A comparison between hearing and tone burst electrophysiological thresholds

SummaryStudies have reported compatibility between hearing and electrophysiological thresholds in the auditory brainstem response (ABR) with tone burst stimuli.Aimsto verify waves I, III, V and their latency times for tone bursts at 500, 1000, 2000 and 4000 Hz and at 80 dB HL, and to compare tone burst electrophysiological thresholds with those obtained from audiological and psychoacoustic evaluations.Methodsaudiological, psychoacoustic and electrophysiological evaluations of 40 male and female normal hearing individuals aged between 18 and 40 years were undertaken.Resultsonly wave V was visualized at 80 dB HL and its latency values decreased with increased frequencies in both genders. At 1000, 2000 and 4000 Hz male subjects presented higher electrophysiological thresholds values than females at all frequencies. At 500, 1000 and 2000 Hz, electrophysiological, hearing, and psychoacoustic thresholds were statistically different in both genders.Conclusionalthough ABR with tone burst stimulus is clinically applicable, further research is needed to standardize test techniques and results

Audiologic and electrophysiologic evaluation in children with psychiatric disorders

Indivíduos com transtornos psiquiátricos podem apresentar distúrbios perceptuais, de atenção e memória, questionando-se a presença de perdas auditivas periféricas e/ou centrais. Assim, o objetivo deste trabalho é descrever os resultados obtidos nas avaliações audiológica e eletrofisiológica, verificando a ocorrência de alterações auditivas periféricas e/ou centrais nesta população. CASUÍSTICA E MÉTODOS: Foram avaliados 20 indivíduos com autismo e síndrome de Asperger, e 20 indivíduos em desenvolvimento típico, entre oito e 19 anos. RESULTADOS: Todos os indivíduos apresentaram resultados normais na avaliação audiológica. No PEATE, 50% dos indivíduos com autismo e 30% com síndrome de Asperger apresentaram alterações, havendo diferença estatisticamente significante na análise dos dados quantitativos em ambos os grupos. Em todos os grupos verificaram-se alterações no PEAML e P300. No PEAML, não houve diferença estatisticamente significante entre os grupos na análise dos dados quantitativos e qualitativos. No P300, observou-se diferença estatisticamente significante quando comparados os grupos controle e síndrome de Asperger na análise dos dados quantitativos. CONCLUSÃO: Verificou-se grande ocorrência de alterações nos potenciais evocados auditivos em crianças autistas e com síndrome de Asperger, embora em algumas análises realizadas não tenha sido constatada diferença estatisticamente significante. Enfatiza-se a importância da investigação minuciosa da função auditiva em indivíduos com transtornos psiquiátricos.Individuals with psychiatric disorders can present perception, attention and memory deficits, raising doubts about peripheral and/or central hearing loss. Thus, the aim of this study is to describe the audiological and electrophysiological results of individuals with psychiatric disorders, looking for peripheral and/or central auditory disorders. METHODS: 20 individuals with autism and Asperger syndrome and 20 individuals without psychiatric disorders from eight to 19 years of age, were submitted to audiological and electrophysiological evaluation. RESULTS: No alterations were observed on the audiological evaluation in all the individuals. In ABR, 50% of individuals with autism and 30% with Asperger syndrome presented alterations. Significant statistical differences were observed between the groups in the quantitative analysis. All groups presented alterations in AMLR and P300. In AMLR, no significant statistical differences were observed between the groups in the qualitative and quantitative analyses. In the P300, we noticed significant statistical differences between Asperger and control groups in the quantitative analysis. CONCLUSIONS: A high occurrence of alterations in auditory evoked potentials was seen in children with psychiatric disorders, although in some analysis it was observed a non-statistically significant difference when comparing study and control groups. We stress the need for a more careful investigation of the auditory function in this population.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Middle and late latency auditory evoked potentials in adults with AIDS

BACKGROUND: middle and late latency auditory evoked potentials. AIM: to verify the occurrence of middle and late latency auditory evoked potentials disorders in adults with Acquired Immunodeficiency Syndrome (AIDS). METHOD: middle and late latency auditory evoked potentials of 8 individuals with AIDS, with ages ranging from 10 to 51 years, with normal hearing, or with sensoryneural hearing losses up to moderate, and normal results in the Auditory Brainstem Response, comparing the results with the responses obtained for a control group which was composed by 25 individuals, with ages ranging from 19 to 24 years, with no hearing complaints and with normal hearing and normal results in the Auditory Brainstem Response. RESULTS: the Pa wave latency and amplitude averages in the C3/A2 and C4/A1 modalities, and the average of the P300 wave were analyzed. No significant differences were observed in the Pa wave amplitude and latency averages between the groups, although a non-statistically significant increase was observed in the latency and a decrease in the amplitude of such wave for the research group in the C3/A2 modality. The latency of the P300 wave was significantly longer to the left for the research group. It was also observed a longer latency to the right, although this was not statistically significant. CONCLUSION: adult individuals with AIDS do not present alterations in the middle latency auditory evoked potential and do present alterations in the cognitive potential, indicating a disorder in the cortical regions of the auditory pathway and a deficit in the cognitive processing of auditory information for this population. Such findings stress the importance of a careful investigation of the auditory function of individuals with AIDS, thus favoring the therapeutic planning.TEMA: potenciais evocados auditivos de média e longa latências. OBJETIVO: verificar a ocorrência de alterações nos potenciais evocados auditivos de média e longa latências em indivíduos adultos portadores da síndrome da imunodeficiência adquirida (AIDS). MÉTODO: foram obtidos os potenciais evocados auditivos de média e longa latências em oito indivíduos com AIDS, de 10 a 51 anos de idade, que apresentavam audição normal ou até perda auditiva neurossensorial de grau moderado e resultados normais na Audiometria de Tronco Encefálico, comparando os resultados com os obtidos no grupo controle constituído por 25 indivíduos, de 19 a 24 anos de idade, sem queixas auditivas e com audição dentro da normalidade, bem como com resultados normais na Audiometria de Tronco Encefálico. RESULTADOS: foram analisadas as médias das latências e amplitudes da onda Pa, nas modalidades contralaterais C3/A2 e C4/A1, e da latência da onda P300. Não foram observadas diferenças estatisticamente significantes com relação às médias da amplitude e latência da onda Pa entre os grupos, embora tenha sido observado um aumento da latência e diminuição da amplitude de tal onda, ainda que não estatisticamente significante, para o grupo estudo na modalidade C3/A2. A latência da onda P300 mostrou-se significantemente aumentada para o lado esquerdo no grupo estudo, sendo também possível observar um aumento da latência, embora não estatisticamente significante, para o lado direito. CONCLUSÃO: indivíduos adultos com AIDS não apresentam alterações no potencial evocado auditivo de média latência e apresentam alterações no potencial cognitivo sugerindo, desta forma, comprometimento da via auditiva em regiões corticais e déficit no processamento cognitivo das informações auditivas nesta população. Tais achados reforçam a importância de uma investigação minuciosa da função auditiva em indivíduos com AIDS auxiliando, desta forma, no delineamento da conduta terapêutica junto a estes pacientes.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUniversidade de São Paulo Faculdade de MedicinaUNIFESP, EPMSciEL

Auditory evoked potentials and multiple sclerosis

Multiple sclerosis (MS) is an inflammatory, demyelinating disease that can affect several areas of the central nervous system. Damage along the auditory pathway can alter its integrity significantly. Therefore, it is important to investigate the auditory pathway, from the brainstem to the cortex, in individuals with MS. Objective: the aim of this study was to characterize auditory evoked potentials in adults with MS of the remittent-recurrent type. Method: the study comprised 25 individuals with MS, between 25 and 55 years, and 25 age- and gender-matched healthy controls (research and control groups). Subjects underwent audiological and electrophysiological evaluations. Results: Statistically significant differences were observed between the groups regarding the results of the auditory brainstem response and the latency of the Na and P300 waves. Conclusion: Individuals with MS present abnormalities in auditory evoked potentials indicating dysfunction of different regions of the central auditory nervous system.Univ São Paulo FMUSP, Auditory Evoked Potentials Lab, Sch Med, Speech Pathol & Audiol Course, São Paulo, BrazilUniv São Paulo FMUSP, Speech Pathol & Audiol Course, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo Hosp, São Paulo, BrazilFMUSP, Rehabil Sci Program, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo Hosp, São Paulo, BrazilWeb of Scienc

Auditory disorders and acquisition of the ability to localize sound in children born to HIV-positive mothers

The objective of the present study was to evaluate children born to HIV-infected mothers and to determine whether such children present auditory disorders or poor acquisition of the ability to localize sound. The population studied included 143 children (82 males and 61 females), ranging in age from one month to 30 months. The children were divided into three groups according to the classification system devised in 1994 by the Centers for Disease Control and Prevention: infected; seroreverted; and exposed. The children were then submitted to audiological evaluation, including behavioral audiometry, visual reinforcement audiometry and measurement of acoustic immittance. Statistical analysis showed that the incidence of auditory disorders was significantly higher in the infected group. In the seroreverted and exposed groups, there was a marked absence of auditory disorders. In the infected group as a whole, the findings were suggestive of central auditory disorders. Evolution of the ability to localize sound was found to be poorer among the children in the infected group than among those in the seroreverted and exposed groups.University of São Paulo School Infectious Diseases Division Department of PediatricsFederal University of São Paulo Department of Speech-Language and Hearing ScienceFederal University of São Paulo Department of Pediatric InfectologyUNIFESP, Department of Speech-Language and Hearing ScienceUNIFESP, Department of Pediatric InfectologySciEL

Speech and non‐speech processing in children with phonological disorders: an electrophysiological study

OBJECTIVE: To determine whether neurophysiological auditory brainstem responses to clicks and repeated speech stimuli differ between typically developing children and children with phonological disorders. INTRODUCTION: Phonological disorders are language impairments resulting from inadequate use of adult phonological language rules and are among the most common speech and language disorders in children (prevalence: 8 - 9%). Our hypothesis is that children with phonological disorders have basic differences in the way that their brains encode acoustic signals at brainstem level when compared to normal counterparts. METHODS: We recorded click and speech evoked auditory brainstem responses in 18 typically developing children (control group) and in 18 children who were clinically diagnosed with phonological disorders (research group). The age range of the children was from 7-11 years. RESULTS: The research group exhibited significantly longer latency responses to click stimuli (waves I, III and V) and speech stimuli (waves V and A) when compared to the control group. DISCUSSION: These results suggest that the abnormal encoding of speech sounds may be a biological marker of phonological disorders. However, these results cannot define the biological origins of phonological problems. We also observed that speech-evoked auditory brainstem responses had a higher specificity/sensitivity for identifying phonological disorders than click-evoked auditory brainstem responses. CONCLUSIONS: Early stages of the auditory pathway processing of an acoustic stimulus are not similar in typically developing children and those with phonological disorders. These findings suggest that there are brainstem auditory pathway abnormalities in children with phonological disorders

Noise-induced tinnitus: auditory evoked potential in symptomatic and asymptomatic patients

OBJECTIVES: We evaluated the central auditory pathways in workers with noise-induced tinnitus with normal hearing thresholds, compared the auditory brainstem response results in groups with and without tinnitus and correlated the tinnitus location to the auditory brainstem response findings in individuals with a history of occupational noise exposure. METHOD: Sixty individuals participated in the study and the following procedures were performed: anamnesis, immittance measures, pure-tone air conduction thresholds at all frequencies between 0.25-8 kHz and auditory brainstem response. RESULTS: The mean auditory brainstem response latencies were lower in the Control group than in the Tinnitus group, but no significant differences between the groups were observed. Qualitative analysis showed more alterations in the lower brainstem in the Tinnitus group. The strongest relationship between tinnitus location and auditory brainstem response alterations was detected in individuals with bilateral tinnitus and bilateral auditory brainstem response alterations compared with patients with unilateral alterations. CONCLUSION: Our findings suggest the occurrence of a possible dysfunction in the central auditory nervous system (brainstem) in individuals with noise-induced tinnitus and a normal hearing threshold

Study of suppression effect in the brainstem auditory evoked potential

TEMA: o efeito de supressão com ruído branco contralateral verificado sobre o potencial evocado auditivo de tronco encefálico pode ter influência do sistema auditivo eferente. OBJETIVOS: avaliar o efeito de supressão com ruído branco contralateral no potencial evocado auditivo de tronco encefálico em indivíduos com limiares auditivos dentro da normalidade. MÉTODOS: participaram desta pesquisa 25 indivíduos, de 18 a 30 anos de idade, de ambos os sexos, que foram submetidos à anamnese, inspeção do meato acústico externo, audiometria tonal liminar, logoaudiometria e medidas de imitância acústica, com o objetivo de selecionar os indivíduos com acuidade auditiva normal. Em seguida os indivíduos selecionados realizaram o potencial evocado auditivo de tronco encefálico sem e com ruído branco contralateral. RESULTADOS: na comparação entre as condições sem e com ruído branco contralateral verificou-se diferença estatisticamente significante para a amplitude da onda I e para as latências absolutas das ondas III e V, porém não foi observada diferença estatisticamente significante com relação às latências interpicos. CONCLUSÕES: o presente estudo verificou aumento nas latências e diminuição nas amplitudes das ondas I, III e V na presença de ruído contralateral, quando comparadas as condições com e sem ruído. Estes resultados sugerem uma possível influência do sistema nervoso auditivo eferente na modulação das respostas do potencial evocado auditivo de tronco encefálico quando se utiliza ruído branco contralateral.BACKGROUND: the suppression effect with contralateral white noise observed in the brainstem auditory evoked potential can be influenced by the efferent auditory system. AIM: to evaluate the suppression effect with contralateral white noise in the Brainstem Auditory Evoked Potential of individuals with normal hearing. METHODS: 25 individuals, ranging in age from 18 to 30 years, of both genders, were submitted to a clinical history questionnaire, inspection of the external auditory canal, conventional audiometry, speech audiometry and acoustic immittance measurements. Only individuals with normal hearing thresholds were selected. The selected individuals underwent brainstem auditory evoked potential testing with and without contralateral white noise. RESULTS: a significant statistical difference was observed between the situations with and without contralateral white noise, for wave I amplitude and waves III and V latencies. No statistical differences were observed for the interpeak latencies. CONCLUSION: the present study indicated increased latencies and reduced amplitudes of waves I, III and V with contralateral noise, when comparing the situations with and without noise. These results suggest a possible influence of the efferent auditory system on the response modulation of Brainstem auditory evoked potential when contralateral white noise is used

The audiological profile of adults with and without hypertension

OBJECTIVE: To determine whether there is any influence of systemic arterial hypertension on the peripheral auditory system. METHODS: This was a cross-sectional study that investigated 40 individuals between 30 and 50 years old, who were divided into groups with and without systemic arterial hypertension, using data from high-frequency audiometry, transient-evoked otoacoustic emissions and distortion-product otoacoustic emissions. The results were compared with those from groups of normal-hearing individuals, with and without systemic arterial hypertension, who underwent the pure-tone audiometry test. All individuals also underwent the following procedures: otoscopy, acoustic immittance measures, pure-tone audiometry at frequencies from 250 to 16000 Hz, transient-evoked otoacoustic emissions test and distortion-product otoacoustic emissions test. RESULTS: No statistically significant difference was observed between the groups with and without systemic arterial hypertension in either conventional or high-frequency audiometry. Regarding transient-evoked otoacoustic emissions, there was a trend toward statistical significance whereby the systemic arterial hypertension group showed lower results. Regarding distortion-product otoacoustic emissions, the systemic arterial hypertension group showed significantly lower results at the following frequencies: 1501, 2002, and 3003 Hz. A discriminant analysis indicated that the distortion-product otoacoustic emissions variables best distinguished individuals with and without systemic arterial hypertension. CONCLUSION: Data from this study suggest cochlear dysfunction in individuals with systemic arterial hypertension because their otoacoustic emission results were lower than those in the systemic arterial hypertension group

A longitudinal study of the peripheral and central auditory pathways in individuals with acute lymphoid leukemia

Objective: To characterize the peripheral and central auditory pathways in individuals with Acute Lymphoid Leukemia (ALL) and compare assessment results before and during chemotherapy. Method: The study included 17 subjects with ALL, divided into two age groups: 3 to 6 (11 individuals) and 7 to 16 years old (6 individuals). Each subject was evaluated twice (before and 3 to 6 months after chemotherapy treatment) with the following procedures: medical history survey, otoscopy, Pure-Tone Threshold (PTA) and speech audiometry, acoustic immittance measures, Brainstem Auditory Evoked Potentials (BAEP) and Long-Latency Auditory Evoked Potentials (LLAEP). Results: PTA was normal. Tympanometry was abnormal in the second assessment in 2 individuals aged 3 to 6 years. One subject in each age group had absent ipsilateral acoustic reflexes. In high-frequency audiometry, 1 individual had abnormal results. BAEP was abnormal in 5 (first assessment) and 7 individuals (second assessment) aged 3 to 6 years and 2 (first assessment) and 1 individual (second assessment) aged 7 to 16 years. As for LLAEP, P1 latency was increased in 5 (first assessment) and 7 individuals (second assessment) aged 3 to 6 years. Conclusion: No hearing loss was identified in the behavioral audiological assessment. BAEP was more affected in the 3-to-6-year-old group, with greater impairment in the lower brainstem in the first and second assessments. In LLAEP, P1 was the most impaired component in children aged 3 to 6 years, and P2 and N2 were so for those 7 to 16 years old, especially in the second assessment