Biomedical subjects

J D Durrant

Publications and source records attributed to J D Durrant.

At least 19 recordsLinked to original sources

PubMed2006

An algorithm for analyzing linkages affected by heterozygous translocations: QuadMap.

Heterozygous chromosome rearrangements such as reciprocal translocations are most accurately displayed as two-dimensional linkage maps. Standard linkage mapping software packages, such as MapMaker, generate only one-dimensional maps and so reciprocal translocations appear as clusters of markers, even though they originate from two nonhomologous chromosomes. To more accurately map these regions, researchers have developed statistical methods that use the variance in map distance to distinguish among the four segments (two translocation, two interstitial) of the translocation. In this study, we describe modifications to one of these protocols, that proposed by Livingstone et al. (2000). We also introduce QuadMap, a new software application for dissecting heterozygous translocation-affected linkage maps.

Algorithms↗

PubMed2005

Lateralization of the effects of the benzodiazepine drug oxazepam on medial olivocochlear system activity in humans.

Benzodiazepines (Bzd) are known to interact with GABAergic inhibitory neurotransmission. Previous research on their effect on human auditory efferent pathways--through evoked otoacoustic emissions suppression by contralateral acoustic stimulation (CAS)--indicated a decrease in medial olivocochlear (MOC) efferent system inhibitory activity, after oral intake of oxazepam--representative of the Bzd drug class. To date, this pharmacological effect was only assessed in the right ear. Since a leftward asymmetry of Bzd receptors localization in human auditory cortex has been described recently, we explored in this study the hypothesis of an asymmetrical action of Bzd on MOC efferent functioning. The results revealed a significant difference of Bzd effect probing the right ear versus the left ear, with CAS-induced suppression being less effective in the right than left ear after oxazepam intake. This finding raises the question of possible neurochemical left-right asymmetry in the descending auditory pathways. The potential localization of this asymmetry is discussed.

Adult↗

PubMed2004

Effect of stimulus frequency and stimulation site on the N1m response of the human auditory cortex.

The aim of the present study was to investigate the functional organization of the auditory cortex for pure tones of 1, 2, 4, 6, 8 and 12 kHz. Ten subjects were tested with a whole-head magnetometer (151 channels). The location, latency and amplitude of the generators of the N1m (the main component of the response, peaking approximately at 100 ms) were explored simultaneously in the right and left hemispheres under monaural stimulation. Our results revealed that tonotopy is a rather complex functional organization of the auditory cortex. From 1 to 12 kHz, tonotopic maps were found for contralateral as well as for ipsilateral stimulation: N1m generators were found to be tonotopically organized mainly in an anterior-posterior direction in both hemispheres, whatever the stimulated ear, but also in an inferior-superior direction in the right hemisphere. Furthermore, latencies were longer in the left than in the right hemisphere. Two different representations of spectral distribution were found in the right auditory cortex: one for ipsilateral and one for contralateral stimulation.

Acoustic Stimulation↗

PubMed2003

Development of auditory asymmetry in transient evoked otoacoustic emissions in pre-term infants.

We previously reported that transient evoked otoacoustic emissions (TEOAEs) continue to develop after the onset of cochlear function in pre-term infants from 34 to 39 weeks of conceptional age (Morlet et al., 1996). The time-course of development differed between genders. Reported here are findings of further analysis of data from the study cohort, comprising 1020 ears of 510 pre-term neonates (conceptional age ranging from 34 to 39 weeks), demonstrating developmental differences between right and left ears. The left ear of female pre-term infants showed enhancement of TEOAE amplitude at low and medium frequencies with age, whereas differences were less dramatic in the right ear. In male infants, TEOAE amplitude decreased in several frequency bands at high frequencies, above 4 kHz, between 34 and 39 weeks conceptional age; most developmental differences were found to be more dramatic in the right than in the left ear. It is tempting to speculate that these developmental features underlie well-known inter-aural asymmetries that have been demonstrated in the adult human.

Analysis of Variance↗

PubMed2000

Frequency and temporal analysis of contralateral acoustic stimulation on evoked otoacoustic emissions in humans.

Previous studies have shown that the effect of contralateral acoustic stimulation (CAS) on ipsilateral evoked otoacoustic emissions (EOAE) depends somewhat upon the spectrum of the eliciting stimulus. The latency of the EOAE, however, is itself frequency-dependent. Consequently, two general ways of analyzing the effects of CAS may be considered: by frequency band or by temporal segment. In this study, we analyzed the effects of CAS both ways in the same subjects, essentially simultaneously. The frequency analysis of the EOAE derived from the wavelet transform (WT). The WT is known to provide a robust approach to the analysis of non-stationary signals and was anticipated to avoid possible time-frequency confounds of the cochlear mechanical system. For comparison, a more basic analysis - using a temporal moving window - was employed. The results largely support earlier findings and confirm that in humans the greatest suppression of EOAEs by CAS is obtained for lower frequency and/or longer latency EOAE components. Despite expectations for the WT analysis, the more basic, temporal, analysis tended to yield the clearer results.

Acoustic Stimulation↗

PubMed1999

Accuracy of hearing aid use time as reported by experienced hearing aid wearers.

OBJECTIVE: The purpose of this study was to investigate the relationship between the amount of time that a person reports wearing his or her hearing aid and the actual time that the hearing aid is worn. Although use time data are used in the analysis and interpretation of investigations concerned with auditory perceptual learning and with user satisfaction, the accuracy of self-reported use time has not been fully investigated. DESIGN: The experimental and control group were fit with a hearing aid that has the capability of storing use time data for later analysis. The experimental group was told that the self-reported use time would be verified with a computer analysis of the hearing aid that provides the actual use time. The control group was not informed of the use time validation procedure. The agreement between self-reported and actual use time was compared statistically between groups (knowledge of validation versus no knowledge of validation). RESULTS: The experimental group provided accurate self-reported use time whereas the control group showed a significant difference between actual use time and self-reported use time. CONCLUSIONS: The results may assist in the interpretation of results of previous investigations that have depended on self-reported use time and in the design of future investigations. For the clinician, the results indicate that relying on a patient's self-reported hearing aid use time for documentation of satisfaction or signal processing preference may be misleading.

Aged↗

PubMed1999

Somatosensory cuing of head-only rotational testing.

Head-only rotational testing (HORT) is a method of assessing the vestibulo-ocular reflex (VOR) that can be performed at the bedside with inexpensive, transportable equipment. Previous studies of HORT using auditory cuing have suggested that test results are in large part independent of the method by which a subject's head is moved, that is, active versus passive. However, many subjects have difficulty moving their head at rotational frequencies of 3 Hz or greater. In an attempt to overcome this difficulty, and to learn more about HORT, we explored the possibility of providing subjects with a somatosensory, rather than an auditory cue for head movement. Somatosensory, cues were provided either by applying gentle pressure against a tightly-fitted headband or by lightly tapping on the shoulders. Our results with young, healthy subjects indicate that somatosensory cuing is an efficacious means of inducing periodic head rotation and that HORT results are unaffected by the type of cue provided. We conclude that somatosensory rather than auditory cuing may be the preferred method of performing HORT.

Adult↗

PubMed1998

Are inner or outer hair cells the source of summating potentials recorded from the round window?

The relative contribution of inner hair cells (IHCs) and outer hair cells (OHCs) to the production of the summating potential (SP) is unresolved in the literature. Since OHCs in the base of the cochlea have been reported to produce little dc receptor potential except at very high sound pressure levels [I. J. Russell and P. M. Sellick, J. Physiol (London) 284, 261-290 (1983)], the IHCs appear to be the dominant source of the SP. However, results of intracochlear recordings are conflicting, although deriving from measurements in different turns of the cochlea [e.g., I. J. Russell and P. M. Sellick, J. Physiol. (London) 284, 261-290 (1983) versus P. Dallos and M. A. Cheatham, Sensory Transduction (1992)]. To determine which type of hair cells is the dominant source of the SP recorded at the round window, we used carboplatin to selectively destroy IHCs or a combination of IHCs and OHCs in the chinchilla. Related work, using measurements of distortion product otoacoustic emissions and cochlear potentials to assess the functional status of the OHCs served to validate this animal model [Trautwein et al., Hearing Res. 96(1-2), 71-82 (1996)]. The SP, cochlear microphonic (CM), and compound action potential (CAP) were recorded from the round window, and cochleograms were determined using well-established histological methods. The results were reasonably distinctive among three groups of ears--control (from untreated normal chinchillas), IHC-loss (extensive IHC loss with minor or no loss of OHCs), and IHC-OHC loss (total IHC loss plus extensive loss of OHCs over the basal half of the cochlea). Ears of chinchillas in the IHC loss group had a decrease of over 50% in SP output compared to control ears with the exact reduction depending somewhat upon the stimulus conditions. Ears in the IHC + OHC loss group, nevertheless, showed even further reduction in SP output which was clearly attributable to destruction of OHCs in the cochlear base. It was concluded that, although the IHCs are responsible for a greater contribution of dc-receptor potential to the SP recorded at the round window, a significant contribution is made by the OHCs, as well. The results suggest, specifically, that the round window "sees" SP output roughly in inverse proportion to the IHC:OHC. Lastly, the complexity of SP production, as recorded from the round window, precludes a completely straightforward interpretation of the SP:CAP in clinical ECochG.

Acoustic Stimulation↗

PubMed1998

Managing hearing loss in a patient with Alzheimer disease.

This case study reports the management of hearing loss in a patient with Alzheimer disease (AD) living at home with a spouse care giver. The report highlights the interaction between symptoms associated with AD and hearing loss and the lack of data regarding remediation of hearing loss in this population. Specifically, the case illustrates the modifications in evaluation and verification of the hearing aid fitting that may be advisable when working with patients with AD. The data for this patient illustrate some novel measurement techniques that may assist the professional in documenting the impact of treatment in this population.

Aged↗

PubMed1997

Evaluation of the nonorganic hearing loss suspect.

OBJECTIVE: To examine the utility of distortion-product otoacoustic emissions (DPOAEs) in the assessment of the nonorganic suspect because DPOAE analysis constitutes an objective test of hair-cell function that yields audiometriclike data. STUDY DESIGN: Retrospective study of clinical findings. SETTING: Audiology outpatient clinic of our university's medical center. PATIENTS: The study cohort comprised 30 patients who presented with a profile of suspicion for nonorganic hearing loss. Most cases were found, with the aid of DPOAE testing, to be nonorganic or to have nonorganic overlays to organic hearing loss. INTERVENTIONS: Interventions were diagnostic only. MAIN OUTCOME MEASURES: Observed audiometric findings and changes thereof. RESULTS: Statistically significant decreases in thresholds occurred in subgroups of those cases deemed to be truly nonorganic in origin. CONCLUSIONS: Especially considering test efficiency, the results support the inclusion of DPOAE analysis in the diagnostic management of the suspect-nonorganic patient.

Acoustic Stimulation↗

PubMed1996

Development of cochlear active mechanisms in humans differs between gender.

Despite onset of function early during the third term of gestation, the human auditory system demonstrates continued maturation, thought previously to occur primarily at the neural level. The electromotile properties of outer hair cells appear to contribute substantially to hearing sensitivity and frequency selectivity and lead to the generation of otoacoustic emissions (OAEs). This report demonstrates continued development of cochlear active mechanisms (i.e. end-organ level) after onset of cochlear function, as reflected by OAEs. Significant gender differences also are reported, corresponding to recently observed intersex differences in cochlear length and precursory to gender differences observed in the adult.

Cochlea↗

PubMed1996

Panic, agoraphobia, and vestibular dysfunction.

OBJECTIVE: Otoneurological abnormalities have been reported in panic disorder. The purpose of this investigation was to determine the prevalence of such findings in panic disorder with and without agoraphobia and to discern whether vestibular dysfunction was associated with specific symptoms. METHOD: Clinical audiological and vestibular tests were administered to 30 patients with uncomplicated panic disorder (without agoraphobia or with only mild agoraphobia), 29 patients with panic disorder with moderate to severe agoraphobia, 27 patients with anxiety but no history of panic attacks, 13 patients with depressive disorders but no history of anxiety or panic attacks, and 45 normal comparison subjects. Evaluators were blind to subjects' diagnostic group. Quantitative measures of subjects' discomfort with space and motion and of the frequency of certain symptoms between and during panic attacks were obtained. Anxiety state levels were measured during the vestibular tests. RESULTS: Vestibular abnormalities were common in all the groups but most prevalent in the patients with panic disorder with moderate to severe agoraphobia. Vestibular dysfunction was associated with space and motion discomfort and with frequency of vestibular symptoms between, but not during, panic attacks. There were no major differences between the two panic groups in anxiety levels during vestibular testing. There were no significant differences between groups on the audiological component of the test battery. Exploratory data analysis indicated that the constellation of vestibular tests most specific for agoraphobia was one indicating compensated peripheral vestibular dysfunction. CONCLUSIONS: Subclinical vestibular dysfunction, as identified by clinical tests, may contribute to the phenomenology of panic disorder, particularly to the development of agoraphobia in panic disorder patients.

Adult↗

PubMed1996

Localizing retrocochlear hearing loss.

PURPOSE: The origin of acute/sudden hearing loss is multifactorial. The association of vestibular symptoms does not necessarily isolate the pathologic condition to the inner ear. The audiogram provides a screen for differentiating conductive from sensorineural loss but often fails to provide more localizing information. METHODS: Three unusual patients with a variety of retrocochlear presentations of hearing loss are presented. Along with conventional auditory brainstem response (ABR) testing, newer auditory tests, including otoacoustic emissions and three-dimensional ABR analysis, can facilitate site-of-lesion testing. Magnetic resonance imaging (MRI) also provides graphic documentation for sources of retrocochlear hearing loss. RESULTS: One patient had gamma-knife treatment of an arteriovenous malformation, incurring a localised lesion to the inferior colliculus contralateral to the side of hearing loss. This effectively eliminated wave V, as confirmed by three-dimensional ABR analysis. A second patient with human immunodeficiency virus developed sudden complete hearing loss with retained otoacoustic emissions, confirming a retrocochlear lesion. A third patient with acute otitis media with sudden hearing loss and vertigo had an abnormal ABR and "mass lesion" on MRI. Hearing subsequently returned to normal, as did a repeated scan. CONCLUSIONS: The unique aspects of each case of retrocochlear hearing loss and the applied auditory electrophysiologic tests are reviewed.

Adult↗

PubMed1996

The efficacy of tympanic electrocochleography in the diagnosis of endolymphatic hydrops.

Electrocochleography (ECoG), an objective electrophysiologic test, is useful in the clinical diagnosis of endolymphatic hydrops. The purpose of this study was further to define the role of ECoG in the diagnosis of this disease. A retrospective chart review of 100 patients undergoing tympanic ECoG was undertaken comparing symptoms, degree of hearing loss, duration of disease, and diagnosis with ECoG results. The apparent sensitivity and specificity of ECoG in the diagnosis of endolymphatic hydrops were determined to be 57% and 94%, respectively. Three of 30 positive ECoG results were falsely positive. Fluctuating hearing loss and the degree of hearing loss (< 40 dB) and duration of disease (< 48 months) were statistically significant in predicting positive ECoG results. We conclude that a positive ECoG result is helpful in objectively confirming the disease. However, a negative result does not rule out hydrops.

Adult↗

PubMed1995

Middle ear effects secondary to nasogastric intubation.

A study was conducted of the status of the middle ear in neurologically impaired patients requiring extended nasogastric tube (NGT) feeding. Ninety percent of the study patients with NGTs demonstrated abnormal middle ear function via immittance testing; whereas, 8.5% and 0% of the clinical and normal control samples, respectively, had abnormal findings. These results support the need to conscientiously observe the middle ear status of patients requiring long-term NGT feedings. A plan for monitoring middle ear function in these patients is suggested.

Acoustic Impedance Tests↗

PubMed1994

3CLT ABR analyses in a human subject with unilateral extirpation of the inferior colliculus.

Reported are the results of analyses of three-channel Lissajous trajectories (3CLTs) of the auditory brain stem responses (ABRs) in a human subject in whom a focal lesion of the brain stem was caused by stereotactic radiosurgery, the 'gamma knife'. The surgery caused total destruction of the right inferior colliculus. The results, using multiple measures for defining ABR components, confirm findings from more conventional 2-channel recordings which, in turn, suggested the presence of an intact wave IV but a negligible, if not totally absent, wave V with stimulation of the left (contralateral) ear. The results thus support theories that wave V is generated by crossed pathways and that wave IV is an independent wave generated by the lateral lemniscus. Since magnetic resonance imaging suggested no destruction of tissue below the inferior colliculus, the findings also support theories of wave V generation at or rostral to the inferior colliculus. In practical terms, the results demonstrate the value of multichannel recordings of the ABR in component identification and in interpreting ABR abnormalities.

Adult↗

PubMed1994

Comparison of earphone radiation recorded from hearing impaired subjects and a resistor network simulator.

Electromagnetic radiation emitted by earphones is a potential source of contamination of auditory evoked potentials, particularly when long-duration stimuli are used to evoke the response. One practical solution to this problem would be to estimate the magnitude and characteristics of this earphone radiation so that an appropriate choice of earphone is made. With this aim, earphone radiation measures obtained from a resistor network simulator laid out over the dimensions of an average head were compared with those obtained from three hearing impaired subjects to determine the efficacy of the simulator in estimating the magnitude of this radiation. Results indicated a close agreement between these measures suggesting that the simulator measures are realistic. It was shown that the earphone radiation (i) increases linearly with stimulus intensity; (ii) varies systematically as a function of recording configuration; and (iii) recorded in the simulator can be used to subtract out earphone radiation contaminating evoked responses recorded from subjects using unshielded earphones. Based on these results it was concluded that the simulator provides a practical means to simulate real recordings, at least for the purposes of estimating stimulus artifact that may contaminate auditory evoked potentials to sustained stimuli.

Cochlea↗

PubMed1993

Observations on temporal aspects of bone-conduction clicks: real head measurements.

To further elucidate nuances of bone-conduction (BC) stimulation, particularly as they may pertain to BC-elicited auditory brainstem responses (ABRs), real head measurements were made of vibratory responses to BC clicks. A miniature accelerometer was held firmly against the skull near a bone vibrator applied to the mastoid, to the opposite mastoid, and to the forehead. Measurements also were made with the vibrator applied to the forehead and the accelerometer placed on a mastoid. The measured vibrations were compared among conditions within and across subjects. The results demonstrate that vibration picked up in the immediate vicinity of the vibrator, roughly mimics the temporal and spectral characteristics of the click observed on an artificial mastoid. However, probing at sites remote to the bone vibrator suggested the introduction of a propagation-like delay as well as low-pass filtering. These findings support observations of previous researchers who demonstrated phase differences between vibrations recorded at different points on the skull, further demonstrating the complexities of skull vibration. Latency differences of ABR responses obtained with forehead versus mastoid placements, for example, cannot be attributed merely to the difference in efficiency between sites of stimulation demonstrated audiometrically. While the real head observations do not permit determination of the actual vibratory lag at the cochlea, they do permit the deduction that a comparable onset delay occurs in BC as in air-conduction stimulation via supra-aural earphones.

Acoustic Stimulation↗