Biomedical subjects

Yael Henkin

Publications and source records attributed to Yael Henkin.

16 recordsLinked to original sources

PubMed2006

Reduced auditory processing capacity during vocalization in children with Selective Mutism.

BACKGROUND: Because abnormal Auditory Efferent Activity (AEA) is associated with auditory distortions during vocalization, we tested whether auditory processing is impaired during vocalization in children with Selective Mutism (SM). METHODS: Participants were children with SM and abnormal AEA, children with SM and normal AEA, and normally speaking controls, who had to detect aurally presented target words embedded within word lists under two conditions: silence (single task), and while vocalizing (dual task). To ascertain specificity of auditory-vocal deficit, effects of concurrent vocalizing were also examined during a visual task. RESULTS: Children with SM and abnormal AEA showed impaired auditory processing during vocalization relative to children with SM and normal AEA, and relative to control children. This impairment is specific to the auditory modality and does not reflect difficulties in dual task per se. CONCLUSIONS: The data extends previous findings suggesting that deficient auditory processing is involved in speech selectivity in SM.

Auditory Perception↗

PubMed2006

A longitudinal study of electrical stimulation levels and electrode impedance in children using the Clarion cochlear implant.

CONCLUSIONS: Electrical stimulation levels and electrode impedance values (EIVs) in children using the Clarion cochlear implant (CI) programmed with CIS strategy stabilized after 3 months of implant use. The data presented here may be useful as a general guideline for the programming of infants and young children and may further be of help for the identification of patients who fall outside the "average" range. OBJECTIVES: The purpose of the present study was to evaluate changes in electrical stimulation levels, i.e. threshold (T) levels, comfortable (M) levels, dynamic range (DR), and EIVs during the first 18 months of implant use, in children using the Clarion CI. MATERIALS AND METHODS: The maps of 18 pre-lingual children (mean age at implantation 4.2 years; range 1-8), using the Enhanced Bipolar 1.2 or Bipolar standard electrode with the S-Series speech processor programmed with CIS strategy, were examined at five time points: connection, and 3, 6, 12, and 18 months post-initial stimulation. T levels, M levels, DR and EIVs were analyzed according to four cochlear segments: apical, apical-medial, medial-basal, and basal. RESULTS: During the first 3 months of implant use T levels increased to some extent, whereas M levels and DR increased significantly. From 3 months and through the entire follow-up, T and M levels as well as DR were stable. EIVs of current carrying electrodes decreased significantly from connection to the 3-month visit; thereafter a stabilization of values was evident. Electrical stimulation levels and EIVs did not differ among the cochlear segments during the entire follow-up.

Adolescent↗

PubMed2006

Identification of syllables in noise: electrophysiological and behavioral correlates.

This study was designed to characterize the effect of background noise on the identification of syllables using behavioral and electrophysiological measures. Twenty normal-hearing adults (18-30 years) performed an identification task in a two-alternative forced-choice paradigm. Stimuli consisted of naturally produced syllables [da] and [ga] embedded in white noise. The noise was initiated 1000 ms before the onset of the speech stimuli in order to separate the auditory event related potentials (AERP) response to noise onset from that to the speech. Syllables were presented in quiet and in five SNRs: +15, +3, 0, -3, and -6 dB. Results show that (1) performance accuracy, d', and reaction time were affected by the noise, more so for reaction time; (2) both N1 and P3 latency were prolonged as noise levels increased, more so for P3; (3) [ga] was better identified than [da], in all noise conditions; and (4) P3 latency was longer for [da] than for [ga] for SNR 0 through -6 dB, while N1 latency was longer for [ga] than for [da] in most listening conditions. In conclusion, the unique stimuli structure utilized in this study demonstrated the effects of noise on speech recognition at both the physical and the perceptual processing levels.

Acoustic Stimulation↗

PubMed2005

Acute otitis media and mastoiditis following cochlear implantation.

OBJECTIVE: To examine the incidence of acute otitis media (AOM) and mastoiditis in children after cochlear implantation (CI) and to evaluate the role of mastoidectomy in decreasing the rate of AOM in implanted children by comparing two surgical techniques: the Posterior tympanotomy approach (MPTA, with mastoidectomy) and the Suprameatal approach (SMA, without mastoidectomy). METHODS: A retrospective study was conducted on 234 children up to 16 years of age who underwent CI between 1993 and 2003 in our department. The children were divided into two groups according to the surgical technique that had been used for the implantation: the MPTA group and the SMA group. RESULTS: Part of the children with a history of pre-implantation AOM (22 of 29 in MPTA group and 26 of 38 in SMA group) did not suffer from AOM post-CI (p=0.59), and an incidence of AOM after CI in children who did not have history of AOM prior to implantation (13 patients of MPTA group and 15 patients of SMA group) was unrelated to surgical approach (p=0.65). The incidence of pre-implantation AOM was similar for the two groups and declined after CI unrelated to performing of mastoidectomy in surgical technique. Overall, 47 children (20.1%) had post-CI AOM compared to 67 children (28.6%) who had pre-CI AOM. Mastoiditis developed in 11 children (4.7%), all 11 in the MPTA group. A subperiosteal abscess was incised and drained with the retroauricular approach in three of these children and the others were managed with intravenously administered ceftriaxone 50mg/kg/day for 3-5 consecutive days, followed by a course of oral cephalexin until there is complete clinical resolution of the effusion in the middle ear. The implants were preserved in all cases. Seven out of 11 children with mastoiditis had no history of AOM prior to implantation. CONCLUSIONS: AOM and mastoiditis represent common complications of CI that can be successfully treated with the prompt use of antibiotics. However, the subperiosteal abscess could require surgical drainage. In our opinion, the decrease of incidence of AOM in implanted children is the result of natural history of otitis media and is unrelated to the surgical approach.

Abscess↗

PubMed2005

Cognitive function in idiopathic generalized epilepsy of childhood.

This study evaluated the cognitive profiles of children with idiopathic generalized epilepsy (IGE), uniformly treated with valproic acid with well-controlled seizures. Twenty-four were neuropsychologically evaluated. They comprised: 14 females, 10 males: 12 with generalized tonic-clonic seizures (GTCS), mean age 14y 4mo, SD ly 7mo, range 12y to 16y 4 mo; 12 with absence seizures (AS]) mean age 14y 5mo, SD ly 10mo, range 11y to 16y 4mo, with intellectual abilities within the normal range and age-appropriate scholastic skills, and 20 healthy controls (12 females, 8 males; mean age 14y 5mo, SD 1y 10mo, range 10y 7mo to 16y 7mo). As a group, children with IGE performed significantly poorer in all tests (non-verbal and verbal attention, verbal learning and memory, word fluency, and controlled sequential fine motor responses) excluding non-verbal memory. Analysis according to type of seizure revealed that both patient groups (AS and GTCS) had an attention deficit, whereas only children with AS showed deficits in verbal learning and memory, word fluency, and controlled fine motor responses. These results suggest a long-term risk of learning impairment for children with IGE, even if they have normal intelligence and their seizures are well controlled.

Adolescent↗

PubMed2005

Cochlear implantation in Waardenburg's syndrome.

CONCLUSIONS: Children with Waardenburg's syndrome (WS) derive significant benefit from cochlear implantation (CI) and do so to an extent that is comparable to that of the general population of implanted children. Although we report on a relatively small cohort, our data are useful for counseling the parents of children with WS considering CI. OBJECTIVE: To present our experience with CI in patients with WS. MATERIAL AND METHODS: A retrospective record review was conducted for five children who underwent CI in our department between 1993 and 2004. RESULTS: Children with WS comprised 1.9% of our entire pediatric CI population: four girls had a familial history of WS and the phenotype of WS Type I, and one boy met the criteria for WS Type II. They were all diagnosed as having bilateral profound sensorineural hearing loss 4-24 weeks after birth. Rehabilitation was initiated immediately and included bilateral fitting of hearing aids and intensive speech and language therapy. Otoscopic and temporal bone high-resolution CT findings were normal in all patients. At surgery, all children were found to have a patent cochlea, and the electrodes were implanted into the scala tympani without difficulty. After 1.3-10.2 years of implant use all children achieved open-set recognition of 2-syllable words, with an average score of 81%. Four of the 5 children achieved open-set recognition of monosyllabic words (average score 40%) and 3 achieved open-set recognition of words in sentences (average score 81%).

Adolescent↗

PubMed2005

Electrical stimulation levels and electrode impedance values in children using the Med-El Combi 40+ cochlear implant: a one year follow-up.

The present study was designed to follow changes in electrical stimulation levels and electrode impedance values (EIV) in children using the Med-El Combi 40+ cochlear implant (CI) during the first 12 months of implant use. The maps of 24 prelingually deaf children implanted at a mean age of 5.9 years (range 1-15.9 years) using the TEMPO+ speech processor programmed with CIS+ strategy were examined at five time points: initial stimulation, and 1, 3, 6, and 12 months post-initial stimulation. Most comfortable levels (M) and electrode impedance values (EIV) were analyzed according to three cochlear segments: apical, medial, and basal. Results indicated a significant increase in M levels until the 3-month time point, thereafter stabilization was evident. Furthermore, M levels in the apical segment were lower than those in the medial and basal segments. EIV decreased from initial stimulation to the 3-month time point and was then stable through the study follow up. Interestingly, the finding of higher EIV in the apical segment may be attributed to the physical characteristics of the Med-El electrode. In conclusion, the pattern of stabilization of M levels found in the present study is similar to that reported for children using other devices. The data presented here may be useful as a guideline for programming M levels and monitoring EIV in infants and young children. They may further help clinicians to identify those children that fall outside the 'typical' range.

Acoustic Impedance Tests↗

PubMed2004

Reduced auditory efferent activity in childhood selective mutism.

BACKGROUND: Selective mutism is a psychiatric disorder of childhood characterized by consistent inability to speak in specific situations despite the ability to speak normally in others. The objective of this study was to test whether reduced auditory efferent activity, which may have direct bearings on speaking behavior, is compromised in selectively mute children. METHODS: Participants were 16 children with selective mutism and 16 normally developing control children matched for age and gender. All children were tested for pure-tone audiometry, speech reception thresholds, speech discrimination, middle-ear acoustic reflex thresholds and decay function, transient evoked otoacoustic emission, suppression of transient evoked otoacoustic emission, and auditory brainstem response. RESULTS: Compared with control children, selectively mute children displayed specific deficiencies in auditory efferent activity. These aberrations in efferent activity appear along with normal pure-tone and speech audiometry and normal brainstem transmission as indicated by auditory brainstem response latencies. CONCLUSIONS: The diminished auditory efferent activity detected in some children with SM may result in desensitization of their auditory pathways by self-vocalization and in reduced control of masking and distortion of incoming speech sounds. These children may gradually learn to restrict vocalization to the minimal amount possible in contexts that require complex auditory processing.

Acoustic Impedance Tests↗

PubMed2004

NRT-based versus behavioral-based MAP: a comparison of parameters and speech perception in young children.

The present study was designed to evaluate the effect of neural response telemetry (NRT)-based cochlear implant (CI) programming versus behavioral-based programming on electrical stimulation parameters (MAP) threshold (T) and comfortable (C) levels and speech perception abilities in young children, during the first year of implant use. Ten congenitally deaf children at the age of 12-39 months (mean age: 25.2 months) implanted with the Nucleus 24R(CS) CI participated in the study. The group was randomly divided into two: (1) NRT-based MAP group (n = 5) consisted of children who were programmed using intra-operative NRT measurements; (2) behavioral-based MAP group (n = 5) consisted of children who were programmed using the behavioral responses of the patients. MAP parameters as well as sound-field aided thresholds and speech perception abilities were compared between the two groups at consecutive programming sessions: 1, 3, 6, and 12 months post initial stimulation. Results indicated no significant differences among NRT-based MAPs and behavioral-based MAPs. Although MAP profiles at initial stimulation differed in the apical region, these differences decreased with time. In addition, a gradual increase of T and C levels of NRT-based MAPs as well as those of behavioral-based MAPs was evident until the 1-month time point, thereafter stabilization occurred. Sound-field aided thresholds improved with time for both groups; however, they were found to be significantly better for the NRT-based MAP group. Despite these differences, speech perception abilities were comparable among groups at 12 months post initial stimulation. NRT-based programming was found to be significantly shorter than behavioral-based programming. In conclusion, for this small group of children, our findings support the use of NRT for programming of young children during the initial period after implantation.

Acoustic Stimulation↗

PubMed2004

Low-resolution electromagnetic tomography (LORETA) in children with cochlear implants: a preliminary report.

The current preliminary report describes the utilization of low-resolution electromagnetic tomography (LORETA) in a small group of highly performing children using the Nucleus 22 cochlear implant (CI) and in normal-hearing (NH) adults. LORETA current density estimations were performed on an averaged target P3 component that was elicited by non-speech and speech oddball discrimination tasks. The results indicated that, when stimulated with tones, patients with right implants and NH adults (regardless of stimulated ear) showed enhanced activation in the right temporal lobe, whereas patients with left implants showed enhanced activation in the left temporal lobe. When stimulated with speech, patients with right implants showed bilateral activation of the temporal and frontal lobes, whereas patients with left implants showed only left temporal lobe activation. NH adults (regardless of stimulated ear) showed enhanced bilateral activation of the temporal and parietal lobes. The differences in activation patterns between patients with CI and NH subjects may be attributed to the long-term exposure to degraded input conditions which may have resulted in reorganization in terms of functional specialization. The difference between patients with right versus left implants, however, is intriguing and requires further investigation.

Acoustic Stimulation↗

PubMed2003

Cochlear implantation in a child with osteogenesis imperfecta.

Osteogenesis imperfecta (OI) is a hereditary disease of connective tissue and affects bone, dentine, sclera, joint, tendon, blood vessels, heart valves, and skin. Approximately 50% of the adult patients with OI have associated hearing impairment. To date, only three cases of cochlear implantation in adults with OI have been reported, but none in children. We present a case of cochlear implantation in a congenitally deaf 6-year-old boy with OI. The Nucleus 24 Contour device was successfully implanted using the suprameatal approach (SMA). At 6 months post-initial stimulation there was no evidence of non-acoustic nerve excitation (i.e. facial twitching) or discomfort, and significant progress in auditory abilities was manifested by open set word identification.

Audiometry↗

PubMed2003

Changes over time in electrical stimulation levels and electrode impedance values in children using the Nucleus 24M cochlear implant.

OBJECTIVE: The present study was designed to evaluate changes in psycho-electric parameters, i.e. threshold levels, comfortable levels, dynamic range, and electrode impedance values during the 1st year post-implantation, in children using the Nucleus 24M cochlear implant system. METHODS: The maps of 25 pre-lingual children programmed with ACE strategy in Monopolar 1 + 2 mode were examined at five time points: connection, 1, 3, 6, and 12 months post-initial stimulation. Maps and electrode impedance values were analyzed according to three cochlear segments: basal, medial, and apical. RESULTS: Significant elevations of thresholds, comfortable levels, and dynamic range were found during the first few months of implant use. Specifically, threshold increased and dynamic range widened until the 3 months visit, whereas comfortable levels continued to increase until the 6 months visit, thereafter levels stabilized. Electrode impedance values decreased significantly from connection to the 1-month visit thereafter a stabilization of values was evident. In addition, thresholds and comfortable levels were found to be significantly lower in the apical segment, whereas dynamic range and electrode impedance values did not differ among the cochlear segments. CONCLUSIONS: Significant changes in psycho-electric parameters and electrode impedance values were evident during the first 6 months of implant use. Given the important role of an optimal map for speech perception, frequent programming sessions during the first few months of implant use are essential.

Acoustic Impedance Tests↗

PubMed2003

Linguistic processing in idiopathic generalized epilepsy: an auditory event-related potential study.

PURPOSE: Auditory processing of increasing acoustic and linguistic complexity was assessed in children with idiopathic generalized epilepsy (IGE) by using auditory event-related potentials (AERPs) as well as reaction time and performance accuracy. METHODS: Twenty-four children with IGE [12 with generalized tonic-clonic seizures (GTCSs), and 12 with absence seizures (ASs)] with average intelligence and age-appropriate scholastic skills, uniformly medicated with valproic acid (VPA), and 20 healthy controls, performed oddball discrimination tasks that consisted of the following stimuli: (a) pure tones; (b) nonmeaningful monosyllables that differed by their phonetic features (i.e., phonetic stimuli); and (c) meaningful monosyllabic words from two semantic categories (i.e., semantic stimuli). RESULTS: AERPs elicited by nonlinguistic stimuli were similar in healthy and epilepsy children, whereas those elicited by linguistic stimuli (i.e., phonetic and semantic) differed significantly in latency, amplitude, and scalp distribution. In children with GTCSs, phonetic and semantic processing were characterized by slower processing time, manifested by prolonged N2 and P3 latencies during phonetic processing, and prolongation of all AERPs latencies during semantic processing. In children with ASs, phonetic and semantic processing were characterized by increased allocation of attentional resources, manifested by enhanced N2 amplitudes. Semantic processing also was characterized by prolonged P3 latency. In both patient groups, processing of linguistic stimuli resulted in different patterns of brain-activity lateralization compared with that in healthy controls. Reaction time and performance accuracy did not differ among the study groups. CONCLUSIONS: AERPs exposed linguistic-processing deficits related to seizure type in children with IGE. Neurologic follow-up should therefore include evaluation of linguistic functions, and remedial intervention should be provided, accordingly.

Acoustic Stimulation↗

PubMed2003

Changes over time in the psycho-electric parameters in children with cochlear implants.

Information regarding typical changes in electrical stimulation levels during different stages post-implantation in children is scarce. Clinically, this information can serve as a general guideline to the nature and frequency of these changes, and consequently help to determine programming schedules that would optimize performance with the implant. Furthermore, it may have implications for the design of cochlear implants, and for monitoring the condition of the implanted cochlea. The main goal of the present study was, therefore, to evaluate changes over time in psycho-electric parameters, i.e. threshold levels, comfortable levels, and dynamic range, in children with the Nucleus 22 cochlear implant system. The maps of 37 prelingual children were examined at five time intervals: 1, 6, 12, 18 and 24 months post-connection. Maps were analyzed according to three cochlear segments: basal, medial, and apical. The results indicated significant changes in the psycho-electric parameters during the first 2 years post-implantation. Specifically, threshold (T) levels increased significantly during the first year and stabilized during the second year, whereas comfort (C) levels and dynamic range (DR) increased significantly during the entire 2-year follow-up. In addition, psycho-electric parameters varied among the different cochlear segments, resulting in a narrower DR in the basal one. Regardless of the underlying cause for these changes, the results of the present study suggest that, in children, the stabilization of psycho-electric parameters is a prolonged, gradual process. Since psycho-electric parameters play an important role in speech perception, these findings emphasize the need for frequent programming in the first 2 years of implant use in children.

Analysis of Variance↗

PubMed2002

Bilateral superior cervical sympathectomy and noise-induced, permanent threshold shift in guinea pigs.

The rich sympathetic innervation to the cochlea suggests its potential control of cochlear blood flow and activity during noise exposure, as part of the general and local stress sympathetic reaction evoked by noise. In a previous study, superior cervical sympathectomy prior to sound exposure in guinea pigs in an awake state, resulted in reduced temporary threshold shift. The present study was conducted to explore whether this potential protection would also be manifested in conditions producing permanent threshold shift (PTS). Thirty-six guinea pigs, divided into four groups of nine guinea pigs each, were sound exposed for 2 h in an awake state. Eighteen guinea pigs underwent superior cervical sympathectomy prior to sound exposure. Auditory brainstem thresholds were recorded prior to sound exposure, and then at 24 h, 1 and 6 weeks post-exposure. Results indicated a reduced PTS at 122 dB sound pressure level (SPL) exposure, suggesting a protective effect of the sympathectomy. However, at 125 dB SPL exposure, the protective effect was reduced.

Animals↗

PubMedDate not supplied

Auditory event-related potentials during phonetic and semantic processing in children.

This study was designed to follow the time course of different levels of linguistic processing using auditory event-related potentials (AERPs). A hierarchical set of acoustically controlled stimuli was used to elicit AERPs in 20 normal children who performed discrimination tasks involving pure tones, phonetic 'easy' and 'difficult' stimuli and semantic stimuli. Results show that (1) AERP latencies were similar for phonetic 'easy' and 'difficult' stimuli, (2) prolonged P(2), N(2) and P(3) latencies characterized semantic processing compared to phonetic processing, (3) a late negativity was elicited during semantic processing only, (4) P(3) amplitudes were larger over the left compared to right scalp during linguistic processing (phonetic and semantic) but were similar during nonlinguistic processing (pure tones) and (5) reaction time was found to be longest for semantic processing whereas performance accuracy was found to be an insensitive measure. These results provide insight into brain processes underlying the perception of speech. Furthermore, they support a dual model of speech perception that includes parallel and serial processing.

Adolescent↗