared to four different clusters of basic symptoms. A fMRI-study was performed in schizophrenic patients with auditive hallucinations in comparison to healthy controls. We offered simple acoustic stimuli perceived as coming from the outside versus inside. For the outside condition, controls activated the medial temporal gyrus on the left side and the rightsided precuneus and postcentral gyrus which represent the auditive source locating and the stimulus processing systems, for inside, they activated the left insula. Hallucinating schizophrenic neither activated the one nor the other system. We discussed the findings as a possible explanation of the schizophrenics' tendency to misinterpret hallucinations as real perceptions.

[Test set for the evaluation of hearing and speech development after cochlear implantation in children]. / Evaluationsset zur Hör-/Sprachentwicklung nach Cochlea-Implantation bei Kindern.

BACKGROUND: Since autumn 1998 the multicenter interdisciplinary study group "Test Materials for CI Children" has been compiling a uniform examination tool for evaluation of speech and hearing development after cochlear implantation in childhood. METHODS USED: After studying the relevant literature, suitable materials were checked for practical applicability, modified and provided with criteria for execution and break-off. For data acquisition, observation forms for preparation of a PC-version were developed. RESULTS: The evaluation set contains forms for master data with supplements relating to postoperative processes. The hearing tests check supra-threshold hearing with loudness scaling for children, speech comprehension in silence (Mainz and Göttingen Test for Speech Comprehension in Childhood) and phonemic differentiation (Oldenburg Rhyme Test for Children), the central auditory processes of detection, discrimination, identification and recognition (modification of the "Frankfurt Functional Hearing Test for Children") and audiovisual speech perception (Open Paragraph Tracking, Kiel Speech Track Program). The materials for speech and language development comprise phonetics-phonology, lexicon and semantics (LOGO Pronunciation Test), syntax and morphology (analysis of spontaneous speech), language comprehension (Reynell Scales), communication and pragmatics (observation forms). The MAIS and MUSS modified questionnaires are integrated. CONCLUSIONS: The evaluation set serves quality assurance and permits factor analysis as well as controls for regularity through the multicenter comparison of long-term developmental trends after cochlear implantation.

Assessment of auditory skills in hearing-impaired children: theoretical foundations and a practical approach.

A proposal of a performance profile for the assessment of auditory skills of hearing-impaired children with cochlear implants or hearing-aids is described here. The associated tests have been realized either with conventional material or on the Auditory Visual Test and Therapy System developed by the Aachen research group. Acoustic stimuli and answering tasks have been chosen according to the special needs of hearing-impaired children in the age range of 3-6 years of developmental age. Two tests will be described exemplary.

Amplitude modulation following response in children as a clinical audiometric tool.

The current study was designed to investigate the clinical application of amplitude modulation following response (AMFR) in cochlear implant candidates. A new digital signal processor (DSP)-assisted PC-based hardware and software was developed to perform both simultaneous generation of amplitude-modulated stimuli and the recording, and synchronized signal processing of the electrode signals. Our first results show that AMFR can be recorded in adults as well as in children without any contamination by response-like stimulus artifacts. Very high sound pressure levels can be applied, allowing frequency-specific assessment of residual hearing. Response threshold detection, using spectral analysis, proved to be superior compared to visual evaluation of average time waveforms.

Multicentric field evaluation of a new speech coding strategy for cochlear implants.

In a multicentric study involving 4 European cochlear implant centers, the speech perception abilities of 20 native German-speaking individuals implanted with the Nucleus 22 Channel Cochlear Implant System when using a new spectral peak (SPEAK) speech coding strategy were investigated. This strategy continuously analyzes the speech signal using 20 digital programmable bandpass filters and presents up to 10 spectral maxima to the 22 implanted electrodes. Each subject's performance on a variety of auditory perceptual tasks was evaluated with the experimental encoder (SPEAK), relative to his or her performance in a reference condition. An ABAB experimental design was used whereby each strategy was reversed and replicated. The reference levels of auditory performance were established using the multipeak (MPEAK) speech-processing strategy of the Nucleus speech processor. Only subjects who achieved open-set monosyllable word recognition in the reference condition were included in this study. Significant differences in group mean scores for most speech recognition subtests were obtained for the SPEAK versus the MPEAK strategy. The largest overall improvements were observed for the sentence tests under noisy conditions.

[How badly does the "normal-hearing" young man of 1992 hear in the high frequency range?]. / Wie schlecht hört der "normalhörende" junge Mann des Jahres 1992 im Hochtonbereich?

In the course of a clinical study we examined young men believed to have normal hearing. Volunteers with a positive history for noise deafness were excluded from further study. Normal hearing was verified by pure-tone audiometry if the hearing loss did not exceed 15 dB for each test tone between 250 Hz and 8000 Hz. As this limit is far below normative threshold values (DIN ISO 7029) we expected to find a large number of otological normal subjects. Using pure-tone audiometry, ABR and noise exposure, we found that 65% of the young male volunteers (mean age 25 years) did not meet the criteria for audiologic normality. The pure-tone thresholds for these subjects were comparable to the expected levels of their fathers' generation.

[Hearing screening in neonates and infants using brain stem evoked acoustic potentials]. / Hörscreening bei Neugeborenen und Säuglingen mittels Ableitung akustisch-evozierter Hirnstammpotentiale.

Reported failure rates of screening using the conventional brainstem auditory response (BAER), audiometry range from 5% to 60% with about 30% of the babies having normal hearing sensitivity on follow-up. The results of testing by an automated infant screener using advanced evoked response technology are compared with those of a conventional evoked response system operated by skilled personnel. 50 newborn were tested at a gestational age of 40-42 weeks. Normal results were obtained in all 25 newborn (50 ears) of the control group using both testing procedures. Out of 25 newborn (50 ears) at risk for congenital perinatal or postnatal hearing disorder, abnormal results for either screening or conventional BAER recording were seen in 6 ears with both methods.

[Ultrasonic diagnosis of the pseudoglottis in laryngectomized patients]. / Die Ultraschalluntersuchung der Pseudoglottis bei Kehlkopflosen.

The validity of ultrasonic imaging as a tool for the investigation of pseudoglottal movements was studied in five good to excellent esophageal speakers. The length of pseudoglottis and vibration rate during phonation of vowels was evaluated by means of B-mode and M-mode sonography respectively. The pseudoglottal vibration rate as seen in M-mode sonography was in high agreement with the fundamental frequency of the simultaneously recorded sound as assessed by speech analysis. Ultrasound imaging is a promising diagnostic and therapeutic tool for the control and development of esophageal speech.

[Ultrasound study of disorders of coordination in tongue movement in swallowing]. / Ultraschalluntersuchung von Koordinationsstörungen der Zungenbewegung beim Schlucken.

Ultrasound imaging of tongue movements permits real-time observation of swallowing and articulation without risk for the patient. The ultrasound images of the tongue motions were recorded on video-tape and then analyzed frame by frame. We were able to detect regular phases of tongue motion during normal swallowing. Clear deviations from normal motion patterns were found in a patient with anarthria, despite absence of swallowing difficulties in every day life.

[Directional hearing and understanding of speech in noise uith "normal hearing" people (author's transl)]. / Richtungshören und Sprachverstehen unter Störschall-einfluss bei "normalhörenden".

Directional hearing and the ability to understand speech against a noisy background depend among other factors on the binaural signal processing mechanisms in human hearing. In present the practical audiometry can not prove completely the operation of binaural signal processing. This fact will be shown here with three patients who complain of bad understanding speech, but in audiometric tests seem to hear normally. In free field tests of directional hearing and understanding speech against a noisy background they differ clearly from a reference group of normal hearing people.