Auriculoterapia: eficácia clínica e comparação entre tecnologias / Auriculothérapie: efficacité clinique et comparaison entre les technologies

A auriculoterapia é uma prática diagnóstica e terapêutica que tem por princípio a estimulação de pontos no pavilhão auricular externo que correspondem a partes específicas do corpo (mapa somatotópico). Sua origem é derivada da acupuntura, prática da medicina tradicional chinesa. Desde seu surgimento em 1951, na França, várias tecnologias para a realização da auriculoterapia foram desenvolvidas. Considerando a existência de diferentes materiais para realização da auriculoterapia (esferas magnéticas, agulhas semipermanentes, agulhas filiformes, estimulação por laser, eletropuntura, cristais e outros), foi solicitada pela assistência da atenção primária revisão rápida para comparação da eficácia, segurança e efetividade das tecnologias relatadas na literatura científica. Quais tecnologias utilizadas para realização da auriculoterapia apresentam maior eficácia clínica quando comparadas entre si?

Auditory brainstem responses to high-resolution audio sounds: Effects of anti-alias filters.

Despite the superior technical specifications of high-resolution audio in comparison to conventional compact discs (CDs) and digital versatile discs (DVDs), whether and how high-resolution audio leads to an improved subjective listening experience remains unclear. The sound quality of conventional digital formats is deteriorated by temporal blur, which is caused by a high-cut filter applied to avoid aliasing of a digital sound source, resulting in spurious artificial sound energy before and after the actual sound onset. Using sound materials of high-resolution audio grade, this study investigated the effects of filter-induced temporal blur on the auditory neural pathway from the cochlea through the rostral brainstem by measuring the auditory brainstem responses (ABRs) of participants with normal hearing. The participants (N = 24) listened to 0.1-ms clicks, with and without a high-cut filter of 22 kHz or 11 kHz applied to them. The amplitudes and latencies of five ABR waves (<10 ms) revealed no significant effects caused by filtering. The participants could not distinguish between the original and the 22-kHz filtered click sounds, while they could distinguish between the original and the 11-kHz filtered sounds. These results indicate that a CD-level anti-alias filter does not affect initial auditory processing and the sound difference is not discernible, at least for artificial sounds with a simple acoustic structure.

A self-training program for sensory substitution devices.

Sensory Substitution Devices (SSDs) convey visual information through audition or touch, targeting blind and visually impaired individuals. One bottleneck towards adopting SSDs in everyday life by blind users, is the constant dependency on sighted instructors throughout the learning process. Here, we present a proof-of-concept for the efficacy of an online self-training program developed for learning the basics of the EyeMusic visual-to-auditory SSD tested on sighted blindfolded participants. Additionally, aiming to identify the best training strategy to be later re-adapted for the blind, we compared multisensory vs. unisensory as well as perceptual vs. descriptive feedback approaches. To these aims, sighted participants performed identical SSD-stimuli identification tests before and after ~75 minutes of self-training on the EyeMusic algorithm. Participants were divided into five groups, differing by the feedback delivered during training: auditory-descriptive, audio-visual textual description, audio-visual perceptual simultaneous and interleaved, and a control group which had no training. At baseline, before any EyeMusic training, participants SSD objects' identification was significantly above chance, highlighting the algorithm's intuitiveness. Furthermore, self-training led to a significant improvement in accuracy between pre- and post-training tests in each of the four feedback groups versus control, though no significant difference emerged among those groups. Nonetheless, significant correlations between individual post-training success rates and various learning measures acquired during training, suggest a trend for an advantage of multisensory vs. unisensory feedback strategies, while no trend emerged for perceptual vs. descriptive strategies. The success at baseline strengthens the conclusion that cross-modal correspondences facilitate learning, given SSD algorithms are based on such correspondences. Additionally, and crucially, the results highlight the feasibility of self-training for the first stages of SSD learning, and suggest that for these initial stages, unisensory training, easily implemented also for blind and visually impaired individuals, may suffice. Together, these findings will potentially boost the use of SSDs for rehabilitation.

Normal values for cervical and ocular vestibular-evoked myogenic potentials using EMG scaling: effect of body position and electrode montage.

BACKGROUND: The clinical utility of cervical and ocular vestibular-evoked myogenic potential (cVEMP and oVEMP) is limited by variability of testing protocols and a dearth of normative data using contemporary methods for amplitude scaling. AIMS/OBJECTIVES: To investigate the effect of body position and electrode montage on VEMP responses and to establish normative values. MATERIAL AND METHODS: This is a repeated measures study of 44 healthy young adult subjects (22 men and 22 women). RESULTS: The highest response rate (99%) for cVEMP was achieved in the supine position with the head elevated and turned. For oVEMP, the highest response rate (90%) was achieved using nasal alar electrode montage with the subject in a sitting position. Scaled peak-to-peak amplitude was higher in males than in females for both cVEMP and oVEMP. CONCLUSION: Normative data for 44 young healthy adults was successfully collected for two body positions for cVEMP and two head positions and two electrode montages for oVEMP. SIGNIFICANCE: Our findings describe VEMP protocols that efficiently detect VEMP responses, and we provide normative VEMP response data for young healthy subjects. We describe a potential difference in response between males and females, which may be clinically important.

Vibration enhanced cell growth induced by surface acoustic waves as in vitro wound-healing model.

We report on in vitro wound-healing and cell-growth studies under the influence of radio-frequency (rf) cell stimuli. These stimuli are supplied either by piezoactive surface acoustic waves (SAWs) or by microelectrode-generated electric fields, both at frequencies around 100 MHz. Employing live-cell imaging, we studied the time- and power-dependent healing of artificial wounds on a piezoelectric chip for different cell lines. If the cell stimulation is mediated by piezomechanical SAWs, we observe a pronounced, significant maximum of the cell-growth rate at a specific SAW amplitude, resulting in an increase of the wound-healing speed of up to 135 ± 85% as compared to an internal reference. In contrast, cells being stimulated only by electrical fields of the same magnitude as the ones exposed to SAWs exhibit no significant effect. In this study, we investigate this effect for different wavelengths, amplitude modulation of the applied electrical rf signal, and different wave modes. Furthermore, to obtain insight into the biological response to the stimulus, we also determined both the cell-proliferation rate and the cellular stress levels. While the proliferation rate is significantly increased for a wide power range, cell stress remains low and within the normal range. Our findings demonstrate that SAW-based vibrational cell stimulation bears the potential for an alternative method to conventional ultrasound treatment, overcoming some of its limitations.

Effects of singing bowl exposure on Karolinska sleepiness scale and pupillographic sleepiness test: A randomised crossover study.

BACKGROUND: The aim of this study was to investigate the effects on subjective and objective sleepiness of a stay above a large struck singing bowl compared to a relaxation period in a silent singing bowl. METHODS: Fifty-eight healthy subjects were recruited for the study, 48 participated on two days, one week apart, during the same timeslot. The Karolinska sleepiness scale was used to evaluate current subjective sleepiness, and the relative pupillary unrest index to assess objective sleepiness. In this randomized cross-over study, the intervention consisted of a 20-minute stay in a hammock while the singing bowl, positioned beneath, was struck seven times. The controlled comparator was a 20-minute stay in the same hammock above the singing bowl, but without being struck. After these two interventions subjective and objective sleepiness were re-evaluated. RESULTS: The mean relative pupillary unrest index values after relaxation in the struck and silent singing bowl groups were 0.74 and respectively 0.71 (p = 0.460). The median Karolinska sleepiness scale value after relaxation with the struck singing bowl was 3 compared with 4 (p = 0.041) for the silent singing bowl. DISCUSSION: This study evaluated the influence of a struck singing bowl on sleepiness during daytime. Subjective sleepiness was significantly lower after relaxation above a struck singing bowl. After gender stratification, the difference was still significant in women. Objective sleepiness was not different in both groups. Finally, we can only speculate if women may be more susceptible to subjective improvements in case of sleepiness and show another perception of relaxation in a struck singing bowl compared to men.

Electric-acoustic stimulation with longer electrodes for potential deterioration in low-frequency hearing.

Background: Electric-acoustic stimulation (EAS) has emerged as a standard treatment for patients with high-frequency hearing loss. EAS is usually performed with shorter electrodes of 16-24 mm in length. As most EAS recipients gradually lose residual acoustic hearing in the implanted ear over time, EAS with longer electrodes without causing significant intra-cochlear damage might be ideal.Objective: The aim of this study was to investigate hearing preservation (HP) results after EAS surgery with longer electrodes.Methods: Ten patients (11 ears) with partial deafness that met the indications for EAS with a MED-EL FLEX28 electrode were included in this study. Auditory thresholds before and at 6 months after activation were examined.Results: In 100% of cases, HP was comfortably achieved, indicating that all patients could utilize acoustic amplification combined with electric stimulation.Conclusion: EAS with longer electrodes can offer broader cochlear coverage, resulting in natural frequency matching in comparison with shorter electrodes, even in EAS cases. The combination of advanced surgical techniques and flexible, long, straight electrodes permits deep insertion that reaches the apical region with little or no insertion trauma.

Efficacy of Binaural Beat Meditation Technology for Treating Anxiety Symptoms: A Pilot Study.

The objective of this study was to examine the efficacy of a novel binaural beat meditation technology for the treatment of anxiety symptoms in both psychiatric outpatients and nonpatients. Twenty psychiatric outpatients with anxiety disorder and eight individuals (nonpatients) in the healing professions were given the opportunity to use this meditation technology over the course of 2 weeks to 2 months. The State-Trait Anxiety Inventory scores were measured in all participants over the course of the study. Of the 20 outpatients who took part in the study, nine used the meditations as planned, whereas 11 did not for various reasons (could not download, forgot, did not have time, etc.), resulting in the formation of three treatment groups: psychiatry + meditation (n = 8), psychiatry only (n = 10), and meditation only (n = 8). The psychiatry + meditation group showed a 13.5-point (26.5%) decrease in State-Anxiety (t = 5.28, p = 0.001), a 14.1-point (24.7%) decrease in Trait-Anxiety (t = -5.12, p = 0.001), and a 27.6-point (25.6%) decrease in Total Anxiety (t = 7.63, p ≤ 0.001). The psychiatry-only group showed a 4.2-point (8.4%) decrease in State-Anxiety (t = -2.20, p = 0.05) and a 7.0-point (6.9%) decrease in Total Anxiety (t = -2.61, p = 0.02). The meditation only showed a 3.5-point (9.8%) decrease in Trait-Anxiety (t = -2.47, p = 0.04). In a multiple regression analysis controlling for sociodemographic factors, medications, and treatment-related variables, the only statistically significant improvement in anxiety was seen in the psychiatry + meditation group for the Total Anxiety score (p < 0.01). These findings suggest that use of this meditation technology may exhibit a positive effect on self-reported measures of anxiety in the context of a psychiatry/psychotherapy practice. However, larger-scale randomized, placebo-controlled trials are needed to confirm our findings.

Equivalent hearing threshold levels for the RadioEar IP30 insert earphone and short-term stimuli: comparison of peak-equivalent and RMS-based measures.

Objective: To determine equivalent threshold sound pressure levels (ETSPL) for the RadioEar IP30 insert earphone for standardised short-term stimuli: IEC 60645-3 reference clicks and tonebursts in the frequency range from 250 Hz to 6 kHz, using the standardised peak-equivalent ETSPL procedure (peETSPL) and a new proposal based on the unweighted equivalent continuous sound pressure level LZeq. of the periodically repeated short-term stimuli (LZeqETSPL).Design: Determination of peETSPL and LZeqETSPL hearing threshold levels with otologically normal test subjects under the conditions given in ISO 389-9 using the standardised occluded-ear simulator according to IEC 60318-4.Study sample: The study was based on tests with 25 subjects.Results: The peETSPLs for the RadioEar IP30 insert earphone were compared with the respective reference threshold levels of the insert earphone ER-3A as standardised in the ISO 389 standards series. The LZeqETSPL approach was tested by estimating the LZeqETSPLs from the peRETSPLs and comparing the estimate with the direct results.Conclusions: Equivalent hearing threshold levels for standardised short-term stimuli for the RadioEar IP30 insert earphone were determined according to ISO 389-9 and given as both peETPSL and LZeqETSPL. The RMS-based LZeqETSPL approach turned out to be well applicable for the RadioEar IP30 insert earphone.

Analysis of probe fitting stimulus properties on transient evoked otoacoustic emissions.

Objective: The objectives of the current study are first, to evaluate the subjective evaluation of probe fitting stimulus properties, and second, to analyse the effects of different probe fittings on transient evoked otoacoustic emission (TEOAE) response and noise amplitudes in subjects.Design: The Q methodology was used to sort 48 probe fittings differing in stimulus properties in seven categories from totally unacceptable to certainly acceptable. Further, TEOAE response and noise amplitudes were measured in one baseline condition with optimal probe fitting and eight experimental conditions with less than optimal probe fittings.Study sample: The probe fittings were ranked by 18 participants, while the repeated measures design was performed in 34 ear.Results: First, it was found that only 19.61% of all distributions of the probe fittings by the participants had a mutual correlation of at least 70.00%. Almost 60% of the variance of distributions was explained by 83.33% of the participants, although most probe fittings significantly differed from other fittings based on spectral broadness. Second, significant differences in TEOAE response and especially noise amplitudes between conditions were found. Further, TEOAE response and noise amplitudes between the baseline and experimental conditions were significantly different depending on ringing and spectral flatness of the stimulus.Conclusion: A substantial amount of subjectivity during TEOAE measurements is involved with regard to the evaluation of probe fitting stimulus properties. TEOAE response but especially noise amplitudes are influenced by varying stimulus parameters which stresses the importance of inspecting these parameters prior to or during EOAE measurements. Although more research is needed, some guidelines regarding these parameters are given which could improve the accuracy of TEOAEs in practice.

A Soft Housing Needle Ultrasonic Transducer for Focal Stimulation to Small Animal Brain.

Conventional acoustic brain stimulators that transmit low frequency (< 1 MHz) bursts in a pulse repetition frequency with large-sized transducers are barely compatible with small animal models because of broad beam width, possible stimulation of auditory pathways, and blocking of field-of-view for in vivo imaging of brain hemodynamics and neuronal activities. A miniaturized ultrasound stimulator with higher stimulation frequencies will enhance spatial specificity and enable simultaneous eliciting and monitoring brain activities. Moreover, the use of non-periodic pulse sequences may reduce unintended stimulations on auditory cortex, which might be caused by transmitting periodic bursting patterns. A platform for ultrasound brain stimulations for small animal models, including a soft housing 10 MHz needle transducer with a beam size of 680 µm, random transmission sequences, and optical imaging systems, was developed. The platform can deliver focal stimulations to the visual and barrel cortex of mice and monitor subsequent brain activities. The stimulated sites in both the visual and primary somatosensory cortices (S1) showed approximately two to three times higher neuronal calcium signal levels than those in peripheral regions. Activities in the auditory cortex were elicited by periodic sequence stimulation, while it was reduced by 67 and 35% for barrel and visual cortex stimulation with the random sequence, respectively.

Acoustic slow wave sleep enhancement via a novel, automated device improves executive function in middle-aged men.

STUDY OBJECTIVES: As slow-wave activity (SWA) is critical for cognition, SWA-enhancing technologies provide an exciting opportunity to improve cognitive function. We focus on improving cognitive function beyond sleep-dependent memory consolidation, using an automated device, and in middle-aged adults, who have depleted SWA yet a critical need for maximal cognitive capacity in work environments. METHODS: Twenty-four healthy adult males aged 35-48 years participated in a randomized, double-blind, cross-over study. Participants wore an automated acoustic stimulation device that monitored real-time sleep EEG. Following an adaptation night, participants were exposed to either acoustic tones delivered on the up phase of the slow-wave (STIM) or inaudible "tones" during equivalent periods of stimulation (SHAM). An executive function test battery was administered after the experimental night. RESULTS: STIM resulted in an increase in delta (0.5-4 Hz) activity across the full-night spectra, with enhancement being maximal at 1 Hz. SWA was higher for STIM relative to SHAM. Although no group differences were observed in any cognitive outcomes, due to large individual differences in SWA enhancement, higher SWA responders showed significantly improved verbal fluency and working memory compared with nonresponders. Significant positive associations were found between SWA enhancement and improvement in these executive function outcomes. CONCLUSIONS: Our study suggests that (1) an automated acoustic device enhances SWA; (2) SWA enhancement improves executive function; (3) SWA enhancement in middle-aged men may be an important therapeutic target for enhancing cognitive function; and (4) there is a need to examine interindividual responses to acoustic stimulation and its effect on subsequent cognitive function. CLINICAL TRIAL REGISTRATION: This study has been registered with the Australian New Zealand Clinical Trials Registry. "The efficacy of acoustic tones in slow-wave sleep enhancement and cognitive function in healthy adult males". https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371548&isReview=true. REGISTRATION: ACTRN12617000399392.

The Echobot: An automated system for stimulus presentation in studies of human echolocation.

Echolocation is the detection and localization of objects by listening to the sounds they reflect. Early studies of human echolocation used real objects that the experimental leader positioned manually before each experimental trial. The advantage of this procedure is the use of realistic stimuli; the disadvantage is that manually shifting stimuli between trials is very time consuming making it difficult to use psychophysical methods based on the presentation of hundreds of stimuli. The present study tested a new automated system for stimulus presentation, the Echobot, that overcomes this disadvantage. We tested 15 sighted participants with no prior experience of echolocation on their ability to detect the reflection of a loudspeaker-generated click from a 50 cm circular aluminum disk. The results showed that most participants were able to detect the sound reflections. Performance varied considerably, however, with mean individual thresholds of detection ranging from 1 to 3.2 m distance from the disk. Three participants in the loudspeaker experiment also tested using self-generated vocalization. One participant performed better using vocalization and one much worse than in the loudspeaker experiment, illustrating that performance in echolocation experiments using vocalizations not only measures the ability to detect sound reflections, but also the ability to produce efficient echolocation signals. Overall, the present experiments show that the Echobot may be a useful tool in research on human echolocation.

Surgical approach for complete cochlear coverage in EAS-patients after residual hearing loss.

INTRODUCTION: In cases with residual-hearing (RH) loss after cochlear implantation, a safe method is needed to provide full spectral resolution and as much auditory information as possible without implant replacement. Aim of this study was to prove the feasibility of accessing a partially inserted cochlear-implant-electrode for complete insertion to its maximum length through the external ear canal using a transcanal approach. METHODS: Two CI electrodes were customized with 18 stimulating channels. The electrode design enables the use of 12 active channels available for electrical stimulation inside the cochlea both after partial and full insertion. 10 CI electrodes were implanted in 10 fresh human cadaveric temporal bones. After initial partial insertion by posterior tympanotomy, the electrode was inserted to its maximum length via a transcanal approach. Radiographs and CT scans were performed to confirm the electrode position. The electrodes were investigated via x-ray after removal. RESULTS: X-ray and CT-scans confirmed the electrode prototypes covering an angular insertion depth between 236° to 307° after initial insertion. Accessing the electrode in the middle ear space was feasible and insertion to its full length was successful. Post-insertion CT confirmed insertion of the 28mm and 31.5mm electrode arrays covering an angular insertion depth between 360° and 540° respectively. No tip foldovers were detected. CONCLUSION: This study confirms the feasibility of extending the electrode insertion to its maximum insertion length using a transcanal approach in temporal bone specimens. This constitutes a second stage procedure on demand in EAS-surgery. This may be beneficial for EAS-patients providing electrical stimulation beyond the basal turn of the cochlea once the functional residual hearing is lost, without replacing the entire CI.

A comparison of ear-canal-reflectance measurement methods in an ear simulator.

Ear-canal reflectance has been researched extensively for diagnosing conductive hearing disorders and compensating for the ear-canal acoustics in non-invasive measurements of the auditory system. Little emphasis, however, has been placed on assessing measurement accuracy and variability. In this paper, a number of ear-canal-reflectance measurement methods reported in the literature are utilized and compared. Measurement variation seems to arise chiefly from three factors: the residual ear-canal length, the ear-probe insertion angle, and the measurement frequency bandwidth. Calculation of the ear-canal reflectance from the measured ear-canal impedance requires estimating the ear-canal characteristic impedance in situ. The variability in ear-canal estimated characteristic impedance and reflectance due to these principal factors is assessed in an idealized controlled setup using a uniform occluded-ear simulator. In addition, the influence of this measurement variability on reflectance-based methods for calibrating stimulus levels is evaluated and, by operating the condenser microphone of the occluded-ear simulator as an electro-static speaker, the variability in estimating the emitted pressure from the ear is determined. The various measurement methods differ widely in their robustness to variations in the three principal factors influencing the accuracy and variability of ear-canal reflectance.

Electric acoustic stimulation (EAS) with the Naída CI Q90 sound processor in experienced cochlear implant users.

Objectives: The benefit of using the electroacoustic functionality was tested compared to electric stimulation alone. Two different cut-off frequencies between acoustic and electric stimulation were tried. Methods: Performance and subjective preference in 10 subjects was measured with electric only and electroacoustic stimulation with two settings: a cut-off for acoustic amplification at the frequency where thresholds exceeded 70 dB and 85 dB. An overlapping setting was also tried in five participants. Results: There was a non-significant trend with a median improvement in SRT of 1.3 dB (70 dB cut-off) and 0.8 dB (85 dB cut-off) compared to the electric only condition. From nine subjects who completed the study, one preferred the 85 dB cut-off frequency, with the others preferred either a 70 dB cut-off or an overlapping setting. Discussion: Nine subjects continued to use the EAS processor after study termination because of subjective benefits. The variability in speech outcomes and subjective preference is underlining the importance of being able to manually change acoustic and electric cut-off frequencies. Conclusion: There were non-significant median group benefits from use of the acoustic component for these existing CI users. A hearing loss of 70 dB HL is an appropriate default cut-off frequency in the fitting software.

Electro-haptic enhancement of speech-in-noise performance in cochlear implant users.

Cochlear implant (CI) users receive only limited sound information through their implant, which means that they struggle to understand speech in noisy environments. Recent work has suggested that combining the electrical signal from the CI with a haptic signal that provides crucial missing sound information ("electro-haptic stimulation"; EHS) could improve speech-in-noise performance. The aim of the current study was to test whether EHS could enhance speech-in-noise performance in CI users using: (1) a tactile signal derived using an algorithm that could be applied in real time, (2) a stimulation site appropriate for a real-world application, and (3) a tactile signal that could readily be produced by a compact, portable device. We measured speech intelligibility in multi-talker noise with and without vibro-tactile stimulation of the wrist in CI users, before and after a short training regime. No effect of EHS was found before training, but after training EHS was found to improve the number of words correctly identified by an average of 8.3%-points, with some users improving by more than 20%-points. Our approach could offer an inexpensive and non-invasive means of improving speech-in-noise performance in CI users.

Instrumentation for electrodiagnostic studies.

The instrument and accessories are an important part of the electrodiagnostic (EDX) testing. Their functional understanding is useful to recognize and reduce various artifacts and noise/interference in the signal. In this review, we will describe the technical specifications of various components of the instrument, and their effect on signals and noise. This will be illustrated using example of electromyography and nerve conduction studies. However the same principles also apply to other modalities of testing. We will also provide general strategies to reduce noise and artifacts, followed by some modality specific examples.

Neurons in primary auditory cortex represent sound source location in a cue-invariant manner.

Auditory cortex is required for sound localisation, but how neural firing in auditory cortex underlies our perception of sound sources in space remains unclear. Specifically, whether neurons in auditory cortex represent spatial cues or an integrated representation of auditory space across cues is not known. Here, we measured the spatial receptive fields of neurons in primary auditory cortex (A1) while ferrets performed a relative localisation task. Manipulating the availability of binaural and spectral localisation cues had little impact on ferrets' performance, or on neural spatial tuning. A subpopulation of neurons encoded spatial position consistently across localisation cue type. Furthermore, neural firing pattern decoders outperformed two-channel model decoders using population activity. Together, these observations suggest that A1 encodes the location of sound sources, as opposed to spatial cue values.

Interactions between egocentric and allocentric spatial coding of sounds revealed by a multisensory learning paradigm.

Although sound position is initially head-centred (egocentric coordinates), our brain can also represent sounds relative to one another (allocentric coordinates). Whether reference frames for spatial hearing are independent or interact remained largely unexplored. Here we developed a new allocentric spatial-hearing training and tested whether it can improve egocentric sound-localisation performance in normal-hearing adults listening with one ear plugged. Two groups of participants (N = 15 each) performed an egocentric sound-localisation task (point to a syllable), in monaural listening, before and after 4-days of multisensory training on triplets of white-noise bursts paired with occasional visual feedback. Critically, one group performed an allocentric task (auditory bisection task), whereas the other processed the same stimuli to perform an egocentric task (pointing to a designated sound of the triplet). Unlike most previous works, we tested also a no training group (N = 15). Egocentric sound-localisation abilities in the horizontal plane improved for all groups in the space ipsilateral to the ear-plug. This unexpected finding highlights the importance of including a no training group when studying sound localisation re-learning. Yet, performance changes were qualitatively different in trained compared to untrained participants, providing initial evidence that allocentric and multisensory procedures may prove useful when aiming to promote sound localisation re-learning.