Effect of Cognitive Rehabilitation by Auditory Stroop Training on Quality of Life of Individuals with Tinnitus

Background: Studies have shown that tinnitus patients have difficulties in cognitive function such as memory and attention. The Stroop task engages the attention network where one aspect of the stimulus is noticed while the other one is ignored. Thus, Stroop training can improve the patient's cognitive control and ability to ignore the tinnitus signal. Method: Thirty chronic tinnitus (> 6 months) patients were included in this study. They were distributed into two 15-member groups: intervention and control. Common audiometric, psychometric, and psychoacoustic evaluations of tinnitus were performed for two groups before intervention and after auditory Stroop training of group 1. Results: There was significant difference in the quality of life and THI scores, VAS of annoyance, and reaction time of Stroop task before and after intervention in group1. The decreased reaction time was positively correlated with improved quality of life, THI score, and VAS of annoyance. Conclusion: Cognitive rehabilitation using tasks such as auditory Stroop can be effective in controlling tinnitus by improving cognitive control.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-023-04011-w.

Combined Bifrontal Transcranial Direct Current Stimulation and Auditory Stroop Training in Chronic Tinnitus

Patients with tinnitus experience difficulties in cognitive control and executive functions. Many of which are regarded as the cause of tinnitus rather than its complications. Methods for the improvement of inhibitory and cognitive control seem to be effective in the control of tinnitus. In this study, transcranial direct current stimulation and auditory Stroop exercise were have been to improve inhibitory control and the ability to ignore tinnitus in patients suffering from chronic tinnitus. 34 patients with chronic tinnitus (> 6 months) were randomly divided into two groups. The first group consist of 17 patients who received 6 sessions of tDCS followed by 6 sessions of auditory Stroop training. The second group received 6 sessions of sham tDCS followed by 6 sessions of auditory Stroop training. The initial evaluations including pure tone audiometry, psychoacoustic measurements, tinnitus handicap inventory (THI) survey and visual analog scale (VAS) of annoyance and loudness were performed before, immediately after, and one month after the tDCS, sham, and Stroop training. The results of this study revealed a significant reduction in THI score, VAS of loudness, and annoyance of tinnitus. A significant correlation was detected between the reaction time of incongruent words in the Stroop task and improvement of THI score and VAS of annoyance. Combined tDCS and Stroop training efficiently improve chronic tinnitus.

Testing A Hypothesis: Tinnitus Control by Enhancing Physiological Inhibition

Background

Deficit in cognitive functions and central executive function is one of the popular hypotheses on the underlying cause of tinnitus. Some studies expressed the effect of tinnitus on the inhibitory cognitive tasks, referring to the slower inhibitory results such as in the Stroop task in the people suffering from tinnitus as compared to normal subjects. Since Stroop engages the network overlapping the attention and tinnitus distress networks, it seems likely that Stroop exercises can effectively contribute to controlling the tinnitus and its consequent distress through improvement of the cognitive function and increasing the physiological inhibition.

Method

A total of 25 patients with chronic tinnitus (> 6 months) were randomly divided into two groups: an intervention group of 15 patients and a control group of 10 patients. Both groups were subjected to initial evaluations including pure tone audiometry, psychoacoustic measurements, tinnitus handicap inventory (THI) survey, and visual analogue scale (VAS) of annoyance and loudness. The intervention group underwent a rehabilitation program consisting of 6 Stroop training sessions. The control group didn't receive any training. Afterwards, both groups were reevaluated and the results were compared to those of initial evaluations.

Results

Results of this study indicated significant differences in THI scores and VAS of annoyance, before and after Stroop training in the intervention group, although no significant difference was observed when it came to VAS of loudness.

Conclusion

Successive sessions of conflict processing training can improve the annoyance of tinnitus by enhancing the patient's inhibition control, making this task a safe practice for tinnitus treatment.

Impact of Combined Bifrontal Transcranial Direct- Current Stimulation and Conflict Processing Training on Tinnitus: a Protocol for Single-Blind Randomized Controlled Trial

Background and Aim: The deficit in cognitive functions and central executive function is one of the popular hypotheses on the underlying cause of tinnitus. These factors are not only the complications of tinnitus but are also involved in the generation of it. In this study, bifrontal transcranial Direct Current Stimulation (tDCS) and conflict processing will be used in the form of auditory Stroop training to improve cognitive performance and inhibition control for tinnitus management. Methods: This study will be carried out on 34 chronic tinnitus patients. The initial evaluations include the tinnitus psychoacoustic evaluations, determination of the tinnitus handicap through tinnitus handicap inventory, and examining the annoyance and loudness of tinnitus through the visual analog scale after which the participants will be investigated in two groups. The first group will receive sessions of tDCS followed by six sessions of conflict processing training. The second group will first receive tDCS in the form of sham, to be followed by six sessions of auditory Stroop. The evaluations will be repeated after each intervention. Discussion: Studies have shown that successive sessions of conflict processing training can enhance cognitive plasticity and inhibition function. As conflict processing training has not been addressed as rehabilitation training in the people suffering from tinnitus, these processes will be designed in four tasks as rehabilitation exercises in Farsi language and applied along with tDCS to the people with chronic tinnitus to decrease and control tinnitus by improving cognitive and inhibition control. Trial registration: Iranian Registry of Clinical Trials (IRCT20120215009014N366) on Sep 17th, 2020. Keywords: Tinnitus; conflict processing; Stroop training; inhibition

Speech Intelligibility in Persian Hearing Impaired Children with Cochlear Implants and Hearing Aids

The aim of present study is to evaluate and compare speech intelligibility in hearing impaired children with cochlear implants (CI) and hearing aid (HA) users and children with normal hearing (NH). The sample consisted of 45 Persian-speaking children aged 3 to 5-years-old. They were divided into three groups, and each group had 15, children, children with CI and children using hearing aids in Hamadan. Participants was evaluated by the test of speech intelligibility level. Results of ANOVA on speech intelligibility test showed that NH children had significantly better reading performance than hearing impaired children with CI and HA. Post-hoc analysis, using Scheffe test, indicated that the mean score of speech intelligibility of normal children was higher than the HA and CI groups; but the difference was not significant between mean of speech intelligibility in children with hearing loss that use cochlear implant and those using HA. It is clear that even with remarkabkle advances in HA technology, many hearing impaired children continue to find speech production a challenging problem. Given that speech intelligibility is a key element in proper communication and social interaction, consequently, educational and rehabilitation programs are essential to improve speech intelligibility of children with hearing loss.

High Frequency Tympanometry (1,000 Hz) for Neonates with Normal and Abnormal Transient Evoked Otoacoustic Emissions

Background and Objectives

This paper aimed at evaluating the characteristics of high-frequency (1,000 Hz) acoustic admittance (ya) for the neonates with transient evoked otoacoustic emissions (TEOAE) as either pass or refer group.

Subjects and Methods

Using a 1,000 Hz probe tone, 297neonates (152 male, 145 female aged 0–104 days old) were evaluated. Tympanometric parameters admittance value at +200 dapa, middle ear admittance, and tympanometric peak pressure were calculated for each tympanogram.

Results

The mean of ya was 0.9678 mmho in the TEOAE for the pass group and 0.7229 mmho in the refer group. The mean of acoustic admittance at +200 (y200) was 2.0657 in the TEOAE for the pass group and 1.7191 for the refer group. The mean of Tpp was 23/8591 in the TEOAE for the pass group and 59/7619 for the refer group.

Conclusions

There were significant differences in the distribution of different types of tympanograms, the mean of ya, tympanic peak pressure, and y200 between the TEOAEs for the pass and the refer groups.

Screening and evaluation of chronic and occult Hepatitis B in chemo - radiotherapy patients with cancer

Background:

Hepatitis B virus infection (HBV) and its complications is one of the most serious problems of the health system in many parts of the world. In the present study, we will assess chronic and occult HBV and isolated anti-Hepatitis B core antigen whose screening and evaluation is not routine in different populations.

Materials and Methods:

This descriptive analytical study was conducted on 213 patients undergoing chemotherapy - radiotherapy referred to the hematology - oncology clinics of Isfahan, Iran in 2012. In order to determine the serum levels of hepatitis B surface antigen (HbSAg), Hepatitis B Antigen and Antibody (HBCAb), aspartate aminotransferase (AST), alanine transaminase (ALT) and Alkaline phosphatase (ALK.P), venous blood samples were obtained. If the HBCAb sample was positive, another sample of the serum was sent to the laboratory to perform polymerase chain reaction and to determine viral load.

Results:

The mean age of the patients was 47.7 ± 9 years, with an age range of 27 -73 years; 98 (46%) and 115 (54%) cases were male and female, respectively, with mean age of 51.9 ± 8.3 and 44.1 ± 8.1 years, and there was no significant difference (P < 0.001). The mean level of liver enzymes including AST, ALT and ALK.P were 34.2 ± 36.02, 38.9 ± 47.1 and 252.1 ± 234.7, respectively. Two cases were HbSAg positive (0.9%) and six cases were HBCAb positive (2.8%) and HbSAg negative. Three cases had a high viral load at the rate of starting treatment among positive anti-HBC patients.

Conclusion:

Because occult hepatitis is investigated less commonly in routine studies, it seems that screening and evaluating its prevalence is useful in the management of patients.

Auditory processing abilities in children with chronic otitis media with effusion

CONCLUSION

The study results indicate that children with a history of otitis media with effusion (OME) suffer from auditory processing disorder to some degree. The findings support the hypothesis that fluctuating hearing loss may affect central auditory processing during critical periods.

OBJECTIVES

Evidence suggests that prolonged OME in children can result in an auditory processing disorder, presumably because hearing has been disrupted during an important developmental period. A lack of auditory stimulation leads to the abnormal development of the hearing pathways in the brain. The aim of the present study was to determine the effects of OME on binaural auditory function and auditory temporal processing.

METHOD

In the present study, the dichotic digit test (DDT) was used for binaural hearing, and the gap in noise (GIN) test was used to evaluate temporal hearing processing.

RESULTS

The average values of GIN differed significantly between children with a history of OME and normal controls (p < 0.001). The mean values of the DDT score were significantly different between the two groups (p = 0.002).

Comparison of the Transient Evoked Otoacoustic Emissions (TEOAEs) and Distortion Products Otoacoustic Emissions (DPOAEs) in Normal Hearing Subjects With and Without Tinnitus

The aim of this study was to investigate the possible role of cochlear outer hair cell function with TEOAE and DPOAE tests in patients with normal hearing and tinnitus. 25 tinnitus patients with normal hearing sensitivity selected as study group. Control group consist of 50 normal hearing subjects without tinnitus. All subjects had thresholds below 25 dBHL at frequencies 250-8,000 Hz, tympanogram type A and normal acoustic reflex thresholds. TEOAE were recorded with click stimulus at 80 dB SPL at 1,000, 2,000, 3,000 and 4000 Hz. DPOAE were measured at frequencies 1,000-8,000 Hz and intensity of L1 55 dB SPL and L2 65 dB SPL. Amplitude of DPOAE and TEOAE were decreased in all frequencies in study group. There was significant difference regarding prevalence abnormal TEOAE and DPOAE between study group and control group. There was relationship between dysfunction of outer hair cells and tinnitus in subjects with normal hearing.

The effect of participatory community-based diabetes cares on the control of diabetes and its risk factors in western suburb of Yasouj, Iran

This study aimed to investigate whether a community-based participatory diabetes care program could efficiently improve diabetic care and reduce its risk factors. To induce a participatory approach, a local group was established in partnership with academics, local leaders, health providers and public representatives. The group conducted community needs assessment and priority setting process. Diabetes was identified as the first priority health problem in this area. A total of 2569 30- to 65-year-old residents were screened for diabetes and 405 of them took part in a 13-week nutrition education and physical exercise intervention. Out of 1336 high-risk individuals, 17% had fasting blood sugar (FBS) ≥126 mg/dl and 13.5% with FBS between 110 and 125 mg/dl. Percentages of participants with triglycerides (TG) ≥150 mg/dl and cholesterol ≥200 mg/dl were 33.8% and 23.5%, respectively. After completion of the intervention, the mean FBS, HbA1C, TG and cholesterol were decreased significantly. Although systolic and diastolic blood pressure and body mass index were decreased too, the differences were not statistically significant. The mean physical activity increased and consumption of fried foods and saturated oil decreased significantly. The results suggest that participatory community-based care could be a feasible model for control of diabetes and its risk factors.

Nutrition and immunity: the effects of the combination of arginine and tryptophan on growth performance, serum parameters and immune response in broiler chickens challenged with infectious bursal disease vaccine

To explore the effects of the combination of tryptophan (Trp) and arginine (Arg) on growth performance, serum parameters and immune response of broiler chickens challenged with intermediate plus strain of infectious bursal disease virus vaccine, an in vivo experiment was conducted. A corn-soybean meal-based diet containing different levels of Arg and Trp was used. Cobb500 male broiler chickens from 0 to 49 days of age were subjected to a diet supplemented with the combination of Trp and Arg. Growth performance parameters and serum parameters were measured at 27 and 49 days of age. To evaluate the immunomodulatory effects of the combination of Trp and Arg on the challenged chickens, we measured the serum levels of interferon-α, interferon-γ and immunoglobulin G at 27, 35, 42, and 49 days of age. The results showed that the three evaluated immune system parameters including interferon-α, interferon-γ and immunoglobulin G were significantly enhanced after treatment. This enhancement resulted in the recovery of infectious bursal disease virus-infected chickens compared with controls as confirmed by histopathological examinations. Moreover, serum parameters such as albumin and total protein increased, whereas the treatment decreased (P<0.05) the feed:gain ratio, aspartate amino-transferase, alkaline phosphatase, lactic dehydrogenase, triglyceride and cholesterol. These findings suggest that the combination of Arg and Trp has a regulatory effect on growth performance. Moreover, it modulates the systemic immune response against infectious bursal disease.