Background and Aim: The vestibular system, which involves the peripheral vestibular apparatus and central vestibular pathways, is crucial for balance and posture. In addition to its primary functions, the vestibular system is closely linked with cognitive processes, as evidenced by its connections with the neocortex and limbic system. Vestibular dysfunction has been associated with cognitive impairments, particularly in areas of auditory cognition, where allocating cognitive resources for balance maintenance detracts from higher cognitive functions. This review examines the existing literature on the auditory-cognitive consequences of vestibular dysfunction.
Recent finding: This systematic review gives comprehensive information about the existing research on the impact of vestibular pathology on auditory cognitive abilities. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 226 articles were initially identified, with six studies meeting the inclusion criteria after thorough screening. The review highlights the varied effects of vestibular dysfunction on auditory cognition, revealing significant impairments in auditory working memory and attention, particularly in conditions like bilateral vestibulopathy and vestibular migraine. However, inconsistencies in the literature regarding specific vestibular pathologies and their impact on auditory cognition underscore the need for further targeted research.
Conclusions: The findings suggest a complex interplay between vestibular function and auditory cognition, with implications for the diagnosis and management of cognitive deficits in individuals with vestibular disorders.

Background and Aim: Due to the annoying nature and prevalence of dizziness, vertigo, and imbalance, the need for rapid diagnosis, and challenges in the differential diagnosis of various vestibular disorders, this study  aimed to translate the dizziness symptom profile (DSP), which is a self-report tool that helps clinicians differentiate the most common vestibular system disorders, into the Persian language and evaluate its validity, reliability, sensitivity, and specificity.
Methods: The profile was translated into Persian as DSP-P. Face, known-groups, and concurrent validities, internal consistency, test-retest reliability, sensitivity, and specificity were determined. 253 patients with dizziness and 59 healthy individuals completed the DSP-P before visiting the otolaryngologist, and the agreement between the proposed diagnoses of DSP-P and the final diagnosis of the otolaryngologist (our gold standard) was examined.
Results: The qualitative face validity of DSP-P was confirmed. There was a significant difference between the mean scores of the study groups (p < 0.001). The diagnosis of DSP-P was completely in agreement with the gold standard in 53.3% of cases. Internal consistency was excellent (α≥0.81) for all categories except the persistent postural-perceptual dizziness, superior canal dehiscence and unspecified unsteadiness categories (0.62≤α≤0.69). Generally, the test-retest reliability of the DSP-P scores and diagnoses was very good. The sensitivity of DSP-P was 94.4% for diagnosing benign paroxysmal positional vertigo, 93.5% for Meniere’s disease, 100% for vestibular neuritis, 86.3% for vestibular migraine, and 84.2% for persistent postural-perceptual dizziness.
Conclusions: The DSP-P was demonstrated to be a valid and reliable history-based diagnostic tool with high sensitivity and specificity.

Background and Aim: Persistent postural-perceptual dizziness (PPPD) is a chronic vestibular disorder characterized by persistent dizziness, non-spinning vertigo, or unsteadiness exacerbated by moving visual stimuli and upright postures. Vestibular rehabilitation therapy (VRT) has shown favorable outcomes. While noisy galvanic vestibular stimulation (nGVS) has been associated with improvements in various psychiatric and neurological conditions, its efficacy in PPPD remains unclear. This study aimed to assess the effectiveness of VRT, nGVS, and their combination on patients with PPPD in terms of postural control, dizziness, anxiety, and depression.
Method: Twenty-seven patients diagnosed with PPPD were randomly assigned to three groups receiving treatment for six weeks: 1) VRT, 2) GVS, and 3) VRT+GVS. Outcome measures included static postural control parameters, Dizziness Handicap Inventory (DHI), and Hospital Anxiety and Depression Scale (HADS) scores.
Results: All groups demonstrated significant improvements in subjective measures (DHI and HADS) following treatment. Postural control improvements were observed only in specific conditions within each group, with no overall significant differences between the groups except for mediolateral (ML) path length with eyes closed on a soft surface. Significant correlations were observed between improvements in postural control outcomes and questionnaire scores within each group. 
Conclusion: VRT and GVS, both individually and in combination, were effective in subjective measurements but had minimal impact on static postural control. Adding nGVS to VRT did not provide additional benefits for PPPD patients. The correlations between postural control and psychological outcomes suggest that improvements in perceived dizziness, anxiety, and depression may be linked to postural stabilization.
Trial Registration Number: The study was registered in the Iranian Registry of Clinical Trials on 18 September 2023 (IRCT20160131026279N6).

Background and Aim: To understand the difficulties of elderly in natural listening situations, the present study assessed the ability of participants to extract phonetic information and semantic information in noise. The main objective was to evaluate the relationship between age and performance in Semantic Information Processing (SIP) and Phonetic Information Processing (PIP) tasks.
Methods: Fifty-three normal hearing participants aged 40 to 65 years were categorized into five age groups. Participants underwent information processing assessments using standardized semantic and phonetic questions from Kannada stories under Signal-to-Noise Ratios (SNR) i.e., quiet, 0 dB SNR, and –4 dB SNR conditions.
Results: Younger participants outperformed older participants in both SIP and PIP tasks. Performance was optimal in quiet conditions, followed by 0 dB and –4 dB SNR. Except at –4 dB, PIP scores exceeded SIP scores. A significant differences was observed between the groups 1–4 and group 5 at 0 dB SNR in PIP condition only. A moderate negative correlations indicated that performance in both SIP and PIP declined with age, with linear regression revealing reductions of 0.216 and 0.210 each year in SIP and PIP respectively.
Conclusion: Age-related declines in PIP were noted at one SNR, while SIP remained stable, aligning with the Transmission Deficit Hypothesis (TDH). Nonetheless, regression analyses indicated a general decline in both SIP and PIP with age, supporting the Inhibitory Deficit Hypothesis (IDH).

Background and aim: Speech prosody, the nonlinguistic elements of speech that convey emotions, is crucial for social interactions and speech comprehension. This study aimed to investigate the Validity and reliability of the Speech Prosody Comprehension Test (SPCT) for Persian-speaking children aged 7-10.
Method: The Persian version of the Speech Prosody Comprehension Test (P-SPCT) was investigated. Face, construct, and discriminant validity, Test-retest reliability, and Internal consistency were examined on 32 children in age 7-10 with 22 (mean age ± SD = 8.63 ± 1.04) normal hearing and 10 (mean age ± SD = 9.20 ± 0.78)with cochlear implant )CI).
Results: Our result demonstrated good face validity. Construct validity revealed strong correlations in intra-sub score items and between subscales and the total score. A significant difference in mean scores was found between normal hearing and cochlear implant user, supporting discriminant validity (P<0.001). High test-retest reliability was demonstrated, with intraclass correlation coefficients (ICCs) ranging from 0.91 to 0.99 for total and all subscales. The measure demonstrated good internal consistency, with a Cronbach's alpha 0.89 for total score.
Conclusion: The Persian version of Speech Prosody Comprehension Test was found to be a valid and reliable clinical tool for assessing speech prosody comprehension in children aged 7-10. Further research with larger samples can confirm the generalizability of these findings.

Objective:  Recent studies try to clarify the difference of neuro-physiological responses of subject with tinnitus. The eye situation (open/close) is challengeable in electroencephalography researches. QEEG analysis are different on eyes close or open, so the recording of brain activities must be clarified by eyes condition. This study aimed to investigate this further in terms of differences in EEG activity between closed and open eyes condition in resting position of tinnitus patients.

Method: QEEG was analyzed in forty-six subjects with tinnitus (34 men and 12 women), in two eye conditions (open/close) for 3 minutes at resting position. Relative power of delta, theta, alpha, beta and gamma bands estimated by sLORETA software. Average of 30 electrodes across the scalp was measured for relative power at each rhythm separately and also, Paired T-test analysis for comparison of Delta/Alpha (DAR), Delta+Theta/Alpha+Beta (DTABR) between open/close eyes were done.

Results: In close eyes condition DAR and DTABR reduced significantly (p=0.009 and p=0.016) in comparison to open eyes. Relative power of delta increased in open eyes whereas surprisingly, alpha reduced significantly in compare to close eyes condition (p<0.001). There was not significant difference between two conditions at theta, beta and gamma rhythms.

Conclusion: Subjects with tinnitus indicate difference EEG activities at two eyes conditions. These changes, in Alpha band is completely revers in comparison to normal subjects that documents at previous researches. Increase of relative power of Alpha in close eyes and reduce of Delta power may be indicate sever tinnitus based on QEEG data. It seems that is better to select open eyes condition for QEEG analysis. Increase of DAR is a good variable in open eye condition and this study suggest the use of it as a potential biomarker for comparison of the severity of tinnitus.

Background and aim: Previous studies have demonstrated that uncompensated Unilateral Vestibular Neuritis (UVN) is a most prevalent cause of dizziness. Despite the many advantages, use of Conventional Vestibular Rehabilitation (CVR) in UVN patients have limitations. The use of tool-based rehabilitation methods can be more pleasant to patients and encourage them to complete the rehabilitation course. This study aimed to compare the effects of combined Whole Body Vibration (WBV), Galvanic Vestibular Stimulation (GVS) and CVR in patients with UVN.
Methods: UVN patients in the age range of 30 to 50 years were randomly divided into three groups with 17 participants each. first group received of CVR, the second group received CVR+WBV, and the third group received CVR+WBV+GVS, which included four weeks of CVR, twenty 5-minute sessions of WBV and eight 20-minute sessions of GVS. Outcome measurements were postural control parameters, Vestibulo-Ocular Reflex (VOR) gain asymmetry, joint position sense error (JPSE) and Dizziness Handicap Inventory (DHI) scores that were assessed at baseline and after four weeks.
Results: There was a significant improvement in all measured variables after the CVR, CVR+WBV and CRV+WBV+GVS treatments. Moreover, the CVR+WBV and CRV+WBV+GVS groups showed significantly greater improvement than the CVR group in posturography results, JPSE and DHI score (p < 0.05) except VOR gain asymmetry (p > 0.05).
Conclusion: CVR, CVR+WBV and CRV+WBV+GVS treatments effectively improve balance function. CVR+WBV and CRV+WBV+GVS training shows additional therapeutic effects in UVN patients. When CVR combined with WBV and GVS, shows additional therapeutic effects in UVN patients.

Background and Aim: This study compared the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) criteria for Meniere's Disease (MD) with vestibular staging methods that address inner ear progression, a consideration not found in the AAO-HNS criteria.
Methods: A cross-sectional study recruited patients with MD, aged 18 to 60, from June 8, 2022, to March 20, 2023; however, we excluded patients with problems such as difficulty rolling their eyes, difficulty turning their head, conductive or mixed hearing loss, cental nerves system disorders, retrocochlear lesions, pregnancy, and receiving psychotropic drugs. Furthermore, patients with a history of labyrinthitis, vestibular migraine, stroke, benign positional vertigo, or bilateral vestibulopathy within the past 6 months were excluded. All patients were tested with audiometry, vestibular evoked myogenic potential, caloric test, and video head impulse test. Two neuro-otologists assessed and classified patients with MD according to the AAO-HNS (1990 and 2020) criteria.
Results: Forty-two patients were enrolled. The correlation between vestibular staging and both AAO-HNS (1990 and 2020) criteria was medium (p=0.02 and p<0.01, respectively). According to AAO-HNS 1995, 69% of definite MD cases were classified as stage C, whereas all probable MD cases and 30% of possible MD cases were categorized as stage B. Regarding AAO-HNS 2020, 70% of definite MD cases were classified as stage C, whereas 33.3% of probable MD cases were classified as stage B.
Conclusion: Definite MD could predict pathology in the cochleo-sacculo-utricular and lateral canals (stage C), whereas probable MD could suggest that the lesion involved the cochleo-sacculo-utricular canal (stage B).
Trial registration: This trial was registered at Thai Clinical Trials Registry on June 6, 2022 (TCTR20220606003)

Background and Aim: Misophonia is a condition characterized by a reduced tolerance to certain sounds or the stimuli linked to those sounds. Our study aimed to investigate the auditory brainstem functioning using electrophysiological measures in normal-hearing individuals with and without misophonia.
Methods: Thirty participants aged between 18 and 30 years were recruited. They were divided into two primary groups: fifteen individuals diagnosed with misophonia and fifteen controls. The selection of participants with misophonia was based on the diagnostic criteria by Schröder et al. and the MisoQuest questionnaire; Auditory Brainstem Response (ABR) was recorded from all the individuals at lower (11.1/s) and higher stimulus rates (90.1/s).
Results: On analysing the data, individuals with misophonia showed significantly shorter absolute latencies of ABR waves III and V at 11.1/s. Also, there was no significant difference in the absolute amplitude of ABR waves at 11.1/s and 90.1/s between the individuals with and without misophonia.
Conclusion: This study indicates that the shorter absolute latencies of ABR waves III and V in individuals in misophonia could be attributed to hyperactivity at the sub-cortical pathway regions compared to the control group.

Background: West Nile virus (WNV) encephalitis is reported to cause “ataxia” in up to 31% of patients, and “vertigo” in up to 14% of patients.  The mechanism of these symptoms is unclear.
The case: We report the case of a lady who contracted WNV encephalitis at age 74 years.  When evaluated 15 months later she complained both of baseline unsteadiness, and of a fluctuating component of disequilibrium.  Instrumented vestibular testing identified bilateral vestibular weakness (in a different pattern on each side).  It also identified periodic alternating nystagmus (PAN), presumably acquired (rather than congenital).  Acquired PAN has been observed in other encephalidites, but has not been previously reported in association with WNV encephalitis.
Conclusion: In this case, WNV encephalitis appears to have caused both vestibular weakness (likely accounting for the baseline unsteadiness) and periodic alternating nystagmus (likely accounting for the fluctuating disequilibrium).