Surveying Colombian Speech-Language Pathologists on their Reported Training & Practices of Auditory-Perceptual Evaluation of Voice

Objective: To explore the training and use of auditory perceptual evaluation of the voice reported by Colombian speech-language pathologists. Study Design: Cross-sectional observational research with a quantitative approach. Methods: A digital questionnaire was designed and distributed to gather information regarding professionals' training process and implementation of auditory-perceptual evaluation procedures. Descriptive statistics were applied, and several generalized linear models were adjusted to determine the influence of certain variables on others. Results: The survey received responses from 40 speech-language pathologists, revealing that the most used scales for training and evaluating vocal quality within this group are direct magnitude estimations (82.5% and 77.5%). Similarly, in this group, the tasks most frequently used to train and use as an evaluation strategy are vowel assessments (38%) followed by spontaneous speech (30%). Practitioners of this group were mostly trained using a conceptual framework involving multiple exposures to rating (42.5%). The use of direct magnitude estimation in training with a normal voice showed significance (p = 0.015), as did the use of the vowel /i/ in training with an equal-appearing interval (p = 0.013). The statistical models relating the scale used to the scale on which participants were trained were also significant (p < 0.05). Conclusions: The GRBAS scale is the training tool most used by the group of speech-language pathologists of the study group in Colombia. Future efforts should focus on improving training practices for auditory-perceptual evaluation, exploring alternative conceptual frameworks, and incorporating external references to enhance validity and reliability.

Objetivo: Explorar los reportes de fonoaudiólogos colombianos acerca del entrenamiento y uso de la evaluación perceptual auditiva de la voz. Diseño de estudio: Se eligió un diseño de investigación observacional transversal con un enfoque cuantitativo. Metodología: Se diseñó y distribuyó un cuestionario digital para recopilar información sobre el proceso de formación de los profesionales y la implementación de procedimientos de evaluación perceptual auditiva. Se aplicaron estadísticas descriptivas y se ajustaron varios modelos lineales generalizados para determinar la influencia de ciertas variables en otras. Resultados: La encuesta recibió respuestas de 40 fonoaudiólogos, revelando que las escalas más utilizadas para la formación y la evaluación de la calidad vocal en el grupo son las estimaciones de magnitud directa (82.5% y 77.5%). Del mismo modo, en este grupo las tareas más frecuentemente utilizadas para la formación y el uso como estrategia de evaluación son las vocales (38%), seguidas por el habla espontánea (30%). La mayoría de los profesionales del grupo fueron formados utilizando un marco conceptual que involucra múltiples exposiciones a la calificación (42.5%). El uso de la estimación de magnitud directa en la formación con una voz normal mostró significancia (p = 0.015), al igual que el uso de la vocal /i/ en la formación con intervalos de igual apariencia (p = 0.013). Los modelos estadísticos que relacionan la escala utilizada con la escala en la que los participantes fueron entrenados también fueron significativos (p < 0.05). Conclusiones: La escala GRBAS es la herramienta de formación más utilizada por el grupo de fonoaudiólogos del estudio. Los esfuerzos futuros deberían centrarse en mejorar las prácticas de formación para la evaluación perceptual auditiva, explorar marcos conceptuales alternativos e incorporar referencias externas para mejorar la validez y la confiabilidad.

The influence of listener experience, measurement scale and speech task on the reliability of auditory-perceptual evaluation of vocal quality

ABSTRACT Purpose To assess the influence of the listener experience, measurement scales and the type of speech task on the auditory-perceptual evaluation of the overall severity (OS) of voice deviation and the predominant type of voice (rough, breathy or strain). Methods 22 listeners, divided into four groups participated in the study: speech-language pathologist specialized in voice (SLP-V), SLP non specialized in voice (SLP-NV), graduate students with auditory-perceptual analysis training (GS-T), and graduate students without auditory-perceptual analysis training (GS-U). The subjects rated the OS of voice deviation and the predominant type of voice of 44 voices by visual analog scale (VAS) and the numerical scale (score "G" from GRBAS), corresponding to six speech tasks such as sustained vowel /a/ and /ɛ/, sentences, number counting, running speech, and all five previous tasks together. Results Sentences obtained the best interrater reliability in each group, using both VAS and GRBAS. SLP-NV group demonstrated the best interrater reliability in OS judgment in different speech tasks using VAS or GRBAS. Sustained vowel (/a/ and /ɛ/) and running speech obtained the best interrater reliability among the groups of listeners in judging the predominant vocal quality. GS-T group got the best result of interrater reliability in judging the predominant vocal quality. Conclusion The time of experience in the auditory-perceptual judgment of the voice, the type of training to which they were submitted, and the type of speech task influence the reliability of the auditory-perceptual evaluation of vocal quality.

Temporal Ordering and Auditory Resolution in Individuals with Sensorineural Hearing Loss

Abstract Introduction Peripheral hearing loss, besides causing inadequate auditory input, can lead to distortions in the tonotopic auditory map and reorganization of neural networks. Therefore, the processing of temporal aspects of a sound stimulus and, consequently, the effectiveness of human communication can be negatively impacted. Objective To test the temporal ordering and auditory resolution of people with mild and moderate sensorineural hearing loss and to compare them with the those of people with normal hearing. Methods A total of 19 right-handed individuals aged 16 to 59 years with mild to moderate postlingually acquired symmetric bilateral sensorineural hearing loss participated in the study. They were submitted to frequency and duration pattern tests and a random gap detection test. Results The mean correct response rate in the frequency pattern test was of 66.3%, and, in the duration pattern test, 71.7%. The mean threshold in the random gap detection test was of 14.1 ms. A comparison with the criteria established for normal subjects without peripheral hearing loss revealed that more than half the subjects had abnormal results in the temporal ordering test, while a smaller fraction had reduced temporal resolution. Conclusions The performance of the subjects with acquired sensorineural hearing loss was poorer than that of the participants without peripheral hearing loss. Their results on the temporal ordering test were also poorer than in the temporal resolution test, demonstrating the importance of analyzing both these auditory skills in people with peripheral hearing loss.

Does a patient with acquired arbovirus infection have a hearing impairment? A scoping review of hearing changes in an adult with Dengue, Chikungunya, and Zika

Abstract Objectives To identify and understand the evidence regarding hearing changes related to acquired Dengue, Chikungunya, and Zika virus infection in adult individuals. Methods A scoping review was performed according to the recommendations of The Joanna Briggs Institute and guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews in the Embase, PubMed/Medline, ScienceDirect, Scopus, and Web of Science databases without restriction on language and year of publication. Case studies, observational studies, and clinical trials reporting hearing loss in adult subjects (>18-60 years of age) of both sexes with DENV, CHIKV, or ZIKV diagnosed by positive molecular/serological examination by RT-PCR or IgM/IgG by ELISA method were included. Results Thirteen studies met the inclusion criteria and were selected for review. The occurrence of auditory symptoms caused by arboviroses and the presence of permanent or transient sensorineural hearing loss was variable in adults. Conclusions Dengue, Chikungunya, and Zika infections in adults are associated with a variety of auditory symptoms. The frequency of permanent or transient sensorineural hearing loss is low but not negligible.

ESTILOS DE APRENDIZAJE EN ESTUDIANTES DE LA LICENCIATURA EN ENFEMERIA DE TRES INSTITUCIONES DE EDUCACIÓN SUPERIOR EN MÉXICO / LEARNING STYLES IN NURSING DEGREE STUDENTS FROM THREE HIGHER EDUCATION INSTITUTIONS IN MEXICO

INTRODUCCIÓN. La sociedad actual demanda de enfermeros que desarrollen la autonomía necesaria para la resolución de problemas, la planificación, el seguimiento y la evaluación de su propio desempeño. Esta autonomía proviene del aprendizaje permanente. OBJETIVO. Determinar los Estilos de Aprendizaje predominantes entre los estudiantes de primer año matriculados en tres instituciones de educación superior en México para cursar la carrera de enfermería. METODOLOGÍA: Estudio cuantitativo y multicéntrico con un diseño descriptivo, y una muestra no probabilística. Para identificar los Estilos de aprendizaje de los estudiantes se utilizó el cuestionario VARK, con coeficiente alfa de Cronbach osciló entre 0.77 y 0.85. La escala fue digitalizada y programada mediante la herramienta Formulario de Google Drive. Se obtuvo un dictamen favorable por el comité de ética de las instituciones. Los resultados se procesaron en el programa estadístico SPSS versión 25.0. RESULTADOS: Se aplicaron 305 cuestionarios, donde 88,63 % fueron mujeres. El estilo de aprendizaje más preponderante fue el Quinestésico (30.39 %), seguido por el Lectura/Escritura (27.42 %), auditivo (26,58 %) y visual (15.61 %). De acuerdo con el estilo modal más del 50 % son multimodales. CONCLUSIÓN: Los resultados muestran que es fundamental contar con datos tanto individuales como grupales de los estudiantes para pensar estrategias de enseñanza y aprendizaje que tengan en cuenta las preferencias de aprendizaje de los estudiantes y la orientación temática del orden disciplinario, desde su ingreso a la universidad.

INTRODUCTION. Today's society demands that nurses develop the necessary autonomy to solve problems, plan, monitor and evaluate their own performance. This autonomy comes from lifelong learning. AIM. To determine the predominant learning styles among first-year nursing students enrolled in three higher education institutions in Mexico. METHODOLOGY: Quantitative and multicenter study with a descriptive designand a non-probabilistic sample. To identify the learning styles of the students, the VARK questionnaire was used, with Cronbach's alpha coefficient ranging between 0.77 and 0.85. The scale was digitized and programmed using the Google Drive Form tool. A favorable opinion was obtained by the ethics committee of each institution. The results were processed in the statistical program SPSS, version 25.0. RESULTS: 305 questionnaires were completed by respondents, 88.63% of which were women. The most predominant learning style was kinesthetic (30.39%), followed by reading/writing (27.42%), auditory (26.58%) and visual (15.61%). As to the modal style, more than 50% were multimodal. CONCLUSION: The results show that it is essential to have both individual and group data related to students so that teaching and learning strategies can take into account their learning preferences, as well as the thematic orientation of the discipline of nursing, from the time of their admission to the university.

Perfil cognitivo en el Mareo Perceptual Postural Persistente: Implicancias sobre su fisiopatología como disfunción cognitiva viso-vestibular superior

Introducción: El mareo perceptual postural persistente (MPPP) es, probablemente, la causa más prevalente de mareo crónico. Sin embargo, su fisiopatología es aún motivo de duda y debate. En el presente artículo, proponemos que el MPPP se caracteriza por disfunciones cognitivas de orden superior, al punto de diferenciarse en estas dimensiones de controles sanos y pacientes con patologías vestibulares no-MPPP. Objetivo: Determinar si pacientes con MPPP presentan alteraciones discriminantes respecto a grupos controles, en ámbitos de atención, memoria de trabajo visoespacial, planificación espacial, funciones ejecutivas y rendimiento cognitivo global. Material y Método: Estudio descriptivo transversal con sujetos de entre 18 y 65 años, reclutados de una unidad de otoneurología ambulatoria. Se aplicaron pruebas Montreal Cognitive Assessment (MoCA), tarea de retención de dígitos, Trail Making Test, Corsi Block-Tapping Task y Torre de Londres. Resultados: 30 pacientes fueron categorizados en tres grupos: grupo MPPP (n = 14), grupo vestibular no-MPPP (n = 11) y grupo control (n = 5). El grupo MPPP exhibió un rendimiento significativamente inferior en pruebas de planificación, velocidad de procesamiento y funciones ejecutivas en ámbitos visoespaciales, mientras que en atención y memoria visoespacial no hubo diferencias entre grupos. Conclusión: El MPPP podría caracterizarse por una disfunción de procesos cognitivos superiores de construcción espacial de mayor complejidad, respetando funciones visoespaciales de menor orden como la memoria de trabajo. Estos hallazgos ofrecen nuevas luces para comprender la fisiopatología del MPPP y sus implicancias clínicas.

Introduction: Persistent postural-perceptual dizziness (PPPD) is probably the most prevalent cause of chronic dizziness. However, its pathophysiology is still a matter of uncertainty and debate. In this article, we propose that PPPD is characterized by higher-order cognitive dysfunctions, to the point of differentiating it from healthy controls and patients with non-PPPD vestibular pathologies. Aim: To determine whether patients with PPPD exhibit discriminant alterations compared to control groups in the areas of attention, visuospatial working memory, spatial planning, executive functions, and global cognitive performance. Materials and Methods: A cross-sectional descriptive study was conducted with subjects between the ages of 18 and 65 years, recruited from an outpatient otoneurology unit. Tests included the Montreal Cognitive Assessment (MoCA), digit retention task, Trail Making Test, Corsi Block-Tapping Task, and the Tower of London. Results: 30 patients were categorized into three groups: PPPD group (n = 14), non-PPPD vestibular group (n = 11), and control group (n = 5). The PPPD group showed significantly lower performance on tests of planning, processing speed, and executive function in visuospatial domains, while there were no differences between groups in attention and visuospatial memory. Conclusion: PPPD may be characterized by dysfunction of higher-order cognitive processes related to spatial construction of greater complexity, while sparing lower-order visuospatial functions such as working memory. These findings offer new insights into the pathophysiology of PPPD and its clinical implications.

Síndrome de Balint y trombosis de senos venosos cerebrales: reporte de caso / Balint syndrome and cerebral venous sinus thrombosis: Case report

Introducción: El síndrome de Balint es un trastorno neurológico infrecuente, de etiología diversa, cuya presentación incluye la triada clásica de: simultagnosia, ataxia óptica y apraxia oculomotora, síntomas secundarios asociados a lesiones parieto-occipitales, con pronóstico variable según la etiología que se encuentre. A continuación, se reporta un caso secundario a una trombosis de senos venosos. Presentación del caso: Mujer de 66 años que ingresa a urgencias por cefalea aguda asociada a síntomas neurológicos progresivos con compromiso visual. Presentó tensión arterial elevada, simultagnosia, ataxia óptica y apraxia oculomotora. Los estudios imagenológicos reportaron hemorragia subaracnoidea por trombosis de seno sigmoideo izquierdo, por lo que se inició anticoagulación, antihipertensivo, con adecuada evolución del cuadro clínico. Discusión: A pesar de que el síndrome de Balint es un trastorno poco común, de etiología diversa, con escasos reportes a escala global, el caso comentado concordó con las características descritas en la literatura. El abordaje de la paciente en su atención inicial permitió la sospecha diagnóstica oportuna y la indicación de ayudas diagnósticas imagenológicas pertinentes. Tales ayudas soportaron un manejo temprano y la adecuada evolución y resolución del cuadro, en el contexto de la asociación del síndrome a una trombosis de senos venosos cerebrales (una etiología infrecuente). Conclusión: Mediante una historia clínica completa y minuciosa, junto a un adecuado examen neurológico, es posible hacer un acercamiento diagnóstico temprano que permita generar la sospecha del síndrome de Balint y la solicitud temprana de imágenes diagnósticas que orienten en el estudio de su etiología y manejo oportuno, con mejores desenlaces en el paciente.

Introduction: Balint Syndrome is a rare neurological disorder with multiple etiologies. The physical signs include a classic triad (simultagnosia, optic ataxia, and oculomotor apraxia). These symptoms are associated with parieto-occipital lesions, and the prognosis depends on the etiology. This article reports a case secondary to venous sinus thrombosis. Presentation of the case: A 66-year-old woman presented to the emergency room with acute headache associated with progressive neurological symptoms and visual impairment. She had high blood pressure, simultanagnosia, optic ataxia, and oculomotor apraxia. Imaging studies revealed subarachnoid hemorrhage due to thrombosis of the left sigmoid sinus, for which anticoagulation and antihypertensive therapy were started. The patient had a favorable clinical outcome. Discussion: Although Balint syndrome is a rare disorder of diverse etiology with few clinical cases reported globally, the case discussed here was consistent with the characteristics described in the literature. The patient's initial assessment allowed for timely diagnostic suspicion and appropriate imaging studies, which supported early management and the appropriate evolution and resolution of the condition, given the association of the syndrome with an uncommon cause as cerebral venous sinus thrombosis. Conclusion: A complete and thorough medical history, along with a proper neurological exam, can lead to an early diagnostic approach that raises suspicion of Balint's syndrome and prompts timely imaging studies to guide the investigation of its etiology and management, ultimately leading to better outcomes for the patient.

Especificidades dos erros cometidos e do tempo despendido na actividade discriminação perceptiva de símbolos gráficos em alunos com dificuldades de aprendizagem / Specifics of errors and time spent in perceptual discrimination of graphic symbols in students with learning difficulties / Particularidades de los errores cometidos y el tiempo empleado en la actividad de la discriminación perceptiva de símbolos gráficos en estudiantes con dificultades de aprendizaje

A discriminação perceptiva de símbolos depende da organização perceptiva do sujeito da ação como sistema bio-psico-social complexo. Objectivo: estudo de especificidades da discriminação perceptiva de símbolos em alunos com dificuldades de aprendizagem. Amostra: 550 participantes ­ 275 com e 275 sem dificuldades de aprendizagem; idades 7 ­ 15 anos; escolaridade ­ 1º, 2º e 3º ciclo do ensino básico. Instrumentos metodológicos ­ entrevista clínico--psicológica, observação psicológica, Teste de Símbolos e Dígitos (SDMT). Resultados: Alunos com dificuldades de aprendizagem tendem a evidenciar mais emparelhamentos dígito-símbolo incorretos e menos corretos e a despenderem bastante mais tempo na execução da tarefa; portanto, executam menos emparelhamentos corretos por minuto, comparativamente a alunos sem dificuldades de aprendizagem. Conclusão: Nas dificuldades de aprendizagem, cometem-se mais erros e assinalam-se menos emparelhamentos correctos na tarefa de emparelhamento, quando há limites no tempo de execução; caso contrário, a disponibilidade de tempo compensa, reduzindo a quantidade de incorreções. Nas dificuldades de aprendizagem, é necessário mais tempo para executar a tarefa de emparelhamento, devido ao processamento de informação mais lento; tempo consumido na decodificação e identificação das correspondências dígito-símbolo e a discriminação perceptiva não se infirma com a rapidez necessária à simultaneidade e automatização do ato. (AU)

The perceptual discrimination of symbols depends on the perceptual organization of the individual as a complex bio-psychosocial system in action. Objective: To study the specifics of perceptual discrimination of symbols in students with learning difficulties. Sample: 550 participants - 275 with learning difficulties and 275 without; aged 7 to 15; educational levels ranging from the 1st to 3rd cycles of basic education. Methodological instruments included clinical-psychological interviews, psychological observations, and the Symbols Digit Modalities Test (SDMT). Results: Students with learning difficulties tend to display more incorrect and fewer correct digit-symbol pairings, and they invest considerably more time in task execution. Consequently, they achieve fewer correct pairings per minute compared to students without learning difficulties. Conclusion: Learning difficulties are associated with increased errors and fewer correct pairings in the task of pairing symbols when time constraints exist. Conversely, when ample time is available, it mitigates the quantity of inaccuracies. Learning difficulties necessitate more time for task completion due to slower information processing. The time spent on decoding, identifying digit-symbol correspondences, and perceptual discrimination does not align with the speed required for simultaneity and automation of the task. (AU)

La discriminación perceptiva de los símbolos depende de la organización perceptiva del sujeto de la acción como un complejo sistema bio-psico-social. Objetivo: estudiar las especificidades de la discriminación perceptiva de símbolos en estudiantes con dificultades de aprendizaje. Muestra: 550 parti-cipantes - 275 con y 275 sin dificultades de aprendizaje; edades de 7 a 15 años; escolaridad - 1º, 2º y 3º ciclo de educación básica. Instrumentos metodológicos: entrevista clínico-psicológica, observación psicológica, Test de Símbolos y Dígitos (SDMT). Resultados: Los estudiantes con dificultades de aprendizaje tienden a mostrar una mayor cantidad de emparejamientos dígito-símbolo incorrectos y menos correctos y dedican mucho más tiempo a la ejecución de la tarea; por lo tanto, realizan menos emparejamientos correctos por minuto, en comparación con los estudiantes sin dificultades de aprendizaje. Conclu-sión: En las dificultades de aprendizaje se cometen más errores y se notan menos emparejamientos correctos en la tarea de emparejamiento, cuando hay límites en el tiempo de ejecución; de lo contrario, la disponibilidad de tiempo es compensatoria, reduciendo el número de inexactitudes. En las dificultades de aprendizaje, se necesita más tiempo para realizar la tarea de empareja-miento, debido al procesamiento más lento de la información; el tiempo que se consume en decodificar e identificar las correspondencias dígito-símbolo y la discriminación perceptiva no ocurre tan rápidamente como es necesario para la simultaneidad y automatización del acto. (AU)

Limiar Diferencial de mascaramento e potencial evocado auditivo de tronco encefálico em adultos normo-ouvintes com zumbido / Masking Level Difference and Auditory Brainstem ResponseIn Normal Hearing Adults With Tinnitus / Umbral de enmascaramiento diferencial y potencial evocado auditivo del tronco encefálico en adultos con audición normal y tinnitus

Introdução: O zumbido é uma ilusão auditiva consciente, uma sensação sonora não relacionada com uma fonte externa de estimulação. Objetivos: Caracterizar a Acufenometria, Limiar Diferencial de Mascaramento, o questionário de qualidade de vida Inventário de Desvantagem do Zumbido e Potencial Auditivo de Tronco Encefálico em adultos normo-ouvintes com zumbido, com a finalidade de comparar seus achados. Método: Vinte indivíduos do sexo feminino e masculino, entre 20 e 60 anos de idade, normo-ouvintes com queixa de zumbido, foram submetidos ao Acufenometria, Limiar Diferencial de Mascaramento, Inventário de Desvantagem do Zumbido e Potencial Evocado Auditivo de Tronco Encefálico. Resultados: AAcufenometriarevelou que o pitch médio foi de 4,3 KHz à orelha direita e 4,6 KHz à orelha esquerda. O loudness médio foi de 21,7 dBNS à orelha direita e 23,5 dBNS à orelha esquerda. O Limiar Diferencial de Mascaramento médio mostrou-se alterado. O Inventário de Desvantagem do Zumbido médio correspondeu à classificação de grau leve. O Potencial Evocado Auditivo de Tronco Encefálico apresentou parâmetros dentro da normalidade bilateralmente. Conclusão: Constatou-se que adultos normo-ouvintes com queixa de zumbido apresentam zumbido de pitch agudo bilateral com discreto impacto na qualidade de vida, condução adequada das vias auditivas até o tronco encefálico e comprometimento na identificação de sons na presença de ruído, demonstrando que o zumbido pode ter repercussões nas habilidades auditivas centrais. (AU)

Introduction: Tinnitus is a conscious auditory illusion, a sound perception unrelated to any external stimulus source. Objectives: To characterize the Acuphenometry, Masking Level Difference, the quality of life questionnaire Tinnitus Handicap Inventory and Auditory Brainstem Response in normal hearing adults with tinnitus, with the purpose of comparing the findings. Method: Twenty female and male individuals, between 20 and 60 years of age, normal hearing with complaints of tinnitus, underwent Acuphenometry, Masking Level Difference, Tinnitus Handicap Inventory and Auditory Brainstem Response. Results: The Acuphenometry showed the average pitch was 4.3 KHz to the right ear and 4.6 KHz to the left ear. The average loudness was 21.7 dBSL to the right ear and 23.5 dBs to the left ear. The average Masking Level Difference was altered. The average Tinnitus Handicap Inventory corresponded to the classification of mild grade. Auditory Brainstem Response showed parameters within normal range bilaterally. Conclusion: It was found that normal hearing adults with tinnitus complaints have bilateral acute pitch tinnitus with a slight impact on quality of life, appropriate conduction of auditory pathways to the brainstem and impaired identification of sounds in the presence of noise, demonstrating that tinnitus can have repercussions on central auditory skills. (AU)

Introducción: El tinnitus es una ilusión auditiva consciente, una sensación de sonido no relacionada con una fuente externa de estimulación. Objetivos: Caracterizar la coincidencia de tono y volumen, el umbral de enmascaramiento diferencial, el inventario de minusvalía para acúfenos y el potencial auditivo del tronco encefálico en adultos normoyentes con acúfenos, con el fin de comparar sus hallazgos. Método:Veinte sujetos masculinos y femeninos, con edades entre 20 y 60 años, audición normal con tinnitus, fueron sometidos a acúfenos, Umbral de Enmascaramiento Diferencial, Inventario de Desventajas de Tinnitus y Potenciales Evocados Auditivos del Tronco Encefalico. Resultados: La combinación de tono y volumen reveló que el tono promedio era de 4,3 KHz en el oído derecho y de 4,6 KHz en el oído izquierdo. Mientras que el volumen medio fue de 21,7 dBNS para el oído derecho y de 23,5 dBNS para el oído izquierdo. Se modificó el umbral diferencial de enmascaramiento promedio. El Inventario de Desventajas de Tinnitus promedio correspondió a la clasificación de grado leve. El Potenciales Evocados Auditivos del Tronco Encefalico presentó parámetros dentro del rango normal bilateralmente. Conclusión:Se encontró que los adultos normooyentes con quejas de tinnitus presentan tinnitus de tono alto bilateral con leve impacto en la calidad de vida, conducción adecuada de las vías auditivas al tronco encefálico y deterioro en la identificación de sonidos en presencia de ruido, demostrando que Tinnitus puede tener repercusiones en las habilidades auditivas centrales. (AU)

La prueba de figuras enmascaradas en la versión SaWa sobre figuras Gottschaldt ­presentación e indicadores psicométricos / The Embedded Figures Test in the SaWa Version on Gottschaldt Figures ­Presentation and Psychometric Indicators­ / O teste de figuras mascaradas na versão SaWa em figuras de Gottschaldt ­Apresentação e indicadores psicométricos­

El artículo presenta la versión de la prueba EfT desarrollada por Sawa sobre las figuras Gottschaldt, como indicador de la capacidad de reestructuración perceptual y del estilo cognitivo en la dimensión de independencia- dependencia de campo. Se examina la consistencia interna del instrumento, su validez estructural y de constructo a partir de los datos recogidos en cuatro diferentes estudios en los que ha sido aplicado (n = 6.530). Los resultados indican altos niveles de consistencia interna y adecuados niveles de validez estructural del instrumento. La validez de constructo se determina mediante el examen de los comportamientos de la prueba frente al sexo y el grado/edad. Los resultados demuestran que el instrumento se comporta de acuerdo con lo esperado en el constructo. Por último, se presentan los baremos del instrumento

This paper presents the version of the Embedded Figures Test (EfT) that Sawa developed using Gottschaldt's figures. The test indicates the perceptual restructur- ing ability and the field dependence-independence dimension of cognitive style. The instrument's internal consistency and its structural and construct validity are examined using data collected in four previous studies in which the test was administered (n = 6.530). Results show high levels of internal consistency and adequate levels of structural validity. The construct validity was determined by examining the instrument's behavior regarding sex and grade/age. Results indicate that the test behaves as expected considering the construct. Finally, the instrument's norms are presented

O artigo apresenta a versão do teste EfT, desenvol- vida por Sawa sobre as figuras de Gottchaldt, como indicador da capacidade de reestruturação perceptiva e, do estilo cognitivo na dimensão independência- -dependência do campo. A consistência interna do instrumento, sua validade estrutural e sua validade de construto são examinadas a partir dos dados co- letados em quatro diferentes estudos em que o teste foi aplicado (n = 6.530). Os resultados indicam altos níveis de consistência interna e níveis adequados de validade estrutural do instrumento. A validade de cons- truto é determinada examinando os comportamentos de teste em relação ao gênero e nível de escolaridade/ idade. Os resultados indicam que o instrumento se comporta conforme o esperado no construto. Por fim, são apresentadas as escalas do instrumento.

Precisión diagnóstica de una versión abreviada de las pruebas de patrones de frecuencia y patrones de duración para la evaluación del ordenamiento auditivo temporal / Diagnostic accuracy of an abbreviated version of the frequency pattern and duration pattern tests for the evaluation of auditory temporal ordering

Introducción: Las pruebas de patrones de frecuencia y patrones de duración son consideradas los gold standard de evaluación del ordenamiento auditivo temporal. A pesar de su amplia difusión, la extensión y duración de estas pruebas dificultan su utilización dentro de baterías de evaluación del procesamiento auditivo. Sin embargo, dadas sus características estructurales, pareciera ser posible reducirlas sin perder su precisión diagnóstica. Objetivo: Determinar las propiedades diagnósticas de versiones abreviadas de las pruebas de patrones de frecuencia y patrones de duración. Material y Método: Se realizó un estudio transversal de diseño observacional analítico. Se evaluaron 166 oídos de 88 sujetos con edades entre 18 y 33 años, los cuales fueron clasificados con normalidad o alteración del ordenamiento auditivo temporal. Se utilizaron las pruebas originales de Auditec de 30 ítems por oído como referencia y los primeros 10 ítems de cada oído como versión abreviada. Resultados: La versión abreviada de la prueba de patrones de frecuencia obtuvo una sensibilidad de un 94,33%, una especificidad del 94,29% y un área bajo la curva ROC de 0,980. La versión abreviada de la prueba de patrones de duración obtuvo una sensibilidad de un 89,58%, especificidad del 71,88% y un área bajo la curva ROC de 0,916. Ambas versiones tuvieron un índice de concordancia adecuado. Conclusiones: Las versiones abreviadas de la prueba de patrones de frecuencia y patrones de duración cuentan con excelentes propiedades diagnósticas para la evaluación del ordenamiento auditivo temporal y pueden ser utilizadas de manera intercambiable con las versiones originales.

Introduction: The frequency and duration pattern tests are considered the gold standard for assessing auditory temporal ordering. Despite their wide dissemination, the length and duration of these tests make it difficult to use them within auditory processing assessment batteries. However, given their structural characteristics, reducing them without losing their diagnostic accuracy seems possible. Aim: Determine the diagnostic properties of abbreviated versions of the Frequency Patterns and Duration Patterns tests. Material and Method: A cross-sectional study with an analytical observational design was carried out. 166 ears of 88 subjects aged between 18 and 33 years were evaluated, classified as normal or altered in temporal auditory order. The original Auditec tests of 30 items per ear were used as a reference, and the first 10 items of each ear as an abbreviated version. Results: The abbreviated version of the frequency patterns test obtained a sensitivity of 94.33%, a specificity of 94.29%, and an area under the ROC curve of 0.980. The abbreviated version of the duration pattern test obtained a sensitivity of 89.58%, a specificity of 71.88%, and an area under the ROC curve of 0.916. Both versions had an adequate concordance index. Conclusion: The abbreviated versions of the frequency patterns and duration patterns test have excellent diagnostic properties for assessing auditory temporal ordering and can be used interchangeably with the original versions.

Clinical observation of postoperative visual perceptual training in children with intermittent exotropia on the recovery of visual function at all levels / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the role of visual perception training on the recovery of visual function at all levels and the improvement of perceptual eye position in children with intermittent exotropia(IXT).METHODS: Prospective clinical study. A total of 74 patients with IXT who received corrective surgery for strabismus in the Ophthalmology Department of the First People's Hospital of Lanzhou City from January to June 2022 were collected and followed up for 3mo. The patients were randomly divided into 2 groups at 1d after surgery: 35 patients in the training group received binocular visual perception training, and 39 patients in the control group did not receive visual training. The changes of visual function and perceived eye position at all levels were observed at 1d and 3mo after operation.RESULTS: There were 24 patients(69%)with simultaneous perception in the training group at 1d after surgery and 34 patients(97%)with recovered visual function at 3mo after surgery, which was significantly higher than 1d after surgery(P=0.002). Furthermore, there were 22 cases(56%)of fusion function in the control group at 3mo after surgery, 13 cases(33%)of far stereopsis, 20 cases(51%)of dynamic stereopsis and 17 cases(44%)of static fine stereopsis. In the training group, there were 31 cases(89%)of fusion function, 25 cases(71%)of far stereopsis, 30 cases(86%)of dynamic stereopsis and 27 cases(77%)of static fine stereopsis, which were significantly higher than those in the control group(all P&#x003C;0.05). The degree of perceived eye displacement in the training group decreased more significantly than that in the control group(all P&#x003C;0.05).CONCLUSION: Postoperative visual perceptual training in children with IXT can promote recovery of visual function at all levels, improve perceptual eye position and enhance the control of eye position at the perceptual level of the brain.

The Secondary Motor Cortex-striatum Circuit Contributes to Suppressing Inappropriate Responses in Perceptual Decision Behavior / 神经科学通报·英文版

The secondary motor cortex (M2) encodes choice-related information and plays an important role in cue-guided actions. M2 neurons innervate the dorsal striatum (DS), which also contributes to decision-making behavior, yet how M2 modulates signals in the DS to influence perceptual decision-making is unclear. Using mice performing a visual Go/No-Go task, we showed that inactivating M2 projections to the DS impaired performance by increasing the false alarm (FA) rate to the reward-irrelevant No-Go stimulus. The choice signal of M2 neurons correlated with behavioral performance, and the inactivation of M2 neurons projecting to the DS reduced the choice signal in the DS. By measuring and manipulating the responses of direct or indirect pathway striatal neurons defined by M2 inputs, we found that the indirect pathway neurons exhibited a shorter response latency to the No-Go stimulus, and inactivating their early responses increased the FA rate. These results demonstrate that the M2-to-DS pathway is crucial for suppressing inappropriate responses in perceptual decision behavior.

Research progress on the questionnaire related to persistent postural-perceptual dizziness / 临床耳鼻咽喉头颈外科杂志

Persistent postural-perceptual dizziness（PPPD） is the most common chronic vestibular disease, the clinical manifestation is dizziness, unstable and non-rotational dizziness for three months or more. And the symptom is exacerbated by upright posture, active or passive movement, and complex visual stimuli. In addition, PPPD is a functional disease, so routine vestibular function tests and imaging tests are often negative. According to the diagnostic criteria established by the Barany Association, the diagnosis of PPPD often relies on history. This article provides a review of PPPD-related questionnaires.

Treinamento para análise perceptivo-auditiva da voz: revisão de escopo / Training for perceptive-auditory voice analysis: scope review

RESUMO Objetivo sintetizar o estado do conhecimento científico sobre treinamento para análise perceptivo-auditiva da voz. Estratégias de pesquisa a estratégia PCC (População, Conceito e Contexto) e combinações de descritores foram utilizadas para busca nas bases de dados PubMed/MEDLINE, LILACS e SciELO. Critérios de seleção foram incluídos estudos com população composta por ouvintes com ou sem experiência na análise perceptivo-auditiva, que incluíssem a análise perceptivo-auditiva da voz, no contexto da clínica vocal, utilizando vozes humanas e/ou sintetizadas, com treinamento individual ou em grupo. Foram observados método de treinamento, vozes utilizadas, tempo de treinamento e se houve treino de habilidades auditivas centrais. Resultados A literatura consultada mostrou ser comum o uso de âncoras auditivas, feedback, vozes naturais soprosas e rugosas e tempo de treinamento com duração máxima de duas horas. Nenhum estudo aplicou o treino de habilidades de processamento auditivo central no treinamento para avaliação perceptivo-auditiva da voz. Conclusão ainda não há consenso sobre qual é o melhor programa de treinamento para análise perceptivo-auditiva da voz.

ABSTRACT Purpose To synthesize the state of scientific knowledge about training for auditory-perceptual voice analysis. Research strategy Question, Concept and Context and combinations of descriptors were formulated for searching in PubMed/Medline, LILACS and SciELO databases. Selection criteria Studies were included with a population composed of listeners with or without experience in auditory-perceptual analysis, which included auditory-perceptual voice analysis, in the context of vocal clinic, using human and/or synthesized voices, with individual or group training. Training method, voices used, training time and whether there was training in central auditory skills were observed. Results It is common to use auditory anchors, feedback, breathy and rough natural voices and training time with a maximum duration of two hours. No study applied the training of central auditory processing skills in training for auditory-perceptual voice assessment. Conclusion There is still no consensus on what is the best training program for auditory-perceptual voice analysis.

O benefício do mascaramento modulado nos potenciais evocados auditivos corticais com estímulo de fala / Masking release in cortical auditory evoked potentials with speech stimulus

RESUMO Objetivo analisar o efeito do mascaramento estável e modulado no Potencial Evocado Auditivo Cortical com estímulo de fala em adultos-jovens. Método participaram 14 indivíduos com idades entre 19 e 28 anos de ambos os sexos e sem perda auditiva. O exame de Potencial Evocado Auditivo Cortical foi realizado com estímulo de fala sintética /ba/ simultâneo ao ruído Speech Shaped Noise apresentado em três condições: ruído estável com intensidade de 30 dB NPSpe (ruído estável fraco), ruído estável com intensidade de 65 dB NPSpe (ruído estável forte) e ruído modulado em intensidade de 30 dB NPSpe e 65 dB NPSpe em 25Hz e com período de modulação de 40 ms. Resultados foram observadas maiores latências nos componentes corticais, exceto P2, na condição de ruído estável forte e medidas mais robustas de amplitude dos componentes corticais P1, N1 e P2 na condição de ruído modulado com diferença estatística significativa na comparação com a condição de ruído estável forte. Houve pior morfologia na condição de ruído estável forte, quando comparado aos demais registros. Os limiares eletrofisiológicos médios para as condições de ruído estável forte e ruído modulado foram 60 dB NPSpe e 49 dB NPSpe, respectivamente, mostrando 11,7 dB de diferença média. Conclusão podemos inferir que houve um menor efeito mascarante do ruído modulado, comparado à condição de ruído estável forte, nas medidas de amplitude dos componentes corticais e uma diferença média de 11,7 dB entre os limiares eletrofisiológicos (interpretado como a medida do Benefício do Mascaramento Modulado).

ABSTRACT Purpose To analyze the effect of masking on the Cortical Auditory Evoked Potential with speech stimulus in young adults. Methods Fourteen individuals aged between 19 and 28 years of both sexes with no hearing loss participated in the study. The Cortical Auditory Evoked Potential examination was performed with synthetic speech stimulus /ba/ simultaneous to Speech Shaped Noise presented under three conditions: steady noise with a 30 dB SPLep intensity (weak steady noise), steady noise with a 65 dB SPLep intensity o (strong steady noise) and modulated noise with 30 dB SPLep and 65 dB SPLep intensities at 25Hz and modulation period of 40 ms. Results Higher latencies were observed in the cortical components, except P2, in the condition of strong steady noise and more meaningful measures of amplitude of the cortical components P1, N1 and P2 in the condition of modulated noise with statistically significant difference in comparison to the strong steady noise condition. There was worse wave morphology in the condition of strong steady noise, when compared to the other records. The average electrophysiological thresholds for the conditions of strong steady noise and modulated noise were 60 dB SPLep and 49 dB SPLep, respectively, showing a 11.7 dB mean difference. Conclusion We could infer that there was a lower masking effect of modulated noise when compared to the strong steady noise condition, in the amplitude measurements of the cortical components and an average difference of 11.7 dB between the electrophysiological thresholds (interpreted as the measure of the Masking Release).

Suicidal Ideation in University Students: a Rorschach Assessment / Ideação Suicida em Estudantes Universitários: Avaliação com Rorschach / Ideación Suicida en Estudiantes Universitarios: Evaluación con Rorschach

Abstract University students are particularly susceptible to suicidal ideation and behavior due to issues inherent to this vital lives' moment. The Rorschach test can help to understand these students' suffering. The objective was to evaluate perception, thinking, stress, and distress in the Rorschach test domains in university students attended at a public university mental health service, comparing students with suicidal ideation with those without it. A total of 36 students aged 18 or over were assessed. The instruments were: Rorschach Performance Assessment System (R-PAS), Columbia Suicide Severity Rating Scale (C-SSRS) and Self Report Questionnaire (SRQ-20). Two analyses were performed using Wilcoxon Mann-Whitney test, according to the presence of suicidal ideation in the last 30 days (SRQ-20) and in the last six months (C-SSRS). Statistically significant differences were found in the two analyses, indicative of greater perceptual distortion in students without suicidal ideation and of stress and distress in students with ideation.

Resumo Estudantes universitários são particularmente suscetíveis a ideação e comportamento suicidas decorrentes de problemas inerentes a este momento vital. O método de Rorschach pode contribuir na compreensão do sofrimento destes estudantes. O objetivo do estudo foi avaliar os domínios percepção, pensamento, estresse e angústia no Rorschach de estudantes universitários atendidos em serviço de saúde mental de universidade pública, comparando estudantes com ideação suicida com aqueles sem ideação. Foram avaliados 36 estudantes com 18 anos ou mais. Os instrumentos foram: Rorschach Performance Assessment System (R-PAS), Escala de Avaliação do Risco de Suicídio de Columbia (C-SSRS) e Self Report Questionnaire (SRQ-20). Foram realizadas duas análises com teste de Wilcoxon Mann-Whitney, segundo a presença de ideação nos últimos 30 dias (SRQ-20) e nos últimos 6 meses (C-SSRS). Foram observadas diferenças estatísticas significativas nas duas análises, indicativas de maior distorção perceptiva nos alunos sem ideação suicida e de angústia e estresse nos estudantes com ideação.

Resumen Estudiantes universitarios son particularmente susceptibles a ideación y comportamiento suicida debido a problemas inherentes a este momento vital. El Rorschach puede ayudar a comprender su sufrimiento. El objetivo fue evaluar los dominios percepción, pensamiento, estrés y angustia en el Rorschach de universitarios atendidos en un servicio de salud mental de universidad pública, comparando estudiantes con ideación suicida con aquellos sin esa ideación. Se evaluaron 36 estudiantes de pregrado y posgrado de 18 años o más. Los instrumentos fueron: Rorschach Performance Assessment System, Escala Columbia para Evaluar la Seriedad de la Ideación Suicida (C-SSRS) y Self Report Questionnaire (SRQ-20). Se realizaron dos análisis con Wilcoxon Mann-Whitney test, según la presencia de ideación en los últimos 30 días (SRQ-20) y en los últimos 6 meses (C-SSRS). Hubo diferencias estadísticamente significativas en los dos análisis, indicativas de mayor distorsión perceptiva en estudiantes sin ideación suicida y de angustia y estrés en estudiantes con ideación.

Influence of pilates training on physical coordination and stability of volleyball players / Influência do treinamento de pilates na coordenação física e estabilidade dos jogadores de voleibol / Influencia del entrenamiento de pilates en la coordinación física y en la estabilidad de los jugadores de voleibol

ABSTRACT Introduction: Pilates prioritizes the control of central muscle groups, which have a strong predilection value for volleyball training. Objective: To investigate the repercussions of Pilates training on motor coordination and stability in volleyball players. Methods: 20 athletes from a female volleyball team were randomly divided between the experimental and the control groups. Pilates intervention was performed in the experimental group. The control group followed the traditional training format, finally comparing the training results after eight weeks. Results: In the flexibility index of the experimental group, the weights increased from 23,11±5,08 times to 28,02±6,42 times; the left and right axes increased from 7,74±10,13 seconds to 8,83±8,13 seconds. In terms of the stability index, the number of intervals repeated in 20 seconds increased from 35.44±0.75 to 46.45±0.91; the lateral throw of the medicine ball was increased from 59.61±16.16 meters to 78.38±16.22 meters. The range of variation of each index is more evident than that of the control group. Conclusion: Pilates training becomes superior to usual training for the improvement of coordination and stability of volleyball players. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O Pilates prioriza o controle de grupos musculares centrais, que possuem um forte valor prediletivo para o treinamento do vôlei. Objetivo: Investigar as repercussões do treino Pilates na coordenação motora e na estabilidade das jogadoras de voleibol. Métodos: 20 atletas de uma equipe feminina de voleibol foram divididas aleatoriamente entre o grupo experimental e o grupo controle. A intervenção do Pilates foi realizada no grupo experimental. O grupo de controle obedeceu ao formato tradicional de treinamento, comparando-se finalmente os resultados do treinamento após 8 semanas. Resultados: No índice de flexibilidade do grupo experimental, os pesos elevaram-se de 23.112 ± 5.088 vezes para 28.020 ± 6.427 vezes; os eixos esquerdo e direito cresceram de 7.745 ± 10.138 segundos para 8.831 ± 8.133 segundos. Em termos de índice de estabilidade, o número de intervalos repetidos em 20 segundos aumentou de 35.444 ± 0.753 para 46.453 ± 0.919; o arremesso lateral da bola medicinal foi elevado de 59.617 ± 16.160 metros para 78.386 ± 16.221 metros. O intervalo de variação de cada índice é mais evidente do que o do grupo de controle. Conclusão: O treinamento de Pilates se torna superior ao treinamento habitual para a melhora da coordenação e estabilidade das jogadoras de vôlei. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Pilates prioriza el control de los grupos musculares centrales, que tienen un fuerte valor de predilección para el entrenamiento del voleibol. Objetivo: Investigar la repercusión del entrenamiento de Pilates sobre la coordinación motora y la estabilidad de jugadoras de voleibol. Métodos: 20 atletas de un equipo femenino de voleibol se dividieron aleatoriamente entre el grupo experimental y el grupo de control. La intervención de Pilates se realizó en el grupo experimental. El grupo de control siguió el formato de entrenamiento tradicional, comparando finalmente los resultados del entrenamiento después de 8 semanas. Resultados: En el índice de flexibilidad del grupo experimental, los pesos aumentaron de 23,11±5,08 veces a 28,02±6,42 veces; los ejes izquierdo y derecho aumentaron de 7,74±10,13 segundos a 8,83±8,13 segundos. En cuanto al índice de estabilidad, el número de intervalos repetidos en 20 segundos aumentó de 35,44±0,75 a 46,45±0,91; el lanzamiento lateral del balón medicinal aumentó de 59,61±16,16 metros a 78,38±16,22 metros. El rango de variación de cada índice es más evidente que el del grupo de control. Conclusión: El entrenamiento con Pilates llega a ser superior al entrenamiento habitual para la mejora de la coordinación y estabilidad de los jugadores de voleibol. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Perceptual learning with hand – eye coordination as an effective tool for managing amblyopia: A prospective study

Purpose: Amblyopia is a serious condition resulting in monocular impairment of vision. Although traditional treatment improves vision, we attempted to explore the results of perceptual learning in this study. Methods: This prospective cohort study included all patients with amblyopia who were subjected to perceptual learning. The presenting data on vision, stereopsis and contrast sensitivity were documented in a pretested online format, and the pre? and post?treatment information was compared using descriptive, cross?tabulation and comparative methods on SPSS 2.2. The mean values were obtained, and P < 0.05 was considered statistically significant. Results: The cohort consisted of 47 patients (23 females and 24 males) with a mean age of 14.11 ± 7.13 years. A statistically significant improvement was detected in visual acuity after the perceptual learning session, and the median follow?up period was 17 days. Also, significant improvements were observed in stereopsis but not in the visual outcomes among the age groups. Conclusion: Perceptual learning with hand–eye coordination is an effective method for managing amblyopia. This approach can improve vision in all age groups. However, visual improvement is significantly influenced by ocular alignment.

Perceptual reversals and time-response analyses within the scope of decoding a bistable image / Análisis de reversibilidades perceptuales y de tiempos de respuesta en el marco de la decodificación de una imagen biestable

Abstract A bistable image admits two possible interpretations, so that the observer can recognize the two percepts, but never at the same time. The alternations between percepts are called "perceptual reversals". When the observer's position is different from the upright position, the ability to make perceptual alternations may be impaired. Besides, the recognition of the percepts of a bistable image can be a complex reaction time visual task, if it involves recognizing two different conceptual units, added to the fact of having to make a subsequent report. A visual task was performed by 88 people in order to establish whether the perception of Boring's bistable image My girlfriend or my mother-in-law is associated with areas that condition its interpretation. It was assumed that decoding the image and reporting the perceived percept implied a complex reaction time. The task itself was done in front of a fixed 120 Hz eye-tracker, in two opposite body positions. Analyses were made reviewing the association of the percepts with bottom-up modulation areas of the image, and considering ocular fixations made 200 and 250 milliseconds before the time of the report. The records of these fixations were obtained so as to establish which of the two reaction times (200 ms or 250 ms) was involved in the bottom-up modulation process from the moment of ocular fixation to the reports given by the participants. It was concluded that perceptual reversals decrease significantly when head idiotropic axis points in the gravity vector direction, in comparison to the upright position. Likewise, associations between visual percepts and bottom-up modulating areas of the image were found when analyses were done by considering ocular fixations made 250 ms before the moment of the report. Interpreting Boring's bistable image implies a complex visual task in accordance with the results obtained.

Resumen Una imagen biestable admite dos interpretaciones, de modo que el observador reconoce cada percepto, pero nunca los dos al mismo tiempo. Cada alternancia entre uno y otro percepto se conoce con el nombre de "reversibilidad perceptual". Este tipo de percepción, denominada también "biestable", puede implicar dos tipos de modulación, una mediada por las características físicas del estímulo visual y por las áreas de fijación ocular, y otra por información contextual o por conocimiento almacenado en memoria. En ese sentido, las alternancias perceptuales que se manifiestan durante la observación de una imagen biestable pueden estar condicionadas por la manera en que el observador recorre con su mirada el estímulo biestable, de manera tal que es manifiesta una asociación entre específicas áreas de la imagen y el percepto que se reconoce. En efecto, para la imagen biestable de Boring Mi novia o mi suegra, se han establecido áreas de fijación ocular que favorecen los dos posibles perceptos (una mujer joven y una mujer de edad). Algunas de estas zonas elicitan más la interpretación de uno de los perceptos, otras de los dos indistintamente, como se reconoce en estudios precedentes. Por otra parte, se ha encontrado evidencia de que cuando la posición corporal del observador es distinta a la posición erguida (el tronco y la cabeza alineados con la vertical), puede dificultarse la capacidad para hacer las alternancias perceptuales. La rotación del eje idiotrópico de la cabeza con respecto al vector que apunta verticalmente hacia el cénit tiene repercusiones en los procesos perceptuales visuales y también en la manifestación de las reversibilidades perceptuales inherentes a la observación de imágenes biestables. El reconocimiento de los perceptos de un estímulo visual biestable puede suponer una tarea visual de tiempo de reacción complejo (superior a 230 milisegundos), dado que esta implica reconocer dos unidades conceptuales diferentes. A esto se suma el hecho de tener que hacer un reporte posterior que implique eferencias motoras. A los efectos de establecer si la percepción de la imagen biestable Mi novia o mi suegra está asociada a las áreas del estímulo que condicionan su interpretación cuando se asume que su decodificación más su reporte implican un tiempo de reacción complejo, se hicieron análisis de tareas visuales realizadas por 88 personas frente a un eye-tracker fijo de 120 Hz en dos posiciones corporales opuestas (una, con el tronco erguido y el eje idiotrópico de la cabeza apuntando hacia el cénit, y otra con el vector idiotrópico de la cabeza apuntando hacia el suelo en paralelo al eje gravitacional). Se revisó la asociación de los perceptos con las áreas de modulación de la imagen y considerando las fijaciones oculares realizadas 200 y 250 milisegundos antes del momento del reporte, el cual fue realizado por cada participante mediante el uso de los botones de un dispositivo conectado al registrador de datos. Los registros de fijaciones oculares, tomados en dos momentos previos al momento del reporte de los perceptos identificados, fueron considerados para establecer cuál de los dos tiempos de reacción (200 ms o 250 ms) está implicado en el proceso de modulación bottom-up desde el momento de la fijación ocular hasta el reporte dado por los participantes. Se concluyó que las reversibilidades perceptuales disminuyen significativamente cuando el eje idiotrópico de la cabeza apunta en el sentido del vector gravitacional en comparación con la posición erguida. Se encontraron asociaciones entre los perceptos y las áreas de modulación cuando en el análisis se consideran las fijaciones oculares registradas, 250 milisegundos antes de los reportes. La interpretación de la imagen analizada supone una tarea visual compleja de conformidad con los resultados, pues el análisis de asociación entre perceptos reportados y áreas moduladoras que arroja significancia es el que se hace revisando las fijaciones oculares hechas 250 ms antes del registro del reporte de cada percepto.