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1.
J Audiol Otol ; 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38382518

RESUMO

Background and Objectives: Most studies in literature attribute the benefits of musical training on speech in noise (SIN) perception to "experience-based" plasticity, which assists in the activation of speech-processing networks. However, whether musicianship provides an advantage for the listening effort (LE) required to comprehend speech in degraded environments has received less attention. The current study aimed to understand the influence of Indian classical music training on SIN perception and its related LE across percussionists, non-percussionists, and non-musicians. Subjects and Methods: A quasi-experiment was conducted on 16 percussionists, 17 non-percussionists, and 26 non-musicians aged 18-35 years with normal hearing. In phase 1, musical abilities were assessed using Mini-Profile of Music Perception Skills (Mini-PROMS). Phase 2 examined SIN using Tamil Phonemically-Balanced Words and Tamil Matrix Sentence Test at +5 dB, 0 dB, and -5 dB SNR and LE using pupillometry, measuring pupil dilations with an eye-tracker. Results: Fractional Logit and Linear Regression models demonstrated that percussionists outperformed non-percussionists in Tuning and Speed subsets of Mini-PROMS. Percussionists outperformed non-percussionists and non-musicians in SIN and LE at -5 dB SNR for words and at 0 dB and -5 dB SNR for sentences. Conclusions: Percussionists have the greatest advantage in decoding SIN with reduced LE followed by non-percussionists and non-musicians, demonstrating musician-advantage in most challenging listening conditions.

2.
J Speech Lang Hear Res ; 67(3): 989-1001, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38386055

RESUMO

PURPOSE: Sensory gating is a phenomenon where the cortical response to the second stimulus in a pair of identical stimuli is inhibited. It is most often assessed in a conditioning-testing paradigm. Both active and passive neuronal mechanisms have been implicated in sensory gating. The present study aimed to assess if sensory gating is caused by an active neural mechanism associated with stimulus redundancy. METHOD: The study was carried out on 20 young neurotypical adults. We assessed the gating phenomenon using identical and nonidentical stimuli pairs presented in an electrophysiological conditioning-testing paradigm. We hypothesized that the novel stimulus in the nonidentical stimulus pair would not exhibit the sensory gating effects (reduction in the amplitude of cortical potentials to the second stimuli in the pair), owing to stimulus novelty. RESULTS: Contrary to our expectations, the response analyses of the cortical auditory evoked potentials revealed that adults gated repetitive and novel stimuli similarly. CONCLUSIONS: The findings are discussed in relation to the significance of methodological factors in evaluating sensory gating. We believe that additional research using oddball presentation of novel stimuli along with appropriate analysis methods is necessary before drawing any conclusions on the mechanisms underlying sensory gating.


Assuntos
Potenciais Evocados Auditivos , Filtro Sensorial , Adulto , Humanos , Potenciais Evocados Auditivos/fisiologia , Filtro Sensorial/fisiologia , Estimulação Acústica/métodos , Eletroencefalografia
3.
J Assoc Res Otolaryngol ; 24(6): 619-631, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38079021

RESUMO

PURPOSE: The role of the medial olivocochlear system in speech perception in noise has been debated over the years, with studies showing mixed results. One possible reason for this could be the dependence of this relationship on the parameters used in assessing the speech perception ability (age, stimulus, and response-related variables). METHODS: The current study assessed the influence of the type of speech stimuli (monosyllables, words, and sentences), the signal-to-noise ratio (+5, 0, -5, and -10 dB), the metric used to quantify the speech perception ability (percent-correct, SNR-50, and slope of the psychometric function) and age (young vs old) on the relationship between medial olivocochlear reflex (quantified by contralateral inhibition of transient evoked otoacoustic emissions) and speech perception in noise. RESULTS: A linear mixed-effects model revealed no significant contributions of the medial olivocochlear reflex to speech perception in noise. CONCLUSION: The results suggest that there was no evidence of any modulatory influence of the indirectly measured medial olivocochlear reflex strength on speech perception in noise.


Assuntos
Percepção da Fala , Percepção da Fala/fisiologia , Emissões Otoacústicas Espontâneas/fisiologia , Fala , Ruído , Reflexo , Cóclea/fisiologia , Núcleo Olivar/fisiologia , Estimulação Acústica
4.
J Audiol Otol ; 27(4): 227-234, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37872757

RESUMO

BACKGROUND AND OBJECTIVES: Speech in noise (SIN) perception is essential for effective day-to-day communication, as everyday conversations seldom transpire in silent environments. Numerous studies have documented how musical training can aid in SIN discrimination through various neural-pathways, such as experience-dependent plasticity and overlapping processes between music and speech perception. However, empirical evidence regarding the impact of musical training on SIN perception remains inconclusive. This study aimed to investigate whether musicians trained in South Indian classical "Carnatic" style of music exhibited a distinct advantage over their non-musician counterparts in SIN perception. The study also attempted to explore whether the listening effort (LE) associated in this process was different across musicians and non-musicians, an area that has received limited attention. SUBJECTS AND METHODS: A quasi-experimental design was employed, involving two groups comprising 25 musicians and 35 non-musicians, aged 18-35 years, with normal hearing. In phase 1, participants' musical abilities were assessed using the Mini-Profile of Music Perception Skills (Mini-PROMS). In phase 2, SIN abilities were tested using the Tamil phonemically balanced words and Tamil Matrix Sentence Test at -5 dB, 0 dB, and +5 dB SNR. Phase 3 tested LE using a dual-task paradigm including auditory and visual stimuli as primary and secondary tasks. RESULTS: Fractional logit and linear regression models demonstrated that musicians outperformed non-musicians in the Mini-PROMS assessment. Musicians also fared better than non-musicians in SIN and LE at 0 dB SNR for words and +5 dB SNR for sentences. CONCLUSIONS: The findings of this study provided limited evidence to support the claim that musical training improves speech perception in noisy environments or reduces the associated listening effort.

5.
Int J Audiol ; : 1-9, 2023 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-37791429

RESUMO

OBJECTIVE: The study investigated the relationship between the strength of the medial olivocochlear reflex (measured via contralateral inhibition of otoacoustic emissions) and speech perception in noise (obtained from behavioural identification task) through meta-analyses. DESIGN: A systematic review and random-effects meta-analysis of studies investigating the relationship in neurotypical adults was performed. STUDY SAMPLE: The systematic search (in PubMed, Scopus, Science Direct and Google Scholar databases) revealed 21 eligible studies, which were critically appraised using the NIH tool for Observational Cohort and Cross-Sectional Studies. Meta-analysis was performed on 17 studies (374 participants) with fair to good quality. RESULTS: The results revealed that the medial olivocochlear reflex accounts for less than 1% of the variations in speech perception in noise in neurotypical individuals. Sub-group analyses conducted to address a few methodological differences also revealed no discernible association between the two variables. CONCLUSIONS: The results reveal no modulatory effect of the medial olivocochlear reflex assessed using contralateral inhibition of otoacoustic emission on the ability to perceive speech in noise. However, more data utilising alternative measures of medial olivocochlear reflex strength is necessary before drawing any conclusions about the role of the medial olivocochlear bundle in speech perception in noise.

6.
Am J Audiol ; 32(4): 889-897, 2023 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-37725711

RESUMO

PURPOSE: Sensory gating is the cortical phenomenon that involves selective inhibition of responses to task-irrelevant stimuli. Perceiving speech in noise, a situation commonly encountered by humans, requires the irrelevant noise to be inhibited while processing the relevant speech stimulus. We hypothesized that the two (sensory gating and speech perception in noise [SPiN]) might be related and that sensory gating may provide evidence of cortical inhibition involved in SPiN. METHOD: An observational research following a correlational design was conducted on 10 neurotypical individuals. Auditory sensory gating was assessed using a conditioning-testing paradigm for tone and speech token pairs. The SPiN was measured using standardized sentences in the participants' native language. RESULTS: Differences were observed in the gating index of the P2 peaks of speech and tone pairs. A significant relationship between SPiN and the auditory sensory gating of the P2 peak of the speech-evoked cortical potential was obtained. CONCLUSION: The results of this preliminary investigation indicate an association between the sensory gating mechanism and neurotypical individuals' ability to perceive speech in noise.


Assuntos
Percepção da Fala , Humanos , Percepção da Fala/fisiologia , Fala , Potenciais Evocados Auditivos/fisiologia , Ruído , Filtro Sensorial , Estimulação Acústica/métodos
7.
J Otol ; 18(3): 132-138, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37497330

RESUMO

Background: Studies on animals have demonstrated that maternal iron deficiency anaemia (IDA) could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions (DPOAEs) of young guinea pigs. Thus, it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA. The current study explores maternal IDA's effect on DPOAEs in newborn babies. Method: A total of 110 newborn babies with gestational age ≥34 weeks were considered and a 'between-subjects' design was used. The participants were divided into 3 groups- "Normal" (61 babies without maternal IDA), "Mild" (28 babies with mild maternal IDA) and "Moderate" (21 babies with moderate maternal IDA). The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies (1 k - 8 kHz) and a range of intensities (70-40 dB SPL in 10 dB steps). Results: The analysis of both DP-gram and DP input-output (I/O) function showed that there was no significant difference (p > 0.05) across the normal, mild, and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities (70-40 dB SPL). Also, the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship. Conclusion: The current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.

8.
Am J Audiol ; 32(1): 119-134, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36548963

RESUMO

OBJECTIVE: The primary aim of the research was to document spatial acuity changes across the life span using a battery of psychoacoustical and perceptual tests. The secondary aim was to identify the optimal metric for measuring spatial processing changes across the life span (ages 10-70 years). DESIGN AND STUDY SAMPLE: A cross-sectional study comprising 115 participants with clinically normal hearing was conducted. Purposive sampling was adopted to recruit participants in the study, who were divided into six groups based on their chronological age. METHOD: Temporal, intensity, spectral, and composite correlates of spatial acuity were assessed using psychoacoustic measures and perceptual questionnaires. The temporal (interaural time difference [ITD]) and intensity correlates (interaural level difference [ILD]) of spatial perception were obtained using a MATLAB (v 2020a), whereas the composite correlate (virtual auditory space identification scores [VASIs]) and perceptual ratings of spatial processing were measured using Paradigm software and speech spatial and qualities in Kannada (SSQ-K). RESULTS: Results across all tests (multivariate analyses variance: 6 age groups × 4 tests, followed by post hoc tests) consistently demonstrate poor ITD and ILD thresholds and overall lower spatial accuracy (VASI, SSQ-K) with increasing age. Discriminant function analyses (DFAs) revealed that VASI had a higher predictive power in capturing age-related changes in auditory spatial processing. The group segregation on spatial performance in DFA became evident after 50 years. CONCLUSION: This study provides evidence of gradual change in all three correlates of spatial processing, with statistically demonstrable deficits appearing from fourth decade of life on VASI and fifth decade of life on binaural processing.


Assuntos
Processamento Espacial , Percepção da Fala , Humanos , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Longevidade , Estudos Transversais , Testes Auditivos , Envelhecimento , Percepção Auditiva
9.
Am J Audiol ; 31(3): 707-718, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35926084

RESUMO

PURPOSE: Speech recognition in noise is a ubiquitous problem in older listeners. Speech, the most commonly encountered noise in the real world, causes greater masking than noise maskers, a phenomenon called informational masking (IM). This is due to the lexical-semantic and/or acoustic-phonetic information present in speech maskers. In this study, we aimed to observe the age-related differences in speech recognition and the magnitudes of IM when the maskers varied in the type of linguistic information. METHOD: In 30 young and 30 older individuals, we measured the signal-to-noise ratio required to obtain 50% correct identification under four-talker babble (lexical-semantic and acoustic-phonetic information), four-talker reverse babble (predominantly acoustic-phonetic information), and speech-shaped noise (SSN; energetic). RESULTS: In both groups, the four-talker babble caused the greatest masking effect (worst performances), whereas the SSN resulted in the least masking effect (best performances). The effectiveness of IM due to the lexical-semantic information was comparable between the two groups. However, the effectiveness of IM due to the acoustic-phonetic information was significantly higher in the older listeners, causing worse performances. CONCLUSIONS: The greater effectiveness of IM due to the acoustic-phonetic information (worse performance) could be due to the minimal-to-mild high-frequency hearing loss and the consequent temporal processing deficits observed in the older listeners. However, it is possible that the older listeners can employ compensatory mechanisms (such as life experiences, contextual cues, employing higher listening efforts, among many possible other mechanisms) to overcome some of these deficits. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20405730.


Assuntos
Fonética , Percepção da Fala , Idoso , Humanos , Ruído , Mascaramento Perceptivo , Semântica
10.
Front Neurosci ; 16: 1080398, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36733923

RESUMO

Purpose: The present study aimed to quantify the effects of spatial training using virtual sources on a battery of spatial acuity measures in listeners with sensorineural hearing impairment (SNHI). Methods: An intervention-based time-series comparison design involving 82 participants divided into three groups was adopted. Group I (n = 27, SNHI-spatially trained) and group II (n = 25, SNHI-untrained) consisted of SNHI listeners, while group III (n = 30) had listeners with normal hearing (NH). The study was conducted in three phases. In the pre-training phase, all the participants underwent a comprehensive assessment of their spatial processing abilities using a battery of tests including spatial acuity in free-field and closed-field scenarios, tests for binaural processing abilities (interaural time threshold [ITD] and level difference threshold [ILD]), and subjective ratings. While spatial acuity in the free field was assessed using a loudspeaker-based localization test, the closed-field source identification test was performed using virtual stimuli delivered through headphones. The ITD and ILD thresholds were obtained using a MATLAB psychoacoustic toolbox, while the participant ratings on the spatial subsection of speech, spatial, and qualities questionnaire in Kannada were used for the subjective ratings. Group I listeners underwent virtual auditory spatial training (VAST), following pre-evaluation assessments. All tests were re-administered on the group I listeners halfway through training (mid-training evaluation phase) and after training completion (post-training evaluation phase), whereas group II underwent these tests without any training at the same time intervals. Results and discussion: Statistical analysis showed the main effect of groups in all tests at the pre-training evaluation phase, with post hoc comparisons that revealed group equivalency in spatial performance of both SNHI groups (groups I and II). The effect of VAST in group I was evident on all the tests, with the localization test showing the highest predictive power for capturing VAST-related changes on Fischer discriminant analysis (FDA). In contrast, group II demonstrated no changes in spatial acuity across timelines of measurements. FDA revealed increased errors in the categorization of NH as SNHI-trained at post-training evaluation compared to pre-training evaluation, as the spatial performance of the latter improved with VAST in the post-training phase. Conclusion: The study demonstrated positive outcomes of spatial training using VAST in listeners with SNHI. The utility of this training program can be extended to other clinical population with spatial auditory processing deficits such as auditory neuropathy spectrum disorder, cochlear implants, central auditory processing disorders etc.

11.
Int J Pediatr Otorhinolaryngol ; 146: 110745, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33940313

RESUMO

BACKGROUND: Very preterm infants are at a greater risk of developing neurodevelopmental impairments such as neuro-motor delays, vision and hearing deficits (Roze and Breart, 2004; Saigal and Doyle, 2008) [1,2]. The hearing difficulties in preterm infants vary depending on the co-morbid conditions. However, prematurity itself is considered as a risk factor that influence the functioning of auditory system. AIM: The current study aims to compare the DPOAEs in very preterm infants and term infants at 1 month, 3 months and 6 months of age (corrected age in preterm infants). METHOD: DPOAEs were recorded in 72 very preterm infants and 30 term infants at 1 month, 3 months and 6 months of age. All these infants had obtained 'pass' results in newborn hearing screening using ABR. DPOAE f2 test frequency was measured at six frequencies (1500 Hz, 2000 Hz, 3000 Hz, 4500 Hz, 6000 Hz and 8000 Hz) with primary tone stimulus intensity L1 equal to 65 dBSPL and L2 equal to 55 dBSPL with primary tone f2/f1 frequency ratio of 1.2. Otoscopic examination and tympanometry was performed prior to DPOAE testing, to ascertain normal middle ear status. RESULTS: DPOAE amplitude did not change significantly between two groups from 1 month till 6 months of age (p > 0.05). DPOAE amplitude and noise floor in very preterm infants were not different from term infants and DPOAE amplitude did not vary significantly across f2 frequencies at various time periods. CONCLUSION: The current study findings provided evidence that prematurity did not constitute as a factor to influence the results of DPOAE in very preterm infants who passed newborn hearing screening test. Any significant reduction in DPOAE amplitude or absence of DPOAE in very preterm infants has to be considered and monitored effectively, as it may not reflect a developmental process of cochlear function; instead it could indicate the presence of inner ear or middle ear pathology.


Assuntos
Recém-Nascido Prematuro , Emissões Otoacústicas Espontâneas , Testes de Impedância Acústica , Limiar Auditivo , Audição , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais
12.
Int J Pediatr Otorhinolaryngol ; 121: 88-94, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30878558

RESUMO

AIM: Aim of this study was to compare the absolute and interpeak latencies of Auditory Brainstem Responses (ABR) in very preterm and late preterm infants at 1 month and 3 months of corrected age. METHOD: ology: ABR traces were obtained from 80 preterm infants (40 very preterm and 40 late preterm) at 1 month and 3 months of corrected age in a prospective, comparative cohort study. Auditory click stimuli at 70 dBnHL and 30 dBnHL, with repetition rate of 11.1/s were used. Absolute latencies of peak I, III, V and interpeak latencies of peak I-V, I-III and III-V were analyzed and compared between preterm groups at 1 month and 3 months of corrected age. Wilcoxon Signed Ranks test was used to compare the ABR variables. Mann Whitney test was used to make inferences between groups. RESULTS: There was a statistically significant difference in absolute latencies and interpeak latencies between very preterm and late preterm infants at 1 month of corrected age (p < 0.05). Absolute latency of peak I was similar among both groups of preterms. Absolute latencies of peak III, V and interpeak latencies I-III, III-V and I-V were prolonged in very preterm infants at 1 month of corrected age. However, these latencies were significantly reduced at 3 months of corrected age. This indicated accelerated maturation/myelination of the central auditory nervous system in very preterm infants. Absolute latencies of peak III and V and interpeak interval I-V was reduced in late preterm infants at 3 months of corrected age and this was statistically significant. This reduction in latency was considered to be a normal age dependent change. CONCLUSION: Findings of the current study revealed that there was no deviation in the pattern of auditory maturation among preterms; it followed the typical 'caudal to rostral' form of maturation. Very preterm infants have less mature neuronal development compared with late preterm infants at 1 month of corrected age which catches up at 3 months of corrected age.


Assuntos
Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Audição/fisiologia , Doenças do Prematuro/fisiopatologia , Nascimento Prematuro/fisiopatologia , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Estudos Prospectivos
13.
Int J Pediatr Otorhinolaryngol ; 111: 119-127, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29958594

RESUMO

BACKGROUND: Auditory brainstem response across preterm infants help in understanding difference if any in auditory maturation. OBJECTIVE: To analyze and compare absolute and interpeak latencies of ABR in very preterm, moderate preterm and late preterm infants at term age. METHOD: ABR traces were obtained from 148 ears of preterm infants (52 of very preterm, 44 of moderately preterm & 52 of late preterm) at term age. ABR was recorded with 11.1/s clicks at different intensity levels. RESULTS: Absolute latencies of peak I, III, V and interpeak latencies of peak I-V, I-III and III-V were analyzed and compared between three preterm groups. One way ANOVA was used to compare ABR parameters between three groups of preterm infants and also to compare ABR parameters across various gestation ages. There were no overall differences in absolute latencies, interpeak latencies and amplitude of ABR between preterm groups and across various gestation ages (P>0.05). Pearson correlation was used to find the correlation between gestation age and ABR parameters. However, no correlation was found. ABRs were similar among preterm groups at term age which reflects that the brainstem maturation is similar among preterm groups. CONCLUSION: Gestational age at birth does not seem to influence absolute and interpeak latencies of ABR at term age. In preterm neonates, the findings lead to suggest that maturation of auditory pathway occurs in a similar manner in preterm infants regardless of gestational age at birth. We conclude that preterm birth alone as a risk factor does not appear to have any marked effect on the development of ABR at term age.


Assuntos
Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Lactente Extremamente Prematuro/fisiologia , Fatores Etários , Análise de Variância , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Fatores de Risco
14.
J Int Adv Otol ; 11(2): 114-7, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26380999

RESUMO

OBJECTIVE: This article aims to describe the characteristics of the binaural interaction component (BIC) of speech-evoked auditory brainstem response (ABR). MATERIALS AND METHODS: All 15 subjects had normal peripheral hearing sensitivity. ABRs were elicited by speech stimulus /da/. RESULTS: The first BIC (BIC-SP1) in the speech-evoked ABR occurred at around 6 ms in the region of peak V. The second BIC (BIC-SP2) was present around 8 ms in the latency region of peak A. The third and fourth BICs of speech-evoked ABR (BIC-SP3 & BIC-SP4) were observed at around 36 ms and 46 ms, respectively, in the latency regions of peaks E and F, respectively. BIC-SP1 and BIC-SP2 were present in all subjects tested (100%), whereas BIC-SP3 and BIC-SP4 were present in 11 (73%). CONCLUSION: Because ABRs are not affected by sleep and mature early, this tool can be evaluated in identifying binaural interaction in younger and difficult-to-test populations.


Assuntos
Percepção Auditiva/fisiologia , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Estimulação Acústica/métodos , Adolescente , Adulto , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes
15.
Int Tinnitus J ; 18(1): 29-34, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24995897

RESUMO

INTRODUCTION: The present study investigated the relationship between the perceived tinnitus severity, depressive and anxiety symptoms in individuals with tinnitus. An attempt was also made to see if any relationship exists between the perceived tinnitus severity and the age, gender or hearing status of the sufferer. MATERIALS AND METHODS: Fifty individuals (31 males, 19 females) with tinnitus (age range 19 to 60 years) were enrolled in the study. After the routine pure tone audiometry, each participant completed the Tinnitus Handicap Inventory, the State-Trait Anxiety Inventory and the Inventory of Depressive Symptomatology-Self Report-30. RESULTS: A significant correlation (r = 0.585, p pp < 0.01 respectively). Furthermore, age, gender and hearing status did not significantly influence the perceived severity of tinnitus. CONCLUSION: The results support the view that there is a strong relation between tinnitus and anxiety-depressive symptoms. Further, perceived severity of tinnitus is not influenced by age, gender and hearing status of the individual.


Assuntos
Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Zumbido/diagnóstico , Zumbido/epidemiologia , Adulto , Fatores Etários , Transtornos de Ansiedade/psicologia , Comorbidade , Transtorno Depressivo/psicologia , Avaliação da Deficiência , Feminino , Perda Auditiva/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Estatística como Assunto , Zumbido/psicologia , Adulto Jovem
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