Clinical and diagnostic characteristics of cochleovestibular function in patients of active working age after exposure to stress

Topicality: Long-term and pronounced psychoemotional tension leads to negative changes in the human body. Many aspects of cochleovestibular changes caused by psychoemotional stress are not studied enough to date. Aim: to increase the diagnostic efficiency of auditory and vestibular disorders in patients of active working age after exposure to stress. Materials and methods: 95 patients of active working age with dizziness, which manifested under stress, and 10 persons of control group were studied. The following tests were performed to all patients: survey with the questionnaire "Comprehensive stress assessment", pure tone and speech audiometry, measurement with filtered speech discrimination tests, assessment of the auditory adaptation level, impedancemetry, registration of auditory brainstem responses (ABR), computed static posturography, vestibular testing. Results and discussion: All subjects were divided into three groups according to the results of the survey with the questionnaire "Comprehensive stress assessment": Group 1 included 21 patients with moderate stress, Group 2 included 35 persons with severe stress that could not be compensated and Group 3 included 39 persons under severe stress, moreover 10 of them were on the verge of exhaustion of adaptive capacities. 60 (63.2 %) patients had normal hearing. 24 (25.2 %) subjects had statistically significant (P <0.05) hearing impairment in the high frequency zone compared with the control group, a statistically significant difference in hearing impairment was detected in the entire frequency range in 11 (11.6 %) persons. Central auditory processing disorders were detected in more than half of patients (according to various tests – from 29 (30.5 %) to 49 (51.6 %) persons). Central vestibular syndrome of varying severity was diagnosed in all 95 patients. The most pronounced disorders of balance according to posturography have been reported in patients with severe stress with vision deprivation in the position with closed eyes. Conclusions: An integrated approach allowed to identify and select, besides traditional research methods, supplementary diagnostic measures for optimal assessment of cochleovestibular changes in patients of active working age after exposure to stress, to detect cochleovestibular disorders and differential topical diagnostics of disorders of the central or peripheral portions of the auditory and vestibular analyzers. These included psychological testing, a test battery to determine central auditory processing disorders – hearing adaptation with load, filtered speech discrimination tests, registration of ABR, registration of postural balance using the Wii Balance Board platform, vestibular testing.

Growth Hormone and the Auditory Pathway: Neuromodulation and Neuroregeneration

Growth hormone (GH) plays an important role in auditory development during the embryonic stage. Exogenous agents such as sound, noise, drugs or trauma, can induce the release of this hormone to perform a protective function and stimulate other mediators that protect the auditory pathway. In addition, GH deficiency conditions hearing loss or central auditory processing disorders. There are promising animal studies that reflect a possible regenerative role when exogenous GH is used in hearing impairments, demonstrated in in vivo and in vitro studies, and also, even a few studies show beneficial effects in humans presented and substantiated in the main text, although they should not exaggerate the main conclusions.

Auditory training in auditory processing disorders (APD)

Auditory processing disorders (APD) are characterized by a reduction in the efficiency of auditory processing, which results in a deficit in identifying and interpreting sounds by the brain. In 2017, auditory processing disorders were awarded an individual diagnostic code. Symptoms that indicate the presence of auditory processing disorders are numerous and non-specific. The primary symptom of impaired auditory processing is difficulty understanding speech in noise. This disorder affects about 5-7% of children. Most often, the result of at least two tests included in the set is considered to be the determinant which constitutes the basis for the diagnosis of disorders. In the diagnostic and therapeutic process of children with auditory processing disorders, the correct diagnosis is of key importance, thanks to which it will be possible to conduct an appropriate treatment. All therapeutic methods, tasks activating auditory perception and language skills should be selected reliably, individually for each participant of the therapy. The use of the so-called auditory training during corrective-compensatory and speech therapy classes in children with central auditory processing disorders should be the standard. It is the main method of treating children with central hearing impairment. Auditory training includes auditory education based on stimulating child’s auditory predispositions and on developing the ability to use them in order to gain better orientation in the environment. At present, therapists in Poland may use various types of therapeutic interactions that have a positive impact on the development of a child’s hearing skills. The aim of the work is to discuss auditory training and to present speech therapy exercises helpful in the therapeutic process of children with auditory processing disorders.

Event related potentials in cases of amblyaudia

<p class="abstract"><strong>Background:</strong> Amblyaudia is a weakness in the listener’s binaural processing of auditory information. Subjects with amblyaudia also demonstrate binaural integration deficits and may display similar patterns in their evoked responses in terms of latency and amplitude of these responses. The purpose of this study was to identify the presence of amblyaudia in a population of young children subjects and to measure mismatch negativity (MMN), P300 and cortical auditory evoked potentials (CAEPs) for those individuals.</p><p class="abstract"><strong>Methods:</strong> Subjects included in this study were divided into 2 groups control group that consisted of 20 normal hearing subjects with normal developmental milestones and normal speech development. The study group (GII) consisted of 50 subjects with central auditory processing disorders (CAPDs) diagnosed by central auditory screening tests. </p><p class="abstract"><strong>Results:</strong> With using dichotic tests including dichotic digits test (DDT) and competing sentence test (CST), we could classify these cases into normal, dichotic dysaudia, amblyaudia, and amblyaudia plus with percentages (40%, 14%, 38%, 8% respectively). Using event related potentials, we found that P300 and MMN are more specific in detecting neurocognitive dysfunction related to allocation of attentional resources and immediate memory in these cases.</p><p class="abstract"><strong>Conclusions:</strong> The presence of amblyaudia in cases of central auditory processing disorders (CAPDs) and event related potentials is an objective tool for diagnosis, prognosis and follow up after rehabilitation.</p>

Time-compressed speech test in adults with and without central auditory processing disorders

ABSTRACT Purpose: to analyze and compare the performance in the time-compressed speech test and the auditory behavior of adults with and without central auditory processing disorders. Methods: an observational, analytical, cross-sectional study with a total of 40 people of both genders aged 18 to 35 years participating in the study. They were submitted to anamnesis, basic audiological assessment, and a core battery of tests for central auditory processing - including the dichotic digits test (binaural integration), frequency pattern test, and time-compressed speech test (TCST). Based on the results of the dichotic digits and frequency pattern tests, the subjects were divided into two groups, with and without central auditory processing disorders. The auditory behavior was assessed with the Scale of Auditory Behavior (SAB) questionnaire. The Mann-Whitney and Fisher’s exact tests were used for the statistical analysis, setting the significance level at p < 0.05. Results: no difference in performance was found between the groups regarding the ears. There was a difference between the groups only in the time-compressed speech test with monosyllable stimuli in the left ear (p = 0.026). Monosyllables were the words that resulted in most errors. Conclusion: it was verified that only the list of stimuli influenced the performance, differing the individuals with and without central auditory processing disorders. There was an association of auditory behavior, analyzed with the SAB questionnaire, with the performance in the TCST with the list of monosyllables. It is suggested that this list be used when assessing adults by the time-compressed speech test.