Does galvanic vestibular stimulation decrease spasticity in clinically complete spinal cord injury?

The aim of this study was to determine changes in clinical and biomechanical measures of spasticity after administering galvanic vestibular stimulation in patients with a complete spinal cord injury (SCI). The spasticity in the lower limbs was assessed using the Modified Ashworth Scale and the pendulum test in seven SCI patients (grade A on the ASIA Impairment Scale) before (0), immediately after (0), and at 5 and 30 min after the real versus sham galvanic vestibular stimulation (15 s each, anode over the right mastoid). Overall, the changes in spasticity were not significantly different between the real and sham galvanic vestibular stimulation. However, the Modified Ashworth Scale and the pendulum test indicated a reduction in spasticity in two out of seven patients. The results suggest that galvanic vestibular stimulation may modify spasticity in some patients with complete SCI, presumably through the residual vestibulospinal influences. Future studies should determine clinical and neurophysiological profiles of responders versus nonresponders and optimize parameters of galvanic vestibular stimulation.

Correlation between Balance Ability and Speech-Language Development in Children.

The longitudinal study was conducted in order to establish whether the success rate of reflexes related to maintaining balance at birth is in correlation with the success rate of maintaining balance in early childhood, as well as to examine the correlation of a certain level of speech and language development with the ability of maintaining balance at birth and at the age of 5. The main study group included 54 children of both genders, aged 5.0 to 5.4, whose balance ability and speech and language status were evaluated based on the battery of standardized tests, whereas the group of reflexes related to the function of the vestibular sense was clinically tested on the 3rd day upon birth, within the same sample of children. The data at birth and at the age of 5 were recorded by means of a digital camera, then scored and statistically and descriptively processed. The research results indicated a statistically significant correlation between the achieved level of balance ability in the newborns and five-year-olds, as well as between balance skills and a certain level of speech and language development in children at the age of 5. The importance of this research lies in new knowledge in the domain of maturation of vestubular function immediately after birth, given that this segment of physiology of a newborn has not so far been processed in such a way, as well as in the recognition of function of the vestibular sense as another parametre of a child's maturation.

Clinical and audiological findings in children with acute otitis media.

CONCLUSION: It is recommended to perform follow-up tympanometry and if necessary tonal audiometry in children who have normal plain otoscopy findings after recovering from acute otitis media (AOM). Children with Type B tympanogram, 3 months following the onset of AOM, are very likely to have a conductive hearing loss. Type B tympanogram is a much better indicator of effusion in the middle ear compared to plain otoscopy. OBJECTIVE: This study was undertaken to investigate the frequency and duration of middle ear effusion in children following an episode of acute otitis media, to track changes in tonal audiometry and tympanometry findings in the post-AOM period, and recognize the optimal timing for performing both tests. METHODS: In this study, 125 children aged 5-7 years with bilateral AOM were randomly selected and separately followed up for 3 months. The children underwent six ear, nose, and throat (ENT 1-6) examinations, six tympanometries (TM 1-6), and three tonal audiometries (TA 1-3). Evaluation of nasopharynx was done at the ENT 1 examination. Children who received ventilation tubes were followed for 21 month altogether. RESULTS: At the first otoscopy, pathological findings were recorded in 250 ears/125 children (100.0%). The number of pathological otoscopy findings decreased at each subsequent examination. At ENT 6 all children had normal otoscopy findings. Type B tympanogram was detected in 49/250 (19.6%) ears at TM 6, performed 3 months following the onset of the disease. At the TA 1 conductive hearing impairment was recorded in 158/250 (63.2%) ears, at TA 2 in 66/250 (26.4%), and at TA 3 in 39/250 (15.6%). Most of them were associated with Type B tympanogram.

Changes in Doppler blood flow velocity in middle cerebral artery in response to airborne sound in low- and high-risk human fetuses.

OBJECTIVE: To examine fetal auditory perception in low- and high-risk pregnancies in period from 27 to 31 weeks gestational age with the aim to establish diagnostic parameters in prenatal detection of the degree of hearing development in a fetus. METHODS: Method of prenatal hearing screening was applied on 80 women divided in two groups: Control group (C=22), consisted of pregnant women with low-risk pregnancies, and Experimental group (E=58), consisted of pregnant women with high-risk pregnancies (pregnancies with diagnosis of: preterm delivery, hypertension and/or intrauterine growth restriction (IUGR), diabetes). PHS was applied in period from 27 to 31 weeks gestational age. Brain circulation changes in fetal middle cerebral artery (MCA) caused by defined sound stimulus, as the indicator of fetal auditory reactions, were registered on Doppler ultrasound apparatus. After visualization of MCA, a sound stimulus was delivered. The stimulus consisted of one defined sound which is a digitally produced sound with the intensity of 90 dB, frequency range of 1500-4500 Hz, and duration of 0.2s (click) and it was presented only once. Measurements in observed artery were taken before (baseline) and after defined sound stimulation. RESULTS: Results showed that the absolute and relative difference in Pulsatility index (baseline and after sound stimulation) were greater for the high-risk group compared to the low-risk group (absolute difference: mean=0.36 vs mean=0.36) (relative difference: mean = ∼ 18% vs mean = ∼ 12%). When the low-risk group and the three high-risk group mean pairs were compared using multiple t-test, the diabetic group differed from the low-risk and two other high-risk groups; the low-risk and the two other high-risk groups did not differ from each other. Fetuses from pregnancies with diagnosis of diabetes demonstrated the most expressive reactibility and significantly higher absolute and relative changes of Pi values (absolute difference: mean=0.54, relative difference: mean=25.49%). CONCLUSION: The values of Pulsatility index (Pi) registered by PHS in low- and high-risk pregnancies may be used as differential and diagnostic parameters in fetal auditory perception examination. Fetuses from pregnancies with diagnosis of diabetes demonstrated significantly higher absolute and relative changes of Pi values compared to other groups of examined fetuses.

[Subjective Visual Vertical test: normative values in healthy population].

INTRODUCTION: Subjective Visual Vertical test (SW test) can be applied to measure one of the functions of the vestibular apparatus, its afferent pathways and nuclei within the brain stem. The test is based on the subjective assessment of verticality. The possibility of perceived visual vertical in healthy subjects can show deviation with accuracy of -/+ 2 degrees at most. OBJECTIVE: The goal of the study is to present the results of the SVV test developed at our department. METHOD: Two kinds of testing procedures were applied; the static test during which the subjects evaluated the verticality on a static background; the dynamic test during which the subjects evaluated the verticality after 20 seconds of rotation of the background to the right or to the left. Ninety-five healthy subjects aged between 21 and 79 years were tested. The whole group was divided into smaller groups according to age criterium. RESULTS: The results showed statistically significant bigger SVV tilt in the subjects aged over 45 years than in the younger subjects. The arithmetic mean of the tilt to the left or tilt to the right in the group younger than 45 years was 0.42 degrees during the static test and 0.49 degrees during the dynamic test. The arithmetic mean for the group older than 45 years was 0.67 during the static test and 0.68 during the dynamic test. CONCLUSION: The testing indicated that SVV perception showed a bigger tilt according to age. This should be taken into consideration in individual testing and evaluation of functional ability.