Behavioral and Hemodynamic Changes Following Dichotic Training in Patients with Neurological Deficits of the Auditory Nervous System: A Case Series

2021 ◽  
Author(s):  
Trey Cline ◽  
Nicole Colgrove ◽  
Matthew Bush ◽  
Jessica Lee ◽  
David Powell ◽  
...  
Keyword(s):  
Auditory Processing ◽  
Dichotic Listening ◽  
Case Series ◽  
Analysis Data ◽  
Auditory Training ◽  
Neurological Deficits ◽  
Intensity Difference ◽  
Neurological Patients ◽  
Show Evidence ◽  
Dichotic Training

Abstract Background Dichotic listening occurs when one attends to different acoustical messages presented simultaneously to both ears. This is important for understanding speech in compromised listening situations, such as background noise. Deficits in dichotic listening can be remediated by participating in auditory training. We present two patients with binaural integration deficits who underwent dichotic interaural intensity difference (DIID) training. Purpose The purpose of this investigation is to demonstrate improvement of dichotic listening deficits following DIID training in neurological patients seen clinically for hearing issues. Research Design This was a case series utilizing a pre- and posttreatment design. Study Sample This case series utilized two female participants who demonstrated binaural integration deficits during an auditory processing evaluation. Intervention The participants underwent a pretraining auditory processing evaluation and functional magnetic resonance imaging (fMRI). Participants then underwent 12, 30-minute DIID training sessions followed by posttreatment auditory processing evaluations and fMRI. Data Collection and Analysis Data was collected at the pretreatment appointment and then immediately following the completion of the training. Results Each patient demonstrated varying degrees of improvement on the posttreatment assessment. Case 1 showed significant improvement on the Speech-in-Noise-Revised (SPIN-R) test. fMRI showed changes in activation patterns following training. Case 2 demonstrated improved scores on the Dichotic Digits Test and SPIN-R and increased activation of the calcarine sulcus following training. Conclusion Dichotic training can be an efficacious treatment for binaural integration deficits and may show evidence of improving speech understanding in noise. This case series demonstrates a promising therapy to help patients improve auditory function by improving dichotic listening skills.

Auditory Training Reverses Lead (Pb)-Toxicity-Induced Changes in Sound-Azimuth Selectivity of Cortical Neurons

2018 ◽  
Vol 29 (8) ◽  
pp. 3294-3304 ◽  
Author(s):  
Xia Liu ◽  
Fanfan Wei ◽  
Yuan Cheng ◽  
Yifan Zhang ◽  
Guoqiang Jia ◽  
...  
Keyword(s):  
Lead Exposure ◽  
Auditory Processing ◽  
Cortical Neurons ◽  
Spatial Information ◽  
Primary Auditory Cortex ◽  
Auditory Training ◽  
Neurological Deficits ◽  
Central Auditory Processing ◽  
Inhibitory Neurotransmitter ◽  
Behavioral Impairments

Abstract Lead (Pb) causes significant adverse effects on the developing brain, resulting in cognitive and learning disabilities in children. The process by which lead produces these negative changes is largely unknown. The fact that children with these syndromes also show deficits in central auditory processing, however, indicates a speculative but disturbing relationship between lead-exposure, impaired auditory processing, and behavioral dysfunction. Here we studied in rats the changes in cortical spatial tuning impacted by early lead-exposure and their potential restoration to normal by auditory training. We found animals that were exposed to lead early in life displayed significant behavioral impairments compared with naïve controls while conducting the sound-azimuth discrimination task. Lead-exposure also degraded the sound-azimuth selectivity of neurons in the primary auditory cortex. Subsequent sound-azimuth discrimination training, however, restored to nearly normal the lead-degraded cortical azimuth selectivity. This reversal of cortical spatial fidelity was paralleled by changes in cortical expression of certain excitatory and inhibitory neurotransmitter receptor subunits. These results in a rodent model demonstrate the persisting neurotoxic effects of early lead-exposure on behavioral and cortical neuronal processing of spatial information of sound. They also indicate that attention-demanding auditory training may remediate lead-induced cortical neurological deficits even after these deficits have occurred.

scholarly journals Evaluating the effectiveness of dichotic training in the elderly adults: a single subject study

2021 ◽  
Author(s):  
Zahra Shahidipour ◽  
Saeid Farahani ◽  
Ghassem Mohammadkhani ◽  
Elham Tavanai ◽  
Nariman Rahbar ◽  
...  
Keyword(s):  
Training Program ◽  
Elderly People ◽  
Dichotic Listening ◽  
Poor Performance ◽  
The Elderly ◽  
Elderly Subjects ◽  
Intensity Difference ◽  
Single Subject ◽  
Elderly Adults ◽  
Dichotic Training

Background and Aim: Elderly people usually show poor performance in dichotic listening tasks. In this condition, the left ear being often the weaker one shows a performance below the normal limits. Studies have shown the effectiveness of dichotic listening training in auditory and language processing for adults and children with neurological disorders. This study aimed to develop a home-version of dichotic training and investigate its effectiveness in elderly adults. Methods: Participants in this single-subject interventional study (AB design) were four elderly subjects (two males and two females) aged 65−75 years. The main inclusion criteria were dichotic listening deficit demonstrated by the dichotic digit test (DDT), no neurological or cognitive disorders, and normal hearing threshold. Dichotic listening training was performed with an informal home-version of dichotic interaural intensity difference (DIID) training program for seven weeks. DDT was performed seven consecutive weeks before (phase A) and after the intervention (phase B) at the end of each week. Results: Data were analyzed by single-subject study statistics. Findings demonstrated an improvement in DDT scores for the left ear and decrease in right ear advantage scores in all the elderly adults after DIID training program. It seems that this training program could remediate poor performance in dichotic listening tasks in elderly people. Conclusion: The advantage of this method is that it can be easily done at home and is costeffective. However, further studies are needed to approve the neuroplasticity and structural changes in the brain after the DIID training program in this population. Keywords: Auditory rehabilitation; dichotic training; dichotic listening; elderly; singlesubject study

scholarly journals Contrast-Induced Encephalopathy after Cerebral Angiogram: A Case Series and Review of Literature

2021 ◽  
pp. 405-413
Author(s):  
Cecelia Allison ◽  
Vaibhav Sharma ◽  
Jason Park ◽  
Clemens M. Schirmer ◽  
Ramin Zand
Keyword(s):  
Rare Complication ◽  
General Pattern ◽  
Treatment Protocol ◽  
Case Series ◽  
Altered Mental Status ◽  
Cortical Blindness ◽  
Neurological Deficits ◽  
Cerebral Angiogram ◽  
Iodinated Contrast Medium ◽  
Iodinated Contrast

Contrast-induced encephalopathy (CIE) is a rare complication that arises from exposure to iodinated contrast medium and can result in a range of symptoms, including cortical blindness, aphasia, focal neurological deficits, and altered mental status. We present 4 individual cases of CIE who presented with stroke-mimic symptoms following surgery with localized iodixanol or ioversol injection. We outline a clinical timeline of all patients, showing that CIE follows a general pattern of delayed onset, worsening symptomology, and ultimately full recovery. All patients received IV hydration, corticosteroids, or both as part of their treatment protocol.

Previously reward-associated sounds interfere with goal-directed auditory processing

2021 ◽  
pp. 174702182199003
Author(s):  
Andy J Kim ◽  
David S Lee ◽  
Brian A Anderson
Keyword(s):  
Visual Processing ◽  
Auditory Processing ◽  
Dichotic Listening ◽  
Auditory Information ◽  
Correct Identification ◽  
Subsequent Test ◽  
Dichotic Listening Task ◽  
Listening Task ◽  
Task Irrelevant ◽  
Visual Domain

Previously reward-associated stimuli have consistently been shown to involuntarily capture attention in the visual domain. Although previously reward-associated but currently task-irrelevant sounds have also been shown to interfere with visual processing, it remains unclear whether such stimuli can interfere with the processing of task-relevant auditory information. To address this question, we modified a dichotic listening task to measure interference from task-irrelevant but previously reward-associated sounds. In a training phase, participants were simultaneously presented with a spoken letter and number in different auditory streams and learned to associate the correct identification of each of three letters with high, low, and no monetary reward, respectively. In a subsequent test phase, participants were again presented with the same auditory stimuli but were instead instructed to report the number while ignoring spoken letters. In both the training and test phases, response time measures demonstrated that attention was biased in favour of the auditory stimulus associated with high value. Our findings demonstrate that attention can be biased towards learned reward cues in the auditory domain, interfering with goal-directed auditory processing.

scholarly journals Simultaneous Cranioplasty and External Ventricular Drain Implantation in Patients with Hydrocephalus: Case Series and Literature Review

2021 ◽  
Author(s):  
Lívio Pereira de Macêdo ◽  
Arlindo Ugulino Netto ◽  
Kauê Franke ◽  
Pierre Vansant Oliveira Eugenio ◽  
John Anderson da Silva Rocha ◽  
...  
Keyword(s):  
External Ventricular Drain ◽  
Neurological Complication ◽  
Case Series ◽  
Neurological Deficits ◽  
Time Interval ◽  
Automobile Accidents ◽  
Decompressive Hemicraniectomy ◽  
Cerebral Herniation ◽  
Intraoperative Period ◽  
The Brain

Abstract Introduction The increase in intracranial pressure (ICP) is a neurological complication resulting from numerous pathologies that affect the brain and its compartments. Therefore, decompressive craniectomy (DC) is an alternative adopted to reduce ICP in emergencies, especially in cases refractory to clinical therapies, in favor of patient survival. However, DC is associated with several complications, including hydrocephalus (HC). The present study presents the results of an unusual intervention to this complication: the implantation of an external ventricular drain (EVD) in the intraoperative period of cranioplasty (CP). Methods Patients of both genders who presented with HC and externalization of the brain through the cranial vault after decompressive hemicraniectomy and underwent EVD implantation, to allow the CP procedure, in the same surgical procedure, were included. Results Five patients underwent DC due to a refractory increase in ICP, due to automobile accidents, firearm projectiles, falls from stairs, and ischemic strokes. All evolved with HC. There was no uniform time interval between DC and CP. The cerebrospinal fluid (CSF) was drained according to the need for correction of cerebral herniation in each patient, before undergoing cranioplasty. All patients progressed well, without neurological deficits in the immediate postoperative period. Conclusion There are still several uncertainties about the management of HC resulting from DC. In this context, other CP strategies simultaneous to the drainage of CSF, not necessarily related to ventriculoperitoneal shunt (VPS), should be considered and evaluated more deeply, in view of the verification of efficacy in procedures of this scope, such as the EVD addressed in this study.

scholarly journals Chronic subdural hematomas: a case series from the medical ward of a north Tanzanian referral hospital

2019 ◽  
Vol 34 (1) ◽  
Author(s):  
Sakina Mehboob Rashid ◽  
Shahrzad Seyedeh Deliran ◽  
Marieke Cornelia Johanna Dekker ◽  
William Patrick Howlett
Keyword(s):  
Mortality Rate ◽  
Case Series ◽  
Medical Ward ◽  
Sub Saharan Africa ◽  
Neurological Deficits ◽  
Definitive Treatment ◽  
Delayed Presentation ◽  
General Medical Ward ◽  
Subdural Hematomas ◽  
History Of

Abstract Background Chronic subdural hematomas (CSDH) initially present as focal neurological deficits with or without signs of increased intracranial pressure, for which admission to the general medical ward may occur if they present with poorly understood neurological deficits and no evident history of trauma. The symptoms may be long standing and mimic stroke upon presentation. Their distribution and specific clinical features in sub-Saharan Africa are largely unknown. Methods We describe a series of subdural hematoma (SDH) inpatients from the medical ward of a tertiary referral center in Northern Tanzania, describing clinical and radiological characteristics and providing clinical outcome where possible. Results Our study population numbered 30, with a male majority (n = 19, 63.3%) and a mean age of 66.8 ± 14.5 years. Mean duration from symptom onset to admission in the medical ward was 20.0 ± 30.8 days. History of head injury was reported in only 43.3% of patients. Improvement in the neurological examination was noted in 68.1% of the 22 patients who underwent surgery. The mortality rate was 20.0%. Conclusion A majority of the patients were elderly males and presented late to the hospital. Delayed presentation and diagnosis due to, amongst other reasons, postponed imaging resulted in a prolonged time to definitive treatment and a high mortality rate compared to other regions of the world.

scholarly journals Snake-Eye Myelopathy and Surgical Prognosis: Case Series and Systematic Literature Review

2020 ◽  
Vol 9 (7) ◽  
pp. 2197 ◽  
Author(s):  
Marco Maria Fontanella ◽  
Luca Zanin ◽  
Riccardo Bergomi ◽  
Marco Fazio ◽  
Costanza Maria Zattra ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Literature Review ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Case Series ◽  
Neurological Deficits ◽  
Poor Prognostic Factor ◽  
Surgical Data ◽  
Magnetic Resonance Imaging Mri ◽  
Degenerative Cervical Myelopathy

The prognostic value of “snake-eyes” sign in spinal cord magnetic resonance imaging (MRI) is unclear and the correlation with different pathological conditions has not been completely elucidated. In addition, its influence on surgical outcome has not been investigated in depth. A literature review according to PRISMA (Preferred reporting items for systematic review and meta-analysis protocols) guidelines on the prognostic significance of “snake-eyes” sign in operated patients was performed. Clinical, neuroradiological, and surgical data of three institutional patients, were also retrospectively collected. The three patients, with radiological evidence of “snake-eyes” myelopathy, underwent appropriate surgical treatment for their condition, with no new post-operative neurological deficits and good outcome at follow-up. The literature review, however, reported conflicting results: the presence of “snake-eyes” sign seems a poor prognostic factor in degenerative cervical myelopathy, even if some cases can improve after surgery. “Snake-eyes” myelopathy represents a rare form of myelopathy; pathophysiology is still unclear. The frequency of this myelopathy may be greater than previously thought and according to our literature review it is mostly a negative prognostic factor. However, from our experience, prognosis might not be so dire, especially when tailored surgical intervention is performed; therefore, surgery should always be considered and based on the complete clinical, neurophysiological, and radiological data.

Auditory Temporal Gap Detection in Children with and without Auditory Processing Disorder

2010 ◽  
Vol 21 (06) ◽  
pp. 404-408 ◽  
Author(s):  
Dennis P. Phillips ◽  
Michel Comeau ◽  
Jessica N. Andrus
Keyword(s):  
Auditory Processing ◽  
Silent Period ◽  
Analysis Data ◽  
Auditory Processing Disorder ◽  
Gap Detection ◽  
Temporal Acuity ◽  
Normal Children ◽  
Modified Method ◽  
Simple Event ◽  
Data Collection And Analysis

Background: Auditory gap detection is a measure of temporal acuity. The paradigm comes in two forms, distinguished by whether the sounds bounding the silent period are the same (within channel [WC]) or different (between channel [BC]). Purpose: The purpose of this study was to test normal children and children referred for auditory processing disorder (APD) assessment, with both gap detection paradigms. Research Design: Best gap durations (i.e., shortest reliably detected gaps) were measured in a two-interval, two-alternative forced-choice design embedded within a modified method of limits, for both WC and BC paradigms, with stimuli presented at 55 dB HL. Study Sample: Sixteen control children and 20 children referred for APD assessment participated in the study. Of the 20 referred children, 9 were diagnostically positive for APD (APD+), and 11 were negative (APD−). The mean age of children in all three groups was 10–11 yr. Data Collection and Analysis: Data collected were best gap durations for each paradigm, for each child. Group differences were assessed using Kruskal-Wallis analyses of variance. Results: WC best gap durations were very similar across the three participant groups. BC best gap durations varied significantly between listener groups, with the greatest difference being between controls and APD+ samples. Conclusions: BC best gap durations differed among the listener groups while WC ones did not. This suggests that the relative timing perceptual operations required by the BC task are more susceptible to the perceptual disturbances in APD than is the simple event detection required by the WC task.

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