Υπερακουσία : ανασκόπηση των παθοφυσιολογικών μηχανισμών

Εισαγωγή: Οι διαταραχές της ακουστότητας αποτελούν ένα σοβαρό κλινικό πρόβλημα τόσο για τον Ωτολόγο-Ακοολόγο όσο και για τον ασθενή. Ανάμεσα σε πολλούς ορισμούς, η Υπερακουσία ορίζεται ως “Δυσανεξία σε συνηθισμένους καθημερινούς ήχους”, αν και ακόμα και η βασική ορολογία και οι ορισμοί που χρησιμοποιούνται εμφανίζουν μεγάλη ποικιλία, σε αυτό το ερευνητικό πεδίο που κυρίως τις τελευταίες δεκαετίες προσελκύει ερευνητικό ενδιαφέρον. Η υπερακουσία μπορεί να εμφανιστεί μεμονωμένα, αλλά πιο συχνά συνυπάρχει με εμβοές και άλλα μη ωτολογικά συμπτώματα. Έχει πολλούς πιθανούς παθοφυσιολογικούς μηχανισμούς που δεν αποκλείουν ο ένας τον άλλο. Συσχετίζεται και με περιφερικές και με κεντρικές διαταραχές, όπως και οι εμβοές και η βαρηκοΐα. Σε αυτήν την ανασκόπηση επιχειρούμε να καταγράψουμε τα σύγχρονα δεδομένα για την παθοφυσιολογία της υπερακουσίας, σε σχέση με συνυπάρχουσες παθήσεις ή ως μεμονώμένο σύμπτωμα. Μέθοδος: Οι μελέτες θα επιλεγούν με βάση τα ακόλουθα κριτήρια: Μελέτες που επικεντρώνονται στους μηχανισμούς της υπερακουσίας σε ασθενείς που έχουν μόνο υπερακουσία ή υπερακουσία ως πρωταρχικό σύμπτωμα ή ως μέρος μιας ομάδας συμπτωμάτων. Μελέτες με πειραματόζωα συμπεριλαμβάνονται στην αναζήτηση εφόσον εστιάζουν στην παθοφυσιολογία. Οι βάσεις δεδομένων που χρησιμοποιήθηκαν είναι οι Medline και GoogleScholar. Προκειμένου να συμπεριληφτούν όσες περισσότερες σχετικές μελέτες, έγινε και προσωπική μη αυτόματη αναζήτηση σχετικών εργασιών, οι οποίες είχαν τον όρο υπερακουσία και εστίαζαν σε κάποιον παθογενετικό μηχανισμό. Όλοι οι τύποι μελετών με διαθέσιμο πλήρες κείμενο συμπεριλήφτηκαν στην διαδικασία αναζήτησης. Μελέτες που δημοσιεύθηκαν τα τελευταία 10 έτη σε αγγλική γλώσσα (Medline και GoogleScholar) συμπεριελήφθησαν. Αποτελέσματα: Συγχρονα δεδομένα σχετικά με την ορολογία, διερεύνηση και αντιμετώπιση της υπερακουσίας καταγράφονται. Πρόσφατα δεδομένα για την ανατομία και φυσιολογία του έσω ωτός και την φυσιολογία της υποκειμενικής αίσθησης ακουστότητας των ήχων θα αναλυθουν εν συντομία. Περιφερικοί και κεντρικοί παθοφυσιολογικοί μηχανισμοί που συμμετέχουν στην υπερακουσία και συγκεκριμένες αιτίες καταγράφονται και αναλύονται. Συζήτηση: Η σύγχρονη βιβλιογραφία υποδεικνύει ότι διαφορετικές μορφές υπερακουσίας προκαλούνται από διαφορετικούς παθογενετικούς μηχανισμούς. Στους περισσότερους ασθενείς με υπερακουσία δεν μπορεί να βρεθεί συγκεκριμένη αιτία. Οι αιτίες μπορούν να χωριστούν σε τρείς κατηγορίες : α) περιφερική ακουστική διαταραχή β) κεντρική ακουστική διαταραχή γ) άλλες κατηγορίες . Οι μεταβολές των ακουστικών ερεθισμάτων εξαιτίας βαρηκοΐας (που καταγράφεται ή όχι στο τονικό ακοόγραμμα) δημιουργούν μηχανισμούς ενίσχυσης του ακουστικού κέρδους εντός των κεντρικών ακουστικών οδών, και αποτελούν σημαντικό παθοφυσιολογικό μηχανισμό της υπερακουσίας. Συμπεράσματα: Η κατανόηση της περίπλοκης παθοφυσιολογίας της υπερακουσίας αποτελεί τη βάση για την κατηγοριοποίηση των ασθενών σε ομοιογενείς ομάδες με διακριτά κλινικά χαρακτηριστικά, και επομένως θα διευκολύνει την ανάπτυξη νέων θεραπευτικών μέσων για αυτή την ιδιαίτερη παθολογία της ακοής.Introduction : Dysregulation of loudness perception can represent a serious clinical problem for both the Otologist-Audiologist and the patient. Among several definitions, hyperacusis can be defined as “intolerance to ordinary environmental sounds”, although even basic terminology and definitions that are used present important variation in this research area, which mainly the last few decades attracts more research interest. Hyperacusis can take place as the only complaint, but more frequently it co-exists with tinnitus and other non otological symptoms. Hyperacusis has several potential mechanisms which are not mutually exclusive; Hyperacusis can probably be associated with both peripheral and central mechanisms, which is similar to tinnitus and hearing loss. In this review we try to summarise what is known of hyperacusis pathophysiology, as related to specific medical conditions or as a sole presenting symptom. Methods: Studies will be selected according to the following criteria: Studies focused on the mechanisms of hyperacusis in patients complaining for hyperacusis only or hyperacusis as the primary complaint or as a symptom of a non otological syndrome. Animal studies trying to identify a potential mechanism of hyperacusis were included as well. Medline and Google Scholar will be searched for eligible studies. In addition, to include as many relevant studies as possible, manual searches of any relevant article which had hyperacusis and a possible mechanism/cause in the title was performed. All type of studies with full-text availability will be included in the research process. There will be restriction concerning the year of publication, including publications of the last 10 years (for Medline and Google Scholar) . Only studies published in English will be included. Outcomes: Updated data regarding the terminology, assessment, and management of hyperacusis will be presented . Recent knowledge for the anatomy and physiology of the inner ear and the process of loudness neural encoding will be briefly reviewed. Peripheral and central mechanisms leading to the generation of hyperacusis and specific causes of hyperacusis related to pathophysiology is analysed. Discussion: Current evidence suggests that different forms of hyperacusis may be mediated by distinct mechanisms. In most patients with hyperacusis, no specific medical cause can be diagnosed. In patients with hyperacusis as part of a symptoms set, possible causes of hyperacusis can be divided into three different groups: a) peripheral auditory system disorders b) central nervous system disorders c) other groups of causes. Changes to auditory input due to hearing loss (including hidden hearing loss) can lead to mechanisms of enhancement of central gain which is described as an important mechanism for loudness hyperacusis. Conclusion: The understanding of pathophysiological basis of hyperacusis, although complex, will facilitate researchers to categorise patients in distinct homogeneous groups with different characteristics ,and thus will help the development of novel therapies for this often devastating disorder

Single-field inflation in models with an R^2 term

We present two cases where the addition of the R^2 term to an inflationary model leads to single-field inflation instead of two-field inflation as is usually the case. In both cases we find that the effect of the R^2 term is to reduce the value of the tensor-to-scalar ratio r

gCube 4.2.0 - RRModel v. 1.9.0

The gCube System - RRModel -------------------------------------------------- Resource Registry Model This software is part of the gCube Framework (https://www.gcube-system.org/): an open-source software toolkit used for building and operating Hybrid Data Infrastructures enabling the dynamic deployment of Virtual Research Environments by favouring the realisation of reuse oriented policies. The projects leading to this software have received funding from a series of European Union programmes including: * the Sixth Framework Programme for Research and Technological Development - DILIGENT (grant no. 004260); * the Seventh Framework Programme for research, technological development and demonstration - D4Science (grant no. 212488), D4Science-II (grant no. 239019),ENVRI (grant no. 283465), EUBrazilOpenBio (grant no. 288754), iMarine (grant no. 283644); * the H2020 research and innovation programme - BlueBRIDGE (grant no. 675680), EGIEngage (grant no. 654142), ENVRIplus (grant no. 654182), Parthenos (grant no. 654119), SoBigData (grant no. 654024); Version -------------------------------------------------- 1.9.0-4.2.0-126259 (2016-12-15) Please see the file named "changelog.xml" in this directory for the release notes. Authors -------------------------------------------------- * Giorgos Papanikos (g.papanikos-AT-di.uoa.gr), University of Athens, Department of Informatics and Telecommunications. * Gerasimos Farantatos (g.farantatos-AT-di.uoa.gr), University of Athens, Department of Informatics and Telecommunications. Maintainers ----------- * Nikolas Laskaris (laskarisn-AT-di.uoa.gr), National Kapodistrian University of Athens, Department Informatics. Download information -------------------------------------------------- Source code is available from SVN: http://svn.research-infrastructures.eu/public/d4science/gcube/trunk/resource-registry/RRModel Binaries can be downloaded from the gCube website: https://www.gcube-system.org/ Installation -------------------------------------------------- Installation documentation is available on-line in the gCube Wiki: https://wiki.gcube-system.org/gcube/index.php Documentation -------------------------------------------------- Documentation is available on-line in the gCube Wiki: https://gcube.wiki.gcube-system.org/gcube/index.php/Resource_Registry Support -------------------------------------------------- Bugs and support requests can be reported in the gCube issue tracking tool: https://support.d4science.org/projects/gcube/ Licensing -------------------------------------------------- This software is licensed under the terms you may find in the file named "LICENSE" in this directory

gCube 4.3.0 - RRModel v. 1.9.0

<p> The gCube System - RRModel<br> --------------------------------------------------<br> <br> Resource Registry Model<br> <br> <br> This software is part of the gCube Framework (https://www.gcube-system.org/): an<br> open-source software toolkit used for building and operating Hybrid Data<br> Infrastructures enabling the dynamic deployment of Virtual Research Environments<br> by favouring the realisation of reuse oriented policies.<br> <br> The projects leading to this software have received funding from a series of <br> European Union programmes including: <br> * the Sixth Framework Programme for Research and Technological Development - <br> DILIGENT (grant no. 004260); <br> * the Seventh Framework Programme for research, technological development and <br> demonstration - D4Science (grant no. 212488), D4Science-II (grant no. <br> 239019),ENVRI (grant no. 283465), EUBrazilOpenBio (grant no. 288754), iMarine <br> (grant no. 283644); <br> * the H2020 research and innovation programme - BlueBRIDGE (grant no. 675680), <br> EGIEngage (grant no. 654142), ENVRIplus (grant no. 654182), Parthenos (grant <br> no. 654119), SoBigData (grant no. 654024);<br> <br> <br> Version<br> --------------------------------------------------<br> <br> 1.9.0-4.3.0-126259 (2017-03-19)<br> <br> Please see the file named "changelog.xml" in this directory for the release notes.<br> <br> <br> Authors<br> --------------------------------------------------<br> <br> * Giorgos Papanikos (g.papanikos-AT-di.uoa.gr), University of Athens, <br> Department of Informatics and Telecommunications.<br> <br> * Gerasimos Farantatos (g.farantatos-AT-di.uoa.gr), University of Athens, <br> Department of Informatics and Telecommunications.<br> <br> Maintainers<br> -----------<br> <br> * Nikolas Laskaris (laskarisn-AT-di.uoa.gr),<br> National Kapodistrian University of Athens, Department Informatics.<br> <br> <br> Download information<br> --------------------------------------------------<br> <br> Source code is available from SVN: <br> http://svn.research-infrastructures.eu/public/d4science/gcube/trunk/resource-registry/RRModel<br> <br> Binaries can be downloaded from the gCube website: <br> https://www.gcube-system.org/<br> <br> <br> Installation<br> --------------------------------------------------<br> <br> Installation documentation is available on-line in the gCube Wiki:<br> https://wiki.gcube-system.org/gcube/index.php<br> <br> <br> Documentation <br> --------------------------------------------------<br> <br> Documentation is available on-line in the gCube Wiki:<br> https://gcube.wiki.gcube-system.org/gcube/index.php/Resource_Registry<br> <br> Support <br> --------------------------------------------------<br> <br> Bugs and support requests can be reported in the gCube issue tracking tool:<br> https://support.d4science.org/projects/gcube/<br> <br> <br> Licensing<br> --------------------------------------------------<br> <br> This software is licensed under the terms you may find in the file named "LICENSE" in this directory.<br> </p

gCube 4.2.1 - RRModel v. 1.9.0

<p> The gCube System - RRModel<br> --------------------------------------------------<br> <br> Resource Registry Model<br> <br> <br> This software is part of the gCube Framework (https://www.gcube-system.org/): an<br> open-source software toolkit used for building and operating Hybrid Data<br> Infrastructures enabling the dynamic deployment of Virtual Research Environments<br> by favouring the realisation of reuse oriented policies.<br> <br> The projects leading to this software have received funding from a series of <br> European Union programmes including: <br> * the Sixth Framework Programme for Research and Technological Development - <br> DILIGENT (grant no. 004260); <br> * the Seventh Framework Programme for research, technological development and <br> demonstration - D4Science (grant no. 212488), D4Science-II (grant no. <br> 239019),ENVRI (grant no. 283465), EUBrazilOpenBio (grant no. 288754), iMarine <br> (grant no. 283644); <br> * the H2020 research and innovation programme - BlueBRIDGE (grant no. 675680), <br> EGIEngage (grant no. 654142), ENVRIplus (grant no. 654182), Parthenos (grant <br> no. 654119), SoBigData (grant no. 654024);<br> <br> <br> Version<br> --------------------------------------------------<br> <br> 1.9.0-4.2.1-126259 (2017-02-12)<br> <br> Please see the file named "changelog.xml" in this directory for the release notes.<br> <br> <br> Authors<br> --------------------------------------------------<br> <br> * Giorgos Papanikos (g.papanikos-AT-di.uoa.gr), University of Athens, <br> Department of Informatics and Telecommunications.<br> <br> * Gerasimos Farantatos (g.farantatos-AT-di.uoa.gr), University of Athens, <br> Department of Informatics and Telecommunications.<br> <br> Maintainers<br> -----------<br> <br> * Nikolas Laskaris (laskarisn-AT-di.uoa.gr),<br> National Kapodistrian University of Athens, Department Informatics.<br> <br> <br> Download information<br> --------------------------------------------------<br> <br> Source code is available from SVN: <br> http://svn.research-infrastructures.eu/public/d4science/gcube/trunk/resource-registry/RRModel<br> <br> Binaries can be downloaded from the gCube website: <br> https://www.gcube-system.org/<br> <br> <br> Installation<br> --------------------------------------------------<br> <br> Installation documentation is available on-line in the gCube Wiki:<br> https://wiki.gcube-system.org/gcube/index.php<br> <br> <br> Documentation <br> --------------------------------------------------<br> <br> Documentation is available on-line in the gCube Wiki:<br> https://gcube.wiki.gcube-system.org/gcube/index.php/Resource_Registry<br> <br> Support <br> --------------------------------------------------<br> <br> Bugs and support requests can be reported in the gCube issue tracking tool:<br> https://support.d4science.org/projects/gcube/<br> <br> <br> Licensing<br> --------------------------------------------------<br> <br> This software is licensed under the terms you may find in the file named "LICENSE" in this directory.<br> </p

gCube 4.1.1 - RRConfProviderWebService v. 1.0.0

<p> The gCube System - RRConfProviderWebService<br> --------------------------------------------------<br> <br> Resource Registry Configuration Provider Web Service<br> <br> <br> This software is part of the gCube Framework (https://www.gcube-system.org/): an<br> open-source software toolkit used for building and operating Hybrid Data<br> Infrastructures enabling the dynamic deployment of Virtual Research Environments<br> by favouring the realisation of reuse oriented policies.<br> <br> The projects leading to this software have received funding from a series of <br> European Union programmes including: <br> * the Sixth Framework Programme for Research and Technological Development - <br> DILIGENT (grant no. 004260); <br> * the Seventh Framework Programme for research, technological development and <br> demonstration - D4Science (grant no. 212488), D4Science-II (grant no. <br> 239019),ENVRI (grant no. 283465), EUBrazilOpenBio (grant no. 288754), iMarine <br> (grant no. 283644); <br> * the H2020 research and innovation programme - BlueBRIDGE (grant no. 675680), <br> EGIEngage (grant no. 654142), ENVRIplus (grant no. 654182), Parthenos (grant <br> no. 654119), SoBigData (grant no. 654024);<br> <br> <br> Version<br> --------------------------------------------------<br> <br> 1.0.0-4.1.1-126429 (2016-12-15)<br> <br> Please see the file named "changelog.xml" in this directory for the release notes.<br> <br> <br> Authors<br> --------------------------------------------------<br> <br> * Alex Antoniadis (a.antoniadis-AT-di.uoa.gr), University of Athens, <br> Department of Informatics and Telecommunications.<br> <br> Maintainers<br> ------------------------<br> <br> Download information<br> --------------------------------------------------<br> <br> Source code is available from SVN: <br> http://svn.research-infrastructures.eu/public/d4science/gcube/branches/resource-registry/rrconfprovider-webservice/1.0/rrconfprovider-webservice<br> <br> Binaries can be downloaded from the gCube website: <br> https://www.gcube-system.org/<br> <br> <br> Installation<br> --------------------------------------------------<br> <br> Installation documentation is available on-line in the gCube Wiki:<br> https://wiki.gcube-system.org/gcube/index.php<br> <br> Documentation <br> --------------------------------------------------<br> <br> Documentation is available on-line in the gCube Wiki:<br> https://wiki.gcube-system.org/gcube/index.php<br> <br> Support <br> --------------------------------------------------<br> <br> Bugs and support requests can be reported in the gCube issue tracking tool:<br> https://support.d4science.org/projects/gcube/<br> <br> <br> Licensing<br> --------------------------------------------------<br> <br> This software is licensed under the terms you may find in the file named "LICENSE" in this directory.<br> </p

gCube 4.1.1 - resourceregistry-configuration-vo-nonupdaters v. 1.0.0

<p> The gCube System - resourceregistry-configuration-vo-nonupdaters<br> --------------------------------------------------<br> <br> ResourceRegistry Configuation VO nonupdaters<br> <br> <br> This software is part of the gCube Framework (https://www.gcube-system.org/): an<br> open-source software toolkit used for building and operating Hybrid Data<br> Infrastructures enabling the dynamic deployment of Virtual Research Environments<br> by favouring the realisation of reuse oriented policies.<br> <br> The projects leading to this software have received funding from a series of <br> European Union programmes including: <br> * the Sixth Framework Programme for Research and Technological Development - <br> DILIGENT (grant no. 004260); <br> * the Seventh Framework Programme for research, technological development and <br> demonstration - D4Science (grant no. 212488), D4Science-II (grant no. <br> 239019),ENVRI (grant no. 283465), EUBrazilOpenBio (grant no. 288754), iMarine <br> (grant no. 283644); <br> * the H2020 research and innovation programme - BlueBRIDGE (grant no. 675680), <br> EGIEngage (grant no. 654142), ENVRIplus (grant no. 654182), Parthenos (grant <br> no. 654119), SoBigData (grant no. 654024);<br> <br> <br> Version<br> --------------------------------------------------<br> <br> 1.0.0-4.1.1-126743 (2016-12-15)<br> <br> Please see the file named "changelog.xml" in this directory for the release notes.<br> <br> <br> Authors<br> --------------------------------------------------<br> * Alexandros Antoniadis (a.antoniadis-AT-di.uoa.gr), University of Athens, <br> Department of Informatics and Telecommunications.<br> <br> Maintainers<br> --------------------------------------------------<br> <br> * Nikolaos Laskaris (laskarisn-AT-di.uoa.gr), National and Kapodistrian University of Athens<br> <br> <br> Download information<br> --------------------------------------------------<br> <br> Source code is available from SVN: <br> http://svn.research-infrastructures.eu/public/d4science/gcube/branches/resource-registry/ResourceRegistry-configuration-vo-nonupdaters/1.0/branches/resource-registry/ResourceRegistry-configuration-vo-nonupdaters<br> <br> Binaries can be downloaded from the gCube website: <br> https://www.gcube-system.org/<br> <br> <br> Installation<br> --------------------------------------------------<br> <br> Installation documentation is available on-line in the gCube Wiki:<br> https://wiki.gcube-system.org/gcube/index.php<br> <br> Documentation <br> --------------------------------------------------<br> <br> Documentation is available on-line in the gCube Wiki:<br> https://wiki.gcube-system.org/gcube/index.php<br> <br> Support <br> --------------------------------------------------<br> <br> Bugs and support requests can be reported in the gCube issue tracking tool:<br> https://support.d4science.org/projects/gcube/<br> <br> <br> Licensing<br> --------------------------------------------------<br> <br> This software is licensed under the terms you may find in the file named "LICENSE" in this directory.<br> </p

gCube 4.3.0 - resourceregistry-configuration-vo-nonupdaters v. 1.0.0

<p> The gCube System - resourceregistry-configuration-vo-nonupdaters<br> --------------------------------------------------<br> <br> ResourceRegistry Configuation VO nonupdaters<br> <br> <br> This software is part of the gCube Framework (https://www.gcube-system.org/): an<br> open-source software toolkit used for building and operating Hybrid Data<br> Infrastructures enabling the dynamic deployment of Virtual Research Environments<br> by favouring the realisation of reuse oriented policies.<br> <br> The projects leading to this software have received funding from a series of <br> European Union programmes including: <br> * the Sixth Framework Programme for Research and Technological Development - <br> DILIGENT (grant no. 004260); <br> * the Seventh Framework Programme for research, technological development and <br> demonstration - D4Science (grant no. 212488), D4Science-II (grant no. <br> 239019),ENVRI (grant no. 283465), EUBrazilOpenBio (grant no. 288754), iMarine <br> (grant no. 283644); <br> * the H2020 research and innovation programme - BlueBRIDGE (grant no. 675680), <br> EGIEngage (grant no. 654142), ENVRIplus (grant no. 654182), Parthenos (grant <br> no. 654119), SoBigData (grant no. 654024);<br> <br> <br> Version<br> --------------------------------------------------<br> <br> 1.0.0-4.3.0-126743 (2017-03-20)<br> <br> Please see the file named "changelog.xml" in this directory for the release notes.<br> <br> <br> Authors<br> --------------------------------------------------<br> * Alexandros Antoniadis (a.antoniadis-AT-di.uoa.gr), University of Athens, <br> Department of Informatics and Telecommunications.<br> <br> Maintainers<br> --------------------------------------------------<br> <br> * Nikolaos Laskaris (laskarisn-AT-di.uoa.gr), National and Kapodistrian University of Athens<br> <br> <br> Download information<br> --------------------------------------------------<br> <br> Source code is available from SVN: <br> http://svn.research-infrastructures.eu/public/d4science/gcube/branches/resource-registry/ResourceRegistry-configuration-vo-nonupdaters/1.0/branches/resource-registry/ResourceRegistry-configuration-vo-nonupdaters<br> <br> Binaries can be downloaded from the gCube website: <br> https://www.gcube-system.org/<br> <br> <br> Installation<br> --------------------------------------------------<br> <br> Installation documentation is available on-line in the gCube Wiki:<br> https://wiki.gcube-system.org/gcube/index.php<br> <br> Documentation <br> --------------------------------------------------<br> <br> Documentation is available on-line in the gCube Wiki:<br> https://wiki.gcube-system.org/gcube/index.php<br> <br> Support <br> --------------------------------------------------<br> <br> Bugs and support requests can be reported in the gCube issue tracking tool:<br> https://support.d4science.org/projects/gcube/<br> <br> <br> Licensing<br> --------------------------------------------------<br> <br> This software is licensed under the terms you may find in the file named "LICENSE" in this directory.<br> </p