Esther Shabtai

Cognitive function in idiopathic generalized epilepsy of childhood

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

Reduced Medial Olivocochlear Bundle System Function in Children with Auditory Processing Disorders

A common complaint of children with auditory processing disorders (APD) is difficulty in understanding speech in the presence of background noise. Evidence from animal and human studies has suggested that the medial olivocochlear bundle (MOCB) may play a role in hearing in noise. The MOCB function can be evaluated by the suppression effect of the transient evoked otoacoustic emissions (TEOAE) in response to contralateral acoustic stimulation (CAS). The present study was conducted to investigate the suppression effect of TEOAE in APD children. The study groups comprised 15 APD children aged 8–13 years associated with learning disabilities and 15 controls matched for gender and age. The suppression effect of TEOAE was evaluated by comparing the TEOAE levels with and without CAS. A significantly reduced suppression effect of TEOAE was demonstrated in the APD group, when compared to the controls. In addition, higher TEOAE levels were found in the APD group, suggesting inherent reduced MOCB activity on the outer hair cells in APD children. These results imply that some APD children present low activity of the MOCB system, which may indicate a reduced auditory inhibitory function and affect their ability to hear in the presence of background noise.

Activation of flexor and extensor trunk muscles in hemiparesis

OBJECTIVEnThe purpose of this work was to study the bilateral activity of trunk flexor and extensor muscles in post-stroke hemiparetic patients.nnnDESIGNnCriterion variables were degree of temporal synchronization and level of electromyographic activity in pertinent muscle pairs during two symmetrical tasks: (1) from reclined sitting, bringing the trunk forward; (2) during upright sitting, shrugging shoulders, and extending back. The recti abdomini and external oblique muscles were tested as prime movers of the first task, and the lumbar erector spinae and latissimus dorsi muscles were tested in the second task. Electromyographic recordings from these muscles during three repetitions of each exercise were used for analysis.nnnRESULTSnCross-correlation analysis pointed to higher temporal synchronization between the abdominal muscles than between the back extensor muscles and in axial compared with para-axial muscles. Differences between patients and controls were found only for the erector spinae muscle pair, which indicates less synchronous activity between the two sides in the patients. The average electromyographic activity level was comparable for corresponding abdominal muscles, both in the patients and in the control subjects. Regarding the back extensor, side differences were detected for the latissimus dorsi muscles in both groups, with the paretic and right side less active in the patients and controls, respectively.nnnCONCLUSIONSnAltogether, the findings do not support the claim of unilateral deficits in the function of trunk muscles in post-stroke hemiparetic patients. They emphasize the need for further characterization of the impairment of trunk extensor and flexor muscles in post-stroke patients.

Evidence for Atypical Auditory Brainstem Responses in Young Children with Suspected Autism Spectrum Disorders.

Aimu2002 The aim of this study was to characterize the auditory brainstem responses (ABRs) of young children with suspected autism spectrum disorders (ASDs) and compare them with the ABRs of children with language delay and with clinical norms.

Repetitive Practice of a Single Joint Movement for Enhancing Elbow Function in Hemiparetic Patients

The primary goal of this study was to assess whether repetitive practice of flexion-extension movements of the affected elbow in hemiparetic patients enhances performance and to compare the effects of this practice mode to the effects of the physical therapy variable exercise program which is routinely applied during sessions. Subjects were 27 poststroke hemiparetic patients, residents of a rehabilitation institute, divided into an experimental (n= 15) and a control group (n = 12). The former were treated with 800 repeated elbow movements in a maximal predetermined amplitude of 80°, provided in 8 equal sessions every other day. The latter received 10 min. of conventional physical therapy for the paretic upper extremity at similar time intervals. Pre- and posttreatment assessments included the bilateral measurements of kinematic variables and activation latencies of the biceps and triceps brachi muscles as well as motor and functional tests. For all criterion variables, the findings pointed to comparable improvement in both groups. It was concluded that repetitive elbow movements had no unique training effect on the kinematics of movement and on activation latencies of the primary muscles controlling elbow function in hemiparetic patients. Further, transfer of the effects of training to execution of movements towards and from the mouth was also comparable in both groups, pointing again to there being no particular advantage in using repetitive movements as a training mode for enhancement of elbow function in hemiparetic patients.

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

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

Identification of Children's Gender and Age by Listeners

OBJECTIVESnVoice carries abundant information about the speaker. This acoustic information changes throughout life. Although the ability of identifying audible cues on a speakers gender and age is considered an intuitive task, little is known about the ability to identify and decipher this perceptual information. Most studies in the field have examined the ability to identify adults gender and age, thus the purpose of the present study was to evaluate listeners ability to identify gender and age of children and adolescents.nnnMETHODSnA total of 120 children in six age groups, 8, 10, 12, 14, 16, and 18 years, were recorded while producing isolated vowels and fixed sentences. The recordings were evaluated by a group of 38 untrained naive listeners, who were asked to identify the speakers gender and age.nnnRESULTSnListeners were able to identify childrens gender at an overall rate of 81.81%. This task was performed more successfully based on recordings of sentences (85.39%) than on isolated vowels (78.22%). Listeners were able to identify the childrens age group at an overall rate of 37.16%. This task was also performed more successfully based on recordings of sentences (39.58%) than on isolated vowels (34.71%). Furthermore, when an error of ±1 age group was allowed, correct responses for age identification exceeded 80%.nnnCONCLUSIONSnListeners have the ability to identify childrens gender and age, based on short audio recordings, even before puberty. The success rates in these perceptual tasks are dependent on the childs age and gender.

Public Information Services in the Field of Communication Disorders: Comparison between Teleservice and E-service

This study evaluates the use of information services in the field of communication disorders by monitoring two communication disorders information services operated in Israel over 8-10 months. One was an E-service and the other was a teleservice. More women than men used the services. Approximately 85% of referrals were judged as appropriate and relevant to the field, and the majority of problems could be treated sufficiently through the service.

Diverticulitis And The Age Factor – Does Age Matter?

Acute diverticulitis has been traditionally associated with worse outcome in young patients, indicating a more aggressive surgical approach is required for them. The aim of this study was to assess whether acute diverticulitis was more virulent in young patients.