Comparing Vor and Self-Motion Perception: The Key to Distinguish Between Ménière and Vestibular Migraine?
Maxime Maheu (Université de Montréal), Abstract #104.
Maxime Maheu, PhD, Assistant Professor, Université de Montréal
To compare the relation between VOR and vestibular perception following caloric stimulation between healthy participants, participants with Menière, and participants with vestibular migraine.
It is known that there is an overlap between the diagnostic criteria of Meniere’s disease (MD) and vestibular migraine (VM). This, coupled with the lack of an objective measure to distinguish these two conditions, delays the management of these patients. Recently, a study has shown that although the vestibular reflexes are comparable between the two pathologies, the vestibular perception could be different. This suggests a possible discrepancy between vestibular reflex and perception. However, to date, no studies investigated this relationship and how it differs between MD and VM.
20 participants divided into 3 groups (Controls: 12; Meniere’s: 6; Vestibular migraine: 3) were evaluated. Participants performed a caloric assessment during which the velocity of the slow phase component of the nystagmus was recorded. For each caloric irrigation, participants were asked to indicate the perceived velocity of the induced rotation using a tachometer. A ratio between the maximum angular velocity of rotation of the tachometer and the maximum velocity of nystagmus was calculated. This variable was compared between the 3 groups using a nonparametric test (Kruskall-Wallis) with Bonferroni correction.
Preliminary results show that the dissociation between VOR and vestibular perception is significantly different between participants with vestibular migraine and healthy participants and between participants with vestibular migraine and those with Meniere’s.
For the first time, these preliminary results not only demonstrate a method for assessing vestibular perception following caloric stimulation but also demonstrate the possibility of distinguishing Meniere’s disease from vestibular migraine.
Long Latency Auditory Evoked Responses in the Identification of Children with Central Auditory Processing Disorders: A Scoping Review.
Amineh Koravand, Melissa MacAskill, and Shaghayegh Omidvar (University of Ottawa), Abstract #140.
Amineh Koravand, PhD, Associate Professor, University of Ottawa
To characterize available research on the long latency auditory evoked responses (LLAERs) in children with central auditory processing disorders (CAPD) and investigate whether LLAERs can be used to identify children with CAPD
LLAERs are evoked responses generated in the auditory cortex. They are known to be a biomarker for maturity in the central auditory system, and some research suggests that LLAER disturbances are associated with speech and language impairments such as hearing loss, and dyslexia. LLAERs may also be useful in evaluating children with CAPD, however, they have not been widely described in this population. As such, the clinical utility remains unknown.
A systematic search strategy was used to identify studies describing the latencies and amplitudes of P1, N1, P2, and N2 waveforms of the LLAERs. Articles published between January 1980 and May 2021 were retrieved via an online database search. They were reviewed by two independent reviewers, and 17 articles meeting inclusion criteria were included for analysis.
Four papers used pre- and post-training study designs, while the remaining studies were cross-sectional. Several studies reported significant differences in LLAERs between children with CAPD and normal-hearing peers, with results tending toward longer latencies and smaller amplitudes regardless of which waveform was considered. N1 and/or N2 results were most likely to reveal significant differences between children with CAPD and normal- hearing controls.
LLAERs, especially waves N1 and N2, may assist in better identification of children with CAPD. However, results should be interpreted with caution due to the heterogeneous nature of the available research. A standardized test battery for diagnosis as well as a standard LLAER test protocol for recording data are recommended for future research. Characteristics other than latency and amplitude should also be explored.
Person-Centered Group Aural Rehabilitation for Rural Newfoundland.
Anne Griffin, Taylor Burt, Katelyn Adey, and Gillian Ash (Memorial University, Central Health Regional Health Authority (NL), University of Ottawa, Western University), Abstract #133.
Anne Griffin MSc Audiology, Research Associate Audiologist, Memorial University of NL
Assess benefits and feasibility of person-centered group aural rehabilitation to address needs identified by people with hearing loss in rural Newfoundland.
The well-documented benefits of group aural rehabilitation are inaccessible in rural Newfoundland and Labrador. Person-centered care engages patients with health professionals collaboratively to develop resources and self-efficacy for improved management of hearing care and communication success in home and community environments.
Three stand-alone workshops were delivered in two rural service hub communities during 2019. Topics were selected from common concerns expressed by people with hearing loss. Timing, location, set-up, and content were designed for maximum ease of interaction and full inclusion for any degree of hearing loss. Student volunteers and local clinician co-presenters enabled accessible interaction and learning of strategies and resources applicable to participant hearing challenges. Participants completed IDA institute’s Line exercise and a topic-related questionnaire pre- and post- workshop. Follow-up interviews 18- 22 months later provided data on participant experience with hearing loss subsequent to workshops attended. Pandemic-related improvements in remote communication technology stimulated the development and trial of a virtual version of one workshop.
Quantified ratings indicated improved self-perception of competency following workshops. Qualitative data revealed participant gains in self-advocacy, communication breakdown resolution and technology use. Feasibility to attend in-person workshops remains challenging. Local clinicians report independent delivery of these workshops is not feasible. The online workshop eliminated multiple barriers to attendance and delivery, achieved goals for inclusion and interaction, and was reported beneficial by participants.
Person-centered workshops proved beneficial toward improved self-management of hearing loss. The Line tool, SESMQ and follow-up interview were found to be user-friendly and informative evaluation tools. Feasibility of in-person workshops remains very challenging in this rural environment. Group aural rehabilitation through teleaudiology can improve feasibility of attendance and delivery: development opportunities should be pursued.
Hearing Aid Recycling Programs: A Valuable Alternative for Low-Income Hearing-Impaired Adults?
Mathieu Hotton, Normand Boucher, Claude Vincent, Tamara-Jeanne Dubé, Mathilde Lefebvre-Demers, Gabrielle Dufour-Cauchon, and Marie-Ève Schmouth (Laval University, CIUSSS Capitale-Nationale, APDA, Cirris), Abstract #110.
Mathieu Hotton Ph.D., Audiologist, Assistant Professor, Laval University
To collect exploratory data on the impacts of participating in a hearing aid recycling program (HARP) for low-income hearing- impaired adults and their significant others (SO).
HARPs are community-based programs which recycle used hearing aids and redistribute them to people in need. Few data are available on these programs and their impact on hearing-impaired clients.
A cross-sectional case study design combining qualitative and quantitative data sources have been used. Individual semi- structured interviews have been carried out with 16 hearing- impaired users of a HARP and 6 of their SO. HA users also completed two questionnaires to assess their satisfaction about HAs and services received, and their social participation and feeling of security after fitting.
Participants were globally satisfied with the HARP. The process of getting a HA from that program was seen as easy and efficient. The way participants were welcomed, the support offered, and the free HAs provided were mentioned as its main advantages. The HARP main disadvantages were the characteristics of the HAs obtained (ex. different size or color, lack of compatibility with a second HA), routine inspection and maintenance costs not covered, and the distance between users’ home and offices where services were dispensed. The most important barrier to participating in the HARP was that most hearing professionals were not aware of its existence. Participants reported an improved social participation and feeling of security after obtaining recycled HAs.
The community-based HARP under investigation may represent a valuable alternative for the acquisition of HAs for low-income hearing-impaired adults. Some improvements might be made to the program to review how the recycled HAs are matched with clients’ needs, to expand the network of offices collaborating with the program, and to increase its visibility for the public and hearing health professionals.