Isabela Crivellaro Gonçalves

Audiological and electrophysiological evaluation of children with acquired immunodeficiency syndrome (AIDS)

We examined the peripheral auditory system and the auditory brainstem pathway of children with Acquired Immunodeficiency Syndrome (AIDS). One hundred and one children, 51 with AIDS diagnosis and 50 normal children were evaluated. Audiological assessment included immittance measures, pure tone and speech audiometry and auditory brainstem response (ABR). The children with AIDS more frequently had abnormal results than did their matched controls, presenting either peripheral or auditory brainstem impairment. We suggest that AIDS be considered a risk factor for peripheral and/or auditory brainstem disorders. Further research should be carried out to investigate the auditory effects of HIV infection along the auditory pathway.

Manifestações eletrofisiológicas em adultos com HIV/AIDS submetidos e não-submetidos à terapia anti-retroviral

BACKGROUND: auditory evoked potentials (AEP) assess the neuroelectric activity on the auditory pathway -from the auditory nerve to the cerebral cortex - in response to an acoustic stimulus or event. Studies have demonstrated electrophysiological abnormalities in individuals with HIV/AIDS. AIM: to characterize the hearing electrophysiological manifestations in adults with HIV/AIDS by comparing the results obtained in the group exposed to antiretroviral therapy with those obtained in the group not exposed to such treatment. METHOD: electrophysiological evaluation of hearing (Auditory Brainstem Response - ABR, Auditory Middle Latency Reponse - AMLR and P300) was conducted in 56 individuals with HIV/AIDS: 24 participants composed group I (not exposed to antiretroviral treatment) and 32 participants composed group II (exposed to treatment). RESULTS: alterations in every AEP were observed in individuals with HIV/ AIDS, especially in the ABR. Indeed, the group exposed to antiretroviral treatment presented more alterations. CONCLUSION: individuals with HIV/AIDS may present alterations on the central and peripheral auditory nervous system. The group exposed to antiretroviral therapy presents more alterations on the brainstem auditory pathway.

Estabilidade dos potenciais evocados auditivos em indivíduos adultos com audição normal

PURPOSE: To evaluate the stability of parameters of auditory evoked potentials in normal adults. METHODS: Forty-nine normal subjects with ages from 18 to 40 years (25 females and 24 males) were submitted to audiological and electrophysiological hearing evaluation (auditory brainstem response - ABR, middle latency response - MLR, and cognitive potential - P300). Subjects were reassessed three months after the initial evaluation. RESULTS: Significant differences were observed between genders regarding the wave latencies III and V and the interpeaks I-III and I-IV of ABR, and the amplitude N2-P3 of the P300. No differences were found between the results of initial and final assessments for the parameters of the ABR, MLR (Na, Pa latencies and Na-Pa amplitude) and P300 (P300 latency). CONCLUSION: Except for the N2-P3 amplitude, it was observed stability of the parameters of ABR, MLR and P300 in normal adults after a period of three months.

Manifestações audiológicas em crianças e adultos com AIDS

BACKGROUND: according to the literature, the incidence of hearing impairment in patients with HIV / AIDS might be caused by alterations in external, middle and / or internal ear. AIM: to characterize and to compare the results of audiological assessment and Auditory Brainstem Response in children and adults with AIDS. METHOD: audiological and electrophysiological (Auditory Brainstem Response) assessment of hearing was carried out in 51 children and 22 adults with HIV/AIDS (research groups I and II, respectively) and in 50 healthy children and 25 healthy adults (control groups I and II, respectively). Participants ranged in age between 3 and 10 years (children) and between 18 and 50 years (adults). RESULTS: the most frequent observed alteration for children with AIDS was related to the middle ear whereas for adults with AIDS it was related to the internal ear. Higher occurrence of abnormal results was observed for adults with AIDS as compared to children with AIDS. CONCLUSION: children and adults with AIDS present alterations in audiological assessment and Auditory Brainstem Response. This suggests the involvement of peripheral and central auditory pathways. Findings of the present study emphasize the effectiveness of using electrophysiological hearing measures in order to better identify the brain injury level in patients with AIDS, besides allowing the monitoring of the development rate of the disease.

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.

Avaliação auditiva na Síndrome da Imunodeficiência Adquirida

OBJETIVO: Caracterizar as manifestacoes audiologicas em adultos com HIV/AIDS e comparar os resultados de individuos expostos e nao expostos ao tratamento anti-retroviral. METODOS: Foram submetidos a avaliacao audiologica 56 individuos com HIV/AIDS de ambos os generos, entre 18 e 58 anos de idade, divididos em dois grupos: GEI - composto por 24 individuos nao expostos ao tratamento anti-retroviral; e GEII - composto por 32 individuos expostos ao tratamento anti-retroviral. RESULTADOS: Verificou-se ocorrencia de resultados alterados na avaliacao audiologica em ambos os grupos, principalmente na audiometria de altas frequencias. Em ambos os grupos a principal alteracao encontrada foi a perda auditiva neurossensorial. O GEII apresentou mais resultados alterados em todos os procedimentos realizados e maior ocorrencia de resultados sugestivos de alteracoes na orelha media, quando comparado ao GEI. CONCLUSAO: Individuos com HIV/AIDS apresentam alteracoes auditivas perifericas, sendo estas mais acentuadas no grupo exposto ao tratamento anti-retroviral.

Auditory evoked potentials and multiple sclerosis

UNLABELLED 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.

Avaliação audiológica e eletrofisiológica em crianças com transtornos psiquiátricos

Individuos com transtornos psiquiatricos podem apresentar disturbios perceptuais, de atencao e memoria, questionando-se a presenca de perdas auditivas perifericas e/ou centrais. Assim, o objetivo deste trabalho e descrever os resultados obtidos nas avaliacoes audiologica e eletrofisiologica, verificando a ocorrencia de alteracoes auditivas perifericas e/ou centrais nesta populacao. CASUISTICA E METODOS: Foram avaliados 20 individuos com autismo e sindrome de Asperger, e 20 individuos em desenvolvimento tipico, entre oito e 19 anos. RESULTADOS: Todos os individuos apresentaram resultados normais na avaliacao audiologica. No PEATE, 50% dos individuos com autismo e 30% com sindrome de Asperger apresentaram alteracoes, havendo diferenca estatisticamente significante na analise dos dados quantitativos em ambos os grupos. Em todos os grupos verificaram-se alteracoes no PEAML e P300. No PEAML, nao houve diferenca estatisticamente significante entre os grupos na analise dos dados quantitativos e qualitativos. No P300, observou-se diferenca estatisticamente significante quando comparados os grupos controle e sindrome de Asperger na analise dos dados quantitativos. CONCLUSAO: Verificou-se grande ocorrencia de alteracoes nos potenciais evocados auditivos em criancas autistas e com sindrome de Asperger, embora em algumas analises realizadas nao tenha sido constatada diferenca estatisticamente significante. Enfatiza-se a importância da investigacao minuciosa da funcao auditiva em individuos com transtornos psiquiatricos.

Estudo das latências e amplitudes dos potenciais evocados auditivos de média latência em indivíduos audiologicamente normais

Contemporary cohort cross-sectional study. Introduction: The auditory middle latency response (AMLR) is generated between 10 and 80 ms and has multiple generators, with a greater contribution from the thalamus-cortical pathways. The establishment of normality criteria for latency and amplitude values is necessary for clinical use. AIM: to analyze the latency and amplitude of the AMLR in individuals without audiological disorders, and verify the reliability of Pa-Nb amplitude. MATERIALS AND METHODS: The AMLR of 25 individuals was collected during 2005 and the Na, Pa, Nb components were analyzed for each tested ear (A1 and A2), and electrode positioning (C3 and C4). RESULTS: A statistically significant difference was noticed among middle latency values for C3A1 and C4A1 regarding components Na and Pa, and no difference for component Nb and mean values for amplitudes Na-Pa and Pa-Nb. Conclusions: We established average and standard deviation values for latency and amplitude parameters for components Na, Pa, Nb and Na-Pa and Pa-Nb, under conditions C3A1, C4A1, C3A2, C4A2, providing a parameter for the analysis and interpretation of this potential.

Audiologic and electrophysiologic evaluation in children with psychiatric disorders

UNLABELLED 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.