Restoration of Deafferentation Reduces Tinnitus, Anxiety, and Depression: A Retrospective Study on Cochlear Implant Patients.

Patients with profound bilateral deafness (BD) are prone to suffering from tinnitus, which further leads to psychological comorbidities and makes it more difficult for patients to communicate with people. This study was aimed at investigating the effect of cochlear implants (CIs) on tinnitus distress and psychological comorbidities in patients with profound BD. This multicenter retrospective study reviewed 51 patients with severe postlingual BD who underwent cochlear implantation; 49 patients underwent unilateral cochlear implantation, and 2 patients underwent bilateral cochlear implantation. The patients were asked to complete all the questionnaires, including the tinnitus handicap inventory (THI), the visual analog scale (VAS) score, the Hospital Anxiety and Depression Scale Questionnaire (HADS), the Categories of Auditory Performance (CAP), and the Speech Intelligibility Rating (SIR), at least 4 months after implantation when the CI was on or off, in approximately May-June 2019. In our study, 94% (48/51) of BD patients suffered from tinnitus before CI, and 77% (37/48) of them suffered from bilateral tinnitus. In addition, 50.9% (26/51) of the CI patients were suffering from anxiety, 52.9% (27/51) of them were suffering from depression (score ≥ 8), and 66.7% (34/51) (27/51) of them were suffering from anxiety or depression. Cochlear implantation could reduce tinnitus more obviously when the CI was on than when the CI was off. Cochlear implantation also reduced anxiety/depression severity. There were significantly positive correlations between tinnitus severity and anxiety/depression severity before and after surgery. Moreover, hearing improvement is positively correlated with reduction level of tinnitus, the better hearing, and the lesser severity of tinnitus. Thus, along with effective restoration of deafferentation, cochlear implantation shows positive therapeutic effects on tinnitus and psychological comorbidities, providing a reference for future clinical and research work.

The effect of audiovisual and binaural listening on the acceptable noise level (ANL): establishing an ANL conceptual model.

BACKGROUND: Little is known regarding the acoustic features of a stimulus used by listeners to determine the acceptable noise level (ANL). Features suggested by previous research include speech intelligibility (noise is unacceptable when it degrades speech intelligibility to a certain degree; the intelligibility hypothesis) and loudness (noise is unacceptable when the speech-to-noise loudness ratio is poorer than a certain level; the loudness hypothesis). PURPOSE: The purpose of the study was to investigate if speech intelligibility or loudness is the criterion feature that determines ANL. To achieve this, test conditions were chosen so that the intelligibility and loudness hypotheses would predict different results. In Experiment 1, the effect of audiovisual (AV) and binaural listening on ANL was investigated; in Experiment 2, the effect of interaural correlation (ρ) on ANL was examined. RESEARCH DESIGN: A single-blinded, repeated-measures design was used. STUDY SAMPLE: Thirty-two and twenty-five younger adults with normal hearing participated in Experiments 1 and 2, respectively. DATA COLLECTION AND ANALYSIS: In Experiment 1, both ANL and speech recognition performance were measured using the AV version of the Connected Speech Test (CST) in three conditions: AV-binaural, auditory only (AO)-binaural, and AO-monaural. Lipreading skill was assessed using the Utley lipreading test. In Experiment 2, ANL and speech recognition performance were measured using the Hearing in Noise Test (HINT) in three binaural conditions, wherein the interaural correlation of noise was varied: ρ = 1 (N(o)S(o) [a listening condition wherein both speech and noise signals are identical across two ears]), -1 (NπS(o) [a listening condition wherein speech signals are identical across two ears whereas the noise signals of two ears are 180 degrees out of phase]), and 0 (N(u)S(o) [a listening condition wherein speech signals are identical across two ears whereas noise signals are uncorrelated across ears]). The results were compared to the predictions made based on the intelligibility and loudness hypotheses. RESULTS: The results of the AV and AO conditions appeared to support the intelligibility hypothesis due to the significant correlation between visual benefit in ANL (AV re: AO ANL) and (1) visual benefit in CST performance (AV re: AO CST) and (2) lipreading skill. The results of the N(o)S(o), NπS(o), and N(u)S(o) conditions negated the intelligibility hypothesis because binaural processing benefit (NπS(o) re: N(o)S(o), and N(u)S(o) re: N(o)S(o)) in ANL was not correlated to that in HINT performance. Instead, the results somewhat supported the loudness hypothesis because the pattern of ANL results across the three conditions (N(o)S(o) ≈ NπS(o) ≈ N(u)S(o) ANL) was more consistent with what was predicted by the loudness hypothesis (N(o)S(o) ≈ NπS(o) < N(u)S(o) ANL) than by the intelligibility hypothesis (NπS(o) < N(u)S(o) < N(o)S(o) ANL). The results of the binaural and monaural conditions supported neither hypothesis because (1) binaural benefit (binaural re: monaural) in ANL was not correlated to that in speech recognition performance, and (2) the pattern of ANL results across conditions (binaural < monaural ANL) was not consistent with the prediction made based on previous binaural loudness summation research (binaural ≥ monaural ANL). CONCLUSIONS: The study suggests that listeners may use multiple acoustic features to make ANL judgments. The binaural/monaural results showing that neither hypothesis was supported further indicate that factors other than speech intelligibility and loudness, such as psychological factors, may affect ANL. The weightings of different acoustic features in ANL judgments may vary widely across individuals and listening conditions.

Immunohistochemical analysis of alphavbeta5 and alphavbeta6 integrins in the endometrium and endometriosis.

We performed a case-controlled study to study the immunoreactivity patterns and staining intensity of alphavbeta5 and alphavbeta6 integrins in ectopic and eutopic endometrium from women with endometriosis and compared them with those in normal control endometrium. Forty eutopic and ectopic samples from patients with endometriosis were compared with 12 control endometrial samples. Staining was evaluated using a computerized image analysis system by a blinded, independent observer. The immunoreactivity patterns for both alphavbeta5 and alphavbeta6 were very similar. In eutopic endometrium from women with or without endometriosis, the immunostaining intensity score for both integrins was stronger during the secretory than the proliferative phase. Immunoreactivity in endometriosis was greater than in eutopic endometrium. There were no significant menstrual cycle-related staining differences in endometriosis. The percentage of blood vessels immunolabeled was greater in endometriosis than eutopic endometrium from endometriosis patients and greater in eutopic endometrium from these patients compared with control endometrium. Ectopic tissue from patients with stages I and II endometriosis showed significantly higher staining intensity than ectopic tissue from patients with stages III and IV disease. Determination of the specific functional consequences of the differences observed in alphavbeta5 and alphavbeta6 integrin immunostaining may provide an increased understanding regarding the pathogenesis of endometriosis.