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Clinical Neurophysiology : Official... Jan 2021Reduced corticospinal excitability at rest is associated with post-stroke fatigue (PSF). However, it is not known if corticospinal excitability prior to a movement is... (Observational Study)
Observational Study
OBJECTIVES
Reduced corticospinal excitability at rest is associated with post-stroke fatigue (PSF). However, it is not known if corticospinal excitability prior to a movement is also altered in fatigue which may then influence subsequent behaviour. We hypothesized that the levels of PSF can be explained by differences in modulation of corticospinal excitability during movement preparation.
METHODS
73 stroke survivors performed an auditory reaction time task. Corticospinal excitability was measured using transcranial magnetic stimulation. Fatigue was quantified using the fatigue severity scale. The effect of time and fatigue on corticospinal excitability and reaction time was analysed using a mixed effects model.
RESULTS
Those with greater levels of PSF showed reduced suppression of corticospinal excitability during movement preparation and increased facilitation immediately prior to movement onset (β = -0.0066, t = -2.22, p = 0.0263). Greater the fatigue, slower the reaction times the closer the stimulation time to movement onset (β = 0.0024, t = 2.47, p = 0.0159).
CONCLUSIONS
Lack of pre-movement modulation of corticospinal excitability in high fatigue may indicate poor sensory processing supporting the sensory attenuation model of fatigue.
SIGNIFICANCE
We take a systems-based approach and investigate the motor system and its role in pathological fatigue allowing us to move towards gaining a mechanistic understanding of chronic pathological fatigue.
Topics: Acoustic Stimulation; Aged; Cross-Sectional Studies; Electromyography; Evoked Potentials, Motor; Fatigue; Female; Humans; Male; Middle Aged; Motor Cortex; Movement; Muscle, Skeletal; Pyramidal Tracts; Reaction Time; Stroke; Transcranial Magnetic Stimulation
PubMed: 33302061
DOI: 10.1016/j.clinph.2020.11.012 -
Frontiers in Neurology 2021Fatigue is a multidimensional symptom with both physical and cognitive aspects, which can affect the quality of daily and working life activities. Motor Imagery (MI)... (Review)
Review
Fatigue is a multidimensional symptom with both physical and cognitive aspects, which can affect the quality of daily and working life activities. Motor Imagery (MI) represents an important resource for use during the rehabilitation processes, useful, among others, for job integration/reintegration, of neurological pathologies, such as Multiple Sclerosis (MS). To define the effective rehabilitation protocols that integrate MI for the reduction of fatigue in patients with MS (PwMS), a literary review was performed through August 2020. Five articles were included in the qualitative synthesis, including two feasibility pilot randomized control trials (RCTs) and 3 RCTs with good quality according to the PEDro score and a low risk of bias according to the Cochrane Collaboration tool. The literature suggested that MI, in association with rhythmic-auditory cues, may be an effective rehabilitation resource for reducing fatigue. Positive effects were observed on perceived cognitive and psychological fatigue. PwMS require greater compensatory strategies than healthy individuals, and the use of rhythmic-auditory cues may be useful for optimizing the cognitive processing of MI, which acts as an internal stimulus that is enhanced and made more vivid by outside cues. These findings provide evidence that MI is a promising rehabilitation tool for reducing fatigue in PwMS and return to work strategies.
PubMed: 34290665
DOI: 10.3389/fneur.2021.696276 -
Journal of Speech, Language, and... Jun 2022Growing evidence suggests that fatigue associated with listening difficulties is particularly problematic for children with hearing loss (CHL). However, sensitive,...
PURPOSE
Growing evidence suggests that fatigue associated with listening difficulties is particularly problematic for children with hearing loss (CHL). However, sensitive, reliable, and valid measures of listening-related fatigue do not exist. To address this gap, this article describes the development, psychometric evaluation, and preliminary validation of a suite of scales designed to assess listening-related fatigue in CHL: the pediatric versions of the Vanderbilt Fatigue Scale (VFS-Peds).
METHOD
Test development employed best practices, including operationalizing the construct of listening-related fatigue from the perspective of target respondents (i.e., children, their parents, and teachers). Test items were developed based on input from these groups. Dimensionality was evaluated using exploratory factor analyses (EFAs). Item response theory (IRT) and differential item functioning (DIF) analyses were used to identify high-quality items, which were further evaluated and refined to create the final versions of the VFS-Peds.
RESULTS
The VFS-Peds is appropriate for use with children aged 6-17 years and consists of child self-report (VFS-C), parent proxy-report (VFS-P), and teacher proxy-report (VFS-T) scales. EFA of child self-report and teacher proxy data suggested that listening-related fatigue was unidimensional in nature. In contrast, parent data suggested a multidimensional construct, composed of mental (cognitive, social, and emotional) and physical domains. IRT analyses suggested that items were of good quality, with high information and good discriminability. DIF analyses revealed the scales provided a comparable measure of fatigue regardless of the child's gender, age, or hearing status. Test information was acceptable over a wide range of fatigue severities and all scales yielded acceptable reliability and validity.
CONCLUSIONS
This article describes the development, psychometric evaluation, and validation of the VFS-Peds. Results suggest that the VFS-Peds provide a sensitive, reliable, and valid measure of listening-related fatigue in children that may be appropriate for clinical use. Such scales could be used to identify those children most affected by listening-related fatigue, and given their apparent sensitivity, the scales may also be useful for examining the effectiveness of potential interventions targeting listening-related fatigue in children.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.19836154.
Topics: Adolescent; Auditory Perception; Child; Hearing Loss; Humans; Mental Fatigue; Parents; Proxy; Psychometrics; Reproducibility of Results; School Teachers; Surveys and Questionnaires
PubMed: 35623338
DOI: 10.1044/2022_JSLHR-22-00051 -
International Journal of Occupational... Jan 2018To determine whether call center dispatchers wearing headsets are subject to auditory fatigue at the end of a work shift.
OBJECTIVES
To determine whether call center dispatchers wearing headsets are subject to auditory fatigue at the end of a work shift.
MATERIAL AND METHODS
Data was gathered at times when call centers were busiest. All call operators wore a headset for up to 12 h. Acoustic environment and noise exposure under the headset were continuously recorded during the entire work shift. Variations in auditory parameters were assessed using pure-tone air-conduction audiometry and an objective test based on distortion product otoacoustic emissions - contralateral suppression of distortion product otoacoustic emission (DPOAE) amplitudes (EchoScan test). Thirty-nine operators and 16 controls, all volunteers, were selected from 3 call centers (sales, assistance, and emergency) where all cognitive tasks were accomplished by phone and on computers.
RESULTS
No acoustic shock was detected during the investigation. The highest normalized noise exposure (daily noise exposure level - L) measured was 75.5 dBA. No significant variation in auditory performances was detected with either pure-tone air-conduction audiometry or the EchoScan test. Nevertheless, dispatchers expressed a feeling of tiredness.
CONCLUSIONS
For an equivalent diffuse field noise exposure, the use of a headset does not seem to worsen auditory fatigue for call center operators. The dispatcher's fatigue was probably due to the duration of the work shift or to the tasks they performed rather than to the noise exposure under a headset. Int J Occup Med Environ Health 2018;31(2):217-226.
Topics: Adult; Audiometry, Pure-Tone; Auditory Fatigue; Computers; Fatigue; France; Hearing Loss, Noise-Induced; Hotlines; Humans; Middle Aged; Noise; Noise, Occupational; Otoacoustic Emissions, Spontaneous; Telephone
PubMed: 29072709
DOI: 10.13075/ijomeh.1896.01131 -
Entropy (Basel, Switzerland) Sep 2021The accurate detection and alleviation of driving fatigue are of great significance to traffic safety. In this study, we tried to apply the modified multi-scale entropy...
The accurate detection and alleviation of driving fatigue are of great significance to traffic safety. In this study, we tried to apply the modified multi-scale entropy (MMSE) approach, based on variational mode decomposition (VMD), to driving fatigue detection. Firstly, the VMD was used to decompose EEG into multiple intrinsic mode functions (IMFs), then the best IMFs and scale factors were selected using the least square method (LSM). Finally, the MMSE features were extracted. Compared with the traditional sample entropy (SampEn), the VMD-MMSE method can identify the characteristics of driving fatigue more effectively. The VMD-MMSE characteristics combined with a subjective questionnaire (SQ) were used to analyze the change trends of driving fatigue under two driving modes: normal driving mode and interesting auditory stimulation mode. The results show that the interesting auditory stimulation method adopted in this paper can effectively relieve driving fatigue. In addition, the interesting auditory stimulation method, which simply involves playing interesting auditory information on the vehicle-mounted player, can effectively relieve driving fatigue. Compared with traditional driving fatigue-relieving methods, such as sleeping and drinking coffee, this interesting auditory stimulation method can relieve fatigue in real-time when the driver is driving normally.
PubMed: 34573834
DOI: 10.3390/e23091209 -
Brain and Behavior Jan 2017Dalfampridine exerts beneficial effects on walking ability in a subgroup of patients with multiple sclerosis (MS). These patients are termed "responders". Here, we... (Observational Study)
Observational Study
OBJECTIVES
Dalfampridine exerts beneficial effects on walking ability in a subgroup of patients with multiple sclerosis (MS). These patients are termed "responders". Here, we investigated whether the responder status with respect to mobility measures would determine whether dalfampridine treatment exerts a beneficial effect on other MS symptoms. We therefore assessed walking ability, upper limb function, cognition, fatigue, visual evoked potentials (VEPs), depression, and quality of life in patients before and after dalfampridine treatment.
METHODS
Patients with MS and impaired mobility were recruited. Maximal walking distance, timed 25 Foot Walk, nine hole peg test, paced auditory serial addition test (PASAT), fatigue severity scale (FSS), VEPs, Beck Depression Inventory (BDI), EuroQol five dimensional questionnaire, and quality of life visual analogue scale were determined before and after 12-14 days of dalfampridine treatment. Repeated measures analysis of variance was applied to determine the effect of dalfampridine treatment.
RESULTS
Of the 34 patients who completed the study, 22 patients were responders and 12 patients nonresponders, according to their performance in mobility measures. Treatment effects for the entire patient cohort were observed for PASAT (= .029) and BDI (= .032). Belonging to the responder cohort did not predict the response to treatment in these tests. For the FSS, response to dalfampridine treatment was dependent on the responder status (= .001) while no effects in the total patient cohort were observed (= .680). Other neurological functions remained unaltered. For VEP latencies, no significant improvements were detected.
CONCLUSION
In this study, we observed beneficial effects of dalfampridine on cognition, depression, and fatigue. These effects were not limited to patients who responded to dalfampridine with improved mobility measures. These findings underscore the need to assess the beneficial effects of dalfampridine on neurological deficits in MS patients in additional randomized clinical trials.
Topics: 4-Aminopyridine; Adult; Cognitive Dysfunction; Depression; Evoked Potentials, Visual; Fatigue; Female; Humans; Male; Middle Aged; Mobility Limitation; Multiple Sclerosis; Outcome Assessment, Health Care; Potassium Channel Blockers; Prospective Studies; Upper Extremity
PubMed: 28127507
DOI: 10.1002/brb3.559 -
Epilepsy & Behavior : E&B Feb 2020The objective of this analysis was to provide a comprehensive analysis of safety data for adjunctive brivaracetam (BRV), an antiepileptic drug (AED) of the racetam... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The objective of this analysis was to provide a comprehensive analysis of safety data for adjunctive brivaracetam (BRV), an antiepileptic drug (AED) of the racetam class, for treatment of focal seizures in patients with epilepsy.
METHODS
Data were pooled from two phase II, placebo-controlled, double-blind, dose-ranging trials (N01114 [ClinicalTrials.gov: NCT00175929], N01193 [NCT00175825]) and three phase III, placebo-controlled, double-blind, 12-week trials (N01252 [NCT00490035], N01253 [NCT00464269], and N01358 [NCT01261325]) in patients aged ≥16 years with focal seizures, as well as a phase III, placebo-controlled, double-blind, 16-week trial in patients aged ≥16 years with focal or generalized epilepsy (N01254 [NCT00504881]). Data are presented for the approved therapeutic dose range of 50-200 mg/day. Data for BRV administered intravenously (25-150 mg doses) were pooled separately from one phase III trial (N01258 NCT01405508]) and two clinical pharmacology trials (N01256 [Part B] [UCB Pharma, data on file]; EP0007 [NCT01796899]). Adverse events (AEs) of interest were summarized in relevant categories.
RESULTS
The safety pool comprised 1957 patients: 1271 receiving adjunctive BRV and 686 receiving placebo. Overall, the incidence of treatment-emergent adverse events (TEAEs) was 66.9% with BRV versus 62.8% with placebo. The most frequently reported TEAEs with BRV (≥5% of patients) versus placebo were somnolence (13.3% vs. 7.9%), headache (10.5% vs. 11.5%), dizziness (10.0% vs. 7.0%), and fatigue (8.2% vs. 4.2%). Incidence of psychiatric disorder-related TEAEs was 11.3% with BRV versus 8.2% with placebo. Behavioral disorder-related TEAE incidence was low (4.0% with BRV vs. 2.5% with placebo). Irritability was reported in 2.7% of BRV-treated patients vs. 1.5% of patients receiving placebo; anger, aggression, and agitation were each reported by ≤1% of patients receiving BRV. Treatment-emergent adverse events potentially associated with psychosis were psychotic disorder (three patients on BRV vs. two patients on placebo), auditory hallucination, illusion, visual hallucination (one patient each on BRV), epileptic psychosis, and hallucination (one patient each on placebo). No additional safety concerns were identified in patients with intravenous (IV) BRV administration (n = 104).
CONCLUSIONS
These safety data for adjunctive BRV support its acceptable safety and tolerability profile.
Topics: Administration, Intravenous; Anticonvulsants; Clinical Trials, Phase II as Topic; Clinical Trials, Phase III as Topic; Dizziness; Double-Blind Method; Drug Therapy, Combination; Epilepsy; Fatigue; Humans; Pyrrolidinones; Treatment Outcome
PubMed: 31937513
DOI: 10.1016/j.yebeh.2019.106864 -
Journal of Voice : Official Journal of... May 2023The voice quality of patients with Coronavirus Disease 2019 (COVID-19) seems to be affected due to lower and upper respiratory involvement. Patient-based voice...
OBJECTIVES
The voice quality of patients with Coronavirus Disease 2019 (COVID-19) seems to be affected due to lower and upper respiratory involvement. Patient-based voice assessment scales are important clinical measures to diagnose voice disorders and monitor treatment outcomes in COVID-19 patients. This study compared vocal fatigue between COVID-19 patients and those with normal voices. Furthermore, the relationship between vocal fatigue and acoustic voice parameters of COVID-19 patients was evaluated.
METHODS
This cross-sectional study enrolled 30 laboratory-confirmed patients with COVID-19 (18 males and 12 females) and 30 healthy individuals with normal voices (14 males and 16 females) to compare their respiratory or phonatory parameters. The Persian versions of the Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) and the vocal fatigue index (VFI) were conducted before and after reading the text. The Jitter, shimmer, maximum phonation time, and harmonic-to-noise ratio (HNR) were analyzed by Praat software based on the recorded voices of CAPE-V tasks. The acoustic assessment and VFI questionnaire results were compared between COVID-19 patients and the control group.
RESULTS
There were significant differences between COVID-19 patients and their healthy counterparts in all VFI subscales (P < 0.001). Moreover, after reading the text, we found significant differences between the two groups regarding Jitter, shimmer, and HNR of /a/ and /i/ vowels (P < 0.05). Our findings also indicated a significant correlation between symptom improvement with rest and acoustic parameters in all tasks, except the Jitter of /a/ before reading the text.
CONCLUSION
Patients with COVID-19 showed significantly more vocal fatigue than people with normal voices after reading the text. Moreover, there was a significant relationship between Jitter, shimmer, and HNR and the tiredness of voice and physical discomfort subscales of VFI.
PubMed: 37277295
DOI: 10.1016/j.jvoice.2023.04.023 -
Audiology Research Dec 2021Very early bilateral implantation is thought to significantly reduce the attentional effort required to acquire spoken language, and consequently offer a profound...
Very early bilateral implantation is thought to significantly reduce the attentional effort required to acquire spoken language, and consequently offer a profound improvement in quality of life. Despite the early intervention, however, auditory and communicative outcomes in children with cochlear implants remain poorer than in hearing children. The distorted auditory input via the cochlear implants requires more auditory attention resulting in increased listening effort and fatigue. Listening effort and fatigue may critically affect attention to speech, and in turn language processing, which may help to explain the variation in language and communication abilities. However, measuring attention to speech and listening effort is demanding in infants and very young children. Three objective techniques for measuring listening effort are presented in this paper that may address the challenges of testing very young and/or uncooperative children with cochlear implants: pupillometry, electroencephalography, and functional near-infrared spectroscopy. We review the studies of listening effort that used these techniques in paediatric populations with hearing loss, and discuss potential benefits of the systematic evaluation of listening effort in these populations.
PubMed: 35076472
DOI: 10.3390/audiolres12010001 -
Open Access Macedonian Journal of... Aug 2019To analyse the effect of expressive writing in three selected cases.
AIM
To analyse the effect of expressive writing in three selected cases.
METHODS
Case studies presented from three psychiatric patients in a hospital-based outpatient clinic in Surabaya, Indonesia, between May 2017 and July 2018. Clinical changes have been observed and reported. Three patients were selected based on the possibility of whether they were able to or not to participate in similar cognitive therapy. These three cases were considered to represent a diagnosis for the psychotic and non-psychotic spectrum. The first case was a male with suicidal depression, the second was a woman with Suicidal Depression, and the third was schizophrenic woman elderly with auditory hallucinations. Expressive writing was formulated from literature studies and then implemented in these patients. Clinical changes were observed both associated with a reduction in symptoms as well as new symptoms. These non-directive measures allowed the author to observe the therapeutic effects and side effects of the intervention given.
RESULTS
Three cases were analysed. Targets were determined by patients themselves without author's intervention. Each patient underwent 10 sessions in minimum and 32 sessions in maximum, from once per week to once per two weeks, and was stopped after it was considered reaching or approaching the desired target, or if unwanted side effects appeared. Main changes were "father hunger" symptom decreased in the first patient, self-esteem increased in the second patient, and cope with auditory hallucination in the third patient. Few adverse events also have been recorded such as masturbation as an obsession ritual of the first patient, possibly provoked double-identity symptom in the second patient and mental fatigue in the elderly in the third patient.
CONCLUSION
Over six months of implementation, expressive writing show desirable results, yet some side effects in patients still need to be aware of.
PubMed: 31777614
DOI: 10.3889/oamjms.2019.402