Biomedical subjects

G P Jacobson

Publications and source records attributed to G P Jacobson.

At least 37 records · Page 2Linked to original sources

PubMed1997

Self-focused and somatic attention in patients with tinnitus.

Self-focused and somatic attention were examined in a sample of 51 patients with tinnitus using the Self-Focus Sentence Completion Test, Private Self-Consciousness Subscale of the Self-Consciousness Scale, Modified Somatic Perception Questionnaire, and the Somatization Subscale of the Symptoms Checklist-90-Revised. Two subgroups of patients emerged following a cluster analysis of the attentional tasks. One group scored lower on both self-attention and somatic attention measures ("low self-attenders"), whereas a second group was more internally directed and scored higher on the attention measures ("high self-attenders"). Between-group comparisons showed that the high self-attenders were, on average, more depressed, had greater emotional distress due to tinnitus, and had greater perceived tinnitus handicap. In contrast, no differences were observed for pitch and loudness measures using either psychophysical or rating scale techniques. Results of this investigation support the belief that attentional mechanisms play an important role in patients' perception of tinnitus and should be considered when planning management strategies.

Adolescent↗

PubMed1996

Development of the Tinnitus Handicap Inventory.

OBJECTIVE: To develop a self-report tinnitus handicap measure that is brief, easy to administer and interpret, broad in scope, and psychometrically robust. DESIGN: A standardization study of a self-report tinnitus handicap measure was conducted to determine its internal consistency reliability and convergent and construct validity. SETTING: Audiology clinics in tertiary care centers in two sites. PARTICIPANTS: In the first investigation, 84 patients reporting tinnitus as their primary complaint or secondary to hearing loss completed the 45-item alpha version of the Tinnitus Handicap Inventory (THI). In the second investigation, 66 subjects also reporting tinnitus completed the 25-item beta version. OUTCOME MEASURES: Convergent validity was assessed using another measure of perceived tinnitus handicap (Tinnitus Handicap Questionnaire). Construct validity was assessed using the Beck Depression Inventory, Modified Somatic Perception Questionnaire, symptom rating scales (annoyance, sleep disruption, depression, and concentration), and perceived tinnitus pitch and loudness judgments. RESULTS: From the alpha version of the THI, we derived a 25-item beta version with the items grouped into functional, emotional, and catastrophic subscales. The total scale yielded excellent internal consistency reliability (Cronbach's alpha = .93). No significant age or gender effects were seen. Weak correlations were observed between the THI and the Beck Depression Inventory, Modified Somatic Perception Questionnaire, and pitch and loudness judgments. Significant correlations were found between the THI and the symptom rating scales. CONCLUSION: The THI is a self-report measure that can be used in a busy clinical practice to quantify the impact of tinnitus on daily living.

Activities of Daily Living↗

PubMed1996

Update on tinnitus.

The study of a disorder such as tinnitus is fraught with difficulties. Tinnitus, like pain, is a subjective symptom. The problem is compounded because several different mechanisms must operate to cause the persistent sensation of tinnitus. Therefore, it is difficult to measure objectively any improvements in the condition. For example, it has been reported previously that sectioning the eighth cranial nerve does not abolish tinnitus in a majority of patients; therefore, central mechanisms must act to preserve the tinnitus. Finally, we know that tinnitus can occur in a host of conditions other than ototoxicity, aging, and noise exposure. Other conditions that may produce tinnitus are migraine headache with auditory aura, temporal lobe seizures, and head injuries. Therefore, it is naive to conceptualize that tinnitus is a disorder with a unitary origin and a unitary "cure".

Diagnosis, Differential↗

PubMed1996

Electrophysiological indices of selective auditory attention in subjects with and without tinnitus.

The present investigation was conducted in an attempt to determine whether selective auditory attention abilities differed between normal subjects and subjects with bothersome tinnitus. Subjects were 37 adults with tinnitus and high-frequency hearing loss (not affecting thresholds at 500 and 1000 Hz) and 15 subjects who were audiometrically and otologically normal. Results suggested that an electrophysiological index of early selective auditory attention (i.e., the negative difference wave, Nd) was of greater magnitude in tinnitus patients. Also, the cortical NI component occurred significantly later in the presence of selective attention in tinnitus subjects only. Results of this investigation may support the view that early selective auditory attention in subjects with bothersome tinnitus differs from that of normal subjects.

Acoustic Stimulation↗

PubMed1995

Hearing loss in Paget's disease of bone: the relationship between pure-tone thresholds and mineral density of the cochlear capsule.

We have developed a unique method of quantitative computed tomography (QCT) that enables measurement of the density of the cochlear capsule in vivo. We performed pure-tone audiometry and QCT on 67 ears from 35 subjects with radiographically confirmed Paget's disease of the skull and on 40 ears from twenty volunteer subjects. The Pearson product-moment correlation coefficients (age- and sex-adjusted) in the group affected by Paget's disease were -0.63 for left ears and -0.73 for right ears for high-frequency air conduction pure-tone thresholds (mean of 1, 2, and 4 kHz) versus cochlear capsule density. Correlation coefficients (age- and sex-adjusted) between cochlear capsule density and air-bone gap (mean at 0.5 and 1 kHz) for the affected group were -0.67 for left ears and -0.63 for right ears. All correlations between hearing thresholds and cochlear capsule density in pagetic subjects were significant at p < 0.001. The regressions were consistent throughout the ranges of hearing level. There were no significant correlations between cochlear capsule mean density and hearing level in the volunteer subjects. These findings demonstrate the feasibility of precise and accurate density measurements in the temporal bone in vivo and support the use of the mean cochlear capsule density as a marker of disease effect. Alteration of cochlear capsule bone density may be related to the mechanisms of hearing loss in Paget's disease of bone.

Adult↗

PubMed1995

Headache disability inventory (HDI): short-term test-retest reliability and spouse perceptions.

We have reported previously that the 25-item Headache Disability Inventory has good internal consistency reliability, robust long-term (2 month) test-retest stability, and good construct validity. We conducted further investigations to evaluate the short-term (1 week) test-retest reliability and spouse perceptions of patients' self-perceived headache disability. The short-term test-retest reliability of the Headache Disability Inventory was excellent. Additionally, the spouse and patients' perceptions of the patient's headache disability generally were congruent, although we observed instances where the differences were marked.

Adult↗

PubMed1995

Retest stability of the tinnitus handicap questionnaire.

The test-retest stability of the Tinnitus Handicap Questionnaire was assessed for a sample of 32 tinnitus patients. The questionnaire is a self-report measure that quantifies the physical, emotional, and social consequences of tinnitus (factor 1), the interfering effects of tinnitus on the hearing ability of the patient (factor 2), and the patients' view of tinnitus (factor 3). Retest stability estimates were obtained in order to determine the applicability of using the questionnaire as an outcome measure following tinnitus management. High test-retest correlations emerged for factors 1 and 2, whereas factor 3 yielded inadequate retest reliability. Therefore, it is recommended that only factors 1 and 2 be used for documenting changes in self-perceived tinnitus handicap following medical, surgical, or rehabilitative intervention.

Adult↗

PubMed1995

Reappraisal of the monothermal warm caloric screening test.

The usefulness of a monothermal warm caloric screening test (MWST) for predicting alternate binaural bithermal test abnormalities has been reexamined. Previously, researchers have reported false-negative rates for the MWST ranging from 0% to over 35%. Alternate binaural bithermal test data from 504 consecutive patients were evaluated with MWST failure criteria of 24.5% and 29%, with and without the addition of failure criteria from subtests of the electronystagmography examination. Sensitivity of the MWST alone was high, and improved with additional failure criteria. The specificity levels were correspondingly high. Results support the use of the MWST with adjunctive failure criteria when patients have otherwise normal electronystagmography findings.

Caloric Tests↗

PubMed1995

When paroxysmal positioning vertigo isn't benign.

The electronystagmographic auditory brainstem response and magnetic resonance imaging findings for a 33-year-old male with a 3.5 cm left vestibular schwannoma are presented. Of particular interest was the presence of an unusual positioning nystagmus following the Dix-Hallpike maneuver in the right head-hanging position. The patient demonstrated a nystagmus that was immediate in onset and not fatigueable upon repeated positioning. During positioning, the patient experienced a vertical bobbing sensation and dysphoria, but not rotational vertigo. Most importantly, the nystagmus had a predominant downbeating vertical component. the case illustrates the diagnostic significance of downbeating nystagmus elicited by the Dix-Hallpike maneuver.

Adult↗

PubMed1995

Hearing loss in Paget's disease of bone: evidence of auditory nerve integrity.

Auditory brainstem responses (ABRs) were recorded in 64 ears with radiographically confirmed Paget's disease involving the skull. Responses were absent in eight ears, all of which had elevated high pure-tone thresholds. Auditory brainstem responses were interpreted as normal in 56 ears; none were abnormal. Computed tomography and digital image analysis were used to quantify internal auditory canal (IAC) dimensions. The midlength diameter and minimum diameter of the IAC of 68 temporal bones from subjects with Paget's disease were found to have no statistically significant relation to hearing thresholds. Increased IAC length showed a limited relation to reduced hearing level in pagetic subjects, possibly consistent with bossing adjacent to the porus acusticus. Findings support the principle that hearing loss in Paget's disease of bone is generally associated with intact auditory nerve function and also support a cochlear site of lesion.

Audiometry, Pure-Tone↗

PubMed1994

Magnetoencephalographic studies of auditory system function.

Magnetoencephalography (MEG) has provided a noninvasive method of demonstrating physiological processes underlying fundamental aspects of auditory system function. MEG technology offers a key advantage over evoked potentials, that being a relatively unimpeded view of structures underlying auditory evoked responses in which cortical sources predominate. Investigators conducting auditory evoked field investigations have demonstrated tonotopicity, amplitopicity, and periodicity pitch representation in the auditory cortex. This article provides a description of MEG, various auditory evoked fields that have been reported, the psychophysics associated with auditory evoked field component N1m, and some clinical applications of this technology.

Auditory Cortex↗

PubMed1994

The Henry Ford Hospital Headache Disability Inventory (HDI).

To quantify the impact of headache of daily living, we developed a 25-item headache disability inventory (HDI). The alpha version of the HDI (alpha-HDI) consisted of 40 items, each requiring a "yes" (four points), "sometimes" (two points), or "no" (zero points) response based on items derived empirically from case history responses of subjects with headache. From the alpha-HDI, we derived a 25-item beta version (beta-HDI) with the items subgrouped into functional and emotional subscales. The internal consistency/reliability was strong, as was construct validity. The test-retest reliability for the beta-HDI was acceptable for the total score and functional and emotional subscale scores. A 29-point change (95% confidence interval) or greater in the total score from test-retest must occur before the changes can be attributed to treatment effects. The HDI is useful in assessing the impact of headache, and its treatment, on daily living.

Adult↗

PubMed1993

Evidence for multiple generators in evoked responses using finite difference field mapping: auditory evoked fields.

Electric potential maps and magnetic field maps have been used to study brain electrical activity. During the temporal course of an evoked cortical response, the electrical activity of specific neuronal subpopulations change in a sequential manner giving rise to measurable electrical potentials and magnetic fields. For these potentials and fields, both the amplitude and rate of amplitude change have characteristic, time-dependent waveforms. Presently, amplitude waveforms from multiple locations are used to generate magnetic field and electric potential maps which have been found to be useful in understanding the activity of the neurons which give rise to these maps (Romani 1990). This paper introduces a data transformation technique which results in a derived map that we have termed a "finite difference field map" (FDFM). This mapping technique provides information associated with the rate at which the amplitude of the neuronal electric activity changes. In this paper, some advantage of FDFM analysis are illustrated by application of this technique to the study of the auditory evoked cortical field (AECF) N1m waveform. Using data obtained from normal subjects it will be demonstrated that application of the FDFM technique allows the localization of the primary N1m source at an earlier latency than is possible using the conventional waveform data. The source location determined at an early latency by FDFM analysis was identical to that obtained at later from the conventional field data. These data suggest that the primary N1m source is stationary. In addition, analysis of the time sequence of FDFM field maps contains evidence of a second spatially separate source which is co-active with primary N1m source.

Adult↗

PubMed1993

The influence of hearing aid cost on perceived benefit in older adults.

Self-report hearing handicap scales are gaining widespread acceptance among clinicians as a technique for quantifying hearing aid benefit. Both auditory and nonauditory (e.g., personality, health, motivation) factors contribute to an individual's response to hearing loss and ultimately to perceived hearing aid benefit. Among the recognized extra-audiological variables, financial concerns may influence a hearing aid user's expectations regarding hearing aid benefit. The present study compared self-perceived benefit in 26 insured and 26 uninsured new hearing aid wearers using the Hearing Handicap Inventory for the Elderly (HHIE). HHIE scores at 3 weeks and 6 mo postfitting were equivalent between groups. The findings suggest that the HHIE may be used as an index of hearing aid benefit without concern that the source of funds required to purchase amplification may act as an uncontrolled variable.

Aged↗

PubMed1993

False negative auditory brainstem response findings in vestibular schwannoma: case reports.

The false negative rate of the auditory brainstem response (ABR) for the detection of vestibular schwannoma (VS; acoustic neuroma) has been reported to range from 2 to 9 percent. The introduction of magnetic resonance with gadolinium contrast (Gd MRI) may be expected to raise the false negative rate, because smaller tumors can now be detected. We present two cases that illustrate some of the complex issues raised by the detection of small asymptomatic VS by Gd MRI that were missed by ABR. The role of ABR testing in the diagnosis and management of VS remains well established and will continue to evolve.

Ear Neoplasms↗

PubMed1993

Reexamination of gender differences in the source location of N1m.

Gender differences in the source location of the auditory evoked field (AEF) component N1m have been reported previously in a small group of subjects. The present study was conducted to evaluate further the existence of gender differences in a larger sample. Neuromagnetic recordings of AEFs were obtained from young normal hearing subjects using a 1000-Hz tone burst presented at 60 dB hearing level (HL). No significant gender-related differences were observed for the N1m peak latencies following left and right ear stimulation. The stimulating parameters and larger sample used in the present study size may account for the difference in gender effects observed between the two studies.

Acoustic Stimulation↗

PubMed1992

The effects of stimulus frequency and recording site on the amplitude and latency of multichannel cortical auditory evoked potential (CAEP) component N1.

Magnetoencephalographic (MEG) applications in auditory evoked field (AEF) recordings have demonstrated that both tonotopicity and amplitopicity exist in the auditory cortex. The present study was conducted to determine whether previously reported characteristics of the AEF could be identified in multichannel cortical auditory evoked potential N1e (e.g., the electrical correlate of the magnetically recorded N1m) component recordings. Multichannel auditory evoked potentials from 11 young normal adults were collected after monaural tone burst stimuli of 250, 1000, and 4000 Hz. Results demonstrated that N1e amplitudes after stimulation at 250 Hz were significantly larger than those obtained after stimulation at 1000 or 4000 Hz. These frequency-specific differences existed for latency as well. Responses obtained after stimulation at 250 Hz were, on the average, 13 msec longer than those obtained after stimulation at 1000 or 4000 Hz. Also, contralateral latencies were significantly shorter than ipsilateral latencies. Although the significant frequency-specific amplitude results support the findings of previous investigators, the frequency-related latency differences have not been described. An explanation of these differences may exist in the spatial differences in the reception areas for low- and high-frequency tones in the primary auditory cortex.

Acoustic Stimulation↗

PubMed1992

Occurrence of auditory evoked field (AEF) N1M and P2M components in a sample of normal subjects.

A great deal of information about the characteristics of components N1m and P2m of the auditory evoked cortical fields (AEFs) has accumulated since the late 1970s. However, a number of fundamental issues have not been addressed. For instance, some previous investigators have suggested that P2m is present consistently in normals, whereas others suggest that when present, P2m is small in amplitude. Preliminary observations in this laboratory suggested that P2m is not observed consistently in normal subjects. Therefore, the specific aim of this investigation was to estimate the frequency of occurrence of the contralaterally recorded N1m and P2m after stimulation of right and left ears in normal subjects. Results demonstrated N1m to be present in all circumstances. Consistent with our preliminary observations, P2m was often absent, and moreso after stimulation of the left ear.

Adult↗