The effects of auditory stimulation on heart rate variability in healthy individuals with normal hearing and with hearing loss: a systematic review and meta-analysis.

PURPOSE: To analyze the effects of auditory stimulation on heart rate variability (HRV) indices in healthy individuals with normal hearing and with hearing loss, regardless of type and/or grade, by means of a systematic review. RESEARCH STRATEGIES: This is a systematic review with a meta-analysis that addresses the following question: in healthy individuals with normal hearing and/or with hearing loss, what are the effects of auditory stimulation on HRV indices in comparison to silence? We consulted the Cochrane Library, Embase, LILACS, PubMed, Web of Science, and Scopus databases and the gray literature (Google Scholar, OpenGrey, and ProQuest). SELECTION CRITERIA: There were no restrictions as to period or language of publication. DATA ANALYSIS: We identified 451 records, an additional 261 in the gray literature, and five studies in a search through the references, resulting in a total of 717 records, with 171 duplicate records. After screening the titles and abstracts of 546 studies, we excluded 490 and considered 56 studies in full to assess their eligibility. RESULTS: Nine of these studies were included in the systematic review, eight of which were suitable for the meta-analysis. CONCLUSION: It is suggested that auditory stimulation may influence the RMSSD, pNN50, SDNN, RRTri and SD2 indices of HRV in healthy adults with normal hearing.

Effectiveness of Computerized Auditory Training on Speech Perception in Children With Hearing Loss: A Systematic Review.

PURPOSE: The purpose of this study was to investigate the effectiveness of using computerized auditory training in the auditory perception of speech in children who use electronic devices through a systematic review of the literature. METHOD: This is a systematic review based on the elaboration of the following guiding question: In hearing-impaired children who use electronic devices, how effective is the use of computerized auditory training in the auditory perception of speech? The Cochrane Library, Embase, LILACS, PubMed, Web of Science, and Scopus databases and gray literature (Google Scholar and ProQuest) were consulted. RESULTS: Nine hundred and eighteen records were identified, with additional two studies in the citation search, totaling 920 studies. After excluding the 184 duplicate references, using the Rayyan platform, the titles and abstracts were screened (n = 736), with 20 studies selected and considered for full reading. Six of the 20 studies were included in the systematic review of the literature. CONCLUSIONS: Positive and beneficial results regarding computerized auditory training are evidenced, which describe and discuss the proof of the effectiveness of the positive effects on the auditory perception of speech in children using hearing aids and cochlear implants with regard to auditory detection skills, discrimination, recognition, and auditory memory. The positive results are inspiring for the continuity and expansion of studies that further investigate the use of computerized auditory training with contemporary technologies and have an impact on the improvement of access to specialized intervention.

Contralateral Masking in the Measurement of Auditory Brainstem Responses with Air-Conducted Tone Burst Stimuli in Individuals with Unilateral Hearing Loss.

BACKGROUND: Contralateral noise masking is an important aspect of auditory brainstem response (ABR) measurements. PURPOSE: The primary aim of this study is to determine how contralateral white noise (WN) masking influences the amplitude and the latency of V wave generated during ABR measurements, using tone burst (TB), in adult ears with normal hearing (NH). The secondary aim of this study is to ascertain the need of contralateral masking in ABR measurements with the TB stimuli using a 3A insertion earphone, and to propose the applicability of WN masking in unilateral sensorineural hearing loss (USNHL). RESEARCH DESIGN: It is a cross-sectional observational and descriptive study. STUDY SAMPLE: Experiment 1: Thirty individuals, without any otologic, psychological, or neurological dysfunction, were selected. Experiment 2: Fifteen individuals with previous audiological diagnoses of severe and profound USNHL were considered. INTERVENTION: The study involves ABR TB at specific frequencies of 0.5, 1, 2, and 4 kHz. DATA COLLECTION AND ANALYSIS: Experiment 1: The evaluation was performed at the fixed intensity of 80 dB nHL (decibel normalized hearing level) on the tested ear, followed by the application of simultaneous masking to the nontested ear, intensity ranged from 0 to 80 dB. Experiment 2: ABR threshold measurements were first performed on the ear with hearing loss (HL) at the frequencies of 1, 2, and 4 kHz. The results were subsequently confirmed using contralateral masking. RESULTS: Experiment 1: At any given frequency, there were no statistically significant differences in the amplitude and latency of V wave with increase in the intensities of WN masking. Experiment 2: Cross-hearing was observed at least once in all frequencies analyzed through the occurrence of V wave. CONCLUSION: In conclusion, the contralateral WN masking at the maximum intensity of 80 dB does not affect the amplitude and latency of V wave of the ABR TB at 1, 2, and 4 kHz. Contralateral masking for the ABR TB presented using 3A insertion earphones is necessary at 1, 2, and 4 kHz in individuals with severe or profound degrees of USNHL and at intensities of 15, 20, and 10 dB above the ABR threshold of the nontested ear.

Unilateral and asymmetric hearing loss in childhood. / Perda auditiva unilateral e assimétrica na infância.

PURPOSE: To describe unilateral and bilateral asymmetric sensorineural hearing loss in children and its etiological, audiological and demographic characteristics. METHODS: Retrospective cross-sectional study developed in the Seção de Implante Coclear of Hospital de Reabilitação de Anomalias Craniofaciais, through the analysis of medical records. RESULTS: Data from 1152 patients were analyzed: 424 (37%) adolescents, adults or elderly, and 728 (63%) children, of whom 691 (95%) had bilateral symmetrical hearing loss, and 37 (5%) had unilateral hearing loss (n=10) or bilateral asymmetric (n=27) sensorineural hearing loss. The mean age at diagnosis of unilateral sensorineural hearing loss was 33.58±21.69 months, and for asymmetric bilateral it was 33.12±21.69 months, with a prevalence of 1.4% and 3.7%, respectively. The highest risk indicator for hearing loss for both groups was the family history of permanent deafness, which began in childhood. The majority of the relatives of children with unilateral sensorineural hearing loss presented the highest low socioeconomic classification (50%), while children with bilateral asymmetric sensorineural hearing loss were also be subdivided into upper (37%) and lower (37%). CONCLUSION: We observed a greater occurrence of asymmetric bilateral sensorineural hearing loss compared to unilateral hearing loss, as well as the hereditary risk indicator, with a predominance of the deep ear and female preponderance in both groups. Although neonatal hearing screening provides early identification of unilateral sensorineural hearing loss, the age at the audiological diagnosis is still above the recommended level. In addition, the majority of the children's family members presented a low level of income.

OBJETIVO: Descrever a perda auditiva sensorioneural unilateral e bilateral assimétrica em crianças quanto às características etiológicas, audiológicas e demográficas. MÉTODO: Estudo retrospectivo transversal, desenvolvido na Seção de Implante Coclear do Hospital de Reabilitação de Anomalias Craniofaciais, por meio da análise de prontuários. RESULTADOS: Foram analisados os dados de 1152 pacientes, sendo 424 (37%) adolescentes, adultos ou idosos e 728 (63%) crianças, dentre as quais, 691 (95%) apresentavam perda auditiva bilateral simétrica e 37 (5%) perda auditiva sensorioneural unilateral (n=10) ou bilateral assimétrica (n=27). A idade média ao diagnóstico na perda auditiva sensorioneural unilateral foi de 33,58±21,69 meses e na bilateral assimétrica de 33,12±21,69 meses, com prevalência de 1,4% e 3,7%, respectivamente. O indicador de risco para a deficiência auditiva de maior ocorrência para ambos os grupos foi o de antecedente familiar. A maioria dos familiares das crianças com perda auditiva sensorioneural unilateral apresentaram a classificação socioeconômica baixa superior (50%), enquanto que as crianças com perda auditiva sensorioneural bilateral assimétrica se subdividiram igualmente em baixa superior (37%) e média inferior (37%). CONCLUSÃO: Houve uma maior prevalência da perda auditiva sensorioneural bilateral assimétrica em relação à unilateral, bem como do indicador de risco de hereditariedade, com predomínio do grau profundo na pior orelha e preponderância do sexo feminino, em ambos os grupos. Apesar de a triagem auditiva neonatal propiciar a identificação precoce da perda auditiva sensorioneural unilateral, a idade no diagnóstico audiológico ainda se encontra acima do recomendado. Adicionalmente, a maioria dos familiares das crianças apresentou nível de rendimento baixo.

Perda auditiva unilateral e assimétrica na infância / Unilateral and asymmetric hearing loss in childhood

RESUMO Objetivo Descrever a perda auditiva sensorioneural unilateral e bilateral assimétrica em crianças quanto às características etiológicas, audiológicas e demográficas. Método Estudo retrospectivo transversal, desenvolvido na Seção de Implante Coclear do Hospital de Reabilitação de Anomalias Craniofaciais, por meio da análise de prontuários. Resultados Foram analisados os dados de 1152 pacientes, sendo 424 (37%) adolescentes, adultos ou idosos e 728 (63%) crianças, dentre as quais, 691 (95%) apresentavam perda auditiva bilateral simétrica e 37 (5%) perda auditiva sensorioneural unilateral (n=10) ou bilateral assimétrica (n=27). A idade média ao diagnóstico na perda auditiva sensorioneural unilateral foi de 33,58±21,69 meses e na bilateral assimétrica de 33,12±21,69 meses, com prevalência de 1,4% e 3,7%, respectivamente. O indicador de risco para a deficiência auditiva de maior ocorrência para ambos os grupos foi o de antecedente familiar. A maioria dos familiares das crianças com perda auditiva sensorioneural unilateral apresentaram a classificação socioeconômica baixa superior (50%), enquanto que as crianças com perda auditiva sensorioneural bilateral assimétrica se subdividiram igualmente em baixa superior (37%) e média inferior (37%). Conclusão Houve uma maior prevalência da perda auditiva sensorioneural bilateral assimétrica em relação à unilateral, bem como do indicador de risco de hereditariedade, com predomínio do grau profundo na pior orelha e preponderância do sexo feminino, em ambos os grupos. Apesar de a triagem auditiva neonatal propiciar a identificação precoce da perda auditiva sensorioneural unilateral, a idade no diagnóstico audiológico ainda se encontra acima do recomendado. Adicionalmente, a maioria dos familiares das crianças apresentou nível de rendimento baixo.

ABSTRACT Purpose To describe unilateral and bilateral asymmetric sensorineural hearing loss in children and its etiological, audiological and demographic characteristics. Methods Retrospective cross-sectional study developed in the Seção de Implante Coclear of Hospital de Reabilitação de Anomalias Craniofaciais, through the analysis of medical records. Results Data from 1152 patients were analyzed: 424 (37%) adolescents, adults or elderly, and 728 (63%) children, of whom 691 (95%) had bilateral symmetrical hearing loss, and 37 (5%) had unilateral hearing loss (n=10) or bilateral asymmetric (n=27) sensorineural hearing loss. The mean age at diagnosis of unilateral sensorineural hearing loss was 33.58±21.69 months, and for asymmetric bilateral it was 33.12±21.69 months, with a prevalence of 1.4% and 3.7%, respectively. The highest risk indicator for hearing loss for both groups was the family history of permanent deafness, which began in childhood. The majority of the relatives of children with unilateral sensorineural hearing loss presented the highest low socioeconomic classification (50%), while children with bilateral asymmetric sensorineural hearing loss were also be subdivided into upper (37%) and lower (37%). Conclusion We observed a greater occurrence of asymmetric bilateral sensorineural hearing loss compared to unilateral hearing loss, as well as the hereditary risk indicator, with a predominance of the deep ear and female preponderance in both groups. Although neonatal hearing screening provides early identification of unilateral sensorineural hearing loss, the age at the audiological diagnosis is still above the recommended level. In addition, the majority of the children's family members presented a low level of income.

Glendonald Auditory Screening Procedure (GASP): clinical markers of the development of auditory recognition and comprehension abilities in children using cochlear implants. / Glendonald Auditory Screening Procedure (GASP): marcadores clínicos de desenvolvimento das habilidades de reconhecimento e compreensão auditiva em crianças usuárias de implante coclear.

PURPOSE: To verify the influence of the age of implantation in the development of closed-set auditory recognition and auditory comprehension abilities in children using unilateral cochlear implants (CI), comparing distinct groups and determining clinical markers. METHODS: Participants were 180 children operated and activated until 36 months of age and who used a CI for at least 60 months. Abilities of auditory recognition in closed-set and auditory comprehension were analyzed through the GASP Tests 5 and 6. The influence of age of implantation was investigated with three groups of children: implanted before 18 months (G1), between 19 and 24 months (G2) and between 25 and 36 months of age (G3). RESULTS: There was no statistically significant difference when comparing the three groups. Children progressively developed auditory abilities, presenting auditory recognition ability together at approximately 41±4 months of CI use and auditory comprehension at 53±4 months. CONCLUSION: There was no correlation between hearing performance and age of implantation for children implanted before 36 months of age. For the abilities of auditory recognition and comprehension, the clinical marker was 41±4 and 53±4 months of auditory age, respectively. Therefore, it is expected that, around 60 months of CI use, children implanted during the sensitive period can understand speech without the aid of orofacial reading, reaching the most complex hearing abilities.

OBJETIVO: Verificar a influência da idade de implantação no desenvolvimento das habilidades de reconhecimento auditivo em conjunto fechado e compreensão auditiva em crianças usuárias de implante coclear unilateral, comparando grupos distintos e determinar os marcadores clínicos de desenvolvimento destas habilidades. MÉTODO: Participaram do estudo 180 crianças operadas e ativadas até os 36 meses de idade e que utilizaram o IC durante, no mínimo, 60 meses. Foram analisadas as habilidades de reconhecimento auditivo em conjunto fechado e compreensão auditiva por meio das Provas 5 e 6 do GASP. Para investigar a influência da idade na implantação, as crianças foram divididas em três grupos: implantadas antes dos 18 meses (G1), entre 19 e 24 meses (G2) e entre 25 e 36 meses de idade (G3). RESULTADOS: Não houve diferença estatisticamente significante quando comparados os três grupos. As crianças desenvolveram progressivamente as habilidades auditivas, apresentando a habilidade de reconhecimento auditivo em conjunto fechado por volta dos 41±4 meses de uso do IC e a de compreensão auditiva por volta dos 53±4 meses. CONCLUSÃO: Não houve correlação entre o desempenho auditivo e a idade de implantação para as crianças implantadas antes dos 36 meses de idade. Para as habilidades de reconhecimento e compreensão auditivas, o marcador clínico foi aos 41±4 e aos 53±4 meses de idade auditiva, respectivamente. Para tanto, espera-se que, por volta dos 60 meses de uso do IC, as crianças implantadas durante o período sensível possam compreender a fala sem o auxílio da leitura orofacial, alcançando as habilidades auditivas mais complexas.

O uso do mascaramento contralateral na pesquisa do potencial evocado auditivo de tronco encefálico por condução aérea: revisão sistemática / Use of contralateral masking in air-conduction auditory brainstem response: systematic review

RESUMO Objetivos analisar criticamente a necessidade do uso do mascaramento contralateral na pesquisa do potencial evocado auditivo de tronco encefálico (PEATE) por condução aérea, na perda auditiva sensorioneural unilateral ou bilateral assimétrica, por meio de uma revisão sistemática da literatura. Estratégia de pesquisa foram consultadas as bases de dados eletrônicas PubMed/MEDLINE, LILACS, ADOLEC, IBECS, SciELO, Web of Science, Scopus e Embase, bem como os anais do Encontro Internacional de Audiologia e do Congresso Brasileiro de Fonoaudiologia, além das bases de instituições com pós-graduação em Fonoaudiologia, utilizando os descritores Evoked Potentials, Auditory, Brain Stem, Perceptual Masking e Hearing Loss, Sensorineural. Critérios de seleção foram selecionados os estudos com níveis de evidência de 1 a 5, publicados em português, inglês ou espanhol, até janeiro de 2018. Os artigos deveriam abordar a necessidade do uso do mascaramento contralateral na pesquisa do PEATE por condução aérea, em indivíduos com perda auditiva sensorioneural unilateral ou bilateral assimétrica. Resultados foram encontrados 334 estudos, sendo que oito artigos contemplaram os critérios preestabelecidos. Os estudos incluídos foram controversos quanto ao uso do mascaramento contralateral. Conclusão não existe um consenso quanto à necessidade do uso do mascaramento contralateral no PEATE por condução aérea, em indivíduos com perda auditiva sensorioneural unilateral. No entanto, a maioria dos estudos direcionou para a sua utilização na pesquisa do PEATE com estímulo clique em indivíduos com perda auditiva sensorioneural unilateral de graus severo e profundo.

ABSTRACT Purpose Critically analyze the need to use contralateral masking in the measurement of Auditory Brainstem Response (ABR) by air conduction on unilateral or bilateral asymmetric sensorineural hearing loss by means of a systematic literature review. Research strategies A search was conducted at the PubMed/MEDLINE, LILACS, ADOLEC, IBECS, SciELO, Web of Science, Scopus and Embase electronic databases, proceedings of the International Meeting of Audiology and the Brazilian Congress of Speech-language Pathology and Audiology, and bases of institutions with Graduate Studies Programs in Speech-language Pathology and Audiology, using the following descriptors: Evoked Potentials, Auditory, Brainstem, Perceptual Masking, Hearing Loss, and Sensorineural. Selection criteria Studies with levels of evidence from 1 to 5 published in Portuguese, English or Spanish until January 2018 were selected. The articles should address the need to use contralateral masking in the measurement of air-conduction ABR in individuals with unilateral or bilateral asymmetric sensorineural hearing loss. Results A total of 334 studies were found, and eight of them met the pre-established criteria. The studies included in the review were controversial as to the need for contralateral masking. Conclusion There is no consensus on the need to use contralateral masking in the measurement of ABR by air conduction in individuals with unilateral sensorineural hearing loss; however, most studies report the use of contralateral masking in the measurement of ABR with click stimulus in individuals with severe and profound unilateral sensorineural hearing loss.

Glendonald Auditory Screening Procedure (GASP): marcadores clínicos de desenvolvimento das habilidades de reconhecimento e compreensão auditiva em crianças usuárias de implante coclear / Glendonald Auditory Screening Procedure (GASP): clinical markers of the development of auditory recognition and comprehension abilities in children using cochlear implants

RESUMO Objetivo Verificar a influência da idade de implantação no desenvolvimento das habilidades de reconhecimento auditivo em conjunto fechado e compreensão auditiva em crianças usuárias de implante coclear unilateral, comparando grupos distintos e determinar os marcadores clínicos de desenvolvimento destas habilidades. Método Participaram do estudo 180 crianças operadas e ativadas até os 36 meses de idade e que utilizaram o IC durante, no mínimo, 60 meses. Foram analisadas as habilidades de reconhecimento auditivo em conjunto fechado e compreensão auditiva por meio das Provas 5 e 6 do GASP. Para investigar a influência da idade na implantação, as crianças foram divididas em três grupos: implantadas antes dos 18 meses (G1), entre 19 e 24 meses (G2) e entre 25 e 36 meses de idade (G3). Resultados Não houve diferença estatisticamente significante quando comparados os três grupos. As crianças desenvolveram progressivamente as habilidades auditivas, apresentando a habilidade de reconhecimento auditivo em conjunto fechado por volta dos 41±4 meses de uso do IC e a de compreensão auditiva por volta dos 53±4 meses. Conclusão Não houve correlação entre o desempenho auditivo e a idade de implantação para as crianças implantadas antes dos 36 meses de idade. Para as habilidades de reconhecimento e compreensão auditivas, o marcador clínico foi aos 41±4 e aos 53±4 meses de idade auditiva, respectivamente. Para tanto, espera-se que, por volta dos 60 meses de uso do IC, as crianças implantadas durante o período sensível possam compreender a fala sem o auxílio da leitura orofacial, alcançando as habilidades auditivas mais complexas.

ABSTRACT Purpose To verify the influence of the age of implantation in the development of closed-set auditory recognition and auditory comprehension abilities in children using unilateral cochlear implants (CI), comparing distinct groups and determining clinical markers. Methods Participants were 180 children operated and activated until 36 months of age and who used a CI for at least 60 months. Abilities of auditory recognition in closed-set and auditory comprehension were analyzed through the GASP Tests 5 and 6. The influence of age of implantation was investigated with three groups of children: implanted before 18 months (G1), between 19 and 24 months (G2) and between 25 and 36 months of age (G3). Results There was no statistically significant difference when comparing the three groups. Children progressively developed auditory abilities, presenting auditory recognition ability together at approximately 41±4 months of CI use and auditory comprehension at 53±4 months. Conclusion There was no correlation between hearing performance and age of implantation for children implanted before 36 months of age. For the abilities of auditory recognition and comprehension, the clinical marker was 41±4 and 53±4 months of auditory age, respectively. Therefore, it is expected that, around 60 months of CI use, children implanted during the sensitive period can understand speech without the aid of orofacial reading, reaching the most complex hearing abilities.

Speech perception performance of subjects with type I diabetes mellitus in noise / Desempenho da percepção de fala no ruído em indivíduos com diabetes mellitus tipo I

Abstract Introduction: Diabetes mellitus (DM) is a chronic metabolic disorder of various origins that occurs when the pancreas fails to produce insulin in sufficient quantities or when the organism fails to respond to this hormone in an efficient manner. Objective: To evaluate the speech recognition in subjects with type I diabetes mellitus (DMI) in quiet and in competitive noise. Methods: It was a descriptive, observational and cross-section study. We included 40 participants of both genders aged 18-30 years, divided into a control group (CG) of 20 healthy subjects with no complaints or auditory changes, paired for age and gender with the study group, consisting of 20 subjects with a diagnosis of DMI. First, we applied basic audiological evaluations (pure tone audiometry, speech audiometry and immittance audiometry) for all subjects; after these evaluations, we applied Sentence Recognition Threshold in Quiet (SRTQ) and Sentence Recognition Threshold in Noise (SRTN) in free field, using the List of Sentences in Portuguese test. Results: All subjects showed normal bilateral pure tone threshold, compatible speech audiometry and "A" tympanometry curve. Group comparison revealed a statistically significant difference for SRTQ (p = 0.0001), SRTN (p < 0.0001) and the signal-to-noise ratio (p < 0.0001). Conclusion: The performance of DMI subjects in SRTQ and SRTN was worse compared to the subjects without diabetes.

Resumo Introdução: O diabetes mellitus (DM) é um distúrbio metabólico crônico de várias origens, que ocorre quando o pâncreas deixa de produzir insulina em quantidade suficiente ou quando o organismo não consegue responder a esse hormônio de maneira eficiente. Objetivo: Avaliar o reconhecimento de fala em indivíduos com diabetes mellitus tipo I (DMI) no silêncio e no ruído competitivo. Método: Estudo descritivo, observacional e transversal. Foram incluídos 40 participantes de ambos os sexos entre 18 e 30 anos, divididos em um grupo controle (GC) de 20 indivíduos saudáveis sem queixas ou alterações auditivas, pareados por idade e sexo com o grupo de estudo, composto por 20 indivíduos com diagnóstico de DMI. Inicialmente aplicou-se uma avaliação audiológica (audiometria tonal, logoaudiometria e imitanciometria) para todos os indivíduos; a seguir, os mesmos foram avaliados para o Limiar de Reconhecimento de Sentenças no Silêncio (LRSS) e Limiar de Reconhecimento de Sentenças no Ruído (LRSR), em campo livre, por meio do teste Lista de Sentenças em Português. Resultados: Todos os participantes apresentaram audiometria tonal dentro dos padrões de normalidade bilateralmente, logoaudiometria compatível e curva timpanométrica do tipo A. A comparação dos grupos revelou uma diferença estatisticamente significante para LRSS (p = 0,0001), LRSR (p < 0,0001) e a relação sinal-ruído (p < 0,0001). Conclusões O desempenho dos indivíduos com DMI para LRSS e LRSR foi pior em comparação com os indivíduos sem diabetes.

Speech perception performance of subjects with type I diabetes mellitus in noise.

INTRODUCTION: Diabetes mellitus (DM) is a chronic metabolic disorder of various origins that occurs when the pancreas fails to produce insulin in sufficient quantities or when the organism fails to respond to this hormone in an efficient manner. OBJECTIVE: To evaluate the speech recognition in subjects with type I diabetes mellitus (DMI) in quiet and in competitive noise. METHODS: It was a descriptive, observational and cross-section study. We included 40 participants of both genders aged 18-30 years, divided into a control group (CG) of 20 healthy subjects with no complaints or auditory changes, paired for age and gender with the study group, consisting of 20 subjects with a diagnosis of DMI. First, we applied basic audiological evaluations (pure tone audiometry, speech audiometry and immittance audiometry) for all subjects; after these evaluations, we applied Sentence Recognition Threshold in Quiet (SRTQ) and Sentence Recognition Threshold in Noise (SRTN) in free field, using the List of Sentences in Portuguese test. RESULTS: All subjects showed normal bilateral pure tone threshold, compatible speech audiometry and "A" tympanometry curve. Group comparison revealed a statistically significant difference for SRTQ (p=0.0001), SRTN (p<0.0001) and the signal-to-noise ratio (p<0.0001). CONCLUSION: The performance of DMI subjects in SRTQ and SRTN was worse compared to the subjects without diabetes.