Displaying publications 21 - 40 of 45 in total

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  1. Awang MA, Zamri NN, Wan Mohamad WN, Zakaria MN
    Int J Adolesc Med Health, 2019 Mar 16;33(4).
    PMID: 30875322 DOI: 10.1515/ijamh-2018-0148
    INTRODUCTION: Acoustic reflex (AR) is a valuable clinical test for hearing diagnosis. Parameters of AR such as its amplitude and threshold have been commonly reported in research. Acoustic reflex latency (ARL) has not been widely studied and more research is warranted to determine its basic properties and clinical usefulness. The present study aimed to determine the influences of stimulation mode and stimulus frequency on ARL.

    METHODS: In this study, 52 healthy young adults were enrolled (mean age = 23.2 ± 0.8 years, 61.8% were males). They underwent the standard AR testing and ARL values were computed. Both ipsilateral and contralateral recordings were made at 500, 1000, 2000 and 4000 Hz frequencies.

    RESULTS: The ARL values obtained are consistent with the findings from the previous studies. Two-way analysis of variance (ANOVA) revealed that the ARL values were not statistically influenced by either stimulation mode (p = 0.061) or stimulus frequency (p = 0.598).

    CONCLUSION: Among young adults, ARL does not appear to be influenced by stimulation mode and stimulus frequency. Further large scale research is warranted to support the present study's findings. The preliminary normative data for ARL obtained in this study can serve as the reference for future research involving this particular population.

  2. Jalaei B, Azmi MHAM, Zakaria MN
    Braz J Otorhinolaryngol, 2018 05 17;85(4):486-493.
    PMID: 29858160 DOI: 10.1016/j.bjorl.2018.04.005
    INTRODUCTION: Binaurally evoked auditory evoked potentials have good diagnostic values when testing subjects with central auditory deficits. The literature on speech-evoked auditory brainstem response evoked by binaural stimulation is in fact limited. Gender disparities in speech-evoked auditory brainstem response results have been consistently noted but the magnitude of gender difference has not been reported.

    OBJECTIVE: The present study aimed to compare the magnitude of gender difference in speech-evoked auditory brainstem response results between monaural and binaural stimulations.

    METHODS: A total of 34 healthy Asian adults aged 19-30 years participated in this comparative study. Eighteen of them were females (mean age=23.6±2.3 years) and the remaining sixteen were males (mean age=22.0±2.3 years). For each subject, speech-evoked auditory brainstem response was recorded with the synthesized syllable /da/ presented monaurally and binaurally.

    RESULTS: While latencies were not affected (p>0.05), the binaural stimulation produced statistically higher speech-evoked auditory brainstem response amplitudes than the monaural stimulation (p<0.05). As revealed by large effect sizes (d>0.80), substantive gender differences were noted in most of speech-evoked auditory brainstem response peaks for both stimulation modes.

    CONCLUSION: The magnitude of gender difference between the two stimulation modes revealed some distinct patterns. Based on these clinically significant results, gender-specific normative data are highly recommended when using speech-evoked auditory brainstem response for clinical and future applications. The preliminary normative data provided in the present study can serve as the reference for future studies on this test among Asian adults.

  3. Mohd Normani Z, Wan Suhailah WH, Nik Adilah NO
    Med J Malaysia, 2018 02;73(1):7-8.
    PMID: 29531196 MyJurnal
    INTRODUCTION: Tinnitus is a common complaint among patients with ear diseases and can be serious if not treated. Recently, a Malay tinnitus questionnaire, known as the "Borang Evaluasi Soal selidik Tinnitus" (BEST) had been developed and preliminarily validated among Malayspeaking population. The aims of the present study were to determine the test-retest reliability and responsiveness of the BEST questionnaire.

    METHOD: Forty-six Malay adults (aged 23-74 years) with tinnitus were enrolled. They were instructed to fill in the BEST questionnaire accordingly. After one week, 21 of them were asked to fill in the questionnaire again. The other 25 subjects underwent tinnitus intervention for three months and following this; the BEST was administered to them again.

    RESULTS: In the test-retest reliability task, the intraclass correlation values obtained were acceptably high (0.70-0.90). After the intervention, significant differences in the BEST result were found in the mind domain, main domain and composite score (p<0.05) with moderate effect sizes (0.61- 0.70).

    CONCLUSION: The test-retest reliability of the BEST was found to be good. It also showed good responsiveness to intervention. The clinical usefulness of the BEST in assessing patients with tinnitus was further supported by the present study.

  4. Zakaria MN, Salim R, Anual MSI, Patuzzi R
    Ear Hear, 2024 Feb 22.
    PMID: 38383959 DOI: 10.1097/AUD.0000000000001497
    OBJECTIVE: Various studies have been conducted to search for the most optimal stimulus for eliciting cervical vestibular evoked myogenic potential (cVEMP). More recently, there is a growing interest to study the usefulness of chirp stimuli in cVEMP recording. Nevertheless, contradictory outcomes have been reported across the studies, and further research with larger samples would be beneficial to provide better insight into this matter. As such, the present study was carried out to compare cVEMP results between narrowband (NB) CE-Chirp (centered at 500 Hz) and 500 Hz tone burst stimuli.

    DESIGN: In this study that employed a comparative study design, 98 normally hearing adults aged between 19 and 24 years were enrolled. All of them underwent the cVEMP testing based on the recommended test protocol. The stimuli were a 500 Hz tone burst and a NB CE-Chirp (360-720 Hz) presented through insert earphones at an intensity level of 120.5 dB peSPL.

    RESULTS: For each stimulus, cVEMP results did not differ significantly between the ears (p > 0.05). Relative to the 500 Hz tone burst, the NB CE-Chirp stimulus produced statistically shorter P1 and N1 latencies (p < 0.001). On the other hand, P1-N1 amplitude was found to be comparable between the two stimuli (p > 0.05).

    CONCLUSIONS: The present study did not find any supporting evidence that the NB CE-Chirp stimulus (centered at 500 Hz) outperformed the conventional 500 Hz tone burst in the cVEMP testing. Both stimuli are considered equally appropriate to record cVEMP responses in clinical settings.

  5. Mohd Mossadeq N, Mohd Khairuddin KA, Zakaria MN
    J Voice, 2024 Nov;38(6):1527.e27-1527.e35.
    PMID: 35760635 DOI: 10.1016/j.jvoice.2022.05.018
    Auditory-perceptual rating of voice is one component of voice evaluation, and the CAPE-V is one of the tools for this purpose. Because of its advantages, the CAPE-V has been adapted into several languages. Accordingly, the adaptation of the CAPE-V into Malay is essential for its utility among the Malaysian population, which this study aimed to accomplish. This study involved translating the CAPE-V into Malay, termed the Malay CAPE-V, followed by establishing its validity. The translation processes (ie, forward translation and backward translation) involved four different translators ie, three speech-language therapists (SLTs), and one linguist with at least 14 years of experience. Most items were similarly translated, except for a few, which were subsequently accepted as similar, following consensus among the translators. In the examination of content validity, two raters (ie, SLTs) with at least 12 years of clinical experience reviewed and scored the tested items. Given that the scale-level content validity index average value (S-CVI/Ave) was above the acceptable level, all items were retained. The examination of construct validity and concurrent validity involved ratings of voice samples recorded from 38 participants, comprising 19 individuals with normal and disordered voices, respectively. The ratings were performed by three raters (ie, SLTs) with at least 12 years of clinical experience. For the construct validity, the Mann-Whitney U test indicated significantly higher scores of the vocal parameters of the Malay CAPE-V for the disordered voice group than for the normal voice group. Meanwhile, for the concurrent validity, the Spearman correlation indicated that all relationships between the scores of the vocal parameters of the Malay CAPE-V and GRBAS Scale were significant, with most of them achieving a very strong positive correlation. The results demonstrated that the Malay CAPE-V is a valid tool for an auditory-perceptual rating of voice among the Malaysian population.
  6. Nurul Nabila Binti Mohtar, Wan Ahmad Wan Aslynn, Mohd Normani Zakaria, Nor Haniza Abdul Wahat, Nurul Syarida Bt Mohd Sakeri
    MyJurnal
    The purpose of this study was to translate and adapt the Vestibular Rehabilitation Benefit Questionnaire (VRBQ) into Malay (My-VRBQ). This is to add on to the limited number of
    vestibular questionnaire available in Malay version. After the permission from the original
    author was obtained, the process of adaptation began with forward-translation by the author with
    audiological background and a linguistic expert. Then, the process of backward translation into
    English were completed by three bilinguals who were proficient in both Malay and English. The final version of the draft was evaluated for its content validity, which was conducted by five professionals with audiological or speech pathology backgrounds. Additionally, its face validity was determine amongst 32 respondents with diverse backgrounds. Ten participants diagnosed with vestibular problems were recruited in the My-VRBQ for internal consistency validation process. They were enlisted from two hospitals in the East Coast of Malaysia. Based on the comments and
    suggestions made by the validators; some changes in terms of the appropriateness of the instructions, items and the sentence structure were made. In the consistency analysis, the My-VRBQ revealed good internal consistency based on Cronbach alpha values (0.77 to 0.96). A translated and validated My-VRBQ has the potential to be used clinically to document vestibular rehabilitation benefits. Nevertheless, future studies are encouraged to further support the present study findings.
  7. Abdul Wahab NA, Wahab S, Abdul Rahman AH, Sidek D, Zakaria MN
    Psychiatry Investig, 2016 Jan;13(1):82-8.
    PMID: 26766950 DOI: 10.4306/pi.2016.13.1.82
    Electrophysiological studies, which are mostly focused on afferent pathway, have proven that auditory processing deficits exist in patients with schizophrenia. Nevertheless, reports on the suppressive effect of efferent auditory pathway on cochlear outer hair cells among schizophrenia patients are limited. The present, case-control, study examined the contralateral suppression of transient evoked otoacoustic emissions (TEOAEs) in patients with schizophrenia.
  8. Wahab S, Zakaria MN, Sidek D, Abdul Rahman AH, Shah SA, Abdul Wahab NA
    Psychiatry Res, 2015 Aug 30;228(3):462-7.
    PMID: 26142835 DOI: 10.1016/j.psychres.2015.06.014
    The Psychotic Symptom Rating Scales (PSYRATS) is the most widely used validated scale to measure the specific symptoms of auditory hallucination and delusion. The aim of this study was to validate and to examine the psychometric properties of the auditory hallucination component of the Malay PSYRATS (MyPSYRATS). The research was done in the Universiti Kebangsaan Malaysia Medical Center (UKMMC) among 51 schizophrenia inpatients and outpatients who had experienced or reported verbal auditory hallucination. The psychometric properties of MyPSYRATS (auditory hallucination) were studied and a comparison was made between the psychometric properties obtained and the Positive and Negative Syndrome Scale (PANSS). The internal consistency of MyPSYRATS was good as revealed by Cronbach's alpha value. Factor analysis replicated three components (emotional, cognitive, and physical) similar to the factorial structure of the original auditory hallucination scale. However, two items were regrouped under the emotional component. Spearman's rank-order correlation showed a significant positive relationship between the total score of auditory hallucinations and PANSS auditory hallucinations item (P3). In conclusion, the auditory hallucination domain of MyPSYRATS is a reliable and valid assessment tool for further clinical applications.

    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  9. Wan Suhailah WH, Mohd Normani Z, Nik Adilah NO, Azizah O, Aw CL, Zuraida Z
    Med J Malaysia, 2015 Jun;70(3):188-97.
    PMID: 26248783 MyJurnal
    INTRODUCTION: The aim of this article was to review the types of psychological interventions for patients with tinnitus, professionals involved in giving the intervention, the effectiveness of each method of interventions and comparisons with non-psychological approaches in treating tinnitus.

    MATERIALS AND METHODS: PubMed database searched.

    RESULTS: Twenty one articles that employed randomized controlled trials design were included. Cognitive behavioural therapy (CBT) was the most common intervention conducted by the researchers. Clinical psychologists and trainee psychologists were the most professionals involved in the therapy. The length of therapy ranged from six weeks to three months.

    DISCUSSION: Psychological interventions were more effective in reducing psychological impacts of tinnitus than non-psychological interventions such as the use of tinnitus maskers. Nevertheless, the combination of the treatments yielded more superior outcomes.

    CONCLUSION: A simplified version of psychological intervention that can be implemented by other clinical professionals should be developed to treat tinnitus holistically to overcome the shortage number of clinical psychologists.
  10. Ismail AI, Abdul Majid AH, Zakaria MN, Abdullah NAC, Hamzah S, Mukari SZS
    Int J Pediatr Otorhinolaryngol, 2018 Jun;109:78-84.
    PMID: 29728190 DOI: 10.1016/j.ijporl.2018.03.030
    OBJECTIVE: The current study aims to examine the effects of human resource (measured with the perception of health workers' perception towards UNHS), screening equipment, program layout and screening techniques on healthcare practitioners' awareness (measured with knowledge) of universal newborn hearing screening (UNHS) in Malaysian non-public hospitals.

    METHODS: Via cross sectional approach, the current study collected data using a validated questionnaire to obtain information on the awareness of UNHS program among the health practitioners and to test the formulated hypotheses. 51, representing 81% response rate, out of 63 questionnaires distributed to the health professionals were returned and usable for statistical analysis. The survey instruments involving healthcare practitioners' awareness, human resource, program layout, screening instrument, and screening techniques instruments were adapted and scaled with 7-point Likert scale ranging from 1 (little) to 7 (many). Partial Least Squares (PLS) algorithm and bootstrapping techniques were employed to test the hypotheses of the study.

    RESULTS: With the result involving beta values, t-values and p-values (i.e. β=0.478, t=1.904, p<0.10; β=0.809, t=3.921, p<0.01; β= -0.436, t=1.870, p<0.10), human resource, measured with training, functional equipment and program layout, are held to be significant predictors of enhanced knowledge of health practitioners. Likewise, program layout, human resource, screening technique and screening instrument explain 71% variance in health practitioners' awareness. Health practitioners' awareness is explained by program layout, human resource, and screening instrument with effect size (f2) of 0.065, 0.621, and 0.211 respectively, indicating that program layout, human resource, and screening instrument have small, large and medium effect size on health practitioners' awareness respectively. However, screening technique has zero effect on health practitioners' awareness, indicating the reason why T-statistics is not significant.

    CONCLUSION: Having started the UNHS program in 2003, non-public hospitals have more experienced and well-trained employees dealing with the screening tools and instrument, and the program layout is well structured in the hospitals. Yet, the issue of homogeneity exists. Non-public hospitals charge for the service they render, and, in turn, they would ensure quality service, given that they are profit-driven and/or profit-making establishments, and that they would have no option other than provision of value-added and innovative services. The employees in the non-public hospitals have less screening to carry out, given the low number of babies delivered in the private hospitals. In addition, non-significant relationship between screening techniques and healthcare practitioners' awareness of UNHS program is connected with the fact that the techniques that are practiced among public and non-public hospital are similar and standardized. Limitations and suggestions were discussed.

  11. Jalaei B, Zakaria MN, Mohd Azmi MH, Nik Othman NA, Sidek D
    Ann Otol Rhinol Laryngol, 2017 Apr;126(4):290-295.
    PMID: 28177264 DOI: 10.1177/0003489417690169
    OBJECTIVES: Gender disparities in speech-evoked auditory brainstem response (speech-ABR) outcomes have been reported, but the literature is limited. The present study was performed to further verify this issue and determine the influence of head size on speech-ABR results between genders.

    METHODS: Twenty-nine healthy Malaysian subjects (14 males and 15 females) aged 19 to 30 years participated in this study. After measuring the head circumference, speech-ABR was recorded by using synthesized syllable /da/ from the right ear of each participant. Speech-ABR peaks amplitudes, peaks latencies, and composite onset measures were computed and analyzed.

    RESULTS: Significant gender disparities were noted in the transient component but not in the sustained component of speech-ABR. Statistically higher V/A amplitudes and less steeper V/A slopes were found in females. These gender differences were partially affected after controlling for the head size.

    CONCLUSIONS: Head size is not the main contributing factor for gender disparities in speech-ABR outcomes. Gender-specific normative data can be useful when recording speech-ABR for clinical purposes.

  12. Zakaria MN, Salim R, Tahir A, Zainun Z, Mohd Sakeri NS
    Clin Otolaryngol, 2019 03;44(2):166-171.
    PMID: 30411501 DOI: 10.1111/coa.13255
    OBJECTIVES: Subjective visual vertical (SVV) is a simple, quick and reliable test for measuring utricular function. The literature on the effects of fundamental demographic variables such as age and gender on SVV is inconclusive and should be supported by research with larger samples. The aim of the present study was to determine the influences of age, gender and geometric pattern of visual image on SVV among healthy adults.

    STUDY DESIGN: This study employed a repeated measures design.

    SETTINGS: Otorhinolaryngology Clinic, Hospital Universiti Sains Malaysia, Malaysia.

    PARTICIPANTS: Eligible Malaysian adults (N = 187, aged 21-75 years) were recruited and categorised into young (N = 60), middle-aged (N = 66) and older (N = 61) groups. Most of them were Malay, and 51.3% were men.

    MAIN OUTCOME MEASURES: Subjective visual vertical angles (in degrees) were determined from each participant in a static upright condition using a computerised SVV device. They were asked to indicate their verticality perception for three types of visual images (solid line, dotted line and arrow pattern).

    RESULTS: Three-way mixed ANOVA revealed insignificant influences of age and gender on SVV results (P > 0.05). In contrast, mean SVV angles were significantly higher for the arrow pattern than for other visual images (P = 0.004).

    CONCLUSION: While the insignificant influences of age and gender on static SVV are further ascertained with larger samples, the perception of verticality is less accurate when aligning a more geometrically complex visual image (ie, arrow pattern). Further SVV research on vestibular-disordered patients is beneficial, particularly to verify the normative data obtained with this complex visual image.

  13. Zakaria MN, Wahat NHA, Zainun Z, Sakeri NSM, Salim R
    J Audiol Otol, 2020 Apr;24(2):107-111.
    PMID: 31995977 DOI: 10.7874/jao.2019.00297
    The present study aimed to determine the test-retest reliability of subjective visual horizontal (SVH) testing when tested with solid and dotted line images. In this repeated measures study, 36 healthy young Malaysian adults (mean age=23.3±2.3 years, 17 males and 19 females) were enrolled. All of them were healthy and had no hearing, vestibular, balance, or vision problems. The SVH angles were recorded from each participant in an upright body position using a computerized device. They were asked to report their horizontality perception for solid and dotted line images (in the presence of a static black background). After 1 week, the SVH procedure was repeated. The test-retest reliability of SVH was found to be good for both solid line [intraclass correlation (ICC)=0.80] and dotted line (ICC=0.78). As revealed by Bland-Altman plots, for each visual image, the agreements of SVH between the two sessions were within the clinically accepted criteria (±2°). The SVH testing was found to be temporally reliable, which can be clinically beneficial. Both solid and dotted lines in the SVH testing are reliable to be used among young adults.
  14. Mukari SZS, Umat C, Chan SC, Ali A, Maamor N, Zakaria MN
    J Audiol Otol, 2020 Jan;24(1):35-39.
    PMID: 31914504 DOI: 10.7874/jao.2019.00262
    BACKGROUND AND OBJECTIVES: The cortical auditory evoked potential (CAEP) is a useful objective test for diagnosing hearing loss and auditory disorders. Prior to its clinical applications in the pediatric population, the possible influences of fundamental variables on the CAEP should be studied. The aim of the present study was to determine the effects of age and type of stimulus on the CAEP waveforms.

    Subjects and METHODS: Thirty-five healthy Malaysian children aged 4 to 12 years participated in this repeated-measures study. The CAEP waveforms were recorded from each child using a 1 kHz tone burst and the speech syllable /ba/. Latencies and amplitudes of P1, N1, and P2 peaks were analyzed accordingly.

    RESULTS: Significant negative correlations were found between age and speech-evoked CAEP latency for each peak (p< 0.05). However, no significant correlations were found between age and tone-evoked CAEP amplitudes and latencies (p>0.05). The speech syllable /ba/ produced a higher mean P1 amplitude than the 1 kHz tone burst (p=0.001).

    CONCLUSIONS: The CAEP latencies recorded with the speech syllable became shorter with age. While both tone-burst and speech stimuli were appropriate for recording the CAEP, significantly bigger amplitudes were found in speech-evoked CAEP. The preliminary normative CAEP data provided in the present study may be beneficial for clinical and research applications in Malaysian children.

  15. Ahmad SA, Abdul Wahat NH, Zakaria MN, Wiener-Vacher SR, Abdullah NA
    Int J Pediatr Otorhinolaryngol, 2020 Aug;135:110132.
    PMID: 32502914 DOI: 10.1016/j.ijporl.2020.110132
    OBJECTIVE: Vestibular assessments in children are essential for the early identification of vestibular and balance dysfunctions. Vestibular evoked myogenic potentials, cervical (cVEMPs) and ocular (oVEMPs) have been reported to be feasible and effective when assessing otolith function in children. The main aim of the study was to obtain normative data for cVEMPs and oVEMPs from preschool and primary school-aged Malaysian children.

    METHODS: A group of 33 healthy children, aged from 5 years 9 months-12 years 4 months (mean ± SD = 8.83 ± 1.92 years), was recruited. Their otolith saccular function was assessed using 750 Hz tone burst for cVEMPs (with ER3A insert phone), while their utricular function was assessed using Brüel & Kjaer Mini-shaker Type 4810 (Naerum, Denmark) for oVEMPs.

    RESULTS: For cVEMPs, the mean value of P13 latency, N23 latency, P13-N23 interamplitude and asymmetry ratio were 12.62 ± 1.38 ms, 19.85 ± 1.95 ms, 92.47 ± 50.35 μV and 14.03 ± 9.75%, respectively. For oVEMPs, the mean value of N10 latency, P15 latency, N10-P15 interamplitude and asymmetry ratio were 9.23 ± 1.07 ms, 14.41 ± 1.04 ms, 10.32 ± 5.65 μV and 15.84 ± 11.49%, respectively. Two-way ANOVA analysis found that ear laterality and gender had no significant effect on all cVEMPs and oVEMPs parameters. No significant correlation was found between age and all VEMPs parameters.

    CONCLUSIONS: The normative data for cVEMPs and oVEMPs obtained in this study can be used as a guide by health professionals to assess saccular and utricular functions among children age from 5 to 12 years of age.

  16. Dzulkarnain AAA, Salamat S, Shahrudin FA, Jamal FN, Zakaria MN
    J Audiol Otol, 2021 Oct;25(4):199-208.
    PMID: 34425654 DOI: 10.7874/jao.2021.00248
    BACKGROUND AND OBJECTIVES: No known studies have investigated the influence of stimulus polarity on the Auditory Brainstem Response (ABR) elicited from level-specific (LS) chirp. This study is important as it provides a better understanding of the stimulus polarity selection for ABR elicited from LS chirp stimulus. We explored the influence of stimulus polarity on the ABR from LS chirp compared to the ABR from click at 80 dBnHL in normal-hearing adults.

    SUBJECTS AND PURPOSE: Nineteen adults with normal hearing participated. The ABRs were acquired using click and LS chirp stimuli using three stimulus polarities (rarefaction, condensation, and alternating) at 80 dBnHL. The ABRs were tested only on the right ear at a stimulus rate of 33.33 Hz. The ABR test was stopped when the recording reached the residual noise level of 0.04 µV. The ABRs amplitudes, absolute latencies, inter-peak latencies (IPLs), and the recorded number of averages were statistically compared among ABRs at different stimulus polarities and stimuli combinations.

    RESULTS: Rarefaction polarity had the largest ABR amplitudes and SNRs compared with other stimulus polarities in both stimuli. There were marginal differences in the absolute latencies and IPLs among stimulus polarities. No significant difference in the number of averages required to reach the stopping criteria was found.

    CONCLUSIONS: Stimulus polarities have a significant influence on the ABR to LS chirp. Rarefaction polarity is recommended for clinical use because of its larger ABR peak I, III, and V amplitudes than those of the other stimulus polarities.

  17. Zakaria MN, Tahir A, Zainun Z, Salim R, Mohd Sakeri NS, Abdul Wahat NH
    Acta Otolaryngol, 2021 Jan;141(1):62-65.
    PMID: 32957810 DOI: 10.1080/00016489.2020.1817552
    BACKGROUND: The graviceptive otolith function can be measured using subjective visual horizontal (SVH) testing. Nevertheless, more research efforts are required to understand the essential variables affecting SVH.

    OBJECTIVE: The aim of the present study was to determine the effects of type of visual image and gender on subjective visual horizontal (SVH) perception among healthy adults.

    MATERIALS AND METHODS: In this comparative study, 50 healthy young adults were enrolled. While in an upright body position, they were required to report their perception of horizontality for two types of visual images (solid line and arrow pattern) using a computerized SVH device.

    RESULTS: The arrow pattern produced significantly bigger SVH angles than the solid line (p < .001). In contrast, no significant influence of gender was found on SVH results (p = .743), Based on the statistical outcomes, the preliminary normative data for SVH were established.

    CONCLUSIONS AND SIGNIFICANCE: The arrow pattern (a more complex visual image) produced bigger SVH deviations than the simple solid line image. In contrast, the horizontality perception does not appear to be affected by gender. The preliminary normative SVH data gathered from the present study can be beneficial for clinical and future research applications.

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