Paul Heyning - Academia.edu (original) (raw)

Papers by Paul Heyning

Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Checklist: recom... more Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Checklist: recommended items to address in a clinical trial protocol and related documents. (DOC 123 kb)

Trials

Background: Patients suffering from chronic, subjective tinnitus are on a quest to find a cure or... more Background: Patients suffering from chronic, subjective tinnitus are on a quest to find a cure or any form of alleviation for their persistent complaint. Current recommended therapy forms provide psychotherapeutic interventions that are intended to train the patient how to deal with the tinnitus sound. Pharmaceutical managements are used to reduce secondary effects of the tinnitus sound such as sleep deprivation, emotional and concentration difficulties, but these treatments do not cure the tinnitus. Recent studies have shown that Tinnitus Retraining Therapy (TRT) significantly improves the quality of life for tinnitus patients. Furthermore, several studies have reported that cognitive behavioral therapy (CBT) relieves a substantial amount of distress by changing dysfunctional cognitions. However, when the tinnitus causes great interference with daily functioning, these treatment methods are not always sufficiently effective. Recent insights show that Eye Movement Desensitization Reprocessing (EMDR) is a highly effective therapy for medically unexplained symptoms such as chronic pain and phantom pain. In scientific research, tinnitus is compared to phantom limb pain. Starting from tinnitus as a phantom percept we therefore aim to demonstrate that the operating mechanisms of EMDR may also be an effective treatment method for patients with subjective tinnitus. The aim of this randomized controlled study with blind evaluator is to examine the effect of EMDR compared to CBT in chronic tinnitus patients. To our knowledge, there are no other studies that evaluate both methods simultaneously. Methods/design: A total of 166 patients with subjective, chronic, non-pulsatile tinnitus will be randomized in two treatment groups: TRT + CBT versus TRT + EMDR. The experimental group will receive the bimodal therapy TRT/EMDR and the active control group will receive the bimodal therapy TRT/CBT. Evaluations will take place at baseline before therapy, at the end of the treatment and 3 months after therapy. The score on the Tinnitus Functional Index (TFI) will be used as the primary outcome measurement. Secondary outcome measurements are the Visual Analogue Scale of Loudness (VAS), Tinnitus Questionnaire (TQ), Hospital Anxiety and Depression Scale (HADS), Hyperacusis Questionnaire (HQ), psychoacoustic measurements and event-related potentials (ERP).

Oto-Rhino-Laryngologia Nova

Brain structure & function, Jun 12, 2015

To date, hampered physiological function after exposure to microgravity has been primarily attrib... more To date, hampered physiological function after exposure to microgravity has been primarily attributed to deprived peripheral neuro-sensory systems. For the first time, this study elucidates alterations in human brain function after long-duration spaceflight. More specifically, we found significant differences in resting-state functional connectivity between motor cortex and cerebellum, as well as changes within the default mode network. In addition, the cosmonaut showed changes in the supplementary motor areas during a motor imagery task. These results highlight the underlying neural basis for the observed physiological deconditioning due to spaceflight and are relevant for future interplanetary missions and vestibular patients.

Fysiotherapeutische casuïstiek, 2006

Veel patienten consulteren een arts wegens duizeligheid en/of een verminderde posturale controle.... more Veel patienten consulteren een arts wegens duizeligheid en/of een verminderde posturale controle. Duizeligheid is een niet-specifieke klacht en kan het gevolg zijn van sterk uiteenlopende aandoeningen van verschillende organen. Met andere woorden, de differentiele diagnose is breed en dient niet alleen rekening te houden met otologische en neurologische factoren, maar ook met factoren gerelateerd aan bijvoorbeeld interne geneeskunde.

Disability and rehabilitation, Jan 17, 2014

Purpose: This pilot study aimed to evaluate the effectiveness of multiple sessions of transcrania... more Purpose: This pilot study aimed to evaluate the effectiveness of multiple sessions of transcranial Direct Current Stimulation (tDCS) during 4 weeks on balance and gait parameters after stroke. Method: Thirty-one stroke patients were included in this randomised, double-blind, sham-controlled crossover study. The Tinetti test was used to assess functional balance and gait after stroke. Secondary measures, Rivermead Motor Assessment (RMA) and Trunk Impairment Scale (TIS), were registered to asses both motricity and trunk performance. All tests were administered at baseline, after 4 and 8 weeks. Patients were randomly divided into two groups. Both groups received both sixteen 20-min sessions of tDCS and sixteen 20-min sessions of Sham stimulation. Application method between groups was changed after 4 weeks. A general linear repeated measures model was used to analyse the results of our study. Results: Results revealed an effect on the total score of the Tinetti test (p = 0.049). No sign...

Advances in oto-rhino-laryngology, 2010

A patient with bilateral severe, sloping, high-frequency hearing loss was treated with sequential... more A patient with bilateral severe, sloping, high-frequency hearing loss was treated with sequential bilateral electric acoustic stimulation (EAS) using the MED-EL Duet EAS cochlear implant. On one side, a partial 18-mm insertion of the electrode array (M-type) in the cochlea was performed. The contralateral side was implanted 39 months later with a deep 30-mm insertion of the electrode array (FLEX(soft) type). The aims were to assess whether low-frequency hearing could be preserved after deep electrode insertion, as well as to assess the benefit of bilateral EAS surgery compared to monaural EAS. Hearing thresholds and speech recognition outcomes were measured preoperatively and up to 48 months postoperatively. Outcomes from the partial and deep insertion side are compared. The benefit of EAS in daily life was assessed with the Abbreviated Profile of Hearing Aid Benefit questionnaire. Benefits of bilateral EAS were calculated from speech reception thresholds measured using the LINT spe...

Respiration Physiology, 1995

Obstructive sleep apnea (OSA) can be associated with depressed hypercapnic ventilatory response (... more Obstructive sleep apnea (OSA) can be associated with depressed hypercapnic ventilatory response (HCVR) (White D.P.,

Advances in Oto-Rhino-Laryngology, 2002

Surgical Neurology, 2008

Background: Sudden sensorineural deafness is a well-known symptom mostly of unknown etiology. Cas... more Background: Sudden sensorineural deafness is a well-known symptom mostly of unknown etiology. Case Description: A case of sudden sensorineural deafness is reported to be caused by a small, remote, ipsilateral tentorial meningioma not compressing the vestibulocochlear nerve or auditory tract. Surgical resection of the meningioma immediately restored the patient's hearing. Conclusion: The authors hypothesize that the sudden sensorineural deafness resulted from a growing meningioma inducing a neurovascular compression of the vestibulocochlear nerve, the vertebral artery already being in close relationship with the vestibulocochlear nerve in the premorbid phase. Resection of the meningioma allows for an autodecompression of this vascular conflict resulting in hearing restoration.

Otology & Neurotology, 2009

The Common Otology Database (COD) is a joint effort by an international group of otologists to or... more The Common Otology Database (COD) is a joint effort by an international group of otologists to organize audit with a standardized reporting method in middle ear surgery. The first results on hearing outcome of the COD are presented in this article. The primary objective was to confirm the validity of the benchmark group by comparing hearing outcome results with previously reported results. The secondary objective was to describe the population, technical aspects, and hearing outcomes of stapes surgery. Nonrandomized prospective multicenter audit. Twenty tertiary-referral otologic centers. Primary and revision stapes operations in patients with otosclerosis. Air-bone gap (ABG), bone-conduction (BC) thresholds, and air-conduction (AC) thresholds were evaluated at 3 and 12 months according to the guidelines of the Committee on Hearing and Equilibrium for the evaluation of conductive hearing loss. Raw data were displayed in an Amsterdam Hearing Evaluation Plot. In primary stapes surgeries, the postoperative ABG was closed to 10 dB or less in 63.6% and to 20 dB or less in 92.6% (median, 8.75 dB). In revision stapes surgeries, the postoperative ABG was closed to 10 dB in 41.2% and to 20 dB in 76.5% of cases (median, 11.25 dB). The overall mean postoperative ABG at 12 months was 10.38 dB compared with 28.75 dB preoperatively. Using laser to perform the fenestration results in a less pronounced BC improvement when compared with procedures without laser assistance. No statistically significant difference in ABG pure-tone average at 3 months could be demonstrated between the different prosthesis types. Results of hearing outcome are similar to previous, primarily retrospective, single-center studies. Our data confirm the effectiveness of stapes surgery in patients with otosclerosis.

ORL, 2011

benefit was measured preoperatively with only a hearing aid and postoperatively at EAS fitting an... more benefit was measured preoperatively with only a hearing aid and postoperatively at EAS fitting and then 3, 6 and 12 months after EAS fitting using the APHAB. Results: Subjects reported significant improvements in the global score with a mean decrease in impairment from 74% preoperatively to 45% after 3 months of EAS use. Furthermore, clinical relevance was demonstrated in multiple subscales between preoperative and first fitting reflecting a true benefit of EAS with a probability of 95%.

Folia Phoniatrica et Logopaedica, 2010

The reported study investigated the effect of 7 rate control methods (RCM) on running speech inte... more The reported study investigated the effect of 7 rate control methods (RCM) on running speech intelligibility, speaking rate (SR), articulation rate (AR) and pause characteristics in 27 individuals with dysarthria. The data reveal that with the exception of slower on demand, each RCM resulted in lower mean SRs and ARs (p ! 0.05). Clinically significant improvements in intelligibility were found in half of the participants with different types of dysarthria. The majority of them had normal or decreased ARs and SRs. The most effective methods were: alphabet board, hand tapping and pacing board. For the majority of speakers, the maximal decrease in speech rate was not associated with the maximal increase in intelligibility.

Folia Phoniatrica et Logopaedica, 2009

This study investigated the effect of rate control methods (RCMs) on speaking rate (SR), articula... more This study investigated the effect of rate control methods (RCMs) on speaking rate (SR), articulation rate (AR), and intelligibility in dysarthric speakers. Method: Nineteen dysarthric patients (7 unilateral upper motor neuron dysarthria, 6 hypokinetic, 3 flaccid, 3 ataxic) participated. SR, AR and intelligibility ratings were determined on the basis of 1min recorded reading passages. Seven RCMs were applied: voluntary rate control, hand tapping, alphabet board, pacing board and delayed auditory feedback with a delay of 50, 100 and 150 ms. Results: Almost all methods resulted in lower mean SRs and ARs (p ! 0.05). Rate control did not improve overall intelligibility of the dysarthric population. However, a meaningful increase of intelligibility was found in 5 participants. This study indicates that the effect of rate control on intelligibility is independent of habitual speech rate and type of dysarthria. Degree of intelligibility may be an influencing factor. The most effective methods are: voluntary rate control, alphabet board, hand tapping and pacing board. Conclusion: RCMs do result in lower speech rates. Some dysarthric individuals do benefit from one or more RCMs, but rate control may also have an inverse effect on intelligibility.

Experimental Brain Research, 2010

Somatic tinnitus has been defined as tinnitus temporally associated to a somatic disorder involvi... more Somatic tinnitus has been defined as tinnitus temporally associated to a somatic disorder involving the head and neck. Several studies have demonstrated the interactions between the somatosensory and auditory system at the dorsal cochlear nucleus (DCN), inferior colliculus, and parietal association areas. The objective is to verify the effect of transcutaneous electrical nerve stimulation of the upper cervical nerve (C2)

Otosclerosis and Stapes Surgery, 2007

&amp;#39;Histologic otosclerosis&amp;#39; refers to a disease process without cli... more &amp;#39;Histologic otosclerosis&amp;#39; refers to a disease process without clinical symptoms or manifestations that can only be discovered by sectioning of the temporal bone at autopsy. &amp;#39;Clinical otosclerosis&amp;#39; concerns the presence of otosclerosis at a site where it causes conductive hearing loss by interfering with the motion of the stapes or of the round window membrane. Various authors have studied the prevalence of histologic otosclerosis on laboratory collections of temporal bones. Some 12-15% of the temporal bones with histologic otosclerosis have demonstrated stapedial fixation. Using these figures for calculating the prevalence of clinical otosclerosis gives an extrapolated clinical prevalence of 0.99-1.2%. This does not correlate well with the clinical data on otosclerotic families from which a clinical prevalence of 0.3% has been estimated. To study the prevalence of histologic otosclerosis in an unselected series of temporal bones. During a 1-year period, 118 consecutive pairs of temporal bones of deceased patients at a tertiary center were collected to determine the prevalence of otosclerosis. Although histology remains the gold standard for evaluation of otosclerosis, the gross observation of temporal bone slices combined with microradiography was used to screen for otosclerotic lesions more rapidly and with a lower cost-benefit ratio. The temporal bones with suspected otosclerosis shown with these techniques were further analyzed by conventional histology. 2.5% of the 236 temporal bones (or 3.4% of patients) studied demonstrated histologic otosclerosis. Although the prevalence of 2.5% is much lower than previously published figures on histologic otosclerosis, the extrapolated data (extrapolated clinical prevalence = 0.30-0.38%) correlate well with clinical studies of otosclerotic families. The previous studies based on laboratory collections were likely biased by the presence of hearing loss or other otological diseases.

International journal of pediatric otorhinolaryngology, 2007

To investigate the additional bilateral benefits of a second cochlear implant (CI) in a group of ... more To investigate the additional bilateral benefits of a second cochlear implant (CI) in a group of young children (<6 years of age) and a group of older children (>6 years of age). This is a Belgian tertiary multi-centre study in which 33 CI-children with a second implant between the age of 2 and 12 participated. Assessments took place pre-second implant and at several time intervals post-fitting on pure tone audiometry and speech recognition in quiet and noise (+10 dBSNR). Testing was done with the first and second implant alone and bilaterally. Results were analysed separately for children younger and older than 6 years at the time of implantation of the 2nd CI. After 18 months of bilateral implant use all children obtained significantly higher hearing thresholds in the bilateral condition in comparison to both the unilateral conditions (p(CI1)=0.035/p(CI2)=0.042 for the younger children and p(CI1)=0.021/p(CI2)=0.007 for the older children). The speech recognition scores in qu...

Anatomical Record, 2000

A newly developed desktop microtomograph was used to evaluate whether it is suitable for visualiz... more A newly developed desktop microtomograph was used to evaluate whether it is suitable for visualizing the three-dimensional (3D) morphology of the mouse inner ear (at a micrometer level) and whether it is applicable as a fast screening tool to detect hereditary abnormalities in this organ. To this end, the epistatic circler, a mutant mouse showing abnormal circling behaviour, was used as a model. The inner ears were dissected out, formaldehyde-fixed, and scanned at maximal resolution along the longitudinal axis. After segmentation, stacks of tomographic images were used for 3D reconstruction of the bony labyrinth. Finally, the obtained data were correlated with subsequent conventional histological examination. The spatial resolution (8 m) achieved by this instrument, was found to be far superior to that obtained by conventional computer tomography (CT) and magnetic resonance (MR)-imaging equipment. The technique provides detailed tomographic images of the bony labyrinths and enables an adequate 3D reconstruction of the inner ear structures in this small mammal. In addition, it allows a screening for pathologic specimens prior to the more time-and labour-consuming histological techniques, which are still essential to gather information at a (sub)cellular level. This imaging technique can be regarded as a valuable tool in future research on hereditary inner ear abnormalities.