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Di Stadio A, De Luca P, Koohi N, Kaski D, Ralli M, Giesemann A, Hartung HP, Altieri M, Messineo D, Warnecke A, Frohman T, Frohman EM. Neuroinflammatory disorders of the brain and inner ear: a systematic review of auditory function in patients with migraine, multiple sclerosis, and neurodegeneration to support the idea of an innovative 'window of discovery'. Front Neurol 2023; 14:1204132. [PMID: 37662038 PMCID: PMC10471191 DOI: 10.3389/fneur.2023.1204132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/24/2023] [Indexed: 09/05/2023] Open
Abstract
Background Hearing can be impaired in many neurological conditions and can even represent a forme fruste of specific disorders. Auditory function can be measured by either subjective or objective tests. Objective tests are more useful in identifying which auditory pathway (superior or inferior) is most affected by disease. The inner ear's perilymphatic fluid communicates with the cerebrospinal fluid (CSF) via the cochlear aqueduct representing a window from which pathological changes in the contents of the CSF due to brain inflammation could, therefore, spread to and cause inflammation in the inner ear, damaging inner hair cells and leading to hearing impairment identifiable on tests of auditory function. Methods A systematic review of the literature was performed, searching for papers with case-control studies that analyzed the hearing and migraine function in patients with neuro-inflammatory, neurodegenerative disorders. With data extracted from these papers, the risk of patients with neurological distortion product otoacoustic emission (DPOAE) was then calculated. Results Patients with neurological disorders (headache, Parkinson's disease, and multiple sclerosis) had a higher risk of having peripheral auditory deficits when compared to healthy individuals. Conclusion Existing data lend credence to the hypothesis that inflammatory mediators transmitted via fluid exchange across this communication window, thereby represents a key pathobiological mechanism capable of culminating in hearing disturbances associated with neuroimmunological and neuroinflammatory disorders of the nervous system.
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Affiliation(s)
- Arianna Di Stadio
- GF Ingrassia Department, University of Catania, Catania, Italy
- IRCCS Santa Lucia, Rome, Italy
| | - Pietro De Luca
- Head and Neck Department, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Nehzat Koohi
- The UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Diego Kaski
- The UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Massimo Ralli
- Department of Sense Organs, University Sapienza, Rome, Italy
| | - Anja Giesemann
- Department of Interventional Neuroradiologie, Hannover Medical School, Hannover, Germany
| | - Hans-Peter Hartung
- Klinik für Neurologie UKD Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
| | - Marta Altieri
- Department of Neurology, University Sapienza, Rome, Italy
| | - Daniela Messineo
- Department of Radiology and Pathology, University Sapienza, Rome, Italy
| | - Athanasia Warnecke
- Department of Otolaryngology-Head and Neck Surgery, Hannover Medical School, Hannover, Germany
| | - Teresa Frohman
- Distinguished Senior Fellows (Sabbatical), Laboratory of Neuroimmunology of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Elliot M. Frohman
- Distinguished Senior Fellows (Sabbatical), Laboratory of Neuroimmunology of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA, United States
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Treatment of Far-Advanced Otosclerosis: Stapedotomy Plus Hearing Aids to Maximize the Recovery of Auditory Function-A Retrospective Case Series. Healthcare (Basel) 2023; 11:healthcare11050676. [PMID: 36900680 PMCID: PMC10000942 DOI: 10.3390/healthcare11050676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 03/02/2023] Open
Abstract
Far-advanced otosclerosis (FAO) refers to severe otosclerosis with scarce auditory functions. The identification of the best method to correctly listen to sound and speech has a large impact on patients' quality of life. We retrospectively analyzed the auditory function of 15 patients affected by FAO who were treated with stapedectomy plus hearing aids independent of the severity of their auditory deficit before surgery. The combination of surgery and hearing aids allowed excellent recovery of the perception of pure tone sounds and speech. Four patients, because of poor auditory thresholds, needed a cochlear implant after stapedectomy. Despite being based on a small sample of patients, our results suggest that stapedotomy plus hearing aids could improve the auditory capacities of patients with FAO independent of their auditory thresholds at T0. The careful selection of patients is fundamental to obtain the best outcomes.
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Guerrieri M, Di Mauro R, Di Girolamo S, Di Stadio A. Hearing and Ageing. Subcell Biochem 2023; 103:279-290. [PMID: 37120472 DOI: 10.1007/978-3-031-26576-1_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Age-related hearing loss (ARHL), or presbycusis, occurs in most mammals, humans included, with a different age of onset and magnitude of loss. It is associated with two major symptoms: loss of sensitivity to sound, especially for high pitches, and a reduced ability to understand speech in background noise. This phenomenon involves both the peripheral structures of the inner ear and the central acoustic pathways. Several mechanisms have been identified as pro-ageing in the human cochlea. The main one is the oxidative stress. The inner ear physiological degeneration can be affected by both intrinsic conditions, such as genetic predisposition, and extrinsic ones, such as noise exposure. The magnitude of neuronal loss precedes and exceeds that of inner hair cell loss, which is also less important than the loss of outer hair cells. Patients with HL often develop atrophy of the temporal lobe (auditory cortex) and brain gliosis can contribute to the development of a central hearing loss. The presence of white matter hyperintensities (WMHs) on the MRI, which is radiologic representation of brain gliosis, can justify a central HL due to demyelination in the superior auditory pathways. Recently, the presence of WMHs has been correlated with the inability to correctly understand words in elderly with normal auditory thresholds.
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Affiliation(s)
| | - Roberta Di Mauro
- ENT Department, MVZ Dr. Roser und Kollegen, Remchingen, Baden-Württemberg, Germany
| | | | - Arianna Di Stadio
- GF Ingrassia Department, University of Catania, Catania, Italy.
- , Rome, Italy.
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Hotz I, Deschwanden PF, Liem F, Mérillat S, Malagurski B, Kollias S, Jäncke L. Performance of three freely available methods for extracting white matter hyperintensities: FreeSurfer, UBO Detector, and BIANCA. Hum Brain Mapp 2021; 43:1481-1500. [PMID: 34873789 PMCID: PMC8886667 DOI: 10.1002/hbm.25739] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 11/11/2021] [Accepted: 11/26/2021] [Indexed: 11/07/2022] Open
Abstract
White matter hyperintensities (WMH) of presumed vascular origin are frequently found in MRIs of healthy older adults. WMH are also associated with aging and cognitive decline. Here, we compared and validated three algorithms for WMH extraction: FreeSurfer (T1w), UBO Detector (T1w + FLAIR), and FSL's Brain Intensity AbNormality Classification Algorithm (BIANCA; T1w + FLAIR) using a longitudinal dataset comprising MRI data of cognitively healthy older adults (baseline N = 231, age range 64–87 years). As reference we manually segmented WMH in T1w, three‐dimensional (3D) FLAIR, and two‐dimensional (2D) FLAIR images which were used to assess the segmentation accuracy of the different automated algorithms. Further, we assessed the relationships of WMH volumes provided by the algorithms with Fazekas scores and age. FreeSurfer underestimated the WMH volumes and scored worst in Dice Similarity Coefficient (DSC = 0.434) but its WMH volumes strongly correlated with the Fazekas scores (rs = 0.73). BIANCA accomplished the highest DSC (0.602) in 3D FLAIR images. However, the relations with the Fazekas scores were only moderate, especially in the 2D FLAIR images (rs = 0.41), and many outlier WMH volumes were detected when exploring within‐person trajectories (2D FLAIR: ~30%). UBO Detector performed similarly to BIANCA in DSC with both modalities and reached the best DSC in 2D FLAIR (0.531) without requiring a tailored training dataset. In addition, it achieved very high associations with the Fazekas scores (2D FLAIR: rs = 0.80). In summary, our results emphasize the importance of carefully contemplating the choice of the WMH segmentation algorithm and MR‐modality.
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Affiliation(s)
- Isabel Hotz
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | | | - Franziskus Liem
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Susan Mérillat
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Brigitta Malagurski
- University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Spyros Kollias
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program (URPP), Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
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Hearing Loss and Cognitive Impairment: Epidemiology, Common Pathophysiological Findings, and Treatment Considerations. Life (Basel) 2021; 11:life11101102. [PMID: 34685474 PMCID: PMC8538578 DOI: 10.3390/life11101102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/04/2021] [Accepted: 10/15/2021] [Indexed: 12/04/2022] Open
Abstract
In recent years, there has been increasing research interest in the correlation between hearing impairment and cognitive decline, two conditions that have demonstrated a strong association. Hearing loss appears as a risk factor for cognitive impairment, especially among certain populations, notably nursing home residents. Furthermore, hearing loss has been identified as a modifiable age-related condition linked to dementia, and it has been estimated that midlife hearing loss, if eliminated, might decrease the risk of dementia in the general population. Several mechanisms have been suggested to explain the pathologic connections between hearing loss and dementia; however, clear evidence is missing, and the common pathophysiological basis is still unclear. In this review, we discussed current knowledge about the relationship between hearing loss and dementia, and future perspectives in terms of the effects of hearing rehabilitation for early prevention of cognitive decline.
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De Luca P, Scarpa A, Ralli M, Tassone D, Simone M, De Campora L, Cassandro C, Di Stadio A. Auditory Disturbances and SARS-CoV-2 Infection: Brain Inflammation or Cochlear Affection? Systematic Review and Discussion of Potential Pathogenesis. Front Neurol 2021; 12:707207. [PMID: 34421805 PMCID: PMC8373381 DOI: 10.3389/fneur.2021.707207] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/28/2021] [Indexed: 12/23/2022] Open
Abstract
Patients affected by COVID-19 present a series of different symptoms; despite some of these are common, other less likely appear. Auditory symptoms seem to be less frequent, maybe because rarer or, alternatively, because they are underestimated during the clinical investigation. The hearing impairment might be related to the central or peripheral involvement of the auditory pathways; in particular, the likelihood of thrombosis might be one of the causes. To date, the prevalence of auditory symptoms such as sudden or progressive sensorineural hearing loss and tinnitus is unclear in COVID-19 patients. However, their presence might be an early sign of thrombosis or spread of the infection into the brain. In this systematic review of the literature we investigated the presence of auditory symptoms in COVID-19 patients and discussed their potential origin and causal relationship with SARS-CoV-2. Results showed that, despite rarely, auditory impairment can appear in patients with COVID-19 and should always be investigated for an early treatment and potential indicator of involvement of the central nervous system.
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Affiliation(s)
- Pietro De Luca
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Alfonso Scarpa
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Domenico Tassone
- Otolaryngology Unit, San Giovanni Addolorata Hospital, Rome, Italy
| | - Matteo Simone
- Otolaryngology Unit, San Giovanni Addolorata Hospital, Rome, Italy
| | - Luca De Campora
- Otolaryngology Unit, San Giovanni Addolorata Hospital, Rome, Italy
| | | | - Arianna Di Stadio
- Department of Surgery and Biomedical Sciences, Section of Otorhinolaryngology, "Santa Maria della Misericordia" University Hospital, Perugia, Italy
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Di Stadio A, Dipietro L, De Lucia A, Ippolito V, Ishai R, Garofalo S, Pastore V, Ricci G, Della Volpe A. A Novel Bone Conduction Hearing System May Improve Memory Function in Children with Single Side Hearing loss: A Case-Control Study. J Int Adv Otol 2021; 16:158-164. [PMID: 32784152 DOI: 10.5152/iao.2020.7941] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES To evaluate the effects of an adhesive adapter prosthesis (AAP) on memory function in pediatric subjects with single side hearing loss (SSHL). MATERIALS AND METHODS Case-control study. 19 pediatric subjects with mild to moderate SSHL treated with AAP and 15 subjects with normal hearing (control group) were included in this study. Working and short-term memory functions were tested in all subjects, in silence and noise conditions. In SSHL subjects, tests were performed before the AAP was applied (T0) and at 1-month (T1) follow-up. The control group was tested once. RESULTS AAP significantly improved working memory function in noise as measured at T1 (p<0.01) compared with T0, but T1 scores in children with SSHL remained significantly different from the ones of the control group (p<0.01). AAP also significantly improved short- term memory function test scores at T1 compared with T0 (p<0.01), but despite being in the normal range for the subjects' age, the scores remained significantly different from those of the control group (p<0.01). CONCLUSION In pediatric subjects with mild, moderate, and moderate-severe SSHL, restoration of bilateral hearing through AAP improved short-term memory function and working memory function in noise, as measured at 1 month follow-up; however, AAP did not seem to lead to a full restoration of such functions as measured by a comparison with healthy controls. Further studies with longer follow-ups might help elucidate whether AAP can elicit further improvements in memory functions.
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Affiliation(s)
| | | | - Antonietta De Lucia
- Otology and Cochlear Implant Unit, Regional Referral Centre Children's Hospital "Santobono-Pausilipon", Naples, Italy
| | - Valentina Ippolito
- Otology and Cochlear Implant Unit, Regional Referral Centre Children's Hospital "Santobono-Pausilipon", Naples, Italy
| | - Reuven Ishai
- Department of Otology and Neurotology and Head and Neck Surgery, Bnai Zion Medical Center, Haifa, Israel
| | - Sabina Garofalo
- Otology and Cochlear Implant Unit, Regional Referral Centre Children's Hospital "Santobono-Pausilipon", Naples, Italy
| | - Vincenzo Pastore
- Otology and Cochlear Implant Unit, Regional Referral Centre Children's Hospital "Santobono-Pausilipon", Naples, Italy
| | - Giampietro Ricci
- Department of Otolaryngology, University of Perugia, Perugia, Italy
| | - Antonio Della Volpe
- Otology and Cochlear Implant Unit, Regional Referral Centre Children's Hospital "Santobono-Pausilipon", Naples, Italy
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Di Stadio A, Ralli M, Roccamatisi D, Scarpa A, Della Volpe A, Cassandro C, Ricci G, Greco A, Bernitsas E. Hearing loss and dementia: radiologic and biomolecular basis of their shared characteristics. A systematic review. Neurol Sci 2021; 42:579-588. [PMID: 33409831 DOI: 10.1007/s10072-020-04948-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 11/27/2020] [Indexed: 02/07/2023]
Abstract
Dementia and hearing loss share radiologic and biologic findings that might explain their coexistence, especially in the elderly population. Brain atrophy has been observed in both conditions, as well as the presence of areas of gliosis. The brain atrophy is usually focal; it is located in the temporal lobe in patients with hearing loss, while it involves different part of brain in patients with dementia. Radiological studies have shown white matter hyperintensities (WMHs) in both conditions. WMHs have been correlated with the inability to correctly understand words in elderly persons with normal auditory thresholds and, the identification of these lesion in brain magnetic resonance imaging studies has been linked with an increased risk of developing cognitive loss. In addition to WMHs, some anatomopathological studies identified the presence of brain gliosis in the elderly's brain. The cause-effect link between hearing loss and dementia is still unknown, despite they might share some common findings. The aim of this systematic review is to analyze radiologic and biomolecular findings that these two conditions might share, identify a common pathological basis, and discuss the effects of hearing aids on prevention and treatment of cognitive decline in elderly patients with hearing loss.
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Affiliation(s)
- Arianna Di Stadio
- Otolaryngology Department, University of Perugia, Perugia, Italy. .,Neuroinflammation Lab, UCL Queen Square Neurology, London, UK.
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Dalila Roccamatisi
- Psychology Department, Università Telematica Internazionale Uninettuno (UTIU), Rome, Italy
| | - Alfonso Scarpa
- Department of Otolaryngology, University of Salerno, Salerno, Italy
| | - Antonio Della Volpe
- Otology and Cochlear Implant Unit, Santobono-Pausilipon Hospital of Naples, Naples, Italy
| | | | - Giampietro Ricci
- Otolaryngology Department, University of Perugia, Perugia, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
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Di Stadio A, Volpe AD, Ralli M, Korsch F, Greco A, Ricci G. Spiral Ganglions and Speech Perception in the Elderly. Which Turn of the Cochlea is the More Relevant? A Preliminary Study on Human Temporal Bones. J Int Adv Otol 2020; 16:318-322. [PMID: 33136010 DOI: 10.5152/iao.2020.8481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To identify the cochlear segment in which spiral ganglion neuron (SGN) loss may more severely impact discrimination thresholds. MATERIALS AND METHODS Thirteen temporal bones from 13 subjects between 55 and 77 years of age were analyzed. The organ of corti was analyzed to identify the loss of hair cells, and the number of SGNs in each cochlear segment were counted. The results of the speech perception test (SPT) and pure tone audiometry (PTA) tests were collected. PTA averages for low and high frequencies were calculated. One-way analysis of variance (ANOVA), Pearson, Spearman, and multilinear regression tests were performed. RESULTS No statistically significant correlation was identified between the patient's age and number of SGNs. Statistically significant differences were observed between the number of SGNs in the different cochlear segments (one-way ANOVA: p<0.0001) and between poor PTA average and SPT scores (negative correlation) (p=0.03). A statistically significant correlation was identified between the overall number of cochlear SGNs and SPT scores (p=0.02) and between the number of SGNs in cochlear segments I (p=0.04) and II and the SPT score (p=0.03). CONCLUSIONS We identified that residual SGNs in the basal and middle turns of the cochlea might be determinants of speech perception.
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Affiliation(s)
| | - Antonio Della Volpe
- Otology and Cochlear Implant Unit, Regional Referral Centre Children's Hospital "Santobono-Pausilipon", Naples, Italy
| | - Massimo Ralli
- Department of Organ of Sense, University La Sapienza, Rome, Italy
| | - Fiammetta Korsch
- Department of Otolaryngology, Santobono Posilipon Hospital, Naples, Italy
| | - Antonio Greco
- Department of Organ of Sense, University La Sapienza, Rome, Italy
| | - Giampietro Ricci
- Department of Otolaryngology, University of Perugia, Perugia, Italy
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