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Ribas-Prats T, Arenillas-Alcón S, Martínez SIF, Gómez-Roig MD, Escera C. The frequency-following response in late preterm neonates: a pilot study. Front Psychol 2024; 15:1341171. [PMID: 38784610 PMCID: PMC11112609 DOI: 10.3389/fpsyg.2024.1341171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Infants born very early preterm are at high risk of language delays. However, less is known about the consequences of late prematurity. Hence, the aim of the present study is to characterize the neural encoding of speech sounds in late preterm neonates in comparison with those born at term. Methods The speech-evoked frequency-following response (FFR) was recorded to a consonant-vowel stimulus /da/ in 36 neonates in three different groups: 12 preterm neonates [mean gestational age (GA) 36.05 weeks], 12 "early term neonates" (mean GA 38.3 weeks), and "late term neonates" (mean GA 41.01 weeks). Results From the FFR recordings, a delayed neural response and a weaker stimulus F0 encoding in premature neonates compared to neonates born at term was observed. No differences in the response time onset nor in stimulus F0 encoding were observed between the two groups of neonates born at term. No differences between the three groups were observed in the neural encoding of the stimulus temporal fine structure. Discussion These results highlight alterations in the neural encoding of speech sounds related to prematurity, which were present for the stimulus F0 but not for its temporal fine structure.
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Affiliation(s)
- Teresa Ribas-Prats
- Brainlab–Cognitive Neuroscience Research Group. Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Sonia Arenillas-Alcón
- Brainlab–Cognitive Neuroscience Research Group. Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Silvia Irene Ferrero Martínez
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- BCNatal–Barcelona Center for Maternal Fetal and Neonatal Medicine (Hospital Sant Joan de Déu and Hospital Clínic), University of Barcelona, Barcelona, Spain
| | - Maria Dolores Gómez-Roig
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- BCNatal–Barcelona Center for Maternal Fetal and Neonatal Medicine (Hospital Sant Joan de Déu and Hospital Clínic), University of Barcelona, Barcelona, Spain
| | - Carles Escera
- Brainlab–Cognitive Neuroscience Research Group. Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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2
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Rossetti E, Pro S, Picardo S, Longo D, DI Capua M. Brain auditory evoked potentials in pediatric Intensive Care Unit: diagnostic role on encephalopathy and central respiratory failure on infants. Minerva Pediatr (Torino) 2024; 76:197-200. [PMID: 33820408 DOI: 10.23736/s2724-5276.21.05931-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Encephalopathy of different etiologies in infants is often the reason for central respiratory insufficiency which eventually leads patients to the Pediatric Intensive Care Unit. Magnetic resonance imaging (MRI) and brainstem auditory evoked potentials (BAEPs) may be useful to identify brainstem alterations among patients with respiratory insufficiency of central origin. MRI is a compulsory technique to identify brain abnormalities, but may fail to detect brainstem lesions of small dimensions. BAEPs play a highly sensitive role on brainstem dysfunction identification because of the generators of different peaks which are related to specific brainstem structures. METHODS The study included ten infants affected by encephalopathy of different etiologies and early neurological respiratory failure. To evaluate BAEPs, the surface electrodes were placed at the vertex (Cz) and on each mastoid side. RESULTS All subjects presented alteration of BAEPs. The brain MRI revealed selective injury of the brainstem in four patients and supratentorial alterations in six patients. CONCLUSIONS The early identification of brainstem lesions in mechanically ventilated infants with encephalopathy may reduce the weaning off mechanical ventilation's attempt numbers and provide early informative discussions with families and clinical caregivers about treatment options, such as tracheostomy, long term ventilation and the reduction of their length of PICU stay. Furthermore, this would support the evaluation process concerning the affected children, their families and the needs of other social groups, including health systems.
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Affiliation(s)
- Emanuele Rossetti
- Pediatric Emergency, Department of Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, Rome, Italy -
| | - Stefano Pro
- Unit of Neurophysiology, Department of Neurology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Sergio Picardo
- Pediatric Emergency, Department of Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Daniela Longo
- Department of Radiology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Matteo DI Capua
- Unit of Neurophysiology, Department of Neurology, Bambino Gesù Children's Hospital, Rome, Italy
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Santos DS, Fernandes LDC, Rissatto-Lago MR, Costa ACN. Auditory Pathway Maturation in Full-term Small for Gestational Age Children: A Systematic Review with Meta-analysis. Int Arch Otorhinolaryngol 2023; 27:e744-e750. [PMID: 37876702 PMCID: PMC10593533 DOI: 10.1055/s-0042-1758215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/01/2022] [Indexed: 10/26/2023] Open
Abstract
Introduction Factors of intrauterine growth restriction have been responsible for the births of full-term babies small for their gestational age (SGA). Scientific evidence points that this restriction can cause changes in the neural maturation process. Objectives To analyze the absolute latencies and interpeak intervals of brainstem auditory evoked potential waves in full-term and SGA children to investigate whether there are changes of neural maturation in this population. Data Synthesis The search for articles that reported the assessment of brainstem auditory evoked potential in SGA newborns compared with a control, appropriate for their gestational age, both born full-term, for the entire period available in the database research until October 31, 2021 was performed based on the MEDLINE/PubMed Central and on the Latin America and the Caribbean Health Sciences Literature and Virtual Health Library electronic databases. A total of 311 studies were found in the database research. Out of this total, 10 studies were included in the review, 5 of which were eligible for the meta-analysis, involving a total of 473 participants of both genders, with 193 participants belonging to the study group and 280 to the control group. Differences between the groups were only observed in the absolute latency of wave V (95% confidence interval [CI]: 0.02-0.15; p < 0.01). Conclusion The SGA condition is responsible for the appearance of brainstem neural conduction dysfunction measured by the brainstem auditory evoked potentials, probably by the maturation process of the auditory pathway of this population.
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Affiliation(s)
| | - Luciene da Cruz Fernandes
- Multidisciplinary Institute of Rehabilitation in Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Ana Caline Nóbrega Costa
- Multidisciplinary Institute of Rehabilitation in Health, Federal University of Bahia, Salvador, Bahia, Brazil
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Novitskiy N, Chan PHY, Chan M, Lai CM, Leung TY, Leung TF, Bornstein MH, Lam HS, Wong PCM. Deficits in neural encoding of speech in preterm infants. Dev Cogn Neurosci 2023; 61:101259. [PMID: 37257249 DOI: 10.1016/j.dcn.2023.101259] [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: 01/11/2023] [Revised: 05/19/2023] [Accepted: 05/25/2023] [Indexed: 06/02/2023] Open
Abstract
Preterm children show developmental cognitive and language deficits that can be subtle and sometimes undetectable until later in life. Studies of brain development in children who are born preterm have largely focused on vascular and gross anatomical characteristics rather than pathophysiological processes that may contribute to these developmental deficits. Neural encoding of speech as reflected in EEG recordings is predictive of future language development and could provide insights into those pathophysiological processes. We recorded EEG from 45 preterm (≤ 34 weeks of gestation) and 45 term (≥ 38 weeks) Chinese-learning infants 0-12 months of (corrected) age during natural sleep. Each child listened to three speech stimuli that differed in lexically meaningful pitch (2 native and 1 non-native speech categories). EEG measures associated with synchronization and gross power of the frequency following response (FFR) were examined. ANCOVAs revealed no main effect of stimulus nativeness but main effects of age, consistent with earlier studies. A main effect of prematurity also emerged, with synchronization measures showing stronger group differences than power. By detailing differences in FFR measures related to synchronization and power, this study brings us closer to identifying the pathophysiological pathway to often subtle language problems experienced by preterm children.
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Affiliation(s)
- Nikolay Novitskiy
- Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, China
| | - Peggy H Y Chan
- Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, China; Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | - Mavis Chan
- Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, China
| | - Chin Man Lai
- Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, China
| | - Tak Yeung Leung
- Department of Obsterics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China
| | - Ting Fan Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | - Marc H Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA; UNICEF, USA; Institute for Fiscal Studies, UK
| | - Hugh S Lam
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China.
| | - Patrick C M Wong
- Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, China.
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Bagheri F, Miresmaeili Z, Mahmoodi-Bakhtiari B, Ahmadi A, Ahmadi ZZ. Effects of sex and gestational age on the auditory brainstem responses among two ears in moderate preterm infants. HEARING, BALANCE AND COMMUNICATION 2023. [DOI: 10.1080/21695717.2023.2176661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Fereshteh Bagheri
- Department of Audiology, School of Rehabilitation Sciences, Babol University of Medical Sciences, Babol, Iran
| | | | | | - Akram Ahmadi
- Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran
| | - Zohreh Ziatabar Ahmadi
- Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, Iran
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Borenstein-Levin L, Taha R, Riskin A, Hafner H, Cohen-Vaizer A, Gordin A, Littner Y, Dinur G, Hochwald O, Kugelman A. Effects of neurodevelopmental risk factors on brainstem maturation in premature infants. Pediatr Res 2022; 92:168-173. [PMID: 34789841 DOI: 10.1038/s41390-021-01849-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 10/16/2021] [Accepted: 10/31/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Interpeak latencies (IPL), as measured by the auditory brainstem-evoked responses (ABR) test, represent the conduction time, and therefore the maturation of the brainstem auditory pathway. We aimed to study the effect of various risk factors for the neurodevelopmental delay on the conduction time in the auditory pathway among normal hearing premature infants, at term postmenstrual age (PMA). METHODS Retrospective analysis of 239 premature infants (gestational age 32.5 ± 2.1 weeks, birth weight 1827 ± 483 g). Interpeak latencies, demographic data, and risk factors were recorded. RESULTS Sex, PMA at ABR test, being small for gestational age (SGA), intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL), and days of invasive ventilation were found to significantly affect the IPL's in the auditory pathway in a univariate analysis. Multivariable regression analysis revealed that male sex and less advanced PMA at the examination were independent factors associated with prolonged IPL's, while bronchopulmonary dysplasia, IVH or PVL and being SGA shortened the IPL's. Non-invasive mechanical ventilation, did not affect the caudal part of the auditory pathway, despite its high noise level. CONCLUSIONS Among various risk factors for the neurodevelopmental delay, male sex was associated with delayed, while IVH or PVL, BPD and SGA could be associated with accelerated auditory brainstem maturation. IMPACT Auditory brainstem-evoked response (ABR) test, among normal hearing infants, can serve as a clinical tool to assess brainstem auditory maturation. Different neurodevelopmental risk factors could have different effects on the maturity of the auditory pathway. Male sex is significantly associated with prolonged interpeak latencies (IPL) among preterm and term infants, while intraventricular hemorrhage or periventricular leukomalacia, bronchopulmonary dysplasia, and being small for gestation age may be associated with shortened IPL The corrected age at ABR testing is of significance, among preterm and term infants.
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Affiliation(s)
- L Borenstein-Levin
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. .,Department of Neonatology, Rambam Health Care Campus, Haifa, Israel.
| | - R Taha
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - A Riskin
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Neonatology, Bnai Zion Medical Center, Haifa, Israel
| | - H Hafner
- Laboratory of Neurosurgery, Rambam Health Care Campus, Haifa, Israel
| | - A Cohen-Vaizer
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of ENT, Rambam Health Care Campus, Haifa, Israel
| | - A Gordin
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of ENT, Rambam Health Care Campus, Haifa, Israel
| | - Y Littner
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Neonatology, Rambam Health Care Campus, Haifa, Israel
| | - G Dinur
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Neonatology, Rambam Health Care Campus, Haifa, Israel
| | - O Hochwald
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Neonatology, Rambam Health Care Campus, Haifa, Israel
| | - A Kugelman
- Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Neonatology, Rambam Health Care Campus, Haifa, Israel
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Delayed Auditory Brainstem Responses (ABR) in children after sight-recovery. Neuropsychologia 2021; 163:108089. [PMID: 34801518 DOI: 10.1016/j.neuropsychologia.2021.108089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 10/29/2021] [Accepted: 11/15/2021] [Indexed: 01/25/2023]
Abstract
Studies in non-human animal models have revealed that in early development, the onset of visual input gates the critical period closure of some auditory functions. The study of rare individuals whose sight was restored after a period of congenital blindness offers the rare opportunity to assess whether early visual input is a prerequisite for the full development of auditory functions in humans as well. Here, we investigated whether a few months of delayed visual onset would affect the development of Auditory Brainstem Responses (ABRs). ABRs are widely used in the clinical practice to assess both functionality and development of the subcortical auditory pathway and, provide reliable data at the individual level. We collected Auditory Brainstem Responses from two case studies, young children (both having less than 5 years of age) who experienced a transient visual deprivation since birth due to congenital bilateral dense cataracts (BC), and who acquired sight at about two months of age. As controls, we tested 41 children (sighted controls, SC) with typical development, as well as two children who were treated (at about two months of age) for congenital monocular cataracts (MC). The SC group data served to predict, at the individual level, wave latencies of each BC and MC participant. Statistics were performed both at the single subject as well as at the group levels on latencies of main ABR waves (I, III, V and SN10). Results revealed delayed response latencies for both BC children compared with the SC group starting from the wave III. Conversely, no difference emerged between MC children and the SC group. These findings suggest that in case the onset of patterned visual input is delayed, the functional development of the subcortical auditory pathway lags behind typical developmental trajectories. Ultimately results are in favor of the presence of a crossmodal sensitive period in the human subcortical auditory system.
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Berticelli AZ, Bueno CD, Rocha VO, Ranzan J, Riesgo RDS, Sleifer P. Central auditory processing: behavioral and electrophysiological assessment of children and adolescents diagnosed with stroke. Braz J Otorhinolaryngol 2021; 87:512-520. [PMID: 31983665 PMCID: PMC9422462 DOI: 10.1016/j.bjorl.2019.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 10/24/2019] [Accepted: 10/28/2019] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Central auditory processing refers to the efficiency and effectiveness with which the central nervous system uses auditory information: it may be altered in neurological disorders and brain injuries, such as strokes. However, despite evidence of probable alterations in the pediatric population, functional abilities and post-stroke limitations are still not well documented in the literature. OBJECTIVE To analyze the findings of the electrophysiological and behavioral evaluations of central auditory processing of children and adolescents diagnosed with stroke from a reference outpatient clinic, as well as to investigate possible associations with the variables: type and location of the stroke and age group. METHODS The present study is characterized as comparative cross-sectional. The sample, for convenience, included individuals aged 7-18 years divided into two groups: study group, composed of individuals with a diagnosis of stroke, and control group, composed of individuals with typical development. The evaluation consisted of the following procedures: anamnesis, basic audiological evaluation, behavioral evaluation of the auditory processing disorder (dichotic digit test, dichotic consonant-vowel, synthetic sentence identification/pediatric speech intelligibility, gaps in noise, pitch pattern sequence, masking level difference), and electrophysiological evaluation (P300 and mismatch negativity). RESULTS Nineteen children and adolescents were included in the study group. The control group was composed of 19 children and adolescents with typical development. In the comparison between the groups, a worse performance is observed for the study group in all the evaluated tests, behavioral and electrophysiological. In the behavioral evaluation of central auditory processing, there was a statistical difference for all tests, except for masking level difference and dichotic digit test, binaural separation step on the left. In the electrophysiological evaluation, there was a statistical difference in the latency of mismatch negativity and P300. No associations were found between the behavioral and electrophysiological findings and the location of the stroke and age group variables. CONCLUSION Children and adolescents diagnosed with stroke present a worse performance in the electrophysiological and behavioral evaluations of central auditory processing when compared to a control group.
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Affiliation(s)
- Amanda Zanatta Berticelli
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.
| | - Claudine Devicari Bueno
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | - Vanessa Onzi Rocha
- Pontifícia Universidade Católica do Rio Grande do Sul, Programa de Pós-Graduação em Medicina: Neurociências, Porto Alegre, RS, Brazil
| | - Josiane Ranzan
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Rudimar Dos Santos Riesgo
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Pricila Sleifer
- Universidade Federal do Rio Grande do Sul, Departamento de Saúde e Comunicação Humana, Porto Alegre, RS, Brazil
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Mohammed ST, El-Farrash RA, Taha HM, Moustafa OA. Auditory Brainstem Evoked Response Patterns in the Neonatal Intensive Care Unit. Am J Perinatol 2021; 38:e231-e238. [PMID: 32276280 DOI: 10.1055/s-0040-1709467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Delayed maturation of auditory brainstem pathway in neonates admitted to the neonatal intensive care unit (NICU) may lead to misdiagnosis of children with normal peripheral hearing and inappropriate use of amplification devices. The aim of this study is to determine the pattern of auditory brain stem response in neonates admitted to the NICU for proper hearing assessment in this high-risk population. STUDY DESIGN This prospective study was conducted on 1,469 infants who were admitted to the NICU, of which 1,423 had one or more risk factors for permanent congenital hearing loss and were screened with automated auditory brain stem response (AABR). A total of 60 infants were referred for diagnostic ABR analysis after failure on AABR screening. The control group comprised 60 well-baby nursery neonates with no risk factors for PCHL. RESULTS Mean values of absolute latencies of waves III and V; interpeak latencies I-III, III-V, and I-V; amplitude of waves I, and V; and I/V amplitude ratio at 90 dBnHL measured for the right and left ears at 1 and 3 months of age show significant difference in NICU neonates compared with controls (p < 0.05). All the diagnostic ABR measurements significantly improved at the age of 3 months (p < 0.001) except wave I absolute latency of both groups (p > 0.05). Significant correlations were found between ABR readings at the age of 1 and 3 months and the gestational age of the NICU neonates (p < 0.05). CONCLUSION Diagnostic ABR findings in NICU neonates suggested delayed maturation of the auditory brainstem pathway with a great impact of gestational age on this maturation. Auditory maturational changes were observed at 3 months of age of patient and control groups.
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Affiliation(s)
| | - Rania Ali El-Farrash
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Bertachini ALL, Januario GC, Novi SL, Mesquita RC, Silva MAR, Andrade GMQ, de Resende LM, de Miranda DM. Hearing brain evaluated using near-infrared spectroscopy in congenital toxoplasmosis. Sci Rep 2021; 11:10135. [PMID: 33980948 PMCID: PMC8115034 DOI: 10.1038/s41598-021-89481-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 04/20/2021] [Indexed: 12/11/2022] Open
Abstract
Congenital toxoplasmosis (CT) is a known cause of hearing loss directly caused by Toxoplasma gondii. Hearing loss might result from sensory, neural, or sensorineural lesions. Early treated infants rarely develop hearing loss, but retinochoroidal lesions, intracranial calcifications and hydrocephalus are common. In this study, we aimed to evaluate the brain evoked hemodynamic responses of CT and healthy infants during four auditory stimuli: mother infant directed speech, researcher infant directed speech, mother reading and researcher recorded. Children underwent Transitionally Evoked Otoacoustic Emission Auditory Testing and Automated Brainstem Auditory Response tests with normal auditory results, but with a tendency for greater latencies in the CT group compared to the control group. We assessed brain hemodynamics with functional near-infrared spectroscopy (fNIRS) measurements from 61 infants, and we present fNIRS results as frequency maps of activation and deactivation for each stimulus. By evaluating infants in the three first months of life, we observed an individual heterogeneous brain activation pattern in response to all auditory stimuli for both groups. Each channel was activated or deactivated in less than 30% of children for all stimuli. There is a need of prospective studies to evaluate if the neurologic or auditory changes course with compromise of children outcomes.
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Affiliation(s)
- Ana Lívia Libardi Bertachini
- Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,NUPAD - Center for Newborn Screening and Genetic Diagnostics, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gabriela Cintra Januario
- Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,NUPAD - Center for Newborn Screening and Genetic Diagnostics, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sergio Luiz Novi
- "Gleb Wataghin'' Institute of Physics, University of Campinas, Campinas, Brazil
| | | | | | - Gláucia Manzan Queiroz Andrade
- Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,NUPAD - Center for Newborn Screening and Genetic Diagnostics, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luciana Macedo de Resende
- Department of Speech and Hearing Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,NUPAD - Center for Newborn Screening and Genetic Diagnostics, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Marques de Miranda
- Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. .,Centro de Tecnologia Em Medicina Molecular, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena 190, Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil.
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11
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Changes in auditory function in premature children: A prospective cohort study. Int J Pediatr Otorhinolaryngol 2020; 139:110456. [PMID: 33096380 DOI: 10.1016/j.ijporl.2020.110456] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To analyze the age-specific pattern of auditory function in preterm children as a function of their gestational age at birth. STUDY DESIGN longitudinal cohort study. METHODS a prospective cohort study involved 271 preterm children aged from 6 months to 15 years old. Children were divided into two groups: 70 children with a gestational age at birth of 32-36 weeks (Group 1) and 201 children with a gestational age of 22-31 weeks (Group 2). Hearing was assessed by ABR, ASSR, OAE, behavioral audiometry, and pure tone audiometry. Additionally, for some children, CT, MRI, and GBJ2 evaluations were performed. Assessments of hearing impaired children were performed 3-4 times a year for children under 2 years of age; 2-3 times a year for children from 2 to 5 years of age; and 1-2 times a year for children over 5 years of age. Infants without any hearing problems were examined 2-3 times during their first year of life, followed by annual examinations as they aged. RESULTS The initial hearing examination identified SNHL and ANSD in 18 children (25.7%) and 64 children (31.8%) in Group 1 and Group 2, respectively. No significant difference in the occurrence of auditory impairment in the two groups was found at the initial assessment (p > 0.05). Further long-term follow-up revealed changes in hearing in 16 children: 15 from Group 2 and only one child from Group 1. Four different kinds of hearing changes were noted: hearing recovery to normal levels in children with ANSD; late onset hearing loss; the transformation of ANSD to SNHL, and vice versa. The age, factors, and possible mechanisms of such changes are discussed in the article. CONCLUSION The auditory function in prematurely born children tends to be unstable, especially at a very early age. In very preterm infants, it may either deteriorate or improve. Infants born before 31 weeks' gestation require long-term follow-up at least until they are 3-4 years of age. Caution is advised regarding very early cochlear implantation for children born before 32 weeks of gestation age.
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12
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Bellia CGDL, Junior HA, Marques JM, Lüders D, Gonçalves CGDO. Brainstem Auditory Evoked Potentials in infants aged 1 to 24 months during a hearing health care service. Clinics (Sao Paulo) 2020; 75:e1579. [PMID: 33146347 PMCID: PMC7561056 DOI: 10.6061/clinics/2020/e1579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/17/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Assessing infants' hearing is of utmost importance, as hearing at this phase is required for the development of oral language. Through hearing, human beings are capable of developing communication. The Brainstem Auditory Evoked Potentials are an indispensable test to diagnose deafness in infants. This study aimed to analyze the results of the Brainstem Auditory Evoked Potentials in children with risk factors for hearing loss. METHODS This cross-sectional study analyzed the Brainstem Auditory Evoked Potentials in 123 infants aged 1 to 24 months at a hearing health care service. The Vivosonic Integrity V500 equipment, which enabled the child to be awake while the testing was carried out, was used in this study. The data were compared by gestational age and sex, according to the standards suggested in the equipment handbook. RESULTS A significant difference was verified for age ranges 4 to 6 months, 13 to 15 months (waves I and V), and 7 to 9 months (wave V). The lower values in absolute wave latencies were comparable to data from the equipment handbook, justifying the need for standardization of the screening process. CONCLUSION There are some differences between the standards in the equipment handbook and those observed in our study. These results will serve as a reference for the standardization of the equipment used in the hearing health care service.
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Seethapathy J, Boominathan P, Uppunda AK, Ninan B. Changes in Auditory Brainstem Response in very preterm and late preterm infants. Int J Pediatr Otorhinolaryngol 2019; 121:88-94. [PMID: 30878558 DOI: 10.1016/j.ijporl.2019.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/26/2019] [Accepted: 03/06/2019] [Indexed: 11/19/2022]
Abstract
AIM Aim of this study was to compare the absolute and interpeak latencies of Auditory Brainstem Responses (ABR) in very preterm and late preterm infants at 1 month and 3 months of corrected age. METHOD ology: ABR traces were obtained from 80 preterm infants (40 very preterm and 40 late preterm) at 1 month and 3 months of corrected age in a prospective, comparative cohort study. Auditory click stimuli at 70 dBnHL and 30 dBnHL, with repetition rate of 11.1/s were used. Absolute latencies of peak I, III, V and interpeak latencies of peak I-V, I-III and III-V were analyzed and compared between preterm groups at 1 month and 3 months of corrected age. Wilcoxon Signed Ranks test was used to compare the ABR variables. Mann Whitney test was used to make inferences between groups. RESULTS There was a statistically significant difference in absolute latencies and interpeak latencies between very preterm and late preterm infants at 1 month of corrected age (p < 0.05). Absolute latency of peak I was similar among both groups of preterms. Absolute latencies of peak III, V and interpeak latencies I-III, III-V and I-V were prolonged in very preterm infants at 1 month of corrected age. However, these latencies were significantly reduced at 3 months of corrected age. This indicated accelerated maturation/myelination of the central auditory nervous system in very preterm infants. Absolute latencies of peak III and V and interpeak interval I-V was reduced in late preterm infants at 3 months of corrected age and this was statistically significant. This reduction in latency was considered to be a normal age dependent change. CONCLUSION Findings of the current study revealed that there was no deviation in the pattern of auditory maturation among preterms; it followed the typical 'caudal to rostral' form of maturation. Very preterm infants have less mature neuronal development compared with late preterm infants at 1 month of corrected age which catches up at 3 months of corrected age.
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Affiliation(s)
- Jayashree Seethapathy
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India.
| | - Prakash Boominathan
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India
| | - Ajith Kumar Uppunda
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
| | - Binu Ninan
- Department of Neonatology, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India
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Umehara T, Hosokawa S, Kita JY, Takahashi G, Okamura J, Nakanishi H, Hosokawa K, Kyou K, Hayashi Y, Mineta H. Risk Factors and Prognostic Factors of Hearing Impairment in Neonatal Intensive Care Unit-Treated Infants. Audiol Neurootol 2019; 24:84-89. [PMID: 31132759 DOI: 10.1159/000500316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/10/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Infants admitted to the neonatal intensive care unit (NICU) have a higher incidence of congenital hearing loss compared with the healthy newborn population. OBJECTIVES To clarify the relationship between risk factors for hearing impairment in NICU-treated infants and deterioration of the auditory brainstem response (ABR) threshold during childhood. METHOD We screened 1,071 high-risk infants admitted to the NICU for hearing impairment. One-hundred forty-eight infants exhibited an abnormal ABR threshold of ≥40 dB nHL. We analyzed the correlation of change in ABR threshold with risk factors for future hearing impairment. RESULTS Among infants treated in the NICU, 148 (13.8%) exhibited an ABR threshold of ≥40 dB nHL; 107 of these 148 (72.3%) showed hearing change in the process (102 showed improvement to normal hearing level, whereas 5 showed further deterioration). Our analysis showed that the factors contributing to the elevation of ABR threshold were oxygen administration and chromosomal aberrations. CONCLUSIONS Factors related to the elevation of ABR threshold were oxygen administration and the presence of chromosomal aberrations. Awareness of risk factors that are more likely to cause hearing loss in infants may aid in follow-up treatment of these children.
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Affiliation(s)
- Tsuyoshi Umehara
- Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Otorhinolaryngology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Seiji Hosokawa
- Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan,
| | - Jun-Ya Kita
- Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Otorhinolaryngology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | | | - Jun Okamura
- Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Department of Otorhinolaryngology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Hiroshi Nakanishi
- Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kumiko Hosokawa
- Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | - Yasuhiro Hayashi
- Department of Otorhinolaryngology, Seirei Yokohama General Hospital, Yokohama, Japan
| | - Hiroyuki Mineta
- Department of Otorhinolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Komori K, Komori M, Eitoku M, Joelle Muchanga SM, Ninomiya H, Kobayashi T, Suganuma N. Verbal abuse during pregnancy increases frequency of newborn hearing screening referral: The Japan Environment and Children's Study. CHILD ABUSE & NEGLECT 2019; 90:193-201. [PMID: 30807899 DOI: 10.1016/j.chiabu.2019.01.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 01/13/2019] [Accepted: 01/31/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Verbal abuse during pregnancy has a greater impact than physical and sexual violence on the incidence of postnatal depression and maternal abuse behavior towards their children. In addition, exposure of children (aged 12 months to adolescence) to verbal abuse from their parents exerts an adverse impact to the children's auditory function. However, the effect of verbal abuse during pregnancy on fetal auditory function has not yet been thoroughly investigated. OBJECTIVE The objective of the study was to examine the relationship between intimate partner verbal abuse during pregnancy and newborn hearing screening (NHS) referral, which indicates immature or impaired auditory function. PARTICIPANTS AND SETTING The Japan Environment and Children's Study is an ongoing nationwide population-based birth-cohort study designed to determine environmental factors during and after pregnancy that affect the development, health, or wellbeing of children. Pregnant women living in 15 areas of Japan were recruited between January 2011 and March 2014. METHODS Multiple imputation for missing data was performed, followed by multiple logistic regression using 16 confounding variables. RESULTS Of 104,102 records in the dataset, 79,985 mother-infant pairs submitted complete data for questions related to verbal and physical abuse and the results of NHS. Of 79,985 pregnant women, 10,786 (13.5%) experienced verbal abuse and 978 (1.2%) experienced physical abuse. Of 79,985 newborns, 787 (0.98%) received a NHS referral. Verbal abuse was significantly associated with NHS referral (adjusted odds ratio: 1.44; 95% confidence interval: 1.05-1.98). CONCLUSIONS Verbal abuse should be avoided during pregnancy to preserve the newborn's auditory function.
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Affiliation(s)
- Kaori Komori
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan
| | - Masahiro Komori
- Department of Otorhinolaryngology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan.
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan
| | - Sifa Marie Joelle Muchanga
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan; Department of Obstetrics and Gynecology, Medical Faculty, University of Kinshasa, Kinshasa 11, lemba, Kinshasa, Democratic Republic of the Congo
| | - Hitoshi Ninomiya
- Department of Civil and Environmental Engineering, Toyo University, 2100, Kujirai, Kawagoe, Saitama, Japan
| | - Taisuke Kobayashi
- Department of Otorhinolaryngology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan
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Li M, Zhu L, Yao D, Xu L, Ji C. Maturation of auditory brainstem response in early term infants at 6 weeks and 9 months. Int J Pediatr Otorhinolaryngol 2019; 116:70-74. [PMID: 30554712 DOI: 10.1016/j.ijporl.2018.10.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/14/2018] [Accepted: 10/16/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Emerging evidence indicates that infants who were born between 37 and 38 weeks of gestation are at higher risk of adverse long-term neurodevelopmental outcomes. Yet little is known about the auditory neural maturation during the first year of their life. AIM To compare the development of auditory brainstem response in early term (ET, 37-38 weeks gestational age, GA) and full term (FT, 39-41 weeks GA) infants. METHODS 126 infants received ABR testing at 6 weeks. 107 of them returned for the second assessment at 9 months, among which, 93 completed the ABR recordings. Comparison of the ABR variables were made depending on gestational age. RESULTS Analysis of covariance (ANCOVA) was used to identify the differences in ABR outcomes between two groups. After controlling for confounders, latencies for wave III, V and I-III, III-V and I-V intervals were prolonged in ET group compared with FT group at 6 weeks (all p<0.03). ABR parameters of both groups developed as the infants got older. At 9 months, ET infants remain showing the longer wave V latency and I-V interval (all p < 0.02) than FT infants. CONCLUSION During early postnatal life, ET has a different pattern of functional auditory brainstem development comparing with FT infants. The prolonged auditory conduction time suggests less mature of the central auditory system in ET infants before 9 months.
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Affiliation(s)
- Mingyan Li
- Children's Hospital Zhejiang University School of Medicine, China
| | - Li Zhu
- Children's Hospital Zhejiang University School of Medicine, China
| | - Dan Yao
- Children's Hospital Zhejiang University School of Medicine, China
| | - Lin Xu
- Children's Hospital Zhejiang University School of Medicine, China
| | - Chai Ji
- Children's Hospital Zhejiang University School of Medicine, China.
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Abstract
Hearing loss is the most common congenital defect. With early diagnosis and intervention, we are able to improve speech and language outcomes in this population. In this article, we discuss the implications of the newborn hearing screen, as well as diagnostic interventions, management, and intervention, and the increasing role of congenital cytomegalovirus screening.
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Affiliation(s)
- Kavita Dedhia
- Department of Pediatric Otolaryngology, Emory University, 2015 Uppergate Drive, Atlanta, GA 30324, USA.
| | - Elise Graham
- Department of Pediatric Otolaryngology, University of Utah, 100 North Mario Capercchi Drive, Salt Lake City, UT 84113, USA
| | - Albert Park
- Department of Pediatric Otolaryngology, University of Utah, 100 North Mario Capercchi Drive, Salt Lake City, UT 84113, USA
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Auditory brainstem response in very preterm, moderately preterm and late preterm infants. Int J Pediatr Otorhinolaryngol 2018; 111:119-127. [PMID: 29958594 DOI: 10.1016/j.ijporl.2018.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 06/02/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Auditory brainstem response across preterm infants help in understanding difference if any in auditory maturation. OBJECTIVE To analyze and compare absolute and interpeak latencies of ABR in very preterm, moderate preterm and late preterm infants at term age. METHOD ABR traces were obtained from 148 ears of preterm infants (52 of very preterm, 44 of moderately preterm & 52 of late preterm) at term age. ABR was recorded with 11.1/s clicks at different intensity levels. RESULTS Absolute latencies of peak I, III, V and interpeak latencies of peak I-V, I-III and III-V were analyzed and compared between three preterm groups. One way ANOVA was used to compare ABR parameters between three groups of preterm infants and also to compare ABR parameters across various gestation ages. There were no overall differences in absolute latencies, interpeak latencies and amplitude of ABR between preterm groups and across various gestation ages (P>0.05). Pearson correlation was used to find the correlation between gestation age and ABR parameters. However, no correlation was found. ABRs were similar among preterm groups at term age which reflects that the brainstem maturation is similar among preterm groups. CONCLUSION Gestational age at birth does not seem to influence absolute and interpeak latencies of ABR at term age. In preterm neonates, the findings lead to suggest that maturation of auditory pathway occurs in a similar manner in preterm infants regardless of gestational age at birth. We conclude that preterm birth alone as a risk factor does not appear to have any marked effect on the development of ABR at term age.
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Jacob-Corteletti LCB, Araújo ES, Duarte JL, Zucki F, Alvarenga KDF. Acoustic Reflex Testing in Neonatal Hearing Screening and Subsequent Audiological Evaluation. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1784-1793. [PMID: 29913009 DOI: 10.1044/2018_jslhr-h-16-0291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 02/16/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR). METHOD We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator. RESULTS In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz. CONCLUSIONS Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds.
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Affiliation(s)
| | - Eliene Silva Araújo
- Department of Audiology and Speech Pathology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Josilene Luciene Duarte
- Department of Audiology and Speech Pathology, Federal University of Sergipe, Lagarto, Brazil
| | - Fernanda Zucki
- Department of Audiology and Speech Pathology, Federal University of Santa Catarina, Florianópolis, Brazil
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20
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Melo ÂD, Biaggio EPV, Rechia IC, Sleifer P. Cortical auditory evoked potentials in full-term and preterm neonates. Codas 2016; 28:491-496. [PMID: 27759841 DOI: 10.1590/2317-1782/20162015291] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 03/08/2016] [Indexed: 11/21/2022] Open
Abstract
Purpose To measure the exogenous components of the cortical auditory evoked potential (CAEP) in term and preterm newborns and compare them considering the variables latency and amplitude. Methods This is a cross-sectional, prospective, comparative, contemporary study. One hundred twenty-seven newborns were evaluated; 96 of these were included in the study after analysis of the exams by three referees. Participants were divided into two groups: Term Group: 66 infants and Preterm Group: 30 neonates. The recordings of CAEP were performed using surface electrodes with newborns comfortably positioned in the lap of their mothers and/or guardians in natural sleep. To this end, binaural verbal stimuli were presented with /ba/ as the frequent stimulation and /ga/ the rare stimulus, at an intensity of 70 dB HL, through insert earphones. The presence or absence of exogenous components and the latency and amplitude of P1 and N1 were analyzed in both groups. Pertinent tests were used in the statistical analysis of data. Results The latency of the waves P1 and N1 was smaller in participants in the Term Group. However, there were no statistically significant differences in the amplitude of P1 and N1 between the groups. No difference between the groups was found when comparing the presence and absence of the components P2 and N2. Conclusion It is possible to measure the CAEP in term and preterm neonates. There was influence of the maturational process only on the measure of latency of the components P1, binaurally, and N1, in the left ear, which were smaller in participants in the Term Group.
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Affiliation(s)
- Ândrea de Melo
- Universidade Federal do Rio Grande do Sul UFRGS - Porto Alegre (RS), Brasil.,Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil
| | | | - Inaê Costa Rechia
- Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil
| | - Pricila Sleifer
- Universidade Federal do Rio Grande do Sul UFRGS - Porto Alegre (RS), Brasil
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21
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Stipdonk LW, Weisglas-Kuperus N, Franken MCJ, Nasserinejad K, Dudink J, Goedegebure A. Auditory brainstem maturation in normal-hearing infants born preterm: a meta-analysis. Dev Med Child Neurol 2016; 58:1009-15. [PMID: 27168415 DOI: 10.1111/dmcn.13151] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 11/28/2022]
Abstract
AIM Children born preterm often have neurodevelopmental problems later in life. Abnormal maturation of the auditory brainstem in the presence of normal hearing might be a marker for these problems. We conducted a meta-analysis of auditory brainstem response (ABR) latencies at term age to describe differences in auditory brainstem maturation between normal-hearing preterm and term-born infants. METHOD Computerized databases were searched for studies published between 1995 and 2014 that reported ABR measurements at term age in infants born preterm in a case-control design. Five peaks reflect the conduction of a neural signal along the brainstem auditory pathway. We collected I to V interpeak latency data, and III to V interpeak latency data, which refers to the more central part of the pathway. RESULTS Preterm-born infants' III to V interval is significantly longer compared to infants born at term (0.081ms, effect-size=0.974), which also reflects on the I to V interval. Moreover, significantly increased ABR interpeak latencies of infants born preterm are related to lower gestational age and the need for neonatal intensive care treatment. INTERPRETATION The delayed conduction time towards and into the auditory brainstem at term age suggests atypical maturation of the brainstem in normal-hearing infants born preterm. Both the duration of gestation and the consequences of the preterm birth (intensive care needed) negatively affect maturation of the auditory brainstem, which may influence later development.
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Affiliation(s)
- Lottie W Stipdonk
- Department of Otorhinolaryngology, Erasmus Medical University Centre-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Nynke Weisglas-Kuperus
- Division of Neonatology, Department of Paediatrics, Erasmus Medical University Centre-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Marie-Christine Jp Franken
- Department of Otorhinolaryngology, Erasmus Medical University Centre-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Kazem Nasserinejad
- Department of Biostatistics, Erasmus Medical University Centre-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Jeroen Dudink
- Division of Neonatology, Department of Paediatrics, Erasmus Medical University Centre-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus Medical University Centre-Sophia Children's Hospital, Rotterdam, the Netherlands
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Sharma M, Bist SS, Kumar S. Age-Related Maturation of Wave V Latency of Auditory Brainstem Response in Children. J Audiol Otol 2016; 20:97-101. [PMID: 27626083 PMCID: PMC5020566 DOI: 10.7874/jao.2016.20.2.97] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/19/2016] [Accepted: 08/08/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Auditory brainstem response (ABR) is a noninvasive measurement of a stimulus-locked, synchronous electrical event. ABR provides information concerning the functional integrity of brainstem nuclei. Age is a key factor in the interpretation of ABR peak latency among different age groups. Progressively with time it follows a "maturation pattern" during which latencies decrease. Wave V is very prominent and reliable for detection of threshold in children. The present study was performed to see the effect of age related auditory maturation on ABR wave V latency in children. SUBJECTS AND METHODS The study involved 80 subjects ranging in age from birth to 12 years. The subjects were divided equally into eight age groups. ABR were elicited by an acoustic click stimuli, brainstem responses collected through electrode and recorded at the same time. Latency of wave V was acknowledged. RESULTS Wave V latency decreased rapidly in early childhood, became slower after 3 years of age and completely matured by 12 years of age. There was no significant difference in latency of wave V between the ears with age. CONCLUSIONS There is a distinct maturation pattern of wave V latency in ABR for both ears. ABR is a reliable test to assess the functional maturation of wave V in children.
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Affiliation(s)
- Mukesh Sharma
- Rehabilitation Unit of Speech and Hearing, Himalayan Institute of Medical Sciences, SRHU, Jollygrant, Dehradun, India.; Department of ENT, Himalayan Institute of Medical Sciences, SRHU, Jollygrant, Dehradun, India
| | - Sampan Singh Bist
- Department of ENT, Himalayan Institute of Medical Sciences, SRHU, Jollygrant, Dehradun, India
| | - Santosh Kumar
- Rehabilitation Unit of Speech and Hearing, Himalayan Institute of Medical Sciences, SRHU, Jollygrant, Dehradun, India.; Department of ENT, Himalayan Institute of Medical Sciences, SRHU, Jollygrant, Dehradun, India
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Sousa AC, Didoné DD, Sleifer P. Longitudinal Comparison of Auditory Steady-State Evoked Potentials in Preterm and Term Infants: The Maturation Process. Int Arch Otorhinolaryngol 2016; 21:200-205. [PMID: 28680486 PMCID: PMC5495585 DOI: 10.1055/s-0036-1584888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 05/10/2016] [Indexed: 11/11/2022] Open
Abstract
Introduction
Preterm neonates are at risk of changes in their auditory system development, which explains the need for auditory monitoring of this population. The Auditory Steady-State Response (ASSR) is an objective method that allows obtaining the electrophysiological thresholds with greater applicability in neonatal and pediatric population.
Objective
The purpose of this study is to compare the ASSR thresholds in preterm and term infants evaluated during two stages.
Method
The study included 63 normal hearing neonates: 33 preterm and 30 term. They underwent assessment of ASSR in both ears simultaneously through insert phones in the frequencies of 500 to 4000Hz with the amplitude modulated from 77 to 103Hz. We presented the intensity at a decreasing level to detect the minimum level of responses. At 18 months, 26 of 33 preterm infants returned for the new assessment for ASSR and were compared with 30 full-term infants. We compared between groups according to gestational age.
Results
Electrophysiological thresholds were higher in preterm than in full-term neonates (
p
< 0.05) at the first testing. There were no significant differences between ears and gender. At 18 months, there was no difference between groups (
p
> 0.05) in all the variables described.
Conclusion
In the first evaluation preterm had higher thresholds in ASSR. There was no difference at 18 months of age, showing the auditory maturation of preterm infants throughout their development.
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Affiliation(s)
- Ana Constantino Sousa
- Phonoaudiology, Universidade Federal do Rio Grande do Sul, Ringgold Standard Institution, Porto Alegre, RS, Brazil
| | - Dayane Domeneghini Didoné
- Postgraduate Degree in Children and Adolescent Health, Universidade Federal do Rio Grande do Sul, Ringgold Standard Institution, Porto Alegre, RS, Brazil
| | - Pricila Sleifer
- Doctor Health and Communication, Universidade Federal do Rio Grande do Sul, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Lecoq L, Gains M, Blond L, Parent J. Brainstem auditory evoked responses in foals: reference values, effect of age, rate of acoustic stimulation, and neurologic deficits. J Vet Intern Med 2015; 29:362-7. [PMID: 25619523 PMCID: PMC4858096 DOI: 10.1111/jvim.12499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 09/04/2014] [Accepted: 10/13/2014] [Indexed: 12/01/2022] Open
Abstract
Background Age and rate of acoustic stimulation affect peak latencies in brainstem auditory evoked responses (BAER) in humans. Those effects are unknown in foals. Hypothesis/Objectives Our goals were to (1) establish reference values for BAER in foals by using 3 different stimulation protocols, (2) evaluate the effects of age and stimulation frequencies on BAER tracing in foals up to 6 months old, and (3) compare the data with BAER obtained from foals with central nervous system (CNS) disorders. Animals Thirty‐nine neurologically normal foals and 16 foals with neurologic diseases. Methods Prospective observational clinical study. BAER recorded by using 3 protocols of stimulation (11.33 repetitions per second [Hz]/70 decibel normal hearing level [dBNHL]; 11.33 Hz/90 dBNHL; 90 Hz/70 dBNHL). Results No effect of age was observed in normal foals (P > .005). No significant difference was observed for latencies and interpeak latencies (IPL) when comparing foals with neurologic diseases and normal foals (P > .05), but 78.6% of foals with neurologic diseases had an asymmetry in their tracing, reflecting a difference in conduction time between the left and right side of the brainstem. Increasing the stimulation rate did not improve detection of CNS disorders. Conclusions and Clinical Importance We propose BAER reference values for foals up to 6 months of age by using 3 protocols. Most foals with neurologic deficits had abnormal BAER tracing.
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Affiliation(s)
- L Lecoq
- Département de Sciences Cliniques, Université de Montréal, Saint-Hyacinthe, QC, Canada
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Jacob-Corteletti LCB, Duarte JL, Zucki F, Mariotto LDF, Lauris JRP, Alvarenga KDF. Acoustic reflex on newborns: the influence of the 226 and 1,000 Hz probes. Codas 2015. [PMID: 26222937 DOI: 10.1590/2317-1782/20152014117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To analyze the occurrence of acoustic reflex and its threshold on newborns using the 226 and 1,000 Hz probes. METHODS Thirty-six newborns with "PASS" results in newborn hearing screening and tympanogram with one or two peaks for both probe tones were included. Group I comprised 20 full-term newborns without risk indicator for hearing loss, and Group II comprised 16 newborns with at least one risk indicator. The study about ipsilateral acoustic reflex thresholds was conducted in 500, 1,000, 2,000, and 4,000 Hz. RESULTS The groups presented the acoustic reflex thresholds between 50 and 100 dB for both probe tones. In the comparison between the probes, there were differences in all frequencies evaluated in Group I, with the lowest threshold mean for the 1,000 Hz probe. In Group II, differences were detected at 2,000 Hz. The mean acoustic reflex thresholds were similar in both groups for the 226 Hz probe. There was a difference for the 1,000 Hz probe in all tested frequencies. The percentage of response was higher in both groups for the 1,000 Hz probe. The kappa test showed extremely poor agreement in the comparison of results between both probes. CONCLUSION The occurrence of acoustic reflex was higher in newborns and its thresholds were lower with the 1,000 Hz probe both for healthy newborns and for newborns at risk.
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Affiliation(s)
| | - Josilene Luciene Duarte
- Speech Language Pathology and Audiology Department, Dental School of Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | - Fernanda Zucki
- Speech Language Pathology and Audiology Department, Dental School of Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | | | - José Roberto Pereira Lauris
- Department of Orthodontics, Pediatric Dentistry and Public Health, Dental School of Bauru, Universidade de São Paulo, Bauru, SP, Brazil
| | - Kátia de Freitas Alvarenga
- Speech Language Pathology and Audiology Department, Dental School of Bauru, Universidade de São Paulo, Bauru, SP, Brazil
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Silva DD, Lopez P, Mantovani JC. Auditory brainstem response in term and preterm infants with neonatal complications: the importance of the sequential evaluation. Int Arch Otorhinolaryngol 2015; 19:161-5. [PMID: 25992173 PMCID: PMC4399179 DOI: 10.1055/s-0034-1378137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 04/26/2014] [Indexed: 11/24/2022] Open
Abstract
Introduction Literature data are not conclusive as to the influence of neonatal complications in the maturational process of the auditory system observed by auditory brainstem response (ABR) in infants at term and preterm. Objectives Check the real influence of the neonatal complications in infants by the sequential auditory evaluation. Methods Historical cohort study in a tertiary referral center. A total of 114 neonates met inclusion criteria: treatment at the Universal Neonatal Hearing Screening Program of the local hospital; at least one risk indicator for hearing loss; presence in both evaluations (the first one after hospital discharge from the neonatal unit and the second one at 6 months old); all latencies in ABR and transient otoacoustic emissions present in both ears. Results The complications that most influenced the ABR findings were Apgar scores less than 6 at 5 minutes, gestational age, intensive care unit stay, peri-intraventricular hemorrhage, and mechanical ventilation. Conclusion Sequential auditory evaluation is necessary in premature and term newborns with risk indicators for hearing loss to correctly identify injuries in the auditory pathway.
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Affiliation(s)
- Daniela da Silva
- Ophthalmology/ENT and Head and Neck Surgery Department, Faculdade de Medicina de Botucatu, Botucatu, São Paulo, Brazil
| | - Priscila Lopez
- Ophthalmology/ENT and Head and Neck Surgery Department, Faculdade de Medicina de Botucatu, Botucatu, São Paulo, Brazil
| | - Jair Cortez Mantovani
- Ophthalmology/ENT and Head and Neck Surgery Department, Faculdade de Medicina de Botucatu, UNESP, Botucatu, Brazil
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Trang H, Masri Zada T, Heraut F. Abnormal auditory pathways in PHOX2B mutation positive congenital central hypoventilation syndrome. BMC Neurol 2015; 15:41. [PMID: 25886294 PMCID: PMC4391482 DOI: 10.1186/s12883-015-0299-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 03/11/2015] [Indexed: 11/12/2022] Open
Abstract
Background Congenital central hypoventilation syndrome (CCHS) is a rare disease characterized by severe central hypoventilation due to abnormal autonomic control of breathing. The PHOX2B gene, mutations of which define the disease, is expressed in a group of nuclei located in brainstem areas. Pathways controlling breathing and auditory pathways traverse very similar anatomic structures. In the present study, we measure brainstem auditory evoked potentials (BAEP) to assess auditory pathways in CCHS and investigate to which extent brainstem auditory pathways are also affected. Methods BAEPs were measured in 15 patients with PHOX2B mutations positive CCHS (8 boys and 7 girls. mean age 6.3 yrs ± 5) as part of their regular follow-up in the Centre of reference for central hypoventilation (Robert Debré University Hospital. Paris. France). Results BAEP responses were found normal in nine patients (60% of the study group) and abnormal in the other six (40%). Abnormal BAEPs which resulted from brainstem dysfunction were found in three patients (20%). Conclusion Dysfunction of brainstem auditory pathways can be observed in CCHS. However, auditory evoked responses can be normal in the disease, therefore suggesting much more complex yet-to-be determined interactions between pathways and functions of central control of breathing and of control of hearing.
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Affiliation(s)
- Ha Trang
- French Center of Reference for Central Hypoventilation, Robert Debré University Hospital, EA 7334 REMES, Paris-Diderot University, 48 boulevard Serurier, 75019, Paris, France.
| | - Tarif Masri Zada
- Department of Physiology, Robert Debré University Hospital, Paris, France.
| | - Fawzia Heraut
- French Center of Reference for Central Hypoventilation, Robert Debré University Hospital, Paris, France.
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Abstract
The present review of the literature is focused on the morphological and functional aspects of antenatal ontogenesis of the hearing system with special reference to the peculiar features of its formation during the post-natal period in the premature infants. In this context, the results of the objective psychoacoustic investigation s are considered (including those obtained by such methods as threshold audiometry, verbal and non-verbal tests, evaluation of central auditory processing of the sound information). Also presented are the results of the objective methods of hearing investigations (acoustic impedancometry, registration of optoacoustic emission and auditory evoked potentials). The underdevelopment of the hearing system in the premature infants manifests itself as the specific functional features of all its components. Their parameters are presented with reference to dynamics of their formation. In addition, the problem of central auditory processing of the disorders that are very likely to be present in the premature infants are discussed.
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Affiliation(s)
- I V Savenko
- I.P. Pavlov First St-Peterburg State Medical University, St-Petersburg, Russia, 197022
| | - M Yu Boboshko
- I.P. Pavlov First St-Peterburg State Medical University, St-Petersburg, Russia, 197022
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Farias VBD, Sleifer P, Pauletti LF, Krimberg CFD. Correlation of the findings of auditory steady-state evoked potential and of behavioral hearing assessment in infants with sensorineural hearing loss. Codas 2014; 26:226-30. [PMID: 25118919 DOI: 10.1590/2317-1782/201420140491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 05/16/2014] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To correlate the findings of an open-field audiometry with the thresholds of steady-state auditory-evoked potentials (SSAEPs) found in infants of up to 6 months of age with sensorineural hearing loss. METHODS This study included 19 infants with sensorineural hearing loss (8 males and 11 females), with minimum age of 2 months and maximum age of 6 months. The SSAEPs were assessed at 500 and 2000 Hz, and the audiometry was performed in open field through observation of behavioral responses to sound stimuli, at the same frequencies. RESULTS We observed a significant correlation between the findings of both tests conducted at 500 and 2000 Hz, with p-values of 0.002 and 0.013, respectively. There was no statistical difference between ears (p=0.532) and genders (p=0.615). CONCLUSION We conclude that there was a significant correlation between the SSAEP thresholds and the findings of the open-field audiometry. Therefore, we can affirm that the SSAEPs are a viable examination, able to predict the degree and configuration of hearing loss in infants of up to 6 months of age, and that they can be included in the clinical routine of hearing assessments conducted in children.
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Affiliation(s)
| | - Pricila Sleifer
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Rosa LAC, Suzuki MR, Angrisani RG, Azevedo MF. Auditory Brainstem Response: reference-values for age. Codas 2014; 26:117-21. [DOI: 10.1590/2317-1782/2014469in] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 02/06/2014] [Indexed: 11/22/2022] Open
Abstract
PURPOSE: To study the absolute latencies of waves I , III and V and interpeak I-III , III-V and I-V of Auditory brainstem responses obtained in preterm newborns in relation to post-conceptual age, term newborns and six months of age infants, establishing reference values for each age group. METHODS: Retrospective study realized through the analysis of tests performed on 80 infants divided into four groups, being the group one composed per newborns assessed between 35 and 36 weeks post-conceptual age; group two by newborns assessed between 37 and 38 weeks; group three with newborns reviewed between 39 to 40 weeks; and group four with infants evaluated with six months. RESULTS: The wave I absolute latency in the group one was 1.81 ms, decreasing to 1.79 ms in groups two and three, and to 1.70 ms in group four. The wave III latency in group one was 4.74 ms, decreasing to 4.62 ms in group two, to 4.56 ms in the group three and to 4.37 ms in the group four. The wave V latency in group one was 7.14 ms, in the group two it was 7.05 ms, in the group three 6.90 ms; and in the group four it was 6.50 ms. Interpeak latencies were also decreased in all groups. CONCLUSION: The latencies studied decreased with the increasing age and were similar values with the international literature.
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Angrisani RMG, Bautzer APD, Matas CG, de Azevedo MF. Auditory brainstem response in neonates: influence of gender and weight/gestational age ratio. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2013; 31:494-500. [PMID: 24473955 PMCID: PMC4183041 DOI: 10.1590/s0103-05822013000400012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 05/15/2013] [Indexed: 03/22/2024]
Abstract
OBJECTIVE To investigate the influence of gender and weight/gestational age ratio on the Auditory Brainstem Response (ABR) in preterm (PT) and term (T) newborns. METHODS 176 newborns were evaluated by ABR; 88 were preterm infants - 44 females (22 small and 22 appropriate for gestational age) and 44 males (22 small and 22 appropriate for gestational age). The preterm infants were compared to 88 term infants - 44 females (22 small and 22 appropriate for gestational age) and 44 males (22 small and 22 appropriate for gestational age). All newborns had bilateral presence of transient otoacoustic emissions and type A tympanometry. RESULTS No interaural differences were found. ABR response did not differentiate newborns regarding weight/gestational age in males and females. Term newborn females showed statistically shorter absolute latencies (except on wave I) than males. This finding did not occur in preterm infants, who had longer latencies than term newborns, regardless of gender. CONCLUSIONS Gender and gestational age influence term infants' ABR, with lower responses in females. The weight/gestational age ratio did not influence ABR response in either groups.
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Affiliation(s)
| | | | - Carla Gentile Matas
- Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP,
Brasil
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Costa TVS, Aurélio FS, Silva VBD, Rodrigues LB. Normatização do potencial evocado auditivo de tronco encefálico em recém-nascidos. REVISTA CEFAC 2013. [DOI: 10.1590/s1516-18462013000600011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: normatizar os achados do equipamento de PEATE da Clínica de Fonoaudiologia da instituição de origem, em recém-nascidos. MÉTODOS: trata-se de um estudo transversal, exploratório não experimental do qual participaram quarenta recém-nascidos, sem indicadores de risco para a deficiência auditiva, que passaram na triagem auditiva neonatal, divididos de acordo com a idade, em semanas (G1, G2, G3 e G4). Para a coleta de dados foi utilizado o equipamento Smart EP-Intelligent Hearing Systems com estímulo clique. RESULTADOS: a média dos valores das latências absolutas das ondas I, III e V de acordo com a idade são, respectivamente: G1=1,62ms, 4,39ms, 6,8ms; G2=1,62ms, 4,4ms, 6,79ms; G3=1,56ms, 4,39ms, 6,74ms; G4=1,54ms, 4,2ms, 6,53ms. Na mesma ordem, a média dos valores das latências interpico I-III, III-V e I-V foram: 2,77ms, 2,42ms e 5,19ms; 2,78ms, 2,39ms e 5,17ms; 2,83ms, 2,35ms e 5,18ms; 2,66ms, 2,33ms e 4,99ms. CONCLUSÃO: as latências absolutas diminuíram com o aumento da idade tendo média de 1,58ms para a onda I, 4,34ms para a onda III e 6,71ms para a onda V. Da mesma forma, as médias dos interpicos I-III, III-V e I-V foram menores no G4 e obteve-se médias, no primeiro mês, de 2,76ms, 2,37ms e 5,13ms.
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Hof JR, Stokroos RJ, Wix E, Chenault M, Gelders E, Brokx J. Auditory maturation in premature infants. Laryngoscope 2013; 123:2013-8. [DOI: 10.1002/lary.24054] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 01/02/2013] [Accepted: 01/22/2013] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Eduard Wix
- Department of Otorhinolaryngology, Head and Neck Surgery; Maastricht University Medical Center; Maastricht; the Netherlands
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Angrisani RMG, Azevedo MFD, Carvallo RMM, Diniz EMDA, Ferraro AA, Guinsburg R, Matas CG. Caracterização eletrofisiológica da audição em prematuros nascidos pequenos para a idade gestacional. Codas 2013; 25:22-8. [DOI: 10.1590/s2317-17822013000100005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Accepted: 09/10/2012] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Caracterizar as respostas do Potencial Evocado Auditivo de Tronco Encefálico em recém-nascidos pré-termo pequenos para idade gestacional, comparando-as às de recém-nascidos pré-termo adequados para idade gestacional, verificando se a condição de pequeno para a idade gestacional é indicador de risco para alteração auditiva retrococlear. MÉTODOS: Estudo multicêntrico transversal prospectivo. Avaliou-se 72 recém-nascidos pré-termo, 35 pequenos e 37 adequados para idade gestacional de ambos os gêneros, com idade gestacional de 30 a 36 semanas e avaliados na pré-alta hospitalar, com presença de emissões otoacústicas evocadas por estímulo transiente e timpanometria tipo A. A análise quantitativa dos dados foi feita baseada na média e desvio-padrão das latências das ondas I, III, V e interpicos I-III, III-V, I-V para cada grupo. Para análise qualitativa, os resultados dos potenciais evocados auditivos foram classificados em alterado ou normal mediante a análise das latências absolutas das ondas I, III, V e dos interpicos I-III, III-V, I-V, considerando-se a faixa etária no momento do exame. RESULTADOS: Evidenciaram-se alterações em 32 crianças (44,44% do total), sendo 15 recém-nascidos pequenos (43%) e 17 adequados (46%), não havendo diferença entre os grupos. Dos 15 recém-nascidos pequenos com potencial evocado auditivo alterado, seis tiveram como risco auditivo apenas o fato de ser pequeno para a idade gestacional. No grupo adequado para idade gestacional, houve maior ocorrência de alterações no gênero masculino. CONCLUSÃO: Não houve diferença nas respostas do potencial evocado auditivo entre os recém-nascidos pré-termo pequenos e adequados, de forma que a condição pequeno não se revelou risco para alteração retrococlear.
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Li M, Zhu L, Mai X, Shao J, Lozoff B, Zhao Z. Sex and gestational age effects on auditory brainstem responses in preterm and term infants. Early Hum Dev 2013; 89:43-8. [PMID: 22849808 PMCID: PMC3490052 DOI: 10.1016/j.earlhumdev.2012.07.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 06/25/2012] [Accepted: 07/10/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Some studies find delayed development of the auditory brainstem in preterm infants, but others do not. AIM To compare auditory brainstem responses (ABRs) in healthy preterm and term infants depending on sex and gestational age (GA). METHODS Participants were 111 preterm (27-36weeks GA) and 92 term (37-41weeks GA) infants. ABR tests were conducted at 6weeks (corrected age if preterm). RESULTS There were no overall differences between term and preterm groups in ABRs. However, males showed longer latencies for waves III, V, and I-III, III-V, and I-V intervals and smaller amplitudes for wave III and V than females in both preterm and term groups (all p values≤.01). A 3-way interaction between group, sex, and GA (p<.05) showed that preterm males with later GA had longer wave I-V interval, whereas term females with later GA showed shorter wave I-V interval. Growth velocity predicted wave I-V interval in preterm infants, controlling for other factors (male: p=.07, female: p<.05). CONCLUSION ABRs in preterm and term infants were similar at 6weeks (corrected age if preterm), but males had less advanced ABRs than females. More rapid growth predicted less mature ABR in later GA preterm infants in this setting where they were unlikely to receive extra iron. The roles of GA, growth, and iron balance in ABR development warrant further study.
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Affiliation(s)
- Mingyan Li
- Children's Hospital Zhejiang University School of Medicine, China
| | - Li Zhu
- Children's Hospital Zhejiang University School of Medicine, China
| | - Xiaoqin Mai
- Center for Human Growth and Development, University of Michigan, USA
| | - Jie Shao
- Children's Hospital Zhejiang University School of Medicine, China
| | - Betsy Lozoff
- Center for Human Growth and Development, University of Michigan, USA,Department of Pediatrics and Communicable Diseases, University of Michigan, USA
| | - Zhengyan Zhao
- Children's Hospital Zhejiang University School of Medicine, China
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Smolkin T, Anton Y, Ulanovsky I, Blazer S, Mick O, Makhoul MI, Makhoul IR. Impact of gestational age on neonatal hearing screening in vaginally-born late-preterm and early-term infants. Neonatology 2013; 104:110-5. [PMID: 23839312 DOI: 10.1159/000350554] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 03/01/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Late-preterm and early-term (LP-ET) infants, defined herein as 35(0)-37(6) weeks' gestation, often fail on 1st otoacoustic emissions (OAE) test. HYPOTHESIS LP-ET infants fail more than term infants (38(0)-42 weeks' gestation) on the 1st OAE test. Aim : To evaluate the effect of gestational age on the 1st OAE test. METHODS We studied 1,572 vaginally-delivered (VD) infants ≥35 weeks' gestation (1.1.2011-30.9.2011). Perinatal and neonatal variables and results of OAE tests were recorded. RESULTS LP-ET infants, compared to full-term infants, had a significantly 2-fold higher need for repeated hearing tests: 80.2 versus 43.3 tests/1,000 neonates, respectively (p = 0.026). Univariate analysis showed that late prematurity and age at 1st OAE were significantly associated with failure on 1st OAE. At age 24-42 h, failure on 1st OAE was 2-fold higher in the LP-ET infants than in full-term infants: 9.4 versus 4.7% (p = 0.02). Risk for failure on 1st OAE was age-dependent: 9-fold higher when 1st OAE was performed at 24-42 h of age (5.3%) versus 0.6% after age 42 h. Multivariate analysis showed that variables that were independently significantly associated with failure on 1st OAE included late prematurity (OR 2.0 (1.1-3.7)) and age at 1st OAE (OR 9.2 (1.2-70.7)). CONCLUSIONS Compared to term infants, VD LP-ET infants had 2-fold higher rates of failure on 1st OAE (up to 42 h of life) and needed repeated hearing tests. Failure rates after 42 h become negligible in both groups. In VD LP-ET infants, 1st OAE is better performed after 42 h of age.
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Affiliation(s)
- Tatiana Smolkin
- Department of Neonatology, Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel
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Jiang ZD, Chen C, Wilkinson AR. Brainstem auditory response findings in term neonates in intensive care unit. J Matern Fetal Neonatal Med 2012; 25:2746-9. [PMID: 22880629 DOI: 10.3109/14767058.2012.718385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Whether term infants in neonatal intensive care unit (NICU) have brainstem auditory abnormalities remains to be determined. This study aimed to detect any abnormality in brainstem auditory function in term neonates who are admitted to NICU. METHODS From a NICU, we recruited 55 term neonates with various perinatal problems. They were studied during the first week after birth using brainstem auditory evoked response (BAER), and the results were compared with normal term controls. RESULTS Wave I and III latencies and I-III interpeak interval of the evoked response in the NICU term neonates were similar to those in the controls. Wave V latency and I-V and III-V interpeak intervals tended to be increased at 21/s clicks. The increase was more obvious at higher rates 51 and 91/s. Analysis of variance revealed that at 21/s clicks only III-V interval was significantly increased (p < 0.05). At 51 and 91/s clicks, wave V latency and III-V and I-V intervals were significantly increased (p < 0.05-0.01). The rates of the abnormalities were seen more at higher than at lower click rates. The amplitudes of waves I, III, and V in the NICU neonates were all slightly reduced, but none differed significantly from the controls. CONCLUSIONS There are some abnormalities in BAER in term neonates in NICU, suggesting functional abnormality in the auditory brainstem in NICU infants.
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Affiliation(s)
- Ze D Jiang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
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Romero ACL, Delecrode CR, Cardoso ACV, Frizzo ACF. Potencial evocado auditivo de tronco encefálico em crianças encaminhadas de um programa de triagem auditiva neonatal. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2012. [DOI: 10.1590/s1519-38292012000200005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: descrever os achados do exame de potencial evocado auditivo de tronco encefálico (PEATE) de crianças de um programa de triagem auditiva neonatal e analisar a diferença de gênero e a interferência da idade nas medidas da latência das ondas do PEATE. MÉTODOS: para tal foram avaliadas 41 crianças com idade entre um a nove meses, referenciadas de um Programa de Triagem Municipal ao Centro de Estudos de Educação e Saúde (CEES) na cidade de Marília, SP no ano de 2010. RESULTADOS: foi observado resultado normal em 31 (75,6%) e alterado em 10 (24,4%) pacientes. Nesses últimos foram observadas alterações principalmente do tipo condutiva unilateral e bilateral. Observou-se também que a medida que a idade aumenta a latência das ondas diminui numa correlação inversa. CONCLUSÕES: o diagnóstico das crianças deste Programa de Triagem Auditiva Neonatal foi precoce. Os resultados do PEATE poderão servir de referência para outros estudos deste âmbito. O PEATE nesta população permite um melhor direcionamento da conduta e intervenção e aconselhamento específico aos familiares.
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Angrisani RMG, Azevedo MFD, Carvallo RMM, Diniz EMDA, Matas CG. Electrophysiological study of hearing in full-term small-for-gestational-age newborns. ACTA ACUST UNITED AC 2012; 24:162-7. [DOI: 10.1590/s2179-64912012000200013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 04/24/2012] [Indexed: 11/22/2022]
Abstract
PURPOSE: To describe the Brainstem Auditory Evoked Potential (BAEP) results of full-term small-for-gestational-age newborns, comparing them to the results of full-term appropriate-for-gestational-age newborns, in order to verify whether the small-for-gestational-age condition is a risk indicator for retrocochlear hearing impairment. METHODS: This multicentric prospective cross-sectional study assessed 86 full-term newborns - 47 small- (Study Group) and 39 appropriate-for-gestational-age (Control Group - of both genders, with ages between 2 and 12 days. Newborns with presence of transient evoked otoacoustic emissions and type A tympanometry were included in the study. Quantitative analysis was based on the mean and standard deviation of the absolute latencies of waves I, III and V and interpeak intervals I-III, III-V and I-V, for each group. For qualitative analysis, the BAEP results were classified as normal or altered by analyzing these data considering the age range of the newborn at the time of testing. RESULTS: In the Study Group, nine of the 18 (38%) subjects with altered BAEP results had the condition of small-for-gestational-age as the only risk factor for hearing impairments. In the Control Group, seven (18%) had altered results. Female subjects from the Study Group tended to present more central alterations. In the Control Group, the male group tended to have more alterations. CONCLUSION: Full-term children born small or appropriate for gestational age might present transitory or permanent central hearing impairments, regardless of the presence of risk indicators.
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Turchetta R, Orlando MP, Cammeresi MG, Altissimi G, Celani T, Mazzei F, Giacomello P, Cianfrone G. Modifications of auditory brainstem responses (ABR): observations in full-term and pre-term newborns. J Matern Fetal Neonatal Med 2011; 25:1342-7. [PMID: 22122007 DOI: 10.3109/14767058.2011.634457] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In this study, we have evaluated by means of auditory brainstem responses (ABR), in a population derived from a newborn hearing screening protocol, some aspects of maturation of the auditory pathways in the first months after birth, and the possible repercussions on early treatment. MATERIALS AND METHODS In this retrospective study newborns were recruited through our hearing screening program, and an ABR evaluation was performed on 339 newborns, that had risk factors or had failed the screening, or both. Such population was divided in two groups for statistical analysis purposes: full-term and pre-term. The initial ABR was pathological in 70 infants. RESULTS We observed an improvement over time of the estimated hearing threshold in follow-up ABRs in 43 newborns (26 in the full-term group, mean improvement 27.9 dB SPL, and 17 in the pre-term group, mean improvement 34.6 dB SPL); such an improvement might be related to a maturation of the auditory pathways that was not complete at birth. CONCLUSIONS The auditory system might not be completely developed at birth, and might require some months to complete; hence any early clinical approach should consider the possibility of an overtreatment, and any therapeutic strategy should only be considered once the diagnosis is certain and definitive.
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Affiliation(s)
- Rosaria Turchetta
- Department of Sensory System, Policlinico Umberto I, Sapienza University, Rome, Italy
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Amorim RB, Agostinho-Pesse RS, Alvarenga KDF. The maturational process of the auditory system in the first year of life characterized by brainstem auditory evoked potentials. J Appl Oral Sci 2011; 17 Suppl:57-62. [PMID: 21499656 PMCID: PMC5467360 DOI: 10.1590/s1678-77572009000700010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Accepted: 02/19/2010] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED The study of brainstem auditory evoked potentials (BAEP) allows obtaining the electrophysiological activity generated in the cochlear nerve to the inferior colliculus. In the first months of life, a period of greater neuronal plasticity, important changes are observed in the absolute latency and inter-peak intervals of BAEP, which occur up to the completion of the maturational process, around 18 months of life in full-term newborns, when the response is similar to that of adults. OBJECTIVE The goal of this study was to establish normal values of absolute latencies for waves I, III and V and inter-peak intervals I-III, III-V and I-V of the BAEP performed in full-term infants attending the Infant Hearing Health Program of the Speech-Language Pathology and Audiology Course at Bauru School of Dentistry, Brazil, with no risk history for hearing impairment. MATERIAL AND METHODS The stimulation parameters were: rarefaction click stimulus presented by the 3ª insertion phone, intensity of 80 dBnHL and a rate of 21.1 c/s, band-pass filter of 30 and 3,000 Hz and average of 2,000 stimuli. A sample of 86 infants was first divided according to their gestational age in preterm (n=12) and full-term (n=74), and then according to their chronological age in three periods: P1: 0 to 29 days (n=46), P2: 30 days to 5 months 29 days (n=28) and P3: above 6 months (n= 12). RESULTS The absolute latency of wave I was similar to that of adults, generally in the 1st month of life, demonstrating a complete process maturity of the auditory nerve. For waves III and V, there was a gradual decrease of absolute latencies with age, characterizing the maturation of axons and synaptic mechanisms in the brainstem level. CONCLUSION Age proved to be a determining factor in the absolute latency of the BAEP components, especially those generated in the brainstem, in the first year of life.
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Affiliation(s)
- Raquel Beltrão Amorim
- Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Coenraad S, Hoeve LJ, Goedegebure A. Incidence and clinical value of prolonged I-V interval in NICU infants after failing neonatal hearing screening. Eur Arch Otorhinolaryngol 2010; 268:501-5. [PMID: 21069370 PMCID: PMC3052503 DOI: 10.1007/s00405-010-1415-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Accepted: 10/22/2010] [Indexed: 11/05/2022]
Abstract
Infants admitted to neonatal intensive care units (NICUs) have a higher incidence of perinatal complications and delayed maturational processes. Parameters of the auditory brainstem response (ABR) were analyzed to study the prevalence of delayed auditory maturation or neural pathology. The prevalence of prolonged I–V interval as a measure of delayed maturation and the correlation with ABR thresholds were investigated. All infants admitted to the NICU Sophia Children’s Hospital between 2004 and 2009 who had been referred for ABR measurement after failing neonatal hearing screening with automated auditory brainstem response (AABR) were included. The ABR parameters were retrospectively analyzed. Between 2004 and 2009, 103 infants were included: 46 girls and 57 boys. In 58.3% (60 infants) of our population, the I–V interval was recordable in at least one ear at first diagnostic ABR measurement. In 4.9%, the I–V interval was severely prolonged. The median ABR threshold of infants with a normal or mildly prolonged I–V interval was 50 dB. The median ABR threshold of infants with a severely prolonged I–V interval was 30 dB. In conclusion, in case both peak I and V were measurable, we found only a limited (4.9%) incidence of severely prolonged I–V interval (≥0.8 ms) in this high-risk NICU population. A mild delay in maturation is a more probable explanation than major audiologic or neural pathology, as ABR thresholds were near normal in these infants.
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Affiliation(s)
- S Coenraad
- Department of Otorhinolaryngology, Sophia Children's Hospital, Erasmus Medical Center, Dr. Molewaterplein 60, SP-1455, 3015 GJ, Rotterdam, The Netherlands.
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Morimoto N, Taiji H, Tsukamoto K, Morimoto Y, Nakamura T, Hommura T, Ito Y. Risk factors for elevation of ABR threshold in NICU-treated infants. Int J Pediatr Otorhinolaryngol 2010; 74:786-90. [PMID: 20434224 DOI: 10.1016/j.ijporl.2010.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Revised: 03/31/2010] [Accepted: 04/01/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Several risk factors for hearing impairment among infants treated in the neonatal intensive care unit (NICU) have been reported, but there have been few studies that show the correlation strength between the risk factors in NICU-treated infants and hearing impairment in childhood. The aim of this study was to clarify the relationship between risk factors in NICU-treated infants and a deteriolation of auditory brainstem response (ABR) threshold in their childhood. METHODS One hundred one NICU-treated infants with ABR threshold of 50 dBnHL or more underwent 2nd ABR test at 20 months after delivery. Multiple regression analysis was performed with ABR threshold change as an objective variable and risk factors as explanatory variables. RESULTS Two ABR tests of the 101 infants resulted in that 7 showed an elevation of ABR threshold by 20 dB, 70 showed a drop of ABR threshold by 20 dB, and 24 showed no significant change. Multiple regression analysis revealed that the factors contributing to the elevation of ABR threshold were congenital diaphragmatic hernia, severe respiratory disease, and a high C-reactive protein (CRP) level. CONCLUSIONS In the infants treated in NICU, an incidence of ABR threshold of 50 dBnHL or more was 9.0%, and 6.9% of the infants with the ABR threshold abnormality showed a significant elevation of ABR threshold in their childhood. Factors significantly related to an elevation of ABR threshold were a history of congenital diaphragmatic hernia, severe respiratory disease, and elevation of CRP. In infants with such factors, periodical examination of hearing is required.
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Affiliation(s)
- Noriko Morimoto
- Department of Otorhinolaryngology, National Center for Child Health and Development, Tokyo, Japan.
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Coenraad S, van Immerzeel T, Hoeve LJ, Goedegebure A. Fitting model of ABR age dependency in a clinical population of normal hearing children. Eur Arch Otorhinolaryngol 2010; 267:1531-7. [PMID: 20532793 PMCID: PMC2924505 DOI: 10.1007/s00405-010-1291-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Accepted: 05/20/2010] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to present a simple and powerful fitting model that describes age-dependent changes of auditory brainstem responses (ABR) in a clinical population of normal hearing children. A total of 175 children (younger than 200 weeks postconceptional age) were referred for audiologic assessment with normal ABR results. ABR parameters of normal hearing children between 2003 and 2008 were included. The results of the right ears recorded at 90 dB nHL were analyzed. A simple and accurate fitting model was formulated based on these data. A very similar age-dependent effect was found for peaks III and V, and I–III and I–V intervals; latencies decrease as postconceptional age increases. It shows that the total age-dependent effect will be completed after 1.5–2 years. The age-dependent effect can be modeled by a relatively simple and accurate exponential function. This fitting model can be easily implemented to analyze ABR results of infants in daily clinical practice. We speculate about the underlying physiological processes.
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Affiliation(s)
- S Coenraad
- Department of Otorhinolaryngology, Sophia Children's Hospital, Erasmus Medical Center, SP-1455, Dr. Molewaterplein 60, 3015 GJ, Rotterdam, The Netherlands.
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