Frontal brain asymmetries as effective parameters to assess the quality of audiovisual stimuli perception in adult and young cochlear implant users

How is music perceived by cochlear implant (CI) users? This question arises as "the next step" given the impressive performance obtained by these patients in language perception. Furthermore, how can music perception be evaluated beyond self-report rating, in order to obtain measurable data? To address this question, estimation of the frontal electroencephalographic (EEG) alpha activity imbalance, acquired through a 19-channel EEG cap, appears to be a suitable instrument to measure the approach/withdrawal (AW index) reaction to external stimuli. Specifically, a greater value of AW indicates an increased propensity to stimulus approach, and vice versa a lower one a tendency to withdraw from the stimulus. Additionally, due to prelingually and postlingually deafened pathology acquisition, children and adults, respectively, would probably differ in music perception. The aim of the present study was to investigate children and adult CI users, in unilateral (UCI) and bilateral (BCI) implantation conditions, during three experimental situations of music exposure (normal, distorted and mute). Additionally, a study of functional connectivity patterns within cerebral networks was performed to investigate functioning patterns in different experimental populations. As a general result, congruency among patterns between BCI patients and control (CTRL) subjects was seen, characterised by lowest values for the distorted condition (vs. normal and mute conditions) in the AW index and in the connectivity analysis. Additionally, the normal and distorted conditions were significantly different in CI and CTRL adults, and in CTRL children, but not in CI children. These results suggest a higher capacity of discrimination and approach motivation towards normal music in CTRL and BCI subjects, but not for UCI patients. Therefore, for perception of music CTRL and BCI participants appear more similar than UCI subjects, as estimated by measurable and not self-reported parameters

Ruolo della stimolazione bimodale nello sviluppo delle abilità percettivo-uditive nei bambini con impianto cocleare monolaterale

Il presente studio prospettico randomizzato ha lo scopo di valutare le differenze che emergono tra una stimolazione bimodale e una elettrica monolaterale nei bambini sordi, in particolare in termini di sviluppo delle abilità percettivo-uditive. Sono stati arruolati 39 bambini di età compresa tra i 12 e 36 mesi di vita, affetti da ipoacusia neurosensoriale bilaterale severo-profonda con residui uditivi in almeno un orecchio. Tutti i pazienti sono stati sottoposti a impianto cocleare monolaterale: 21 di questi indossavano solo l’impianto (stimolazione elettrica monolaterale, Gruppo 1) mentre i restanti 18 utilizzavano l’impianto da una parte e la protesi acustica controlaterale dall’altra (stimolazione bimodale, Gruppo 2). Ciascuno di questi pazienti è stato sottoposto a una batteria di test progettata per valutare le abilità percettivo-uditive preverbali e verbali immediatamente prima e a distanza di 6 e 12 mesi dall’intervento di impianto cocleare. Non si è apprezzata una differenza statisticamente significativa tra i gruppi al tempo 0, mentre a 6 e 12 mesi dall’impianto i pazienti con stimolazione bimodale ottenevano in ogni test somministrato prestazioni migliori del gruppo con sola stimolazione elettrica monolaterale. Di conseguenza, nonostante la sordità/udito monolaterale non infici l’acuità uditiva in situazioni d’ascolto semplici, l’uso contemporaneo dell’impianto e della protesi (udito binaurale attraverso una stimolazione bimodale) garantisce un vantaggio nella acquisizione delle abilità percettivo-uditive, consistente nel raggiungimento delle tappe dello sviluppo percettivo più velocemente e in maggiore quantità rispetto ai bambini con solo un impianto cocleare. Perciò, mantenere attiva la rete nervosa uditiva controlaterale, anche se non dominante nel determinare l’acuità uditiva, garantisce dei benefici rispetto al non uso del dispositivo. Queste informazioni possono rappresentare un’evidenza iniziale per stabilire linee guida condivise per la migliore gestione riabilitativa dei pazienti sottoposti a intervento di impianto cocleare, e possibilmente fornire un’evidenza scientifica solida al fine di una indicazione certa all’impianto cocleare bilaterale

Recurrence, Reactivation, or Inflammatory Rebound of SARS-CoV-2 Infection With Acute Vestibular Symptoms: A Case Report and Revision of Literature

A case of recurrent coronavirus disease 2019 (COVID-19) with neurovestibular symptoms was reported. In March 2020, a physician working in an Italian pediatric hospital had flu-like symptoms with anosmia and dysgeusia, and following a reverse transcription PCR (RT/PCR) test with a nasopharyngeal swab tested positive for SARS-CoV-2. After home quarantine, 21 days from the beginning of the symptoms, the patient tested negative in two subsequent swabs and was declared healed and readmitted to work. Serological testing showed a low level of immunoglobulin G (IgG) antibody title and absence of immunoglobulin M (IgM). However, 2 weeks later, before resuming work, the patient complained of acute vestibular syndrome, and the RT/PCR test with mucosal swab turned positive. On the basis of the literature examined and reviewed for recurrence cases and vestibular symptoms during COVID-19, to our knowledge this case is the first case of recurrence with vestibular impairment as a neurological symptom, and we defined it as probably a viral reactivation. The PCR retest positivity cannot differentiate re-infectivity, relapse, and dead-viral RNA detection. Serological antibody testing and viral genome sequencing could be always performed in recurrence cases

Higher Right Hemisphere Gamma Band Lateralization and Suggestion of a Sensitive Period for Vocal Auditory Emotional Stimuli Recognition in Unilateral Cochlear Implant Children: An EEG Study

In deaf children, huge emphasis was given to language; however, emotional cues decoding and production appear of pivotal importance for communication capabilities. Concerning neurophysiological correlates of emotional processing, the gamma band activity appears a useful tool adopted for emotion classification and related to the conscious elaboration of emotions. Starting from these considerations, the following items have been investigated: (i) whether emotional auditory stimuli processing differs between normal-hearing (NH) children and children using a cochlear implant (CI), given the non-physiological development of the auditory system in the latter group; (ii) whether the age at CI surgery influences emotion recognition capabilities; and (iii) in light of the right hemisphere hypothesis for emotional processing, whether the CI side influences the processing of emotional cues in unilateral CI (UCI) children. To answer these matters, 9 UCI (9.47 ± 2.33 years old) and 10 NH (10.95 ± 2.11 years old) children were asked to recognize nonverbal vocalizations belonging to three emotional states: positive (achievement, amusement, contentment, relief), negative (anger, disgust, fear, sadness), and neutral (neutral, surprise). Results showed better performances in NH than UCI children in emotional states recognition. The UCI group showed increased gamma activity lateralization index (LI) (relative higher right hemisphere activity) in comparison to the NH group in response to emotional auditory cues. Moreover, LI gamma values were negatively correlated with the percentage of correct responses in emotion recognition. Such observations could be explained by a deficit in UCI children in engaging the left hemisphere for more demanding emotional task, or alternatively by a higher conscious elaboration in UCI than NH children. Additionally, for the UCI group, there was no difference between the CI side and the contralateral side in gamma activity, but a higher gamma activity in the right in comparison to the left hemisphere was found. Therefore, the CI side did not appear to influence the physiologic hemispheric lateralization of emotional processing. Finally, a negative correlation was shown between the age at the CI surgery and the percentage of correct responses in emotion recognition and then suggesting the occurrence of a sensitive period for CI surgery for best emotion recognition skills development

Seismic behaviour and design of innovative hybrid coupled shear walls

In this work innovative hybrid coupled shear walls (HCSW) are considered, their design is discussed, their efficiency and limitations evaluated by means of nonlinear static (pushover) analysis. Different numbers of storeys, wall geometries and design assumptions are studied in order to give an overview of situations of interest in European seismic prone areas. This study is part of a larger research project named INNO-HYCO (INNOvative HYbrid and COmposite steel-concrete structural solutions for building in seismic area) funded by the European Commission

Predictive role of audiological and clinical features for functional results after stapedotomy

OBJECTIVE: To analyze and compare the preoperative factors that potentially influence the outcome of stapedotomy in our study group. MATERIALS AND METHODS: 161 cases were enrolled. Clinical variables considered to influence functional results - air conduction (AC) and bone conduction (BC) pure-tone average (PTA), air-bone gaps (ABG), sensorineural hearing loss (SNHL), ABG gain and DeltaSNHL - were gender, age, case type (unilateral vs. bilateral), ear side (right vs. left), pregnancy, vascular disease and family history of otosclerosis. The audiometric variables were preoperative AC- and BC-PTA, SNHL and ABG. RESULTS: Univariate logistic regression analysis showed that the probability of obtaining a > or =10 dB gain is significantly affected by the following factors: age or =50 dB and preoperative ABG > or =30 dB. All the other factors included into the registration (gender, familiarity, side, bilateral vs. unilateral, pregnancy, vascular diseases and preoperative BC-PTA) were not found to significantly affect postoperative gain (p > 0.05). Nevertheless, multivariate logistic regression analysis maintained a statistically significant correlation only between gain > or =10 dB and both preoperative ABG > or =30 dB and age <50 years. CONCLUSIONS: The accurate knowledge of predictive factors is a valuable tool that permits the surgeon to plan surgery with a better case selection as well as assisting in counseling the patient with regard to the likelihood of success of the procedure

Alpha EEG Frontal Asymmetries during Audiovisual Perception in Cochlear Implant Users. A Study with Bilateral and Unilateral Young Users

The aim of the present study is to investigate the variations of the electroencephalographic (EEG) alpha rhythm in order to measure the appreciation of bilateral and unilateral young cochlear implant users during the observation of a musical cartoon. The cartoon has been modified for the generation of three experimental conditions: one with the original audio, another one with a distorted sound and, finally, a mute version

ENT Function in a 14-Days Guinness Scuba Dive.

Scuba diving is known to affect the rhino-pharyngo-tubaric district (RPT unit). The aim of the study was to document function modifications of the RPT unit in 6 Italian divers (3 men and 3 women) who lived for 14 days consecutively at a depth of 8-10 m, breathing air (21% oxygen) at a pressure ranging between 1.8 and 2 ATA. RPT and inner ear assessment were carried out before the dive (TIME 0) and 24 h (TIME 1) after resurfacing, in order to investigate diving-related RPT and inner ear alterations. Physical examination after resurfacing revealed: fungal external otitis, otoscopic findings consistent with middle ear barotraumas and rhinosinusitis. Rhino-manometry showed a remarkable increase in inspiratory nasal flow and a substantial decrease in nasal resistance. No epithelial cell disruption was retrieved comparing pre and post resurfacing samples. Post-diving tubaric dysfunction was found. Pure tone audiometry revealed a bilateral 40 dB HL hearing loss at 4 kHz in 1 diver. Relevant PTA functions did not seem to be affected by the experiment, no remarkable changes were found at the Sensory Organisation Test and at the Motor Control Test. The 14-day underwater period had a positive effect on nasal flows and resistances