1.Hearing Loss in High-Risk Newborns: The Effectiveness of One-stage Hearing Screening in the Neonatal Intensive Care Unit of the Jose R. Reyes Memorial Medical Center.
Christine Joyce G ZAMBALES ; Elias T REALA
Philippine Journal of Otolaryngology Head and Neck Surgery 2025;40(1):9-14
Objective:To determine the effectiveness of a one-stage hearing screening protocol in detecting hearing loss in high risk newborns at the Neonatal Intensive Care Unit of the Jose R. Reyes Memorial Medical Center.
Methods:
Design:Cross-Sectional Study
Setting:Tertiary Government Training Hospital
Population:High-risk newborns admitted at the Neonatal Intensive Care Unit of the Jose R. Reyes Memorial Medical Center from March to December 2023 underwent a one stage universal newborn hearing screening protocol. Excluded from the study were patients who were admitted for less than 48 hours, without consent from their parents or guardians and babies who were not cleared medically to undergo testing, and those who presented with aural atresia and/or any physical anomaly of the head and the external ear.
Results:A total of 169 babies were initially seen with 16 babies lost to follow up resulting in a final total of 153 babies (or 306 ears) tested. The refer and false positive rates were 9.8% and 8.92%, respectively, on average comparable to or even better than the two-step protocol in most studies. Sensitivity was determined to be 100% while specificity was 91.08%. The incidence of hearing loss in the study population was 19.8/1000, consistent with various study outcomes for high risk newborns. There was no reported incidence of auditory neuropathy in this study. The primary risk factors that were present in babies with hearing loss were: low birth weight, prematurity, neonatal intensive care unit admission of more than 5 days and exposure to ototoxic medications.
Conclusion:The one-staged Automated Auditory Brainstem Response (AABR) is an effective and efficient newborn hearing screening protocol for high-risk newborns in the Neonatal Intensive Care Unit (NICU) setting and eventually, may be considered as an alternative hearing screening technique whenever available in this cohort. More studies about improving newborn hearing screening, cost-analysis, diagnostics and interventions of hearing loss should be pursued in implementation of the Universal Hearing Screening Law in the Philippines.
Human ; Male ; Female ; Infant Newborn: First 28 Days After Birth ; Newborn Screening ; Evoked Potentials ; Brain Stem ; Neonatal Intensive Care
3.Study on gene therapy for DPOAE and ABR threshold changes in adult Otof-/- mice.
Zijing WANG ; Qi CAO ; Shaowei HU ; Xintai FAN ; Jun LV ; Hui WANG ; Wuqing WANG ; Huawei LI ; Yilai SHU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):49-56
Objective:This study aims to analyze the threshold changes in distortion product otoacoustic emissions(DPOAE) and auditory brainstem response(ABR) in adult Otof-/- mice before and after gene therapy, evaluating its effectiveness and exploring methods for assessing hearing recovery post-treatment. Methods:At the age of 4 weeks, adult Otof-/- mice received an inner ear injection of a therapeutic agent containing intein-mediated recombination of the OTOF gene, delivered via dual AAV vectors through the round window membrane(RWM). Immunofluorescence staining assessed the proportion of inner ear hair cells with restored otoferlin expression and the number of synapses.Statistical analysis was performed to compare the DPOAE and ABR thresholds before and after the treatment. Results:AAV-PHP. eB demonstrates high transduction efficiency in inner ear hair cells. The therapeutic regimen corrected hearing loss in adult Otof-/- mice without impacting auditory function in wild-type mice. The changes in DPOAE and ABR thresholds after gene therapy are significantly correlated at 16 kHz. Post-treatment,a slight increase in DPOAE was observeds,followed by a recovery trend at 2 months post-treatment. Conclusion:Gene therapy significantly restored hearing in adult Otof-/- mice, though the surgical delivery may cause transient hearing damage. Precise and gentle surgical techniques are essential to maximize gene therapy's efficacy.
Mice
;
Animals
;
Otoacoustic Emissions, Spontaneous/physiology*
;
Hearing/physiology*
;
Ear, Inner
;
Hearing Loss/therapy*
;
Genetic Therapy
;
Auditory Threshold/physiology*
;
Evoked Potentials, Auditory, Brain Stem/physiology*
;
Membrane Proteins
4.Recognition of high-frequency steady-state visual evoked potential for brain-computer interface.
Ruixin LUO ; Xinyi DOU ; Xiaolin XIAO ; Qiaoyi WU ; Minpeng XU ; Dong MING
Journal of Biomedical Engineering 2023;40(4):683-691
Coding with high-frequency stimuli could alleviate the visual fatigue of users generated by the brain-computer interface (BCI) based on steady-state visual evoked potential (SSVEP). It would improve the comfort and safety of the system and has promising applications. However, most of the current advanced SSVEP decoding algorithms were compared and verified on low-frequency SSVEP datasets, and their recognition performance on high-frequency SSVEPs was still unknown. To address the aforementioned issue, electroencephalogram (EEG) data from 20 subjects were collected utilizing a high-frequency SSVEP paradigm. Then, the state-of-the-art SSVEP algorithms were compared, including 2 canonical correlation analysis algorithms, 3 task-related component analysis algorithms, and 1 task discriminant component analysis algorithm. The results indicated that they all could effectively decode high-frequency SSVEPs. Besides, there were differences in the classification performance and algorithms' speed under different conditions. This paper provides a basis for the selection of algorithms for high-frequency SSVEP-BCI, demonstrating its potential utility in developing user-friendly BCI.
Humans
;
Brain-Computer Interfaces
;
Evoked Potentials, Visual
;
Algorithms
;
Discriminant Analysis
;
Electroencephalography
5.A design and evaluation of wearable p300 brain-computer interface system based on Hololens2.
Qi LI ; Tingjia ZHANG ; Yu SONG ; Yulong LIU ; Meiqi SUN
Journal of Biomedical Engineering 2023;40(4):709-717
Patients with amyotrophic lateral sclerosis ( ALS ) often have difficulty in expressing their intentions through language and behavior, which prevents them from communicating properly with the outside world and seriously affects their quality of life. The brain-computer interface (BCI) has received much attention as an aid for ALS patients to communicate with the outside world, but the heavy device causes inconvenience to patients in the application process. To improve the portability of the BCI system, this paper proposed a wearable P300-speller brain-computer interface system based on the augmented reality (MR-BCI). This system used Hololens2 augmented reality device to present the paradigm, an OpenBCI device to capture EEG signals, and Jetson Nano embedded computer to process the data. Meanwhile, to optimize the system's performance for character recognition, this paper proposed a convolutional neural network classification method with low computational complexity applied to the embedded system for real-time classification. The results showed that compared with the P300-speller brain-computer interface system based on the computer screen (CS-BCI), MR-BCI induced an increase in the amplitude of the P300 component, an increase in accuracy of 1.7% and 1.4% in offline and online experiments, respectively, and an increase in the information transfer rate of 0.7 bit/min. The MR-BCI proposed in this paper achieves a wearable BCI system based on guaranteed system performance. It has a positive effect on the realization of the clinical application of BCI.
Humans
;
Amyotrophic Lateral Sclerosis
;
Brain-Computer Interfaces
;
Quality of Life
;
Event-Related Potentials, P300
;
Wearable Electronic Devices
6.Visual function changes of dysthyroid optic neuropathy and ROC curve analysis for early diagnostic indicators.
Sha WANG ; Jinwei WANG ; Lu CHEN ; Jia TAN
Journal of Central South University(Medical Sciences) 2023;48(8):1197-1202
OBJECTIVES:
Dysthyroid optic neuropathy (DON) is a class of diseases that makes seriously endanger to the vision of patients with thyroid-associated ophthalmopathy. This study aims to observe the visual function changes in patients with DON, and to evaluate the diagnostic value of indicators diagnosing DON.
METHODS:
A retrospective study was conducted on 98 eyes of 49 patients with dysthyroid optic neuropathy (DON) who were treated in Xiangya Hospital of Central South University from January 2017 to December 2019. All patients were received the examination of best corrected visual acuity (BCVA), Humphrey visual field, visual evoked potential (VEP), and contrast sensitivity. Ninety-eight eyes were divided into a DON group (45 eyes) and a non-DON group (53 eyes). T-test was used to compare the related indicators between the 2 groups. The sensitivity and specificity of each indicator were analyzed by receiver operating characteristic (ROC) curve.
RESULTS:
The BCVA and visual field index (VFI) of the DON group were significantly lower than those of the non-DON group (all P<0.05). The mean deviation (MD) and pattern standard deviation (PSD) of the DON group were significantly higher than those of the non-DON group (all P<0.05). The low frequency contrast sensitivity (CSL), medium frequency contrast sensitivity (CSM), and high frequency contrast sensitivity (CSH) of the DON group were significantly lower than those of the non-DON group (all P<0.05), with CSH being particularly prominent. Compared with the non-DON group, at spatial frequencies of 15°, 30°, and 60°, the amplitude of N135 wave was significantly reduced, and the latency of N75 wave, P100 wave, and N135 wave was significantly prolonged in the DON group (all P<0.05); at spatial frequencies of 15° and 30°, the amplitude of P100 wave was significantly reduced in the DON group (P<0.05). The ROC curve analysis results showed that the area under the curve (AUC) of VFI, CSL, CSM, CSH and 15° P100 amplitude diagnosing DON were 0.812, 0.841, 0.880, 0.784, and 0.791, respectively, with CSM possessing the highest sensitivity and specificity.
CONCLUSIONS
The visual function of patients with DON is decreased. VFI, contrast sensitivity of low, medium, and high frequency, and 15° P100 wave amplitude might be effective indicators for early diagnosis of DON.
Humans
;
ROC Curve
;
Optic Nerve Diseases/complications*
;
Retrospective Studies
;
Evoked Potentials, Visual
;
Graves Ophthalmopathy
7.Implicit, But Not Explicit, Emotion Regulation Relieves Unpleasant Neural Responses Evoked by High-Intensity Negative Images.
Yueyao ZHANG ; Sijin LI ; Kexiang GAO ; Yiwei LI ; Jiajin YUAN ; Dandan ZHANG
Neuroscience Bulletin 2023;39(8):1278-1288
Evidence suggests that explicit reappraisal has limited regulatory effects on high-intensity emotions, mainly due to the depletion of cognitive resources occupied by the high-intensity emotional stimulus itself. The implicit form of reappraisal has proved to be resource-saving and therefore might be an ideal strategy to achieve the desired regulatory effect in high-intensity situations. In this study, we explored the regulatory effect of explicit and implicit reappraisal when participants encountered low- and high-intensity negative images. The subjective emotional rating indicated that both explicit and implicit reappraisal down-regulated negative experiences, irrespective of intensity. However, the amplitude of the parietal late positive potential (LPP; a neural index of experienced emotional intensity) showed that only implicit reappraisal had significant regulatory effects in the high-intensity context, though both explicit and implicit reappraisal successfully reduced the emotional neural responses elicited by low-intensity negative images. Meanwhile, implicit reappraisal led to a smaller frontal LPP amplitude (an index of cognitive cost) compared to explicit reappraisal, indicating that the implementation of implicit reappraisal consumes limited cognitive control resources. Furthermore, we found a prolonged effect of implicit emotion regulation introduced by training procedures. Taken together, these findings not only reveal that implicit reappraisal is suitable to relieve high-intensity negative experiences as well as neural responses, but also highlight the potential benefit of trained implicit regulation in clinical populations whose frontal control resources are limited.
Humans
;
Emotional Regulation
;
Electroencephalography
;
Evoked Potentials/physiology*
;
Cognition/physiology*
;
Emotions/physiology*
8.A comparative study of detection methods for assessing superior and inferior vestibular nerve damages in patients with vestibular neuritis.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(10):829-836
Objective:This study aims to compare the examination results of the vestibular evoked myogenic potential(VEMP) and video head impulse testing(vHIT) in patients with vestibular neuritis(VN), thus exploring the methods to distinguish superior and inferior vestibular nerve damages in VN patients, and their feasibility. Methods:A total of 25 patients with unilateral VN treated in the Otology Department of the First Hospital of Qinhuangdao from May 2018 to July 2021 were recruited. They were respectively tested for ocular VEMP(oVEMP), cervical VEMP(cVEMP) and vHIT, and the examination results were analyzed. Results:Examination results of oVEMP showed that 96%(24/25) patients had one-ear abnormalities with the amplitude decline or no waveform introduced, and 4%(1/25) patient had no waveform introduced of both ears. The overall abnormal rate examined by oVEMP was 100%(26/26). Examination results of cVEMP showed that 36%(9/25) patients had one-ear abnormalities with the amplitude decline or no waveform introduced, and 4%(1/25) patients had no waveform introduced of both ears. The overall abnormal rate examined by cVEMP was 40%(10/25), and 60%(15/25) patients had normal waveforms of both ears. Examination results of vHIT showed that 100%(25/25) patients had semicircular canal gain decline of one side, 92%(23/25) had anterior Semicircular canal decline of one side, and 36%(9/25) had posterior semicircular canal decline of one side. VEMP and vHIT results were compared. Examination results of VEMP showed that 60%(15/25) VN patients had superior vestibular nerve damage, and 40%(10/25) had both superior and inferior vestibular nerve damages. Examination results of vHIT showed that 64%(16/25) VN patients had superior vestibular nerve damage, and 36%(9/25) had both superior and inferior vestibular nerve damages. There was no significant difference in the ratio of VN patients with superior and inferior vestibular nerve damages examined by VEMP or vHIT(χ²=0.085, P>0.05). The matching ratio of VEMP and vHIT results was 80%(20/25), and the non-matching ratio was 20%(5/25). Conclusion:Consistent results obtained from both VEMP and vHIT can preliminarily identify the type of vestibular nerve damage. If their results are not consistent, it is recommended not to identify the scope of the vestibular nerve damage.
Humans
;
Vestibular Neuronitis/diagnosis*
;
Vestibular Nerve
;
Head Impulse Test/methods*
;
Semicircular Canals
;
Vestibular Evoked Myogenic Potentials/physiology*
9.Advances in brain-computer interface based on high-frequency steady-state visual evoked potential.
Chenguang ZHENG ; Yang LIU ; Xiaolin XIAO ; Xiaoyu ZHOU ; Fangzhou XU ; Minpeng XU ; Dong MING
Journal of Biomedical Engineering 2023;40(1):155-162
Steady-state visual evoked potential (SSVEP) has been widely used in the research of brain-computer interface (BCI) system in recent years. The advantages of SSVEP-BCI system include high classification accuracy, fast information transform rate and strong anti-interference ability. Most of the traditional researches induce SSVEP responses in low and middle frequency bands as control signals. However, SSVEP in this frequency band may cause visual fatigue and even induce epilepsy in subjects. In contrast, high-frequency SSVEP-BCI provides a more comfortable and natural interaction despite its lower amplitude and weaker response. Therefore, it has been widely concerned by researchers in recent years. This paper summarized and analyzed the related research of high-frequency SSVEP-BCI in the past ten years from the aspects of paradigm and algorithm. Finally, the application prospect and development direction of high-frequency SSVEP were discussed and prospected.
Humans
;
Brain-Computer Interfaces
;
Evoked Potentials, Visual
;
Algorithms
10.Application of cochlear nerve action potential monitoring in the resection of vestibular schwannomas.
Xiu Ying WANG ; Jun ZHANG ; Jiao CONG ; Qun WANG ; Ding ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(3):200-205
Objective: To investigate the application of cochlear nerve action potential (CNAP) monitoring in the resection of vestibular schwannoma, especially evaluating its significance for hearing preservation. Methods: From April 2018 to December 2021, 54 patients with vestibular schwannoma who underwent resection via retrosigmoid approach were collected in Chinese PLA General Hospital. Before surgery, all patients had effective hearing (AAO-HNS grade C or above). Brainstem auditory evoked potential (BAEP) combined with CNAP monitoring was performed during surgery. The CNAP monitoring was combined with continuous monitoring and cochlear nerve mapping. And patients were divided into hearing preservation group and non-preserved group according to postoperative AAO-HNS grade. SPSS 23.0 software was used to analyze the differences of CNAP and BEAP parameters between the two groups. Results: A total of 54 patients completed intraoperative monitoring and data collection, including 25 males (46.3%) and 29 females (53.7%), aged 27-71 years with an average age of 46.2 years. The maximum tumor diameter were (18.1±5.9) mm (range 10-34 mm). All tumors were totally removed with preserved facial nerve function (House-Brackmann grade I-II). The hearing preservation rate of 54 patients was 51.9% (28/54). During surgery, the V wave extraction rate of BAEP waveform was 85.2% (46/54) before tumor resection, 71.4% (20/28) in the hearing preservation group after tumor resection, and disappeared in the hearing preservation group (0/26). CNAP waveform was elicited in 54 patients during operation. Differences were found in the distribution of CNAP waveforms after tumor resection. The waveforms of the hearing-preserving group were triphasic and biphasic, while those in the non-preserving group were low-level and positive. For hearing preservation group, the amplitude of N1 wave after tumor resection was significantly higher than that before tumor resection[14.45(7.54, 33.85)μV vs 9.13(4.88, 23.35)μV, P=0.022]; However, for the non-preserved group, the amplitude of N1 wave after tumor resection was significantly lower than that before tumor resection [3.07(1.96, 4.60)μV vs 6.55(4.54, 9.71)μV, P=0.007]; After tumor resection, the amplitude was significantly higher than that of the unreserved group [14.45(7.54, 33.85)μV vs 3.07(1.96, 4.60)μV, P<0.001]. Conclusions: BAEP combined with CNAP monitoring is conducive to intraoperative hearing protection, and the application of cochlear nerve mapping can prompt the surgeon to avoid nerve injury. The waveform and N1 amplitude of CNAP after tumor resection have a certain value in predicting postoperative hearing preservation status.
Female
;
Male
;
Humans
;
Middle Aged
;
Neuroma, Acoustic/surgery*
;
Action Potentials
;
Evoked Potentials, Auditory, Brain Stem
;
Cochlea
;
Cochlear Nerve


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