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Fulltext Normal vestibulo ocular reflex (vor) gain measured using the video head impulse test (vhit) in healthy young adults.

Jamaluddin SA, Omar NA

IIUM Medical Journal Malaysia, 2019;18(3):88-94.
MyJurnal

Many new objective tests to assess the function of specific structures of the vestibular organ are currently adopted in vestibular clinics. One of the objective assessments include the video head impulse test (vHIT) where gain & velocity responses of eye relative to the head movements are recorded using an infrared camera. Methods: Thirty normal hearing subjects age between 18 to 25 years old participated in this study. At least ten Lateral, Left Anterior Right Posterior (LARP), and Right Anterior Left Posterior (RALP) responses were recorded for each participant by making small and rapid unpredictable head movements. Results: The average velocity gain for Lateral responses at 40 ms, 60 ms and 80 ms were 1.05 ± 0.003, 1.03 ± 0.002 and 1.01 ± 0.003 respectively. The LARP average velocity regression were 1.01 ± 0.24 for Left Anterior and 1.05 ± 0.25 for Right Posterior, with an average gain asymmetry of 5.13%. The RALP average velocity regression were 1.08 ± 0.31 for Right Anterior and 1.12 ± 0.30 for Left Posterior, with an average gain asymmetry of 5.87%. One sample T-test were conducted to compare Lateral responses to a previous study by Mossman et al. (2015) where significant differences in velocity gain at 60 ms and 80 ms between studies were found where, t (59) = 5.56, p
Simplified cochlear frequency selectivity measure for sensorineural hearing loss screening: comparison with digit triplet test (DTT) and shortened speech, spatial and qualities of hearing scale (SSQ) questionnaire

Rasidi WNA, Seluakumaran K, Jamaluddin SA

Eur Arch Otorhinolaryngol, 2023 Oct;280(10):4391-4400.
PMID: 36988687 DOI: 10.1007/s00405-023-07929-7

PURPOSE: Pure-tone audiometry (PTA) is the gold standard for screening and diagnosis of hearing loss but is not always accessible. This study evaluated a simplified cochlear frequency selectivity (FS) measure as an alternative option to screen for early frequency-specific sensorineural hearing loss (SNHL).
METHODS: FS measures at 1 and 4 kHz center frequencies were obtained using a custom-made software in normal-hearing (NH), slight SNHL and mild-to-moderate SNHL subjects. For comparison, subjects were also assessed with the Malay Digit Triplet Test (DTT) and the shortened Malay Speech, Spatial and Qualities of Hearing Scale (SSQ) questionnaire.
RESULTS: Compared to DTT and SSQ, the FS measure at 4 kHz was able to distinguish NH from slight and mild-to-moderate SNHL subjects, and was strongly correlated with their thresholds in quiet determined separately in 1-dB step sizes at the similar test frequency. Further analysis with receiver operating characteristic (ROC) curves indicated area under the curve (AUC) of 0.77 and 0.83 for the FS measure at 4 kHz when PTA thresholds of NH subjects were taken as ≤ 15 dB HL and ≤ 20 dB HL, respectively. At the optimal FS cut-off point for 4 kHz, the FS measure had 77.8% sensitivity and 86.7% specificity to detect 20 dB HL hearing loss.
CONCLUSION: FS measure was superior to DTT and SSQ questionnaire in detecting early frequency-specific threshold shifts in SNHL subjects, particularly at 4 kHz. This method could be used for screening subjects at risk of noise-induced hearing loss.
Investigating the Effects of Level-Specific CE-Chirp on Auditory Brainstem Response Waves in Normal Hearing Infants

Chahed N, Dzulkarnain AAA, Jamaluddin SA

Malays J Med Sci, 2024 Apr;31(2):62-71.
PMID: 38694577 DOI: 10.21315/mjms2024.31.2.7

BACKGROUND: Auditory brainstem response (ABR) to the level-specific (LS) CE-Chirp has been reported to provide optimum neural synchrony along cochlear partitions, theoretically improving ABR waveform resolution. Despite this promising finding, limited studies have been conducted to contrast the results between LS CE-Chirp and Click stimuli. The current study aimed to compare the results of ABR between the two stimuli (Click and LS CE-Chirp).
METHOD: Sixty-seven normal-hearing infants, both with and without risk factors, aged less than 7 months old, participated in this study. The ABR test was conducted at 70 dBnHL using 33.3 stimulus repetition rates with both Click and LS CE-Chirp stimuli. The signal averaging was stopped at a maximum fixed signal average of 2,500 sweeps. Data were statistically compared between the two stimuli using the Wilcoxon signed-rank test.
RESULTS: The waves I and V ABRs elicited by LS CE-Chirp exhibited significantly larger amplitudes than the Click stimulus. However, the amplitude of wave III and absolute latencies were similar in both stimuli at a supra-threshold level.
CONCLUSION: LS CE-Chirp has the advantage of larger amplitudes than the ABR from Click at the supra-threshold level (70 dBnHL) in normal-hearing infants.
Stimulus-response incompatibility eliminates inhibitory cueing effects with saccadic but not manual responses

Eng V, Lim A, Kwon S, Gan SR, Jamaluddin SA, Janssen SMJ, et al.

Atten Percept Psychophys, 2017 May;79(4):1097-1106.
PMID: 28229429 DOI: 10.3758/s13414-017-1295-8

There are thought to be two forms of inhibition of return (IOR) depending on whether the oculomotor system is activated or suppressed. When saccades are allowed, output-based IOR is generated, whereas input-based IOR arises when saccades are prohibited. In a series of 4 experiments, we mixed or blocked compatible and incompatible trials with saccadic or manual responses to investigate whether cueing effects would follow the same pattern as those observed with more traditional peripheral onsets and central arrows. In all experiments, an uninformative cue was displayed, followed by a cue-back stimulus that was either red or green, indicating whether a compatible or incompatible response was required. The results showed that IOR was indeed observed for compatible responses in all tasks, whereas IOR was eliminated for incompatible trials-but only with saccadic responses. These findings indicate that the dissociation between input- and output-based forms of IOR depends on more than just oculomotor activation, providing further support for the existence of an inhibitory cueing effect that is distinct to the manual response modality.
Perceived changes in symptoms and quality-of-life amongst patients with dizziness: A single-centre experience in Malaysia

Wong KYR, Abdul Rasheed SRSMA, Jamaluddin SA, Hussein Al-Hadeethi YF

Med J Malaysia, 2022 Nov;77(6):730-735.
PMID: 36448392

INTRODUCTION: Dizziness is a common complaint by patients, yet it always presents as a diagnostic challenge to the attending clinician. An accurate diagnosis is essential to correctly administer the precise treatment regime, alleviate the symptoms, and improve the quality-of-life of patients who present with dizziness. A specialised vestibular clinic with a holistic approach of meticulous history-taking, complete physical examination, a collection of audiovestibular test battery, and facilities for vestibular rehabilitation was set up to assist in the management of these patients. This study aims to investigate the effect of vestibular clinic intervention on the symptoms and qualityof- life of patients who were managed in the vestibular clinic.
MATERIALS AND METHODS: A total of 64 new patients who were managed in the vestibular clinic were selected and the validated Malay - Vestibular Rehabilitation Benefit Questionnaire (My-VRBQ) was completed during the first and follow-up visits to measure the changes in symptoms and quality-of-life before and after receiving care at the vestibular clinic.
RESULTS: Our study showed that there was a positive effect of vestibular clinic intervention on the symptoms and quality-of-life of patients who were managed by the vestibular clinic. Statistically significant improvements were seen in the total My-VRBQ scores, symptoms scores, and quality-of-life scores. The subscale scores of dizziness, anxiety, and motion-provoked dizziness also showed statistically significant improvement among the patients who received care at the vestibular clinic.
CONCLUSION: This indicates that the vestibular clinic was an essential part of the work-up, diagnosis, and treatment of patients with dizziness; and a specialised vestibular clinic was able to bring about positive outcomes in the symptoms and quality-of-life of patients with balance disorders.