Longitudinal study of hearing loss in childhood: Relationship between Hearing Impairment,Poor Learning and Family Background

Of the Dutch school population 0.1% suffer from a hearing loss which makes it necessary for them to attend a special school. This permanent, binaural hearing impairment is of a moderate to severe degree (degrees II and III) and adversely affects the child's linguistic skills and school performance. Of the pupils attending ordinary schools 4–5% suffer from a hearing loss which, according to the Dutch audiologist Huizing, lies on the borderline of a slight to moderate hearing impairment (degrees I and II). This loss is characterised by its temporary nature, the fact that it is monaural in 71% of the cases and that there is no evidence for its clearly affecting the learning process. The risk of hearing impairment is predominantly determined by the child's family background.     

Tinnitus impairs cognitive efficiency

Many people who complain of tinnitus say that the noises impair their mental concentration. This complaint was investigated by self-report (primarily the Cognitive Failures Questionnaire) and by means of five cognitive tasks, four presented via laptop computer and one given manually. The tasks measured performance under single and dual-task conditions and included tests of sustained attention, reaction time, verbal fluency and immediate and delayed memory. Two groups of outpatients attending audiological clinics (tinnitus, n?=?43; hearing impairment, n?=?17) were compared with non-clinical volunteers (n?=?32). The results replicated earlier findings that tinnitus outpatients report significantly more everyday cognitive failures than do controls. The tinnitus group responded significantly more slowly than the two control groups on the variable fore-period reaction time task under dual-task conditions. In general, comparisons between the groups on other tasks showed equivalent performance, but both clinical groups performed more poorly than non-clinical controls on verbal fluency. We conclude that cognitive inefficiency in tinnitus participants is related to the control of attentional processes, consistent with our earlier theoretical speculation about the nature of tinnitus complaint and with published findings on the effects of chronic pain on cognitive processes.     

Positive AMPA receptor modulation in the treatment of neuropsychiatric disorders: A long and winding road

Glutamatergic transmission is widely implicated in neuropsychiatric disorders, and the discovery that ketamine elicits rapid-acting antidepressant effects by modulating α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) signaling has spurred a resurgence of interest in the field. This review explores agents in various stages of development for neuropsychiatric disorders that positively modulate AMPARs, both directly and indirectly. Despite promising preclinical research, few direct and indirect AMPAR positive modulators have progressed past early clinical development. Challenges such as low potency have created barriers to effective implementation. Nevertheless, the functional complexity of AMPARs sets them apart from other drug targets and allows for specificity in drug discovery. Additional effective treatments for neuropsychiatric disorders that work through positive AMPAR modulation may eventually be developed.     

伴智能障碍的脑白质疏松症患者相关危险因素分析

目的分析伴智能障碍的脑白质疏松症(LA)患者的相关危险因素。方法 207例LA患者分为伴有智能障碍组和无智能障碍组,对患者的性别、年龄、高血压病史、糖尿病史、冠心病史及既往脑梗死病史等进行相关因素分析和Logistic回归分析。结果两组年龄、高血压病史、糖尿病史、既往脑梗死病史和LA的严重程度均有显著差异。多因素回归分析最终入选模型的变量是年龄、高血压病史、既往脑梗死病史和重度LA。结论高龄、高血压病史、既往脑梗死病史和重度LA,对LA是否伴智能障碍有独立的提示作用。     

On Functions,Abilities and Quality of Life After Subarachnoid Haemorrhage: Occupational Therapy Aspects

This investigation addresses functions/impairments, abilities/disabilities and quality of life (QoL) in a consequtive series of non-hospitalized long-term survivors [2, 5–12 years] of subarachnoid haemorrhage (SAH). The investigated parameters of functions/impairments were: motor, language, perceptual and memory functions. Abilities/disabilities studied were: activities of daily living (ADL) including both personal- and instrumental ADL, working and leisure capacities. Quality of life was assessed using a double visual analogue scale. Occurrence of depression was registered using a self-rating scale.

A questionnaire focusing motor and language impairments, personal ADL, work and leisure activities was initially mailed to 324 subjects. Most of them answered the questionnaire. Ten hospitalized subjects could not validly report their functions and abilities and for that reason were excluded.

In a follow-up investigation up to 247 long-term non-hospitalized subjects were investigated by a physician and an occupational therapist. A total of 82% had at least one impairment. The majority (73%) had memory impairment and among these subjects equal proportions (about 50%) had impairments of long-and short-term memory. Forty-five percent were perceptually impaired, while motor impairment occurred for 25% and aphasia in 10%. Only a small minority (9%) were, according to self-reports, regarded as being to some extent disabled in personal ADL. The corresponding numbers of disabled in instrumental ADL, leisure and working-capacity were 52%, 48% and 40% respectively. Depression was found in 22%—among whom the majority had minimal or mild depression. Overall QoL was judged to be unchanged or increased in 62% of cases and, therefore, decreased in 38%.

As expected, impairments to a significant degree caused disabilities. None of the five different categories of impairment were associated with mood (depressed/not depressed) and QoL (decreased/not decreased). Occurrence of depression was significantly associated with the different aspects of disabilities. In contrast, among a series of instrumental ADL-variables, leisure and working capacity, QoL was influenced negatively only by decreased ability to act sociably and, to a minor extent, by depressed mood.

Judging from the extent of decreased quality of life, it appears that nearly 40% of all non-hospitalized former victims of SAH have not coped successfully with the impact of the SAH. A follow-up programme aiming at optimizing the coping process of SAH victims is, therefore, outlined     

The encoding of word forms into memory may be challenging for college students with developmental language impairment

Purpose: To describe the word-learning problems characteristic of developmental language impairment (LI).

Method: College students with LI (n?=?39) or normal language development (ND, n?=?40) attempted to learn novel word forms. Training for half of the words was meaning-focused; training for the other half was form-focused. Form recognition and stem completion tasks administered immediately after training tapped encoding of the lexical configuration and a repetition of the stem completion task one week later tapped consolidation. A visual world paradigm tapped lexical engagement.

Result: At the immediate post-test, the LI group was poorer at recognition and completion of word forms than their ND peers, suggesting a deficit in encoding the lexical configuration. However, the gap between the LI and ND groups in stem completion did not grow over the week, suggesting intact consolidation. Form-focused training yielded better performance than meaning-focused training at immediate- and one week tests. For both groups, newly trained words slowed the recognition of familiar English words, revealing lexical engagement.

Conclusion: The encoding of word-form configurations is challenging for some, but not all, college students with LI. Training that encourages a focus on the form may be a useful part of vocabulary intervention for those affected.     

Altered REM sleep architecture in patients with Myotonic dystrophy type 1: is related to sleep apnea?

ObjectiveTo determine the sleep architecture and sleep respiratory abnormalities and to correlate with sleep symptoms in patients with Myotonic dystrophy type 1 (DM1).MethodsWe recruited a cohort of genetically confirmed patients with DM1, who attended the Neuromuscular clinic between July 2016 and December 2019. Clinical, sleep and whole night polysomnography data were collected. The analysis of sleep architecture, sleep respiratory parameters and comparison with healthy controls (HC) was performed in our sleep laboratory.ResultsA total of 59 patients with DM1 underwent sleep evaluation. Hypersomnolence in 42 (77.8%), ESS>10 in 23 (39%), and PSQI>5 in 18 (30.5%) were found in patients with DM1. Thirty-one (68.89%) patients with DM1 and 22 (95.65%) HC had more than 4-h of total sleep time (TST). More than 4 h of TST was taken to compare respiratory and sleep architecture parameters. Patients with DM1 had reduced sleep efficiency, reduced N2 sleep, and increase in N1 sleep, wake index, stage shift index, nocturnal sleep-onset REM periods compared to HC. AHI>15 was found in 16 (51.61%) DM1 and in 3 HC (13.64%). AHI had positive correlation with BMI, but not with age, ESS or disease progression (MIRS). All DM1 with AHI>15; 8(80%) and 1(33.33%) in AHI5to15, and AHI<5 groups, respectively had hypersomnolence.ConclusionIn this first study on Indian cohort, daytime hypersomnolence, poor nocturnal sleep quality, sleep architecture irregularities are identified to be common in patients with DM1. These abnormalities may be explained by sleep-related breathing disorders that are highly prevalent in these patients.