Deterioration Of Intelligibility Research Articles

Responsive Versus Continuous Deep Brain Stimulation for Speech in Essential Tremor: A Pilot Study.

Responsive deep brain stimulation (rDBS) uses physiological signals to deliver stimulation when needed. rDBS is hypothesized to reduce stimulation-induced speech effects associated with continuous DBS (cDBS) in patients with essential tremor (ET). To determine if rDBS reduces cDBS speech-related side effects while maintaining tremor suppression. Eight ET participants with thalamic DBS underwent unilateral rDBS. Both speech evaluations and tremor severity were assessed across three conditions (DBS OFF, cDBS ON, and rDBS ON). Speech was analyzed using intelligibility ratings. Tremor severity was scored using the Fahn-Tolosa-Marin Tremor Rating Scale (TRS). During unilateral cDBS, participants experienced reduced speech intelligibility (P = 0.025) compared to DBS OFF. rDBS was not associated with a deterioration of intelligibility. Both rDBS (P = 0.026) and cDBS (P = 0.038) improved the contralateral TRS score compared to DBS OFF. rDBS maintained speech intelligibility without loss of tremor suppression. A larger prospective chronic study of rDBS in ET is justified. © 2024 International Parkinson and Movement Disorder Society.

Effectiveness of an Artificial Intelligence–Enabled Intervention for Detecting Clinical Deterioration

Inpatient clinical deterioration is associated with substantial morbidity and mortality but may be easily missed by clinicians. Early warning scores have been developed to alert clinicians to patients at high risk of clinical deterioration, but there is limited evidence for their effectiveness. To evaluate the effectiveness of an artificial intelligence deterioration model-enabled intervention to reduce the risk of escalations in care among hospitalized patients using a study design that facilitates stronger causal inference. This cohort study used a regression discontinuity design that controlled for confounding and was based on Epic Deterioration Index (EDI; Epic Systems Corporation) prediction model scores. Compared with other observational research, the regression discontinuity design facilitates causal analysis. Hospitalized adults were included from 4 general internal medicine units in 1 academic hospital from January 17, 2021, through November 16, 2022. An artificial intelligence deterioration model-enabled intervention, consisting of alerts based on an EDI score threshold with an associated collaborative workflow among nurses and physicians. The primary outcome was escalations in care, including rapid response team activation, transfer to the intensive care unit, or cardiopulmonary arrest during hospitalization. During the study, 9938 patients were admitted to 1 of the 4 units, with 963 patients (median [IQR] age, 76.1 [64.2-86.2] years; 498 males [52.3%]) included within the primary regression discontinuity analysis. The median (IQR) Elixhauser Comorbidity Index score in the primary analysis cohort was 10 (0-24). The intervention was associated with a -10.4-percentage point (95% CI, -20.1 to -0.8 percentage points; P = .03) absolute risk reduction in the primary outcome for patients at the EDI score threshold. There was no evidence of a discontinuity in measured confounders at the EDI score threshold. Using a regression discontinuity design, this cohort study found that the implementation of an artificial intelligence deterioration model-enabled intervention was associated with a significantly decreased risk of escalations in care among inpatients. These results provide evidence for the effectiveness of this intervention and support its further expansion and testing in other care settings.

Green Technology in Food Processing: Creating a Better Future for the Next Generation

Green is recognised as the colour of fresh leaves, and is often associated with something that is safe for creatures and the environment. There are several definitions of green technology, however the key words in those definitions are minimal impact on environmental pollution, safe for human, and sustainable natural resources. The application of the “green concept” in food technology not only imparts environmentally safe practices, but also produces healthy and nutritious produce. There are several technologies previously applied for non-food purposes that now can also be used for food processing, such as liquid or supercritical carbon dioxide, ultrasonic wave, pulse electric field. It is time to minimise or leave processes that cause environmental pollution pollute the environment to save this earth and next generations. Our next generations cannot be separated from the impacts of food intake, such as deterioration of intelligence and character. Therefore, from now on, we should start swapping to environmentally friendly food technologies.

SAT-357 First Case in Saudi Arabia Revealing Fahr Syndrome Secondary to Hypoparathyroidism: A Case Report

Introduction: Fahr Syndrome is a rare inherited or sporadic neurological disorder. It is characterized as in abnormal calcium deposition or in other words, calcification in the brain which almost always occurs bilaterally. Patients with Fahr syndrome usually presents with neurological symptoms such as seizures, tetany, speech impairment, dementia, deterioration of intelligence, involuntary movements. The etiology of Fahr syndrome is mostly associated with endocrine disorders especially hypoparathyroidism either primary or secondary or pseudo hyperparathyroidism; including adult onset neurodegenerative conditions, infectious disease like intrauterine and perinatal infections or inherited congenital causes are also considered. Clinical Case The authors report a 33-year-old Ethiopian female not known to any medical illness presented with abnormal involuntary left-hand movement, headache and dizziness. Further examination shows positive Chvostek’s and Trousseau’s signs. In addition, laboratory findings reveal decreased levels of serum calcium (1.227 mmol/L, normal range of 2.2-2.65 mmol/L), serum albumin (33.53 mg/dL, normal range of 35-52 g/L) and parathyroid hormone (0.3pmol/L, normal range of 1.1-8.43 pmol/L), decreased vitamin D serum level (14.52 ng/ml, normal range of 30-75 ng/ml). Interestingly, brain imaging shows bilateral symmetrical subcortical white matter, basal ganglia, cerebellar dentate nuclei calcifications. Thus, Fahr syndrome diagnosis was made. She was promptly treated with calcium and vitamin D replacement. Calcium gluconate was given intravenously with oral calcium carbonate and oral cholecalciferol. The patient recovered with this treatment leading to positive results without any recurring symptoms.INTERNAL Conclusion In conclusion, Fahr syndrome is a rare sequel of hypoparathyroidism, mostly presented with neurological symptoms due to hypocalcemia which after correction subdues the occurring manifestation such as in this case presented. Early diagnosis of Fahr syndrome due to hypoparathyroidism is crucial for prompt treatment and reversal of symptoms also to prevent complications.INTERNAL

Handedness, cognitive processing and intelligence in patients with epilepsy

Summary Introduction. The current knowledge of significance of some neurobiological and clinical variables for the development of cognitive deterioration in patients with epilepsy remains sparse and controversial. Aim. The current study has been carried out in order to elucidate the role of handedness in terms of influence on cognitive processing and intelligence in patients with epilepsy. Material and methods. One hundred and thirty two patients (62 males, 70 females, aged 27.8 ± 8.9 years) with epilepsy participated in the study. Patients were divided into two groups. The first group included 112 patients that were characterized by intelligence and cognitive impairment while the second group (20 patients) had no mental deterioration and was regarded as controls. The two diagnostic categories accorded with ICD-10 criteria. The diagnosis of Dementia (F-02.8) was confirmed in 54 patients, while the diagnosis of Mild Cognitive Impair- ment (F-06.7) was confirmed in 58 patients. Results. Our results show that the level of left-handers among patients with cognitive Impairment achieved 14.2%, whilst in the group without cognitive deterioration there were no left-handers, and this difference was statistically significant (p = 0.051). An analysis of possible influence of motor lateralization on degree of cognitive deterioration, revealed that left-handedness determines the higher degrees of intelligence deterioration com- pared with right-handedness (χ 2 = 6.64; p < 0,05). These data were confirmed by use of Wechsler Adult Intelli- gence Scale (WAIS) and the Mini Mental State Examination (MMSE) tests, and all left-handed epilepsy patients achieved lower scores on MMSE, total WAIS, as well as verbal and nonverbal WAIS scores. Conclusion. Our data confirm a role of some neurobiological variables, with emphasis on cerebral motor lat- eralization, in their influence upon intelligence level and cognitive deterioration in epilepsy. These data may be used for predictive purposes of intelligence assessment in patients with epilepsy.

1328 – Postradiation intelligence impairment

Background Cognitive impairment in the remote period of Acute Radiation Sickness (ARS) is an expected outcome. Aim This study was undertaking to examine the contribution of irradiation on the intelligence deterioration. Methods In 14-15 years after the Chernobyl accident a cross-sectional IQ-study on ARS-patients (n = 29) and normal controls (n = 24) was done. Verbal (VIQ), Performance (PIQ) and Full (FIQ) IQs were assessed by adapted version of the Wechsler Adult Intelligence Scale (WAIS). Pre-exposure IQ was estimated with the regression equation by Dr. Beilin Gao (China). Results VIQ and FIQ is lower in ARS-patients. Dose of 1 Gy could be realized in FIQ deterioration on 4.1-6 scores at 1-3.8 Gy. FIQ reducing on 1 score could be resulted by 0.17-0.24 Gy. According to pre-exposure IQ estimations, IQ deterioration in ARS-patients is in 2-3 times much more than in control. In ARS-patients this IQ deterioration is significant (more than SD). Non-radiation confounding factors are analyzed. Conclusions Refusal of alternative explanations of the cognitive deficit among ARS-patients could testify to radiation nature of this effect. Reducing of VIQ and FIQ are the evidence of brain organic syndrome with paramount involvement of the left, dominating, hemisphere in the remote period of ARS.

Hemispherectomy: a basis for mental development in children with epilepsy

To detect change in mental development or intelligence over two years following hemispherectomy in children with pharmacologically intractable epilepsy. Seventeen infants and preschoolers (median age at epilepsy onset of 0.0 years and at hemispherectomy 1.5 years; epilepsy duration of 0.2-2.6 years) and 12 older children (median age at onset of 1.0 year and at hemispherectomy 8.3 years; epilepsy duration of 1.1-11.7 years) with pharmacologically intractable seizures due to developmental, acquired or progressive pathology. Prospective study with consecutive inclusion of children, fixed assessment intervals (shortly before and 6, 12 and 24 months after hemispherectomy) and assessment using developmental scales and intelligence scales. Dependent variables included mental developmental index (MDI), mental age (MA) and mental developmental delay (MDD) in younger children and intelligence quotient (IQ) in older children. Mental development had arrested or deteriorated prior to hemispherectomy in 14 children (82%) assessed with developmental scales. In 14 children, it was not possible to more precisely determine MDI than "below the lowest MDI that the test manual provided" either before or after hemispherectomy. MA, however, increased in 16 children. Overall, IQ changed negligibly over two years after hemispherectomy, although an individual approach revealed variability. Children with Rasmussen encephalitis did not recover from the significant presurgical deterioration of intelligence. Removal of the affected hemisphere enables epileptic children, even those with severe mental delay, to further develop mentally.

Perception of speech disorders: Difference between the degree of intelligibility and the degree of severity

AbstractObjective: In the clinical practice of speech disorders, trained listeners are often used as judges for scaling procedures in the perceptual assessment of a speech signal. The aim of this paper is to study how a group of experts performs a task of severity judgment compared with a task of intelligibility judgment. Study design: During an off-line experiment, 33 stimuli were presented as icons on a Powerpoint slide. Each icon was associated with a line allowing scoring of each stimulus heard by a simple click on it; each stimulus was judged in terms of voice, resonance, prosody and phonemic qualities. With an analogical scale placed at the bottom of the screen, the judges were asked to put a copy of the icon along the line; the space above the line was used for severity and the one under the line for the deterioration of intelligibility, the arrow being oriented on the right side for the ‘most severe’ or ‘the least intelligible’ and representing a range from 1 to 30. Results: The mean scores of sev...

Deterioration of intelligence in methamphetamine‐induced psychosis: Comparison with alcohol dependence on WAIS‐III

Long-term use of methamphetamine could induce psychosis, but consequences with regards to intelligence have seldom been investigated. Long-term use of alcohol could also result in intellectual deterioration. The IQ of 34 methamphetamine-induced psychosis (MIP) patients (age, 28.7 +/- 6.1 years) and 34 alcohol-dependent (AD) patients (age, 40.7 +/- 7.3 years) was compared using the Chinese version of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). The average full-scale IQ, verbal IQ, performance IQ, verbal comprehension index, working memory index, perceptual organization index, and processing speed index was 82.3 +/- 10.8, 84.3 +/- 11.9, 81.9 +/- 12.1, 85.5 +/- 11.9, 84.7 +/- 12.5, 85.4 +/- 13.6, and 78.5 +/- 12.7 in MIP patients and 90.5 +/- 12.0, 95.2 +/- 11.3, 86.0 +/- 13.7, 95.5 +/- 11.0, 87.1 +/- 14.5, 96.2 +/- 13.1, and 84.5 +/- 15.0 in AD patients, respectively. There were six MIP patients (17.6%) whose full-scale IQ was <70 and 13 (38.2%) whose full-scale IQ was <85 and >70, while one AD patient had a full-scale IQ <70 (2.9%) and 10 (22%) had full-scale IQ <85 and >70. Long-term use of methamphetamine can result not only in psychosis, but also in mentality deterioration. Intelligence deterioration is more severe in clinical MIP patients than AD patients. Assessment of the mentality of MIP patients is suggested to help with the implementation of rehabilitative programs for these patients.

Perceptual Reinforcement of Speech Signal Based on Partial Specific Loudness

In the presence of background noise, the perceptual loudness of speech signal significantly decreases, resulting in the deterioration of intelligibility and clarity. In this letter, we propose a novel approach to enhance the perceived quality of the speech signal when the additive noise cannot be directly controlled. Instead of controlling the background noise, we propose to reinforce the speech signal so that it can be heard more clearly in noisy environments. To find a suitable reinforcement rule, the loudness perception model proposed by Moore et al. is adopted. Experimental results show that the loudness of the reinforced signal can be maintained at the level almost the same as that of the original noise-free speech, and the proposed algorithm can enhance the perceived speech quality under various noise environments.

Presbyacousie

Presbyacusis, or age-related hearing loss, is the most common cause of acquired sensorineural hearing loss on adults. Age-related in hearing is multifactorial, involving both genetic and environmental factors, among them noise exposure is important. There is a large interindividual variation for the age of installation of presbyacusia and its evolution. The diagnosis is established in case a bilateral and symmetrical sensorineural deafness is observed, prevalent on the acute frequencies. The deterioration of intelligibility in vocal audiometry is a prognostic element. The optimal treatment is based on a bilateral and early audio prosthesis. In some cases, auditory rehabilitation may benefit from a multidisciplinary management that comprises orthophonic rehabilitation and psychological support. In the absence of improvement, age is not a contraindication to the implementation of middle ear or cochlear implant.

Aural Habilitation Update: The Role of Speech Production Skills of Infants and Children With Hearing Loss

Aural Habilitation Update: The Role of Speech Production Skills of Infants and Children With Hearing Loss

Intervention Decision-Making for Persons with Amyotrophic Lateral Sclerosis

Intervention Decision-Making for Persons with Amyotrophic Lateral Sclerosis

Long-term intelligence outcome of post-encephalo-duro-arterio-synangiosis childhood Moyamoya patients

Long term post-encephalo-duro-arterio-synangiosis (EDAS) intelligence quotient (IQ) evaluated by Wechsler tests stays around the normal range (mean full intelligence quotient (FIQ), verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ) at 100.0±155, 100.0±15.7 and 100.2±163, respectively) at more than 9.5 years after the operation, provided that the patient has FIQ above 70 pre-operatively. This fact encourages us to employ operative treatment for this difficult disease in which intelligence deterioration has been reported to be a common occurrence.

Asymmetrical blood flow in the temporal lobe in the Charles Bonnet syndrome: serial neuroimaging study.

Clinical features and results of neuroimagings of an 86 year old woman with the Charles Bonnet syndrome are reported. She had become completely blind bilaterally due to cataracts and glaucoma. Shortly after an operation for cataracts, she developed visual hallucinations which lasted for 22 years. She had no deterioration of intelligence. Computed tomography (CT) and magnetic resonance imaging (MRI) showed moderate generalized atrophy, particularly of the temporal lobes. A serial single photon emission computed tomography (SPECT) study during visual hallucinations demonstrated hyperperfusion in the left temporal region and the basal ganglia and hypoperfusion in the right temporal region. These findings suggest that asymmetrical blood flow, particularly in the temporal regions, may be correlated with visual hallucination in the Charles Bonnet syndrome.

Asymmetrical Blood Flow in the Temporal Lobe in the Charles Bonnet Syndrome: Serial Neuroimaging Study

Clinical features and results of neuroimagings of an 86 year old woman with the Charles Bonnet syndrome are reported. She had become completely blind bilaterally due to cataracts and glaucoma. Shortly after an operation for cataracts, she developed visual hallucinations which lasted for 22 years. She had no deterioration of intelligence. Computed tomography (CT) and magnetic resonance imaging (MRI) showed moderate generalized atrophy, particularly of the temporal lobes. A serial single photon emission computed tomography (SPECT) study during visual hallucinations demonstrated hyperperfusion in the left temporal region and the basal ganglia and hypoperfusion in the right temporal region. These findings suggest that asymmetrical blood flow, particularly in the temporal regions, may be correlated with visual hallucination in the Charles Bonnet syndrome.

Vascular Dementia

Vascular dementia is almost always associated with organic brain lesions due to ischemia, not with arteriosclerosis alone. In Japan, more than 50% of dementia in population older than 65 years are of vascular origin. Vascular dementia occurs with diffuse vascular lesions in the cerebral white matter or circumscribed lesions in particular areas such as the thalamus, anterior limb of the internal capsule, and cingulate gyrus, all of which constitute the ascending activating system or the limbic system. Vascular dementia is clinically characterized by stepwise progression, fluctuating course and predominant deterioration of intelligence with relative preservation of personality. Reversibility, disproportionate impairment of intelligence and personality, and dementia caused by a focal lesion observed in vascular dementia pose problems with regard to the classical concept of dementia. The similarity and difference between remitting dementia and disturbance of consciousness remain to be scrutinized.

Rett syndrome in China: Report of 9 patients

This is the first report of Rett syndrome in China. Clinical and laboratory data were obtained from 9 girls with Rett syndrome. In addition to the previously reported clinical manifestations (i.e., early deterioration of intelligence, microcephaly, peculiar stereotypic hand movements, and epilepsy), 2 other features were observed in these patients: abnormal evoked response audiometry and low content of the elements, copper and zinc in the hair. The cause of these associated phenomena is unknown.

Communication disorders in Legionnaires' disease.

ABSTRACTAlthough dysarthria has often been noted in Legionnaires' disease sufferers, description of its components has been scarce. Speech production ability was assessed in four long‐standing cases using the Frenchay Dysarthria Assessment and some supplementary measures. Present in all subjects were deterioration in intelligibility, slow speaking rate, articulatory errors with the tongue the most involved of the articulators, and disruption of respiratory, laryngeal and swallow mechanisms. Cerebellar signs were evident in all subjects but the overall dysarthria pattern did not correspond closely with ataxic dysarthric features. Reference to aphasia is also made in the Legionnaires' disease literature, but the Token Test, Graded Naming Test and the reading and writing tests of the Western Aphasia Battery did not reveal language deficiency in any of the subjects.

Intelligibility at High Voice Levels and the Use of a Megaphone

A small megaphone was tested for use in direct voice communication high levels of vocal output against backgrounds of noise. Intelligibility scores were determined for 12 talkers, speaking with and without the megaphone, over a range of field voice levels of 70 to 100 db SPL (at 1 m). Nearly the entire over-all acoustical gain produced by the megaphone was realized in improved intelligibility above backgrounds of white noise and low-frequency noise. The acoustical gain of the megaphone permitted a lower voice level, and, hence, delayed the deterioration in intelligibility associated with distortions due to shouting. Frequency shifts in the voice spectrum were measured, with and without the megaphone, over a range of vocal efforts from conversational to maximum shout. Control tests demonstrated that the voice-frequency shifts associated with shouting are not the primary factor in the deterioration of intelligibility; the frequency shifts appear to be only symptomatic of serious vocal distortions in shouting.