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Scientific Reports Jun 2024This study aims to investigate auditory hypersensitivity and cortical function in migraine patients using the Hyperacusis Questionnaire and the Event-Related Potential...
This study aims to investigate auditory hypersensitivity and cortical function in migraine patients using the Hyperacusis Questionnaire and the Event-Related Potential (ERP) technique. The study analyzes alterations in the latency and amplitude of the event-related potentials MMN and P300 components. The findings contribute to a better understanding of the physiological relationship between migraine and auditory hypersensitivity. Seventeen migraine patients were admitted to the outpatient clinic of the Department of Otorhinolaryngology-Head and Neck Surgery at Peking University People's Hospital from June 2023 to September 2023. Nineteen matched healthy subjects were also selected. All participants underwent the pure tone audiometry and the auditory brainstem response test to determine hearing thresholds, the Hyperacusis Questionnaire, the Tinnitus Handicap Inventory, and an ERP examination. The Oddball classical paradigm was used as the stimulation task, and electroencephalography signals were recorded synchronously. The scores of the Hyperacusis Questionnaire, latency and amplitude of MMN and P300 component were compared between the migraine group and the control group, and their correlation was analyzed. The latency of MMN at the Fz and Cz sites in migraine patients was significantly shorter than that in the control group (P < 0.05), and the amplitudes were significantly higher than those in the control group (P < 0.05). The variances in latency and amplitude of P300 at Cz and Pz sites in migraine patients were not statistically significant when compared with the control group. (P > 0.05). The Hyperacusis Questionnaire was negatively correlated with MMN latency, with a correlation coefficient of - 0.374 (P = 0.025), and positively correlated with MMN amplitude, with a correlation coefficient of 0.378 (P = 0.023). There was no significant similarity between the Hyperacusis Questionnaire and P300 latency and amplitude (P > 0.05). Overall, auditory hypersensitivity was enhanced in individuals with migraines compared to healthy individuals, leading to faster information processing, while there may be less impairment in cognitive function.
Topics: Humans; Female; Migraine Disorders; Male; Hyperacusis; Adult; Surveys and Questionnaires; Middle Aged; Electroencephalography; Event-Related Potentials, P300; Evoked Potentials; Case-Control Studies; Young Adult; Audiometry, Pure-Tone
PubMed: 38898084
DOI: 10.1038/s41598-024-65014-3 -
Iranian Journal of Otorhinolaryngology May 2024COVID-19 infection was accompanied by otologic symptoms, a pattern that was captured early by Google Trends. The objective of this study is to investigate searches for...
INTRODUCTION
COVID-19 infection was accompanied by otologic symptoms, a pattern that was captured early by Google Trends. The objective of this study is to investigate searches for otologic symptoms and identify correlations with the pandemic onset.
MATERIALS AND METHODS
Search interest for otologic symptoms was gathered using Google Trends from two years before and two years following the pandemic start date. A two-tailed Mann-Whitney U test was used to identify significant changes and effect size.
RESULTS
In total, search interest for 14 terms was collected, with significant changes identified in 11. Six terms showed increased search interest, with the most significant rises observed for headache (r=0.589, 0.001), dizziness (r=0.554, 0.001), and tinnitus (r=0.410, 0.001). Search interest decreased for five terms, with the most notable declines found in searches for migraine headache (r=0.35, 0.001) and phonophobia (r=0.22, 0.002). No significant changes were seen in ear pressure (0.142), neck pain (0.935), and sudden hearing loss (0.863) searches.
CONCLUSION
COVID-19 infection is often accompanied otologic symptoms and holds a diagnostic role. Fluctuating search interest may be attributed to a true increase in cases, media trends, or people's desires to stay informed. Google Trends robustly captured trends in search interest and presented itself as a valuable epidemiological tool.
PubMed: 38745683
DOI: 10.22038/IJORL.2024.75617.3532 -
American Journal of Audiology Dec 2023Hyperacusis often leads to debilitating psychosocial consequences, but there is no standard protocol for its diagnosis and management in the United States. In this...
PURPOSE
Hyperacusis often leads to debilitating psychosocial consequences, but there is no standard protocol for its diagnosis and management in the United States. In this study, we surveyed U.S. clinical audiologists to understand their education and clinical practices surrounding the evaluation and treatment of hyperacusis.
METHOD
An online survey was distributed to clinical audiologists across the United States. Survey responses were quantified using descriptive statistics and inductive content analysis.
RESULTS
Hyperacusis definitions and clinical practice patterns varied widely across the 102 respondents. Respondents cited a lack of education and training as the primary barrier to effective audiological diagnosis and management of hyperacusis, with most respondents reporting ≤ 5 hr of hyperacusis education. Other primary barriers to effective audiological management of hyperacusis included time constraints, reimbursement, poor sensitivity and specificity of available diagnostic tools, and poor efficacy of available treatments and management strategies. Most respondents (82.5%) agreed that audiologists are the primary professionals who are responsible for implementing hyperacusis interventions. However, 63.3% of respondents reported that their clinic does not have a hyperacusis management protocol, and 80.0% routinely recommend treatment that is outside their scope of practice to implement (cognitive behavioral therapy).
CONCLUSIONS
Clinical audiologists in the United States do not receive uniform education on hyperacusis, and they report multiple barriers to its evidence-based diagnosis and management. Effective hyperacusis management necessitates a multidisciplinary approach. The information obtained via this survey will pave the way toward the refinement of interprofessional education programs and the development of systematic, evidence-based clinical protocols for hyperacusis.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.24431188.
Topics: Humans; United States; Audiology; Hyperacusis; Practice Patterns, Physicians'; Audiologists; Educational Status
PubMed: 37917915
DOI: 10.1044/2023_AJA-23-00118 -
Frontiers in Neuroanatomy 2024Auditory information is relayed from the cochlea via the eighth cranial nerve to the dorsal and ventral cochlear nuclei (DCN, VCN). The organization, neurochemistry and...
INTRODUCTION
Auditory information is relayed from the cochlea via the eighth cranial nerve to the dorsal and ventral cochlear nuclei (DCN, VCN). The organization, neurochemistry and circuitry of the cochlear nuclei (CN) have been studied in many species. It is well-established that glycine is an inhibitory transmitter in the CN of rodents and cats, with glycinergic cells in the DCN and VCN. There are, however, major differences in the laminar and cellular organization of the DCN between humans (and other primates) and rodents and cats. We therefore asked whether there might also be differences in glycinergic neurotransmission in the CN.
METHODS
We studied brainstem sections from humans, chimpanzees, and cats. We used antibodies to glycine receptors (GLYR) to identify neurons receiving glycinergic input, and antibodies to the neuronal glycine transporter (GLYT2) to immunolabel glycinergic axons and terminals. We also examined archival sections immunostained for calretinin (CR) and nonphosphorylated neurofilament protein (NPNFP) to try to locate the octopus cell area (OCA), a region in the VCN that rodents has minimal glycinergic input.
RESULTS
In humans and chimpanzees we found widespread immunolabel for glycine receptors in DCN and in the posterior (PVCN) and anterior (AVCN) divisions of the VCN. We found a parallel distribution of GLYT2-immunolabeled fibers and puncta. The data also suggest that, as in rodents, a region containing octopus cells in cats, humans and chimpanzees has little glycinergic input.
DISCUSSION
Our results show that glycine is a major transmitter in the human and chimpanzee CN, despite the species differences in DCN organization. The sources of the glycinergic input to the CN in humans and chimpanzees are not known.
PubMed: 38425805
DOI: 10.3389/fnana.2024.1331230 -
Frontiers in Neurology 2023Tension-Type Headache (TTH) is regarded as the third most prevalent disorder worldwide, prompting children to seek medical attention. Our objective is to investigate the...
BACKGROUND
Tension-Type Headache (TTH) is regarded as the third most prevalent disorder worldwide, prompting children to seek medical attention. Our objective is to investigate the prevalence of TTH among students aged 6 to 18 years in various geographical regions of Iran, while also assessing the impact of headaches on their quality of life.
METHODS
Employing a cross-sectional survey, we have carefully distributed self-completed structured questionnaires to students in 121 meticulously selected schools throughout the country, ensuring the representation of its diverse population.
RESULTS
Among the 2,958 potential participants, we have included a total of 2031 individuals in our study. This comprises 57.3% children and 42.7% adolescents, with 50.02% being males and 49.97% females. Specifically, we have examined 950 subjects with TTH and 1,081 individuals without any form of headache. TTH was diagnosed in 32.1% of the participants. Notably, we have observed a significant difference in the average age between the TTH subjects and those without headaches. Participants without headaches were more likely to be enrolled in primary schools, while those diagnosed with TTH predominantly attended high schools. We found no significant relationship between urban-rural areas or different geographic regions and the prevalence of TTH or its subtypes. Phonophobia was commonly associated with TTHs. Lastly, the mean quality-of-life score was highest for individuals without headaches, followed by those with low frequency episodic TTH, high frequency episodic TTH, and chronic TTHs. There was also a significant relation between headache severity and quality of life scores.
CONCLUSION
The significant prevalence of TTH in children and adolescents and its adverse impact on the daily activities of individuals underscore the utmost importance of accurate diagnosis and efficient management.
PubMed: 37780714
DOI: 10.3389/fneur.2023.1259624 -
Journal of Clinical Medicine Oct 2023Hyperacusis, a kind of decreased sound tolerance, is difficult to measure objectively. It often co-occurs with tinnitus. There is a need for valid and reliable...
Hyperacusis, a kind of decreased sound tolerance, is difficult to measure objectively. It often co-occurs with tinnitus. There is a need for valid and reliable patient-reported outcome measures to capture this subjective phenomenon. The aim of the study was to create a questionnaire capturing hyperacusis in terms of loudness, fear, and pain and to evaluate its psychometric properties. The study sample consisted of 106 adult patients with hyperacusis and tinnitus with a mean age of 45.2 years. A medical interview, an audiological examination, and several questionnaires (the Tinnitus Handicap Inventory, the Hyperacusis Questionnaire, the State-Trait Anxiety Inventory, and Visual Analog Scales) were applied. The final 14-item Hyperacusis Assessment Questionnaire showed an appropriate three-factor structure with 70.5% of the variance explained. Convergent and divergent validity were confirmed by correlations with other measures of hyperacusis, anxiety, tinnitus severity, misophonia, and hearing thresholds. The internal consistency assessed with Cronbach's alpha was excellent (α = 0.91), as was reproducibility (intraclass correlation, ICC = 0.96). The new Hyperacusis Assessment Questionnaire is a psychometrically sound and brief tool assessing the severity of hyperacusis in terms of loudness, fear, and pain. It can be used in clinical practice and scientific research for patients with hyperacusis and tinnitus.
PubMed: 37892760
DOI: 10.3390/jcm12206622 -
Iranian Journal of Child Neurology 2024Gangliosidosis is one of the hereditary metabolic diseases caused by the accumulation of Gangliosid in the central nervous system, leading to severe and progressive...
ABSTRACT
Gangliosidosis is one of the hereditary metabolic diseases caused by the accumulation of Gangliosid in the central nervous system, leading to severe and progressive neurological deficits. Regarding phenotype, GM1 and GM2-Gangliosidosis are divided into Infantile, Juvenile, and Adult.
MATERIALS & METHODS
In this study, thirty-seven patients with GM1 and GM2-Gangliosidosis were referred to the neurology department of Mofid Children's Hospital in Tehran, Iran, whose disease was confirmed from September 2019 to December 2021. This study assessed age, sex, and developmental status before the onset of the disease, clinical manifestations, brain imaging, and electroencephalography.
RESULTS
97.20% of patients were the result of family marriage. Approximately 80% of juvenile patients were developmentally normal before the onset of the disease. Developmental delay was more common among infantile GM1-Gangliosidosis than infantile GM2-Gangliosidosis, but in total, more than 50% of GM1&GM2-Gangliosidosis patients had reached their developmental milestone before the onset of the disease. With the onset of disease symptoms, 100% of patients regressed in terms of movement, 97.20% of them mentally, and 75% of them had seizures during the disease. The most common clinical findings were cherry-red spot, Mongolian spot, macrocephaly, organomegaly, hyperacusis, and scoliosis. The most common brain imaging findings included bilateral thalamus involvement, brain atrophy, PVL, and delayed myelination. The most common finding in electroencephalography was background low voltage with abnormal sharp waves.
CONCLUSION
This study concluded that most of the patients are the result of family marriage, and most of the juvenile patients are developmentally normal before the onset of the disease. In addition, more than 50% of infantile patients reach their developmental milestones before the onset of the disease. The most common clinical findings of these patients are seizures, cherry-red spot, macrocephaly, hyperacusis, Mongolian spot, and bilateral involvement of the thalamus.
PubMed: 38617391
DOI: 10.22037/ijcn.v18i2.40751 -
Taiwanese Journal of Obstetrics &... Mar 2024Recurrent disseminated coccidioidal meningitis in two subsequent pregnancies is rare and can pose a challenge in ensuring the health of both mother and baby. In this...
OBJECTIVE
Recurrent disseminated coccidioidal meningitis in two subsequent pregnancies is rare and can pose a challenge in ensuring the health of both mother and baby. In this unique case we highlight this rare occurrence and subsequent treatment.
CASE REPORT
A 29-year-old G4P1021 with a history of disseminated coccidioidomycosis in a previous pregnancy presented at 8 weeks gestation with nausea, headache, and neck pain. Cerebrospinal fluid analysis was positive for recurrent coccidioidal infection. She was started on Amphotericin and discharged. She re-presented at 30 week's gestation with phonophobia and photophobia, emesis, neck pain and swelling. MRI showed evidence of ventriculomegaly with communicating hydrocephalus. She was treated with therapeutic lumbar punctures throughout her pregnancy and a ventriculoperitoneal shunt following delivery. She had a spontaneous vaginal delivery at 38 weeks and 3 days with no complications.
CONCLUSION
This unique case highlights the susceptibility of recurrent disseminated coccidioidomycosis in subsequent pregnancies and treatment thereof.
Topics: Humans; Infant; Female; Pregnancy; Adult; Coccidioidomycosis; Neck Pain; Meningitis, Fungal; Amphotericin B; Hydrocephalus
PubMed: 38485323
DOI: 10.1016/j.tjog.2024.01.022 -
Heliyon May 2024Medication overuse headache (MOH) is a secondary headache disorder that leads to pronounced disability and decreased quality of life. Available therapeutic options for...
BACKGROUND
Medication overuse headache (MOH) is a secondary headache disorder that leads to pronounced disability and decreased quality of life. Available therapeutic options for MOH are limited, and many are only effective in a subset of individuals. Although the existing evidence is limited, acupuncture may be an effective treatment option for MOH.
CASE PRESENTATION
A 45-year-old Chinese woman presented to the Medical Acupuncture Department of Sanming Integrated Traditional Chinese and Western Medicine Hospital on April 11, 2022. Thirty-five years ago, she had episodic migraines. The frequency increased over time, however, and for the past 10 years she has had daily headaches. These headaches were characterized by daily persistent throbbing pain on the left side of the patient's head, accompanied by photophobia, phonophobia, neck stiffness, dizziness, and fatigue. Without painkillers, the patient rated her headache intensity as 9 out of 10 on a visual analog scale (0 = no pain, 10 = intolerable pain), and reported that the headaches lasted for up to 7 days or more. With painkillers, the headaches had a reduced intensity (5 of 10), but persisted. The patient had taken 1-3.5 compound aminopyrine phenacetin tablets daily for more than 5 years. Standard conservative therapy (patient education, medication withdrawal, and behavioral intervention) for MOH had failed to improve her symptoms. Before her visit, the patient had headache and engaged in short-term medication use on 30 days per month. The total monthly headache intensity score was 90. The patient's Migraine-Specific Quality of Life Questionnaire (MSQ) score was 33 points, her Hamilton Depression Scale (HAMD) score was 24 points, and her Hamilton Anxiety Scale (HAMA) score was 20 points.
RESULTS
After 48 acupuncture sessions over 24 weeks, the patient completely discontinued short-term analgesic use and the monthly number of headache days and headache intensity score were both reduced by 96.67 % (from 30 to 1 and 90 to 3, respectively), with no adverse effect. Compared with baseline, the MSQ, HAMD, and HAMA scores improved by 45, 17, and 16 points, respectively. At 12 months, the patient's condition remained stable and her MOH had not relapsed.
CONCLUSION
In the context of the current literature and the present case, electroacupuncture shows promise for the long-term relief of chronic migraine with MOH when other treatments fail.
PubMed: 38720738
DOI: 10.1016/j.heliyon.2024.e30417 -
Journal of the Belgian Society of... 2023Chiari malformation exhibits well-defined clinical signs, symptoms, and incidence rates in clinical studies. However, cerebellar tonsil ectopia presents with ambiguous...
OBJECTIVES
Chiari malformation exhibits well-defined clinical signs, symptoms, and incidence rates in clinical studies. However, cerebellar tonsil ectopia presents with ambiguous symptoms and undetermined incidence rates in numerous studies. Our objective was to determine the incidence of cerebellar tonsil ectopia in individuals with headaches and identify additional clinical symptoms. This aims to improve diagnosis accuracy for clinicians and neurologists, leading to more effective treatment approaches.
METHODS
A cross-sectional study conducted in 2022 included 2305 participants aged 4-78 years presenting with headache. Chiari malformation was diagnosed using magnetic resonance imaging (MRI) scans, with a definition of cerebellar tonsil herniation extending beyond 5mm into the cervical canal.
RESULTS
The prevalence of Chiari malformation was 3.4%, with no significant gender difference (p = 0.72). There was a significant correlation between Chiari malformation and headache exacerbation due to the Valsalva maneuver (p < 0.001) and the presence of vertigo (p < 0.001). No significant association was found between Chiari malformation and accompanying symptoms such as nausea (p = 0.43), photophobia (p = 0.2), phonophobia (p = 0.52), and speech disorders (p = 0.45).
CONCLUSION
These findings suggest a notable prevalence of Chiari malformation among headache patients and its association with specific headache characteristics, such as acute and occipital headaches, exacerbation by the Valsalva maneuver, and the co-occurrence of vertigo. These results underscore the need to consider Chiari malformation in the differential diagnosis of patients presenting with these specific headache features.
PubMed: 37808341
DOI: 10.5334/jbsr.3264