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Depression and Hearing loss

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Depression and Hearing loss. Honiton hearing Blog

 

Depression and Hearing Loss

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By kind permission of The hearing review:

Depression and its connection to hearing loss seems pretty logical and self-evident, especially if you’re a dispensing professional who experiences daily the difference that amplification can make in a person’s life. In fact, many clinicians find themselves explaining the connection as follows: a person’s hearing loss and related communication problems can lead to gaffes and social faux pas; leading to embarrassment, anxiety, and loss of self-esteem; leading to gradual withdrawal from social situations and physical activity; leading to social isolation and loneliness; and eventually bringing them down the path to depression.

Karl Strom_photo

While this is probably an adequate description for some cases, a recent webinar1 by Victor Bray, PhD, associate professor and former dean of Salus University’s Osborne College of Audiology, points to more recent scientific literature that paints a far more complex picture of hearing loss and its association with depression—one we all should be aware of. The utility of hearing aids, cochlear implants, and assistive devices is made no less important by this complexity; however, it’s vital to understand who might be most at risk for depression in your patient population, how best to administer simple screening tools (ie, the PHQ-2 or PHQ-9), and why it’s important to refer patients to a medical doctor or psychologist, when indicated. 

Depression, also known as major depressive disorder (MDD), is present in 5-10% of the general population (up to 40% in some groups), and is a serious medical illness that negatively affects feelings, thoughts, and actions. The primary risk factors for depression are co-morbid chronic medical conditions (hearing loss is a pervasive chronic condition, especially among seniors) and recent stressful events. And, as with cognitive decline and dementia—the subject of my editorial last month—the stakes in treating depression are high for society and healthcare professionals. As Hsu and colleagues (2016) pointed out:

Depression is a common mental disorder, which affects 350 million people in the world. Unipolar depressive disorders and adult-onset hearing loss, the most common neuropsychiatric conditions, and sense organ disorder, respectively, are the first and second leading nonfatal causes of year loss due to disability among adults in high-income countries.2

Several of the studies reviewed by Dr Bray tend to suggest that the odds ratio for acquiring depression increases by a factor of about two if you have untreated hearing loss. However, a lot of the studies also show that a variety of chronic illnesses—ranging from cirrhosis to diabetes mellitus—can be associated with depression, so there could be some underlying neurophysiological common cause in hearing loss and other health problems that hasn’t been discovered yet. Dr Bray also looks at some very intriguing research about how dual-sensory loss (ie, hearing and vision loss) and sudden sensorineural hearing loss (particularly among young people) can greatly increase the risk for depression, as well as studies that are shedding light on how treated hearing loss might positively affect those suffering from anxiety, loneliness, and depression. 

As Dr Bray explains, the linkage of hearing loss to depression could come from both a social (downstream) effect, as described at the beginning of this article, and a biological/neurological (upstream) effect, as proposed in a model by Rutherford et al.3 If that were the case, an effective treatment plan could involve therapy and/or medication from a psychologist, in coordination with a hearing device and/or auditory and cognitive retraining from a hearing care professional. 

Dr Bray’s webinar was sponsored by Hamilton CapTel, and the company also sponsored an exceptionally interesting and well-viewed webinar last year about hearing loss and associated co-morbidities (including depression) by Harvey Abrams, PhD.4,5 When viewed together, they put an exclamation point on the fact that hearing loss isn’t just about the ears, it’s about health, the brain, quality of life, healthy aging, and so much more—while underscoring the crucial role of the hearing care professional in general healthcare.

To see Dr Bray’s webinar, visit https://bit.ly/2Lpt4AW. 

Citation for this article: Strom KE. Depression and hearing loss. Hearing Review. 2018;25(8):6.

References

1. Bray V. Depression, hearing loss, and treatment with hearing aids [Webinar]. July 13, 2018. Available at: http://www.hearingreview.com/2018/07/new-webinar-depression-hearing-loss-treatment-hearing-aids

2. Hsu W-T, Hsu C-C, Wen M-H, et al. Increased risk of depression in patients with acquired sensory hearing loss: A 12-year follow-up study. Medicine. 2016;95(44):e5312.

3. Rutherford BR, Brewster K, Golub JS, Kim AH, Roose SP. Sensation and psychiatry: Linking age-related hearing loss to late-life depression and cognitive decline. Am J Psychiatry. 2017;175(3):215-224.

4. Abrams H. Hearing loss and associated comorbidities: What do we know [Webinar]? May 31, 2017. Available at: http://www.hearingreview.com/2017/05/new-webinar-hearing-loss-associated-comorbidities-know/

5. Abrams H. Hearing loss and associated comorbidities: What do we know? Hearing Review. 2017;24(12):32-35. Available at: http://www.hearingreview.com/2017/11/hearing-loss-associated-comorbidities-know/

BBC news reader now wears a hearing aid.

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Newsreader Lewis Vaughan Jones makes debut wearing hearing aid

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This post is from the original BBC news item.

 “It was crowded and loud on air”

A newsreader who suddenly lost the hearing in his left ear, has received messages of support after his first appearance on air with a hearing aid.

Lewis Vaughan Jones, 37, feared his career presenting the news on the BBC and ITN was over after doctors told him the hearing loss was permanent.

“That was the darkest moment,” he told BBC Radio 5 live.

He also spoke of his embarrassment in social situations and the difficulties of coming to terms with a hearing aid.

Vaughan Jones had good hearing all his life until he got a cold several months ago and couldn’t hear in one ear.

Doctors found his left eardrum was no longer working and the nerve which takes sound to the brain had given up, he told BBC Breakfast.

When they told him the sudden hearing loss and the tinnitus were permanent, he walked out of hospital “completely bamboozled”, he added.

The charity Action on Hearing Loss says about 11m people in the UK have some form of hearing loss, and 2m use hearing aids. It estimates that there are about 6.7m people who could benefit from hearing aids.

Before being fitted with a hearing aid, Vaughan Jones said his situation had left him frustrated and embarrassed.

“There’s only so many times you can interrupt. You feel embarrassed so you withdraw,” he said.

He also described how he would smile and nod along when spending time with friends and family, feeling unable to engage and as though he was missing out.

His hearing aid, he said, has been a massive help, allowing him to return to work.

His return to screen, however, was a noisy one as he can hear the director and correspondents through an earpiece in his right ear and an amplified, distorted version of his own voice through the hearing aid in his left.

The brain should learn to quieten down that distortion, he said.

Getting used to wearing a hearing aid has not come easy.

“I was self-conscious about it. My hair is slightly longer so that’s a reflection that I might have been trying to hide it,” he adds.

Now back on air, he wants to show everyone he is wearing one.

“There’s no logical reason why I shouldn’t wear my hearing aid on air and feel good about it,” he said.

Some took to Twitter to agree.

Robbie M said he started wearing two hearing aids five years ago after finding he was unable to hear in meetings. He advised Vaughan Jones to “wear them with pride,” adding: “Quality of life over people’s thoughts every time.”

Nikki Magrath said: “Great to hear you talk about SSHL [Sudden Sensorineural Hearing Loss] today. I know just how it feels. Has happened twice – once with full recovery.”

Heading a football could create Balance issues

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Heading a Football May Be Linked to Increase in Balance Problems

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Soccer players who head the ball more often may be more likely to have balance problems than players who do not head the ball as often, according to a preliminary study released today that will be presented at the American Academy of Neurology’s (AAN) Sports’ Concussion Conference in Indianapolis July 20 to 22, 2018, the AAN announced on its website.

“Soccer headers are repetitive subconcussive head impacts that may be associated with problems with thinking and memory skills and structural changes in the white matter of the brain,” said study author John Jeka, PhD, of the University of Delaware in Newark, Del. “But the effect of headers on balance control has not been studied.”

For the study, 20 soccer players recruited from the community in Newark took a balance test where they walked along a foam walkway with their eyes closed under two conditions: with galvanic vestibular stimulation (GVS) and without GVS. For GVS, electrodes placed behind each ear stimulate the nerves that send messages from the balance system in the inner ear to the brain. So the stimulator can make you feel like you are moving when you are not. In this case, it made participants feel like they were falling sideways.

The soccer players, who had an average age of 22, also completed questionnaires about how many times they had headed the ball during the past year. The number of headers over a year for each participant ranged from 16 to 2,100, with an average of 451 headers. Those numbers were calculated by asking participants for the average number of headers during a practice and game, the average number of practices and games per week, and the average number of months per year that the player participated.

The study found that the players with the largest number of headers had the largest balance responses to GVS in both foot placement and hip adduction during the walking test, which indicated that they had vestibular processing and balance recovery problems. Researchers found for every 500 headers, foot placement response increased about 9 millimeters and hip adduction response increased about 0.2 degrees.

“Soccer players must have good balance to play the game well, yet our research suggests that headers may be undermining balance, which is key to all movement, and yet another problem now linked to headers,” said study author Fernando V. Santos, PT, of the University of Delaware. “It is important that additional research be done to look more closely at this possible link with balance and to confirm our findings in larger groups of people.”

A limitation of the study was that participants relied on memory when reporting how many times they headed the ball. The study was supported by the National Institutes of Health (NIH).

Learn more about concussion at www.BrainandLife.org, the American Academy of Neurology’s free patient and caregiver magazine and website focused on the intersection of neurologic disease and brain health. Follow Brain & Life on Facebook, Twitter, and Instagram.

To learn more about the AAN’s Sports Concussion Guideline and access resources, visit https://www.aan.com/concussion.

Original Paper: Santos FV, Caccese JB, Gongora M, et al. Greater exposure to repetitive subconcussive head impacts is associated with vestibular dysfunction and balance impairments during walking. Paper presented at: 2018 AAN Sports Concussion Conference; Indianapolis, IN. https://www.aan.com/PressRoom/Home/GetDigitalAsset/12757

Source: AAN

Image: © Macleoddesigns | Dreamstime.com

Tinnitus therapy Devon

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An international study from 2012 found that 15% of the global population experience permanent tinnitus but many more are affected by temporary tinnitus. A Danish study, also from 2012, with 14,000 participants found that 27% of those in the study experienced either temporary or permanent tinnitus. In other words, more than one quarter of the Danish population are affected tinnitus.

But despite a lot of research on the topic, there is still a lot to learn about tinnitus. According to Chief Physician Ture Andersen at Odense University Hospital in Denmark, tinnitus is often a symptom of damage to the inner ear. Tinnitus is not a disease, but can be a symptom of a disease or an impaired auditory system. It is defined as the perception of noise or ringing in the ears when no external sound is actually present. The sounds are most commonly described as ringing, whistling, wheezing, buzzing or humming, but can be described in many other ways. A large Swedish study showed that excessive noise at work and in other environments results in fatigue, headaches and ultimately impaired hearing or tinnitus. Another study, from France, shows that only one in 123 people with tinnitus do not have a hearing impairment.

 

Eva’s history

Eva Jensen, who lives in Greve, Denmark, fits in well to these statistics. With a moderate to severe hearing loss, Eva can’t hear much without her hearing aids and she experiences tinnitus.
“What does your tinnitus sound like?” I asked Eva. She explained that it is a constant buzzing sound, which lies somewhere in the middle of the pitch spectrum. “I think it developed at my work where there was a lot of noise,” says Eva. In 2006 she stopped working as an Educational Assistant in a nursery because of a back injury and since then she has suffered from constant back pain.
“It was only when I stopped working that I started thinking about my tinnitus. My husband was still working so I was at home alone where it was completely quiet and I became more aware of the ringing in my ears.” She experiences it all day, especially when she takes off her hearing aids in the evening. “Since my injury I have the TV on constantly – it helps me think of something other than my back pain,” says Eva.

Eva’s experience with Relief app

“It’s really great to be able to use the app when my tinnitus is driving me crazy. If you are strongly affected by tinnitus, I would definitely recommend this app. There are so many possibilities with creating your own soundscapes, you can always find a sound that’s comfortable. There is no doubt that I’m going to keep it on my phone, so I can get help when my tinnitus it really bothering me,” says Eva with a smile.

ReSound Relief

The idea of helping people focus on something other than the pain, or in this case tinnitus, is the basic concept of a new app made by the hearing aid manufacturer GN Hearing. The free app is called ReSound Relief and offers a combination of audio therapy and relaxation exercises. My editorial team and I tested the app, which offers some new and unique features compared to other apps we have tried. One very smart feature of the app is that it allows you to create your own soundscapes.

Relief allows you to combine a variety of familiar sounds such as birdsong or bubbling water with music and other therapeutic nature sounds. The ability to combine sounds, offers an almost endless amount of possibilities. This sound mixing feature allows you to mix five different sounds and you can individually adjust the volume of each sound.

After downloading the app, you can listen to music on your smartphone as usual, and if you use wireless hearing aids or headphones, you can stream directly through them. The ReSound Relief app also contains a feature called MyRelief that keeps a record of how you use the app and which sounds you have used the most. It creates a personalized plan and allows you to track your progress, much like an exercise app. “When we were developing the concept of this app, we analyzed the market for other tinnitus apps and found that mostof them just use sounds as a distraction. Very few actually guide the user through the tinnitus management process. Tinnitus management for many is more than just playing a sound.

The idea of MyRelief is that you can use it as part of the treatment provided by a Hearing Care Professional. Because MyRelief keeps a record of your use, it provides useful information that a Hearing Care professional can use as part of tinnitus counseling” says Michael Piskosz, Senior Audiologist at GN Hearing.

Article taken from a press release by GnResound May 2018

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Tinnitus therapy in Devon. The Honiton hearing centre.

For more information on Tinnitus read our Tinnitus page here.

New Study Examines Inequality in Treatment for Hearing Loss

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New Study Examines Inequality in Treatment for Hearing Loss

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By Kara Gavin, Lead Public Relations Representative

Hearing loss seems like one of the great equalizers of old age, striking people of all kinds as their ears gradually lose the ability to pick out sounds or hear certain pitches.

But a new national study reveals major gaps in whether Americans over age 55 get help for their hearing loss—gaps that vary greatly by age, race, education, and income, according to an article published on the Michigan Medicine website.

In all, just over a third of older adults who say they have hearing loss are using a hearing aid to correct it, the study finds. But those who are non-Hispanic white, college educated, or have incomes in the top 25% were about twice as likely as those of other races, education levels, or income ranges to have a hearing aid.

The cost of hearing aids is most to blame, say the researchers from the University of Michigan who published the study in The Gerontologist. They presented it this week at the annual research meeting of the AcademyHealth professional society for health care researchers.

Hearing aids can cost thousands of dollars out of a patient’s pocket because most health insurance programs, including Medicare, don’t cover them.

In fact, the study finds that the only factor that leveled the playing field for hearing aid use was having insurance through the Department of Veterans Affairs, which covers hearing aids in many cases. Hearing-impaired veterans ages 55 to 64 were more than twice as likely as their nonveteran peers to use a hearing aid, even after the researchers corrected for other differences. The gap between veterans and nonveterans was also significant for those over 65.

But the detailed interviews conducted for the study also show that personal concerns about hearing aid use, and lack of engagement with health providers, play a role.

“Hearing aids are not easy for many to obtain due to their costs,” says Michael McKee, MD, MPH, the U-M family medicine physician and assistant professor who led the analysis.

Michael McKee, MD, MPH

Michael McKee, MD, MPH

“However, there are a number of additional issues that place at-risk groups at an even larger disadvantage to achieving good hearing health. Many of these issues are beyond the financial aspects, including racial/ethnicity and sociocultural elements, for instance stigma and vanity.”

National survey and local interviews

McKee, who uses a cochlear implant to overcome his own hearing loss, worked on the study with Helen Levy, PhD, a health economist and professor at the U-M Institute for Social Research, and other colleagues. The authors are members of the U-M Institute for Healthcare Policy and Innovation.

They used survey data from the nationally representative Health and Retirement Study, which is based on interviews conducted by the Institute for Social Research with funding from the National Institutes of Health.

The analysis included data from more than 35,500 people nationwide over age 55 who said they had hearing loss. In addition, McKee and colleagues conducted in-depth interviews with 21 other older adults with hearing loss in the communities surrounding the university.

The authors conclude that the Centers for Medicare & Medicaid Servicesshould consider covering hearing aids for Medicare participants and those in Medicaid plans for lower-income adults of any age. Some state Medicaid plans do cover hearing aids, but it is not required.

“Many people may not realize that Medicare does not cover hearing aids,” says Levy. “But it doesn’t, so cost can be a significant obstacle preventing older adults with hearing loss from getting the help that they need.”

More findings from the study:

  • The percentage of older adults with hearing loss who used a hearing aid rose with age, from about 15% of those in their late 50’s to more than 57% of those in their late 80s.
  • Forty percent of non-Hispanic white adults with hearing loss used a hearing aid, compared with 18.4% of non-Hispanic black and 21.1% of Hispanic adults with hearing loss.
  • Nearly 46% of hearing-impaired older adults who had gone to college reported that they used a hearing aid, compared with just under 29% of those who hadn’t graduated from high school.
  • Nearly half of those with incomes in the top 25% wore a hearing aid, compared with about one-quarter of those in the bottom 25%.
  • There were no significant differences in hearing aid use based on the size of the community where the person lived, nor their level of health literacy as measured on a standard test.
  • Interviews showed that cost, lack of insurance coverage (or knowledge about insurance coverage), vanity, and stigma were common reasons for not using hearing aids. Participants also cited a lack of attention to hearing loss by their primary care provider and worries about finding an audiologist they could trust.
  • Many interview participants who used a hearing aid mentioned efforts that hearing-related professionals made to connect them to discounts and insurance programs.

More about hearing loss

Estimates of hearing loss incidence place it at 29% of people in their 50s, 45% of those in their 60s, 68% of those in their 70s, and 89% of those in their 80s.

Previous studies have shown that untreated hearing loss reduces older adults’ ability to carry out everyday tasks, reduces their quality of life, and is linked to social isolation, lower income, reduced cognitive function, and poorer physical and psychological health.

A recent study led by McKee’s colleague Elham Mahmoudi, PhD, found that having a hearing aid was associated with a lower chance of being hospitalized or visiting an emergency room in the past year. That study focused on people over 65 who had severe hearing loss, and it used data from a federal database.

McKee leads the Health Info Lab, which is researching health information use and literacy among deaf and hard-of-hearing individuals.

This article is copyrighted by the University of Michigan and used with permission.

Original Paper: McKee MM, Choi H, Wilson S, DeJonckheere MJ, Zazove P, Levy H. Determinants of hearing aid use among older Americans with hearing loss. The Gerontologist. 2018. Available at: https://academic.oup.com/gerontologist/advance-article-abstract/doi/10.1093/geront/gny051/5000029?redirectedFrom=fulltext

Source: Michigan Medicine/University of Michigan, The Gerontologist

Image: University of Michigan

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Earwax removal in Devon

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Earwax removal Devon @ Honiton hearing.

GN Hearing Launches Rechargeable Battery Option for ReSound Linx 3D

Devon earwax removal and hearing tests available at the Honiton hearing centre. We also conduct hearing tests and supply and fit the very latests digital hearing aids in Devon.

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GN Hearing—the medical device division of the GN Group—has introduced a rechargeable battery option for the ReSound LiNX 3D hearing aids, the company announced. The rechargeable battery solution, available in North America and other major markets from September 1, gives ReSound users more options to choose from. The rechargeable option is also available for Beltone Trust in North America, and from September 1, this will be extended to other major markets.

The rechargeable battery option is made available based on an understanding of user expectations as well as a commitment to empower users to choose the solution best suited for their needs and preferences. The announcement follows GN Hearing’s release of the innovative 5thgeneration 2.4 GHz wireless technology ReSound LiNX 3D hearing aids, which offer unmatched sound quality, an enhanced fitting experience, and comprehensive remote fine-turning, giving users a new hearing care experience, GN Hearing said.

According to the company, ReSound LiNX 3D rechargeable has all of the benefits of ReSound LiNX 3D, now combined with the all-day power of a rechargeable battery. With overnight charging, users will experience the advantage of all-day power, without the need to change batteries.

ReSound Linx 3D rechargeable accessory.

ReSound LiNX 3D rechargeable accessory.

“GN Hearing is pleased to provide yet another option for hearing aid users, built on our commitment to providing unmatched sound quality and user experience,” said Anders Hedegaard, president & CEO, GN Hearing. “This new rechargeable battery solution allows hearing care professionals to offer an additional option to their clients, and gives hearing aids users even more choices to tailor their hearing experience to their unique preferences,” he added.

Source: GN Hearing 

Image: GN Hearing 

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Hearing health @ Honiton Hearing

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Honiton Hearing News:

We search around the world to keep you up to date on the latest hearing related articles. Today we have found an interesting article regarding an unusual subject.  If you suffer from any hearing related issues such as earwax build up or you are looking to get a hearing test we treat many customers from around the Devon and Honiton area.

Earwax removal, Microsuction and the very latest digital hearing aids are available.

 

Though public transportation is thought to be better for the environment in that it reduces greenhouse gas emissions, saves energy, and improves air quality, according to the Federal Transit Administration, there may be a negative effect on your personal health.

According to a recent Canadian study, commuters traveling during peak hours were exposed to maximum noise levels. A summary of the study’s results, published on the Hear-it AISBL—a nonprofit organization that provides information on hearing loss—website, show the results of the study, which was published in the Journal of Otolaryngology—Head & Neck Surgery. In this article, we’ll share the highlights, edited and adapted from the Hear-it website.

COMMUTING STYLES

Researchers looked at two different commuting situations among Toronto residents: people waiting for a streetcar/bus as compared to people walking/biking to a subway. Bikers were exposed to louder noise than those walking or driving a vehicle. Noise levels were higher for those waiting on a subway platform as compared to those in the subway car. And, finally, research showed that those waiting at bus stops were exposed to the loudest noise of all.

PEAK NOISE

Though commuters often only experienced short and intense bursts of impulse noise exceeding the 114 dBA limit recommended by the EPA, researchers concluded this can be just as harmful as prolonged noise exposure. Up to 20% of the peak mean noise measurementsexceeded 114 dBA, and up to 85% of measurements at bus stops were higher than 120 dBA, according to the study. Researchers were concerned that prolonged exposure could lead to noise-induced hearing loss.

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Best earwax removal in Devon (Honiton)

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Best earwax removal in Devon (Honiton)

 

The Honiton hearing centre in Devon are regarded as being the best in Devon according to clients. They come back time after time after trying other earwax removal clinics in the Devon area.

 

Colin Eaton the top audiologist for the Whole of Devon runs the Honiton Hearing Centre and is a proud member of AHHIP the industry council and advisory body for hearing audiologists.  http://www.aihhp.org/

If you are looking for earwax removal using the gentle technique of Microsuction https://honiton-hearing.co.uk/services/earwax-removal/ or the more traditional water irrigation technique, here at the Honiton hearing centre they can do them both.

 

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In the news this week:

Researchers Identify New Type of Vertigo, According to Study Published in ‘Neurology’

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Neurologists have identified a new type of vertigo with no known cause, according to a study published in the May 23, 2018 online issue of Neurology, the medical journal of the American Academy of Neurology(AAN), the AAN announced on its website.

With vertigo, people have episodes of dizziness that can last from minutes to days. Vertigo can be caused by serious conditions, such as tumors, or conditions that are fairly benign, such the inner ear disorder Meniere’s disease. But for some people, no cause can be found.

In this new study, neurologists have identified a new type of vertigo where treatment may be effective.

“These conditions can be difficult to diagnose and quite debilitating for people, so it’s exciting to be able to discover this new diagnosis of a condition that may respond to treatment,” said study author Ji-Soo Kim, MD, PhD, of Seoul National University in Seongnam, South Korea.

To diagnose this new condition, the person sits in a dark room and the examiner moves the patient’s head forward and then the head is shaken horizontally for about 15 seconds. Then the patient opens his or her eyes and a video recording is taken of eye movements. The neurologists discovered that after the test, people with this new condition had eye movements called nystagmus that lasted longer than for other people. The new condition is called recurrent spontaneous vertigo with head-shaking nystagmus.

Among 338 people with vertigo with no known cause, 35 had this new condition and were included in the study. The participants had attacks of vertigo ranging from two or three times a week to once a year. They also experienced nausea or vomiting, headaches, and intolerance of head motions during the attacks.

The participants were compared to 35 people with other conditions that can cause vertigo, such Meniere’s disease, vestibular migraine, and vestibular neuritis. The test measured the time constant, or the time that represents the speed with which the reflexive eye movements can respond to change. For those with the new condition, the time constant during the primary phase of the nystagmus was 12 seconds, while it was six seconds for those with Meniere’s disease and five seconds for those with vestibular neuritis and vestibular migraine.

The neurologists also found that people with the new type of vertigo were more likely to have severe motion sickness than those with other types of vertigo.

A total of 20 of the 35 people with the new type of vertigo who had frequent attacks and severe symptoms were given preventive medication. About one-third of those had partial or complete recovery with the new medication. During the long-term follow-up of an average of 12 years after the first symptoms for 31 participants, five reported no more attacks, 14 said their symptoms had improved, and only one said symptoms had gotten worse.

Kim said that people with this condition may have a hyperactive mechanism in their vestibular system that helps the brain respond to movement of the body and in the environment.

“It’s possible that the vertigo occurs when this unstable mechanism is disrupted by factors either within the person’s body or in their environment,” Kim said.

The study was supported by the National Research Foundation of Korea. Learn more about the brain at www.BrainandLife.org, the American Academy of Neurology’s free patient and caregiver magazine and website focused on the intersection of neurologic disease and brain health. Follow Brain & Life on Facebook, Twitter, and Instagram.

The American Academy of Neurology is said to be the world’s largest association of neurologists and neuroscience professionals, with 34,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease, and epilepsy.

For more information about the American Academy of Neurology, visit AAN.com or find us on Facebook, Twitter, LinkedIn, and YouTube.

Original Paper: Lee S-U, Jeong-Yoon C, Hyo-Jung K, Ji-Soo, K. Recurrent spontaneous vertigo with interictal headshaking nystagmus. Neurology. 2018. Available at: http://n.neurology.org/content/early/2018/05/23/WNL.0000000000005689

Source: AAN, Neurology 

 

 

 

Tinnitus therapy, Honiton, Devon

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Brainwave Abnormality Could Be Common to Parkinson’s Disease, Tinnitus, Depression

Tinnitus, news update:

Earwax removal, hearing aids and hearing tests in Honiton, Devon.

 

The Honiton hearing centre in Devon offers Tinnitus therapy

A brainwave abnormality could be a common link between Parkinson’s disease, neuropathic pain, tinnitus, and depression—a link that authors of a new study suggest could lead to treatment for all four conditions.

Dr Sven Vanneste, an associate professor in the School of Behavioral and Brain Sciences at The University of Texas at Dallas, is one of three authors of a paper in the journal Nature Communications regarding thalamocortical dysrhythmia (TCD), a theory that ties a disruption of brainwave activity to the symptoms of a wide range of neurological disorders, The University of Texas announced.

Dr Sven Vanneste, associate professor in the School of Behavioral and Brain Sciences.

Dr Sven Vanneste, associate professor in the School of Behavioral and Brain Sciences.

Vanneste and his colleagues—Dr Jae-Jin Song of South Korea’s Seoul National University and Dr Dirk De Ridder of New Zealand’s University of Otago—analyzed electroencephalograph (EEG) and functional brain mapping data from more than 500 people to create what Vanneste believes is the largest experimental evaluation of TCD, which was first proposed in a paper published in 1996.

“We fed all the data into the computer model, which picked up the brain signals that TCD says would predict if someone has a particular disorder,” Vanneste said. “Not only did the program provide the results TCD predicted, we also added a spatial feature to it. Depending on the disease, different areas of the brain become involved.”

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“The strength of our paper is that we have a large enough data sample to show that TCD could be an explanation for several neurological diseases.”

Brainwaves are the rapid-fire rhythmic fluctuations of electric voltage between parts of the brain. The defining characteristics of TCD begin with a drop in brainwave frequency—from alpha waves to theta waves when the subject is at rest—in the thalamus, one of two regions of the brain that relays sensory impulses to the cerebral cortex, which then processes those impulses as touch, pain, or temperature.

A key property of alpha waves is to induce thalamic lateral inhibition, which means that specific neurons can quiet the activity of adjacent neurons. Slower theta waves lack this muting effect, leaving neighboring cells able to be more active. This activity level creates the characteristic abnormal rhythm of TCD.

“Because you have less input, the area surrounding these neurons becomes a halo of gamma hyperactivity that projects to the cortex, which is what we pick up in the brain mapping,” Vanneste said.

While the signature alpha reduction to theta is present in each disorder examined in the study—Parkinson’s, pain, tinnitus, and depression—the location of the anomaly indicates which disorder is occurring.

“If it’s in the auditory cortex, it’s going to be tinnitus; if it’s in the somatosensory cortex, it will be pain,” Vanneste explained. “If it’s in the motor cortex, it could be Parkinson’s; if it’s in deeper layers, it could be depression. In each case, the data show the exact same wavelength variation—that’s what these pathologies have in common. You always see the same pattern.”

EEG data from 541 subjects was used. About half were healthy control subjects, while the remainder were patients with tinnitus, chronic pain, Parkinson’s disease, or major depression. The scale and diversity of this study’s data set are what set it apart from prior research efforts.

“Over the past 20 years, there have been pain researchers observing a pattern for pain, or tinnitus researchers doing the same for tinnitus,” Vanneste said. “But no one combined the different disorders to say, ‘What’s the difference between these diseases in terms of brainwaves, and what do they have in common?’ The strength of our paper is that we have a large enough data sample to show that TCD could be an explanation for several neurological diseases.”

With these results in hand, the next step could be a treatment study based on vagus nerve stimulation—a therapy being pioneered by Vanneste and his colleagues at the Texas Biomedical Device Center at UT Dallas. A different follow-up study will examine a new range of psychiatric diseases to see if they could also be tied to TCD. Tinnitus, is thought to be connected.

For now, Vanneste is glad to see this decades-old idea coming into focus and suggest that Tinnitus is getting better understood,.

“More and more people agree that something like thalamocortical dysrhythmia exists,” he said. “From here, we hope to stimulate specific brain areas involved in these diseases at alpha frequencies to normalize the brainwaves again. We have a rationale that we believe will make this type of tinnitus therapy work.”

The research was funded by the National Research Foundation of Korea(NRF) and the Seoul National University Bundang Hospital.

Original Paper: Vanneste S, Song J-J, De Ridder D. Thalamocortical dysrhythmia detected by machine learning. Nature Communications. 2018;9(1103)

Source: Nature Communications, University of Texas at Dallas, Tinnitus.

Image: University of Texas at Dallas

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Hearing aid batteries in Honiton, Devon

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News update on how rechargeable hearing aid batteries actually work in real life.

EXPERT INSIGHT #2: How long should the hearing aid battery last after a full charge, and how does Bluetooth affect this?

The Honiton hearing centre for earwax removal and Microsuction.

Courtesy of ZPower

 

 

 

 

Barry A. Freeman, PhD

Hearing aid batteries and rechargeable batteries are all around us these days. Honiton hearing centre looks at a recent news article showing how they all work in real life scenarios.

Barry Freeman, PhD, is vice president of business development for ZPower, and has been leader and educator in the global audiology community for over 35 years. Prior to joining ZPower, he was CEO and president of Audiology Consultants Inc (ACI), a private audiology consulting firm, and senior director of Audiology and Education for Starkey Hearing Technologies, a global manufacturer of hearing aids. Dr Freeman has served as chair and professor of Audiology at Nova Southeastern University (NSU) and has taught full time or as an adjunct professor in some of the most distinguished audiology programs in the country. Additionally, he owned and practiced for 20 years at the Center for Audiology in Clarksville, Tenn, and Hearing Services of Kentucky in Hopkinsville, Ky. He is a past president of the American Academy of Audiology (AAA), served on the AAA Board of Directors for 6 years, and continues to serve on several professional boards.

Q & As: This Week’s Top Selections

Q: How long should the battery last after a full charge?  How much does Bluetooth activity affect this? —Brent Spehar

A: This is a great and very important question.  Battery life is dependent on several factors including the amount of capacity of the battery, how fast the hearing aid drains the current, and the wear behaviors and habits of the user.

Much like how a car’s mileage range depends on its gas tank, the driving conditions, and the owner’s driving habits, a hearing aid’s battery life depends on the capacity of the battery, the wearer’s listening environments, and use of the various hearing aid functions, including audio streaming.

I like to use the example of an automobile.  How many gallons of gas does the fuel tank hold or, for hearing aid batteries, how many mAh capacity is in the battery?  How many miles per gallon does the car use or how many mA does the battery drain both when streaming and not streaming?  And, finally, is the car driven on the highway or in the city and is the air conditioner on or off?  Or, for hearing aids, how many hours per day does the hearing aid stream?  Does the hearing aid use 2.4 GHz streaming or does it is use NFMI with an intermediate device that has its own battery?  And, what features are turned on or off on the hearing aid?

Ask Your Question!

Send your questions to editor@hearingreview.com or via the comment box below.

Once you answer these questions, you can figure out “how long the battery will last after a full charge.”  I gave some example calculations in the HRarticle:  The Changing Landscape of Hearing Aid Batteries (Hearing Review, October 31, 2017).  

Please note a factor we have learned in our electronics’ lab.  Not all hearing aids are the same.  Some 2.4 GHz products have current drains averaging 4.8-5.0 mA when streaming while other 2.4 GHz products using lower power Bluetooth will drain the battery at 3.0-3.4 mA while streaming.  Some 2.4 GHz products when not streaming may have battery drains of 1.8-2.0 mA, while some of the newer products with bilateral beam-forming may drain the battery at 2.3-2.5 mA when not streaming.

The key is to know your products and know your patient’s listening habits.  This is critical to good counseling.

Q: Is the life of the hearing aid circuit reduced as a result of using the rechargeable system? It did happen when [a previous model of hearing aid] were rechargeable. —Anjan Muhury

A: The ZPower Rechargeable System has been thoroughly evaluated by the hearing aid manufacturers and there is no indication that the system will have a negative effect on the life of the hearing aid circuit. The ZPower silver-zinc battery is designed to mimic the performance of traditional zinc-air batteries and is transparent to the DSP of the hearing aids. Extensive studies of hearing aids using the ZPower System also show the system including the ZPower silver-zinc batteries have no impact on the electrophysiologic performance of the hearing aids. Therefore, the ZPower System will not have a negative impact on the hearing aid circuitry or performance.

Previous Q & A’s

Q: What’s a realistic time frame for a rechargeable hearing aid battery to last?

A: Rechargeable silver-zinc batteries last about a year. They are removeable and therefore easily replaced. It is recommended that rechargeable silver-zinc batteries are replaced once a year by a hearing care professional.

Li-ion batteries are sealed within the hearing aid, and are usually removable only by the hearing aid manufacturer. They last approximately 4 to 5 years.

Q: What would happen if my patient accidentally places their hearing aids in the charger while they have zinc air batteries in them?

A: When the hearing aids are put on the charger, the charger will check to see what type of battery is in the hearing aid.  If the charger detects a disposable zinc air battery, the lights on the charger will turn red.  If the charger detects a silver-zinc battery, the lights on the charger will start blinking green; once the battery is fully charged, the lights will turn solid green.

Q: Can my patients overcharge a ZPower battery if they leave it in the charger for too long?

A: The batteries will not overcharge if left in the charger.  It is a best practice to put the hearing aids back on the charger when the hearing aids are not being worn during the day.  This will keep the hearing aids turned off and the batteries charged.  For long-term storage, if batteries will not be used for over 2 weeks, the rechargeable batteries should be removed from the hearing aids and stored in a location where they will not touch each other or other metal objects.

Q: What happens when the silver-zinc rechargeable battery is getting low on power?

A: The hearing aid wearer will hear the low battery warning.  Once the low-battery warning occurs or once a hearing aid shuts off due to a low battery condition, the battery door should not be opened and closed to reboot the hearing aid. Rebooting after the low battery warning can override the smart circuitry in the battery door into believing it has a traditional disposable battery installed and, although the hearing aid will continue to work for a short period, it may over-discharge the battery. If a low-battery warning from the hearing aids is received, the hearing aids should be placed in the charging base for charging or the batteries should be replaced with non-rechargeable batteries.  The rechargeable batteries should not be stored with metal objects such as keys or coins.

Q: How often should the batteries be charged?

A: The batteries should be fully charged every night. Once the hearing aids are finished charging, the indicator lights turn from blinking green to solid green. A full charge may take up to 7 hours—the charge time varies based on how much the battery was depleted during the day. Do not try to extend battery life by charging every other day, as this increases the chances of depleting the battery. A fully depleted battery will take longer to charge and may not fully charge in time for next use.

Q: What happens if the hearing aid wearer forgets to charge the battery at night?

A: They can use a disposable zinc-air battery until it is convenient to re-charge the batteries—ideally the rechargeable batteries should be charged the next night.  The rechargeable silver-zinc batteries are a gold color, so they will not be mixed up with zinc-air disposable batteries.  The rechargeable batteries should be stored in a safe place and should not be stored with metal objects such as keys or coins.

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