P300 event-related potentials in stutterers and nonstutterers

This study investigated possible differences between adult stutterers and nonstutterers in the P300 event-related potential. Responses to tonal stimuli were recorded from electrodes placed over the left (C3) and righ (C4) hemispheres. The two groups exhibited different patterns of interhemispheric activity. Although all 8 participants in the fluent group exhibited P300s that were higher in amplitude over the right hemisphere, 5 of the 8 disfluent participants had higher amplitude activity over the left hemisphere. These results provide evidence that stutterers and nonstutterers may exhibit differences between hemispheres in the processing of some types of nonlinguistic (tonal) stimuli.     

P300 potentials evoked by visual stimulation

INTRODUCTION: The P300 potential is a long-latency endogenous component of the event-related potentials to low-probability target stimuli. The same stimulus delivered without cognitive process does not provoke endogenous components; moreover event-related potentials are not dependent of the sensory pathways used for stimulating the subjects. P300 potential is a biological parameter used in scientific investigations in Clinical Neurophysiology, Neurology, Psychophysiology and Psychiatry. The most frequent methodology for obtaining P300 event-related potential is based on the 'odd-ball' paradigm using auditory stimulation. In this revision we analyzed the difficulties of this methodology and we propose to use the visual stimulation in order to obtain well defined P300 potential, based on a better signal to noise ratio and minor overlapping of exogenous and endogenous components of the evoked potentials. The improvement in the quality of the results obtained when comparing with auditory stimulation, it is supposed to facilitate that the use of P300 potential overflows the field of the investigation and permits their extensive use in the clinical practice.     

Cognitive deficits in alcoholics--significance of cognitive evoked potentials (P-300)

Method of event related potential has proved to be very useful in estimation of higher nerve functions damage, especially P-300 component as a precise indicator of cognitive and perceptual functioning. According to data available in literature, significant degree of correlation exists between evoked potential parameters (amplitude and latency) and deficit of psychic functions. The sample consisted of 37 patients (male and female) who had signs or alcohol-induced organic mental disorder (according to ICD-10). "Oddball" paradigm of P-300 was used. The results were compared with control group of 20 healthy persons. The results emphasized lower amplitude and prolonged latencies in the group of alcoholics. These findings were more significant in female subsample and may suggest that females are more vulnerable to alcohol than males. Our findings lead to the conclusion that method of event related potential (P-300) may help in estimating organic deficit in alcoholic patients.     

Cognitive impairment in schizophrenic patients on event-related potentials component P300

There have been many reports on the Event-Related Potentials (ERPs) abnormalities, especially P300 amplitudes reduction, in schizophrenic patients. However the relationships between P300 abnormalities and schizophrenic subtypes have not been clarified. This study aims to investigate the relationships in a relatively large number of drug free schizophrenics. Seventy three unmedicated schizophrenic patients (45 males, 28 females) who met the DSM-III-R criteria for schizophrenia were tested. Twenty seven of the schizophrenics were paranoid type according to the DSM-III-R, 23 were undifferentiated, 19 were disorganized, 2 catatonic and 2 residual. Seventy three healthy controls were age and gender matched to the patient group. All the ERPs were recorded during auditory odd ball task. Stimuli consists of 2 kHz and 1 kHz tone bursts, and the respective probabilities of the rare and frequent stimuli were 0.2 and 0.8. They were presented random order. The duration of each stimulus was 90 msec with rise and fall times of 10 msec, and the intensity was approximately 70 dB SPL for all the stimuli. The inter-stimulus intervals were 1.7 +/- 0.1 seconds. The subjects were instructed to count the numbers of rare tones. The scalp EEGs were recorded from Ag-AgCl electrodes at 16 sites that referred to linked earlobes. P300 amplitudes reduction [F (1,144) = 39.33, p < 0.001] and P300 latencies prolongation [F (1,144) = 12.41, p < 0.001] were found in schizophrenic group as a whole. Lower amplitude of P300 was observed at both right and left temporal sites in the subjects with undifferentiated type and disorganized type. Although in the subjects with paranoid type, the reduction was recognized at left temporal region, reduced amplitude was not seen at right temporal site. While no relationships between P300 amplitudes, the score of BPRS and SAPS were detected, in the patient with paranoid type, significant negative correlation between P300 amplitudes and SANS total scores was observed (r = -0.425, p = 0.03) at Pz site. These results were discussed with respect to cognitive impairment of schizophrenia.     

Stimulus-inadequate sensations in cochlear implant patients

From August 1984 to April 1987 the Department of Otolaryngology at the Medizinische Hochschule in Hannover implanted the NUCLEUS 22 channel cochlear implant system (CI) in their first 56 adults. Since implantation, 27 (51%) patients have described undesirable sensations from their implant. These were defined as stimulus-inadequate sensations (SIS) and were classified into three types: 1) pain-like sensations; 2) high-frequency sensations; and 3) non-stimulation. Twenty-three patients were radiographically investigated by polytomography. All of the intracochlear electrodes were visualised and a correlation between SIS and the radiological findings was established. It was found that i) SIS similar to pain are caused by electrical stimulation of the mucous membranes and periosteum of the tympanic cavity; ii) the high-frequency SIS seemed to be due to non-physiological electrical stimulation of the basal ganglion cells; and iii) the reason for non-stimulation is probably damaged electrodes and fibrosis around the electrode. Conventional tomography is the method of choice for estimating the number and configuration of intracochlear electrodes.     

Event-related potentials (P300) in primary headache in childhood and adolescence

There is strong evidence for a loss of habituation during cognitive processing in migraine as measured by P300 and contingent negative variation in adults. Event-related potentials evoked by an oddball paradigm have not yet been studied in children and adolescents suffering from different primary headache types. We recorded visually evoked event-related potentials (two consecutive trials, 200 stimuli each) in 48 children and adolescents suffering from migraine without or with aura, from episodic tension-type headache, and from ergotamine-induced headache and analyzed the latencies, amplitudes, and reaction times. No statistically significant differences were noted between all headache types and healthy controls analyzing the averaged parameters for the whole measurement. However, a highly significant loss of cortical habituation as measured by P300 amplitude and latency could be observed in migraine without and with aura by analyzing the first and the second trial of measurement separately. This phenomenon increased with age and could not be seen in healthy controls, or patients with tension-type headache or ergotamine-induced headache. Our data suggest a specific cognitive processing in migraine even in children and adolescents. Measurement of the habituation effect in P300 latency and amplitude provides a specific method to differentiate between primary headache types in childhood and adolescence.     

Modulation detection interference in cochlear implant subjects

The aim of this study was to determine whether detection thresholds for amplitude modulated signals on a single electrode were influenced by a masking modulation on a second electrode in cochlear implant users. Data were collected from four post-linguistically deafened subjects using the Cochlear Limited prosthesis. Investigated were the effects of the spatial separation between test and masker electrodes, 0 to 5 electrodes (0 to 3.75 mm), and the amount of masking modulation: 24%, 48%, 72%, and 96% above detection thresholds. Initially, modulation detection thresholds for stimulation on a single electrode without masking modulation were obtained for a set of six electrodes in the middle of the array. Modulation detection thresholds on a fixed test electrode were then obtained with unmodulated and modulated masking on a second electrode, which was one of the six electrodes in the initial study. In both studies, thresholds were measured for modulated pulse duration at the modulation frequencies of 10-200 Hz. In the first study, the shape of the detection thresholds as a function of modulation frequency, the temporal modulation transfer function, generally resembled a low-pass filter for two subjects. For the other two subjects, the functions were relatively flat across modulation frequencies. In the second study, unmodulated masking resulted in a small elevation in detection thresholds across electrodes. Modulation detection interference (MDI), the difference between thresholds for the modulated maskers and the unmodulated masker, was greater for larger amounts of masking modulation than for smaller amounts of masking modulation. For three of the four subjects, MDI was higher for smaller spatial separations between the two electrodes than for larger spatial separations suggesting that a portion of MDI may be due to overlap of neural excitation distributions produced by stimulation on two electrodes in close proximity on the array.     

Auditory event related potentials in major depression: prolonged P300 latency and increased P200 amplitude

BACKGROUND: Some studies have shown disturbances in auditory event related potentials (AERPs) in patients with major depression. METHODS: In this exploratory study, the late AERP components, N100 (latency), P200 (amplitude and latency) and P300 (amplitude and latency) were recorded in 68 subjects, i.e. 39 major depressed subjects, with (n=4) or without (n=35) cognitive deterioration, 18 patients with Alzheimer's dementia (SDAT) and 11 normal volunteers. Twenty-five major depressed patients had repeated measurements of AERPs both before and after treatment with antidepressants. RESULTS: Major depressed subjects without cognitive deterioration had significantly higher P300 latency and P200 amplitude than normal volunteers. SDAT patients and major depressed patients with cognitive impairment had a significantly higher P300 latency than depressed patients without cognitive impairment. In the latter, no significant alterations in any of the AERP components upon subchronic treatment with antidepressants were recorded. Nonresponders to antidepressant therapy had significantly higher pretreatment P300 latency and P200 amplitude than responders to treatment (P=0.006) and normal volunteers (P=0.0004). CONCLUSIONS: The findings may suggest that delayed P300 latency as well as increased P200 amplitude accompany major depression and may predict a nonresponse to subsequent antidepressive therapy.     

The relation between electric auditory brain stem and cognitive responses and speech perception in cochlear implant users

Electrically evoked brainstem responses (EABR) and event-related cortical potentials were recorded in seven postlingually deaf adults who were experienced users of a Nucleus multichannel cochlear implant. The patients were divided into two subgroups: good performers and moderate performers. Poor EABR were found in two of the moderate performers. The latencies and amplitudes of the cortical N1 P2 complex in the good performers were within the same range as those of subjects with normal hearing, but were deviant in the group of moderate performers. This may indicate disturbed cochleotopical organization of the auditory cortex in the latter group. P300 measurements in the good performers showed normal latencies, whereas in the moderate performers they were prolonged. The results suggest that the outcomes of electrophysiological measurements to assess the integrity of a patient's auditory neural system on a brainstem and a cortical level, are related to the patient's performance with the cochlear implant.     

Nuclear magnetic resonance and cochlear implant

Chou underlined that ive potential effects may be anticipated if MRI is realized on implantees: 1) force on the implant by strong magnetic field, 2) current induced by the implant in the radiofrequency (RF) field, 3) damage of implant by RF exposure, 4) MRI image distortion caused by the implant, 5) implant and adjacent tissue heating due to the absorption of RF energy. We studied the reality of the four first of these risks on the Digisonic cochlear implant from MXM using the Siemens Magneton 42 SP, which supplied the implants during 10 minutes with 1 Tesla magnetic field, RF 42 MHz, maximum intensity 10 kV. During T1 and T2 sequences we could notice that: 1) Provided the receiver is strongly attached in its skull niche as requested by normal surgical procedure, no deplacement may be observed: 2) No adverse current may been observed as well on the implanted electrodes as in the internal circuitry; 3) No damage or adverse magnetisation have been detected in the 3 studied receivers; 4) Cerebral imaging of the animal is moderately darkened by the implant. The volume of the shadow involved by the implant is approximately three times the volume of the implant. As Chou demonstrated that no observable heating could be detected after a long MRI sequence, and as Portnoy using Nucleus device observed also that neither adverse current nor implant damage could be detected, we estimate that there are no real contraindication to perform MRI on implantees, provided the surgical attachment has been correctly realised. Practical attitudes will be evoked and discussed.     

Multichannel (Ineraid) cochlear implant update

From April 1984 to May 1991, 49 profoundly deaf patients received implantation of the Ineraid multichannel cochlear implant at the University of Utah. The auditory results of 48 patients indicated improvement in mean pure-tone performance to 500 Hz (32.9 +/- 10.1 dB), 1000 Hz (27.1 +/- 10.0 dB), and 2000 Hz (30.1 +/- 9.8 dB). This group of patients had mean performances of 61.2% on auditory-only environmental sounds (Minimum Auditory Capabilities [MAC] battery), 48.8% on auditory-only CID sentences, and 95.5% on auditory-plus-visual CID sentences. The percutaneous pedestal has been well-tolerated. Changes in the surgical skin incisions have been made. A home use speech therapy program has been developed on VHS tapes.     

Changes in vowel quality in post-lingually deafened cochlear implant users

The present study addresses the effect of cochlear implantation on vowel production of 20 post-lingually deafened Dutch subjects. All subjects received the Nucleus 22 implant (3 WSP and 17 MSP processors). Speech recordings were made pre-implantation and three and twelve months post-implantation with the implant switched on and off. The first and second formant frequencies were measured for eleven Dutch vowels (monophthongs only) in an h-vowel-t context. Twelve months post-implantation, the results showed an increase in the ranges of the first and second formant frequency covered by the respective vowels when the implant was switched on. The increase in the formant frequency range was most marked for some subjects with a relatively small formant range pre-implantation. Also, at 12 months post-implantation with the implant switched on we found a significant shift of the first and second formant frequency towards the normative values. Moreover, at this time the results showed significantly increased clustering of the respective vowels, suggesting an improvement in the ability to produce phonological contrasts between vowels. Clustering is defined as the ratio of the between-vowel variance of the first and second formant frequency and the within-vowel variance of three tokens of the same vowel.     

Studies of prosody perception by cochlear implant patients

Prosodic information is conveyed to normally-hearing listeners by variations in acoustic fundamental frequency, amplitude envelope, and duration of speech segments. This study measured cochlear implant patients' sensitivity to these parameters in electrically coded speech. The psychophysical discrimination of electric parameters used to code prosodic information, were examined, together with prosody perception using speech processing strategies which modified the contributions of these parameters. Patients were implanted with the Cochlear Limited prosthesis and used the MPEAK speech processing strategy. In the psychophysical studies, difference limens were measured for steady-state and time-varying stimuli, of different pulse rates and pulse durations, over a series of different stimulus durations. These limens were obtained using an adaptive procedure which converged on the 50 per cent correct point. In the prosody perception studies, performance was measured for the MPEAK strategy and for strategies which modified the contributions of pulse rate and pulse duration. Data were collected for five tests of prosodic contrasts. Difference limens for steady-state pulse rates were larger at higher rates (17 per cent at 400 pulses/s) than at lower rates (6 per cent at 100 pulses/s). For some patients, limens for the time-varying pulse rates were larger than those for the steady-state pulse rates while for the other patients, the limens were similar. Difference limens for pulse duration were 0.3 dB, corresponding to 4 per cent of the dynamic range, for steady-state stimuli and doubled in size for the time-varying stimuli. Prosody perception performance was generally poorer for the modified strategies than for the MPEAK strategy, suggesting that the removal of information coded by pulse rate and pulse duration reduced the perception of prosodic contrasts.     

Outcome of rehabilitation of adult cochlear implant patients

Cochlear implantation is nowadays a well-accepted method of auditory rehabilitation in selected adults and children. We present rehabilitation data on 21 adult patients provided with the Nucleus CI22M.     

Differential associations of P300 amplitude and latency with cognitive and psychiatric function in solvent-exposed adults

Cognitive and mood changes are central components of solvent encephalopathy. This study examined event-related potentials in relation to neuropsychological and psychiatric function in solvent-exposed adults. Results revealed that longer P300 latency was associated with poorer cognitive test scores, whereas reduced P300 amplitude was related to increased psychiatric symptomatology. The findings suggest that the cognitive deficits and the psychiatric disturbance following solvent exposure may have different neurophysiological bases.     

Predictive factors for speech perception in patients with cochlear implant

Cochlear implant therapy is an epoch-making advance in artificial sensory organ transplants, but the positive effects on speech perception vary. Quantification theory type I, a multivariate analysis, was used to determine predictive factors for speech perception in patients with cochlear implants. Fifty-one postlingual deaf adults (18 male and 33 female, mean age, 53.4, mean duration of deafness, 8.6 years) were tested for speech perception three or more months after a Nucleus 22 channels cochlear implant. The cause of deafness in nine patients was labyrinthitis, ototoxicity in five, meningitis in three and unknown in the remaining 34. Speech perception was measured by vowel, consonant and word recognition using a live voice, and monosyllable, word and sentence recognition using a videodisc. All tests were administered in a sound only condition. Results of the univariate analysis indicated that age at implantation was correlated with monosyllable recognition, and duration of deafness was correlated with live voice word recognition. Residual hearing and coding strategy were both correlated with all outcome measures. The multivariate analysis revealed that coding strategy, duration of deafness, residual hearing and the number of electrodes were significant predictors of live voice word recognition in that order.     

Intracochlear placement of cochlear implant electrodes in soft surgery technique

It is commonly accepted that the intracochlear placement of the cochlear implant electrode is potentially damaging to the hearing rests which may exist. Consequently, cochlear implants have been recommended for totally deaf ears only. The question has been raised whether or not it is possible to preserve residual hearing during intracochlear implantation through extremely careful surgical techniques. Experience has shown, that the cochleotomy of the scala tympani anterior to the round window niche, careful preservation of the fibrine endost layer and the use of Healon are amongst the surgical procedures described which may assist in retaining the rest function of the inner ear. These observations which are discussed in detail suggest that the experienced surgeon can effect preservation of residual hearing for patients who cannot derive significant benefits from conventional acoustic amplifiers.