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Nascimento JAD, Silva LAF, Samelli AG, Matas CG. Peripheral Auditory Pathway and ABR Characterization in Adults with Williams Syndrome. Int Arch Otorhinolaryngol 2024; 28:e502-e508. [PMID: 38974619 PMCID: PMC11226263 DOI: 10.1055/s-0044-1785457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/16/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction Williams syndrome (WS) is a genetic disorder caused by a microdeletion in chromosome 7, affecting ∼ 28 genes. Studies have demonstrated conductive losses seemingly related to the absence of the elastin gene and mild to profound sensorineural losses due to cochlear fragility. Objective To characterize and compare the peripheral auditory system and auditory brainstem response (ABR) of adults with WS and neurotypical adults matched by age and gender. Methods We conducted a cross-sectional observational study with 30 individuals of both sexes, aged 18 to 37 years - 15 of them with WS (study group) and 15 with neither the syndrome nor hearing complaints (control group), matched for sex and age. The subjects underwent pure-tone and speech audiometry, acoustic immittance, transient-evoked otoacoustic emissions (TEOAEs), and ABR. Results Early-onset sensorineural hearing loss was found in 53.3% of the study sample, mostly mild, occurring above 3 kHz. The TEOAEs were absent in 53.3% of assessed subjects; for those in whom they were present, the signal-to-noise responses were significantly lower than in the control group. In the ABR, increased absolute latencies were observed in waves I and III. Conclusion Individuals with WS have early and progressive cochlear impairments, mainly affecting the basal region of the cochlea. They may have low brainstem changes which seem to begin in adulthood.
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Affiliation(s)
- Jacqueline Aquino do Nascimento
- Department of Physical, Speech-Language-Hearing, and Occupational Therapies, School of Medicine, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
| | - Liliane Aparecida Fagundes Silva
- Department of Physical, Speech-Language-Hearing, and Occupational Therapies, School of Medicine, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
| | - Alessandra Gianella Samelli
- Department of Physical, Speech-Language-Hearing, and Occupational Therapies, School of Medicine, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
| | - Carla Gentile Matas
- Department of Physical, Speech-Language-Hearing, and Occupational Therapies, School of Medicine, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
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Silva LAF, Kawahira RSH, Kim CA, Matas CG. Audiological profile and cochlear functionality in Williams syndrome. Codas 2022; 34:e20210041. [PMID: 35043861 PMCID: PMC9769433 DOI: 10.1590/2317-1782/20212021041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/10/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE to evaluate cochlear functionality in Williams syndrome (WS) individuals. METHODS a study with 39 individuals, being 22 with WS aged between 7 and 17 years, 15 male and 7 female, and 17 individuals with typical development and normal hearing. All individuals were evaluated using pure tone audiometry, acoustic immittance measurements, and Transient Evoked Otoacoustic Emissions (TEOAE). The audiological profile in individuals with WS was analyzed, and TEOAE responses were compared between WS individuals without hearing loss and typical developmental individuals. RESULTS The hearing loss was observed in 50% of patients, being 78.95% sensorineural and 21.05% mixed. This hearing loss was predominantly mild to moderate, affecting mainly frequencies above 3 kHz. As for TEOAE, there was a higher incidence of absence and lower amplitude responses in individuals with WS. CONCLUSION WS individuals have hair cell dysfunction, mainly in the basal region of the cochlea. Thus, TEOAE analysis is an important clinical resource to be considered in the routine audiological evaluation.
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Affiliation(s)
- Liliane Aparecida Fagundes Silva
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina – FM, Universidade de São Paulo – USP – São Paulo (SP), Brasil.
| | - Rachel Sayuri Honjo Kawahira
- Unidade de Genética, Faculdade de Medicina – FM, Instituto da Criança, Hospital das Clinicas – HC, Universidade de São Paulo – USP – São Paulo (SP), Brasil.
| | - Chong Ae Kim
- Unidade de Genética, Faculdade de Medicina – FM, Instituto da Criança, Hospital das Clinicas – HC, Universidade de São Paulo – USP – São Paulo (SP), Brasil.
| | - Carla Gentile Matas
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina – FM, Universidade de São Paulo – USP – São Paulo (SP), Brasil.
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Silva LAF, Kim CA, Matas CG. Características da avaliação auditiva na síndrome de Williams: revisão sistemática. Codas 2018; 30:e20170267. [DOI: 10.1590/2317-1782/20182017267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/27/2018] [Indexed: 12/21/2022] Open
Abstract
RESUMO Objetivo Identificar por meio de uma revisão sistemática da literatura quais são as características da avaliação audiológica clínica de indivíduos com síndrome de Williams. Estratégia de pesquisa Inicialmente foi determinada a seguinte pergunta de pesquisa: “Quais são as características da avaliação auditiva clínica em indivíduos com síndrome de Williams?”. A partir desta, foi realizado um levantamento bibliográfico em 4 bases de dados, utilizando-se dos seguintes descritores: síndrome de Williams (Williams syndrome), perda auditiva (hearing loss) e audiologia (audiology). Critérios de seleção Foram selecionados artigos com nível de evidência 1 ou 2, publicados na íntegra nos idiomas português brasileiro ou inglês. Análise dos dados Foram analisados os resultados obtidos nos testes auditivos utilizados na rotina clínica, incluindo: imitanciometria, audiometria tonal, emissões otoacústicas e potencial evocado auditivo de tronco encefálico. Resultados 209 estudos foram encontrados, porém apenas 12 contemplaram os critérios de inclusão para o estudo. Foi possível observar prevalência de curva timpanométrica do tipo A, que pode ocorrer juntamente com ausência de reflexos acústicos, perda auditiva neurossensorial de grau leve a moderado acometendo principalmente as frequências altas, emissões otoacústicas ausentes ou de menor amplitude e potencial evocado auditivo de tronco encefálico sem alteração retrococlear. Conclusão O comprometimento coclear é comum em indivíduos com síndrome de Williams e as principais alterações na avaliação auditiva nesta população são a ausência das emissões otoacústicas e dos reflexos acústicos bem como a presença de perda auditiva neurossensorial de grau leve a moderado principalmente nas frequências altas na audiometria tonal.
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Van Eynde C, Swillen A, Lambeens E, Verhaert N, Desloovere C, Luts H, Poorten VV, Devriendt K, Hens G. Prevalence and Nature of Hearing Loss in 22q11.2 Deletion Syndrome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2016; 59:583-589. [PMID: 27249537 DOI: 10.1044/2015_jslhr-h-15-0098] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 11/18/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE The purpose of this study was to clarify the prevalence, type, severity, and age-dependency of hearing loss in 22q11.2 deletion syndrome. METHOD Extensive audiological measurements were conducted in 40 persons with proven 22q11.2 deletion (aged 6-36 years). Besides air and bone conduction thresholds in the frequency range between 0.125 and 8.000 kHz, high-frequency thresholds up to 16.000 kHz were determined and tympanometry, acoustic reflex (AR) measurement, and distortion product otoacoustic emission (DPOAE) testing were performed. RESULTS Hearing loss was identified in 59% of the tested ears and was mainly conductive in nature. In addition, a high-frequency sensorineural hearing loss with down-sloping curve was found in the majority of patients. Aberrant tympanometric results were recorded in 39% of the ears. In 85% of ears with a Type A or C tympanometric peak, ARs were absent. A DPOAE response in at least 6 frequencies was present in only 23% of the ears with a hearing threshold ≤30 dB HL. In patients above 14 years of age, there was a significantly lower percentage of measurable DPOAEs. CONCLUSION Hearing loss in 22q11.2 deletion syndrome is highly prevalent and both conductive and high-frequency sensorineural in nature. The age-dependent absence of DPOAEs in 22q11.2 deletion syndrome suggests cochlear damage underlying the high-frequency hearing loss.
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Santoro SD, Giacheti CM, Rossi NF, Campos LMG, Pinato L. Correlations between behavior, memory, sleep-wake and melatonin in Williams-Beuren syndrome. Physiol Behav 2016; 159:14-9. [DOI: 10.1016/j.physbeh.2016.03.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 02/26/2016] [Accepted: 03/02/2016] [Indexed: 01/12/2023]
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Paglialonga A, Barozzi S, Brambilla D, Soi D, Cesarani A, Spreafico E, Tognola G. Analysis of subtle auditory dysfunctions in young normal-hearing subjects affected by Williams syndrome. Int J Pediatr Otorhinolaryngol 2014; 78:1861-5. [PMID: 25193583 DOI: 10.1016/j.ijporl.2014.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 08/08/2014] [Accepted: 08/09/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess if young subjects affected by Williams syndrome (WS) with normal middle ear functionality and normal hearing thresholds might have subtle auditory dysfunctions that could be detected by using clinically available measurements. METHODS Otoscopy, acoustic reflexes, tympanometry, pure-tone audiometry, and distortion product otoacoustic emissions (DPOAEs) were measured in a group of 13 WS subjects and in 13 age-matched, typically developing control subjects. Participants were required to have normal otoscopy, A-type tympanogram, normal acoustic reflex thresholds, and pure-tone thresholds≤15 dB HL at 0.5, 1, and 2 kHz bilaterally. To limit the possible influence of middle ear status on DPOAE recordings, we analyzed only data from ears with pure-tone thresholds≤15 dB HL across all octave frequencies in the range 0.25-8 kHz, middle ear pressure (MEP)>-50 daPa, static compliance (SC) in the range 0.3-1.2 cm3, and ear canal volume (ECV) in the range 0.2-2 ml, and we performed analysis of covariance to remove the possible effects of middle ear variables on DPOAEs. RESULTS No differences in mean hearing thresholds, SC, ECV, and gradient were observed between the two groups, whereas significantly lower MEP values were found in WS subjects as well as significantly decreased DPOAEs up to 3.2 kHz after adjusting for differences in middle ear status. CONCLUSIONS Results revealed that WS subjects with normal hearing thresholds (≤15 dB HL) and normal middle ear functionality (MEP>-50 daPa, SC in the range 0.3-1.2 cm3, ECV in the range 0.2-2 ml) might have subtle auditory dysfunctions that can be detected by using clinically available methods. Overall, this study points out the importance of using otoacoustic emissions as a complement to routine audiological examinations in individuals with WS to detect, before the onset of hearing loss, possible subtle auditory dysfunctions so that patients can be early identified, better monitored, and promptly treated.
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Affiliation(s)
- Alessia Paglialonga
- National Research Council of Italy (CNR), Institute of Electronics, Computer and Telecommunication Engineering (IEIIT), Piazza Leonardo da Vinci 32, I-20133 Milano, Italy.
| | - Stefania Barozzi
- Audiology Unit, Department of Specialistic Surgical Sciences, University of Milan; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via Pace 9, I-20122 Milano, Italy
| | - Daniele Brambilla
- Audiology Unit, IRCCS Eugenio Medea, via Don Luigi Monza 20, I-23842 Bosisio Parini, Lecco, Italy
| | - Daniela Soi
- Audiology Unit, Department of Specialistic Surgical Sciences, University of Milan; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via Pace 9, I-20122 Milano, Italy
| | - Antonio Cesarani
- Audiology Unit, Department of Specialistic Surgical Sciences, University of Milan; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via Pace 9, I-20122 Milano, Italy
| | - Emanuela Spreafico
- Audiology Unit, IRCCS Eugenio Medea, via Don Luigi Monza 20, I-23842 Bosisio Parini, Lecco, Italy
| | - Gabriella Tognola
- National Research Council of Italy (CNR), Institute of Electronics, Computer and Telecommunication Engineering (IEIIT), Piazza Leonardo da Vinci 32, I-20133 Milano, Italy
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Canales CP, Wong ACY, Gunning PW, Housley GD, Hardeman EC, Palmer SJ. The role of GTF2IRD1 in the auditory pathology of Williams-Beuren Syndrome. Eur J Hum Genet 2014; 23:774-80. [PMID: 25248400 DOI: 10.1038/ejhg.2014.188] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 08/11/2014] [Accepted: 08/15/2014] [Indexed: 12/15/2022] Open
Abstract
Williams-Beuren Syndrome (WBS) is a rare genetic condition caused by a hemizygous deletion involving up to 28 genes within chromosome 7q11.23. Among the spectrum of physical and neurological defects in WBS, it is common to find a distinctive response to sound stimuli that includes extreme adverse reactions to loud, or sudden sounds and a fascination with certain sounds that may manifest as strengths in musical ability. However, hearing tests indicate that sensorineural hearing loss (SNHL) is frequently found in WBS patients. The functional and genetic basis of this unusual auditory phenotype is currently unknown. Here, we investigated the potential involvement of GTF2IRD1, a transcription factor encoded by a gene located within the WBS deletion that has been implicated as a contributor to the WBS assorted neurocognitive profile and craniofacial abnormalities. Using Gtf2ird1 knockout mice, we have analysed the expression of the gene in the inner ear and examined hearing capacity by evaluating the auditory brainstem response (ABR) and the distortion product of otoacoustic emissions (DPOAE). Our results show that Gtf2ird1 is expressed in a number of cell types within the cochlea, and Gtf2ird1 null mice showed higher auditory thresholds (hypoacusis) in both ABR and DPOAE hearing assessments. These data indicate that the principal hearing deficit in the mice can be traced to impairments in the amplification process mediated by the outer hair cells and suggests that similar mechanisms may underpin the SNHL experienced by WBS patients.
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Affiliation(s)
- Cesar P Canales
- Cellular and Genetic Medicine Unit, School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia
| | - Ann C Y Wong
- Translational Neuroscience Facility, Department of Physiology, School of Medical Sciences, UNSW Australia, Sydney, NWS, Australia
| | - Peter W Gunning
- Cellular and Genetic Medicine Unit, School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia
| | - Gary D Housley
- Translational Neuroscience Facility, Department of Physiology, School of Medical Sciences, UNSW Australia, Sydney, NWS, Australia
| | - Edna C Hardeman
- Cellular and Genetic Medicine Unit, School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia
| | - Stephen J Palmer
- Cellular and Genetic Medicine Unit, School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia
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