Effects of Virtual Reality for Postural Control in Chronic Neck Pain: A Single-Blind, Randomized Controlled Study.

OBJECTIVE: The purpose of this study was to investigate the effects of virtual reality (VR) on postural control, posture, and kinesiophobia in patients with chronic neck pain (CNP). METHODS: Forty-one participants with CNP were randomly allocated to the VR and control groups. The VR group experienced VR with glasses for 20 minutes and then performed motor control (MC) exercises for 20 minutes. The control group received only MC exercises for 40 minutes. Both groups received 18 sessions over 6 weeks. Computerized dynamic posturography outcomes, including sensory organization test (SOT), limits of stability, and unilateral stance tests, gait speed, forward head posture (FHP), shoulder protraction (SP), cervical lordosis angle, kinesiophobia, and exercise compliance were recorded. RESULTS: The VR group had more effects regarding composite equilibrium (Cohen's d = 1.20) of SOT and kinesiophobia (Cohen's d = -0.96), P < .05). Also, the VR group was more effective in exercise compliance (P < .05). Contrary to these results, the control group was more effective in correcting FHP and SP (Cohen's d > 0.7, P < .05). CONCLUSION: Virtual reality seemed to have an effect on postural control, posture, and kinesiophobia in patients with chronic neck pain.

Evaluation of the Relationship between Static Balance and Mental Fatigue in Healthy Adults: Preliminary Study.

Mental fatigue (MF) occurs when a demanding cognitive-task is performed over a long period of time, making it difficult to continue daily tasks and maintain balance. The aim of this investigation was to determine whether the Stroop test induces mental fatigue and to examine its effects on static balance. The study is a quasi-experimental design with pre-post testing. Twenty participants (19-44) were included. Static posturography was used to evaluate balance at baseline following a 25-min relaxation period of rest and in the MFC (mental-fatigue condition) following the induction of MF with the Stroop test. The other measurements were the Multidimensional Fatigue Inventory (MFI), Fatigue Severity Scale (FSS), and Visual Analogue Scale (VAS). The study found that mental fatigue significantly increased at MFC compared to baseline, as indicated by MFI (p=.031) and FSS (p=.007) results with moderate effect sizes (d = 0.52, d = 0.67, respectively). Similarly, the study found a statistically significant increase in mental fatigue as measured by VAS results (p=.000, d = 0.95). However, the study did not find any statistically significant impairment in static balance due to mental fatigue in healthy young subjects. The results suggest that the Stroop test can induce mental fatigue, but it does not impair static balance.

A language-independent hearing screening self-test at school-entry.

The usage of a tablet-based language-independent self-test involving the recognition of ecological sounds in background noise, the Sound Ear Check, was investigated. The results of 692 children, aged between 5 and 9 years and 4 months, recruited in seven different countries, were used to analyze the validity and the cultural independence of test. Three different test procedures, namely a monaural adaptive procedure, a procedure presenting the sounds dichotically in diotic noise, and a procedure presenting all the sounds with a fixed signal-to-noise ratio and a stopping rule were studied. Results showed high sensitivity and specificity of all three procedures to detect conductive, sensorineural and mixed hearing loss > 30 dB HL. Additionally, the data collected from different countries were consistent, and there were no clinically relevant differences observed between countries. Therefore, the Sound Ear Check can offer an international hearing screening test for young children at school entry, solving the current lack of hearing screening services on a global scale.

Sex related differences in the perception and production of emotional prosody in adults.

This study aimed to investigate the features of sex-related emotional prosody production patterns and perception abilities in adult speakers. The study involved 42 native Turkish speakers (27 females and 15 males). Sex-related perception and production of the emotions "anger," "joy," "sadness," and "neutral" were examined. Participants were first asked to indicate the actor's emotional state by selecting one of the given emotion alternatives provided. They were then instructed to produce the same stimuli with varying emotions. We analyzed the change in voice characteristics employed in different emotions in terms of F0 (Hz), speaking rate (seconds), and intensity (dB) using pairwise emotion comparison. The findings showed no sex differences in emotional prosody perceptions (p = 0.725). However, differences in the production of emotional prosody between sex have been documented in pitch variation of speech. Within-group analyses revealed that women tended to use a higher pitch when expressing joy versus sadness and a neutral state of feeling. Both men and women exhibited varying loudness levels for different emotional states in the speech loudness analysis. When expressing sadness, both men and women speak slower than when expressing as contrasted to anger, joy, or neutral states of feeling. Although Turkish speakers' ability to perceive emotional prosody is similar to that of other languages, they favor speech loudness fluctuation in the production of emotional prosody.

Balance Impairment in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis.

BACKGROUND: Balance weaknesses related to mobility and fall risk in patients with rheumatic diseases are well-known. Vestibular dysfunction could negatively contribute to the balance ability of this patient population. This study aims to investigate the effects of Rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS), among the most common rheumatic diseases, on postural balance related to vestibular function. METHODS: Seventy-eight participants were grouped as RA (n=34, 43%), AS (n=24, 30.7%), and the control group consisted of healthy individuals (n=20, 25.6%). Cervical Vestibular Evoked Myogenic Potentials (cVEMP) test, which assesses the vestibular function objectively, Dizziness Handicap Inventory (DHI), which evaluates vertigo subjectively, and Berg Balance Scale (BBS) were performed. RESULTS: Different degrees of VEMP latency prolongations were found in the AS and RA groups. Right, and left ear N1 latencies were significantly longer in the AS group than in RA and control. Right ear P1 latency prolongation was statistically significant in the RA group. Amplitude asymmetry ratio (AAR) was found to be considerably higher in the RA and AS groups than in the control group (p<0.05). The mean BBS score in the AS group was below the fall risk score of 45. A negative statistically significant effect was observed between latency prolongation and BBS in AS groups. CONCLUSION: The abnormal VEMP findings in individuals with RA and AS shows inner ear vestibular system dysfunction. This vestibular impairment strictly contributes to their postural imbalance and requires a focused vestibular rehabilitation program for balance treatment.

A Comparative Study of Readability, Acceptability, and the Adaptation of an Internet-based Cognitive Behavioral Therapy for Tinnitus.

BACKGROUND: Internet-based cognitive behavioral therapy has shown effectiveness in managing chronic tinnitus. Internet-based cognitive behavioral therapy is currently available in only a few languages (English, Swedish, Spanish, and German). The current study aimed to adapt, evaluate, and compare the readability and acceptability of the Turkish internet-based cognitive behavioral therapy materials compared to previous versions. METHODS: Internet-based cognitive behavioral therapy materials were adapted from the preexisting American English to the Turkish population in a 4-step process: (1) cultural adaptations, (2) acceptability adaptation of materials to the Turkish-speaking population, and (3) literacy-level adjustments. Experts (n=11) and patients (n=11) rated the intervention materials and the ePlatform for acceptability, including usability, content, presentation, and suitability (4). RESULTS: Literacy-level adjustments generated acceptable and readability levels of the Turkish version of the internet-based cognitive behavioral therapy program. The average readability score was 76.15 ± 0.35. The Turkish internet-based cognitive behavioral therapy (Mdn: 7.00) was statistically lower compared to the Swedish (Mdn: 9.00) but higher when compared to the American English and Spanish (Mdn: 5.00) versions. There were no statistical differences between the British English and Turkish versions in readability scores. Acceptability in the internet-based cognitive behavioral therapy platform was rated favorably. CONCLUSION: The Turkish internet-based cognitive behavioral therapy was found to be user-friendly and easy to understand, with navigations that are straightforward, have clear information, and are supported by audiologists. The readability score of the Turkish internet-based cognitive behavioral therapy is within recommended limits to ensure comprehensibility. We suggest that an online cognitive behavioral therapy program is adaptable for other languages for countries with a limited number of clinicians focused on cognitive behavioral therapy and tinnitus.

Hearing Loss Related to Gene Mutations in Distal Renal Tubular Acidosis.

INTRODUCTION: Distal renal tubular acidosis (dRTA) is a disease that may develop either primarily or secondarily, resulting from urinary acidification defects in distal tubules. Hearing loss may accompany primary forms of dRTA. This study aims to determine the characteristics of hearing loss due to different gene mutations in patients with dRTA. METHODS: Behavioral and electrophysiological audiological evaluations were performed after otolaryngology examination in 21 patients with clinically diagnosed dRTA. Radiological imaging of the inner ear (n = 9) was conducted and results of genetic analyses using next-generation sequencing method (n = 16) were included. RESULTS: Twenty-one patients with dRTA from 20 unrelated families, aged between 8 months and 33 years (median = 12, interquartile range = 20), participated. All patients with ATP6V1B1 mutations (n = 9) had different degrees of hearing loss. There was one patient with hearing loss in patients with ATP6V0A4 mutations (n = 6). One patient with the WDR72 mutation had normal hearing. Large vestibular aqueduct syndrome (LVAS) was detected in 6 (67%) of 9 patients whose radiological evaluation results were available. CONCLUSIONS: LVAS is common in patients with dRTA and may influence the type and severity of hearing loss in these patients. The possibility of both congenital and late-onset and progressive hearing loss should be considered in dRTA patients. A regular audiological follow-up is essential for the early detection of a possible late-onset or progressive hearing loss in these patients.

Concordance of vestibular test batteries in patients with vestibular neuritis.

BACKGROUND: A growing number of vestibular function tests are utilized to differentiate and verify the diagnosis of vestibular neuritis. The aim of this study is to retrospectively investigate the consistency of the results of the objective vestibular test batteries in patients with a preliminary diagnosis of vestibular neuritis. METHODS: We reviewed a total of 37 adult patients (mean age: 39.03 ± 11.67, 19 females, 18 males) who met the inclusion criteria with a prediagnosis of vestibular neuritis from 379 patients suffering vestibular symptoms. Caloric test (CVT), video head impulse test (vHIT), and ocular and cervical VEMP tests were compared with Cohen's kappa (Κ) analysis according to the likely affected part of the vestibular nerve. RESULTS: The highest statistically significant K value was found between horizontal vHIT and ocular VEMP (K = 0.707; good grade, p < 0.05). All the tests compared with CVT were poorly in agreement (K = 0.288; 0.262; 0.256 for HvHIT, oVEMP, AvHIT, respectively, p < 0.05). DISCUSSION: VEMP and vHIT tests have prominent diagnostic value and agree with each other for detecting and differentiating the types of vestibular neuritis. Further studies should aim to include cutting-edge technologies such as functional HIT and ocular counter roll test.

Auditory Processing Differences Correlate With Autistic Traits in Males.

Autism spectrum disorder (ASD) has high prevalence among males compared to females but mechanisms underlying the differences between sexes are poorly investigated. Moreover, autistic symptoms show a continuity in the general population and are referred to as autistic traits in people without an ASD diagnosis. One of the symptoms of ASD is sensory processing differences both in sensitivity and perception. To investigate sensory processing differences in autistic traits, we examined auditory and visual processing in a healthy population. We recruited 75 individuals (39 females and 36 males, mean age = 23.01 years, SD = 3.23 years) and assessed autistic traits using the Autism Spectrum Quotient, and sensory sensitivity using the Sensory Sensitivity Scales. Sensory processing in the visual domain was examined with the radial motion stimulus and the auditory domain was assessed with the 1,000 Hz pure tone stimulus with electroencephalography-evoked potentials. The results showed that the auditory sensitivity scores of the males (r aud (34) = 0.396, p aud = 0.017) and the visual sensitivity scores of females were correlated with autistic traits (r vis (37) = 0.420, p vis = 0.008). Moreover, the P2 latency for the auditory stimulus was prolonged in the participants with a higher level of autistic traits (r s (61) = 0.411, p = 0.008), and this correlation was only observed in males (r s (31) = 0.542, p = 0.001). We propose that auditory processing differences are related to autistic traits in neurotypicals, particularly in males. Our findings emphasize the importance of considering sex differences in autistic traits and ASD.

Evaluation of temporal and suprasegmental auditory processing in patients with unilateral hearing loss.

OBJECTIVES: To determine the temporal order, resolution, and perception of prosody skills in Single-Sided Deafness (SSD) compared to an age- and sex-matched normal hearing group's same side ear and both ears. METHODS: This was a Case-Control study including 30 subjects with SSD, and age- and sex-matched 30 subjects with bilateral normal hearing (total of 60 subjects- mean age: 38.7 ± 11.6 years). The Montreal Cognitive Assessment (MoCA), Frequency Pattern Test (FPT), Duration Pattern Test (DPT), Random Gap Detection Test (RGDT), Evaluation of Motor Response Time and Emotional Prosody Assessment were performed on the clinically normal ear in the SSD group, the same side ear in the normal hearing group, and both ears of the normal hearing group (the SSD, MNH, and BNH groups, respectively). RESULTS: Individuals with SSD had worse results in DPT (p < .001), gap detection at 0.5 kHz (p < .001), gap detection at 4 kHz (p < .001), and composite score (p < .001) than the BNH group. For reaction time measurements, the SSD group had slower performance scores than the BNH group for DPT (p < .001) and FPT (p < .001). CONCLUSIONS: Poor temporal processing ability and reduced reaction times may help explain the difficulties in those with SSD in performing daily living activities such as speech understanding in noise and requires more processing efforts. However, there were no significant differences between the groups in frequency pattern performance and emotional prosody skills, supporting the claim that fundamental frequency is one of the most important measures of perception in emotional prosody. We demonstrated that unilateral hearing is adequate to analyze frequency patterns to aid in prosody perception. Analysis of reaction times in temporal processing and emotional prosody could provide different perspectives of auditory processing. Slower reaction time of SSD should be considered for habilitation purposes.

Evaluation of auditory temporal processing in patients fitted with bone-anchored hearing aids.

PURPOSE: The present study aimed to identify temporal processing abilities in users of bone-anchored hearing aid (BAHA). METHODS: Seventeen subjects with BAHA (SWB) users and 29 subjects with normal-hearing were compared using the frequency pattern test, duration pattern test, and speech-in-noise test. Besides behavioral temporal processing tests, a multi-feature mismatch negativity (MMN) test was performed in BAHA users to assess the accuracy of objective auditory discrimination at the cortical level, irrespective of the subjects' attention or behavioral task. RESULTS: The results of the multi-feature MMN test showed that BAHA users could perceive differences in frequency, duration, intensity. However, no response was elicited regarding localization of stimulus and gaps within tones. Word recognition performance in noise was significantly poorer compared with normal hearing groups. All age groups showed no differences in terms of temporal processing abilities except 30-39 years duration pattern ability weaker in SWB group. CONCLUSION: The present study was the first to indicate that the use of unilateral BAHA has no effect on the localization of auditory stimuli at the cortical level according to electrophysiological test. Although Baha users have near-normal levels of hearing thresholds and temporal ordering abilities with their devices, since they benefit from the unilateral device, they still have some difficulties in resolution, recognizing and distinguishing the spatial aspects of speech, especially in multiple and noisy listening environments.