Masoud Motasaddi Zarandy
Mansoureh Adel Ghahraman
Executive Manager & Designer:
Vol 27 No 2 (2018)
Background and Aim: Type 1 diabetes (T1D) is a common disorder that can cause various conflicts in the central nervous system (CNS). One of the important abilities of the CNS is the temporal processing. The purpose of this study was to compare the ability of temporal processing in patients with T1D and normal subjects using the gap in noise (GIN) test.
Methods: In this cross-sectional study, 25 T1D patients aged 20 to 30 years old and 25 normal subjects in the same age range were selected through available sampling method and were evaluated by gap in noise test. The level of HbA1c shows how the quality of metabolic control of diabetes has changed over the past 2 to 3 months. The relationship between the approximate threshold (ATh) values and the percent correct answers to the GIN test with HbA1c was investigated.
Results: Both ATh and percent correct responses were significantly different between patients with T1D and normal subjects in both ears and in both sexes (p<0.05). Moreover, the results showed a significant correlation between HbA1c with ATh and the percent correct responses. Also, there was no significant correlation between the duration of the disease with the ATh and the percent correct responses to GIN test.
Conclusion: Patients with TID have a weaker outcome than their normal counterparts during the GIN test. These results may indicate a defect in the ability to temporal processing in these subjects.
Background and Aim: Assessment of vestibular rehabilitation outcomes is a necessary step in this process. Assessment by clinical devices can reveal and measure some aspects of intervention but cannot show its effects on the patient quality of life. Vestibular rehabilitation benefit questionnaire is a scale for evaluating the effects of vestibular deficits on the quality of life and psychological aspects more efficiently than similar questionnaires. This research studied preparation and assessment of validity and reliability of Persian version of this questionnaire.
Methods: The translation process was based on International Quality Of Life Assessment protocol with considering cultural adaptation. Face validity and content validity, including content validity ratio and content validity index (CVI) were evaluated and test-retest reliability and Cronbach alpha was measured for reliability assessment of 108 vestibular deficit patients who received vestibular rehabilitation interventions. Furthermore, dizziness handicap inventory was used to evaluate correlation between vestibular rehabilitation benefit questionnaire and dizziness handicap inventory results.
Results: Questions with imperfections were modified. CVI in Lawshe method was equal to 1 indicating the necessity of inserting some questions in the questionnaire. Intraclass correlation was 0.94 for the test-retest reliability and the Cronbach alpha was 0.68, i.e. Persian vestibular rehabilitation benefit questionnaire has good reliability. In addition, the Spearman correlation coefficient was 0.74, indicating a good correlation between two questionnaire scores.
Conclusion: Persian version of vestibular rehabilitation benefit questionnaire is as reliable and valid as its original version and can be used for patients with vestibular deficits under vestibular rehabilitation treatment.
Background and Aim: Middle ear of neonates is mass-dominant. Therefore, by increasing the frequency of probe tone from 226 Hz to 1000 Hz, middle ear abnormalities can be detected better. This study aimed to evaluate the effect of age, sex, ear and weight on the characteristics of 1000 Hz tympanometry in neonates.
Methods: A total of 255 neonates (136 boys and 119 girls) aged from 1 to 90 days, with normal transient evoked otoacoustic emissionat least in one ear were studied. Compensated static admittance at middle ear pressure (YPP) and admittance at pressure of +200 daPa (Y200) were measured with 1000 Hz tympanometry.
Results: Mean (SD) YPP and Y200 values were 0.97 (0.48) and 2.07 (0.46) mmho in the right ears and 0.98 (0.53) and 2.05 (0.48) mmho in the left ears, respectively. In both ears, gender had no significant effect on compensated YPP, but Y200 values were significantly different between girls and boys (p<0.05). Ear did not affect the YPP and Y200 values. There was also a linear relationship between age and weight with compensated YPP and Y200 values, so that compensated YPP and Y200 values increased with higher weight and age.
Conclusion: Age and weight by affecting the physical and impedance characteristics of ear canal and tympanic membrane, can also affect the characteristics of the high frequency tympanometry. Lack of gender effects on compensated YPP and its effect on Y200 can be attributed to the difference in compliance between tympanic membrane and ear canal in boys and girls.
Background and Aim: Recent studies have reported connections between vestibular function and cognition and also reported more prevalence of vestibular impairment in patients with Alzheimer's disease. Because patients with amnestic mild cognitive impairment (aMCI) are more likely to develop Alzheimer's disease, this study was conducted to evaluate vestibular dysfunction of otolith organs in aMCI patients compared to normal subjects.
Methods: In our case-control study, 11 patients (22 ears) with aMCI with mean age of 56.73±8.83 years and 11 normal participants (22 ears) with mean age of 54.30±7.4 years were evaluated for ocular and cervical vestibular evoked myogenic potentials (o- and cVEMP). Occurrence of VEMP responses, amplitude, latency and threshold of these waves were recorded and compared between the two groups.
Results: Ocular VEMP was absent in 63.6% of aMCI patients and in 18.2% of the normal group. The difference was significant (p=0.002), while occurrence rate, amplitude, latencies and threshold of cVEMP were not significantly different between the two groups (p>0.05). McNemar's test showed that there was no significant relationship between occurrences of two potentials in aMCI group.
Conclusion: These findings show the presence of vestibular dysfunction, especially in the pathways of ocular vestibular evoked potential, in patients with amnestic mild cognitive impairment. Given that previous studies have shown that cVEMP was absent in Alzheimer's disease, absence of oVEMP can be used as an indicator for predicting future impairment in individuals with amnestic MCI.
Background and Aim: Acceptable noise level (ANL) measures the amount of accepted background noise while listening to the story. In the current study, ANL was carried out in children with learning disability (LD) and compared with the results of normal children by using examiner- and self-adjusted methods.
Methods: Forty seven (25 male, 22 female) normal children with good and better educational background and 46 (27 male, 19 female) LD children ranging in age from 7-12 years old were participated. ANL was assessed using an ear-level loudspeaker in front of children. The differences of ANL, most comfortable level (MCL), and background noise level (BNL) between groups and their relationship between examiner- and self-adjusted procedures were investigated.
Results: Mean ANLs of LD children either in examiner- or self-adjusted methods (8.91±4.66 and 11.00±5.38, respectively) were worse than those of normal children (7.19±3.63 and 9.61±3.41, respectively). The difference between mean ANL of normal and LD children was statistically significant only for examiner-adjusted method (p=0.05). There were also significant differences in BNL between groups for examiner- and self-adjusted method (p<0.05). A strong positive correlation was found between examiner- and self-adjusted conditions for ANL, MCL, and BNL among groups (p<0.001).
Conclusion: ANL is clinically applicable in LD children. Moreover, LD children accept lower background noise; therefore modification of their listening environment is recommended. Because of a strong positive relationship between ANL in examiner- and self-adjusted procedures, both methods can be implemented in different situations.
Background and Aim: Several studies have shown the anatomical associations between the vestibular system and cognitive processes, especially spatial memory. One of the first problems that occur in Alzheimer's disease (AD) is spatial memory deficits. The preclinical stage of AD is mild cognitive impairment (MCI). Amnestic type of MCI (aMCI) is more likely to progress to AD. Previous studies have demonstrated high incidence of vestibular disorders in AD patients; however, the balance system of aMCI patients has not been investigated. Therefore, the present study aimed to investigate vestibulo-ocular reflex (VOR) impairments in aMCI patients compared with control group.
Methods: In this cross-sectional study VOR gain and catch-up saccades in six semicircular canals were measured in 12 aMCI patients and 12 normal controls using video head impulse test.
Results: Vestibulo-ocular reflex gains in direction of all vertical semicircular canals were lower in aMCI- compared with normal-group (right anterior canal 0.74±0.17 vs 0.87±0.12; right posterior canal 0.77±0.10 vs 0.90±0.10; left anterior canal 0.87±0.10 vs 0.97±0.11; left posterior 0.72±0.18 vs 0.87±0.90). Catch-up saccades were found in direction of all canals in aMCI patients while there were no saccades in normal groups.
Conclusion: In aMCI patients there was more vestibular dysfunction, which might be associated with cognitive deficits especially spatial type. In brief, vestibular investigation is suggested in aMCI patients.
Background and Aim: Central auditory processing disorder (C)APD can affect academic, social and communicative status of its patients whether children or adults. One of the most important skills involved in these disorders is decoding. The rehabilitation method for the decoding deficit in Buffalo auditory processing model is the phonemic synthesis program (PSP). In this study, the Persian version of PSP was developed and then the efficacy of this method in the rehabilitation of Persian children with (C)APD was evaluated.
Methods: This study was conducted in two stages. At first, the Persian version of PSP was prepared in accordance with its English version. Then, a child with (C)APD according to the results of Persian versions of Phonemic Synthesis Test (P-PST) and staggered spondaic words (P-SSW) was rehabilitated with this method. The treatment was given to the patient three sessions a week, each session lasted 30 minutes. Data were analyzed using visual analysis and non-parametric tests.
Results: During the treatment phase, a significant improvement was seen in P-PST and P-SSW test results (p<0.05).
Conclusion: Based on the study results, the Persian version of PSP improves decoding, tolerance fading memory, and organization disorders.
Background and Aim: Hearing loss is a social damage affecting the most important aspect of social life i.e. communication. People with high frequency hearing loss do not accept hearing aid easily and resist its using. The purpose of this study was to determine the role of hearing aid in the quality of life of the elderly people with high frequency hearing loss.
Methods: This study was performed on 22 elderly people over 60 years old with mild to moderate sensory neural high frequency hearing loss living in Hamadan City, Iran. Hearing Handicap Inventory for the Elderly (HHIE) questionnaire was completed before and three month after using hearing aid. Social, emotional, and total scores before and after intervention were compared, too.
Results: Findings showed significant improvement of social, emotional and total scores before and three months after using hearing aid (p<0.001). Comparison of mean scores showed that prescribing hearing aid was effective in improving the quality of life in the elderly with high frequency hearing loss.
Conclusion: Considering beneficial effects of hearing aid on improving the quality of life in elderly patients with high frequency hearing loss, applying appropriate hearing aid and if needed rehabilitation programs are recommended.