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Inguscio BMS, Cartocci G, Sciaraffa N, Nicastri M, Giallini I, Aricò P, Greco A, Babiloni F, Mancini P. Two are better than one: Differences in cortical EEG patterns during auditory and visual verbal working memory processing between Unilateral and Bilateral Cochlear Implanted children. Hear Res 2024; 446:109007. [PMID: 38608331 DOI: 10.1016/j.heares.2024.109007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024]
Abstract
Despite the proven effectiveness of cochlear implant (CI) in the hearing restoration of deaf or hard-of-hearing (DHH) children, to date, extreme variability in verbal working memory (VWM) abilities is observed in both unilateral and bilateral CI user children (CIs). Although clinical experience has long observed deficits in this fundamental executive function in CIs, the cause to date is still unknown. Here, we have set out to investigate differences in brain functioning regarding the impact of monaural and binaural listening in CIs compared with normal hearing (NH) peers during a three-level difficulty n-back task undertaken in two sensory modalities (auditory and visual). The objective of this pioneering study was to identify electroencephalographic (EEG) marker pattern differences in visual and auditory VWM performances in CIs compared to NH peers and possible differences between unilateral cochlear implant (UCI) and bilateral cochlear implant (BCI) users. The main results revealed differences in theta and gamma EEG bands. Compared with hearing controls and BCIs, UCIs showed hypoactivation of theta in the frontal area during the most complex condition of the auditory task and a correlation of the same activation with VWM performance. Hypoactivation in theta was also observed, again for UCIs, in the left hemisphere when compared to BCIs and in the gamma band in UCIs compared to both BCIs and NHs. For the latter two, a correlation was found between left hemispheric gamma oscillation and performance in the audio task. These findings, discussed in the light of recent research, suggest that unilateral CI is deficient in supporting auditory VWM in DHH. At the same time, bilateral CI would allow the DHH child to approach the VWM benchmark for NH children. The present study suggests the possible effectiveness of EEG in supporting, through a targeted approach, the diagnosis and rehabilitation of VWM in DHH children.
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Affiliation(s)
- Bianca Maria Serena Inguscio
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy.
| | - Giulia Cartocci
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy
| | | | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
| | - Pietro Aricò
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy; Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, Via Ariosto 125, Rome 00185, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
| | - Fabio Babiloni
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy; Department of Computer Science, Hangzhou Dianzi University, Xiasha Higher Education Zone, Hangzhou 310018, China
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
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Nicastri M, Dincer D'Alessandro H, Baccolini V, Migliara G, Sciurti A, De Vito C, Ranucci L, Giallini I, Greco A, Mancini P. Executive functions in preschool and school-age cochlear implant users: do they differ from their hearing peers? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2024; 281:579-600. [PMID: 37816839 DOI: 10.1007/s00405-023-08260-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/20/2023] [Indexed: 10/12/2023]
Abstract
PURPOSE Executive functions (EF) play a fundamental role in planning and executing goal-driven behaviours. The purpose of this systematic review and meta-analysis was to investigate EF skills mastered by preschool/school-age cochlear implanted children (CIC) without morpho-functional abnormalities and to compare their outcomes with typically hearing children (THC). METHODS Bibliographic search for observational studies of any language/date up to 16 December 2022 was performed with the following electronic databases: PubMed, Scopus, and Web of Science. After removal of duplicates, 2442 records were subjected to a three-stage screening process and 83 potentially eligible articles were identified. A total of 15 studies was included in the final analysis: 9 articles directly meeting the eligibility criteria plus 6 more studies thanks to the authors sharing their data set, specifically for participants who met present inclusion criteria. RESULTS Meta-analysis showed a statistically significant difference only for verbal short-term memory, whereas group differences for visuospatial short-term memory and verbal/visuospatial working memory were not significant. For fluency skills, meta-analysis revealed statistical significance for the semantic fluency task but not for the rapid naming test. Qualitative analysis reflected group similarities in flexibility but CIC's difficulties in auditory attention/planning skills. Controversial findings for inhibitory control skills were observed. CONCLUSIONS EF performance comparisons between CIC and THC show inter-skill and inter-test variances. Due to the paucity of existing studies, present findings should be interpreted with caution. Future research in this domain is strongly recommended.
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Affiliation(s)
- Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Hilal Dincer D'Alessandro
- Department of Audiology, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Migliara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Antonio Sciurti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Laura Ranucci
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
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Nicastri M, Dinçer D'Alessandro H, Giallini I, D'Amico A, Geraci A, Inguscio BMS, Guerzoni L, Cuda D, Vestri A, Fegatelli DA, Mancini P. Emotional abilities in preadolescents and adolescents with long-term cochlear implant use. Int J Pediatr Otorhinolaryngol 2024; 177:111866. [PMID: 38224654 DOI: 10.1016/j.ijporl.2024.111866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/10/2024] [Indexed: 01/17/2024]
Abstract
OBJECTIVES Emotional abilities (EAs) are particularly important during preadolescence/adolescence, two challenging periods characterized by significant biological, physical, and cognitive changes. The present study attempted to a holistic EA approach in preadolescents/adolescents with cochlear implants (CI) and typical hearing (TH), considering various aspects such as perception, cognitive facilitation, comprehension, and management of emotions. A secondary aim was to identify significant demographic and audiological factors of EA development. METHODS CI/TH groups were matched for chronological age, nonverbal IQ, gender, economic income, and maternal level of education. Each group consisted of 43 participants (age range 10-18 years). EAs were evaluated by using the multi-trait/method IE-ACCME test. Auditory-linguistic assessments included participants' lexical skills and Matrix performance as well. RESULTS EA performance for perception and cognitive facilitation did not show any statistically significant CI/TH group differences (p > 0.05). Significant CI/TH differences emerged for emotion comprehension and management: CI group performed significantly worse in understanding emotional blends (t = 2.56, p = 0.014) but better in personal emotion management (t = -2.01, p = 0.048). For the CI group, gender showed statistically significant effects on cognitive facilitation in sensations, with males performing better than females (U = 129, p = 0.018). TH preadolescents showed significantly lower scores in understanding emotional changes in comparison to TH adolescents (U = 125.5, p = 0.01). Emotional blends understanding showed a weak negative correlation with Matrix performance (r = - 0.38, p = 0.013) and a moderate positive correlation with lexical skills (r = 0.40, p = 0.008). Relationships management showed various significant correlations: weak negative correlations with age at CI (r = - 0.38, p = 0.011) and Matrix performance (r = - 0.36, p = 0.016) as well as weak positive correlations with nonverbal-IQ (r = 0.38, p = 0.013) and positive moderate correlations with lexical skills (r = 0.49, p < 0.001). CONCLUSION Cochlear implantation seems to show significant positive effects on emotional development in children, allowing them to achieve age appropriate EAs as they grow up and become preadolescents/adolescents. EA assessment in CI users may not only support monitorization of EA trajectory, but also early identification of any EA disorders, so that subjects with low EA profiles could be timely and properly intervened.
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Affiliation(s)
- Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Hilal Dinçer D'Alessandro
- Department of Audiology, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Antonella D'Amico
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy; WeSearch Lab - Laboratory of Behavioral Observation and Research on Human Development, University of Palermo, Palermo, Italy
| | - Alessandro Geraci
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy; WeSearch Lab - Laboratory of Behavioral Observation and Research on Human Development, University of Palermo, Palermo, Italy
| | | | - Letizia Guerzoni
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Domenico Cuda
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Annarita Vestri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Danilo Alunni Fegatelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
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Dinçer D'Alessandro H, Nicastri M, Portanova G, Giallini I, Russo FY, Magliulo G, Greco A, Mancini P. Low-frequency pitch coding: relationships with speech-in-noise and music perception by pediatric populations with typical hearing and cochlear implants. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-023-08445-4. [PMID: 38194096 DOI: 10.1007/s00405-023-08445-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/27/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE This study aimed to investigate the effects of low frequency (LF) pitch perception on speech-in-noise and music perception performance by children with cochlear implants (CIC) and typical hearing (THC). Moreover, the relationships between speech-in-noise and music perception as well as the effects of demographic and audiological factors on present research outcomes were studied. METHODS The sample consisted of 22 CIC and 20 THC (7-10 years). Harmonic intonation (HI) and disharmonic intonation (DI) tests were used to assess LF pitch perception. Speech perception in quiet (WRSq)/noise (WRSn + 10) were tested with the Italian bisyllabic words for pediatric populations. The Gordon test was used to evaluate music perception (rhythm, melody, harmony, and overall). RESULTS CIC/THC performance comparisons for LF pitch, speech-in-noise, and all music measures except harmony revealed statistically significant differences with large effect sizes. For the CI group, HI showed statistically significant correlations with melody discrimination. Melody/total Gordon scores were significantly correlated with WRSn + 10. For the overall group, HI/DI showed significant correlations with all music perception measures and WRSn + 10. Hearing thresholds showed significant effects on HI/DI scores. Hearing thresholds and WRSn + 10 scores were significantly correlated; both revealed significant effects on all music perception scores. CI age had significant effects on WRSn + 10, harmony, and total Gordon scores (p < 0.05). CONCLUSION Such findings confirmed the significant effects of LF pitch perception on complex listening performance. Significant speech-in-noise and music perception correlations were as promising as results from recent studies indicating significant positive effects of music training on speech-in-noise recognition in CIC.
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Affiliation(s)
- Hilal Dinçer D'Alessandro
- Department of Audiology, Faculty of Health Sciences, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
| | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Ginevra Portanova
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | | | - Giuseppe Magliulo
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
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Nicastri M, Lo Castro F, Giallini I, Inguscio BMS, Mariani L, Portanova G, Ruoppolo G, Orlando MP, Dincer D'Alessandro H, Mancini P. Vocal singing skills by cochlear implanted children without formal musical training: Familiar versus unfamiliar songs. Int J Pediatr Otorhinolaryngol 2023; 170:111605. [PMID: 37245390 DOI: 10.1016/j.ijporl.2023.111605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/03/2023] [Accepted: 05/21/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Vocal singing skills in pediatric CI users are not much known due to the limited number of studies. The principal aim of the present study was to evaluate vocal singing skills in Italian pediatric CI users. A further aim was to investigate factors that may significantly influence their performance. METHODS The participants were twenty-two implanted children and twenty-two hearing peers. Their vocal singing skills for familiar ("Happy Birthday to You") and unfamiliar songs ("Baton Twirler" from Pam Pam 2- Tribute to Gordon) were evaluated in relation to their music perception (the Gordon test). Acoustic analysis was performed using Praat and MATLAB software. Nonparametric statistical tests and principal component analysis (PCA) were used to analyze the data. RESULTS Hearing children outperformed implanted peers in both music perception and vocal singing tasks (all measures regarding intonation, vocal range, melody, and memory for the familiar song versus measures regarding intonation and overall melody production for the unfamiliar song). Music perception and vocal singing performances revealed strong correlations. For the familiar and unfamiliar songs, age-appropriate vocal singing was observed in 27.3% versus 45.4% of children, all implanted within 24 months of age. Age at implantation and duration of CI experience were moderately correlated with the total score obtained from the Gordon test. CONCLUSION Implanted children show limited vocal singing skills in comparison to their hearing peers. However, some children implanted within 24 months of age seem to achieve vocal singing skills as good as their hearing peers. Future research could be useful to better understand the role of brain plasticity to implement specific training programs for both music perception and vocal singing.
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Affiliation(s)
- Maria Nicastri
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Fabio Lo Castro
- CNR-INM-Section of Acoustics and Sensors "O.M.ca Corbino", 00133, Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University, Rome, Italy
| | | | - Laura Mariani
- Department of Sense Organs, Sapienza University, Rome, Italy
| | | | | | | | - Hilal Dincer D'Alessandro
- Istanbul University-Cerrahpasa, Faculty of Health Sciences, Department of Audiology, Istanbul, Turkey.
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Giallini I, Inguscio BMS, Nicastri M, Portanova G, Ciofalo A, Pace A, Greco A, D’Alessandro HD, Mancini P. Neuropsychological Functions and Audiological Findings in Elderly Cochlear Implant Users: The Role of Attention in Postoperative Performance. Audiol Res 2023; 13:236-253. [PMID: 37102772 PMCID: PMC10136178 DOI: 10.3390/audiolres13020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Objectives: The present study aimed to investigate in a group of elderly CI users working memory and attention, conventionally considered as predictors of better CI performance and to try to disentangle the effects of these cognitive domains on speech perception, finding potential markers of cognitive decline related to audiometric findings. Methods Thirty postlingually deafened CI users aged >60 underwent an audiological evaluation followed by a cognitive assessment of attention and verbal working memory. A correlation analysis was performed to evaluate the associations between cognitive variables while a simple regression investigated the relationships between cognitive and audiological variables. Comparative analysis was performed to compare variables on the basis of subjects’ attention performance. Results: Attention was found to play a significant role in sound field and speech perception. Univariate analysis found a significant difference between poor and high attention performers, while regression analysis showed that attention significantly predicted recognition of words presented at Signal/Noise +10. Further, the high attention performers showed significantly higher scores than low attentional performers for all working memory tasks. Conclusion: Overall findings confirmed that a better cognitive performance may positively contribute to better speech perception outcomes, especially in complex listening situations. WM may play a crucial role in storage and processing of auditory-verbal stimuli and a robust attention may lead to better performance for speech perception in noise. Implementation of cognitive training in auditory rehabilitation of CI users should be investigated in order to improve cognitive and audiological performance in elderly CI users.
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Mancini P, Nicastri M, Giallini I, Odabaşi Y, Greco A, Dincer D'Alessandro H, Portanova G, Mariani L. Long-term speech perception and morphosyntactic outcomes in adolescents and young adults implanted in childhood. Int J Pediatr Otorhinolaryngol 2023; 167:111514. [PMID: 36947998 DOI: 10.1016/j.ijporl.2023.111514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Long-term assessments of children with cochlear implants (CI) are important inputs to help guide families and professionals in therapeutic and counselling processes. Based on these premises, the primary aim of the present study was to assess the long-term speech and language outcomes in a sample of prelingually deaf or hard of hearing (DHH) adolescents and young adults with unilateral or bilateral implantation in childhood. The secondary aim was to investigate the correlations of age at implantation with long-term speech and language outcomes. MATERIALS AND METHODS Retrospective observational study on 54 long-term CI users, 33 unilateral and 21 bilateral (mean age at CI surgery 38.1 ± 24.6 months; mean age at last follow-up assessment 19.1 ± 4.3 years of age and mean follow-up time 16 ± 3.7 years). Means and standards were used to describe speech perception (in quiet, in fixed noise and in adaptive noise using It-Matrix) and morphosyntactic comprehension (TROG-2) outcomes. A univariate analysis was used to evaluate outcome differences between unilateral and bilateral patients. Bivariate analysis was performed to investigate the relationships between age at CI, audiological variables, and language outcomes. Finally, multivariate analysis was performed to quantify the relationship between It-Matrix, sentence recognition in quiet and at SNR+10 and TROG-2. RESULTS The participants showed good speech recognition performance in quiet (94% for words and 89% for sentences) whilst their speech-in-noise scores decreased significantly. For the It-Matrix, only 9.2% of the participants showed scores within the normative range. This value was 60% for TROG-2 performance. For both auditory and language skills, group differences for unilateral versus bilateral CI users were not statistically significant (p > 0.05). Bivariate analysis showed that age at CI correlated significantly with overall results at TROG-2 (r = -0.6; p < 0.001) and with It-Matrix (r = 0.5; p < 0.001). TROG-2 was negatively correlated with results for It-Matrix (r = -0.5; p < 0.001). In the multivariate analysis with It-Matrix as a dependent variable, the model explained 63% of the variance, of which 60% was related to sentence recognition and 3% to morphosyntax. CONCLUSIONS These data contribute to the definition of average long-term outcomes expected in subjects implanted during childhood whilst increasing our knowledge of the effects of variables such as age at CI and morphosyntactic comprehension on speech perception. Although the majority of this prelingually DHH cohort did not achieve scores within a normative range, remarkably better It-Matrix scores were observed when compared to those from postlingually deafened adult CI users.
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Affiliation(s)
| | - Maria Nicastri
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Yilmaz Odabaşi
- Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Antonio Greco
- Department of Sense Organs, Sapienza University, Rome, Italy
| | | | - Ginevra Portanova
- Department of Sense Organs, Sapienza University, Rome, Italy; Clinical and Experimental Neuroscience and Psychiatry PhD Program, Italy
| | - Laura Mariani
- Department of Sense Organs, Sapienza University, Rome, Italy; Clinical and Experimental Neuroscience and Psychiatry PhD Program, Italy.
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Nicastri M, Giallini I, Inguscio BMS, Turchetta R, Guerzoni L, Cuda D, Portanova G, Ruoppolo G, Dincer D'Alessandro H, Mancini P. The influence of auditory selective attention on linguistic outcomes in deaf and hard of hearing children with cochlear implants. Eur Arch Otorhinolaryngol 2023; 280:115-124. [PMID: 35831674 DOI: 10.1007/s00405-022-07463-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/23/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Auditory selective attention (ASA) is crucial to focus on significant auditory stimuli without being distracted by irrelevant auditory signals and plays an important role in language development. The present study aimed to investigate the unique contribution of ASA to the linguistic levels achieved by a group of cochlear implanted (CI) children. METHODS Thirty-four CI children with a median age of 10.05 years were tested using both the "Batteria per la Valutazione dell'Attenzione Uditiva e della Memoria di Lavoro Fonologica nell'età evolutiva-VAUM-ELF" to assess their ASA skills, and two Italian standardized tests to measure lexical and morphosyntactic skills. A regression analysis, including demographic and audiological variables, was conducted to assess the unique contribution of ASA to language skills. RESULTS The percentages of CI children with adequate ASA performances ranged from 50 to 29.4%. Bilateral CI children performed better than their monolateral peers. ASA skills contributed significantly to linguistic skills, accounting alone for the 25% of the observed variance. CONCLUSIONS The present findings are clinically relevant as they highlight the importance to assess ASA skills as early as possible, reflecting their important role in language development. Using simple clinical tools, ASA skills could be studied at early developmental stages. This may provide additional information to outcomes from traditional auditory tests and may allow us to implement specific training programs that could positively contribute to the development of neural mechanisms of ASA and, consequently, induce improvements in language skills.
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Affiliation(s)
- Maria Nicastri
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University, Rome, Italy
| | | | | | - Letizia Guerzoni
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Domenico Cuda
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | | | - Giovanni Ruoppolo
- I.R.C.C.S. San Raffaele Pisana, Via Nomentana, 401, 00162, Rome, Italy
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Inguscio BMS, Cartocci G, Sciaraffa N, Nicastri M, Giallini I, Greco A, Babiloni F, Mancini P. Gamma-Band Modulation in Parietal Area as the Electroencephalographic Signature for Performance in Auditory-Verbal Working Memory: An Exploratory Pilot Study in Hearing and Unilateral Cochlear Implant Children. Brain Sci 2022; 12:1291. [PMID: 36291225 PMCID: PMC9599211 DOI: 10.3390/brainsci12101291] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 07/30/2023] Open
Abstract
This pilot study investigates the neurophysiological patterns of visual and auditory verbal working memory (VWM) in unilateral cochlear implant users (UCIs). We compared the task-related electroencephalogram (EEG) power spectral density of 7- to 13-year-old UCIs (n = 7) with a hearing control group (HC, n = 10) during the execution of a three-level n-back task with auditory and visual verbal (letters) stimuli. Performances improved as memory load decreased regardless of sensory modality (SM) and group factors. Theta EEG activation over the frontal area was proportionally influenced by task level; the left hemisphere (LH) showed greater activation in the gamma band, suggesting lateralization of VWM function regardless of SM. However, HCs showed stronger activation patterns in the LH than UCIs regardless of SM and in the parietal area (PA) during the most challenging audio condition. Linear regressions for gamma activation in the PA suggest the presence of a pattern-supporting auditory VWM only in HCs. Our findings seem to recognize gamma activation in the PA as the signature of effective auditory VWM. These results, although preliminary, highlight this EEG pattern as a possible cause of the variability found in VWM outcomes in deaf children, opening up new possibilities for interdisciplinary research and rehabilitation intervention.
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Affiliation(s)
- Bianca Maria Serena Inguscio
- Department of Sense Organs, Sapienza University of Rome, Viale dell’Università 31, 00161 Rome, Italy
- BrainSigns Srl, Lungotevere Michelangelo, 9, 00192 Rome, Italy
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell’Università 30, 00161 Rome, Italy
| | - Giulia Cartocci
- BrainSigns Srl, Lungotevere Michelangelo, 9, 00192 Rome, Italy
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, 00161 Rome, Italy
| | | | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Viale dell’Università 31, 00161 Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Viale dell’Università 31, 00161 Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale dell’Università 31, 00161 Rome, Italy
| | - Fabio Babiloni
- BrainSigns Srl, Lungotevere Michelangelo, 9, 00192 Rome, Italy
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, 00161 Rome, Italy
- Department of Computer Science, Hangzhou Dianzi University, Xiasha Higher Education Zone, Hangzhou 310018, China
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale dell’Università 31, 00161 Rome, Italy
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Mariani L, Cilfone A, Nicastri M, Pipitone LL, Stella F, de Vincentiis M, Greco A, Mancini P, Longo L, Ruoppolo G. Accuracy of Dysphagia Standard Assessment (DSA®) bedside screening test: a flowchart for patient eligibility. Neurol Sci 2022; 43:5411-5419. [PMID: 35660987 PMCID: PMC9385749 DOI: 10.1007/s10072-022-06175-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/26/2022] [Indexed: 11/24/2022]
Abstract
Background Oropharyngeal dysphagia (OD) screening tests have improved patient management; however, the complex applicability and high percentage of false negatives do not allow these tests to be considered completely reliable if not supported by an instrumental investigation. The aim of the present study is to evaluate an OD screening test, the Dysphagia Standard Assessment (DSA®) with different volumes and viscosities. Materials and methods Prospective study of 72 patients evaluated for suspected OD through a double-blind methodology conducted by two operators. All patients underwent fiberoptic endoscopic evaluation of swallowing (FEES) as a reference test and a separate DSA® test. DSA® was performed by administering boluses with different viscosities, with the signal of interruption of the test being: onset of the cough reflex, wet voice after swallowing, and/or desaturation of O2 ≥ 5%. The Penetration-Aspiration Scale (PAS) was evaluated by FEES. The cut-off identified to diagnose OD was PAS ≥ 3. Results The test showed an accuracy of 82%, a sensitivity of 0.93 (95% C.I. 0.84–0.97), and a specificity of 0.78 (95% C.I. 0.67–0.87); positive predictive value 0.55 (95% C.I. 0.43–0.67); negative predictive value 0.97 (95% C.I. 0.90–0.99), positive likelihood ratio 4.37 (95% C.I. 3.6–5.2); likelihood negative ratio 0.08 (95% C.I. 0.06–0.09). Conclusions According to the preliminary results, the test showed good outcomes in determining the presence or absence of OD with a wide spectrum of applicability with some limitations that could be overcome by the selection of a target population. For this reason, a flowchart to address patient eligibility was developed.
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Affiliation(s)
- Laura Mariani
- Department of Sense Organs, Otorhinolaryngology Section, Sapienza University of Rome, Policlinico Umberto I, Viale dell'Università, 33, 00161, Rome, Italy.
| | - Armando Cilfone
- Department of Sense Organs, Otorhinolaryngology Section, Sapienza University of Rome, Policlinico Umberto I, Viale dell'Università, 33, 00161, Rome, Italy
| | - Maria Nicastri
- Department of Sense Organs, Otorhinolaryngology Section, Sapienza University of Rome, Policlinico Umberto I, Viale dell'Università, 33, 00161, Rome, Italy
| | - Lucia Libera Pipitone
- Department of Sense Organs, Otorhinolaryngology Section, Sapienza University of Rome, Policlinico Umberto I, Viale dell'Università, 33, 00161, Rome, Italy
| | - Federica Stella
- Department of Sense Organs, Otorhinolaryngology Section, Sapienza University of Rome, Policlinico Umberto I, Viale dell'Università, 33, 00161, Rome, Italy
| | - Marco de Vincentiis
- Department of Sense Organs, Otorhinolaryngology Section, Sapienza University of Rome, Policlinico Umberto I, Viale dell'Università, 33, 00161, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Otorhinolaryngology Section, Sapienza University of Rome, Policlinico Umberto I, Viale dell'Università, 33, 00161, Rome, Italy
| | - Patrizia Mancini
- Department of Sense Organs, Otorhinolaryngology Section, Sapienza University of Rome, Policlinico Umberto I, Viale dell'Università, 33, 00161, Rome, Italy
| | - Lucia Longo
- Department of Sense Organs, Otorhinolaryngology Section, Sapienza University of Rome, Policlinico Umberto I, Viale dell'Università, 33, 00161, Rome, Italy
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Inguscio BMS, Nicastri M, Giallini I, Greco A, Babiloni F, Cartocci G, Mancini P. School wellbeing and psychological characteristics of online learning in families of children with and without hearing loss during the Covid-19 pandemic. Psychol Sch 2022; 60:PITS22761. [PMID: 35942392 PMCID: PMC9350277 DOI: 10.1002/pits.22761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/13/2022] [Accepted: 06/06/2022] [Indexed: 11/25/2022]
Abstract
This study investigated the psychological characteristics of online learning on Italian students with and without hearing loss (HL) and on their parents, who were forced into isolation during the Covid-19 pandemic. An online survey collected information on socio-demographic data and opinions concerning online learning from 61 children (mean age 11; 25 males, 36 females), including 43 with HL and also from their parents; additionally, school wellbeing and anxiety were assessed. The results showed that, in both the student and parent groups, no significant effect of HL on school wellbeing and anxiety was found. Additionally, in parents, State Anxiety was significantly higher than Trait Anxiety, suggesting one possible impact of lockdown on psychological wellbeing. Differences due to HL were observed and discussed in correlation analyses. The Authors believe that this study is the first contribution to the psychological evaluation of the impact of online learning on families with hearing-impaired children, from the perspective of a successful, inclusive didactic.
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Affiliation(s)
| | - Maria Nicastri
- Department of Sense OrgansSapienza University of RomeRomeItaly
| | - Ilaria Giallini
- Department of Sense OrgansSapienza University of RomeRomeItaly
| | - Antonio Greco
- Department of Sense OrgansSapienza University of RomeRomeItaly
| | - Fabio Babiloni
- BrainSigns SrlLungotevere MichelangeloRomeItaly
- Department of Molecular MedicineSapienza University of RomeRomeItaly
- Department of Computer ScienceHangzhou Dianzi University, Xiasha Higher Education ZoneHangzhouChina
| | - Giulia Cartocci
- BrainSigns SrlLungotevere MichelangeloRomeItaly
- Department of Molecular MedicineSapienza University of RomeRomeItaly
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Giallini I, Nicastri M, Inguscio BMS, Portanova G, Magliulo G, Greco A, Mancini P. Effects of the "Active Communication Education" Program on Hearing-Related Quality of Life in a Group of Italian Older Adults Cochlear Implant Users. Front Psychol 2022; 13:827684. [PMID: 35668973 PMCID: PMC9163787 DOI: 10.3389/fpsyg.2022.827684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/02/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction The present study aimed to evaluate the effects of the Active Communication Education (ACE) program on the social/emotional impacts of hearing loss (HL) in a group of older adults with a cochlear implant (CI). Design Prospective cohort study design, with a “within-subject” control procedure. Study Sample Twenty adults over-65 post-lingually deafened CI users. All subjects were required to be native Italian speakers, to have normal cognitive level, have no significant psychiatric conditions and/or diagnosed incident dementia, and used CI for at least 9 months. Materials and Methods Twenty participants were assessed using the Hearing Handicap Inventory for the Elderly (HHIE), the Geriatric Depression Scale (GDS), and the Speech, Spatial, and Qualities of Hearing Scale (SSQ) before, during, and after ACE program, with a one and 6-month follow up. The cognitive and audiological evaluation was carried out before commencing the ACE program. Results The ACE program had a positive impact by reducing HL’s social/emotional effects. Participants benefited from a rehabilitative approach by improving multilevel skills: comprehension of audiological and hearing dimensions, acquisition of communicative, pragmatic and problem-solving strategies, and interaction and sharing of experiences with peers. Conclusion Although targeting the older adults with moderate HL, the ACE program also seemed to benefit older adult CI users. An improvement in social and emotional adaptation to hearing difficulties can, in turn, significantly promote optimal use of CI in the older adults, thereby possibly reducing the risk of losing motivation and engagement in device use and in rehabilitation protocols.
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Affiliation(s)
- Ilaria Giallini
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Maria Nicastri
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | | | - Ginevra Portanova
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Giuseppe Magliulo
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Patrizia Mancini
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
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13
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Inguscio BMS, Mancini P, Greco A, Nicastri M, Giallini I, Leone CA, Grassia R, Di Nardo W, Di Cesare T, Rossi F, Canale A, Albera A, Giorgi A, Malerba P, Babiloni F, Cartocci G. ‘Musical effort’ and ‘musical pleasantness’: a pilot study on the neurophysiological correlates of classical music listening in adults normal hearing and unilateral cochlear implant users. Hearing, Balance and Communication 2022. [DOI: 10.1080/21695717.2022.2079325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Carlo Antonio Leone
- Department of Otolaryngology/Head and Neck Surgery, Monaldi Hospital, Naples, Italy
| | - Rosa Grassia
- Department of Otolaryngology/Head and Neck Surgery, Monaldi Hospital, Naples, Italy
| | - Walter Di Nardo
- Otorhinolaryngology and Physiology, Catholic University of Rome, Rome, Italy
| | - Tiziana Di Cesare
- Otorhinolaryngology and Physiology, Catholic University of Rome, Rome, Italy
| | - Federica Rossi
- Otorhinolaryngology and Physiology, Catholic University of Rome, Rome, Italy
| | - Andrea Canale
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Italy
| | - Andrea Albera
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Italy
| | | | | | - Fabio Babiloni
- BrainSigns Srl, Rome, Italy
- Department of Computer Science, Hangzhou Dianzi University, Hangzhou, China
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulia Cartocci
- BrainSigns Srl, Rome, Italy
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
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Nicastri M, Ruoppolo G, Guerzoni L, Cuda D, Giallini I, Cocchi C, de Vincentiis M, Greco A, Mancini P. Listening comprehension in profoundly deaf children with cochlear implants: the role of auditory perception and foundational linguistic and cognitive skills. Eur Arch Otorhinolaryngol 2022; 279:3917-3928. [PMID: 35022862 DOI: 10.1007/s00405-021-07156-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/25/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of the study was to investigate the listening comprehension (LC) skills in deaf and hard of hearing children (DHH) using cochlear implants (CI). Besides, personal and audiological variables that could influence the levels of competence reached were analyzed. METHODS Thirty-four children using CI were enrolled. LC skills were assessed through the standardized Italian test "Comprensione Orale-Test e Trattamento" (CO-TT). A univariate analysis was conducted to compare LC with gender, listening mode (unilateral or bilateral), maternal level of education and family income. A bivariate analysis was performed to search possible connections between children's performances and their individual characteristics, audiological conditions, and language levels. Finally, a multivariate analysis was performed using a stepwise hierarchical linear regression model which included all variables whose p value resulted ≤ 0.05. RESULTS Twenty-one children using CI (61.8%) showed adequate performances in terms of chronological age, while 13 (38.2%) showed difficulties in LC. Maternal level of education, age at diagnosis and non-verbal cognitive level accounted for 43% of the observed variance. Auditory attention skills explained an additional 15% of variance. Morphosyntactic comprehension added a further 12% of variance. CONCLUSION CI can really help many DHH children to reach adequate LC skills, but in some cases difficulties remain. Factors influencing LC need to be early investigated and considered when planning an appropriate rehabilitative intervention.
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Affiliation(s)
- Maria Nicastri
- Department of Sensorial Organs, Sapienza University of Rome, Via Nomentana, 401 00162, Rome, Italy
| | - Giovanni Ruoppolo
- Department of Sensorial Organs, Sapienza University of Rome, Via Nomentana, 401 00162, Rome, Italy.
| | - Letizia Guerzoni
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Domenico Cuda
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Ilaria Giallini
- Department of Sensorial Organs, Sapienza University of Rome, Via Nomentana, 401 00162, Rome, Italy
| | - Chiara Cocchi
- Department of Sensorial Organs, Sapienza University of Rome, Via Nomentana, 401 00162, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sensorial Organs, Sapienza University of Rome, Via Nomentana, 401 00162, Rome, Italy
| | - Patrizia Mancini
- Department of Sensorial Organs, Sapienza University of Rome, Via Nomentana, 401 00162, Rome, Italy
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Giallini I, Nicastri M, Mariani L, Turchetta R, Ruoppolo G, de Vincentiis M, Vito CD, Sciurti A, Baccolini V, Mancini P. Benefits of Parent Training in the Rehabilitation of Deaf or Hard of Hearing Children of Hearing Parents: A Systematic Review. Audiol Res 2021; 11:653-672. [PMID: 34940018 PMCID: PMC8698273 DOI: 10.3390/audiolres11040060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/09/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
The present study is a systematic review on the effectiveness of Parent Training (PT) and coaching in deaf and hard of hearing (DHH) rehabilitation programs which reviews and synthesizes the existing body of evidence to assess the benefits of these programs in enhancing parents' sensitivity, responsivity and promoting language development in DHH children during the first years after HA fitting or CI activation. Five published studies met the Population, Intervention, Comparison and Outcomes (PICO) inclusion criteria and were eligible to be included, but heterogeneity in terms of the study design, interventions and outcomes did not allow for performing a meta-analysis. All included studies shared the view that a parent's learning is a circular (rather than frontal) process, and the results appear promising in terms of enhancing parents' responsiveness and promoting DHH child language development. Nevertheless, the available evidence was judged to not be robust enough due to limitations in the studies' designs. Further high-quality evidence is needed to evaluate the true degree of clinical value and the cost effectiveness of PT programs aimed at increasing parents' responsiveness to their DHH children.
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Affiliation(s)
- Ilaria Giallini
- Department of Sense Organs, University Sapienza of Rome, 00185 Rome, Italy; (I.G.); (M.N.); (L.M.); (R.T.); (G.R.); (M.d.V.)
| | - Maria Nicastri
- Department of Sense Organs, University Sapienza of Rome, 00185 Rome, Italy; (I.G.); (M.N.); (L.M.); (R.T.); (G.R.); (M.d.V.)
| | - Laura Mariani
- Department of Sense Organs, University Sapienza of Rome, 00185 Rome, Italy; (I.G.); (M.N.); (L.M.); (R.T.); (G.R.); (M.d.V.)
| | - Rosaria Turchetta
- Department of Sense Organs, University Sapienza of Rome, 00185 Rome, Italy; (I.G.); (M.N.); (L.M.); (R.T.); (G.R.); (M.d.V.)
| | - Giovanni Ruoppolo
- Department of Sense Organs, University Sapienza of Rome, 00185 Rome, Italy; (I.G.); (M.N.); (L.M.); (R.T.); (G.R.); (M.d.V.)
| | - Marco de Vincentiis
- Department of Sense Organs, University Sapienza of Rome, 00185 Rome, Italy; (I.G.); (M.N.); (L.M.); (R.T.); (G.R.); (M.d.V.)
| | - Corrado De Vito
- Department of Public Health and Infectious Diseases, University Sapienza of Rome, 00185 Rome, Italy; (C.D.V.); (A.S.); (V.B.)
| | - Antonio Sciurti
- Department of Public Health and Infectious Diseases, University Sapienza of Rome, 00185 Rome, Italy; (C.D.V.); (A.S.); (V.B.)
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, University Sapienza of Rome, 00185 Rome, Italy; (C.D.V.); (A.S.); (V.B.)
| | - Patrizia Mancini
- Department of Sense Organs, University Sapienza of Rome, 00185 Rome, Italy; (I.G.); (M.N.); (L.M.); (R.T.); (G.R.); (M.d.V.)
- Correspondence: ; Tel.: +39-3387880512
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Mancini P, Mariani L, Nicastri M, Cavicchiolo S, Giallini I, Scimemi P, Zanetti D, Montino S, Lovo E, Di Berardino F, Trevisi P, Santarelli R. Cochlear implantation in children with Autism Spectrum Disorder (ASD): Outcomes and implant fitting characteristics. Int J Pediatr Otorhinolaryngol 2021; 149:110876. [PMID: 34385039 DOI: 10.1016/j.ijporl.2021.110876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/19/2021] [Accepted: 08/05/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Little is known regarding fitting parameters and receptive and expressive language development in cochlear-implanted children (CCI) with profound sensorineural hearing loss (SHL) who are diagnosed with Autism Spectrum Disorder (ASD). The aim of the study was to evaluate a group of ASD CCI users in order to describe their ASD clinical features and CCI outcomes; report on the average electrical charge requirements; and evaluate the possible correlations between electrical and psychophysical outcomes with ASD characteristics. MATERIALS AND METHODS A multicentre observational study of 22 ASD children implanted in four cochlear implant (CI) centers. Data concerning profound SHL diagnosis, ASD diagnosis, CI timing and CI compliance were collected. Sound Field (SF) was assessed through repeated behavioural measurements. Categories of Auditory Perception (CAP) and Categories of Language (CL) were used to evaluate speech perception and language skills at short (≤2 yrs), medium (5 yrs) and long term (>10 yrs) follow-up. Fitting parameters such as comfortable thresholds, pulse-width (pw, μsec) and clinical units converted into units of charge/phase were collected. The diagnosis of ASD was acquired by the referral neuropsychiatric department and severity was assessed through the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and the Childhood Autism Rating Scale (CARS). RESULTS At the final follow-up session the median SF threshold for CI outcomes was 30 dB HL (min 15 - max 60). CAP score was extremely variable: 45.5% showed no improvement over time and only 22% of children reached CAP scores of 5-7. CL 45.5% showed no improvement over time and score was 1-2 in the majority of ASD children (72.7%), while only 18.2% reached the highest level of language skills. There were no statistically significant differences at each follow-up between subjects with or without comorbidities. CAP and CL were inversely correlated with DSM-V A and B domains, corresponding to lower speech and language scores in children with more severe ASD symptoms, and maintained their correlation at mid and long follow-ups whilst controlling for age at CI. Electrical charge requirements did not correlate with SF or age at implant but did inversely correlate with ASD severity. With regards to CI compliance: only 13.6% children (3) with severe DSM-V A/B levels and CARS score were partial/intermittent users. CONCLUSION The present study is a targeted contribution to the current literature to support clinical procedures for CI fitting and audiological follow-up in children with ASD. The findings indicate that the outcomes of CI use and the fitting procedures are both influenced by the severity of the ASD symptoms rather than the demographic variables or associated disorders.
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Affiliation(s)
| | - Laura Mariani
- Department of Sense Organs, University Sapienza of Rome, Italy.
| | - Maria Nicastri
- Department of Sense Organs, University Sapienza of Rome, Italy
| | - Sara Cavicchiolo
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Italy
| | - Ilaria Giallini
- Department of Sense Organs, University Sapienza of Rome, Italy
| | - Pietro Scimemi
- Department of Neuroscience, University of Padua, Padua - UOSD Otolaryngology and Audiology, Santi Giovanni e Paolo Hospital, Venice, Italy
| | - Diego Zanetti
- Department of Specialistic Surgical Sciences, Foundation IRCCS Ca' Granda Maggiore Hospital, Milan, Italy
| | - Silvia Montino
- Department of Neuroscience, University of Padua, UOC Otolaryngology, Padua Hospital, Italy
| | - Elisa Lovo
- Department of Neuroscience, University of Padua, UOC Otolaryngology, Padua Hospital, Italy
| | - Federica Di Berardino
- Department of Specialistic Surgical Sciences, Foundation IRCCS Ca' Granda Maggiore Hospital, Milan, Italy
| | - Patrizia Trevisi
- Department of Neuroscience, University of Padua, UOC Otolaryngology, Padua Hospital, Italy
| | - Rosamaria Santarelli
- Department of Neuroscience, University of Padua, Padua - UOSD Otolaryngology and Audiology, Santi Giovanni e Paolo Hospital, Venice, Italy
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Nicastri M, Giallini I, Amicucci M, Mariani L, de Vincentiis M, Greco A, Guerzoni L, Cuda D, Ruoppolo G, Mancini P. Variables influencing executive functioning in preschool hearing-impaired children implanted within 24 months of age: an observational cohort study. Eur Arch Otorhinolaryngol 2021; 278:2733-2743. [PMID: 32918140 PMCID: PMC8266786 DOI: 10.1007/s00405-020-06343-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/28/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Executive Functions (EFs) are fundamental to every aspect of life. The present study was implemented to evaluate factors influencing their development in a group of preschools orally educated profoundly deaf children of hearing parents, who received CI within 2 years of age. METHODS Twenty-five preschool CI children were tested using the Battery for Assessment of Executive Functions (BAFE) to assess their flexibility, inhibition, and non-verbal visuo-spatial working memory skills. The percentage of children performing in normal range was reported for each of the EF subtests. Mann-Whitney and Kruskal-Wallis were performed to assess differences between gender, listening mode, and degree of parents' education subgroups. The Spearman Rank Correlation Coefficient was calculated to investigate the relationship between EF scores of audiological and linguistic variables. RESULTS Percentages ranging from 76 to 92% of the children reached adequate EF scores at BAFE. Significant relations (p < 0.05) were found between EFs and early intervention, listening, and linguistic skills. Furthermore, CI children from families with higher education level performed better at the response shifting, inhibitory control, and attention flexibility tasks. Economic income correlated significantly with flexibility and inhibitory skills. Females performed better than males only in the attention flexibility task. CONCLUSIONS The present study is one of the first to focus attention on the development of EFs in preschool CI children, providing an initial understanding of the characteristics of EFs at the age when these skills emerge. Clinical practice must pay increasing attention to these aspects which are becoming the new emerging challenge of rehabilitation programs.
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Affiliation(s)
- Maria Nicastri
- Department of Sensorial Organs, Sapienza University of Rome, Viale dell'Università, 31, 00161, Rome, Italy
| | - Ilaria Giallini
- Department of Sensorial Organs, Sapienza University of Rome, Viale dell'Università, 31, 00161, Rome, Italy
| | - Martina Amicucci
- Department of Sensorial Organs, Sapienza University of Rome, Viale dell'Università, 31, 00161, Rome, Italy
| | - Laura Mariani
- Department of Sensorial Organs, Sapienza University of Rome, Viale dell'Università, 31, 00161, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sensorial Organs, Sapienza University of Rome, Viale dell'Università, 31, 00161, Rome, Italy
| | - Letizia Guerzoni
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Domenico Cuda
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Giovanni Ruoppolo
- Department of Sensorial Organs, Sapienza University of Rome, Viale dell'Università, 31, 00161, Rome, Italy.
| | - Patrizia Mancini
- Department of Sensorial Organs, Sapienza University of Rome, Viale dell'Università, 31, 00161, Rome, Italy
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Giustolisi B, Guasti MT, Nicastri M, Mancini P, Palma S, Genovese E, Arosio F. Production of third-person direct object clitics in children with cochlear implants speaking Italian. Clin Linguist Phon 2021; 35:577-591. [PMID: 32794410 DOI: 10.1080/02699206.2020.1803406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 06/11/2023]
Abstract
Previous research has shown that the production of third-person singular accusative object clitics (3DO clitics) might be taxing in Italian-speaking pre-school children with cochlear implants (CIs). We investigated this topic by assessing 3DO clitic production in 14 children with an average age of 8 years, who had received CI between age 1 and 4. The first goal of the study was to analyze whether school-aged children with CIs exhibit atypical behavior in 3DO clitic production. The second goal was to analyze whether children with CIs are prone to agreement errors in case of gender mismatch between the subject and the 3DO clitic, as has been shown for normal-hearing, typically developing children. To achieve this, we used two tasks in which subject and object clitic grammatical genders were manipulated so that they would or would not match. As for the first goal, the majority of children with CIs had good performance on the clitic tasks. However, some participants' performance was poor. The pattern of deviant responses differed among the poor performers. We believe that children with CIs showing impairments in 3DO clitic production need careful individual analysis in order to plan effective speech therapy. As for the second goal, children with CIs were more prone to agreement errors in the mismatch condition compared to the match condition; this dimension needs to be considered when assessing and eventually rehabilitating clitic production.
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Affiliation(s)
| | | | - Maria Nicastri
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Patrizia Mancini
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Silvia Palma
- ENT, Primary Care Department, ASL Modena, Modena, Italy
| | - Elisabetta Genovese
- Dipartimento di Medicina Diagnostica, Clinica e di Sanità Pubblica, Università di Modena and Reggio Emilia, Modena, Italy
| | - Fabrizio Arosio
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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Calistri V, Mancini P, Raz E, Nicastri M, Tinelli E, Russo FY, Fiorelli M, De Seta E, Carpentieri D, De Vincentiis M, Caramia F. fMRI in Bell's Palsy: Cortical Activation is Associated with Clinical Status in the Acute and Recovery Phases. J Neuroimaging 2020; 31:90-97. [PMID: 33146926 DOI: 10.1111/jon.12798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/18/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Using functional magnetic resonance imaging (fMRI), we explored cortical activation in patients with acute Bell's palsy (BP) and analyzed its correlates with clinical status in the acute phase, and with 6-month outcome. METHODS Twenty-four right-handed patients with acute BP within 15 days of onset and 24 healthy controls underwent fMRI during performance of unilateral active (hemi-smiling) and passive lip movement tasks with both the paretic and the normal lip. The degree of paresis was evaluated during the acute stage and at the 6-month follow up using the House-Brackmann (HB) grading scale. Complete recovery was defined as HB grade II or less at the end of the 6-month period. The difference in the HB grade (ΔHB) between the acute stage and the 6-month follow up was used to evaluate clinical improvement. RESULTS There were 24 patients with unilateral acute BP. HB grades ranged from III to VI. At 6 months, 11 patients (46%) had completely recovered and 12 (50%) were partially improved. Compared with healthy subjects, BP patients had a significantly greater activation of the frontal areas and the insula ipsilateral to the paretic side. In BP patients, there was an inverse correlation between the activation of the ipsilateral hemisphere when moving the paretic side and the degree of paresis at baseline. An association was also observed between activation and clinical outcome (both complete recovery and ΔHB). CONCLUSIONS In patients with BP, fMRI may represent a useful tool to predict long-term outcome, guide therapeutic approach, and monitor treatment response.
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Affiliation(s)
- Valentina Calistri
- Department of Human Neurosciences, Neuroradiology Unit, Sapienza University, Rome, Italy
| | | | - Eytan Raz
- Department of Radiology, Neuroradiology Unit, New York University School of Medicine, New York, NY
| | - Maria Nicastri
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Emanuele Tinelli
- Department of Human Neurosciences, Neuroradiology Unit, Sapienza University, Rome, Italy
| | | | - Marco Fiorelli
- Department of Human Neurosciences, Neuroradiology Unit, Sapienza University, Rome, Italy
| | - Elio De Seta
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Daniele Carpentieri
- Department of Human Neurosciences, Neuroradiology Unit, Sapienza University, Rome, Italy
| | | | - Francesca Caramia
- Department of Human Neurosciences, Neuroradiology Unit, Sapienza University, Rome, Italy
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Guerzoni L, Mancini P, Nicastri M, Fabrizi E, Giallini I, Cuda D. Does early cochlear implantation promote better reading comprehension skills? Int J Pediatr Otorhinolaryngol 2020; 133:109976. [PMID: 32163823 DOI: 10.1016/j.ijporl.2020.109976] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/22/2020] [Accepted: 02/29/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE to investigate the effect of age at CI activation and to explore the role of other variables such as linguistic skills, stimulation modality and gender on reading comprehension. STUDY DESIGN Prospective observational nonrandomized study. METHODS 89 children with profound congenital sensorineural hearing loss were included in the study. The mean age at CI activation was 21 months (DS ± 11; range 7-50). The Italian reading standardized test, "Prove di lettura MT", was used to assess reading comprehension. The individual raw data MT score were converted into z scores (expected values: means = 0 and SD = 1). The positive values indicated better performance and negative values indicated worse performance. RESULTS Early implanted children achieved significantly better reading comprehension skills, 55 out of 89 children are within 1 SD from the overall mean. 34 children (38.2%) attainted MT z-scores less than 1 SD below the mean. Children with unilateral CI performed somewhat worse if compared to bilateral CI and bimodal stimulation mode, although the differences were weakly significant from a statistical point of view. A strong and positive correlation (rho .69, p < .001) was found with the lexical and morphosyntactic comprehension (rho .70, p < .001). Not significantly different values were observed for gender and parental education level. CONCLUSION Early cochlear implantation promoted better development of reading skills in children with cochlear implantation. LEVEL OF EVIDENCES: outcomes research.
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Affiliation(s)
- Letizia Guerzoni
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Via Cantone Del Cristo 40, 29121, Piacenza, Italy.
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale Dell'Universita 31, 00161, Rome, Italy
| | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Viale Dell'Universita 31, 00161, Rome, Italy
| | - Enrico Fabrizi
- Department of Economics and Social Sciences, Universita Cattolica Del S. Cuore, Via Emilia Parmense 84, 29122, Piacenza, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Viale Dell'Universita 31, 00161, Rome, Italy
| | - Domenico Cuda
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Via Cantone Del Cristo 40, 29121, Piacenza, Italy
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Ruoppolo G, Longo L, Pescerelli P, Mango C, Nicastri M, Flaccadoro F, Mancini P, Greco A, De Vincentiis M. CoQ10 and Vitamin A Supplementation Support Voice Rehabilitation. A Double-Blind, Randomized, Controlled, Three-Period Cross-Over Pilot Study. Front Pharmacol 2019; 10:939. [PMID: 31551767 PMCID: PMC6747928 DOI: 10.3389/fphar.2019.00939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/22/2019] [Indexed: 11/13/2022] Open
Abstract
Objectives: To evaluate the effectiveness of an adjuvant therapy (CoQ10 in its water-soluble form and vitamin A) in supporting voice rehabilitation in a large group of patients with muscle tension dysphonia (MTD). Study Design: Twelve-week, double-blind, randomized, controlled, three-period cross-over pilot study. The primary endpoint was the change in the Dysphonia Severity Index (DSI) over the 12-week study period. Secondary endpoints were the changes in the subcomponents of DSI, including MPT, F0-high, I-low, and jitter. Exploratory endpoints were the changes in the Shimmer and in Voice Handicap Index (VHI). Methods: Patients were randomly assigned in a 1:1 ratio to two counter-balanced arms. Group A (ADJ-PLA) patients were administered QTer 300 mg and Vit A acetate 500.000 Ul/g 1 mg twice daily for a 4-week intervention period, followed by a 4-week period of wash-out, and then were submitted to a last 4-week period of placebo. Patients in Group B (PLB-ADJ) were given the treatment period in reverse order. Both groups received a 45-min voice therapy in a group format once a day for 4 weeks during the first and the second active periods. The therapy was held during the wash-out period. Results: The analysis of main time effect indicated a trend toward recovery of vocal function regardless of group assignment. A significant time by group effect was found on DSI [F = 3.4 (2.5, 80.5), p = 0.03], F0-high [F = 4.5 (2.6, 82.9), p = 0.008] and Shimmer [F = 3.6 (1.5, 46.9), p = 0.048], under CoQ10 and Vit A treatment, with a small effect size. There was no significant time by group effect on the other study measures, namely MPT, I-low, VHI. Conclusions: A trend toward recovery of vocal function was observed in all the patients, likely due to voice rehabilitation. The improvement of DSI was greater under CoQ10 and Vitamin treatment, indicating a more pronounced improvement of vocal quality under adjuvant therapy. The study protocol was reviewed and approved by the Ethics Committee of Policlinico Umberto I Hospital, Rome, Italy Rif. 3069/13.02.2014.
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Affiliation(s)
- Giovanni Ruoppolo
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
- *Correspondence: Ruoppolo Giovanni,
| | - Lucia Longo
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | | | - Chiara Mango
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Flavia Flaccadoro
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Marco De Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
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Mancini P, Giallini I, Prosperini L, D'alessandro HD, Guerzoni L, Murri A, Cuda D, Ruoppolo G, De Vincentiis M, Nicastri M. Level of emotion comprehension in children with mid to long term cochlear implant use: How basic and more complex emotion recognition relates to language and age at implantation. Int J Pediatr Otorhinolaryngol 2016; 87:219-32. [PMID: 27368475 DOI: 10.1016/j.ijporl.2016.06.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 06/09/2016] [Accepted: 06/10/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The current study was designed with three main aims: To document the level of emotional comprehension skills, from basic to more complex ones, reached by a wide sample of cochlear implant (CI) deaf children with at least 36 months of device use; To investigate subjective and audiological factors that can affect their emotional development; To identify, if present, a "critical age", in which early intervention might positively affect adequate emotional competence development. DESIGN This is an observational cohort study. Children with congenital severe/profound deafness were selected based on: aged by 4-11 years, minimum of 36 months of CI use, Italian as the primary language in the family; normal cognitive level and absence of associated disorders or socio-economic difficulties. Audiological characteristics and language development were assessed throughout standardized tests, to measure speech perception in quiet, lexical comprehension and production. The development of emotions' understanding was assessed using the Test of Emotion Comprehension (TEC) of Pons and Harris, a hierarchical developmental model, where emotion comprehension is organized in 3 Stages (external, mental and reflective). Statistical analysis was accomplished via the Spearman Rank Correlation Coefficient, to study the relationship between the personal and audiological characteristics; a multivariate linear regression analysis was carried out to find which variables were better associated with the standardized TEC values; a chi-squared test with Yate's continuity correction and Mann-Whitney U test were used to account for differences between continuous variables and proportions. RESULTS 72 children (40 females, 32 males) with a mean age of 8.1 years were included. At TEC score, 57 children showed normal range performances (79.17% of recipients) and 15 fell below average (20.83% of recipients). The 16.63% of older subjects (range of age 8-12 years) didn't master the Stage 3 (reflective), which is normally acquired by 8 years of age and failed 2 or all the 3 items of this component. Subjects implanted within 18 months of age had better emotion comprehension skills. TEC results were also positively correlated with an early diagnosis, a longer implant use, better auditory skills and higher scores on lexical and morphosintactic tests. On the contrary, it was negatively correlated with the presence of siblings and the order of birth. The gender, the side and the severity of deafness, type of implant and strategy were not correlated. CONCLUSIONS Early implanted children have more chance to develop adequate emotion comprehension, especially when the complex aspects are included, due to the very strong link between listening and language skills and emotional development. Furthermore, longer CI auditory experience along with early intervention allows an adequate communication development which positively influences the acquisition of such competencies.
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Affiliation(s)
- Patrizia Mancini
- Department of Sense Organs, University Sapienza of Rome, 00161 Rome, Italy.
| | - Ilaria Giallini
- Department of Sense Organs, University Sapienza of Rome, 00161 Rome, Italy.
| | - Luca Prosperini
- Department of Neurology and Psychiatry, University Sapienza of Rome, 00161 Rome, Italy.
| | | | - Letizia Guerzoni
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, 29121 Piacenza, Italy.
| | - Alessandra Murri
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, 29121 Piacenza, Italy.
| | - Domenico Cuda
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, 29121 Piacenza, Italy.
| | - Giovanni Ruoppolo
- Department of Sense Organs, University Sapienza of Rome, 00161 Rome, Italy.
| | | | - Maria Nicastri
- Department of Sense Organs, University Sapienza of Rome, 00161 Rome, Italy.
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Guerzoni L, Murri A, Fabrizi E, Nicastri M, Mancini P, Cuda D. Social conversational skills development in early implanted children. Laryngoscope 2015; 126:2098-105. [DOI: 10.1002/lary.25809] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Letizia Guerzoni
- Department of Otorhinolaryngology; “Guglielmo da Saliceto” Hospital; Piacenza Italy
| | - Alessandra Murri
- Department of Otorhinolaryngology; “Guglielmo da Saliceto” Hospital; Piacenza Italy
| | - Enrico Fabrizi
- Department of Economics and Social Sciences; Università Cattolica del S. Cuore; Piacenza Italy
| | - Maria Nicastri
- Department of Sense Organs; Sapienza University of Rome; Rome Italy
| | - Patrizia Mancini
- Department of Sense Organs; Sapienza University of Rome; Rome Italy
| | - Domenico Cuda
- Department of Otorhinolaryngology; “Guglielmo da Saliceto” Hospital; Piacenza Italy
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Mancini P, Dincer D'Alessandro H, Guerzoni L, Cuda D, Ruoppolo G, Musacchio A, Di Mario A, De Seta E, Bosco E, Nicastri M. Adequate formal language performance in unilateral cochlear implanted children: is it indicative of complete recovery in all linguistic domains? Insights from referential communication. Int J Pediatr Otorhinolaryngol 2015; 79:598-604. [PMID: 25724630 DOI: 10.1016/j.ijporl.2015.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 01/11/2015] [Accepted: 02/03/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Referential communication (RC) is a key element in achieving a successful communication. This case series aimed to evaluate RC in children with unilateral cochlear implants (CIs) with formal language skills within the normal range. METHODS AND MATERIALS A total of 31 children with CIs, with language development within the normal range, were assessed using the Pragmatic Language Skills test (MEDEA). RESULTS Of the children with CIs, 83.9% reached performance levels appropriate for their chronological ages. The results confirmed a positive effect of cochlear implantation on RC development, although difficulties remained in some CI users. CONCLUSIONS The outcomes emphasize the need to pay greater attention to the pragmatic aspects of language, assessing them with adequate testing in the early phase after cochlear implantation. Clear knowledge of children's communicative competence is the key in optimizing their communicative environments in order to create the basis for future successful interpersonal exchanges and social integration.
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Affiliation(s)
- Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy.
| | - Hilal Dincer D'Alessandro
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Letizia Guerzoni
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Via Cantone del Cristo 40, 29121 Piacenza, Italy
| | - Domenico Cuda
- Department of Otorhinolaryngology, "Guglielmo da Saliceto" Hospital, Via Cantone del Cristo 40, 29121 Piacenza, Italy
| | - Giovanni Ruoppolo
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Angela Musacchio
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Alessia Di Mario
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Elio De Seta
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Ersilia Bosco
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
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Mancini P, De Seta D, Prosperini L, Nicastri M, Gabriele M, Ceccanti M, Sementilli G, Terella M, Bertoli GA, Filipo R, Inghilleri M. Prognostic factors of Bell's palsy: Multivariate analysis of electrophysiological findings. Laryngoscope 2014; 124:2598-605. [DOI: 10.1002/lary.24764] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/06/2014] [Accepted: 05/07/2014] [Indexed: 11/07/2022]
Affiliation(s)
| | | | - Luca Prosperini
- Department of Neurology and Psychiatry; University Sapienza; Rome Italy
| | - Maria Nicastri
- Department of Sense Organs; University Sapienza; Rome Italy
| | - Maria Gabriele
- Department of Neurology and Psychiatry; University Sapienza; Rome Italy
| | - Marco Ceccanti
- Department of Neurology and Psychiatry; University Sapienza; Rome Italy
| | | | - Maria Terella
- Department of Sense Organs; University Sapienza; Rome Italy
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Nicastri M, Filipo R, Ruoppolo G, Viccaro M, Dincer H, Guerzoni L, Cuda D, Bosco E, Prosperini L, Mancini P. Inferences and metaphoric comprehension in unilaterally implanted children with adequate formal oral language performance. Int J Pediatr Otorhinolaryngol 2014; 78:821-7. [PMID: 24636746 DOI: 10.1016/j.ijporl.2014.02.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 02/12/2014] [Accepted: 02/17/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess skills in inferences during conversations and in metaphors comprehension of unilaterally cochlear implanted children with adequate abilities at the formal language tests, comparing them with well-matched hearing peers; to verify the influence of age of implantation on overall skills. METHODS The study was designed as a matched case-control study. 31 deaf children, unilateral cochlear implant users, with normal linguistic competence at formal language tests were compared with 31 normal hearing matched peers. Inferences and metaphor comprehension skills were assessed through the Implicit Meaning Comprehension, Situations and Metaphors subtests of the Italian Standardized Battery of "Pragmatic Language Skills MEDEA". Differences between patient and control groups were tested by the Mann-Whitney U test. Correlations between age at implantation and time of implant use with each subtest were investigated by the Spearman rank correlation coefficient. RESULTS No significant differences between the two groups were found in inferencing skills (p=0.24 and p=0.011 respectively for Situations and Implicit Meaning Comprehension). Regarding figurative language, unilaterally cochlear implanted children performed significantly below their normal hearing peers in Verbal Metaphor comprehension (p=0.001). Performances were related to age at implantation, but not with time of implant use. CONCLUSIONS Unilaterally cochlear implanted children with normal language level showed responses similar to NH children in discourse inferences, but not in figurative language comprehension. Metaphors still remains a challenge for unilateral implant users and above all when they have not any reference, as demonstrated by the significant difference in verbal rather than figurative metaphors comprehension. Older age at implantation was related to worse performance for all items. These aspects, until now less investigated, had to receive more attention to deeply understand specific mechanisms involved and possible effects of different levels of figurative language complexity (presence or absence of contextual input, degree of transparency and syntactic frozenness). New insight is needed to orient programs in early intervention settings in considering and adequately responding to all these complex communicative need of children with hearing loss.
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Affiliation(s)
- Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Roberto Filipo
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Giovanni Ruoppolo
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Marika Viccaro
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Hilal Dincer
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Letizia Guerzoni
- Department of Otorhinolaryngology "Guglielmo da Saliceto" Hospital, Via Cantone del Cristo 40, 29121 Piacenza, Italy
| | - Domenico Cuda
- Department of Otorhinolaryngology "Guglielmo da Saliceto" Hospital, Via Cantone del Cristo 40, 29121 Piacenza, Italy
| | - Ersilia Bosco
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy
| | - Luca Prosperini
- Department of Neurology and Psychiatry, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, 00161 Rome, Italy.
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Bosco E, D'Agosta L, Traisci G, Nicastri M, Filipo R. Use of Sign Language in Paediatric Cochlear Implant Users: Whys and Wherefores. Cochlear Implants Int 2013; 11 Suppl 1:249-53. [DOI: 10.1179/146701010x12671177988959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Bosco E, Nicastri M, Ballantyne D, Mancini P, D'Agosta L, Traisci G, Giusti L, Filipo R. Long-Term Evaluation of Prelingually Deaf Subjects Implanted During Adolescence and Adulthood. Cochlear Implants Int 2013; 11 Suppl 1:254-8. [DOI: 10.1179/146701010x12671177988995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Nicastri M, Mancini P, De Seta D, Bertoli G, Prosperini L, Toni D, Inghilleri M, Filipo R. Efficacy of Early Physical Therapy in Severe Bell’s Palsy. Neurorehabil Neural Repair 2013; 27:542-51. [DOI: 10.1177/1545968313481280] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Bell’s palsy (BP) is the most frequent form of peripheral palsy of the facial nerve. Prognosis for recovery is good for most patients; in the remaining cases, different grades of residual impairment persist. Physical therapy, in association with drug administration, aims to improve outcomes. Objective. To assess the efficacy of early physical therapy in association with standard drug administration versus pharmacological therapy only, in terms of time to maximum gains and grade of recovery of function, and to examine who will most benefit from rehabilitation. Methods. From June 2008 to May 2010, 232 individuals were evaluated. The 87 patients meeting the eligibility criteria were randomly assigned to the experimental group (prednisone and valacyclovir plus physical therapy, n = 39) or the control group (pharmacological therapy, n = 48) within 10 days of onset. Intention-to-treat analyses were done. Results. The physical therapy had a significant effect on grade ( P = .038) and time ( P = .044) to recovery only in patients presenting with severe facial palsy (House-Brackmann [HB] grade V/VI). No significant differences were found between the study and control groups for outcome of synkinesis. Conclusion. Physical therapy appears to be effective only in the more severe BP (baseline HB grade V/VI), whereas less severe BP (baseline HB grade IV) results in complete spontaneous recovery, regardless of physical therapy.
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Affiliation(s)
- Maria Nicastri
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Patrizia Mancini
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | - Daniele De Seta
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
| | | | - Luca Prosperini
- Department of Neurology and Psychiatry, University Sapienza of Rome, Rome, Italy
| | - Danilo Toni
- Department of Neurology and Psychiatry, University Sapienza of Rome, Rome, Italy
| | - Maurizio Inghilleri
- Department of Neurology and Psychiatry, University Sapienza of Rome, Rome, Italy
| | - Roberto Filipo
- Department of Sense Organs, University Sapienza of Rome, Rome, Italy
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Bosco E, Nicastri M, Ballantyne D, Viccaro M, Ruoppolo G, Ionescu Maddalena A, Mancini P. Long term results in late implanted adolescent and adult CI recipients. Eur Arch Otorhinolaryngol 2012. [PMID: 23179930 DOI: 10.1007/s00405-012-2264-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of the present study is to assess long-term outcomes of CI in prelingual deafened adolescents and adults, describing, where present, differences in performance, self perceived benefit and highlighting specific characteristics. Twenty-three patients were enrolled: 10 adolescents, 13 young adults. Each patient underwent speech perception/language development, psychological evaluation and structured interviews on self perception concerning CI. 70 % adolescents and 100 % adults used their cochlear implant for most of the day; two adolescents were partial users and one was a non-user. Adolescents' average word recognition and comprehension scores improved respectively from 7 to 29.8 % (p = 0.01) and 3 to 26 % (p = 0.1). Adults' average scores improved significantly from 1.5 to 41.9 % (p = 0.01) and from 18.5 to 52.7% (p = 0.001), respectively. None of the subjects showed a linguistic age adequate to the chronological one: average linguistic age was 7.6 years for adolescents and 19.3 for adults. Structured interviews showed improvement in self-esteem. Adults and most adolescents were fully or moderately satisfied with their implant. Cochlear implantation can be considered a valid option for the rehabilitation of highly motivated and well-selected pre-lingual deafened adolescents and adults. Although there is a substantial variability in both groups of patients and language skills are only marginally influenced by CI, there is still a significant improvement in speech perception. CI was described by both groups as having had a positive impact on their lives; nevertheless adolescents were the ones with a tendency to under-use CI, even those with better hearing outcomes.
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Affiliation(s)
- Ersilia Bosco
- Department of Sensorial Organs, University Sapienza of Rome, Policlinico Umberto I Viale del Policlinico, 00161 Rome, Italy
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Filipo R, Spahiu I, Covelli E, Nicastri M, Bertoli GA. Botulinum toxin in the treatment of facial synkinesis and hyperkinesis. Laryngoscope 2012; 122:266-70. [PMID: 22252570 DOI: 10.1002/lary.22404] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 09/27/2011] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Facial synkinesis and hyperkinesis commonly impair the outcome of facial nerve palsy. Botulinum toxin type A has shown positive results in the treatment of these symptoms. Our experience is reported in this article. STUDY DESIGN Prospective study. METHODS Forty-one patients affected by facial synkinesis and hyperkinesis due to facial palsy were treated. The etiology of the facial palsy was: 28 Bell's palsy cases, nine iatrogenic cases (seven acoustic neuroma surgeries, one tympano-jugular glomus tumor removal, and one middle ear surgery), three herpes zoster virus cases, and one case of Melkersson-Rosenthal syndrome. Botulinum toxin type A was used in the treatment. Clinical evaluation was obtained through the Sunnybrook Grading Scale and an author's modification of this method purposely designed for evaluation of hyperkinesis. Further evaluation through a self-administered synkinesis questionnaire was also performed. RESULTS All patients showed some improvement of synkinesis and hyperkinesis after treatment. The mean values of the data obtained, regardless of the method of evaluation, gave statistically significant results. Correlation between objective and subjective evaluation methods was also statistically positive. CONCLUSIONS This work stresses the importance of considering synkinesis and hyperkinesis separately because they are different conditions. These two symptoms showed improvement after botulinum toxin treatment, but only hyperkinesis showed a positive correlation when objective and subjective evaluations were performed. This treatment is effective in the management of facial synkinesis and hyperkinesis due to facial palsy, thus improving quality of life. It is a safe, minimally invasive treatment that can be repeated.
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Affiliation(s)
- Roberto Filipo
- Department of Sensory Organs, Sapienza University of Rome, Rome, Italy
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Viccaro M, Filipo R, Bosco E, Nicastri M, Mancini P. Long-Term Follow-Up of Implanted Children with Cytomegalovirus-Related Deafness. ACTA ACUST UNITED AC 2012; 17:395-9. [DOI: 10.1159/000341160] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 06/11/2012] [Indexed: 11/19/2022]
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Mancini P, Bosco E, D'Agosta L, Traisci G, Nicastri M, Giusti L, Musacchio A. Testing auditory skills in children CI users: is phonemic discrimination related to acoustic variables only? Cochlear Implants Int 2010; 11 Suppl 1:332-5. [PMID: 21756643 DOI: 10.1179/146701010x12671177989679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- P Mancini
- Department of Neurology and Otolaryngology, University of Rome, La Sapienza, Italy.
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Mancini P, Bosco E, D'agosta L, Traisci G, Nicastri M, Capelli G, Ballantyne D, Filipo R. Implementation of perceptual channels in children implanted with a HiRes 90K device. Acta Otolaryngol 2009; 129:1442-50. [PMID: 19922095 DOI: 10.3109/00016480902777131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS The increased spectral resolution that characterizes the HiRes 120 device contributes to improvement of performance. Discrimination and identification in noise are consistent with reports of improved perception under everyday listening situations. OBJECTIVES This work focuses on speech perception findings after implementation of current steering in HiResolution strategy of children implanted with Clarion HiRes 90K. SUBJECTS AND METHODS Comparison was made between three groups of children: standard HiRes control group, a second group switched over from HiRes to HiRes 120 and the third group switched on with HiRes 120. Children were tested before and 12 months after implementation of HiRes 120. A standard test battery was administered to obtain a speech perception development profile. The Auditory Speech Sound Evaluation (A section signE) test was carried out to evaluate discrimination and identification of phonemes in quiet and in noise. RESULTS The HiRes and HiRes 120 switch-over groups showed quite similar results for speech perception in quiet. However, the HiRes 120 switch-over group achieved these results within a shorter time after conversion. Switch-on children showed improvement in all speech perception categories, reaching approximately 60% recognition and 30% comprehension in quiet. Results for A section signE discrimination scores in quiet and noise showed a clear improvement for both HiRes 120 switch-on and switch-over groups compared with the HiRes group.
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Affiliation(s)
- Patrizia Mancini
- Department of Neurology and Otolaryngology, I Medical School, La Sapienza University of Rome, Rome, Italy.
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Mancini P, Bosco E, D'Agosta L, Traisci G, Nicastri M, Capelli G, Ballantyne D, Filipo R. Implementation of perceptual channels in children implanted with a HiRes 90K device. Acta Otolaryngol 2009. [DOI: 10.1080/00016480902777131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nicastri M, Chiarella G, Gallo LV, Catalano M, Cassandro E. Multidimensional Voice Program (MDVP) and amplitude variation parameters in euphonic adult subjects. Normative study. Acta Otorhinolaryngol Ital 2004; 24:337-41. [PMID: 15952683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The introduction, in the late 70s, of the first digital spectrograph (DSP Sonograph) by Kay Elemetrics has improved the possibilities of spectroacoustic voice analysis in the clinical field. Thanks to the marketing, in 1993, of the Multi Dimensional Voice Program (MDVP) advanced system, it is now possible to analyse 33 quantitative voice parameters which, in turn, allow evaluation of fundamental frequency, amplitude and spectral energy balance and the presence of any sonority gap and diplophony. Despite its potentials, the above-mentioned system is not widely used yet, partly on account of the lack of a standard procedure. Indeed, there are still only a few case reports in the literature taking into consideration prescriptive aspects related both to procedure and analysis. This study aims to provide the results of amplitude perturbation parameter analysis in euphonic adult patients. In our opinion, these are the most significant parameters in determining the severity of a phonation disorder. The study has been carried out on 35 patients (24 female, 11 male, mean age 31.6 years, range 19-59). The voice signal has been recorded using a 4300 B Kay Computer Speech Lab (CSL) supported by a personal computer including a SM48 Shure-Prolog microphone located at a distance of 15 cm and angled at 45 degrees. Input microphone saturation has been adjusted to 6/9 of the CH1 channel. The voice sample consisted in a held /a/ and the analysis has been carried out on the central 3 seconds of the recording. The analysis has been carried out using a 5105 MDVP software version 2.3 and the signal digitalised at a 50 kHz sample rate. In order for the sample to be as free from intensity or frequency changes as possible, each patient underwent a training session (including at least 3 phonation tests) before the recording. The study included only emissions between 55 and 65 dB and with spectrum stability. Environmental noise has constantly been monitored and maintained below 30 dB. Data from the 24 female patients showed: absolute Shimmer (ShdB) = 0.203 dB, relative shimmer (Shim %) = 2.226, amplitude perturbation quotient (APQ) = 1.758, smoothed amplitude perturbation quotient = 3.309, peak amplitude variation (vAm) = 7.042. Data from the 11 males showed: absolute Shimmer (ShdB) = 0.269 dB, relative shimmer (Shim %) = 2.892, amplitude perturbation quotient (APQ) = 2.611, smoothed amplitude perturbation quotient (SAPQ) = 3.433, peak amplitude variation (vAm) = 6.385. Statistical analysis (t test) showed no statistically significant difference between sexes, thus a single set of rules was used for both sexes.
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Affiliation(s)
- M Nicastri
- Department of Experimental and Clinical Medicine G. Salvatore, Audiology Unit, Magna Graecia University, Catanzaro, Italy
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Cassandro E, Chiarella G, Catalano M, Gallo LV, Marcelli V, Nicastri M, Petrolo C. Changes in clinical and instrumental vestibular parameters following acute exposition to auditory stress. Acta Otorhinolaryngol Ital 2003; 23:251-6. [PMID: 15046413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Besides Tullio's phenomenon, resulting from anatomic changes in the labyrinth, a hypersensitivity to acoustic stimuli of the saccular structures appears to be the underlying cause of the vestibular responses detected in some patients. In order to evaluate the incidence of vestibular symptoms triggered by acute exposure to auditory stress (disco music), 40 subjects aged between 18 and 26 years, with no audiological and vestibular disorders, were submitted to otoneurologic tests. Subjects were exposed to disco music [intensity 128 dB (C)], for 3 hours. Tests have been carried out before and immediately after exposure. Canalar and macular functions have been evaluated using vestibular investigation techniques and vestibular evoked myogenic potentials. When compared to baseline data, post-exposure test results did not reveal any canalar damage. Pre- and post-exposure recordings of the vestibular-oculomotor reflex threshold have shown no significant changes. Conversely, post-stimulus recordings have shown a significant increase in the amplitude of the vestibular evoked myogenic potential response, thus indicating a possible irritative involvement of the macular receptor. This result suggests a direct action upon the receptor by acoustic stimulation which could, therefore, be the underlying cause of vestibular symptoms reported by patients following exposure to sufficiently intense acoustic stimuli. Prior to this study. a questionnaire concerning the relationship between habitual disco visiting and audio-vestibular symptoms has been completed by 310 students at the University of Catanzaro. This survey revealed a significant incidence of vestibular symptoms due to acoustic stress (Tullio's phenomenon) which led us to hypothesise that balance disorders due to auditory stress are much more frequent than commonly held, particularly since, in many cases, diagnoses is unknown or not easy due to the difficult procedures by which these conditions are diagnosed.
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Affiliation(s)
- E Cassandro
- Department of Experimental and Clinical Medicine G. Salvatore, Audiology Unit, Magna Graecia University, Catanzaro, Italy.
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Cassandro E, Nicastri M, Chiarella G, Genovese E, Gallo LV, Catalano M. Development of communication and speech skills after cochlear implant in a sign language child. Acta Otorhinolaryngol Ital 2003; 23:88-93. [PMID: 14526555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
In selecting patients to undergo cochlear implant, a pre-existing use of sign language gives rise to two problems that have been widely debated in the literature. First, the caution shown toward the candidacy of patients using this mode of communication, since it is considered a possible element of interference in the acquisition of speech. Secondly, refusal of the cochlear implant procedure, on the part of the deaf community, on the grounds both of cultural identity and of it being more "natural" for a deaf person to use an unimpaired visual channel rather than an impaired hearing channel. In order to establish whether knowledge of sign language does, indeed, affect speech production negatively and evaluate which mode of communication, oral or gestual, is preferred, the present investigation was carried out on a preverbal deaf child who had undergone cochlear implant at about 7 years of age and has always used both languages. His verbal skills were evaluated in the precochlear implant stage, then at 6 and 12 months after, together with the changes in his use of sign language and in the relationship between the two modes. Results, besides observing the presence of linguistic evolution at each level examined and already evident at 6 months, also documented a progressive reduction in the spontaneous use of sign language. In conclusion, the present experience revealed no temporal or qualitative differences in post-cochlear implant evolution of speech skills, in comparison with that observed in patients with an exclusively aural-oral approach. Furthermore, the increased use of the hearing pathway, made possible by cochlear implant, determined a spontaneous choice of verbal language as the most natural and economic mode of communication.
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Affiliation(s)
- E Cassandro
- Department of Experimental Medicine, Audiology Unit G. Salvatore Clinic, University Magna Graecia, Catanzaro, Italy
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