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Objective Benign Paroxysmal Positional Vertigo (BPPV) as the most common vestibular disorder can affect the quality of life. This study aimed to compare the effectiveness of the half somersault maneuver (HSM) as a treatment to that of the Epley maneuver (EM) as a clinical-based treatment in subjects with PC-BPPV. Methods In this randomized study, 43 participants with unilateral posterior canal BPPV were recruited. The experimental group received the HSM, whereas the control group received the EM. All participants were asked to fill in the Vestibular Rehabilitation Benefit Questionnaire (VRBQ), Dizziness Handicap Inventory (DHI), and Vertigo Symptom Scale (VSS) questionnaires at pretreatment and at 48 hours, 1 week, and 1 month posttreatment. The severity of residual dizziness was determined by the visual analog scale (VAS) weekly for up to 4 weeks after treatment. The success rate and the recurrence rate were assessed after the 3-month follow-up. Results The differences between the results of pretreatment and post-treatment questionnaires for both groups were significant. However, the differences were not significant between the 2 groups for the DHI scores, the total, dizziness, motion-provoked dizziness, and symptom subscale scores of the VRBQ, and the anxiety subscale scores of the VSS. There were significant differences between the 2 groups for VAS, the total VSS and vertigo subscale scores, and the VRBQ anxiety subscale scores. Conclusion Even though both maneuvers are significantly effective in the treatment of PC-BPPV, subjects in the HSM group reported more improvement in terms of psychometric symptoms and residual dizziness compared to the EM group.

Purpose The aim of the study was to evaluate the additional effect of vestibular rehabilitation therapy (VRT) compared with the modified Epley procedure alone on residual dizziness after a successful modified Epley procedure in patients with posterior canal benign paroxysmal positional vertigo (BPPV). Method In this cross-sectional analytical comparative study, 47 patients (35 women and 12 men) aged 18–80 years with posterior canal BPPV were randomly assigned to one of two following groups: the control group, who received the modified Epley procedure only, and the VRT group, who received the modified Epley procedure plus vestibular rehabilitation for 4 weeks. Outcome measures, including the Dizziness Handicap Inventory (DHI), the Vertigo Symptom Scale–Long Version (VSS-L), and the Vertigo Symptom Scale–Short Form (VSS-SF), were conducted on the same session before initial therapy (T1), at 48 hr later (T2), and at 4 weeks later (T3). Presence or absence of residual dizziness was evaluated at T2. Results Residual dizziness was found in 20 (42.6%) patients after a successful modified Epley procedure. There was no statistically significant difference between the mean DHI, VSS-L, and VSS-SF scores at T1, T2, and T3 in patients who manifested with residual dizziness and those without residual dizziness in both groups. The average DHI, VSS-L, and VSS-SF score reduced during the time in both groups. These results were demonstrated that the VRT group and the control group have similar reductions in symptoms after treatment with the VRT plus modified Epley procedure and the modified Epley procedure only, respectively. Conclusions Residual dizziness is a common condition after a successful modified Epley procedure for BPPV. The VRT plus modified Epley procedure is as effective as modified Epley procedure alone in the management of residual dizziness. Further studies with supervised and customized VRT and longer follow-up periods are needed. Supplemental Material https://doi.org/10.23641/asha.14825508

Background and purpose Gender disparities in auditory brainstem response (ABR) results have been reported but the exact reasons remain controversial. Difference in head size between genders has been suggested but the literature is lacking, particularly at threshold levels. In this short communication, we compared ABR results between males and females with comparable head sizes at supra-threshold and threshold levels. Materials and methods In this comparative study, of 58 healthy young adults, 30 of them (17 females and 13 males) with comparable head sizes underwent the standard ABR testing. Wave V latencies and ABR thresholds were determined and analyzed accordingly. Results At the supra-threshold level, significantly shorter wave V latencies were found in females than in males (p = 0.029). This difference was substantive (d = 0.86) and persisted even when the head size was included in the analysis (p = 0.032). In contrast, no significant differences in ABR thresholds were found between genders (p > 0.05). Conclusions Significant gender differences in ABR results among young adults were only found at the supra-threshold level, which were not related to the head size. Based on the study outcomes, gender-specific normative data for ABR are still beneficial for clinical applications, particularly when recording ABR at high stimulation levels.

Background and Objectives Mild cognitive impairment (MCI) is a disorder that usually occurs in the elderly, leading to dementia in some progressive cases. The purpose of this study is to examine the utility of central auditory processing tests as early diagnostic tools for identifying the elderly with MCI. Subjects and Methods This study was conducted on 20 elderly patients with MCI and 20 healthy matched peers. The speech perception ability in a quiet environment and in the presence of background noise and also temporal resolution were assessed by using Speech Perception in Noise (SPIN) and Gap in Noise (GIN) tests, respectively. Results The results indicated that the ability to understand speech in a quiet environment did not differ significantly between the two groups. However, SPIN at the three signal-tonoise ratios and the temporal resolution scores were significantly different between the two groups (p

Objectives: Gender disparities in speech-evoked auditory brainstem response (speech-ABR) outcomes have been reported, but the literature is limited. The present study was performed to further verify this issue and determine the influence of head size on speech-ABR results between genders. Methods: Twenty-nine healthy Malaysian subjects (14 males and 15 females) aged 19 to 30 years participated in this study. After measuring the head circumference, speech-ABR was recorded by using synthesized syllable /da/ from the right ear of each participant. Speech-ABR peaks amplitudes, peaks latencies, and composite onset measures were computed and analyzed. Results: Significant gender disparities were noted in the transient component but not in the sustained component of speech-ABR. Statistically higher V/A amplitudes and less steeper V/A slopes were found in females. These gender differences were partially affected after controlling for the head size. Conclusions: Head size is not the main contributing factor for gender disparities in speech-ABR outcomes. Gender-specific normative data can be useful when recording speech-ABR for clinical purposes.

Introduction The performance of auditory steady state response (ASSR) in threshold testing when recorded ipsilaterally and contralaterally, as well as at low and high modulation frequencies (MFs), has not been systematically studied. Objective To verify the influences of mode of recording (ipsilateral vs. contralateral) and modulation frequency (40 Hz vs. 90 Hz) on ASSR thresholds. Methods Fifteen female and 14 male subjects (aged 18–30 years) with normal hearing bilaterally were studied. Narrow-band CE-chirp® stimuli (centerd at 500, 1000, 2000, and 4000 Hz) modulated at 40 and 90 Hz MFs were presented to the participants' right ear. The ASSR thresholds were then recorded at each test frequency in both ipsilateral and contralateral channels. Results Due to pronounced interaction effects between mode of recording and MF (p < 0.05 by two-way repeated measures ANOVA), mean ASSR thresholds were then compared among four conditions (ipsi-40 Hz, ipsi-90 Hz, contra-40 Hz, and contra-90 Hz) using one-way repeated measures ANOVA. At the 500 and 1000 Hz test frequencies, contra-40 Hz condition produced the lowest mean ASSR thresholds. In contrast, at high frequencies (2000 and 4000 Hz), ipsi-90 Hz condition revealed the lowest mean ASSR thresholds. At most test frequencies, contra-90 Hz produced the highest mean ASSR thresholds. Conclusions Based on the findings, the present study recommends two different protocols for an optimum threshold testing with ASSR, at least when testing young adults. This includes the use of contra-40 Hz recording mode due to its promising performance in hearing threshold estimation.

Many studies have suggested that cochlear implant (CI) users vary in terms of speech recognition in noise. Studies in this field attribute this variety partly to subcortical auditory processing. Studying speech-Auditory Brainstem Response (speech-ABR) provides good information about speech processing; thus, this work was designed to compare speech-ABR components between two groups of CI users with good and poor speech recognition in noise scores.The present study was conducted on two groups of CI users aged 8-10 years old. The first group (CI-good) consisted of 15 children with prelingual CI who had good speech recognition in noise performance. The second group (CI-poor) was matched with the first group, but they had poor speech recognition in noise performance. The speech-ABR test in a sound-field presentation was performed for all the participants.The speech-ABR response showed more delay in C, D, E, F, O latencies in CI-poor than CI-good users (P0.05), meanwhile no significant difference was observed in initial wave (V(t= -0.293, p= 0.771 and A (t= -1.051, p= 0.307). Analysis in spectral-domain showed a weaker representation of fundamental frequency as well as the first formant and high-frequency component of speech stimuli in the CI users with poor auditory performance.Results revealed that CI users who showed poor auditory performance in noise performance had deficits in encoding the periodic portion of speech signals at the brainstem level. Also, this study could be as physiological evidence for poorer pitch processing in CI users with poor speech recognition in noise performance.

Due to its objective nature, auditory brainstem response (ABR) evoked by complex stimuli has been gaining attention lately. The present study aimed to compare the speech-evoked auditory brainstem response (speech-ABR) results between two ethnic groups: Malay and Chinese. In addition, it was also of interest to compare the speech-ABR outcomes obtained from the present study with the published Caucasian data. Thirty healthy male adults (15 Malay and 15 Chinese) were enrolled in this comparative study. Speech syllable/da/presented at 80 dBnHL was used to record speech-ABR waveforms from the right ear of each subject. Amplitudes and latencies of speech-ABR peaks (V, A, C, D, E, F and O), as well as composite onset measures (V/A duration, V/A amplitude and V/A slope) were computed and analyzed. When the two ethnic groups were compared, all speech-ABR results were not statistically different from each other (p > 0.05). When the data from the present study were compared with the published Caucasian data, most of the statistical analyses were significant (p

Introduction: Binaurally evoked auditory evoked potentials have good diagnostic values when testing subjects with central auditory deficits. The literature on speech-evoked auditory brainstem response evoked by binaural stimulation is in fact limited. Gender disparities in speech-evoked auditory brainstem response results have been consistently noted but the magnitude of gender difference has not been reported. Objective: The present study aimed to compare the magnitude of gender difference in speech-evoked auditory brainstem response results between monaural and binaural stimulations. Methods: A total of 34 healthy Asian adults aged 19–30 years participated in this comparative study. Eighteen of them were females (mean age = 23.6 ± 2.3 years) and the remaining sixteen were males (mean age = 22.0 ± 2.3 years). For each subject, speech-evoked auditory brainstem response was recorded with the synthesized syllable /da/ presented monaurally and binaurally. Results: While latencies were not affected (p > 0.05), the binaural stimulation produced statistically higher speech-evoked auditory brainstem response amplitudes than the monaural stimulation (p 0.80), substantive gender differences were noted in most of speech-evoked auditory brainstem response peaks for both stimulation modes. Conclusion: The magnitude of gender difference between the two stimulation modes revealed some distinct patterns. Based on these clinically significant results, gender-specific normative data are highly recommended when using speech-evoked auditory brainstem response for clinical and future applications. The preliminary normative data provided in the present study can serve as the reference for future studies on this test among Asian adults. Resumo: Introdução: Potenciais auditivos evocados de modo binaural apresentam bons valores diagnósticos ao testar indivíduos com déficits auditivos centrais. A literatura sobre a resposta do potencial evocado do tronco encefálico com estímulo de fala de modo binaural é, de fato, limitada. As diferenças de gênero nos resultados desse exame têm sido consistentemente observadas, mas a magnitude da diferença de gênero ainda não foi relatada. Objetivo: Comparar a magnitude da diferença de gênero nos resultados do potencial evocado do tronco encefálico com estímulo de fala entre estímulos monaural e binaural. Método: Um total de 34 adultos asiáticos saudáveis com idades entre 19 e 30 anos participaram deste estudo comparativo. Dezoito deles eram do sexo feminino (média de idade = 23,6 ± 2,3 anos) e os outros dezesseis do sexo masculino (média de idade = 22,0 ± 2,3 anos). Para cada indivíduo, o potencial evocado do tronco encefálico com estímulo de fala foi registrado com a sílaba sintetizada /da/ apresentada de forma monaural e binaural. Resultados: Embora as latências não tenham sido afetadas (p > 0,05), a estimulação binaural produziu amplitudes de potencial evocado do tronco encefálico com estímulo de fala estatisticamente maiores que a estimulação monaural (p 0,80), diferenças substanciais de gênero foram observadas na maioria dos picos de potencial evocado do tronco encefálico com estímulo de fala para ambos os modos de estímulo. Conclusão: A magnitude da diferença de gênero entre os dois modos de estímulo revelou alguns padrões distintos. Com base nesses resultados clinicamente significantes, os dados normativos específicos para o gênero são altamente recomendados quando se usa o potencial evocado do tronco encefálico com estímulo de fala para aplicações clínicas e futuras. Os dados normativos preliminares fornecidos pelo presente estudo podem servir como referência para futuros estudos sobre esse exame em asiáticos adultos. Keywords: Brainstem, Speech, Binaural, Monaural, Effect size, Palavras-chave: Tronco encefálico, Fala, Binaural, Monaural, Tamanho do efeito

For estimating behavioral hearing thresholds, auditory steady state response (ASSR) can be reliably evoked by stimuli at low and high modulation frequencies (MFs). In this regard, little is known regarding ASSR thresholds evoked by stimuli at different MFs in female and male participants. In fact, recent data suggest that 40-Hz ASSR is influenced by estrogen level in females. Hence, the aim of the present study was to determine the effect of gender and MF on ASSR thresholds in young adults. Twenty-eight normally hearing participants (14 males and 14 females) were enrolled in this study. For each subject, ASSR thresholds were recorded with narrow-band chirps at 500, 1,000, 2,000, and 4,000 Hz carrier frequencies (CFs) and at 40 and 90 Hz MFs. Two-way mixed ANOVA (with gender and MF as the factors) revealed no significant interaction effect between factors at all CFs (p > 0.05). The gender effect was only significant at 500 Hz CF (p < 0.05). At 500 and 1,000 Hz CFs, mean ASSR thresholds were significantly lower at 40 Hz MF than at 90 Hz MF (p < 0.05). Interestingly, at 2,000 and 4,000 Hz CFs, mean ASSR thresholds were significantly lower at 90 Hz MF than at 40 Hz MF (p < 0.05). The lower ASSR thresholds in females might be due to hormonal influence. When recording ASSR thresholds at low MF, we suggest the use of gender-specific normative data so that more valid comparisons can be made, particularly at 500 Hz CF.

Objective Auditory brainstem responses evoked by complex stimuli such as speech syllables have been studied in normal subjects and subjects with compromised auditory functions. The stability of speech-evoked auditory brainstem response (speech-ABR) when tested over time has been reported but the literature is limited. The present study was carried out to determine the test-retest reliability of speech-ABR in healthy children at a low sensation level. Methods Seventeen healthy children (6 boys, 11 girls) aged from 5 to 9 years (mean = 6.8 ± 3.3 years) were tested in two sessions separated by a 3-month period. The stimulus used was a 40-ms syllable /da/ presented at 30 dB sensation level. Results As revealed by pair t-test and intra-class correlation (ICC) analyses, peak latencies, peak amplitudes and composite onset measures of speech-ABR were found to be highly replicable. Compared to other parameters, higher ICC values were noted for peak latencies of speech-ABR. Conclusion The present study was the first to report the test-retest reliability of speech-ABR recorded at low stimulation levels in healthy children. Due to its good stability, it can be used as an objective indicator for assessing the effectiveness of auditory rehabilitation in hearing-impaired children in future studies.

Background and Aim: Vestibular-Evoked Myogenic Potentials (VEMP) is a new vestibular function test that assesses the vestibulospinal pathway.Although many studies have investigated different inner ear pathologies by using VEMP, the role of this test in brainstem pathologies and demyelinating processes of central nervous system is still remained to be defined and discussed.The aim of this study was to compare VEMP in multiple sclerosis patients and normal individuals.Methods: We carried out a cross-sectional study in 21 patients (15 female, 6 male) fulfilling diagnostic criteria of clinically definite multiple sclerosis, and 20 normal individuals (15 female, 6 male). ages ranging from 17 to 50 years old.The VEMPs was recorded using 500 Hz short tone burst (STB). The p13 and n23 latencies and p13-n23 peak-to-peak amplitude were the studied parameters.Results: VEMP results were abnormal in 47.6% of patients. P13 latency and p13-n23 peak to peak amplitude in both ears showed significant difference between the two groups (p

We examined the effects of noise on acquisition and retention of the spatial memory task in equal and unequal context in adult male rats. The natural noise in Azadi football stadium was recorded and measured by sound level meter instrument and set in high (HI), moderate (MI), and low (LI) intensities, 86, 64, and 47 decibels A (dbA), respectively. Rats were trained in Morris water maze (MWM) for 3-consecutive-day program and at day 4 visible and probe tests were done under one of the above noise intensities. The retention was evaluated at day 7 on the basis of equal and unequal noise exposure situation. Escape latency, traveled distance, and swimming speed were recorded and used for subsequent analysis. Our results showed significant increases in the escape latency and traveled distance by increasing the noise intensity during acquisition period, and also retention test in equal noise situation. Furthermore, retention test in the group that was under HI noise during both training period and retention test escape latency and traveled distance compared to the groups which was under HI noise during training period and LI or MI noise during retention test (HI-LI or HI-MI).

In a 1996 study, we encountered an important question: “Can a masker noise affect the test ear during the masking process in ABR testing? And “What is the route of this effect? During that study, we found that the masker noise affected the nontest ear, even with low intensities of noise. These effects seemed to be related to “central masking.” In 2006, we performed a study on 9 males using a new method. White noise was delivered to the nontest ear at five levels (0, 10, 20, 30, and 40 dB SPL), while the click of 125-μsec duration was constantly kept at 120 dB SPL in all stages and delivered to the test ear. The absolute latencies of I, III, and V waves and also interpeak latencies (IPLs) of I–V, I–III, and III–V were then measured and recorded. The results showed that in the right ear the absolute latencies of I, III, and V waves decreased, up to 20 dB SPL of noise, and after 30 dB SPL, absolute latency inlatcreased. However, this effect was not seen in the left ear. A survey of IPLs in both ears ...

Objective: A survey on hearing state of blind schoolboys in Tehran. Method and Material: This cross-sectional descriptive survey was conducted on 640 ears of 320 blind schoolboys of 5-23 years old as a hearing screening in Tehran blind schools, 2000-01. Results: 20.94% was hearing-impaired of whom 13.75% had bilateral and 7.19% had unilateral hearing loss. 15.16% of students suffered from sensory-neural hearing loss (SNHL), 1.56% from conductive hearing loss (CHL) and 0.62% from mixed hearing loss (MHL), that is, SNHL occurred 10 times more than CHL. Hearing loss was often mild and moderate, and audiogram configuration was primarily high tone loss (HTL). On the whole, 8.13% of students needed medical treatment, 15.13% needed audiological rehabilitation and 3.44% of them were in need of both medical and rehabilitation Intervention. General information about hearing problem was very low among students, their parents and teachers, which was 26.87%, 20.9% and 22.39%, respectively. There is significant relation between SNHL and parents' relationship. Conclusion: The prevalence of hearing loss in blinds is higher than in normal-visions. It is often sensorineural. So, it is important to identify these children through hearing screening (Using more high frequencies) and to conduct medical as well as rehabilitative intervention.

Rehabilitation of deaf individual is one of the important subjects that has attracted attention of many researchers during past centuries. Different opinions have been established in this direction. Electrophysiologic tests were established and developed parallel to developments in rehabilitation. Therefore, opinion of using electrophysiologic test for evaluation and fitting of hearing aid became gradually popular. Ultimately, the electrophysiologic tests are used in evaluation and fitting of hearing aid in two ways: 1-Direct way 2- Indirect way "nIn direct way aided ABR is obtained and special attention is paid to wave V. This technique has many difficulties. Inindirect way, electrophysiologic tests such, ECochG, OAE and ABR, AMLR, ALR and P300 and other objective tests are used, especially in infants and neonates for evaluating the state of hearing. Researches are continuing in this field. It is probable to have aided electrophysiologic responses with speech stimuli in near future.

Masking is a necessary part in ABR test the same as other Audiological experiments to obtain the real responses without the intrusion of the other ear. In the current research we are aimed at studying the effect of the masking noise on the pure latency of wave V and interwave latencies of I-III, III-V and I-V. Noise was delivered to the non test ear with intensities of 0, 30, 50 and 70 dB in four different sessions while the intensity level of the stimulus was fixed in all four sessions.