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Biomedical subjects

F Pirozzolo

Publications and source records attributed to F Pirozzolo.

7 recordsLinked to original sources

Correlational analysis of speech audiometric scores, hearing loss, age, and cognitive abilities in the elderly.

A battery of speech audiometric measures and a battery of neuropsychological measures were administered to 200 elderly individuals with varying degrees of pure-tone sensitivity loss. Results were analyzed from the standpoint of the extent to which variation in speech audiometric scores could be predicted by knowledge of pure-tone hearing level, age, and cognitive status. For the four monotic test procedures (PB, SPIN-Low, SPIN-High, and SSI) degree of hearing loss bore the strongest relation to speech recognition score. Cognitive status accounted for little of the variance in any of these four speech audiometric scores. In the case of the single dichotic test procedure (DSI), both degree of hearing loss and speed of mental processing, as measured by the Digit Symbol subtest of the WAIS-R, accounted for significant variance. Finally, age accounted for significant unique variance only in the SSI score.

Aged

Central auditory processing disorder: a case study.

We carried out extensive audiologic, electrophysiologic, and neuropsychologic testing on a young woman who complained that she had difficulty hearing in her educational environment. Conventional audiometric results, including pure-tone, speech, and immittance audiometry, were all within normal limits. The subject performed normally on tests involving the processing of rapidly changing temporal information, interaural time and intensity difference detection, and both absolute and relative sound localization. Early, middle, late and task-related auditory evoked potentials were essentially normal, although some asymmetry was observed in the middle latency (MLR) and late (LVR) responses. There was, however, a consistent left-ear deficit on dichotic sentence identification, on threshold and suprathreshold speech measures in the left sound field when various types of competition were delivered in the right sound field, and on cued-target identification in the left sound field in the presence of multitalker babble. Results suggest a central auditory processing disorder characterized by an asymmetric problem in the processing of binaural, noncoherent signals in auditory space. When auditory space was structured such that the target was directed to the left ear, and the competition to the right ear, unwanted background was less successfully suppressed than when the physical arrangement was reversed.

Acoustic Impedance Tests

The separability of central auditory and cognitive deficits: implications for the elderly.

After viral encephalitis a 40-year-old man showed both central auditory deficit and severe cognitive deficits. The asymmetric central auditory deficit was revealed by speech audiometry. The effect could be explained neither by peripheral sensitivity loss nor by cognitive status. Results highlight the separability of central auditory and cognitive deficits. Implications for the elderly are discussed.

Adult

Impact of central auditory processing disorder and cognitive deficit on the self-assessment of hearing handicap in the elderly.

We studied the impact of central auditory processing disorder (CAPD) and cognitive deficit (CD) on the self-assessment of hearing handicap in 122 elderly subjects. Self-assessment was quantified by means of the Hearing Handicap Inventory for the Elderly (HHIE). Results showed that cognitive impairment exerted no significant effect on the self-assessment of hearing handicap. Subjects with CAPD, however, rated themselves as significantly more handicapped than non-CAPD subjects. Furthermore this difference did not interact with degree of loss. It was present even in subjects without significant peripheral sensitivity loss. These results support the conclusion that CAPD status is a relevant dimension in the evaluation of the elderly subject with or without peripheral hearing loss.

Aged

Speech understanding in the elderly.

Both auditory and cognitive status were determined in 130 elderly persons, in the age range from 51 to 91 years. Data were analyzed from the standpoint of the congruence of auditory and cognitive deficits. The prevalence of central auditory processing disorder was 50%, and the prevalence of cognitive deficit was 41%. Findings in the two areas were congruent, however, in only 63% of the total sample. Central auditory status was abnormal in the presence of normal cognitive function in 23% of subjects. Central auditory status was normal in the presence of cognitive deficit in 14% of subjects. In general, results did not support the hypothesis that decline in speech understanding in the elderly can be explained as the consequence of concomitant cognitive decline.

Aged

Clinical, biochemical, and neuropathologic findings following transplantation of adrenal medulla to the caudate nucleus for treatment of Parkinson's disease.

We transplanted autologous adrenal medullary tissue into the caudate nucleus of 3 patients with advanced Parkinson's disease. The 1st patient, a 59-year-old man with parkinsonian symptoms for 15 years, had mild improvement in his motor functioning after the operation. However, his postoperative course was characterized by prolonged drowsiness and complex visual hallucinations. The patient died suddenly 8 months after the transplant, and an autopsy revealed coronary atherosclerosis. Examination of the graft site showed necrotic adrenal medullary tissue surrounded by inflammatory cells. The 2nd patient, a 50-year-old man with a 21-year history of parkinsonian symptoms, improved the most after the procedure. The 3rd patient, a 43-year-old man with 12 years of parkinsonian symptoms, had mild improvement in his motor functioning. CSF homovanillic acid increased postoperatively in the 3 patients, but then returned to preoperative levels in all except the 2nd patient. The anatomic, neurochemical, and physiologic basis for the modest clinical improvement shown in these patients is not yet understood.

Activities of Daily Living

Intracerebroventricular bethanechol chloride infusion in Alzheimer's disease. Results of a collaborative double-blind study.

The use of intracerebroventricular bethanechol chloride infusion in patients with Alzheimer's disease was first reported in 1984. An initial trial in four patients demonstrated the feasibility of this approach for cholinergic drug delivery to the brain, but objective improvement in cognitive function was not documented. A collaborative placebo-controlled double-blind crossover study has now been carried out in 49 patients with biopsy-documented Alzheimer's disease. The results demonstrate a statistical improvement in Mini-Mental State scores and significantly slower performance on Trails A testing during drug infusion. Other neuropsychological test scores were not similarly affected. The degree of improvement was not sufficient to justify further treatment of Alzheimer's disease patients by intracerebroventricular infusion of bethanechol chloride. The drug delivery system used in the study was well tolerated, with two irreversible complications in more than 50,000 patient days.

Alzheimer Disease