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A look at the long-term effectiveness of an integrated tinnitus management approach (WZT) and the pattern of amplification and sound therapy use among primary tinnitus patients once successful remediation of symptoms is achieved. Habituation is classically defined as the process of adapting to a stimulus through repeated exposure.
The attentional processes involve perceptual filters that determine which sensory perceptions are brought to our conscious attention. The vast majority of tinnitus patients present at least some degree of hearing loss, fueling the theory that the central auditory nervous system responds to the hearing deficit by increasing its gain, further adding to the perception of tinnitus.
The use of music has been shown to reduce stress hormones.10 Physiological and behavioral reactions to tinnitus can be mitigated through the use of music. Hearing aids with either noise generators or some kind of music have become popular in tinnitus management.
Consequently, there is a growing consensus that a multifaceted individualized approach to tinnitus management is more likely to result in the best outcomes. In addition, WZT incorporates the use of fractal (commercially termed Zen) tones and broadband amplification characterized by an extremely low compression kneepoint, relaxation exercises, and sleep management.
The effectiveness of WZT in several studies has been reported,1,18-19 but none of these investigations have indicated the effectiveness or usage characteristics beyond a 6-month period. All participants were given a comprehensive audiologic and tinnitus evaluation including the Tinnitus Handicap Inventory (THI),20 Tinnitus Functional Index (TFI),21 and Widex Tinnitus Intake questionnaire.17 Participants were required to have cognitive, comprehension, and manual dexterity abilities sufficient for treatment, and all subjects paid for the tinnitus treatment for up to 12 months post hearing aid fitting. Additionally, all subjects were fit with Widex Dream or Clear hearing aids containing fractal (Zen) tones.
Even though the initial fitting met most subjects’ needs, some required individual modifications in their Zen + programming.
Subjects were instructed to use the devices during their waking hours when hearing and communication were essential. Figure 3 depicts the relationship between TFI baseline and 12-month post WZT for individual subjects. Figure 5 shows the mean use (in time percentage) of the Zen + programs as well as the amplification alone (the “Master” program) program. Datalogging also revealed that the Zen A (Aqua + microphone on) and Zen B (Aqua and noise plus microphone on) programs were the most frequently used programs. The use of Zen C (noise only plus microphone on) was very limited, varying from 9-12% during the 12 months. The fact that all 19 of the subjects achieved clinically significant improvements when comparing TFI scores from baseline to each of the follow-up visit scores, including those obtained at the 12-month visit, would seem to provide an unequivocal answer to that question. Unfortunately, it is impossible to determine whether the overall use of amplification increased, because even during the 48% of time in which amplification-alone wasn’t being used at the 12-month visit, 17 out of 19 subjects were still utilizing Zen + programs that contained amplification.
2) Even though subjects had achieved an acceptable resolution of their tinnitus, they still recognized, and in some cases achieved, an even greater appreciation for the benefits received from amplification—either by assisting their hearing or by continuing to minimize their tinnitus distress. Results from myriad investigations leave little doubt that WZT is an effective approach to tinnitus management.
The inverse relationship between the use of Zen programs versus amplification-alone over time suggests that patients (even those whose primary complaint was tinnitus, rather than hearing loss) perceive a continued benefit for using amplification for improving their hearing, and possibly for tinnitus relief, even post habituation or successful resolution. Meikle MB, Henry JA, Griest SE, Stewart BJ, Abrams HB, McArdle R, Myers PJ, Newman CW, Sandridge S, Turk DC, Folmer RL, Frederick EJ, House JW, Jacobson GP, Kinney SE, Martin WH, Nagler SM, Reich GE, Searchfield G, Sweetow R, Vernon JA. Homeopathic remedies for tinnitus – ringing ,hissing, Homeopathic remedy aethusa is an excellent remedy for tinnitus that presents itself as hissing sound in ears . Home remedy for tinnitus – home-remedies-for-you, Read more about causes, symptoms, treatment and home remedies for tinnitus. Homeopathic remedies for tinnitus and herbal remedy for, Homeopathic remedies for tinnitus and herbal remedy for tinnitus our best selling herbal and homeopathic remedy product buy 2 and get 1 free today. Tinnitus treatment remedies from t-gone – the original, The original homeopathic tinnitus treatment remedies from t-gone tinnitus remedies. Tinnitus treatment natural therapy, supplements, herbal remedy, Tinnitus natural treatment, vitamins, herbs, and supplements (ringing in the ears) by ray sahelian, m.d. Amazing all-natural Tinnitus breakthrough permanently eliminates Tinnitus issues without drugs or surgery.
Functional neuroimaging in neurootology with Brain Electrical Activity Mapping (BEAM) has been introduced to record cortical Vestibular Evoked Potentials (VestEP) in response to a rotatory stimulus. Brain Electrical Activity Mapping (BEAM) is a special electrophysiological imaging procedure providing a graphic and quantitative recording of responses to a stimulus related electroencephalogram (EEG) event. Since 1990 the Vestibular Evoked Potentials have been recorded in response to short lasting angular accelerations (Vestibulo-Sensory Reflex - VSR) in the Department of Neurootology, University of Würzburg. VestEP recordings with BEAM provides a graphic and quantitative recording of responses of the patient to a rotatory stimulus. This paper is a review of our clinical experience with Brain Electrical Activity Mapping of Vestibular Evoked Potentials. Furthermore, the routine Evoked Potential (EP) study is based mainly on two dimensions; amplitude and latency. That is why in this study we have used a new approach of Vestibular Evoked Potentials by means of Brain Electrical Activity Mapping (VestEP-BEAM approach) in order to investigate the spatial and temporal properties of the rotationally evoked brain electrical events. Properties of the vestibular stimulation: The vestibular stimuli applied in this study were repetitive short-lasting rotatory movements (repetitive angular accelerations, clockwise and counterclockwise in consecutive serial trials) of the whole subject's body around a vertical axis.
Altogether 25 stepwise rotations are averaged for each one of the CW and CCW-directed rotations. In addition, individual hearing protectors (Bilsom Propp-o-Plast, Sweden) are applied to both ears of the subject to avoid possible acoustic contribution to the rotationally evoked potentials. The initial reference data were obtained on 58 subjects, free from neurological and neurootological diseases and subjective complaints. The denomination of the VestEP-components have been performed with respect to the negative peaks (the only exception is the IVth component, which is the most dominant and stable positive peak). The scalp location of the electrodes is a factor also influencing the VestEP-component latencies.
The statistical analysis by means of the t-criterion test revealed significant latency differences of the various VestEP-components in dependance of the electrode location within the antero-posterior plane (Longitudinal Line Analysis). The presence of some degree of interhemispheric asymmetry in VestEP component latencies (Transversal Line Asymmetry) is also to be mentioned. Furthermore, the VestEP-latencies produced by rotation directed to the left (ROTL-stimulus) also look to be slightly shorter in comparison to those obtained by ROTR-stimulus, at least for some of the electrode derivations (Labyrintb-related Asymmetry). Amplitude Mapping of the prominent VestEP peaks reveals high specific BEAM images demonstrating the space distribution of the principle VestEP components over the scalp.
Furthermore, the amplitude maps of the VestEPs can be presented in consecutive time steps of 5 msec ("Animation", "cartooning effect"). In our field experiments we also tried to find an objective measure for the vestibulo-cortical acceleration threshold.
For finding an optimal stimulation profile with respect to the stimulus impact applied we have compared various BEAM responses at different accelerations.
There exists a moderately expressed inter-individual variability of the VestEP acceleration thresholds between the healthy persons.
General information from all four display-modes of the BEAM of the evoked potentials (EP) are considered in establishing a neurootological diagnosis. Accordingly, we have extended the method with a multichannel display of the brain isoelectric contours during a specific vestibular stimulation such as rotation. Additionally, we have registered the threshold sensitivity of the vestibular endorgan and pathways to the acceleration stimulus.
This combined approach increases significantly the clinical information and diagnostic power of the VestEPBEAM method. Based on the latency values of the principle VestEP components in our study we can conclude that the particular response registered by our experimental paradigm is most likely generated at cortical levels; both in the primarily vestibular and in the non-specific associative areas. Quite interesting and promising are the data obtained from amplitude mapping of the VestEP components (amplitude dimension analysis). We expect that in the near future the VestEP-study will even more prove to be an useful tool for both research and diagnosis in the field of neurootology. Environmental noise- white noise, pink noise- is a useful tool for quieting tinnitus, but how can you tell if you’re using the correct frequency? Tinnitus symptoms affect people differently; some experience constant, high-pitched ringing in the ears, while others may suffer through a steady low-octave series of whooshing sounds.
While there is no cure for tinnitus, many patients have found relief by incorporating tinnitus retraining therapy (TRT) or habituation therapy into their tinnitus treatment plan. In choosing the right environmental noise to treat tinnitus, it’s important to take into account spectral density, which refers to the way that power from sound signals is distributed through various frequencies. Just as your tinnitus sounds operate at different frequencies, so do a variety of white, pink, or purple noises that may provide the right combination of acoustics to help quiet tinnitus ringing sounds. Example: The flat sound of a rotating ceiling fan, or the static emanating from a car radio.
White noise is often used for blocking out unwanted sounds, including tinnitus, allowing you to focus better on work or rest more peacefully at night. Many tinnitus retraining therapies (TRT’s) or habituation therapies recommend starting out with white noise, as it contains the widest range of frequencies. Unlike white noise, pink noise produces sound in which each octave carries the same power, equal energy per octave.
Pink noise is preferred for relaxing the mind and achieving restful sleep, especially when tinnitus ear ringing makes it difficult to sleep through the night. To treat tinnitus with pink noise, purchase a sound machine that offers a selection of soothing environmental sounds, and place it by your nightstand. Sometimes referred to as Brownian, red noise is any noise signal that mimics the Brownian motion. Brown noise contains power that lowers by 6 dB with increasing frequency, and is best suited for treating tinnitus noises that respond well to low rumbling sounds, such as the deep echo of thunder. In addition to masking tinnitus, red or brown noise is also helpful for soothing migraines.
Unlike brown noise, purple noise utilizes power that increases by 6 dB with increased frequency.
Gray noise is similar to white noise, but distorted to produce the effect of equal volume at all frequencies. If you found this article helpful, then please share with your friends, family, and coworkers by email, Facebook, or Google+.
When tinnitus habituation occurs, either the perception of the tinnitus, or the reaction to the tinnitus, is greatly, if not fully, diminished.2 In this article, habituation will be regarded as substantial and meaningful lessening of the negative reaction to the tinnitus as defined by clinically significant reductions in subjective distress scores.


The reaction to it varies from a minor annoyance to one that can significantly and negatively impact one’s quality of life. In clinically significant tinnitus, these filters determine that attention should be applied to the specific patterns of neural activity associated with the tinnitus.3,4 The engagement of the autonomic system and amygdala leads to further increases in the sensitivity of the auditory system and reinforcement of the attentional filters, creating further increase in tinnitus loudness and awareness, which in turn increases the level of stress. A limitation of the use of popular music, however, is the chance that these stimuli can attract excessive attention to both the music and the tinnitus. Most tinnitus strategies employed over the past two decades consist of a combination of directive (instructional) counseling and acoustic stimulation (either noise, amplification, or a combination of the two). There is also an option to include broadband noise in addition to, or in lieu of, the Zen tones. A total of 20 subjects were initially enrolled in this cohort study conducted at the ENT Associates of South Florida in Boca Raton, Fla.
The hearing loss varied from mild to moderately severe, and the average hearing thresholds of the subjects are shown in Figure 1. Clinicians participating in this investigation had considerable experience in tinnitus patient management and were familiar with the fitting of Widex hearing aids and Zen programming.
The specific models chosen ranged from models 110 to 440, and were selected based on the joint decision of the patient and clinician taking in audiologic as well as economic considerations. Zen + B (noise) or Zen noise (C) were only recommended if the clients experienced periods where the tinnitus was very bothersome. Although turning off the microphone in the Zen+ programs was an option, only two subjects chose to do so. They were further taught that the Zen fractal tones should be audible, but relatively soft and that the tones should not interfere with conversational speech.
The TFI and THI were administered at baseline, as well as at 2, 4, 6, 9, and 12 months post-treatment.
The TFI was chosen because of its extremely strong psychometric evidence and multiple domain clinical relevance. Individual subject Tinnitus Functional Index (TFI) baseline and 12 month post Widex Zen Therapy scores for the 19 subjects. Note that, at the 2-month visit, the three Zen + programs were used 73% of the time, but amplification-alone was only used an average of 27% of the time. Therefore, one can confidently say that, as habituation (or resolution of the tinnitus distress) increased, the need for additional sound therapy beyond amplification decreased—though subjects continued to use amplification.
It is of particular importance to note that clinically significant changes were found at the 2-month visit for all of the subjects on the TFI. One way to approach this issue is to compare the pattern of fractal tone, noise, and amplification-only usage at the 6-month follow-up, since 15 of 19 subjects (79%) achieved clinical resolution of their tinnitus distress (<20 on the TFI) by that visit, to the 12-month follow-up visit.
The exceptions were the 2 subjects who chose to turn off the microphone in Program C at the onset of the project.
This is particularly relevant considering the fact that 17 of the 19 subjects originally presented with primary complaints of tinnitus, rather than hearing difficulty.
As seen in earlier studies, when given the choice between listening to sound therapy containing fractal tones versus programs containing noise, the overwhelming majority (as reflected by comparing usage of Zen A vs Zen C) choose fractal tones.
However, the excellent results obtained in this study are certainly, in part, related to the expertise of the clinicians. Further studies are needed to determine the relative contribution of each of the WZT components (including the undisputed importance of counseling), but until these data are available, it seems prudent to utilize the multiple counseling and sound therapy tools offered in an integrated approach like WZT. The Tinnitus Functional Index: Development of a new clinical measure for chronic, intrusive tinnitus.
A comparison of benefit and economic value between two sound therapy tinnitus management options.
Sweetow, PhD, is Professor of Otolaryngology and former Director of Audiology at the University of California, San Francisco (UCSF); Melodi Fehl, MA, is a Clinical Audiologist and Patti Ramos, AuD, is Director of Audiology and Rehabilitative Services at ENT Associates of South Florida in Boca Raton, Fla. Between 1988 and 1990 the technique of EEG-Epoch method with a Fast Fourier Analysis was used to record spontaneous cortical potentials as represented in a surface related image, following caloric, rotatory, optikinetic stimulation.34,36,37,42,55,56 This technique was supplemented with the technique of producing stimulus related evoked potentials in response to vestibular, acoustic, visual, and olfactory stimulation.
The spatial and temporal properties of the rotational evoked brain electrical events and their clinical implications are presented. However, they have some limitations, associated mostly with their relative high intra - and interindividual variability, high sensitivity to biological, psycho-physiological and environmental factors, insufficient information about the time and spatial distribution of the evoked activity over the cortex, etc.
The onset of the positive acceleration served as a trigger impulse for starting the averaging of the EEG segments. In order to escape the habituation effect a time pause of 3 - 5 minutes is introduced between the consecutive sessions.
4), available with an option of 17 selfcontained, self-supplied DC preamplifiers PPA1 (input resistance of 400 MΩ).
A special data bank containing 400 BEAM-VestEP investigations on 300 subjects, either symptom free volunteers and neurootological patients suffering from vertigo, sudden hearing loss, tinnitus, balance disorders, have been created. The shortest latencies of the initial VestEP-components (I, II and III) can be obtained from the central transversal line area (T3 - C3 - Cz - C4 -T4 electrodes).
This time distribution of the BEAM-VestEP images also revealed a high degree of modality-related specificity. However, some problems may appear due to the high sensitivity of the VestEP waves from the vigilance state, fatigue, drug admission, etc. The information from a routine EP study is based on an analysis of the amplitude and latency parameters of the principle components with respect to the electrode position. This combined VestEP-BEAM approach represents a functional neuroimaging technique for studying of the space and temporal peculiarities in the scalp distribution of the rotationally evoked brain electrical events. Supratentorial localisation sights in longitudinal and transversal plane (Interhemispheric Asymmetry, IHA).
Psychophysiology of vestibular function and its disorders; vertigo and dizziness sensation, space orientation, distortions of space and time. Neck-related changes on vertigo pointing towards modulatory effects of somato-sensory inputs.
A special advantage of our multielectrode arrangement of BEAM is that it provides additional topodiagnostic information. The VestEP-BEAM approach 28 permits a study of all five EP dimensions, thus offering some important further additional advantages in the acquisition of neurophysiological data.
Technically, this is the simplest and easiest type of EP-mapping, because of the usually sharp VestEP-peaks. If an afferent influx of impulses occurs in vertically oriented cortical neurons at a high frequency for a longer period, then wave-like Excitatory Postsynaptic Potentials (EPSPs) will be generated at the superficial dendritic arborization.35,50 This produces a broadly spreaded depolarization of the cortical neuronal elements. Also an increasing dialog with allied disciplines of clinical neurophysiology, sensory physiology, neurology, neurosurgery, psychiatry, orthopedic surgery, traumatology, occupational medicine, and ophthalmology will be established. Brain Electrical Activity Mapping - Eine weitere objektive Projektionsebene für neurootologische Funktionspriifungen.
Speckmann EJ, Elger CEo Introduction to the neurophysiological basis of the EEG and DC Potentials. Scientists have categorized acoustical variables into a rainbow of colors, each one representing a specific range of spectral density. By listening to background music throughout the day and evening for several months, it is possible to distract the brain from nagging tinnitus noise and effectively “forget” about it.
That’s because white sound is the great equalizer, combining high and low frequencies into one even spectrum, equal energy per frequency. The condition typically involves multiple neuro-plastic changes to sites producing auditory, attentional, and emotional processes of the brain. The mechanisms of emotional disturbance associated with tinnitus define the “reaction” to hearing the tinnitus sound, as opposed to the “perception” of the sound.
Auditory fractal tones utilize harmonic but unpredictable musical relationships, and are generated by a recursive process where the algorithm is applied multiple times to process its previous output. Widex Zen Therapy extends these approaches by additionally incorporating cognitive behavioral interventions in the form of adjustment-based counseling designed to identify the unwanted thoughts and behaviors hindering natural habituation, challenge their validity, and replace them with alternative and logical thoughts and behaviors. The approach is individualized, in that the necessary components of WZT are determined after a comprehensive evaluation of the tinnitus and the patient’s reaction.
All but one (19 subjects, 11 females and 8 males with a mean age of 65, ranging from 49 to 86) completed the study. The Widex Intake Questionnaire, TFI, THI, and the clinician’s observation of the subjects were used to determine which WZT components were employed.
The hearing aids had wide dynamic range compression (WDRC), compression thresholds as low as 0 dB HL, adaptive multichannel directional microphone, noise reduction, active feedback cancellation, data logging, and inter-ear capabilities. Thus, the volume was to be set so that the annoyance level of the tinnitus would just begin to decrease.
Hearing aid datalog records were accessed at these time intervals to ascertain hearing aid use both during the therapeutic effort to induce habituation and after.
Any symbol falling below this diagonal line suggests some degree of reduction in tinnitus distress. The mean use of hearing aids, including amplification and Zen programs, was 8 hours during the 12-month course of this investigation. By the end of the study (ie, 10 months later), however, the combined use of the Zen programs had decreased to 47%, while the amplification-alone usage increased to 53%. While the effectiveness of an integrated approach like WZT has been repeatedly shown in studies cited earlier, none of those studies looked at the longer-term effects lasting out to 1 year post therapy onset. Moreover, 17 of 19 subjects (91%) had TFI scores suggesting their tinnitus was no longer clinically significant by the conclusion of the 12-month study.
The data showed that the combined use of the three Zen + programs decreased from 56% to 48% (compared to 73% at the 2-month visit), while the use of the amplification-alone (Master) program progressively increased from 44% to 52% (compared to 27% at the 2-month visit).
This has been shown in other studies as well,11,12,14 and is likely due to the inherent relaxing qualities of the Zen tones. It is not realistic to expect the 100% success found in this project to be found in the real world.
The technique has provided new insights into the origin and quality of complaints of vertigo and tinnitus.
Speculations with respect to its clinical significance and implications for diagnosis and.treatment are presented. In order to reduce the emotional stress and muscle artifacts we have used a slow deceleration (not a sudden stop) as a stop stimulus.
The total session time for a person lasted for about 30 minutes including the time for electrode montage. The biosignals are transmitted to the main amplifier via a slip ring assembly, containing 17 slip rings, each one with twin sliding contacts.


In order to minimize the eye movement artifacts, gaze fixation is introduced through a structured fixation target, rotating with the chair.
A few montage schemes and programs are employed, some of them including the middle line electrodes Fz and Cz. The frequency band of the recorded spontaneous brain electrical activity is determined by a low frequency cutoff of 0.1 Hz and a high-frequency cut-off of 35 Hz. In addition, a few children (9-11 years) as well as a few older persons (37- 55 years) were investigated in order to appreciate the age-related variabi lity in the VestEP-properties.
A-Mode of single electrode EEG-curves with BEAM-images related to cursor-selected typical wave patterns.
Both clockwise (CW) and counterclockwise (CCW) accelerations basically elicit similar waveform patterns, although some differences or peculiarities exist among the clinically healthy persons (Table 2). The shortest latencies of the later components (IV, V and VI) can be registered from more frontally located brain regions: Fp1, Fp2, Fz (Fig.
Diagram of the latency distribution of the first component of the vestibular evoked potentials over the scalp in (msec). Amplitude Mapping of the IIIrd component of the Vestibular Evoked Potential (VestEP), obtained from a 21-year-old healthy man.
Classical interpretation of the evoked potential data in terms of latency and amplitude provides only a twodimensional basis of differentiation between the normal and abnormal functional state of the investigated sensory structures and pathways. The prolonged depolarization of the superficial structures caused by sensory afferentation will express itself by a negative shift in EEG, resp.
Spectral Analysis of the Nystagmus and the Simultaneous Cortical Activity (preliminary Study).
Differentialdiagnose und Differentialtherapie von Schwindel und Ohrensausen beim alten Menschen. Ohrgeräusche - Neurootologische Gesichtspunkte zur Differentialdiagnose und Differentialtherapie.
Combined Analysis of horizontal and vertical optokinetic Nystagmus Reactions by means of ENG and Brain Mapping.
Los potenciales evocados equilibriometricos por medio del BEAM - y su importancia en el diagnostico y tratamiento de los pacientes con vertigo. The International Tinnitus Journal (ITJ): A New Platform for Clinical and Scientific Tinnitology. On the Functional State of Central Vestibular Structures in Monaural Symptomatic Tinnitus Patients. Vestibular late evoked potentials, a complementary tool for neurootological topodiagnostics in dizzy patients.
Our first findings about the late acoustical evoked potentials, with full cortical response representation. The Influence of Betahistine on the Vestibular Evoked Potentials in Patients with Peripheral Vestibular Disorders. Long-latency rotational evoked potentials in subjects with and without bilateral vestibular loss. Recording of shortlatency vestibular evoked potentials induced by acceleration impulses in experimental animals:current status of the method and its applications.
Recording of short latency vestibular evoked potentials to acceleration in rats by means of skin electrodes. Visually Evoked Potentials and their Evaluation in Brain Electrical Activity Mapping (BEAM). Extended Normative Data on Vestibular Evoked Potentials Displayed by Brain Electrical Acitivity Mapping.
Uber die kombinierte Verwendung von akustisch und visuell evozierten Potentialen in der Neurootologie.
Die Darstellung per- und postrotatorischer Vestibularisreaktionen mittels des Brain Electrical Activity Mapping. Vestibular Evoked Potentials - a New Method for Study of the Combined Factors of Environmental Factors. To find out which color best masks constant tinnitus noise, it’s sometimes necessary to dip into all the shades of sound, from white or pink noise, to brown or violet. Seventeen of the subjects initially presented to the clinic with a primary complaint of tinnitus, rather than hearing difficulty. All subjects were given instructional counseling, relaxation exercises including progressive muscle relaxation (PMR), deep breathing and guided imagery, and sleep suggestions.
A more detailed explanation of the Zen programming is available.17 Subjects were advised to not adjust the Zen volume unless deemed necessary by environmental conditions. The number of sessions necessary to accomplish a successful outcome varied and was defined by a clinically significant reduction in THI and TFI scores, or achievement of a non-significant score (< 20 for the TFI or less than 18 for the THI) for two consecutive visits, as well as a subjective report that tinnitus awareness, or tinnitus disturbance, or quality of life was no longer an issue negatively impacted by the tinnitus. A reduction of 13 points is considered clinically significant on the TFI.21 The dashed line represents the 13-point benefit score considered clinically significant. This decrease may be related to the fact that subjects had their tinnitus distress reduced over time and no longer felt the need to use fractal tones and noise as frequently as they did during the first 2 months of sound therapy. Not unexpectedly, there was a trend for the subjects least affected at baseline to also show the least amount of improvement. This implies that, as resolution was achieved, subjects tended to utilize the Zen programs, particularly those containing noise (B and C), less frequently while increasing their reliance on amplification-only.
This point underscores the importance of offering multiple sound therapy options, such as a variety of fractal tone styles and adjustable bandwidth noises, to those patients (approximately 10% in this study) who may prefer acoustic stimuli other than fractal tones.
Electrophysiologic recordings suggest that the symptoms of tinnitus and vertigo are related to activities of the upper gyrus of the temporal lobe with extension to other major areas of cerebral cortex. The chair is used in a semilighted room, permitting the examination to be carried out in total darkness or in an illuminated environment.
Altogether 19 scalp located electrodes are used in order to study the scalp topography of the VestEP. The grapho-elements of the evoked EEGs namely in the central section of the EEG locations determine the spreads of the electrical field - visualized over the cortex.
Mean data obtained by rotation-to-the-Ieft (ROTL-stimulus) and rotationto-the-right (ROTR-stimulus) in healthy persons.
Moving more frontally or more occipitally from the transversal line area (T3-C3-Cz-C4-T4 line) the response progressively reduces in its amplitude. Mean data obtained by rotation-to-the-left (ROTL-stimulus) and rotation-to-the-right (ROTR-stimulus) in healthy persons.
Consequently, the potential differences between the referential point (which is electrically "silent" in practical plan) and each one of the scalp electrodes (which is electronegative in respect to the reference point) reflect not only the amplitudes of the VestEP-components but also the degree (or gradient) of their relative electronegativity. Excerpta Medica, International Congress Series, 1087, Elsevier Publishers, Amsterdam, Lausanne, New York, Oxford, Shannon, Tokyo, 231-234, 1995. Excerpta Medica, International Congress Series, 1087, Elsevier Publishers, Amsterdam, Lausanne, New York, Oxford, Shannon, Tokyo, 395-398, 1995. Proceedings of the 3rd European Congress of the European Federation of Oto-RhinoLaryngological Societies EUFOS, Budapest June 1996, Editors: O. The overall aim of Widex Zen Therapy is to ensure that the tinnitus does not negatively impact the patient’s quality of life, as opposed to reducing the loudness level or production of the tinnitus. All but 7 subjects had experienced tinnitus for more than 1 year, and all but 4 reported tinnitus in both ears.
Additional counseling in the form of cognitive behavioral intervention was applied when the clinicians believed appropriate. Subjects who showed clinically and significantly improvements didn’t require all the planned sessions; however, the THI, TFI, and datalogging measures were still collected as planned. Symbols falling below the diagonal dashed line reflect clinically significant relief from tinnitus.
The usage of Zen A (fractal tones) decreased somewhat, but this reduction was not statistically significant.
The onset of the positive acceleration phase serves as a trigger impulse for starting the averaging process.
The stimulus profile is programmed by a Schneider function generator and has the shape showed in Fig.
The amplification and paper monitoring of the row EEG is done by means of a 17 channel PICKER SCHWARZER Encephaloscript ES 16000 (input impedance of 100 MΩ).
The responses are monitored on-line and subsequently processed on a: PICKER SCHWARZER Brain Surveyor BS 2400 (Fig. The shortest latencies can be registered from the central (Cz, C3, C4) and temporal (T3, T4, T5, T6) cortical areas. The highest negativity shift dominate over both central areas, more expressed over the right hemisphere. A well expressed tendency for an amplitude decrease and a latency increase of the VestEP-waves can be seen with the progressive decrease of the acceleration rate. Thus, mapping of the amplitudes of the negative VestEP components means spatial visualisation of the gradients of the electronegativity over the scalp.
Atlas der Elektronystagmographie (Atlas der neurootologischen Untersuchungstechnik, Registrierkurven, Befundauswertung, Schwindeldiagnostik).
XV Congreso Nacional de la Sociedad Espanola de ORL y Patologia Cervicofacial, 27 - 46, 1993. 4), supplying facilities for spatial and chronological analysis of both spontaneous and evoked brain electrical activity (Brain Electrical Activity Mapping, BEAM) 28. The latencies over the left parietotemporal region seem to be mild shorter than those in the corresponding areas in the right hemisphere.
In addition, 15 of the 19 subjects’ final TFI were below the 20-point score considered clinically significant. An epoch of 1000 ms, following the onset of the stepwise acceleration stimulus is used for analysis of the rotationally evoked brain electrical events.
In addition, it should be noted that the final mean TFI score was 11.76, a tinnitus distress score considered clinically insignificant. Peak-to-peak amplitudes and principal component latencies are measured and subsequently computed on a personal computer (Macintosh) for their averaged values and standard deviations.



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