Evaluation of the efficacy and safety of cannabidiol-rich cannabis extract in children with autism spectrum disorder: randomized, double-blind, and placebo-controlled clinical trial

Abstract Objective Autism spectrum disorder (ASD) is characterized by persistent deficits in social communication and social interaction and by restricted and repetitive patterns of behavior. Some studies have shown that substances derived from Cannabis sativa improve the quality of life of children with ASD without causing serious adverse effects, thus providing an alternative therapeutic option. The objective of this study was to evaluate the efficacy and safety of a cannabis extract rich in cannabidiol (CBD) in children with ASD. Methods In this randomized, double-blind, placebo-controlled clinical trial, 60 children, aged from 5 to 11 years, were selected and divided into two groups: the treatment group, which received the CBD-rich cannabis extract, and the control group, which received the placebo. They both used their respective products for a period of 12 weeks. Statistical analysis was done by two-factor mixed analysis of variance (two-way ANOVA). Results Significant results were found for social interaction (F1,116 = 14.13, p = 0.0002), anxiety (F1,116 = 5.99, p = 0.016), psychomotor agitation (F1,116 = 9.22, p = 0.003), number of meals a day (F1,116 = 4.11, p = 0.04), and concentration (F1,48 = 6.75, p = 0.01), the last of which was only significant in mild ASD cases. Regarding safety, it was found that only three children in the treatment group (9.7%) had adverse effects, namely dizziness, insomnia, colic, and weight gain. Conclusion CBD-rich cannabis extract was found to improve one of the diagnostic criteria for ASD (social interaction), as well as features that often co-exist with ASD, and to have few serious adverse effects.

Central auditory processing and aphasia: A scoping review / Processamento auditivo central e afasia: uma revisão de escopo

ABSTRACT Purpose: to report scientific evidence on the impact of aphasia on central auditory processing and map the contribution of auditory training to aphasic individuals. Methods: a scoping review approaching national and international databases (SciELO, LILACS, PubMed, Scopus, and Cochrane Library) and the gray literature (Google Scholar and Open Grey). The inclusion criteria covered articles that addressed the interface between central auditory processing and aphasia, excluding duplicates, literature reviews, and scientific abstracts. Literature Review: the review comprised 13 articles that met the eligibility criteria for this study. Seven of the selected articles assessed central auditory processing, four used electrophysiological examinations (such as auditory brainstem response and long-latency auditory evoked potentials) to assess the auditory pathway, and only one analyzed the intervention in aphasic individuals with auditory training. Conclusion: scientific evidence points to an important change in aphasic people's central auditory processing, with impaired figure-ground, auditory closure, temporal resolution and ordering, and binaural integration. Moreover, it is relevant to assess auditory processing, given the contribution of auditory training in speech-language-hearing therapy for a better prognosis in the rehabilitation of aphasia.

RESUMO Objetivo: reportar as evidências científicas do impacto da afasia no Processamento Auditivo Central e mapear a contribuição do Treinamento Auditivo para a população afásica. Métodos: trata-se de uma revisão de escopo realizada nas bases de dados nacionais e internacionais: Scielo, Lilacs, Pubmed, Scopus, Cochrane Library e com uma busca adicional à literatura cinzenta no Google Scholar e Open Grey. Os critérios de inclusão abrangeram artigos que abordassem a interface do processamento auditivo central e afasia, excluindo-se as duplicações, artigos de revisão da literatura e resumos científicos. Revisão de Literatura: selecionaram-se 13 artigos que cumpriram os critérios de elegibilidade deste estudo. Dos artigos selecionados, sete apresentaram a avaliação do Processamento Auditivo Central, quatro apresentaram os exames eletrofisiológicos - como os exames de Potencial Evocado Auditivo de Tronco Encefálico (PEATE) e Potencial Evocado Auditivo de Longa Latência (PEALL) - para avaliação da via auditiva e apenas um estudo analisou a intervenção dos indivíduos afásicos por meio do treinamento auditivo. Conclusão: as evidências científicas apontam importante alteração no Processamento Auditivo Central dos afásicos, apresentando prejuízos nas habilidades auditivas de figura-fundo, fechamento auditivo, resolução e ordenação temporal e integração binaural. Ainda, demonstra-se como relevante a avaliação do processamento, devido à contribuição do Treinamento Auditivo nas terapias fonoaudiológicas para um melhor prognóstico na reabilitação das afasias.

Avazum app usability testing. / Teste de usabilidade do aplicativo Avazum.

PURPOSE: To verify the effectiveness, efficiency, and satisfaction in the usability test of the tinnitus assessment application. METHODS: This is a descriptive usability test study that assessed the satisfaction, effectiveness, and efficiency of the application. The test was carried out virtually via Google Forms. First, the participants received instructions on how to access and use Avazum, through texts and illustrative images. Afterward, the users used the application, observing its functions and usability. Next, the participants answered the usability questionnaire. Statistical analysis was performed using the Statistical Package for the Social Sciences, version 21.0, to perform descriptive analysis such as frequency, percentages of data in the System Usability Questionnaire (SUS), and analysis in the Net Promoter Score (NPS). RESULTS: Thus, the overall mean SUS score was consistent with satisfactory usability, which implies that the application does not present serious usability problems. Also, the overall NPS percentage indicated very good user satisfaction, with a good percentage of promoting users. As far as effectiveness is concerned, it was found that Avazum reached its goals, besides being efficient, as it uses clear language and is comfortably used. CONCLUSION: Avazum obtained very good satisfaction from users, in addition to achieving its goals. It proved to be effective, has clear language, and is comfortably used, adducing efficiency in the multidisciplinary evaluation of tinnitus.

OBJETIVO: Verificar a efetividade, eficiência e satisfação no teste de usabilidade para o aplicativo de avaliação do zumbido. MÉTODO: Trata-se de um estudo descritivo de teste de usabilidade, no qual será avaliado satisfação, eficácia e eficiência do aplicativo. O teste foi realizado virtualmente por meio de um formulário do Google Forms. Primeiramente, os participantes receberam as instruções de acesso e uso do avazum através de textos e imagens ilustrativas. Logo após, os usuários fizeram o uso do aplicativo, observando suas funções e usabilidade. Em seguida, os participantes responderam o questionário de usabilidade. A análise estatística foi realizada no software Statistics Package for the Social Sciences (SPSS) versão 21.0 para realizar a análise descritiva como frequência, percentagens dos dados do System Usability Questionnaire (SUS), além de análise do score do Net Promoter Score (NPS). RESULTADOS: Sendo assim, a média geral do score do SUS foi condizente com score de usabilidade satisfatório, o que implica dizer que o aplicativo não apresenta graves problemas de usabilidade, além da porcentagem geral NPS indicar uma satisfação muito boa dos usuários, com bom percentual de usuários promotores. No que diz respeito sobre a efetividade, foi possível observar que o Avazum atinge os objetivos propostos, além de ser eficiente, pois apresenta uma linguagem clara e confortabilidade durante o uso. CONCLUSÃO: O Avazum obteve satisfação muito boa dos usuários, além de atingir os objetivos propostos, tornando-o efetivo, apresentou uma linguagem clara e confortabilidade durante o uso, aduzindo eficiência na avaliação multidisciplinar do zumbido.

Are the EEG microstates correlated with motor and non-motor parameters in patients with Parkinson's disease?

OBJECTIVES: This study compared electroencephalography microstates (EEG-MS) of patients with Parkinson's disease (PD) to healthy controls and correlated EEG-MS with motor and non-motor aspects of PD. METHODS: This cross-sectional exploratory study was conducted with patients with PD (n = 10) and healthy controls (n = 10) matched by sex and age. We recorded EEG-MS using 32 channels during eyes-closed and eyes-open conditions and analyzed the four classic EEG-MS maps (A, B, C, D). Clinical information (e.g., disease duration, medications, levodopa equivalent daily dose), motor (Movement Disorder Society - Unified Parkinson Disease Rating Scale II and III, Timed Up and Go simple and dual-task, and Mini-Balance Evaluation Systems Test) and non-motor aspects (Mini-Mental State Exam [MMSE], verbal fluency, Hospital Anxiety and Depression Scale, and Parkinson's Disease Questionnaire-39 [PDQ-39]) were assessed in the PD group. Mann-Whitney U test was used to compare groups, and Spearman's correlation coefficient to analyze the correlations between coverage of EEG-MS and clinical aspects of PD. RESULTS: The PD group showed a shorter duration of EEG-MS C in the eyes-closed condition than the control group. We observed correlations (rho = 0.64 to 0.82) between EEG-MS B, C, and D and non-motor aspects of PD (MMSE, verbal fluency, PDQ-39, and levodopa equivalent daily dose). CONCLUSION: Alterations in EEG-MS and correlations between topographies and cognitive aspects, quality of life, and medication dose indicate that EEG could be used as a PD biomarker. Future studies should investigate these associations using a longitudinal design.

Intensidade e desconforto do zumbido pós-covid-19: um estudo comparativo / Intensity and discomfort of post-COVID-19 tinnitus: a comparative study

RESUMO Objetivo caracterizar o grau de intensidade e desconforto do zumbido de indivíduos, pós-COVID-19. Métodos pesquisa observacional, exploratória e de corte transversal com 242 participantes, divididos em dois grupos iguais, pareados de acordo com gênero e faixa etária: grupo-controle (GC), composto por indivíduos com zumbido em período pré-pandêmico, e grupo de estudo (GE), composto por participantes que referiram zumbido pós-COVID-19, de diferentes regiões do país. Foram comparados os escores gerais e de domínios específicos do Tinnitus Handicap Inventory (THI) e da Escala Visual Analógica (EVA), por meio de análise estatística descritiva, testes de normalidade, comparação de grupos e de correlação entre as variáveis. Resultados em cada grupo, 93 participantes eram do gênero feminino e 28, do masculino, sendo a média das idades de 35 anos. Os graus desprezível e leve do THI e leve e moderado da EVA foram maiores para o GE, enquanto o domínio catastrófico do THI e a EVA apontaram piores escores para o GC. Houve diferença significativa entre todos os domínios das escalas inter e intragrupos. Conclusão manifestações mais brandas de incômodo, intensidade e desconforto do zumbido pós-COVID-19 foram encontradas, em comparação ao sintoma decorrente de outras causas. Assim, o impacto do zumbido para a população estudada foi menos autorreferido, apontando para melhores possibilidades terapêuticas e prognósticas.

ABSTRACT Purpose to characterize the degree of intensity and discomfort of tinnitus in post-COVID-19 individuals. Methods observational, exploratory and cross-sectional research with 242 participants, divided into two equal groups matched according to sex and age group. The control group, composed of individuals with tinnitus in the pre-pandemic period, and the study group, composed of participants who reported post-COVID-19 tinnitus in different regions of the country. General and domain-specific scores from the Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) were compared through descriptive statistical analysis, normality tests, comparison of groups and correlation between variables. Results in each group, 93 participants were female and 28 male, with a mean age of 35 years. The "negligible" and "mild" degrees of the THI and the "mild" and "moderate" of the VAS were higher for the SG, while the catastrophic domain of the THI and the VAS indicate worse scores for the CG. There was a significant difference between all domains of the inter- and intra-group scales. Conclusion milder manifestations of post-COVID-19 tinnitus disturbance, intensity and discomfort were found, compared to symptoms arising from other causes. Thus, the self-reported impact of the studied population was lower, pointing to better therapeutic and prognostic possibilities.

Teste de usabilidade do aplicativo Avazum / Avazum app usability testing

RESUMO Objetivo Verificar a efetividade, eficiência e satisfação no teste de usabilidade para o aplicativo de avaliação do zumbido. Método Trata-se de um estudo descritivo de teste de usabilidade, no qual será avaliado satisfação, eficácia e eficiência do aplicativo. O teste foi realizado virtualmente por meio de um formulário do Google Forms. Primeiramente, os participantes receberam as instruções de acesso e uso do avazum através de textos e imagens ilustrativas. Logo após, os usuários fizeram o uso do aplicativo, observando suas funções e usabilidade. Em seguida, os participantes responderam o questionário de usabilidade. A análise estatística foi realizada no software Statistics Package for the Social Sciences (SPSS) versão 21.0 para realizar a análise descritiva como frequência, percentagens dos dados do System Usability Questionnaire (SUS), além de análise do score do Net Promoter Score (NPS). Resultados Sendo assim, a média geral do score do SUS foi condizente com score de usabilidade satisfatório, o que implica dizer que o aplicativo não apresenta graves problemas de usabilidade, além da porcentagem geral NPS indicar uma satisfação muito boa dos usuários, com bom percentual de usuários promotores. No que diz respeito sobre a efetividade, foi possível observar que o Avazum atinge os objetivos propostos, além de ser eficiente, pois apresenta uma linguagem clara e confortabilidade durante o uso. Conclusão O Avazum obteve satisfação muito boa dos usuários, além de atingir os objetivos propostos, tornando-o efetivo, apresentou uma linguagem clara e confortabilidade durante o uso, aduzindo eficiência na avaliação multidisciplinar do zumbido.

ABSTRACT Purpose To verify the effectiveness, efficiency, and satisfaction in the usability test of the tinnitus assessment application. Methods This is a descriptive usability test study that assessed the satisfaction, effectiveness, and efficiency of the application. The test was carried out virtually via Google Forms. First, the participants received instructions on how to access and use Avazum, through texts and illustrative images. Afterward, the users used the application, observing its functions and usability. Next, the participants answered the usability questionnaire. Statistical analysis was performed using the Statistical Package for the Social Sciences, version 21.0, to perform descriptive analysis such as frequency, percentages of data in the System Usability Questionnaire (SUS), and analysis in the Net Promoter Score (NPS). Results Thus, the overall mean SUS score was consistent with satisfactory usability, which implies that the application does not present serious usability problems. Also, the overall NPS percentage indicated very good user satisfaction, with a good percentage of promoting users. As far as effectiveness is concerned, it was found that Avazum reached its goals, besides being efficient, as it uses clear language and is comfortably used. Conclusion Avazum obtained very good satisfaction from users, in addition to achieving its goals. It proved to be effective, has clear language, and is comfortably used, adducing efficiency in the multidisciplinary evaluation of tinnitus.

Translation, Cultural Adaptation and Validation to Brazilian Portuguese of the Tinnitus Functional Index Questionnaire

Abstract Introduction Tinnitus affects a large portion of the world's population. There are several questionnaires being used for the evaluation of the severity of tinnitus and its impact in quality of life; however, they do not measure treatment-related changes. So, a new self-reported questionnaire was developed, the Tinnitus Functional Index (TFI), which has been translated into several languages. Objective To perform the translation, cultural adaptation and validation of the TFI questionnaire for Brazilian Portuguese. Method This is a multicenter project divided into two stages: translation and cultural adaptation; and validation and reliability. For the validation, the Brazilian Portuguese version of the TFI was correlated with the Tinnitus Handicap Inventory (THI) domains for tinnitus and quality of life and was evaluated by the Spearman ρ test. The reliability and internal consistency were evaluated by the Cronbach α test. Result The Brazilian version of the TFI was obtained through an initial translation process, synthesis of translations, backtranslation and evaluation by a committee of experts. This version was then applied in 88 patients complaining of tinnitus from speech therapy and otorhinolaryngology outpatient clinics of the three school clinics. The Brazilian version presented high reliability, as evidenced by the Cronbach α value (α = 0.870), and strong correlation (rho = 0.760 and p = 0.000). Conclusion The high reliability found in the results demonstrates that the Brazilian Portuguese version of the TFI is a valid and reliable instrument to evaluate the severity and impact of tinnitus on quality of life and changes related to its treatment.

Translation, Cultural Adaptation and Validation to Brazilian Portuguese of the Tinnitus Functional Index Questionnaire.

Introduction Tinnitus affects a large portion of the world's population. There are several questionnaires being used for the evaluation of the severity of tinnitus and its impact in quality of life; however, they do not measure treatment-related changes. So, a new self-reported questionnaire was developed, the Tinnitus Functional Index (TFI), which has been translated into several languages. Objective To perform the translation, cultural adaptation and validation of the TFI questionnaire for Brazilian Portuguese. Method This is a multicenter project divided into two stages: translation and cultural adaptation; and validation and reliability. For the validation, the Brazilian Portuguese version of the TFI was correlated with the Tinnitus Handicap Inventory (THI) domains for tinnitus and quality of life and was evaluated by the Spearman ρ test. The reliability and internal consistency were evaluated by the Cronbach α test. Result The Brazilian version of the TFI was obtained through an initial translation process, synthesis of translations, backtranslation and evaluation by a committee of experts. This version was then applied in 88 patients complaining of tinnitus from speech therapy and otorhinolaryngology outpatient clinics of the three school clinics. The Brazilian version presented high reliability, as evidenced by the Cronbach α value (α = 0.870), and strong correlation (rho = 0.760 and p = 0.000). Conclusion The high reliability found in the results demonstrates that the Brazilian Portuguese version of the TFI is a valid and reliable instrument to evaluate the severity and impact of tinnitus on quality of life and changes related to its treatment.

Evaluation of the efficacy and safety of cannabidiol-rich cannabis extract in children with autism spectrum disorder: randomized, double-blind and controlled placebo clinical trial.

INTRODUCTION: Autism Spectrum Disorder is characterized by persistent deficits in social communication, social interaction, and restricted and repetitive patterns of behavior. Some studies have shown that substances derived from Cannabis sativa improve the quality of life of autistic children without causing serious adverse effects, thus providing a therapeutic alternative. METHOD: This was a randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of a cannabis extract rich in cannabidiol (CBD) in autistic children. Sixty children, aged between 5 and 11 years, were selected and divided into two groups: the treatment group, which received the CBD-rich cannabis extract, and the control group, which received the placebo, both used the product for a period of 12 weeks. Statistical analysis was done by two-factor mixed analysis of variance (ANOVA two way). RESULTS: Significant results were found for social interaction [F(1,116)=14.13, p=0.0002)], anxiety [F(1,116)=5.99, p=0.016], psychomotor agitation [F(1,116)=9.22, p=0.003)], number of meals a day [F(1,116)=4.11, p=0.04)] and concentration [F (1,48)=6.75, p=0.01], the latter being significant only in mild autism spectrum disorder. Regarding safety, it was found that only three children in the treatment group (9.7%) had adverse effects, namely dizziness, insomnia, colic and weight gain. CONCLUSION: CBD-rich cannabis extract was found to improve one of the diagnostic criteria for ASD (social interaction), as well as often co-existing features, and to have few serious adverse effects.

Effect of transcranial Direct Current Stimulation for tinnitus treatment: A systematic review and meta-analysis.

OBJECTIVES: To evaluate the effect of tDCS on tinnitus distress, loudness and psychiatric symptoms. METHODS: A systematic literature search of PubMed, Web of Science, Cochrane Library, VHL, EMBASE, PsycINFO, OVID, and CINAHL databases was carried out on articles published until July 2021. Inclusion criteria were published controlled trials using tDCS intervention with tinnitus patients, using a sham/control group, and measuring tinnitus loudness, distress and/or psychiatric symptoms. A meta-analysis was performed for the overall effect as well as to compare subgroups according to tDCS target (left temporoparietal area (LTA) and dorsolateral prefrontal cortex (DLPFC)). RESULTS: Fourteen articles with 1031 participants were included. Six studies applied tDCS over the DLPFC, six over the LTA and two over both areas. Although the overall meta-analysis showed that tDCS significantly decreased tinnitus loudness (SMD=-0.35; 95%CI=-0.62 to -0.08, p = 0.01) and distress (SMD=-0.50, 95%CI=-0.91 to -0.10, p = 0.02).The subgroup analysis showed a significant effect only for tDCS over LTA for loudness (SMD=-0.46, 95%CI=-0.80 to -0.12, p = 0.009), and no other area resulted in significant change. There was no significant effect of treatment on psychiatric symptoms. CONCLUSION: tDCS may improve tinnitus loudness and distress with a small to moderate effect size. Despite the overall positive effect, only LTA tDCS yielded a significant effect. Further well-controlled studies with larger sample sizes and broader exploration of tDCS montages and doses are warranted.

Cannabis and cannabinoid use in autism spectrum disorder: a systematic review.

INTRODUCTION: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction, associated with the presence of restricted and repetitive patterns of behavior, interests, or activities. Cannabis has been used to alleviate symptoms associated with ASD. METHOD: We carried out a systematic review of studies that investigated the clinical effects of cannabis and cannabinoid use on ASD, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA checklist). The search was carried out in four databases: MEDLINE/PubMed, Scientific Electronic Library Online (SciELO), Scopus, and Web of Science. No limits were established for language during the selection process. Nine studies were selected and analyzed. RESULTS: Some studies showed that cannabis products reduced the number and/or intensity of different symptoms, including hyperactivity, attacks of self-mutilation and anger, sleep problems, anxiety, restlessness, psychomotor agitation, irritability, aggressiveness perseverance, and depression. Moreover, they found an improvement in cognition, sensory sensitivity, attention, social interaction, and language. The most common adverse effects were sleep disorders, restlessness, nervousness and change in appetite. CONCLUSION: Cannabis and cannabinoids may have promising effects in the treatment of symptoms related to ASD, and can be used as a therapeutic alternative in the relief of those symptoms. However, randomized, blind, placebo-controlled clinical trials are necessary to clarify findings on the effects of cannabis and its cannabinoids in individuals with ASD. SYSTEMATIC REVIEW REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO), code 164161.

Perception of Tinnitus: Direct and Indirect Effects of Resilience, Personality Traits, and Psychiatric Symptoms.

BACKGROUND: Psychiatric conditions are common in individuals with tinnitus. Therefore, the ways individuals cope with such conditions and personality can influence the characteristics of tinnitus. PURPOSE: The study aims to investigate the direct and indirect effects of resilience, personality traits, and psychiatric symptoms on the tinnitus perception. RESEARCH DESIGN: This is a descriptive, cross-sectional, and observational study involving quantitative results. STUDY SAMPLE: Thirty-seven individuals with chronic tinnitus (for more than 6 months) sought the tinnitus care service (mean age = 44.6 years; SD = 11.7 years). DATA COLLECTION AND ANALYSIS: The specific anamnesis of tinnitus, adult self-report questionnaire, resilience scale, big five inventory, Tinnitus Handicap Inventory (M = 45.0; SD = 24.1), and visual analog scale (M = 6.4; SD = 2.7) were used. Psychoacoustic measurements (loudness: M = 25.4; SD = 12.8) of tinnitus were performed to characterize the condition in terms of pitch and loudness. The study analyzed the relationship between tinnitus (annoyance, severity, and loudness), psychiatric symptoms, personality, and resilience using multiple mediations. RESULTS: Resilience did not influence tinnitus severity (BCa: -1.12 to 0.51), annoyance (BCa: -0.10 to 0.11), or loudness (BCa: -0.44 to 0.28) when mediated by anxiety and depression. Additionally, there was only a direct effect of resilience for annoyance (t = - 2.14, p = 0.03; BCa: -0.10 to 0.11). There was no direct influence of anxiety and depression on the tinnitus severity (b = 0.53, p > 0.05), annoyance (b = - 0.01, p > 0.05), or loudness (b = 0.11, p > 0.05). However, there was an association of personality traits (neuroticism) with the tinnitus severity (b = 1.16, 95% CI: 0.15-2.17; t = 2.53, p = 0.02) and annoyance (b = 0.12, 95% CI: 0.003-0.24; t = 2.09, p = 0.04). CONCLUSION: Resilience and psychiatric symptoms did not have a direct or indirect influence on the tinnitus annoyance, severity, or loudness. However with a direct association of resilience and annoyance, and neuroticism trait with the tinnitus annoyance and severity. Our results suggest that patients with chronic tinnitus and high neuroticism should receive personalized treatment.

Characterization of patients with tinnitus seen by the Hearing Health service / Caracterização dos pacientes com zumbido atendidos por serviço de Saúde Auditiva

ABSTRACT Purpose: to establish the profile of individuals with tinnitus treated at a Hearing Health service and to associate the symptom with gender, audiological profile, and presence of vertigo. Methods: a descriptive, retrospective study with an analysis of 6,000 medical records of individuals treated at a hearing health service was carried out. The data collected from the medical records were: sociodemographic data, characteristics of hearing impairment, characteristics of tinnitus and vertigo, speech therapy interview, and otorhinolaryngological, audiological, otoneurological assessments, characteristics of life style and risk factors. An descriptive analysis was performed using the Chi-square test of association, adopting a statistical significance level of 5% (p<0.05) for the inferential analysis. Results: there was a statistically significant association between the presence of tinnitus and gender, normal hearing, and vertigo, and a significant association was also found between tinnitus and unilateral and bilateral conductive hearing loss, and unilateral and bilateral sensorineural hearing loss. Conclusion: there was a significant association, in the population evaluated, for the presence of tinnitus and female gender, normal hearing, unilateral and bilateral conductive hearing loss, unilateral and bilateral sensorineural hearing loss, and the presence of vertigo.

RESUMO Objetivo: estabelecer o perfil dos indivíduos com zumbido, atendidos em um serviço de Saúde Auditiva e associar o sintoma com gênero, perfil audiológico e presença de vertigem. Métodos: estudo descritivo, retrospectivo. Foi realizada a análise de 6.000 prontuários de indivíduos atendidos em um serviço de saúde auditiva, os dados coletados do prontuário foram: dados sociodemográficos, características da deficiência auditiva, caraterísticas do zumbido e da vertigem, entrevista fonoaudiológica, avaliações otorrinolaringológicas, audiológicas, otoneurológicas, estilo de vida e dos fatores de risco. A análise descritiva, foi realizada por meio do teste de associação Qui-quadrado, sendo adotado o nível de significância estatística de 5% (p<0,05) para a análise inferencial. Resultados: houve associação estatisticamente significante entre presença de zumbido e gênero, audição normal e vertigem e foi constatada também associação significante entre zumbido e perda auditiva condutiva unilateral e bilateral, perda auditiva sensorioneural unilateral e bilateral. Conclusão: houve associação significante, na população avaliada, para presença de zumbido e gênero feminino, audição normal, perda auditiva condutiva unilateral e bilateral, perda auditiva sensorioneural unilateral e bilateral e presença de vertigem.

Cannabis and cannabinoid use in autism spectrum disorder: a systematic review

Abstract Introduction Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction, associated with the presence of restricted and repetitive patterns of behavior, interests, or activities. Cannabis has been used to alleviate symptoms associated with ASD. Method We carried out a systematic review of studies that investigated the clinical effects of cannabis and cannabinoid use on ASD, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA checklist). The search was carried out in four databases: MEDLINE/PubMed, Scientific Electronic Library Online (SciELO), Scopus, and Web of Science. No limits were established for language during the selection process. Nine studies were selected and analyzed. Results Some studies showed that cannabis products reduced the number and/or intensity of different symptoms, including hyperactivity, attacks of self-mutilation and anger, sleep problems, anxiety, restlessness, psychomotor agitation, irritability, aggressiveness perseverance, and depression. Moreover, they found an improvement in cognition, sensory sensitivity, attention, social interaction, and language. The most common adverse effects were sleep disorders, restlessness, nervousness and change in appetite. Conclusion Cannabis and cannabinoids may have promising effects in the treatment of symptoms related to ASD, and can be used as a therapeutic alternative in the relief of those symptoms. However, randomized, blind, placebo-controlled clinical trials are necessary to clarify findings on the effects of cannabis and its cannabinoids in individuals with ASD. Systematic review registration International Prospective Register of Systematic Reviews (PROSPERO), code 164161.

Auditory Skills as a Predictor of Rater Reliability in the Evaluation of Vocal Quality.

OBJECTIVE: To determine whether an association exists between auditory skills and the reliability of judgments of the vocal deviation grade and the degrees of roughness and breathiness and to evaluate whether these skills are predictive of interrater reliability in auditory-perceptual evaluations. METHODS: The sample consisted of 20 speech-language pathology students without previous training in auditory-perceptual evaluation. The students underwent a basic audiological evaluation and a central auditory processing evaluation. They then participated in two auditory-perceptual evaluation sessions assessing the general grade (GG) and the degrees of roughness and breathiness of 44 samples of sustained vowel production with the presence or absence of dysphonia. For statistical analysis, the intraclass correlation coefficient (ICC) and a beta regression model were used. RESULTS: A difference was found in the average ICCs of the GG parameter between listeners with high and low temporal resolution and binaural interaction skills. Temporal resolution skills and binaural interaction affected the ICC of listeners in the GG evaluation, reducing the likelihood of reliability by 2.8 and 3.6 times, respectively. CONCLUSION: An association exists between temporal resolution skills and binaural interaction and the reliability of listeners in evaluations of vocal deviation severity. Listeners with low levels of these skills show less reliability in evaluations of the severity of vocal deviation. In addition, temporal resolution and binaural interaction are predictors and explain 42.7% of the variability in the reliability of evaluations of vocal deviation severity.

Auditory and vestibular symptoms after COVID-19 infection: a preliminary Brazilian report

ABSTRACT Purpose: to present preliminary data on the influence of COVID-19 on the appearance and/or worsening of auditory and vestibular symptoms in the population of a Brazilian state. Methods: an observational, descriptive and quantitative approach of research, carried out from September 2020 to May 2021, in Paraíba, Northeastern Brazil. The research consisted of a self-report questionnaire on the manifestation of COVID-19, general post-infection symptoms, and audio-vestibular symptoms before and after COVID-19, posted on social media using the snowball technique. Results: the sample consisted of 173 people, 89% reporting symptomatic manifestations of COVID-19 with home treatment, 6.9% being asymptomatic, and 4% symptomatic with hospital treatment. A decrease in smell was reported by 126 patients, headache by 76, tinnitus by 76, and dizziness by 72, after infection by COVID-19. An increase in audio-vestibular symptoms was observed, affecting even those who did not present them before COVID. Conclusions: the preliminary results of the research point to a high occurrence and worsening of auditory and vestibular symptoms, following COVID-19.

Simplified assessment of central auditory processing in individuals presented with trisomy 21 / Avaliação simplificada do processamento auditivo central em indivíduos com a presença da trissomia 21

ABSTRACT Purpose: to analyze the performance of individuals with trisomy 21 (T21) in the simplified assessment of central auditory processing, identify the impaired skills, and compare it with the results of the hearing self-perception questionnaire administered to the parents. Methods: a descriptive, observational, quantitative study conducted at the Speech-Language-Hearing Teaching Clinic of a public university. The sample comprised 16 individuals with T21, aged 8 to 33 years. Simplified assessment tests of central auditory processing were conducted, namely, sounds localization and sequential memory for verbal and nonverbal sounds, diotically. Then, the Scale of Auditory Behaviors (SAB) was administered to the subjects' parents/guardians. The descriptive statistical analysis with the chi-square test considered p<0.05. Results: in the simplified assessment, 81.3% had abnormal results in the memory tests for verbal sounds; 75%, in the memory tests for nonverbal sounds; and 37.5%, in the sound localization test. In the Scale of Auditory Behaviors, 62.5% of the answers indicated changes in the central auditory processing, demonstrating that the scale can be useful to identify such changes. However, there was no significant association between the questionnaire and the behavioral test results. Conclusion: the results point to impaired sequential memory skills for verbal and nonverbal sounds in most individuals assessed. The simplified assessment results indicate the need for assessments of central auditory processing. Hence, the simplified assessment is highly important to detect possible changes in the central auditory processing that might interfere with the communication and overall learning of individuals presented with trisomy 21.

RESUMO Objetivo: analisar o desempenho de indivíduos com Trissomia 21 (T21) na avaliação simplificada com processamento auditivo central, identificando as habilidades alteradas, e comparar com o resultado obtido no questionário de autopercepção da audição aplicado aos pais. Métodos: estudo descritivo, observacional e de caráter quantitativo realizado na Clínica Escola de Fonoaudiologia de uma universidade pública. A amostra foi composta por 16 indivíduos com T21, com idade entre 8 e 33 anos. Foram realizados os testes da avaliação simplificada do processamento auditivo central, tais como: localização, memória sequencial verbal e não-verbal de forma diótica. Em seguida, aplicou-se o questionário de Escala de Funcionamento Auditivo (Scale Of Auditory Behaviors-SAB) aos pais/responsáveis dos indivíduos. Para análise estatística descritiva por meio do teste Qui-quadrado, considerando p<0,05. Resultados: na avaliação simplificada, 81,3% apresentaram resultados alterados para os testes de memória para sons verbais, 75% alterados para o teste de memória para sons não verbais e 37,5% com alteração para o teste de localização sonora. No questionário Escala de Funcionamento Auditivo, 62,5% das respostas indicaram alteração para o processamento auditivo central (PAC), demonstrando que a escala pode ser útil na identificação de alterações do PAC. Entretanto, não se observou associação significante entre o questionário e os resultados dos testes comportamentais. Conclusão: os resultados apontam para alteração das habilidades de memória sequencial verbal e não-verbal na maioria dos indivíduos avaliados. Por sua vez, os resultados da avaliação simplificada indicam necessidade de avaliação do PAC. Sendo assim, considera-se de grande importância a avaliação simplificada para detectar possíveis alterações do processamento auditivo central que podem interferir no aprendizado da comunicação e global dos indivíduos com a presença da trissomia 21.

Transcranial direct current stimulation improves tinnitus perception and modulates cortical electrical activity in patients with tinnitus: A randomized clinical trial.

OBJECTIVES: This study aims to determine whether transcranial direct current stimulation (tDCS): a) is effective in the treatment of tinnitus by decreasing its annoyance and severity; b) modulates the cortical electrical activity of such individuals. METHODS: A double-blind, placebo-controlled clinical trial was conducted with 24 patients with tinnitus, randomized into two groups: Group 1 (n = 12) received anodal tDCS over the left temporoparietal area (LTA) and cathodal tDCS over the right dorsolateral prefrontal cortex (DLPFC) and Group 2 (n = 12) received placebo intervention. Tinnitus perception using a visual analog scale (VAS) and the Tinnitus Handicap Inventory (THI) questionnaire, in addition to electroencephalogram (EEG) was measured with eyes opened and closed at baseline and after the intervention. For the treatment, patients were subjected to five consecutive sessions of tDCS with the anodal electrode over the LTA and cathodal electrode over the right DLPFC (7 × 5 cm, 2 mA for 20 min). tDCS was turned off after 30 s in the sham group. RESULTS: Active tDCS significantly improved tinnitus annoyance and severity. It was associated with decreased beta and theta EEG frequency bands with eyes opened and decreased alpha frequency with eyes closed. sLORETA identified changes in frequency bands in the frontal, temporoparietal, and limbic regions. Finally, there were negative correlations between baseline EEG frequency bands and tDCS-induced change in tinnitus annoyance and severity. CONCLUSIONS: These results demonstrate that tDCS modulates the EEG activity and alleviates tinnitus perception. This effect may be related to baseline EEG activity.

Auditory attention in individuals with tinnitus / Auditory attention in individuals with tinnitus

Abstract Introduction Tinnitus is characterized by the presence of a sound in the absence of external sound stimulus. In individuals with normal audiometry, it may be associated with auditory attention difficulty, especially in those who report high tinnitus annoyance. Objective To investigate auditory attention ability in individuals with tinnitus complaint. Methods Cross-sectional analytical observational study. We evaluated 30 volunteers with normal hearing (up to 25 dBHL): 15 with tinnitus (test group) and 15 with no complaints (control group), aged between 18-40 years. The volunteers answered the tinnitus handicap inventory questionnaire and a visual analogue scale. Subsequently, a basic audiological evaluation (meatoscopy, tonal and vocal audiometry, and imittanciometry) and psychoacoustic measures of tinnitus (loudness and pitch) were performed. To evaluate auditory attention, the following tests were performed: auditory cognitive evoked potential (P300), central auditory processing tests (dichotic digits test and speech-in-noise test) and sustained auditory attention ability test. Results In the tinnitus handicap inventory, individuals with tinnitus had a mean score of 37.78 (±27.05), characterized as moderate degree. In the dichotic digits test (binaural separation), a difference was observed between the groups in both ears. Moreover, there was a difference in the speech-in-noise test in both ears (RE: p = 0.044; LE: p = 0.019), in P300 (p = 0.049) and in total sustained auditory attention ability test (p = 0.032). Also, there is a negative correlation between sustained auditory attention ability test, decrease in attentiveness and binaural integration (RE: p = 0.044; LE: p = 0.048). Conclusions Individuals with tinnitus had a poorer performance compared to the control group regarding auditory attention ability. Therefore, it is inferred that tinnitus is associated with poor performance in selective and sustained auditory attention in the assessed volunteers. These aspects should be considered for the management of patients with tinnitus.

Resumo Introdução O zumbido caracteriza-se pela presença de som na ausência de estímulo sonoro externo. Em indivíduos com audiometria normal pode estar associado à dificuldade na atenção auditiva, principalmente naqueles que referem alto incômodo do zumbido. Objetivo Investigar a habilidade de atenção auditiva em indivíduos com queixa de zumbido. Método Pesquisa do tipo observacional analítica de caráter transversal. Foram avaliados 30 voluntários com audição normal (até 25 dBNA): 15 com zumbido (grupo teste) e 15 sem a queixa (grupo controle), entre 18 e 40 anos. Os voluntários responderam o questionário do handicap do zumbido - Tinnitus Handicap Inventory - e a escala visual analógica. Em seguida, fez-se a avaliação audiológica básica (meatoscopia, audiometria tonal, vocal e imitanciometria) e medidas psicoacústicas do zumbido (loudness e pitch). Para avaliar a atenção auditiva, foram usados os testes: potencial evocado auditivo cognitivo (P300), processamento auditivo central (dicótico de dígitos e de fala no ruído) e o de atenção auditiva sustentada. Resultados No Tinnitus Handicap Inventory, indivíduos com zumbido apresentaram escore médio de 37,78 (± 27,05); caracterizado por grau moderado. No teste dicótico de dígitos (separação binaural) percebeu-se diferença entre os grupos, nas duas orelhas. Além disso, houve diferença no teste de fala no ruído, em ambas as orelhas (OD: p = 0,044; OE: p = 0,019), no P300 (p = 0,049) e no teste de atenção auditiva sustentada total (p = 0,032). Além de correlação negativa entre o teste de atenção auditiva sustentada, decréscimo de vigilância e integração binaural (OD: p = 0,044; OE: p = 0,048). Conclusão Os indivíduos com zumbido apresentaram desempenho inferior ao grupo controle na habilidade de atenção auditiva. Portanto, infere-se que o zumbido está associado ao baixo desempenho na atenção auditiva seletiva e sustentada nos voluntários pesquisados. Tais aspectos devem ser considerados para o manejo do paciente com zumbido.

Auditory attention in individuals with tinnitus.

INTRODUCTION: Tinnitus is characterized by the presence of a sound in the absence of external sound stimulus. In individuals with normal audiometry, it may be associated with auditory attention difficulty, especially in those who report high tinnitus annoyance. OBJECTIVE: To investigate auditory attention ability in individuals with tinnitus complaint. METHODS: Cross-sectional analytical observational study. We evaluated 30 volunteers with normal hearing (up to 25dBHL): 15 with tinnitus (test group) and 15 with no complaints (control group), aged between 18-40 years. The volunteers answered the tinnitus handicap inventory questionnaire and a visual analogue scale. Subsequently, a basic audiological evaluation (meatoscopy, tonal and vocal audiometry, and imittanciometry) and psychoacoustic measures of tinnitus (loudness and pitch) were performed. To evaluate auditory attention, the following tests were performed: auditory cognitive evoked potential (P300), central auditory processing tests (dichotic digits test and speech-in-noise test) and sustained auditory attention ability test. RESULTS: In the tinnitus handicap inventory, individuals with tinnitus had a mean score of 37.78 (±27.05), characterized as moderate degree. In the dichotic digits test (binaural separation), a difference was observed between the groups in both ears. Moreover, there was a difference in the speech-in-noise test in both ears (RE: p=0.044; LE: p=0.019), in P300 (p=0.049) and in total sustained auditory attention ability test (p=0.032). Also, there is a negative correlation between sustained auditory attention ability test, decrease in attentiveness and binaural integration (RE: p=0.044; LE: p=0.048). CONCLUSIONS: Individuals with tinnitus had a poorer performance compared to the control group regarding auditory attention ability. Therefore, it is inferred that tinnitus is associated with poor performance in selective and sustained auditory attention in the assessed volunteers. These aspects should be considered for the management of patients with tinnitus.