Auditory and Vestibular Research

War and Hearing Impairments: Pay Attention to Silent Victims

Nasrin Gohari, Zahra Hosseini Dastgerdi — Sun, 19 Oct 2025 09:32:06 +0000

The Article Abstract is not available.

A Review on the Measures of Auditory Cognition in Individuals with Vestibular Disorders

Vibha Vinod, Animesh Barman — Sun, 19 Oct 2025 09:36:37 +0000

Background and Aim: The vestibular system, which involves the peripheral vestibular apparatus and central vestibular pathways, is crucial for balance and posture. In addition to its primary functions, the vestibular system is closely linked with cognitive processes, as evidenced by its connections with the neocortex and limbic system. Vestibular dysfunction has been associated with cognitive impairments, particularly in areas of auditory cognition, where allocating cognitive resources for balance maintenance detracts from higher cognitive functions. This review examines the existing literature on the auditory-cognitive consequences of vestibular dysfunction.

Recent Findings: This systematic review gives comprehensive information about the existing research on the impact of vestibular pathology on auditory cognitive abilities. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 226 articles were initially identified, with six studies meeting the inclusion criteria after thorough screening. The review highlights the varied effects of vestibular dysfunction on auditory cognition, revealing significant impairments in auditory working memory and attention, particularly in conditions like bilateral vestibulopathy and vestibular migraine. However, inconsistencies in the literature regarding specific vestibular pathologies and their impact on auditory cognition underscore the need for further targeted research.

Conclusion: The findings suggest a complex interplay between vestibular function and auditory cognition, with implications for the diagnosis and management of cognitive deficits in individuals with vestibular disorders.

Comparative Efficacy of Vestibular Rehabilitation, Noisy Galvanic Vestibular Stimulation, and Their Combination on Postural Control, Dizziness, Anxiety, and Depression in Patients with Persistent Postural-Perceptual Dizziness

Sun, 19 Oct 2025 09:42:58 +0000

Background and Aim: Persistent Postural-Perceptual Dizziness (PPPD) is a chronic vestibular disorder characterized by persistent dizziness, non-spinning vertigo, or unsteadiness exacerbated by moving visual stimuli and upright postures. Vestibular Rehabilitation Therapy (VRT) has shown favorable outcomes. While noisy Galvanic Vestibular Stimulation (nGVS) has been associated with improvements in various psychiatric and neurological conditions, its efficacy in PPPD remains unclear. This study aimed to assess the effectiveness of VRT, nGVS, and their combination on patients with PPPD in terms of postural control, dizziness, anxiety, and depression.

Methods: Twenty-seven patients diagnosed with PPPD were randomly assigned to three groups receiving treatment for six weeks: 1) VRT, 2) GVS, and 3) VRT+GVS. Outcome measures included static postural control parameters, Dizziness Handicap Inventory (DHI), and Hospital Anxiety and Depression Scale (HADS) scores.

Results: All groups demonstrated significant improvements in subjective measures (DHI and HADS) following treatment. Postural control improvements were observed only in specific conditions within each group, with no overall significant differences between the groups except for Mediolateral (ML) path length with eyes closed on a soft surface. Significant correlations were observed between improvements in postural control outcomes and questionnaire scores within each group.

Conclusion: VRT and GVS, both individually and in combination, were effective in subjective measurements but had minimal impact on static postural control. Adding nGVS to VRT did not provide additional benefits for PPPD patients. The correlations between postural control and psychological outcomes suggest that improvements in perceived dizziness, anxiety, and depression may be linked to postural stabilization.

Trial Registration Number: The study was registered in the Iranian Registry of Clinical Trials on 18 September 2023 (IRCT20160131026279N6).

Effect of Ageing on Semantic and Phonetic Information Processing

Vishal Kooknoor, Hemanth Narayana Shetty — Sun, 19 Oct 2025 09:47:01 +0000

Background and Aim: To understand the difficulties of elderly in natural listening situations, the present study assessed the ability of participants to extract phonetic information and semantic information in noise. The main objective was to evaluate the relationship between age and performance in Semantic Information Processing (SIP) and Phonetic Information Processing (PIP) tasks.

Methods: Fifty-three normal hearing participants aged 40 to 65 years were categorized into five age groups. Participants underwent information processing assessments using standardized semantic and phonetic questions from Kannada stories under Signal-to-Noise Ratios (SNR) i.e., quiet, 0 dB SNR, and –4 dB SNR conditions.

Results: Younger participants outperformed older participants in both SIP and PIP tasks. Performance was optimal in quiet conditions, followed by 0 dB and –4 dB SNR. Except at

–4 dB, PIP scores exceeded SIP scores. A significant differences was observed between the groups 1–4 and group 5 at 0 dB SNR in PIP condition only. A moderate negative correlations indicated that performance in both SIP and PIP declined with age, with linear regression revealing reductions of 0.216 and 0.210 each year in SIP and PIP respectively.

Conclusion: Age-related declines in PIP were noted at one SNR, while SIP remained stable, aligning with the Transmission Deficit Hypothesis (TDH). Nonetheless, regression analyses indicated a general decline in both SIP and PIP with age, supporting the Inhibitory Deficit Hypothesis (IDH).

The Validity and Reliability of the Speech Prosody Comprehension Test for Children with Normal Hearing and Cochlear Implants

Sun, 19 Oct 2025 09:51:25 +0000

Background and Aim: The comprehension of speech prosody, the nonlinguistic elements of speech that convey emotions, is crucial for social interactions and speech comprehension. This study aimed to investigate the validity and reliability of the Speech Prosody Comprehension Test (SPCT) for Persian-speaking children aged 7–10.

Methods: In this study, face validity, construct validity, discriminant validity, test- retest reliability by calculating the Intraclass Correlation Coefficient (ICC), and internal consistency using Cronbach’s alpha coefficient of the SPCT were examined on 32 children aged 7–10 years, including 22 with normal hearing (mean age=8.63±1.04 years) and 10 with unilateral Cochlear Implant (CI) (mean age=9.20±0.78 years)

Results: The result demonstrated good face validity (face validity index=88.75). Construct validity was confirmed due to the existence of strong correlations within the subscale items and between the subscale items and the total score. A significant difference in mean scores was found between the normal-hearing and CI groups (p<0.001), indicating discriminant validity. High test-retest reliability was demonstrated for the overall scale (ICC=0.99) and for all subscales (ICC=0.91–0.97). The test also had high internal consistency, with a Cronbach’s alpha of 0.89 for the overall scale.

Conclusion: The SPCT is a valid and reliable clinical tool for assessing speech prosody comprehension in children aged 7–10 with normal hearing and unilateral CI. Further research with larger samples is recommended to confirm the generalizability of the findings to children with other hearing conditions and age groups.

Abnormal Slow Electroencephalography Activity in Eyes-Open and Eyes-Closed Conditions as an Optimal Marker for Tinnitus

Sun, 19 Oct 2025 09:55:18 +0000

Background and Aim: Recent studies try to clarify the difference of neuro-physiological responses of people with tinnitus. Quantitative Electroencephalography (QEEG) analysis is different in the eyes-closed or eyes-open conditions. This study aimed to compare the EEG activity of tinnitus patients between eyes-closed and eyes-open conditions at rest position.

Methods: Participants were 46 people with tinnitus (34 males and 12 females). Their QEEG was recorded in two eye conditions (close/open) for three minutes at resting position. Relative power of delta, theta, alpha, beta and gamma bands were estimated. Paired t-test was used for comparison of Delta/Alpha Ratio (DAR), and Delta+Theta/Alpha+Beta Ratio (DTABR) between the two eye conditions.

Results: The DAR and DTABR ratios were significantly higher in the eyes-open condition compared to the eyes-closed condition (p=0.009 and p=0.016, respectively). The delta power increased and alpha power decreased significantly in the eyes-open condition compared to the eyes-closed condition (p<0.001).

Conclusion: People with tinnitus have different EEG activities in eyes open/closed conditions. Increased delta power and decreased alpha power in the eyes-open condition may be an indicative of severe tinnitus. It seems better to record EEG activity with eyes open. Increased DAR is a good indicator in the eyes-open condition which is recommended to be used as a potential biomarker for comparing the severity of tinnitus.

Efficacy of Combining Conventional Vestibular Rehabilitation with Whole Body Vibration and Galvanic Vestibular Stimulation on Balance of Patients with Uncompensated Unilateral Vestibular Neuritis

Ali Jahangard, Majid Ashrafi, Fatemeh Heidari — Sun, 19 Oct 2025 09:59:08 +0000

Background and Aim: Previous studies have demonstrated that uncompensated Unilateral Vestibular Neuritis (UVN) is the most prevalent cause of dizziness. Use of Conventional Vestibular Rehabilitation (CVR) has some limitations. The use of tool-based rehabilitation methods can be more pleasant to these patients and encourage them to complete the rehabilitation course. This study aimed to compare the effects of combining CVR with Whole Body Vibration (WBV) and Galvanic Vestibular Stimulation (GVS) on balance function in patients with UVN.

Methods: In this study, 51 patients with uncompensated UVN aged 30-50 years were randomly divided into three groups of 17, including CVR (group 1), CVR+WBV (group 2), and CVR+WBV+GVS (group 3). The interventions included four weeks of CVR, twenty 5-minute sessions of WBV, and eight 20-minute sessions of GVS. Outcome measures were postural control parameters, Vestibulo-Ocular Reflex (VOR) gain asymmetry, cervical Joint Position Sense Error (JPSE), and Dizziness Handicap Inventory (DHI) score that were assessed before and after interventions.

Results: Of 51 patients, 45 completed the study. There was a significant improvement in all measured variables in all groups, where the group 2 and group 3 showed significantly greater improvement than the group 1 in posturography results, cervical JPSE, and DHI score (p<0.05). There was no significant difference among the groups in the VOR gain asymmetry (p>0.05).

Conclusion: The CVR, CVR+WBV and CRV+WBV+GVS can improve the balance of UVN patients among which CVR+WBV and CRV+WBV+GVS are more effective. Combining CVR with WBV and GVS leads to additional therapeutic effects in UVN patients.

Cross-Sectional Analysis of Meniere’s Disease: Comparing the American Academy of Otolaryngology- Head and Neck Surgery Diagnostic Criteria with Vestibular Staging

Sun, 19 Oct 2025 10:02:33 +0000

Background and Aim: This study compared the American Academy of Otolaryngology- Head and Neck Surgery (AAO-HNS) criteria for Meniere’s Disease (MD) with vestibular staging methods that address inner ear progression, a consideration not found in the AAO- HNS criteria.

Methods: A cross-sectional study recruited patients with MD, aged 18 to 60, from June 8, 2022, to March 20, 2023; however, we excluded patients with problems such as difficulty rolling their eyes, difficulty turning their head, conductive or mixed hearing loss, cental nerves system disorders, retrocochlear lesions, pregnancy, and receiving psychotropic drugs. Furthermore, patients with a history of labyrinthitis, vestibular migraine, stroke, benign positional vertigo, or bilateral vestibulopathy within the past 6 months were excluded. All patients were tested with audiometry, vestibular evoked myogenic potential, caloric test, and video head impulse test. Two neuro-otologists assessed and classified patients with MD according to the AAO-HNS (1990 and 2020) criteria.

Results: Forty-two patients were enrolled. The correlation between vestibular staging and both AAO-HNS (1990 and 2020) criteria was medium (p=0.02 and p<0.01, respectively). According to AAO-HNS 1995, 69% of definite MD cases were classified as stage C, whereas all probable MD cases and 30% of possible MD cases were categorized as stage B. Regarding AAO-HNS 2020, 70% of definite MD cases were classified as stage C, whereas 33.3% of probable MD cases were classified as stage B.

Conclusion: Definite MD could predict pathology in the cochleo-sacculo-utricular and lateral canals (stage C), whereas probable MD could suggest that the lesion involved the cochleo-sacculo-utricular canal (stage B).

Trial registration: This trial was registered at Thai Clinical Trials Registry on June 6, 2022 (TCTR20220606003).

Comparative Effectiveness of Sound Therapy, Transcranial Direct Current Stimulation, and Low-Level Laser Therapy for Chronic Tinnitus Management: A Randomized Clinical Trial

Bashar Ali Naji Altamimi , Ghassem Mohammadkhani, Nematollah Rouhbakhsh — Sun, 19 Oct 2025 10:05:36 +0000

Background and Aim: Tinnitus, the perception of sound without an external source, can significantly impact the quality of life. Although no definitive cure exists, various treatments are available to reduce tinnitus symptoms. This study aimed to compare the effectiveness of sound therapy, trnscranial Direct Current Stimulation (tDCS), and Low-Level Laser Therapy (LLLT) in managing chronic tinnitus.

Methods: In this randomized clinical trial, 78 adults with chronic tinnitus and normal hearing were divided into three groups of sound therapy, tDCS, and LLLT. The groups received interventions for six weeks. Psychoacoustically, we assessed tinnitus pitch, tinnitus loudness, Minimum Masking Level (MML), and residual inhibition (RI). Tinnitus loudness and distress were also measured using the Visual Analog Scales (VAS), and the functional impact was evaluated using the Tinnitus Handicap Inventory (THI) and Tinnitus Functional Index (TFI). Auditory Brainstem Response (ABR) test was performed to assess neural conduction.

Results: All interventions significantly reduced tinnitus loudness, MML, and distress (p<0.05). Sound therapy showed the most significant improvements in THI, TFI, and VAS scores. No significant changes were found in ABR latencies. Post-hoc analysis revealed greater benefits in the sound therapy group regarding THI and TFI scores compared to the tDCS and LLLT groups.

Conclusion: Sound therapy, tDCS, and LLLT are effective in reducing tinnitus symptoms, with sound therapy having greater effects. To improve procedures and investigate customized strategies, more research is recommended.

IRCT registration number: IRCT20111113008082N5.

Integration of Hearing and Balance Screenings for Preschool Children Aged 4-6 Years in Tehran, Iran

Seyedeh Fatemeh Mousavisadr, Fatemeh Heidari, Amir-Abbas Ebrahimi — Sun, 19 Oct 2025 10:09:06 +0000

Background and Aim: Hearing impairment is the third leading cause of years lived with disability, particularly affecting children through language and speech delays, cognitive issues, and vestibular dysfunction. This study aimed to conduct both hearing and balance screenings for preschool children aged 4-6 years in Tehran, Iran.

Methods: In this study, 384 children (180 boys and 204 girls) from the east of Tehran city during spring 2023 participated. After taking the children’s history and calculating their Body Mass Index (BMI), hearing screening were performed at screening, diagnostic, and intervention levels. Balance function was screened using the balance subtest of the short form of Bruininks-Oseretsky test of motor proficiency- second version (BOT-2).

Results: Among 768 ears examined, the prevalence of hearing loss (HL) was 11.2%, ranging from slight to moderate HL. Conductive HL had the highest prevalence (9.1%), followed by sensori-neural HL (1.3%) and mixed HL (0.8%). Of these, only 3% sought intervention. The mean total balance scores for age groups of 4, 5, and 6 years were 22.05±3.40, 26.02±3.72, and 28.13±4.50, respectively. Boys, children with higher BMIs, those with HL, and those with lower physical activity had significantly lower balance scores (p<0.05).

Conclusion: Given the type and degree of HL in preschool children and its relationship with balance scores, routine universal hearing and balance screenings for preschool children is recommended. Additionally, it is recommended to increase awareness among parents, child instructors, and pediatric healthcare providers in Iran regarding the importance of hearing and balance screenings for preschool children.

Case Report: Acquired Periodic Alternating Nystagmus and Vestibular Weakness in West Nile Virus Encephalitis

Marcello Cherchi — Sun, 19 Oct 2025 10:11:04 +0000

Background and Aim: West Nile Virus (WNV) encephalitis is reported to cause “ataxia” in up to 31% of patients, and “vertigo” in up to 14% of patients. The mechanism of these symptoms is unclear.

The Case: We report the case of a lady who contracted WNV encephalitis at age 74 years. When evaluated 15 months later she complained both of baseline unsteadiness, and of a fluctuating component of disequilibrium. Instrumented vestibular testing identified bilateral vestibular weakness (in a different pattern on each side). It also identified Periodic Alternating Nystagmus (PAN), presumably acquired (rather than congenital). Acquired PAN has been observed in other encephalidites, but has not been previously reported in association with WNV encephalitis.

Conclusion: In this case, WNV encephalitis appears to have caused both vestibular weakness (likely accounting for the baseline unsteadiness) and periodic alternating nystagmus (likely accounting for the fluctuating disequilibrium).