Monitoring auditory cortical plasticity in hearing aid users with long latency auditory evoked potentials: a longitudinal study

OBJECTIVE: The objective of this study was to compare long-latency auditory evoked potentials before and after hearing aid fittings in children with sensorineural hearing loss compared with age-matched children with normal hearing. METHODS: Thirty-two subjects of both genders aged 7 to 12 years participated in this study and were divided into two groups as follows: 14 children with normal hearing were assigned to the control group (mean age 9 years and 8 months), and 18 children with mild to moderate symmetrical bilateral sensorineural hearing loss were assigned to the study group (mean age 9 years and 2 months). The children underwent tympanometry, pure tone and speech audiometry and long-latency auditory evoked potential testing with speech and tone burst stimuli. The groups were assessed at three time points. RESULTS: The study group had a lower percentage of positive responses, lower P1-N1 and P2-N2 amplitudes (speech and tone burst), and increased latencies for the P1 and P300 components following the tone burst stimuli. They also showed improvements in long-latency auditory evoked potentials (with regard to both the amplitude and presence of responses) after hearing aid use. CONCLUSIONS: Alterations in the central auditory pathways can be identified using P1-N1 and P2-N2 amplitude components, and the presence of these components increases after a short period of auditory stimulation (hearing aid use). These findings emphasize the importance of using these amplitude components to monitor the neuroplasticity of the central auditory nervous system in hearing aid users

Study of long latency auditory evoked potentials in children pre and post-fitting individual hearing aid adaptation

Introdução: A perda auditiva na infância, mesmo perdas auditivas mínimas, pode dificultar ou atrasar a aquisição de linguagem da criança. Quanto mais tardio for o diagnóstico e o início da intervenção, maiores serão os efeitos da privação sensorial na via auditiva. Em crianças usuárias de aparelho de amplificação sonora individual (AASI), a utilização dos Potenciais Evocados Auditivos de Longa Latência (PEALL) torna-se uma ferramenta de verificação capaz de mensurar a maturação do sistema nervoso auditivo central (SNAC) ao longo do tempo de uso da amplificação. Objetivo: Caracterizar os potenciais evocados auditivos de longa latência (PEALL) em crianças com perda auditiva neurossensorial pré e pós-adaptação do aparelho de amplificação sonora individual (AASI). Metodologia: Estudo longitudinal constituído por 32 sujeitos e dividido em dois grupos: grupo estudo e grupo controle. O grupo estudo foi composto por 18 crianças, sendo cinco do gênero feminino e 13 do gênero masculino, com idade entre sete e 12 anos (média de idade: 9 anos e 2 meses), com perda auditiva neurossensorial bilateral simétrica de grau leve a moderado, sem experiência prévia com qualquer tipo de amplificação. Todas as crianças foram adaptadas com AASI bilateral após a primeira avaliação eletrofisiológica para a captação dos PEALL (componentes P1, N1, P2, N2 e P300) com estímulo de fala e estímulo tone burst, sendo que esta avaliação se repetiu 3 meses e 9 meses após o uso do AASI. O grupo controle foi composto por 14 crianças, sendo seis do gênero feminino e 8 do gênero masculino, com idade entre sete e 12 anos (média de idade: 9 anos e 8 meses). Todas as crianças deste grupo apresentaram audição normal e a avaliação para obtenção dos PEALL foi realizada respeitando o mesmo intervalo de tempo do grupo estudo: M0 - avaliação inicial; M3 e M9 - avaliação após três e nove meses da avaliação inicial. Resultados: Na comparação dos valores de latência e amplitude com o estímulo tone-burst no GE (condição sem AASI), observou-se diferença estatisticamente significante entre os três momentos de avaliação (M0xM3xM9) para a latência do P1 na orelha esquerda (OE) e latência do P300 na orelha direita (OD), com diminuição da latência ao longo do tempo. Na comparação dos momentos de avaliação dois a dois, para o componente P1 a diferença significante deu-se entre os momentos M0xM9 (p-valor=0,022), e para o componente P300 entre M0xM3 (p-valor=0,013). Com relação ao estímulo de fala pode-se observar uma diminuição estatisticamente significante nas latências dos componentes P2 (p-valor=0,010) e N2 (p-valor=0,007) (OE) entre os momentos M3 e M9. Quanto à presença e ausência dos componentes dos PEALL com estímulo de fala, verificou-se ausência dos componentes P1 e N1 no momento M3 assim como para N1, P2 e P300 no momento M9. Com estímulo tone burst observou-se ausência de respostas para os componentes N1 e P2, nos diferentes momentos de avaliação. No que diz respeito à correlação entre o tempo de privação sensorial e os componentes do PEALL obtidos com estímulo tone-burst na OD (condição com AASI) observou-se correlação estatisticamente significante entre tempo de privação sensorial e amplitude do P300 (p-valor=0,006), sendo que quanto maior o tempo de privação sensorial, menor a amplitude do P300 (r=-0,655). Com relação à correlação entre a frequência de uso do AASI e os componentes dos PEALL observou-se correlação estatisticamente significante entre frequência de uso do AASI e amplitude P2-N2 (p-valor=0,033) para o estímulo de fala na condição com AASI na OE. Conclusão: O PEALL demonstrou ser uma ferramenta clínica viável na avaliação de crianças usuárias de AASI, permitindo monitorar e mensurar a plasticidade neuronal do Sistema Nervoso Auditivo Central após um período de estimulação auditivaIntroduction: Hearing loss in childhood, even when very small, can hinder or even delay the process of language acquisition. The effects of sensory deprivation in the auditory pathway worsen, as diagnosis and the beginning of intervention are delayed. The use of Long Latency Auditory Evoked Potentials (LLAEP) in children that use individual hearing aids becomes a scanning tool capable of measuring the central auditory nervous system\'s (CANS) maturation throughout the period of use of the hearing aid. Purpose: To characterize the long latency auditory evoked potentials (LLAEP) in children with sensorineural hearing loss before and after fitting of hearing aids. Methodology: Longitudinal study composed of 32 subjects and divided into 2 groups: study group and control group. The study group was composed of 18 children, of these 5 were female and 13 were male, with ages between 7 and 12 years (age average: 9 years and 2 months), with mild to moderate bilateral symmetrical sensorineural hearing loss, with no previous experience using any kind of hearing aid. All of the children were fitted with bilateral hearing aids after the first electrophysiological assessment in order to record the LLAEP (components P1, N1, P2, N2 and P300), with speech and tone-burst stimuli; this assessment was repeated 3 and 9 months after the fitting of the hearing aids. The control group was composed of 14 children, of these 6 were female and 8 were male, with ages between 7 and 12 years (age average 9 years and 8 months). All of the children in this group showed normal hearing and the assessments to record the LLAEP were carried out in the same intervals of time as the study group: A0 - initial assessment; A3 and A9 - assessments 3 and 9 months after the initial assessment. Results: When comparing the latency and amplitude results with the tone-burst stimulus in the study group (SG) (without hearing aids), a statistically significant difference between the 3 assessments (A0xA3xA9) was observed for the P1 latency in the left ear (LE) and the P300 latency in the right ear (RE), with a decrease in latency with the passing of time. When comparing the assessments two by two, for the P1 component, the significant difference was recorded between A0xA9 (p-value=0,022), and for the P300 component, the significant difference was recorded between A0xA3 (p-value=0,013). Regarding the speech stimulus, a statistically significant decrease can be observed in the latency of the components P2 (p-value=0,010) and N2 (p-value=0,007) (LE) between A3 and A9. As for the presence and absence of the LLAEP components with the speech stimulus, an absence of the components P1 and N1 at A3 was observed, as well as for N1, P2 and P300 at A9. An absence of response was observed with the tone-burst stimulus for the N1 and P2 components, at the different times of assessment. As for the correlation between the period of sensory deprivation and the LLAEP components obtained from the tone-burst stimulus in the RE (with hearing aids), a statistically significant correlation was observed between the period of sensory deprivation and the amplitude of the P300 (p-value=0,006) - where there was a higher sensory deprivation time, the amplitude of the P300 was lower (r=-0,655). As for the correlation between the frequency of the use of hearing aids and the components of the LLAEP, a statistically significant relationship was observed between the frequency of use of hearing aids and the P2-N2 amplitude (p-value=0,033) for the speech stimulus when using hearing aids in the LE. Conclusion: The LLAEP proved to be a viable clinical tool in the assessment of children using hearing aids, allowing for the monitoring and measuring of the neural plasticity of the Central Auditory Nervous System after a period of hearing stimulatio

Monitoring auditory cortical plasticity in hearing aid users with long latency auditory evoked potentials: a longitudinal study

OBJECTIVE: The objective of this study was to compare long-latency auditory evoked potentials before and after hearing aid fittings in children with sensorineural hearing loss compared with age-matched children with normal hearing. METHODS: Thirty-two subjects of both genders aged 7 to 12 years participated in this study and were divided into two groups as follows: 14 children with normal hearing were assigned to the control group (mean age 9 years and 8 months), and 18 children with mild to moderate symmetrical bilateral sensorineural hearing loss were assigned to the study group (mean age 9 years and 2 months). The children underwent tympanometry, pure tone and speech audiometry and long-latency auditory evoked potential testing with speech and tone burst stimuli. The groups were assessed at three time points. RESULTS: The study group had a lower percentage of positive responses, lower P1-N1 and P2-N2 amplitudes (speech and tone burst), and increased latencies for the P1 and P300 components following the tone burst stimuli. They also showed improvements in long-latency auditory evoked potentials (with regard to both the amplitude and presence of responses) after hearing aid use. CONCLUSIONS: Alterations in the central auditory pathways can be identified using P1-N1 and P2-N2 amplitude components, and the presence of these components increases after a short period of auditory stimulation (hearing aid use). These findings emphasize the importance of using these amplitude components to monitor the neuroplasticity of the central auditory nervous system in hearing aid users

Effect of hearing aids use on speech stimulus decoding through speech-evoked ABR

Abstract Introduction The electrophysiological responses obtained with the complex auditory brainstem response (cABR) provide objective measures of subcortical processing of speech and other complex stimuli. The cABR has also been used to verify the plasticity in the auditory pathway in the subcortical regions. Objective To compare the results of cABR obtained in children using hearing aids before and after 9 months of adaptation, as well as to compare the results of these children with those obtained in children with normal hearing. Methods Fourteen children with normal hearing (Control Group - CG) and 18 children with mild to moderate bilateral sensorineural hearing loss (Study Group - SG), aged 7-12 years, were evaluated. The children were submitted to pure tone and vocal audiometry, acoustic immittance measurements and ABR with speech stimulus, being submitted to the evaluations at three different moments: initial evaluation (M0), 3 months after the initial evaluation (M3) and 9 months after the evaluation (M9); at M0, the children assessed in the study group did not use hearing aids yet. Results When comparing the CG and the SG, it was observed that the SG had a lower median for the V-A amplitude at M0 and M3, lower median for the latency of the component V at M9 and a higher median for the latency of component O at M3 and M9. A reduction in the latency of component A at M9 was observed in the SG. Conclusion Children with mild to moderate hearing loss showed speech stimulus processing deficits and the main impairment is related to the decoding of the transient portion of this stimulus spectrum. It was demonstrated that the use of hearing aids promoted neuronal plasticity of the Central Auditory Nervous System after an extended time of sensory stimulation

Effect of hearing aids use on speech stimulus decoding through speech-evoked ABR

<div><p>Abstract Introduction The electrophysiological responses obtained with the complex auditory brainstem response (cABR) provide objective measures of subcortical processing of speech and other complex stimuli. The cABR has also been used to verify the plasticity in the auditory pathway in the subcortical regions. Objective To compare the results of cABR obtained in children using hearing aids before and after 9 months of adaptation, as well as to compare the results of these children with those obtained in children with normal hearing. Methods Fourteen children with normal hearing (Control Group - CG) and 18 children with mild to moderate bilateral sensorineural hearing loss (Study Group - SG), aged 7-12 years, were evaluated. The children were submitted to pure tone and vocal audiometry, acoustic immittance measurements and ABR with speech stimulus, being submitted to the evaluations at three different moments: initial evaluation (M0), 3 months after the initial evaluation (M3) and 9 months after the evaluation (M9); at M0, the children assessed in the study group did not use hearing aids yet. Results When comparing the CG and the SG, it was observed that the SG had a lower median for the V-A amplitude at M0 and M3, lower median for the latency of the component V at M9 and a higher median for the latency of component O at M3 and M9. A reduction in the latency of component A at M9 was observed in the SG. Conclusion Children with mild to moderate hearing loss showed speech stimulus processing deficits and the main impairment is related to the decoding of the transient portion of this stimulus spectrum. It was demonstrated that the use of hearing aids promoted neuronal plasticity of the Central Auditory Nervous System after an extended time of sensory stimulation.</p></div

Age at the diagnosis and in the beginning of intervention from hearing impaired children, in a public Brazilian hearing health service

Introduction: The earlier the diagnosis and the intervention from the hearing impairment less will be the impact for the development of cognitive abilities, hearing and of speech from the child. Objective: Characterize the age in the diagnosis and the beginning of intervention of the hearing loss and the accompaniment of the assisted children in a public Brazillian hearing health service - Espaço Reouvir from the Clinicas Hospital from the Medical School from the University of São Paulo. Method: Retrospective study with information from 166 medical records from children regarding the: gender; etiology, type, degree and laterality of the hearing impairment; age in the diagnosis and adaptation of the Hearing aids (HA) and accompaniment in the service. Results: The sample was composed by 56% men and 44% women. The prevailing etiology was from multifactorial origin. The hearing loss from the neurosensory type occurred in 88,6% of the cases. The degree of moderate hearing loss was the most frequent (30,7%), symmetry in both ears was found in 69,9% of the cases and unilateral hearing loss in 2,4%. The average age in the diagnosis was of 5,46 years and in the intervention was of 6,86 years. A total of 96,98% of children had already completed the process of adaptation and 78,32% still remained in the accompaniment. Conclusion: The program Reouvir-HCFMUSP still receives children, both for diagnosis and or intervention in a late manner. However, still is possible the realization of the accompaniment of a significant number of users of the hearing aids, enabling a process of adaptation more effective