1
|
Anderson S, Cavaletti G, Hood LJ, Polydefkis M, Herrmann DN, Rance G, King B, McMichael AJ, Senna MM, Kim BS, Napatalung L, Wolk R, Zwillich SH, Schaefer G, Gong Y, Sisson M, Posner HB. A phase 2a study investigating the effects of ritlecitinib on brainstem auditory evoked potentials and intraepidermal nerve fiber histology in adults with alopecia areata. Pharmacol Res Perspect 2024; 12:e1204. [PMID: 38969959 PMCID: PMC11226387 DOI: 10.1002/prp2.1204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 04/24/2024] [Accepted: 04/28/2024] [Indexed: 07/07/2024] Open
Abstract
Reversible axonal swelling and brainstem auditory evoked potential (BAEP) changes were observed in standard chronic (9-month) toxicology studies in dogs treated with ritlecitinib, an oral Janus kinase 3/tyrosine kinase expressed in hepatocellular carcinoma family kinase inhibitor, at exposures higher than the approved 50-mg human dose. To evaluate the clinical relevance of the dog toxicity finding, this phase 2a, double-blind study assessed BAEP changes and intraepidermal nerve fiber (IENF) histology in adults with alopecia areata treated with ritlecitinib. Patients were randomized to receive oral ritlecitinib 50 mg once daily (QD) with a 4-week loading dose of 200 mg QD or placebo for 9 months (placebo-controlled phase); they then entered the active-therapy extension and received ritlecitinib 50 mg QD (with a 4-week loading dose of 200 mg in patients switching from placebo). Among the 71 patients, no notable mean differences in change from baseline (CFB) in Waves I-V interwave latency (primary outcome) or Wave V amplitude on BAEP at a stimulus intensity of 80 dB nHL were observed in the ritlecitinib or placebo group at Month 9, with no notable differences in interwave latency or Wave V amplitude between groups. The CFB in mean or median IENF density and in percentage of IENFs with axonal swellings was minimal and similar between groups at Month 9. Ritlecitinib treatment was also not associated with an imbalanced incidence of neurological and audiological adverse events. These results provide evidence that the BAEP and axonal swelling finding in dogs are not clinically relevant in humans.
Collapse
Affiliation(s)
- Samira Anderson
- Department of Hearing and Speech SciencesUniversity of MarylandCollege ParkMarylandUSA
| | - Guido Cavaletti
- Experimental Neurology Unit, School of Medicine and SurgeryUniversity of Milano‐BicoccaMonzaItaly
| | - Linda J. Hood
- Department of Hearing and Speech SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Michael Polydefkis
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | | | - Gary Rance
- Department of Audiology and Speech PathologyThe University of MelbourneCarltonVictoriaAustralia
| | - Brett King
- Department of DermatologyYale University School of MedicineNew HavenConnecticutUSA
| | - Amy J. McMichael
- Department of DermatologyWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Maryanne M. Senna
- Department of DermatologyLahey Hospital and Medical CenterBurlingtonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - Brian S. Kim
- Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Lynne Napatalung
- Pfizer IncNew YorkNew YorkUSA
- Mount Sinai HospitalNew YorkNew YorkUSA
| | | | | | | | | | | | | |
Collapse
|
2
|
Jafari Z, Fitzpatrick EM, Schramm DR, Rouillon I, Koravand A. Prognostic Value of Electrophysiological and MRI Findings for Pediatric Cochlear Implant Outcomes: A Systematic Review. Am J Audiol 2024:1-18. [PMID: 39018270 DOI: 10.1044/2024_aja-23-00272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/19/2024] Open
Abstract
PURPOSE Magnetic resonance imaging (MRI), electric compound action potential (eCAP), and electric auditory brainstem response (eABR) are among the routine assessments performed before and/or after cochlear implantation. The objective of this review was to systematically summarize and critically appraise existing evidence of the prognostic value of eCAP, eABR, and MRI for predicting post-cochlear implant (CI) speech perception outcomes in children, with a particular focus on the lesion site. METHOD The present systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Three electronic databases (ProQuest, PubMed, and Scopus) were searched with no restrictions on language, publication status, or year of publication. Studies on children identified with sensorineural hearing loss, auditory neuropathy spectrum disorder, cochlear nerve deficiency, or cochleovestibular nerve abnormalities reporting the relevance of eCAP, eABR, and/or MRI results to CI speech perception outcomes were included. The literature search yielded 1,887 publications. Methodological quality and strength of evidence were assessed by the Crowe Critical Appraisal Tool and the Grading of Recommendations Assessment, Development, and Evaluation tool, respectively. RESULTS Of the 25 included studies, the relevance of eCAP, eABR, and/or MRI findings to post-CI speech perception outcomes was reported in 10, 11, and 11 studies, respectively. The studies were strongly in support of the prognostic value of eABR and MRI for CI outcomes. However, the relevance of eCAP findings to speech perception outcomes was uncertain. CONCLUSION Despite the promising findings, caution is warranted in interpreting them due to the observational and retrospective design of the included studies, as well as the heterogeneity of the population and the limited control of confounding factors within these studies. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26169859.
Collapse
Affiliation(s)
- Zahra Jafari
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
| | - Elizabeth M Fitzpatrick
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
- Child Hearing Laboratory, CHEO Research Institute, Ottawa, Ontario, Canada
| | - David R Schramm
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, Ontario, Canada
| | - Isabelle Rouillon
- Department of Pediatric Otolaryngology, AP-HP, Hôpital Necker - Enfants Malades, Paris, France
| | - Amineh Koravand
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
| |
Collapse
|
3
|
Deng L, Wen C, Yu Y, Li Y, Liu H, Fu X, Cheng X, Huang L. A novel mutation in the OTOF gene in a Chinese family with auditory neuropathy. Intractable Rare Dis Res 2024; 13:104-109. [PMID: 38836175 PMCID: PMC11145404 DOI: 10.5582/irdr.2024.01004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 06/06/2024] Open
Abstract
Gene therapy for monogenic auditory neuropathy (AN) has successfully improved hearing function in target gene-deficient mice. Accurate genetic diagnosis can not only clarify the etiology but also accurately locate the lesion site, providing a basis for gene therapy and guiding patient intervention and management strategies. In this study, we collected data from a family with a pair of sisters with prelingual deafness. According to their auditory tests, subject Ⅱ-1 was diagnosed with profound sensorineural hearing loss (SNHL), Ⅱ-2 was diagnosed with AN, Ⅰ-1 was diagnosed with high-frequency SNHL, and Ⅰ-2 had normal hearing. Using whole-exome sequencing (WES), one nonsense mutation, c.4030C>T (p.R1344X), and one missense mutation, c.5000C>A (p.A1667D), in the OTOF (NM_001287489.1) gene were identified in the two siblings. Their parents were heterozygous carriers of c.5000C>A (father) and c.4030C>T (mother). We hypothesized that c.5000C>A is a novel pathogenic mutation. Thus, subject Ⅱ-1 should also be diagnosed with AN caused by OTOF mutations. These findings not only expand the OTOF gene mutation spectrum for AN but also indicate that WES is an effective approach for accurately diagnosing AN.
Collapse
Affiliation(s)
- Lin Deng
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Cheng Wen
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Yiding Yu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Yue Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Hui Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Xinxing Fu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Xiaohua Cheng
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Lihui Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Otolaryngology, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| |
Collapse
|
4
|
Jafari Z, Fitzpatrick EM, Schramm DR, Rouillon I, Koravand A. Predictors of cochlear implant outcomes in pediatric auditory neuropathy: A matched case-control study. PLoS One 2024; 19:e0304316. [PMID: 38809896 PMCID: PMC11135674 DOI: 10.1371/journal.pone.0304316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVES Current evidence supports the benefits of cochlear implants (CIs) in children with hearing loss, including those with auditory neuropathy spectrum disorder (ANSD). However, there is limited evidence regarding factors that hold predictive value for intervention outcomes. DESIGN This retrospective case-control study consisted of 66 children with CIs, including 22 with ANSD and 44 with sensorineural hearing loss (SNHL) matched on sex, age, age at CI activation, and the length of follow-up with CIs (1:2 ratio). The case and control groups were compared in the results of five open-set speech perception tests, and a Forward Linear Regression Model was used to identify factors that can predict the post-CI outcomes. RESULTS There was no significant difference in average scores between the two groups across five outcome measures, ranging from 88.40% to 95.65%. The correlation matrix revealed that younger ages at hearing aid fitting and CI activation positively influenced improvements in speech perception test scores. Furthermore, among the variables incorporated in the regression model, the duration of follow-up with CIs, age at CI activation, and the utilization of two CIs demonstrated prognostic significance for improved post-CI speech perception outcomes. CONCLUSIONS Children with ANSD can achieve similar open-set speech perception outcomes as children with SNHL. A longer CI follow-up, a lower age at CI activation, and the use of two CIs are predictive for optimal CI outcome.
Collapse
Affiliation(s)
- Zahra Jafari
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ottawa, Ontario, Canada
- School of Communication Sciences and Disorders (SCSD), Dalhousie University, Halifax, NS, Canada
| | - Elizabeth M. Fitzpatrick
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ottawa, Ontario, Canada
- Child Hearing Lab, CHEO Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - David R. Schramm
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Isabelle Rouillon
- Speech and Language Pathology, and Otolaryngology Department, Necker Hospital, Paris, France
| | - Amineh Koravand
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
5
|
Rance G, Wills R, Kornberg A, Zanin J. Diffusion-Weighted Magnetic Resonance Imaging (dMRI) and Cochlear Implant Outcomes in Axonal Auditory Neuropathy: A Case Report. J Clin Med 2024; 13:3072. [PMID: 38892782 PMCID: PMC11172963 DOI: 10.3390/jcm13113072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/10/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Progressive auditory dysfunction is common in patients with generalized neurodegenerative conditions, but clinicians currently lack the diagnostic tools to determine the location/degree of the pathology and, hence, to provide appropriate intervention. In this study, we present the white-matter microstructure measurements derived from a novel diffusion-weighted magnetic resonance imaging (dMRI) technique in a patient with axonal auditory neuropathy and consider the findings in relation to the auditory intervention outcomes. METHODS We tracked the hearing changes in an adolescent with Riboflavin Transporter Deficiency (Type 2), evaluating the sound detection/discrimination, auditory evoked potentials, and both structural- and diffusion-weighted MRI findings over a 3-year period. In addition, we explored the effect of bilateral cochlear implantation in this individual. RESULTS Between the ages of 15 years and 18 years, the patient showed a complete loss of functional hearing ability. The auditory brainstem response testing indicated an auditory neuropathy with evidence of normal cochlear function but disrupted auditory neural activity. While three structural MRI assessments across this period showed a clinically normal cochleovestibular anatomy, the dMRI evaluation revealed a significant loss of fiber density consistent with axonopathy. The subsequent cochlear implant function was affected with the high levels of current required to elicit auditory sensations and concomitant vestibular and facial nerve stimulation issues. CONCLUSIONS The case study demonstrates the ability of dMRI technologies to identify the subtle white-matter microstructure changes in the auditory pathway, which may disrupt the neural function in patients with auditory axonopathy.
Collapse
Affiliation(s)
- Gary Rance
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC 3052, Australia;
| | - Raoul Wills
- Cochlear Implant Clinic, The Royal Victorian Eye and Ear Hospital, East Melbourne, VIC 3002, Australia;
| | - Andrew Kornberg
- Department of Neurology, Royal Children’s Hospital, Parkville, VIC 3052, Australia;
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3052, Australia
| | - Julien Zanin
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC 3052, Australia;
| |
Collapse
|
6
|
Shi T, Chen Z, Li J, Wang H, Wang Q. AIF translocation into nucleus caused by Aifm1 R450Q mutation: generation and characterization of a mouse model for AUNX1. Hum Mol Genet 2024; 33:905-918. [PMID: 38449065 PMCID: PMC11070138 DOI: 10.1093/hmg/ddae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/30/2023] [Accepted: 01/05/2024] [Indexed: 03/08/2024] Open
Abstract
Mutations in AIFM1, encoding for apoptosis-inducing factor (AIF), cause AUNX1, an X-linked neurologic disorder with late-onset auditory neuropathy (AN) and peripheral neuropathy. Despite significant research on AIF, there are limited animal models with the disrupted AIFM1 representing the corresponding phenotype of human AUNX1, characterized by late-onset hearing loss and impaired auditory pathways. Here, we generated an Aifm1 p.R450Q knock-in mouse model (KI) based on the human AIFM1 p.R451Q mutation. Hemizygote KI male mice exhibited progressive hearing loss from P30 onward, with greater severity at P60 and stabilization until P210. Additionally, muscle atrophy was observed at P210. These phenotypic changes were accompanied by a gradual reduction in the number of spiral ganglion neuron cells (SGNs) at P30 and ribbons at P60, which coincided with the translocation of AIF into the nucleus starting from P21 and P30, respectively. The SGNs of KI mice at P210 displayed loss of cytomembrane integrity, abnormal nuclear morphology, and dendritic and axonal demyelination. Furthermore, the inner hair cells and myelin sheath displayed abnormal mitochondrial morphology, while fibroblasts from KI mice showed impaired mitochondrial function. In conclusion, we successfully generated a mouse model recapitulating AUNX1. Our findings indicate that disruption of Aifm1 induced the nuclear translocation of AIF, resulting in the impairment in the auditory pathway.
Collapse
Affiliation(s)
- Tao Shi
- Senior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General Hospital, Medical School of Chinese PLA, 6 Fucheng Road, Beijing 100048, P. R. China
- National Clinical Research Center for Otolaryngologic Diseases, Chinese PLA General Hospital, 6 Fucheng Road, Beijing 100048, P. R. China
| | - Ziyi Chen
- Senior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General Hospital, Medical School of Chinese PLA, 6 Fucheng Road, Beijing 100048, P. R. China
- National Clinical Research Center for Otolaryngologic Diseases, Chinese PLA General Hospital, 6 Fucheng Road, Beijing 100048, P. R. China
| | - Jin Li
- Senior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General Hospital, Medical School of Chinese PLA, 6 Fucheng Road, Beijing 100048, P. R. China
- National Clinical Research Center for Otolaryngologic Diseases, Chinese PLA General Hospital, 6 Fucheng Road, Beijing 100048, P. R. China
| | - Hongyang Wang
- Senior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General Hospital, Medical School of Chinese PLA, 6 Fucheng Road, Beijing 100048, P. R. China
- National Clinical Research Center for Otolaryngologic Diseases, Chinese PLA General Hospital, 6 Fucheng Road, Beijing 100048, P. R. China
| | - Qiuju Wang
- Senior Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General Hospital, Medical School of Chinese PLA, 6 Fucheng Road, Beijing 100048, P. R. China
- National Clinical Research Center for Otolaryngologic Diseases, Chinese PLA General Hospital, 6 Fucheng Road, Beijing 100048, P. R. China
| |
Collapse
|
7
|
Rance G, Tomlin D, Graydon K. Tone-burst elicited auditory brainstem responses in full-term and pre-term infants. Int J Audiol 2024:1-8. [PMID: 38690678 DOI: 10.1080/14992027.2024.2341119] [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: 12/07/2023] [Accepted: 03/29/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To investigate the reliability of tone-burst auditory brainstem response (TB-ABR) latencies and thresholds in pre-term and full-term infants. DESIGN TB-ABRs to 500 Hz and 4000 Hz tone-burst stimuli were recorded at two-week intervals over the first six weeks of life in a group of full-term infants (40-46 weeks gestational age [GA]) and over ten weeks (36-46 weeks gestation) in a group of preterm infants. Linear mixed model analyses evaluated within-subject changes and the effects of the subject group, age at assessment, and stimulus frequency on ABR latency and threshold. STUDY SAMPLE Twenty-four infants participated. Nine were full-term (GA: 39-41 weeks) and fifteen were healthy pre-term (GA: 28-34 weeks) at birth. RESULTS TB-ABR wave V latencies at 70 dBnHL decreased throughout the study (p < 0.001) in pre-term babies for both test frequencies by approximately 0.5 ms. There were, however, no group or GA (at birth) effects indicating that response latency normalized in these children by the due date. Similarly, TB-ABR threshold levels in the premature group were elevated (p = 0.001) by approximately 5 dB in pre-term evaluation but were equivalent to those of full-term participants in the post-term assessment period. CONCLUSIONS In healthy, pre-term infants, tone-burst ABR testing is reliable from 36 weeks gestation.
Collapse
Affiliation(s)
- Gary Rance
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| | - Dani Tomlin
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| | - Kelley Graydon
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| |
Collapse
|
8
|
Rance G, Tomlin D, Yiu EM, Zanin J. Remediation of Perceptual Deficits in Progressive Auditory Neuropathy: A Case Study. J Clin Med 2024; 13:2127. [PMID: 38610891 PMCID: PMC11012630 DOI: 10.3390/jcm13072127] [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: 02/12/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Auditory neuropathy (AN) is a hearing disorder that affects neural activity in the VIIIth cranial nerve and central auditory pathways. Progressive forms have been reported in a number of neurodegenerative diseases and may occur as a result of both the deafferentiation and desynchronisation of neuronal processes. The purpose of this study was to describe changes in auditory function over time in a patient with axonal neuropathy and to explore the effect of auditory intervention. METHODS We tracked auditory function in a child with progressive AN associated with Charcot-Marie-Tooth (Type 2C) disease, evaluating hearing levels, auditory-evoked potentials, and perceptual abilities over a 3-year period. Furthermore, we explored the effect of auditory intervention on everyday listening and neuroplastic development. RESULTS While sound detection thresholds remained constant throughout, both electrophysiologic and behavioural evidence suggested auditory neural degeneration over the course of the study. Auditory brainstem response amplitudes were reduced, and perception of auditory timing cues worsened over time. Functional hearing ability (speech perception in noise) also deteriorated through the first 1.5 years of study until the child was fitted with a "remote-microphone" listening device, which subsequently improved binaural processing and restored speech perception ability to normal levels. CONCLUSIONS Despite the deterioration of auditory neural function consistent with peripheral axonopathy, sustained experience with the remote-microphone listening system appeared to produce neuroplastic changes, which improved the patient's everyday listening ability-even when not wearing the device.
Collapse
Affiliation(s)
- Gary Rance
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC 3053, Australia; (D.T.); (J.Z.)
| | - Dani Tomlin
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC 3053, Australia; (D.T.); (J.Z.)
| | - Eppie M. Yiu
- Department of Neurology, Royal Children’s Hospital, Parkville, VIC 3052, Australia
- Neurosciences Research, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Julien Zanin
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC 3053, Australia; (D.T.); (J.Z.)
| |
Collapse
|
9
|
Wang H, Guan L, Wu X, Guan J, Li J, Li N, Wu K, Gao Y, Bing D, Zhang J, Lan L, Shi T, Li D, Wang W, Xie L, Xiong F, Shi W, Zhao L, Wang D, Yin Y, Wang Q. Clinical and genetic architecture of a large cohort with auditory neuropathy. Hum Genet 2024; 143:293-309. [PMID: 38456936 PMCID: PMC11043192 DOI: 10.1007/s00439-024-02652-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/25/2024] [Indexed: 03/09/2024]
Abstract
Auditory neuropathy (AN) is a unique type of language developmental disorder, with no precise rate of genetic contribution that has been deciphered in a large cohort. In a retrospective cohort of 311 patients with AN, pathogenic and likely pathogenic variants of 23 genes were identified in 98 patients (31.5% in 311 patients), and 14 genes were mutated in two or more patients. Among subgroups of patients with AN, the prevalence of pathogenic and likely pathogenic variants was 54.4% and 56.2% in trios and families, while 22.9% in the cases with proband-only; 45.7% and 25.6% in the infant and non-infant group; and 33.7% and 0% in the bilateral and unilateral AN cases. Most of the OTOF gene (96.6%, 28/29) could only be identified in the infant group, while the AIFM1 gene could only be identified in the non-infant group; other genes such as ATP1A3 and OPA1 were identified in both infant and non-infant groups. In conclusion, genes distribution of AN, with the most common genes being OTOF and AIFM1, is totally different from other sensorineural hearing loss. The subgroups with different onset ages showed different genetic spectrums, so did bilateral and unilateral groups and sporadic and familial or trio groups.
Collapse
Affiliation(s)
- Hongyang Wang
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Liping Guan
- Hebei Industrial Technology Research Institute of Genomics in Maternal and Child Health, Shijiazhuang, 050000, People's Republic of China
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Xiaonan Wu
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Jing Guan
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Jin Li
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Nan Li
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Kaili Wu
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Ya Gao
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Dan Bing
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Jianguo Zhang
- Hebei Industrial Technology Research Institute of Genomics in Maternal and Child Health, Shijiazhuang, 050000, People's Republic of China
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Lan Lan
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Tao Shi
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Danyang Li
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Wenjia Wang
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Linyi Xie
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Fen Xiong
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Wei Shi
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Lijian Zhao
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
- Medical Technology College, Hebei Medical University, Shijiazhuang, 050000, People's Republic of China
| | - Dayong Wang
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China
| | - Ye Yin
- BGI Genomics, BGI-Shenzhen, Shenzhen, 518083, People's Republic of China
| | - Qiuju Wang
- Senior Department of Otolaryngology Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, The Sixth Medical Center of Chinese PLA General Hospital, Medical School of Chinese PLA, 28 Fuxing Road, Beijing, 100853, People's Republic of China.
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, 100853, People's Republic of China.
| |
Collapse
|
10
|
Paul A, Bense F, Boithias Guerot C, De La Rubia S, Lebeaux C, Papon JF. Leading Risk Factors for Congenital Deafness in the Context of Universal Neonatal Screening: Our Observations in a Four-Year Retrospective Study. Int J Neonatal Screen 2024; 10:11. [PMID: 38390975 PMCID: PMC10885021 DOI: 10.3390/ijns10010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/20/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
It has been demonstrated that universal hearing neonatal screening (UHNS) is efficient at providing early diagnosis and rehabilitation for deafness. The risk factors of deafness in children have been identified, but less specifically in those diagnosed after UHNS. In this study, we aim to study these factors in infants who were referred after screening and to compare our experience to recent data. We studied infants referred to our department for diagnosis after screening between January 2018 and December 2021. Their medical history and neonatal hearing risk factors were assessed. Associations between factors were also analyzed. Sixty-six infants were included. A family history of deafness (47%), syndromic deafness (41%), intrauterine growth retardation or prematurity (19.7%), and prolonged NICU admission (18%) were the most observed factors. When analyzing according to these associations, family history of deafness and syndromic cases remained the most prevalent factors (74%), while only five cases (7.8%) presented with other neonatal risk factors only. The majority of congenital hearing loss cases are observed in infants with suspected genetic deafness. Parental counseling, the diagnostic pathway, as well as the healthcare system should be adapted according to these risk factors.
Collapse
Affiliation(s)
- Antoine Paul
- Otolaryngology Department—Cochlear Implant Center, Hôpital Bicêtre, Assistance Publique—Hôpitaux de Paris, Paris-Saclay University, 94270 Kremlin-Bicêtre, France
| | - Fanny Bense
- Otolaryngology Department—Cochlear Implant Center, Hôpital Bicêtre, Assistance Publique—Hôpitaux de Paris, Paris-Saclay University, 94270 Kremlin-Bicêtre, France
| | - Claire Boithias Guerot
- Neonatal Intensive Care Unit Department, Hôpital Bicêtre, Assistance Publique—Hôpitaux de Paris, Paris-Saclay University, 94270 Kremlin-Bicêtre, France
| | - Sofia De La Rubia
- Neonatal Intensive Care Unit Department, Hôpital Antoine Béclère, Assistance Publique—Hôpitaux de Paris, Paris-Saclay University, 92140 Clamart, France
| | - Cécile Lebeaux
- Center of Perinatal Care of Val-de-Marne Department, 94000 Créteil, France
| | - Jean-François Papon
- Otolaryngology Department—Cochlear Implant Center, Hôpital Bicêtre, Assistance Publique—Hôpitaux de Paris, Paris-Saclay University, 94270 Kremlin-Bicêtre, France
| |
Collapse
|
11
|
Wei G, Tian X, Yang H, Luo Y, Liu G, Sun S, Wang X, Wen H. Adjunct Methods for Alzheimer's Disease Detection: A Review of Auditory Evoked Potentials. J Alzheimers Dis 2024; 97:1503-1517. [PMID: 38277292 DOI: 10.3233/jad-230822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
The auditory afferent pathway as a clinical marker of Alzheimer's disease (AD) has sparked interest in investigating the relationship between age-related hearing loss (ARHL) and AD. Given the earlier onset of ARHL compared to cognitive impairment caused by AD, there is a growing emphasis on early diagnosis and intervention to postpone or prevent the progression from ARHL to AD. In this context, auditory evoked potentials (AEPs) have emerged as a widely used objective auditory electrophysiological technique for both the clinical diagnosis and animal experimentation in ARHL due to their non-invasive and repeatable nature. This review focuses on the application of AEPs in AD detection and the auditory nerve system corresponding to different latencies of AEPs. Our objective was to establish AEPs as a systematic and non-invasive adjunct method for enhancing the diagnostic accuracy of AD. The success of AEPs in the early detection and prediction of AD in research settings underscores the need for further clinical application and study.
Collapse
Affiliation(s)
- Guoliang Wei
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Xuelong Tian
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Hong Yang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Yinpei Luo
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Guisong Liu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Shuqing Sun
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Xing Wang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Huizhong Wen
- Department of Neurobiology, School of Basic Medicine, Chongqing Key Laboratory of Neurobiology, Army Medical University, Chongqing, China
| |
Collapse
|
12
|
Qiu Y, Wang H, Pan H, Ding X, Guan J, Zhuang Q, Wu K, Lei Z, Cai H, Dong Y, Zhou H, Lin A, Wang Q, Yan Q. NADH improves AIF dimerization and inhibits apoptosis in iPSCs-derived neurons from patients with auditory neuropathy spectrum disorder. Hear Res 2024; 441:108919. [PMID: 38043402 DOI: 10.1016/j.heares.2023.108919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
Auditory neuropathy spectrum disorder (ANSD) is a hearing impairment involving disruptions to inner hair cells (IHCs), ribbon synapses, spiral ganglion neurons (SGNs), and/or the auditory nerve itself. The outcomes of cochlear implants (CI) for ANSD are variable and dependent on the location of lesion sites. Discovering a potential therapeutic agent for ANSD remains an urgent requirement. Here, 293T stable transfection cell lines and patient induced pluripotent stem cells (iPSCs)-derived auditory neurons carrying the apoptosis inducing factor (AIF) p.R422Q variant were used to pursue a therapeutic regent for ANSD. Nicotinamide adenine dinucleotide (NADH) is a main electron donor in the electron transport chain (ETC). In 293T stable transfection cells with the p.R422Q variant, NADH treatment improved AIF dimerization, rescued mitochondrial dysfunctions, and decreased cell apoptosis. The effects of NADH were further confirmed in patient iPSCs-derived neurons. The relative level of AIF dimers was increased to 150.7 % (P = 0.026) from 59.2 % in patient-neurons upon NADH treatment. Such increased AIF dimerization promoted the mitochondrial import of coiled-coil-helix-coiled-coil-helix domain-containing protein 4 (CHCHD4), which further restored mitochondrial functions. Similarly, the content of mitochondrial calcium (mCa2+) was downregulated from 136.7 % to 102.3 % (P = 0.0024) in patient-neurons upon NADH treatment. Such decreased mCa2+ levels inhibited calpain activity, ultimately reducing the percentage of apoptotic cells from 30.5 % to 21.1 % (P = 0.021). We also compared the therapeutic effects of gene correction and NADH treatment on hereditary ANSD. NADH treatment had comparable restorative effects on functions of ANSD patient-specific cells to that of gene correction. Our findings offer evidence of the molecular mechanisms of ANSD and introduce NADH as a potential therapeutic agent for ANSD therapy.
Collapse
Affiliation(s)
- Yue Qiu
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China; Institute of Brain Science, Wannan Medical College, Wuhu, Anhui 241000, China
| | - Hongyang Wang
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, the Sixth Medicine Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Huaye Pan
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Xue Ding
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Jing Guan
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, the Sixth Medicine Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Qianqian Zhuang
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Kaiwen Wu
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, the Sixth Medicine Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Zhaoying Lei
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Huajian Cai
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Yufei Dong
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Hui Zhou
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Aifu Lin
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Qiuju Wang
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, the Sixth Medicine Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Qingfeng Yan
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China; Department of Pediatrics, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China; Key Laboratory for Cell and Gene Engineering of Zhejiang Province, Hangzhou, Zhejiang 310058, China.
| |
Collapse
|
13
|
Wu J, Chen J, Ding Z, Fan J, Wang Q, Dai P, Han D. Outcomes of cochlear implantation in 75 patients with auditory neuropathy. Front Neurosci 2023; 17:1281884. [PMID: 38027523 PMCID: PMC10679445 DOI: 10.3389/fnins.2023.1281884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Background Cochlear implantation (CI) outcomes in patients with auditory neuropathy (AN) are variable, which hampers patients' decisions on CI. Objective This study aims to assess the outcomes of CI in individuals diagnosed with AN and to examine the various factors that may influence the effectiveness of this intervention. Methods A total of 75 patients diagnosed with AN were included in the study. The hearing threshold, the score of categories of auditory performance (CAP), speech intelligibility rating (SIR), and speech audiometry were tested. Genetic testing was conducted by medical exome sequencing in 46 patients. Results After CI, the average aided hearing threshold for patients with prelingual and post-lingual onset was 38.25 ± 6.63 dB and 32.58 ± 9.26 dB, respectively; CAP score improved to 5.52 ± 1.64 (p < 0.001) and 6.00 ± 0.96 (p < 0.001), respectively; SIR score increased to 3.57 ± 1.22 (p < 0.001) and 4.15 ± 0.95 (p < 0.001), respectively. Maximum speech recognition ranged from 58 to 93% for prelingual onset patients and 43 to 98% for those with post-lingual onset. Speech outcomes of CI in cases with cochlear nerve (CN) deficiency were significantly poorer (p = 0.008). Molecular etiologies, including TWIST1, ACTG1, m.A7445G, and a copy-number variant (CNV) carrying ACTB, were related to AN here. Conclusion CI is a viable therapy option for patients with AN; CN deficiency might impact outcomes of CI.
Collapse
Affiliation(s)
| | | | | | | | | | - Pu Dai
- Key Lab of Hearing Impairment Science of Ministry of Education, Key Lab of Hearing Impairment Prevention and Treatment of Beijing, National Clinical Research Center for Otolaryngologic Diseases, College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China
| | - Dongyi Han
- Key Lab of Hearing Impairment Science of Ministry of Education, Key Lab of Hearing Impairment Prevention and Treatment of Beijing, National Clinical Research Center for Otolaryngologic Diseases, College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China
| |
Collapse
|
14
|
Munson HE, De Simone L, Schwaede A, Bhatia A, Mithal DS, Young N, Kuntz N, Rao VK. Axonal polyneuropathy and ataxia in children: consider Perrault Syndrome, a case report. BMC Med Genomics 2023; 16:278. [PMID: 37932750 PMCID: PMC10626675 DOI: 10.1186/s12920-023-01599-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 07/04/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Perrault Syndrome (PRLTS) is a rare, autosomal recessive disorder that presents with bilateral sensorineural hearing loss in all patients and gonadal dysfunction in females. It has been linked to variants in CLPP, ERAL1, HARS2, HSD17B4, LARS2, and TWNK genes. All reported cases due to TWNK variants have included neurologic features, such as ataxia and axonal sensorimotor neuropathy. CASE PRESENTATION A 4.5-year-old female presented to neuromuscular clinic due to ataxia. Neurological examination revealed truncal ataxia and steppage gait, reduced deep tendon reflexes, and axonal sensorimotor polyneuropathy. Auditory brainstem response testing revealed an uncommon type of sensorineural hearing loss known as auditory neuropathy/auditory synaptopathy (AN/AS) affecting both ears. Magnetic Resonance Imaging (MRI) revealed subtle cauda equina enhancement. Nerve conduction studies led to a provisional diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP), and intravenous immune globulin (IVIG) was initiated. The patient was unresponsive to treatment, thus whole exome testing (WES) was conducted in tandem with IVIG weaning. WES revealed a compound heterozygous state with two variants in the TWNK gene and a diagnosis of Perrault Syndrome was made. CONCLUSIONS Perrault Syndrome should be considered in the differential for children who present with bilateral sensorineural hearing loss, axonal polyneuropathy, and ataxia. Further examination includes testing for ovarian dysgenesis and known PRLTS genetic variants.
Collapse
Affiliation(s)
- Hannah E Munson
- Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL, USA.
| | - Lenika De Simone
- Division of Genetics, Birth Defects and Metabolism, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Abigail Schwaede
- Division of Neurology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and the Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Avanti Bhatia
- Department of Speech-Language Pathology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Divakar S Mithal
- Division of Neurology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and the Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Nancy Young
- Stanley Manne Children's Research Institute, Chicago, IL, USA
- Division of Otolaryngology, Department of Otolaryngology, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nancy Kuntz
- Division of Neurology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and the Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Vamshi K Rao
- Division of Neurology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and the Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Stanley Manne Children's Research Institute, Chicago, IL, USA
| |
Collapse
|
15
|
Tropitzsch A, Schade-Mann T, Gamerdinger P, Dofek S, Schulte B, Schulze M, Fehr S, Biskup S, Haack TB, Stöbe P, Heyd A, Harre J, Lesinski-Schiedat A, Büchner A, Lenarz T, Warnecke A, Müller M, Vona B, Dahlhoff E, Löwenheim H, Holderried M. Variability in Cochlear Implantation Outcomes in a Large German Cohort With a Genetic Etiology of Hearing Loss. Ear Hear 2023; 44:1464-1484. [PMID: 37438890 PMCID: PMC10583923 DOI: 10.1097/aud.0000000000001386] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/04/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES The variability in outcomes of cochlear implantation is largely unexplained, and clinical factors are not sufficient for predicting performance. Genetic factors have been suggested to impact outcomes, but the clinical and genetic heterogeneity of hereditary hearing loss makes it difficult to determine and interpret postoperative performance. It is hypothesized that genetic mutations that affect the neuronal components of the cochlea and auditory pathway, targeted by the cochlear implant (CI), may lead to poor performance. A large cohort of CI recipients was studied to verify this hypothesis. DESIGN This study included a large German cohort of CI recipients (n = 123 implanted ears; n = 76 probands) with a definitive genetic etiology of hearing loss according to the American College of Medical Genetics (ACMG)/Association for Molecular Pathology (AMP) guidelines and documented postoperative audiological outcomes. All patients underwent preoperative clinical and audiological examinations. Postoperative CI outcome measures were based on at least 1 year of postoperative audiological follow-up for patients with postlingual hearing loss onset (>6 years) and 5 years for children with congenital or pre/perilingual hearing loss onset (≤6 years). Genetic analysis was performed based on three different methods that included single-gene screening, custom-designed hearing loss gene panel sequencing, targeting known syndromic and nonsyndromic hearing loss genes, and whole-genome sequencing. RESULTS The genetic diagnosis of the 76 probands in the genetic cohort involved 35 genes and 61 different clinically relevant (pathogenic, likely pathogenic) variants. With regard to implanted ears (n = 123), the six most frequently affected genes affecting nearly one-half of implanted ears were GJB2 (21%; n = 26), TMPRSS3 (7%; n = 9), MYO15A (7%; n = 8), SLC26A4 (5%; n = 6), and LOXHD1 and USH2A (each 4%; n = 5). CI recipients with pathogenic variants that influence the sensory nonneural structures performed at or above the median level of speech performance of all ears at 70% [monosyllable word recognition score in quiet at 65 decibels sound pressure level (SPL)]. When gene expression categories were compared to demographic and clinical categories (total number of compared categories: n = 30), mutations in genes expressed in the spiral ganglion emerged as a significant factor more negatively affecting cochlear implantation outcomes than all clinical parameters. An ANOVA of a reduced set of genetic and clinical categories (n = 10) identified five detrimental factors leading to poorer performance with highly significant effects ( p < 0.001), accounting for a total of 11.8% of the observed variance. The single strongest category was neural gene expression accounting for 3.1% of the variance. CONCLUSIONS The analysis of the relationship between the molecular genetic diagnoses of a hereditary etiology of hearing loss and cochlear implantation outcomes in a large German cohort of CI recipients revealed significant variabilities. Poor performance was observed with genetic mutations that affected the neural components of the cochlea, supporting the "spiral ganglion hypothesis."
Collapse
Affiliation(s)
- Anke Tropitzsch
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Hearing Center, Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Center for Rare Hearing Disorders, Centre for Rare Diseases, University of Tübingen, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Thore Schade-Mann
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Hearing Center, Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Philipp Gamerdinger
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Hearing Center, Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Saskia Dofek
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Björn Schulte
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Martin Schulze
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Sarah Fehr
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Saskia Biskup
- CeGaT GmbH und Praxis für Humangenetik Tübingen, Tübingen, Germany
| | - Tobias B. Haack
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Petra Stöbe
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Andreas Heyd
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
| | - Jennifer Harre
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Anke Lesinski-Schiedat
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Andreas Büchner
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Thomas Lenarz
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Athanasia Warnecke
- Department of Otorhinolaryngology—Head & Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all” of the German Research Foundation, Hannover, Germany
| | - Marcus Müller
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Barbara Vona
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Ernst Dahlhoff
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Hubert Löwenheim
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Neurosensory Center, Departments of Otolaryngology—Head & Neck Surgery and Ophthalmology, University of Tübingen Medical Center, Tübingen, Germany
| | - Martin Holderried
- Department of Otolaryngology—Head & Neck Surgery, University of Tübingen Medical Center, Tübingen, Germany
- Department of Medical Development and Quality Management, University Hospital Tübingen, Tübingen, Germany
| |
Collapse
|
16
|
Boboshko MY, Savenko IV, Garbaruk ES, Knyazeva VM, Vasilyeva MJ. Impact of Prematurity on Auditory Processing in Children. PATHOPHYSIOLOGY 2023; 30:505-521. [PMID: 37987307 PMCID: PMC10661290 DOI: 10.3390/pathophysiology30040038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 11/22/2023] Open
Abstract
Prematurity is one of the most crucial risk factors negatively affecting the maturation of the auditory system. Children born preterm demonstrate high rates of hearing impairments. Auditory processing difficulties in preterm children might be a result of disturbances in the central auditory system development and/or sensory deprivation due to peripheral hearing loss. To investigate auditory processing in preterm children, we utilized a set of psychoacoustic tests to assess temporal processing and speech intelligibility. A total of 241 children aged 6-11 years old (136 born preterm and 105 healthy full-term children forming the control group) were assessed. The preterm children were divided into three groups based on their peripheral hearing status: 74 normal hearing (NH group); 30 children with bilateral permanent sensorineural hearing loss (SNHL group) and 32 children with bilateral auditory neuropathy spectrum disorder (ANSD group). The results showed significantly worse performance in all tests in premature children compared with full-term children. NH and SNHL groups showed significant age-related improvement in speech recognition thresholds in noise that might signify a "bottom-up" auditory processing maturation effect. Overall, all premature children had signs of auditory processing disorders of varying degrees. Analyzing and understanding the auditory processing specificity in preterm children can positively contribute to the more effective implementation of rehabilitation programs.
Collapse
Affiliation(s)
- Maria Y. Boboshko
- Department of Higher Nervous Activity and Psychophysiology, St. Petersburg State University, 199034 St. Petersburg, Russia;
- Laboratory of Hearing and Speech, Pavlov First St. Petersburg State Medical University, 197022 St. Petersburg, Russia; (I.V.S.); (E.S.G.)
| | - Irina V. Savenko
- Laboratory of Hearing and Speech, Pavlov First St. Petersburg State Medical University, 197022 St. Petersburg, Russia; (I.V.S.); (E.S.G.)
| | - Ekaterina S. Garbaruk
- Laboratory of Hearing and Speech, Pavlov First St. Petersburg State Medical University, 197022 St. Petersburg, Russia; (I.V.S.); (E.S.G.)
- Scientific Research Center, St. Petersburg State Pediatric Medical University, 194100 St. Petersburg, Russia
| | - Veronika M. Knyazeva
- Department of Higher Nervous Activity and Psychophysiology, St. Petersburg State University, 199034 St. Petersburg, Russia;
| | - Marina J. Vasilyeva
- Department of Higher Nervous Activity and Psychophysiology, St. Petersburg State University, 199034 St. Petersburg, Russia;
| |
Collapse
|
17
|
Jafari Z, Fitzpatrick EM, Schramm DR, Rouillon I, Koravand A. An Umbrella Review of Cochlear Implant Outcomes in Children With Auditory Neuropathy. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4160-4176. [PMID: 37647160 DOI: 10.1044/2023_jslhr-23-00128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
PURPOSE The objective of this overview of systematic reviews (SRs; umbrella review) was to systematically summarize and critically appraise current evidence of cochlear implant (CI) outcomes in children with auditory neuropathy spectrum disorder (ANSD). METHOD This study was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. The methodological quality and the risk of bias in the included SRs were assessed using A MeaSurement Tool to Assess systematic Reviews 2 checklist and the Risk of Bias in Systematic Reviews tool, respectively. RESULTS According to eight included SRs, children with ANSD achieve CI outcomes (speech perception performance) similar to their peers with sensorineural hearing loss. In children with postsynaptic ANSD (cochlear nerve deficiency), cochlear nerve hypoplasia is associated with better speech recognition outcomes compared with cochlear nerve aplasia, especially in the absence of additional disabilities. Except for one study, the overall quality of the included SRs was critically low, and except for three studies, evidence of a high risk of bias was identified in other included SRs. CONCLUSIONS Current evidence supports CI benefits for children with ANSD. To improve the quality of evidence, well-designed, prospective studies with appropriate sample sizes, using valid outcome measures, clarifying matching criteria, and taking into account the role of confounding factors are essential.
Collapse
Affiliation(s)
- Zahra Jafari
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
| | - Elizabeth M Fitzpatrick
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
- Child Hearing Laboratory, CHEO Research Institute, Ottawa, Ontario, Canada
| | - David R Schramm
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, Ontario, Canada
| | - Isabelle Rouillon
- Speech and Language Pathology, and Otolaryngology Department, Necker Hospital, Paris, France
| | - Amineh Koravand
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
| |
Collapse
|
18
|
Muthukumar R, Jaya V, Vignesh SS, Thenmozhi K. Prevalence and Auditory Characteristics of Auditory Neuropathy Spectrum Disorder in Adult Population with Sensory Neural Hearing Loss: A Hospital Based Study in South India. Indian J Otolaryngol Head Neck Surg 2023; 75:1906-1911. [PMID: 37636754 PMCID: PMC10447738 DOI: 10.1007/s12070-023-03766-6] [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: 07/03/2022] [Accepted: 03/31/2023] [Indexed: 08/29/2023] Open
Abstract
Auditory neuropathy spectrum disorder (ANSD) is a heterogenous group of disorder characterized by abnormalities in auditory brainstem responses (ABR) with preserved otoacoustic emissions and/or cochlear microphonics. The aim of the study is to estimate the prevalence and evaluate the audiological characteristics of ANSD in adult population with sensory neural hearing loss. A prospective study was conducted on the adult population (≥ 18 years) attending ENT outpatients clinic at Rajiv Gandhi Government General Hospital, Chennai. All patients reported to the department with auditory and vestibular symptoms underwent case history, otoscopic examination, and routine audiological evaluation (pure tone audiometry, speech audiometry and immittance audiometry). Patients with indications of ANSD in case history and routine audiological evaluation were further evaluated using distortion product otoacoustic emissions and ABR. A total of 8682 adult population was evaluated during the period of 2017 to 2018. Out of 8682 patients, 1343 (15.46%) of them had sensory neural hearing loss of varying degrees. Out of 1343 adults with sensory neural hearing loss, 24 (1.78%) adults were diagnosed as ANSD. The prevalence of ANSD in adult population with sensory neural hearing loss in our study is 1.32% per 1000 adults. The clinical characteristics of ANSD shows impairment in speech perception irrespective of degree of hearing loss, preserved cochlear functions and abnormal ABR. Hence ANSD is not a rare clinical finding in adults with sensory neural hearing loss, but its prevalence was estimated to be lower in Indian population. Often young females are affected causing significant impairment in speech perception and disability.
Collapse
Affiliation(s)
- R Muthukumar
- Upgraded Institute of Otorhinolaryngology and Institute of Speech and Hearing, Madras Medical college and Rajiv Gandhi Government General hospital, Chennai, 600003 India
| | - V Jaya
- Institute of Speech and Hearing, Madras Medical college and Rajiv Gandhi Government General hospital, Chennai, Tamil Nadu 600003 India
| | - S S Vignesh
- Institute of Speech and Hearing, Madras Medical college and Rajiv Gandhi Government General hospital, Chennai, Tamil Nadu 600003 India
| | - K Thenmozhi
- Institute of Speech and Hearing, Madras Medical college and Rajiv Gandhi Government General hospital, Chennai, Tamil Nadu 600003 India
| |
Collapse
|
19
|
Morlet T, O'Reilly R, Pritchett C, Venskytis E, Parkes W. A 15-year Review of 260 Children With Auditory Neuropathy Spectrum Disorder: II. Management and Outcomes. Ear Hear 2023; 44:979-989. [PMID: 37036283 DOI: 10.1097/aud.0000000000001366] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
OBJECTIVES Following a review of the demographic and clinical characteristics of all pediatric patients diagnosed with auditory neuropathy spectrum disorder (ANSD) by a pediatric health care system from 2005 to 2020, the present report highlights the type and timing of intervention and outcomes in the same 260 patients with ANSD. DESIGN This was a retrospective study reviewing the demographic data, medical history, imaging studies, audiological and speech language data, type of audiological intervention (hearing aids or cochlear implants), and mode of communication in 260 pediatric patients diagnosed with ANSD over a 15-year period. RESULTS A significant decrease over time in the age at hearing aid fitting was observed. While a similar reduction in the age at implantation occurred over time, cochlear implantation is still rarely performed by 12 months of age in most ANSD patients. Among bilateral ANSD patients fitted with hearing aids, the majority (89.2%) did not benefit from conventional amplification and most received cochlear implants. Some hearing aid benefit for speech and language development was observed in 5.8%, though communication difficulties were persistent and most used a combination of oral and sign language for communication. Only six patients (5%) received significant benefit from their hearing aids for speech and language development. CONCLUSIONS This review of ANSD management over a 15-year period reveals that hearing aids are not a viable option to develop speech and language for most infants and children with ANSD. This finding confirms previous reports and suggest that while hearing aid trials are warranted, children must be tracked closely so as to avoid delays in decision making. Cochlear implantation constitutes the major (if not only) rehabilitative intervention that allows for speech perception in patients who do not benefit from conventional amplification.
Collapse
Affiliation(s)
- Thierry Morlet
- Auditory Physiology and Psychoacoustics Research Laboratory, Nemours Children Health, Wilmington, Delaware, USA
- Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark, Delaware, USA
- Osborne College of Audiology, Salus University, Elkins Park, Pennsylvania, USA
| | - Robert O'Reilly
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Cedric Pritchett
- Department of Otolaryngology, Nemours Children Hospital, Orlando, Florida, USA
| | - Emily Venskytis
- Department of Audiology and Speech-Language Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - William Parkes
- Department of Otolaryngology, Nemours Children Hospital, Wilmington, Delaware, USA
| |
Collapse
|
20
|
Rance G, Carew P, Winata L, Sale P, Delatycki M, Sly D. Auditory neuropathy in mice and humans with Friedreich ataxia. Ann Clin Transl Neurol 2023; 10:953-963. [PMID: 37060174 PMCID: PMC10270266 DOI: 10.1002/acn3.51777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/20/2023] [Accepted: 03/08/2023] [Indexed: 04/16/2023] Open
Abstract
OBJECTIVE Recent studies have found that human Friedreich ataxia patients have dysfunction of transmission in the auditory neural pathways. Here, we characterize hearing deficits in a mouse model of Friedreich ataxia and compare these to a clinical population. METHODS Sixteen mice with a C57BL/6 background were evaluated. Eight were YG8Pook/J animals (Friedreich ataxia phenotype) and eight wild-type mice served as controls. Auditory function was assessed between ages 6 and 12 months using otoacoustic emissions and auditory steady-state responses. At study end, motor deficit was assessed using Rotorod testing and inner ear tissue was examined. Thirty-seven individuals with Friedreich ataxia underwent auditory steady-state evoked potential assessment and response amplitudes were compared with functional hearing ability (speech perception-in-noise) and disease status was measured by the Friedreich Ataxia Rating Scale. RESULTS The YG8Pook/J mice showed anatomic and functional abnormality. While otoacoustic emission responses from the cochlear hair cells were mildly affected, auditory steady-state responses showed exaggerated amplitude reductions as the animals aged with Friedreich ataxia mice showing a 50-60% decrease compared to controls who showed only a 20-25% reduction (F(2,94) = 17.90, p < 0.00). Furthermore, the YG8Pook/J mice had fewer surviving spiral ganglion neurons, indicating greater degeneration of the auditory nerve. Neuronal density was 20-25% lower depending on cochlear region (F(1, 30) = 45.02, p < 0.001). In human participants, auditory steady-state response amplitudes were correlated with both Consonant-Nucleus-Consonant word scores and Friedreich Ataxia Rating Scale score. INTERPRETATION This study found degenerative changes in auditory structure and function in YG8Pook/J mice, indicating that auditory measures in these animals may provide a model for testing Friedreich ataxia treatments. In addition, auditory steady-state response findings in a clinical population suggested that these scalp-recorded potentials may serve as an objective biomarker for disease progress in affected individuals.
Collapse
Affiliation(s)
- Gary Rance
- Department of Audiology and Speech PathologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Peter Carew
- Department of Audiology and Speech PathologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Leon Winata
- Department of OtolaryngologyUniversity of MelbourneMelbourneVictoriaAustralia
| | - Phillip Sale
- Department of OtolaryngologyUniversity of MelbourneMelbourneVictoriaAustralia
| | - Martin Delatycki
- Victorian Clinical Genetics Services, Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - David Sly
- Department of OtolaryngologyUniversity of MelbourneMelbourneVictoriaAustralia
- Ear Science Institute AustraliaPerthWestern AustraliaAustralia
| |
Collapse
|
21
|
Saidia AR, Ruel J, Bahloul A, Chaix B, Venail F, Wang J. Current Advances in Gene Therapies of Genetic Auditory Neuropathy Spectrum Disorder. J Clin Med 2023; 12:jcm12030738. [PMID: 36769387 PMCID: PMC9918155 DOI: 10.3390/jcm12030738] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Auditory neuropathy spectrum disorder (ANSD) refers to a range of hearing impairments characterized by an impaired transmission of sound from the cochlea to the brain. This defect can be due to a lesion or defect in the inner hair cell (IHC), IHC ribbon synapse (e.g., pre-synaptic release of glutamate), postsynaptic terminals of the spiral ganglion neurons, or demyelination and axonal loss within the auditory nerve. To date, the only clinical treatment options for ANSD are hearing aids and cochlear implantation. However, despite the advances in hearing-aid and cochlear-implant technologies, the quality of perceived sound still cannot match that of the normal ear. Recent advanced genetic diagnostics and clinical audiology made it possible to identify the precise site of a lesion and to characterize the specific disease mechanisms of ANSD, thus bringing renewed hope to the treatment or prevention of auditory neurodegeneration. Moreover, genetic routes involving the replacement or corrective editing of mutant sequences or defected genes to repair damaged cells for the future restoration of hearing in deaf people are showing promise. In this review, we provide an update on recent discoveries in the molecular pathophysiology of genetic lesions, auditory synaptopathy and neuropathy, and gene-therapy research towards hearing restoration in rodent models and in clinical trials.
Collapse
Affiliation(s)
- Anissa Rym Saidia
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, 34295 Montpellier, France
| | - Jérôme Ruel
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, 34295 Montpellier, France
- Cognitive Neuroscience Laboratory, Aix-Marseille University, CNRS, UMR 7291, 13331 Marseille, France
| | - Amel Bahloul
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, 34295 Montpellier, France
| | - Benjamin Chaix
- Department of ENT and Head and Neck Surgery, University Hospital of Montpellier, 34295 Montpellier, France
| | - Frédéric Venail
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, 34295 Montpellier, France
- Department of ENT and Head and Neck Surgery, University Hospital of Montpellier, 34295 Montpellier, France
| | - Jing Wang
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, 34295 Montpellier, France
- Department of ENT and Head and Neck Surgery, University Hospital of Montpellier, 34295 Montpellier, France
- Correspondence: ; Tel.: +33-499-63-60-48
| |
Collapse
|
22
|
Wang R, Bai X, Yang H, Ma J, Yu S, Lu Z. Identification of a novel AIFM1 variant from a Chinese family with auditory neuropathy. Front Genet 2022; 13:1064823. [DOI: 10.3389/fgene.2022.1064823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Auditory neuropathy (AN) is a specific type of hearing loss characterized by impaired language comprehension. Apoptosis inducing factor mitochondrion associated 1 (AIFM1) is the most common gene associated with late-onset AN. In this study, we aimed to screen the pathogenic variant of AIFM1 in a Chinese family with AN and to explore the molecular mechanism underlying the function of such variant in the development of AN.Methods: One patient with AN and eight unaffected individuals from a Chinese family were enrolled in this study. A comprehensive clinical evaluation was performed on all participants. A targeted next-generation sequencing (NGS) analysis of a total of 406 known deafness genes was performed to screen the potential pathogenic variants in the proband. Sanger sequencing was used to confirm the variants identified in all participants. The pathogenicity of variant was predicted by bioinformatics analysis. Immunofluorescence and Western blot analyses were performed to evaluate the subcellular distribution and expression of the wild type (WT) and mutant AIFM1 proteins. Cell apoptosis was evaluated based on the TUNEL analyses.Results: Based on the clinical evaluations, the proband in this family was diagnosed with AN. The results of NGS and Sanger sequencing showed that a novel missense mutation of AIFM1, i.e., c.1367A > G (p. D456G), was identified in this family. Bioinformatics analysis indicated that this variant was pathogenic. Functional analysis showed that in comparison with the WT, the mutation c.1367A > G of AIFM1 showed no effect on its subcellular localization and the ability to induce apoptosis, but changed its protein expression level.Conclusion: A novel variant of AIFM1 was identified for the first time, which was probably the genetic cause of AN in a Chinese family with AN.
Collapse
|
23
|
Cooper HE, Halliday LF, Bamiou DE, Mankad K, Clark CA. Brain structure correlates with auditory function in children diagnosed with auditory neuropathy spectrum disorder. Brain Behav 2022; 12:e2773. [PMID: 36184939 PMCID: PMC9660490 DOI: 10.1002/brb3.2773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 08/01/2022] [Accepted: 09/01/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Auditory neuropathy spectrum disorder (ANSD) is a term for a collection of test results which indicate disruption of the auditory signal at some point along the neural pathway. This results in a spectrum of functional outcomes, ranging from reasonably normal hearing to profound hearing loss. This study assessed brain structure changes and behavioral correlates in children diagnosed with ANSD. METHODS Seventeen children who had previously been diagnosed with ANSD were recruited to the study and underwent a battery of behavioral measures of hearing, language, and communication, along with structural MR imaging. Analysis of cortical thickness of temporal lobe structures was carried out using FreeSurfer. Tract-based spatial statistics were performed on standard diffusion parameters of fractional anisotropy and diffusivity metrics. The control group comprised imaging data taken from a library of MRI scans from neurologically normal children. Control images were matched as closely as possible to the ANSD group for age and sex. RESULTS Reductions in right temporal lobe cortical thickness were observed in children with ANSD compared to controls. Increases in medial diffusivity in areas including the corpus callosum and in the right occipital white matter were also seen in the group with ANSD compared to controls. Speech perception abilities, both in quiet and in noise, were correlated with cortical thickness measurements for several temporal lobe structures in children with ANSD, and relationships were also seen between diffusion metrics and measures of auditory function. CONCLUSION This study shows that children with ANSD have structural brain differences compared to healthy controls. It also demonstrates associations between brain structure and behavioral hearing abilities in children diagnosed with ANSD. These results show that there is a potential for structural imaging to be used as a biomarker in this population with the possibility of predicting functional hearing outcome.
Collapse
Affiliation(s)
- Hannah E Cooper
- Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, London, UK.,Faculty of Brain Sciences, UCL Ear Institute, University College London, London, UK.,Audiology Department, Royal Berkshire NHS Foundation Trust, Reading, UK
| | - Lorna F Halliday
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Doris-Eva Bamiou
- Faculty of Brain Sciences, UCL Ear Institute, University College London, London, UK.,National Institute of Health Research (NIHR) University College London Hospitals Biomedical Research Centre, University College London, London, UK
| | - Kshitij Mankad
- Department of Neuroradiology, Great Ormond Street Hospital for Children, London, UK
| | - Christopher A Clark
- Developmental Imaging and Biophysics Section, UCL Great Ormond Street Institute of Child Health, London, UK
| |
Collapse
|
24
|
Keita M, McIntyre K, Rodden LN, Schadt K, Lynch DR. Friedreich ataxia: clinical features and new developments. Neurodegener Dis Manag 2022; 12:267-283. [PMID: 35766110 PMCID: PMC9517959 DOI: 10.2217/nmt-2022-0011] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/15/2022] [Indexed: 11/21/2022] Open
Abstract
Friedreich's ataxia (FRDA), a neurodegenerative disease characterized by ataxia and other neurological features, affects 1 in 50,000-100,000 individuals in the USA. However, FRDA also includes cardiac, orthopedic and endocrine dysfunction, giving rise to many secondary disease characteristics. The multifaceted approach for clinical care has necessitated the development of disease-specific clinical care guidelines. New developments in FRDA include the advancement of clinical drug trials targeting the NRF2 pathway and frataxin restoration. Additionally, a novel understanding of gene silencing in FRDA, reflecting a variegated silencing pattern, will have applications to current and future therapeutic interventions. Finally, new perspectives on the neuroanatomy of FRDA and its developmental features will refine the time course and anatomical targeting of novel approaches.
Collapse
Affiliation(s)
- Medina Keita
- Departments of Pediatrics & Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kellie McIntyre
- Departments of Pediatrics & Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Layne N Rodden
- Departments of Pediatrics & Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kim Schadt
- Departments of Pediatrics & Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David R Lynch
- Departments of Pediatrics & Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| |
Collapse
|
25
|
Auditory neuropathy: from etiology to management. Curr Opin Otolaryngol Head Neck Surg 2022; 30:332-338. [PMID: 35939320 DOI: 10.1097/moo.0000000000000829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW Auditory neuropathy is a disorder of auditory dysfunction characterized by the normal function of the outer hair cells and malfunction of the inner hair cells, synapses, postsynapses and/or auditory afferent nervous system. This review summarizes the process of discovery and naming of auditory neuropathy and describes the acquired, associated genetic disorders and management available. RECENT FINDINGS In the last 40 years, auditory neuropathy has undergone a process of discovery, naming and progressive elucidation of its complex pathological mechanisms. Recent studies have revealed numerous acquired and inherited causative factors associated with auditory neuropathy. Studies have analyzed the pathogenic mechanisms of various genes and the outcomes of cochlear implantation. New therapeutic approaches, such as stem cell therapy and gene therapy are the future trends in the treatment of auditory neuropathy. SUMMARY A comprehensive understanding of the pathogenic mechanisms is crucial in illustrating auditory neuropathy and assist in developing future management strategies.
Collapse
|
26
|
Lu F, Liang P, Fan B, Zhu Q, Xue T, Liu Z, Wang R, Zhang Y, Zhang X, WeiLi, Wang J, Chen J, Zha D. TNN is first linked to auditory neuropathy. Biochem Biophys Res Commun 2022; 632:69-75. [DOI: 10.1016/j.bbrc.2022.09.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/21/2022] [Indexed: 11/27/2022]
|
27
|
Rance G, Maier A, Zanin J, Haebich KM, North KN, Orsini F, Dabscheck G, Delatycki MB, Payne JM. A randomized controlled trial of remote microphone listening devices to treat auditory deficits in children with neurofibromatosis type 1. Neurol Sci 2022; 43:5637-5641. [PMID: 35723774 PMCID: PMC9385787 DOI: 10.1007/s10072-022-06203-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022]
Abstract
Background A high proportion of patients with neurofibromatosis type 1 (NF1) present with functional hearing deficiency as a result of neural abnormality in the late auditory brainstem. Methods In this randomized, two-period crossover study, we investigated the hypothesis that remote-microphone listening devices can ameliorate hearing and communication deficits in affected school-aged children (7–17 years). Speech perception ability in background noise was evaluated in device-active and inactive conditions using the CNC-word test. Participants were then randomized to one of two treatment sequences: (1) inactive device for two weeks (placebo), followed by active device use for two weeks, or (2) active device for 2 weeks, followed by inactive device for 2 weeks. Listening and communication ratings (LIFE-R Questionnaire) were obtained at baseline and at the end of each treatment phase. Results Each participant demonstrated functional hearing benefits with remote-microphone use. All showed a speech perception in noise increase when the device was activated with a mean phoneme-score difference of 16.4% (p < 0.001) and reported improved listening/communication abilities in the school classroom (mean difference: 23.4%; p = 0.017). Discussion Conventional hearing aids are typically ineffective as a treatment for auditory neural dysfunction, making sounds louder, but not clearer for affected individuals. In this study, we demonstrate that remote-microphone technologies are acceptable/tolerable in pediatric patients with NF1 and can ameliorate their hearing deficits. Conclusion Remote-microphone listening systems offer a viable treatment option for children with auditory deficits associated with NF1.
Collapse
|
28
|
Lokwani P, Prabhu P, Nisha KV. Profiles and predictors of onset based differences in vocal characteristics of adults with auditory neuropathy spectrum disorder (ANSD). J Otol 2022; 17:218-225. [PMID: 36249919 PMCID: PMC9547112 DOI: 10.1016/j.joto.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/14/2022] [Accepted: 08/08/2022] [Indexed: 10/25/2022] Open
|
29
|
Comprehensive Etiologic Analyses in Pediatric Cochlear Implantees and the Clinical Implications. Biomedicines 2022; 10:biomedicines10081846. [PMID: 36009393 PMCID: PMC9405031 DOI: 10.3390/biomedicines10081846] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
Cochlear implantation is the treatment of choice for children with profound sensorineural hearing impairment (SNHI), yet the outcomes of cochlear implants (CI) vary significantly across individuals. To investigate the CI outcomes in pediatric patients with SNHI due to various etiologies, we prospectively recruited children who underwent CI surgery at two tertiary referral CI centers from 2010 to 2021. All patients underwent comprehensive history taking, next generation sequencing (NGS)-based genetic examinations, and imaging studies. The CI outcomes were evaluated using Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores. Of the 160 pediatric cochlear implantees (76 females and 84 males) included in this study, comprehensive etiological work-up helped achieve clinical diagnoses in 83.1% (133/160) of the patients, with genetic factors being the leading cause (61.3%). Imaging studies identified certain findings in 31 additional patients (19.3%). Four patients (2.5%) were identified with congenital cytomegalovirus infection (cCMV), and 27 patients (16.9%) remained with unknown etiologies. Pathogenic variants in the four predominant non-syndromic SNHI genes (i.e., SLC26A4, GJB2, MYO15A, and OTOF) were associated with favorable CI outcomes (Chi-square test, p = 0.023), whereas cochlear nerve deficiency (CND) on imaging studies was associated with unfavorable CI outcomes (Chi-square test, p < 0.001). Our results demonstrated a clear correlation between the etiologies and CI outcomes, underscoring the importance of thorough etiological work-up preoperatively in pediatric CI candidates.
Collapse
|
30
|
Zhang Y, Chen J, Zhang Y, Sun B, Liu Y. Using Auditory Characteristics to Select Hearing Aid Compression Speeds for Presbycusic Patients. Front Aging Neurosci 2022; 14:869338. [PMID: 35847672 PMCID: PMC9285002 DOI: 10.3389/fnagi.2022.869338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/20/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives This study aimed to select the optimal hearing aid compression speeds (fast-acting and slow-acting) for presbycusic patients by using auditory characteristics including temporal modulation and speech-in-noise performance. Methods In total, 24 patients with unilateral or bilateral moderate sensorineural hearing loss who scored higher than 21 on the Montreal Cognitive Assessment (MoCA) test participated in this study. The electrocochleogram (ECochG) results, including summating potentials (SP) and action potentials (AP), were recorded. Subjects' temporal modulation thresholds and speech recognition at 4 individualized signal-to-noise ratios were measured under three conditions, namely, unaided, aided with fast-acting compression (FAC), and aided with slow-acting compression (SAC). Results The results of this study showed that modulation discrimination thresholds in the unaided (−8.14 dB) and aided SAC (−8.19 dB) conditions were better than the modulation thresholds in the FAC (−4.67 dB) conditions. The speech recognition threshold (SRT75%) for FAC (5.21 dB) did not differ significantly from SAC (3.39 dB) (p = 0.12). A decision tree analysis showed that the inclusion of the AP, unaided modulation thresholds, and unaided SRT75% may correctly identify the optimal compression speeds (FAC vs. SAC) for individual presbycusic patients with up to 90% accuracy. Conclusion Both modes of compression speeds improved a presbycusic patient's speech recognition ability in noise. The SAC hearing aids may better preserve the modulation thresholds than the FAC hearing aids. The measurement of AP, along with the unaided modulation thresholds and unaided SRT75%, may help guide the selection of optimal compression speeds for individual presbycusic patients.
Collapse
Affiliation(s)
- Yi Zhang
- Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Chen
- School of Electronics Engineering and Computer Science, Peking University, Beijing, China
| | - Yanmei Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Peking University First Hospital, Beijing, China
| | - Baoxuan Sun
- Widex Hearing Aid (Shanghai) Co., Ltd., Shanghai, China
| | - Yuhe Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- *Correspondence: Yuhe Liu
| |
Collapse
|
31
|
Round Window Electrocochleography to Low Frequency Tones in Pediatric Cochlear Implant Recipients with and Without Auditory Neuropathy Spectrum Disorder: Separating Hair Cell and Neural Contributions Using a Computational Model. Otol Neurotol 2022; 43:781-788. [PMID: 35763496 PMCID: PMC9329248 DOI: 10.1097/mao.0000000000003568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
HYPOTHESIS Characterize the contribution of the auditory nerve neurophonic (ANN) to electrocochleography (ECochG) of pediatric cochlear implant (CI) recipients with and without auditory nerve spectrum disorder (ANSD). BACKGROUND ECochG is an emerging technique for predicting outcomes in CI recipients. Its utility may be increased by separating the cochlear microphonic (CM), produced by hair cells, from the ANN, the evoked potential correlate of neural phase-locking, which are mixed in the ongoing portion of the response to low frequency tone bursts. METHODS Responses to tone bursts of different frequency and intensities were recorded from the round window of pediatric CI recipients. Separation of the CM and ANN was performed using a model of the underlying processes that lead to the shapes of the observed waveforms. RESULTS Preoperative mean pure tone amplitudes of the included ANSD (n = 36) and non-ANSD subjects (n = 123), were similar (89.5 and 93.5, p = 0.1). Total of 1,024 ECochG responses to frequency and intensity series were recorded. The mean correlation (r) between the input and the modeled signals was 0.973 ± 0.056 (standard deviation). The ANN magnitudes were higher in the ANSD group (ANOVAs, F = 26.5 for frequency and 21.9 for intensity, df's = 1, p's < 0.001). However, its relative contribution to the overall signal was lower (ANOVAs, F = 25.8 and 12.1, df = 1, p's < 0.001). CONCLUSIONS ANN was detected in low frequency ECochG responses but not high frequency responses in both ANSD and non-ANSD subjects. ANSD subjects, evidence of neural contribution in responses to low frequency stimuli was highly variable and often comparable to signals recorded in non-ANSD subjects. The computational model revealed that on average the ANN comprised a lower proportion of the overall signal than in non-ANSD subjects.
Collapse
|
32
|
Lin PH, Wu HP, Wu CM, Chiang YT, Hsu JS, Tsai CY, Wang H, Tseng LH, Chen PY, Yang TH, Hsu CJ, Chen PL, Wu CC, Liu TC. Cochlear Implantation Outcomes in Patients with Auditory Neuropathy Spectrum Disorder of Genetic and Non-Genetic Etiologies: A Multicenter Study. Biomedicines 2022; 10:biomedicines10071523. [PMID: 35884828 PMCID: PMC9313466 DOI: 10.3390/biomedicines10071523] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 01/04/2023] Open
Abstract
With diverse etiologies and clinical features, the management of pediatric auditory neuropathy spectrum disorder (ANSD) is often challenging, and the outcomes of cochlear implants (CIs) are variable. This study aimed to investigate CI outcomes in pediatric patients with ANSD of different etiologies. Thirty-six children with ANSD who underwent cochlear implantation between 2001 and 2021 were included. Comprehensive etiological analyses were conducted, including a history review, next-generation sequencing-based genetic examinations, and imaging studies using high-resolution computed tomography and magnetic resonance imaging. Serial behavioral and speech audiometry were performed before and after surgery, and the outcomes with CI were evaluated using the Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores. By etiology, 18, 1, 1, and 10 patients had OTOF-related, WFS1-related, OPA1-related, and cochlear nerve deficiency (CND)-related ANSD, respectively. Six patients had no definite etiology. The average CI-aided behavioral threshold was 28.3 ± 7.8 dBHL, and those with CND-related ANSD were significantly worse than OTOF-related ANSD. The patients’ median CAP and SIR scores were 6 and 4, respectively. Favorable CI outcomes were observed in patients with certain etiologies of ANSD, particularly those with OTOF (CAP/SIR scores 5–7/2–5), WFS1 (CAP/SIR score 6/5), and OPA1 variants (CAP/SIR score 7/5). Patients with CND had suboptimal CI outcomes (CAP/SIR scores 2–6/1–3). Identifying the etiologies in ANSD patients is crucial before surgery and can aid in predicting prognoses.
Collapse
Affiliation(s)
- Pei-Hsuan Lin
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 10002, Taiwan; (P.-H.L.); (P.-L.C.)
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Department of Otolaryngology, National Taiwan University Hospital Yunlin Branch, Yunlin 64041, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 42743, Taiwan;
| | - Che-Ming Wu
- Department of Otolaryngology & Head and Neck Surgery, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City 23652, Taiwan;
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taoyuan 33305, Taiwan
| | - Yu-Ting Chiang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
| | - Jacob Shujui Hsu
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
| | - Cheng-Yu Tsai
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
| | - Han Wang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
| | - Li-Hui Tseng
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
| | - Pey-Yu Chen
- Department of Otolaryngology, MacKay Memorial Hospital, Taipei 10449, Taiwan;
- Department of Audiology and Speech-Language Pathology, Mackay Medical College, New Taipei City 25245, Taiwan
| | - Ting-Hua Yang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
| | - Chuan-Jen Hsu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 42743, Taiwan;
| | - Pei-Lung Chen
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 10002, Taiwan; (P.-H.L.); (P.-L.C.)
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 10002, Taiwan
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 10002, Taiwan
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 30261, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 30261, Taiwan
- Hearing and Speech Center, National Taiwan University Hospital, Taipei 10002, Taiwan
- Correspondence: (C.-C.W.); (T.-C.L.)
| | - Tien-Chen Liu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Correspondence: (C.-C.W.); (T.-C.L.)
| |
Collapse
|
33
|
Affortit C, Blanc F, Nasr J, Ceccato JC, Markossian S, Guyot R, Puel JL, Flamant F, Wang J. A disease-associated mutation in thyroid hormone receptor α1 causes hearing loss and sensory hair cell patterning defects in mice. Sci Signal 2022; 15:eabj4583. [PMID: 35700264 DOI: 10.1126/scisignal.abj4583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Resistance to thyroid hormone due to mutations in THRA, which encodes the thyroid hormone receptor α (TRα1), shows variable clinical presentation. Mutations affecting TRβ1 and TRβ2 cause deafness in mice and have been associated with deafness in humans. To test whether TRα1 also affects hearing function, we used mice heterozygous for a frameshift mutation in Thra that is similar to human THRA mutations (ThraS1/+ mice) and reduces tissue sensitivity to thyroid hormone. Compared to wild-type littermates, ThraS1/+ mice showed moderate high-frequency sensorineural hearing loss as juveniles and increased age-related hearing loss. Ultrastructural examination revealed aberrant orientation of ~20% of sensory outer hair cells (OHCs), as well as increased numbers of mitochondria with fragmented morphology and autophagic vacuoles in both OHCs and auditory nerve fibers. Molecular dissection of the OHC lateral wall components revealed that the potassium ion channel Kcnq4 was aberrantly targeted to the cytoplasm of mutant OHCs. In addition, mutant cochleae showed increased oxidative stress, autophagy, and mitophagy associated with greater age-related cochlear cell damage, demonstrating that TRα1 is required for proper development of OHCs and for maintenance of OHC function. These findings suggest that patients with THRA mutations may present underdiagnosed, mild hearing loss and may be more susceptible to age-related hearing loss.
Collapse
Affiliation(s)
- Corentin Affortit
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, Montpellier, France
| | - Fabian Blanc
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, Montpellier, France.,Department of ENT and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Jamal Nasr
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, Montpellier, France
| | - Jean-Charles Ceccato
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, Montpellier, France
| | - Suzy Markossian
- Institut de Génomique Fonctionnelle de Lyon (IGFL), INRAE USC1370, CNRS (UMR5242), ENS, Lyon, France
| | - Romain Guyot
- Institut de Génomique Fonctionnelle de Lyon (IGFL), INRAE USC1370, CNRS (UMR5242), ENS, Lyon, France
| | - Jean-Luc Puel
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, Montpellier, France
| | - Frédéric Flamant
- Institut de Génomique Fonctionnelle de Lyon (IGFL), INRAE USC1370, CNRS (UMR5242), ENS, Lyon, France
| | - Jing Wang
- Institute for Neurosciences of Montpellier (INM), University Montpellier, INSERM, Montpellier, France.,Department of ENT and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| |
Collapse
|
34
|
Lalayants MR, Chugunova TI, Bakhshinyan VV, Tavartkiladze GA. [Electrically evoked ABR through cochlear implant in children with auditory neuropathy spectrum disorder]. Vestn Otorinolaringol 2022; 87:4-9. [PMID: 35605265 DOI: 10.17116/otorino2022870214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To estimate the applicability of electrically evoked auditory brainstem response (eABR) registration for the estimation of neural integrity after cochlear implantation (CI) in children with auditory neuropathy spectrum disorder (ANSD) and to compare the eABR data with patient's hearing performance. MATERIAL AND METHODS 4 children, Nucleus (Cochlear) CI users, with ANSD were enrolled in the study. Hearing performance in these children ranged from successful to unsatisfied. eABR were recorded via Eclipse EP25 (Interacoustics). Electrical bipolar stimulation was achieved with Custom Sound EP software (Cochlear). RESULTS EABR were registered with the use of different stimulation parameters (pulse width, stimulated electrodes) in 3 patients with satisfactory results of rehabilitation. eABR thresholds corresponded to maximum comfortable levels of patients stimulation MAP. eABR were absent in the patient with poor hearing performance. CONCLUSIONS EABR measurements in children with ANSD demonstrated restoration of neuronal conduction in the auditory pathway up to the brainstem after cochlear implantation in 3 patients. eABR results were well correlated with hearing performance. Thereby, the study of eABR applicability for clinical practice will be expanded.
Collapse
Affiliation(s)
- M R Lalayants
- National Research Center for Audiology and Hearing Rehabilitation, Moscow, Russia.,Russian Medical Academy for Continuous Professional Education, Moscow, Russia
| | - T I Chugunova
- National Research Center for Audiology and Hearing Rehabilitation, Moscow, Russia
| | - V V Bakhshinyan
- National Research Center for Audiology and Hearing Rehabilitation, Moscow, Russia.,Russian Medical Academy for Continuous Professional Education, Moscow, Russia
| | - G A Tavartkiladze
- National Research Center for Audiology and Hearing Rehabilitation, Moscow, Russia.,Russian Medical Academy for Continuous Professional Education, Moscow, Russia
| |
Collapse
|
35
|
Smalley J, Hole K. Prevalence, behavioural, and management outcomes of infants with auditory neuropathy spectrum disorder. Dev Med Child Neurol 2022; 64:593-599. [PMID: 34719022 DOI: 10.1111/dmcn.15103] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 11/29/2022]
Abstract
AIM To provide an overview of electrophysiological and behavioural outcomes from a large UK centres data set on children diagnosed with auditory neuropathy (ANSD) between 2002 and March 2018. METHOD A systematic audit was undertaken, collating the electrophysiological data from auditory brainstem response (ABR) follow-up, risk factors, and later behavioural results/management. These were then compared to look for trends between groups. The study sample consisted of 118 925 infants born, with 46 (0.039%, 0.39 per 1000 births) being diagnosed with congenital ANSD (39 bilateral, seven unilateral). RESULTS Twenty-nine per cent of ears with ANSD had short latency components on ABR testing. Forty-four per cent of ears with present cochlear microphonics but absent transient-evoked otoacoustic emissions (TE-OAE) and no ABR went on to have profound behavioural hearing threshold levels. All but one child went on to show a hearing loss on behavioural testing. ANSD was not confined to the population from neonatal intensive care units: there were three bilateral and five unilateral cases in the typically developing infant population. INTERPRETATION The incidence of ANSD is higher in this sample than that reported previously in the literature. Children who had cochlear microphonics with absent ABR and absent TE-OAE had significantly worse later behavioural outcomes than other patterns of electrophysiological results.
Collapse
Affiliation(s)
- Jason Smalley
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Kevin Hole
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| |
Collapse
|
36
|
Giffen KP, Li Y, Liu H, Zhao XC, Zhang CJ, Shen RJ, Wang T, Janesick A, Chen BB, Gong SS, Kachar B, Jin ZB, He DZ. Mutation of SLC7A14 causes auditory neuropathy and retinitis pigmentosa mediated by lysosomal dysfunction. SCIENCE ADVANCES 2022; 8:eabk0942. [PMID: 35394837 PMCID: PMC8993119 DOI: 10.1126/sciadv.abk0942] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 02/22/2022] [Indexed: 05/13/2023]
Abstract
Lysosomes contribute to cellular homeostasis via processes including macromolecule degradation, nutrient sensing, and autophagy. Defective proteins related to lysosomal macromolecule catabolism are known to cause a range of lysosomal storage diseases; however, it is unclear whether mutations in proteins involved in homeostatic nutrient sensing mechanisms cause syndromic sensory disease. Here, we show that SLC7A14, a transporter protein mediating lysosomal uptake of cationic amino acids, is evolutionarily conserved in vertebrate mechanosensory hair cells and highly expressed in lysosomes of mammalian cochlear inner hair cells (IHCs) and retinal photoreceptors. Autosomal recessive mutation of SLC7A14 caused loss of IHCs and photoreceptors, leading to presynaptic auditory neuropathy and retinitis pigmentosa in mice and humans. Loss-of-function mutation altered protein trafficking and increased basal autophagy, leading to progressive cell degeneration. This study implicates autophagy-lysosomal dysfunction in syndromic hearing and vision loss in mice and humans.
Collapse
Affiliation(s)
- Kimberlee P. Giffen
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE 68178, USA
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University/University of Georgia Medical Partnership, Athens, GA 30602, USA
| | - Yi Li
- Beijing Institute of Otorhinolaryngology, Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Huizhan Liu
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE 68178, USA
| | - Xiao-Chang Zhao
- Beijing Institute of Otorhinolaryngology, Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Chang-Jun Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing 100730, China
| | - Ren-Juan Shen
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing 100730, China
| | - Tianying Wang
- Beijing Institute of Otorhinolaryngology, Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Amanda Janesick
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA 94305, USA
| | - Bo-Bei Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Shu-Sheng Gong
- Department of Otorhinolaryngology-Head and Neck Surgery, Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Bechara Kachar
- Laboratory of Cell Structure and Dynamics, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD 20892, USA
| | - Zi-Bing Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing 100730, China
| | - David Z. He
- Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE 68178, USA
| |
Collapse
|
37
|
Savenko IV, Garbaruk ES, Boboshko MY. [The issue of auditory neuropathy: from origins to the present]. Vestn Otorinolaringol 2022; 87:60-69. [PMID: 35274894 DOI: 10.17116/otorino20228701160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The issue of auditory neuropathy spectrum disorders (ANSD) has been in a focus of specialists attention for a relatively short time, but during this time a huge amount of scientific and practical knowledge about this hearing disorder has been accumulated. ANSD is a specific auditory deficit caused by dysfunction of periphery part of the auditory system, which may affect the inner hair cells, the spiral ganglion neurons and the auditory nerve, as well as the area of synaptic contact between them, while the outer hair cells, as a rule, remain intact. As a result, a specific condition is formed, in which a patient's otoacoustic emissions and/or cochlear microphonics are present, auditory brainstem responses are abnormal or absent, electrophysiological data may not correlate with hearing level, the discrepancy between pure tone audiometry and speech discrimination is observed. ANSD prevalence, epidemiology, contemporary views on its etiology, including detailed information on hereditary forms of the disorder and its risk factors are considered in the review. The data on the basic rungs of the ANSD pathogenesis, which underlie the development of various forms of the disorder and mainly determine the rehabilitation approach, are presented. The detailed clinical and audiological characteristics of ANSD are presented; contemporary approach to ANSD diagnosis and rehabilitation, including indications for surgical treatment, are considered.
Collapse
Affiliation(s)
- I V Savenko
- Pavlov State Medical University, St. Petersburg, Russia
| | - E S Garbaruk
- Pavlov State Medical University, St. Petersburg, Russia.,St. Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - M Yu Boboshko
- Pavlov State Medical University, St. Petersburg, Russia.,Mechnikov North-Western State Medical University, St. Petersburg, Russia
| |
Collapse
|
38
|
Poovaiah P, Rajasekaran AK, Yuvraj P, Belur YK, Atchayaram N. Audiovestibular Dysfunction in Siblings with Charcot-Marie-Tooth Disease 4F: A Case Series. J Am Acad Audiol 2022; 32:616-624. [PMID: 35176805 DOI: 10.1055/s-0042-1744105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Charcot-Marie-Tooth disease type 4F (CMT4F) is an autosomal recessive disorder with symptoms presenting in early adulthood. This clinical case series demonstrates atypical findings in cervical and ocular vestibular evoked myogenic potentials (VEMP) in siblings with CMT4F. PURPOSE The aim of this study was to highlight the audiovestibular test findings in CMT4F. RESEARCH DESIGN Case series study sample: 4 siblings, 3 of whom diagnosed with CMT4F. DATA COLLECTION AND ANALYSIS Audiological test battery and electrophysiological tests comprising auditory brainstem response (ABR) and VEMP (both cervical and ocular) were performed in our patient population. RESULTS Older siblings, in whom the hearing loss was present, manifested prolonged peak V latencies in ABR. Three out of four siblings with CMT4F showed prolongation of latencies on cervical and ocular VEMP. CONCLUSIONS In many neurodegenerative conditions, prolongation of ABR peak latencies has often been reported in the literature. There have also been a few reports of prolonged VEMP peak latencies. This article reports prolongation of only VEMP peak latencies (in both cervical and ocular recordings). The youngest sibling had prolongation of VEMP latencies, with ABR peak latencies being normal. The assumption we put forth that CMT4F may affect the vestibular pathway first requires to be tested on a larger sample and by longitudinally studying the individuals with disease condition.
Collapse
Affiliation(s)
- Prashasti Poovaiah
- Department of Speech Pathology & Audiology, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India
| | - Aravind Kumar Rajasekaran
- Department of Speech Pathology & Audiology, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India
| | - Pradeep Yuvraj
- Department of Speech Pathology & Audiology, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India
| | - Yamini K Belur
- Department of Speech Pathology & Audiology, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India
| | - Nalini Atchayaram
- Department of Neurology, National Institute of Mental Health & Neurosciences, Bangalore, Karnataka, India
| |
Collapse
|
39
|
Savenko IV, Garbaruk ES, Boboshko MY. [Auditory neuropathy and prematurity: modern view of the issue (literature review)]. Vestn Otorinolaringol 2022; 87:63-71. [PMID: 35818948 DOI: 10.17116/otorino20228703163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Auditory neuropathy spectrum disorder (ANSD) is a specific auditory disorder caused by dysfunction of periphery part of the auditory system, in which the function of the outer hair cells is preserved, but the afferent input at the cochlear level suffers due to the pathology of the inner hair cells, neurons of the spiral ganglion and/or the auditory nerve, as well as synaptic contact between them. As a result, a specific condition is formed, in which a patient's otoacoustic emissions and/or cochlear microphonics are present, auditory brainstem responses are abnormal or absent, the discrepancy between the hearing level and the electrophysiological data, poor speech perception which may not correlate with the hearing thresholds. ANSD is a multifactorial disease. One of the main risk factors is perinatal pathology and, in particular, prematurity. The possible factors associated with prematurity that provoke the onset of the disease, features of the pathogenesis, clinical and audiological peculiarities of ANSD in premature infants, contemporary approaches to the habilitation of such patients are discussed in the article. The necessity of an individual, patient-oriented approach to the treatment of premature infants with ANSD is substantiated; such an approach should be based both on the genesis of the disorder, taking into account possible points of lesion in the auditory system, and the developmental peculiarities of a premature baby considering the presence of concomitant diseases associated with prematurity. In the article attention is focused on the main directions of habilitation work with such children, including a multidisciplinary approach, regular careful monitoring of the auditory, speech and language skills, intensive psychological and speech therapist support, the choice of an adequate way of intervention and its improvement as necessary.
Collapse
Affiliation(s)
- I V Savenko
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
| | - E S Garbaruk
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
- St. Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - M Yu Boboshko
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
- Mechnikov North-West State Medical University, St. Petersburg, Russia
| |
Collapse
|
40
|
Almishaal AA, Saleh S, Alferaih H, Alhelo O. Prevalence, risk factors, and audiological characteristics of auditory neuropathy. Int J Audiol 2021; 61:1018-1026. [PMID: 34928752 DOI: 10.1080/14992027.2021.2014074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objective of this study was to determine the prevalence, risk factors, and audiological characteristics of auditory neuropathy spectrum disorder (ANSD) in the pediatric population. DESIGN A retrospective review of medical charts was conducted for children visiting two hospitals in Saudi Arabia. STUDY SAMPLE Medical records of 1025 patients with sensorineural hearing loss (SNHL) were reviewed. We analyzed the databases for results of audiological examinations, risk factors, and outcomes of intervention including hearing aid (HA) and cochlear implantation (CI). RESULTS Out of 1025 children with SNHL, 101 patients (9.85%) were identified to have ANSD. Audiological characteristics of the ANSD group revealed a severe-to-profound degree of hearing loss, all showed type A tympanogram and absent reflexes, absent auditory brainstem response (ABR) findings with present cochlear microphonic while otoacoustic emissions were absent in 54.5% of patients. The most prevalent risk factors for ANSD in this group were family history of hearing loss, consanguinity, hyperbilirubinemia, and low birth weight. Pure tone and speech detection thresholds improved significantly with CI compared to HA use in this sample of patients with ANSD. CONCLUSION This study shows that ANSD is not extremely rare among Saudi children with severe to profound hearing loss, with a prevalence of 9.85%.
Collapse
Affiliation(s)
- Ali A Almishaal
- College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| | - Shaza Saleh
- King Abdullah Ear Specialist Center, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hala Alferaih
- Ear, Nose, and Throat Department, Audiology Clinic, King Fahad General Hospital, Jeddah, Saudi Arabia
| | - Osamah Alhelo
- College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| |
Collapse
|
41
|
Mao D, Wunderlich J, Savkovic B, Jeffreys E, Nicholls N, Lee OW, Eager M, McKay CM. Speech token detection and discrimination in individual infants using functional near-infrared spectroscopy. Sci Rep 2021; 11:24006. [PMID: 34907273 PMCID: PMC8671543 DOI: 10.1038/s41598-021-03595-z] [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] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/29/2021] [Indexed: 11/08/2022] Open
Abstract
Speech detection and discrimination ability are important measures of hearing ability that may inform crucial audiological intervention decisions for individuals with a hearing impairment. However, behavioral assessment of speech discrimination can be difficult and inaccurate in infants, prompting the need for an objective measure of speech detection and discrimination ability. In this study, the authors used functional near-infrared spectroscopy (fNIRS) as the objective measure. Twenty-three infants, 2 to 10 months of age participated, all of whom had passed newborn hearing screening or diagnostic audiology testing. They were presented with speech tokens at a comfortable listening level in a natural sleep state using a habituation/dishabituation paradigm. The authors hypothesized that fNIRS responses to speech token detection as well as speech token contrast discrimination could be measured in individual infants. The authors found significant fNIRS responses to speech detection in 87% of tested infants (false positive rate 0%), as well as to speech discrimination in 35% of tested infants (false positive rate 9%). The results show initial promise for the use of fNIRS as an objective clinical tool for measuring infant speech detection and discrimination ability; the authors highlight the further optimizations of test procedures and analysis techniques that would be required to improve accuracy and reliability to levels needed for clinical decision-making.
Collapse
Affiliation(s)
- Darren Mao
- The Bionics Institute, 384-388 Albert St, East Melbourne, VIC, 3002, Australia.
| | - Julia Wunderlich
- The Bionics Institute, 384-388 Albert St, East Melbourne, VIC, 3002, Australia
- Department of Medical Bionics, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Borislav Savkovic
- The Bionics Institute, 384-388 Albert St, East Melbourne, VIC, 3002, Australia
| | - Emily Jeffreys
- The Bionics Institute, 384-388 Albert St, East Melbourne, VIC, 3002, Australia
| | - Namita Nicholls
- The Bionics Institute, 384-388 Albert St, East Melbourne, VIC, 3002, Australia
| | - Onn Wah Lee
- The Bionics Institute, 384-388 Albert St, East Melbourne, VIC, 3002, Australia
- Department of Medical Bionics, University of Melbourne, Parkville, VIC, 3010, Australia
- Faculty of Health Sciences, Centre for Rehabilitation and Special Need Studies, Universiti Kebangsaan Malaysia, 53200, Kuala Lumpur, Malaysia
| | - Michael Eager
- The Bionics Institute, 384-388 Albert St, East Melbourne, VIC, 3002, Australia
| | - Colette M McKay
- The Bionics Institute, 384-388 Albert St, East Melbourne, VIC, 3002, Australia
- Department of Medical Bionics, University of Melbourne, Parkville, VIC, 3010, Australia
| |
Collapse
|
42
|
Soares JC, Veeranna SA, Parsa V, Allan C, Ly W, Duong M, Folkeard P, Moodie S, Allen P. Verification of a Mobile Psychoacoustic Test System. Audiol Res 2021; 11:673-690. [PMID: 34940019 PMCID: PMC8698855 DOI: 10.3390/audiolres11040061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/25/2021] [Accepted: 12/08/2021] [Indexed: 11/20/2022] Open
Abstract
Many hearing difficulties can be explained as a loss of audibility, a problem easily detected and treated using standard audiological procedures. Yet, hearing can be much poorer (or more impaired) than audibility predicts because of deficits in the suprathreshold mechanisms that encode the rapidly changing, spectral, temporal, and binaural aspects of the sound. The ability to evaluate these mechanisms requires well-defined stimuli and strict adherence to rigorous psychometric principles. This project reports on the comparison between a laboratory-based and a mobile system's results for psychoacoustic assessment in adult listeners with normal hearing. A description of both systems employed is provided. Psychoacoustic tests include frequency discrimination, amplitude modulation detection, binaural encoding, and temporal gap detection. Results reported by the mobile system were not significantly different from those collected with the laboratory-based system for most of the tests and were consistent with those reported in the literature. The mobile system has the potential to be a feasible option for the assessment of suprathreshold auditory encoding abilities.
Collapse
Affiliation(s)
- Jordana C. Soares
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, ON N6G 1H1, Canada; (J.C.S.); (S.A.V.); (C.A.); (W.L.); (M.D.); (P.F.); (S.M.); (P.A.)
| | - Sangamanatha A. Veeranna
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, ON N6G 1H1, Canada; (J.C.S.); (S.A.V.); (C.A.); (W.L.); (M.D.); (P.F.); (S.M.); (P.A.)
- School of Speech and Hearing Sciences, The University of Southern Mississippi, Hattiesburg, MS 39401, USA
| | - Vijay Parsa
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, ON N6G 1H1, Canada; (J.C.S.); (S.A.V.); (C.A.); (W.L.); (M.D.); (P.F.); (S.M.); (P.A.)
- School of Communication Sciences and Disorders, Western University, London, ON N6A 3K7, Canada
- Department of Electrical and Computer Engineering, Western University, London, ON N6A 5B9, Canada
| | - Chris Allan
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, ON N6G 1H1, Canada; (J.C.S.); (S.A.V.); (C.A.); (W.L.); (M.D.); (P.F.); (S.M.); (P.A.)
- School of Communication Sciences and Disorders, Western University, London, ON N6A 3K7, Canada
| | - Winnie Ly
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, ON N6G 1H1, Canada; (J.C.S.); (S.A.V.); (C.A.); (W.L.); (M.D.); (P.F.); (S.M.); (P.A.)
| | - Minh Duong
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, ON N6G 1H1, Canada; (J.C.S.); (S.A.V.); (C.A.); (W.L.); (M.D.); (P.F.); (S.M.); (P.A.)
| | - Paula Folkeard
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, ON N6G 1H1, Canada; (J.C.S.); (S.A.V.); (C.A.); (W.L.); (M.D.); (P.F.); (S.M.); (P.A.)
| | - Sheila Moodie
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, ON N6G 1H1, Canada; (J.C.S.); (S.A.V.); (C.A.); (W.L.); (M.D.); (P.F.); (S.M.); (P.A.)
- School of Communication Sciences and Disorders, Western University, London, ON N6A 3K7, Canada
| | - Prudence Allen
- National Centre for Audiology, Faculty of Health Sciences, Western University, London, ON N6G 1H1, Canada; (J.C.S.); (S.A.V.); (C.A.); (W.L.); (M.D.); (P.F.); (S.M.); (P.A.)
- School of Communication Sciences and Disorders, Western University, London, ON N6A 3K7, Canada
| |
Collapse
|
43
|
Burdo S, Di Berardino F, Bruno G. Is auditory neuropathy an appropriate term? A systematic literature review on its aetiology and pathogenesis. ACTA OTORHINOLARYNGOLOGICA ITALICA 2021; 41:496-506. [PMID: 34825666 PMCID: PMC8686806 DOI: 10.14639/0392-100x-n0932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 05/15/2021] [Indexed: 11/23/2022]
Abstract
To clarify the aetio-pathogenesis of Auditory Neuropathy Spectrum Disorder (ANSD), a total of 845 papers were divided into four categories: Review, Audiology, Treatment and Aetiology. Aetiology was the topic analysed categorising papers as: Genetics, Histopathology, Imaging and Medical diseases. Isolated ANs were in relation to Otoferlin, Pejvakin and DIAPH3 deficiency, and the syndromes were mainly Charcot Marie Tooth, Friedreich Ataxia, mitochondrial disorders and those associated with optic neuropathies. In histopathology papers, important information was available from analyses on human premature newborns and on some syndromic neuropathies. From cochlear dysmorphism to cerebral tumours associated with ANs, these are described in what is identified as the Imaging area. Finally, the prevalent clinical pathology was bilirubinopathy, followed by diabetes. In conclusion, AN/ANSDs do not refer to a clear pathological condition, but to an instrumental pattern without any evidence of auditory nerve involvement, except in a few conditions. The terms AN/ANSD are misleading and should be avoided, including terms such as “synaptopathy” or “dis-synchrony”.
Collapse
|
44
|
Rance G, Zanin J, Maier A, Chisari D, Haebich KM, North KN, Dabscheck G, Seal ML, Delatycki MB, Payne JM. Auditory Dysfunction Among Individuals With Neurofibromatosis Type 1. JAMA Netw Open 2021; 4:e2136842. [PMID: 34870681 PMCID: PMC8649832 DOI: 10.1001/jamanetworkopen.2021.36842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE Neurofibromatosis type 1 (NF1) affects hearing through disruption of central auditory processing. The mechanisms, functional severity, and management implications are unclear. OBJECTIVE To investigate auditory neural dysfunction and its perceptual consequences in individuals with NF1. DESIGN, SETTING, AND PARTICIPANTS This case-control study included children and adults with NF1 and control participants matched on age, sex, and hearing level. Patients were recruited through specialist neurofibromatosis and neurogenetic outpatient clinics between April and September 2019. An evaluation of auditory neural activity, monaural/binaural processing, and functional hearing was conducted. Diffusion-weighted magnetic resonance imaging (MRI) data were collected from a subset of participants (10 children with NF1 and 10 matched control participants) and evaluated using a fixel-based analysis of apparent fiber density. MAIN OUTCOMES AND MEASURES Type and severity of auditory dysfunction evaluated via laboratory testing and questionnaire data. RESULTS A total of 44 participants (18 [41%] female individuals) with NF1 with a mean (SD) age of 16.9 (10.7) years and 44 control participants (18 [41%] female individuals) with a mean (SD) age of 17.2 (10.2) years were included in the study. Overall, 11 participants (25%) with NF1 presented with evidence of auditory neural dysfunction, including absent, delayed, or low amplitude electrophysiological responses from the auditory nerve and/or brainstem, compared with 1 participant (2%) in the control group (odds ratio [OR], 13.03; 95% CI, 1.59-106.95). Furthermore, 14 participants (32%) with NF1 showed clinically abnormal speech perception in background noise compared with 1 participant (2%) in the control group (OR, 20.07; 95% CI, 2.50-160.89). Analysis of diffusion-weighted MRI data of participants with NF1 showed significantly lower apparent fiber density within the ascending auditory brainstem pathways. The regions identified corresponded to the neural dysfunction measured using electrophysiological assessment. CONCLUSIONS AND RELEVANCE The findings of this case-control study could represent new neurobiological and clinical features of NF1. Auditory dysfunction severe enough to impede developmental progress in children and restrict communication in older participants is a common neurobiological feature of the disorder.
Collapse
Affiliation(s)
- Gary Rance
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| | - Julien Zanin
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| | - Alice Maier
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Donella Chisari
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| | - Kristina M. Haebich
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Kathryn N. North
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Gabriel Dabscheck
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- The Royal Children’s Hospital, Parkville, Victoria, Melbourne
| | - Marc L. Seal
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Martin B. Delatycki
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- Victorian Clinical Genetics Services, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Jonathan M. Payne
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- The Royal Children’s Hospital, Parkville, Victoria, Melbourne
| |
Collapse
|
45
|
Veeranna SA, Allan C, Allen P. Assessment of cochlear electrophysiology in typically developing children and children with auditory processing disorder. Int J Pediatr Otorhinolaryngol 2021; 151:110962. [PMID: 34736007 DOI: 10.1016/j.ijporl.2021.110962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/27/2021] [Accepted: 10/25/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Children with auditory processing disorder (APD) are reported to have abnormal auditory brainstem responses (ABR) but little is understood about their cochlear integrity. Poor cochlear integrity can affect neural responses. In this study, cochlear and auditory brainstem integrity was investigated in children with APD. METHOD Twenty children with APD, sixteen typically developing children and twenty adults participated in this study. Click evoked electrocochleography (ECochG) and ABRs were recorded from all the participants. Cochlear responses were analyzed using a) latency and amplitude of summating potential; action potential, b) transmission time between summating potential and action potential, c) summating potential/action potential amplitude ratio and d) action potential latency difference to condensation and rarefaction polarity. Amplitude in the ABR components was examined. RESULTS Children with APD showed similar cochlear function to the typically developing children. There were no significant differences in wave I amplitude between children with APD and typically developing children. However, wave V amplitude was significantly reduced in children with APD compared to typically developing children. CONCLUSION In the absence of any functional differences in the cochlea, children with APD can show poor amplitude in the later components of the ABR. The ABR anomalies observed in children with APD arise due to poor neural processing, possibly after the first auditory synapse.
Collapse
Affiliation(s)
| | - Chris Allan
- National Centre for Audiology, Western University, London, Canada; School of Communication Science and Disorder, Western University, London, Canada
| | - Prudence Allen
- National Centre for Audiology, Western University, London, Canada; School of Communication Science and Disorder, Western University, London, Canada
| |
Collapse
|
46
|
Wang W, Li J, Lan L, Xie L, Xiong F, Guan J, Wang H, Wang Q. Auditory Neuropathy as the Initial Phenotype for Patients With ATP1A3 c.2452 G > A: Genotype-Phenotype Study and CI Management. Front Cell Dev Biol 2021; 9:749484. [PMID: 34692702 PMCID: PMC8531511 DOI: 10.3389/fcell.2021.749484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 08/31/2021] [Indexed: 01/10/2023] Open
Abstract
Objective: The objective of this study is to analyze the genotype–phenotype correlation of patients with auditory neuropathy (AN), which is a clinical condition featuring normal cochlear responses and abnormal neural responses, and ATP1A3 c.2452 G > A (p.E818K), which has been generally recognized as a genetic cause of cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss (CAPOS) syndrome. Methods: Four patients diagnosed as AN by clinical evaluation and otoacoustic emission and auditory brainstem responses were recruited and analyzed by next-generation sequencing to identify candidate disease-causing variants. Sanger sequencing was performed on the patients and their parents to verify the results, and short tandem repeat-based testing was conducted to confirm the biological relationship between the parents and the patients. Furthermore, cochlear implantation (CI) was performed in one AN patient to reconstruct hearing. Results: Four subjects with AN were identified to share a de novo variant, p.E818K in the ATP1A3 gene. Except for the AN phenotype, patients 1 and 2 exhibited varying degrees of neurological symptoms, implying that they can be diagnosed as CAPOS syndrome. During the 15 years follow-up of patient 1, we observed delayed neurological events and progressive bilateral sensorineural hearing loss in pure tone threshold (pure tone audiometry, PTA). Patient 2 underwent CI on his left ear, and the result was poor. The other two patients (patient 3 and patient 4, who were 8 and 6 years old, respectively) denied any neurological symptoms. Conclusion:ATP1A3 p.E818K has rarely been documented in the Chinese AN population. Our study confirms that p.E818K in the ATP1A3 gene is a multiethnic cause of AN in Chinese individuals. Our study further demonstrates the significance of genetic testing for this specific mutation for identifying the special subtype of AN with somewhat favorable CI outcome and offers a more accurate genetic counseling about the specific de novo mutation.
Collapse
Affiliation(s)
- Wenjia Wang
- College of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
| | - Jin Li
- College of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
| | - Lan Lan
- College of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
| | - Linyi Xie
- College of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
| | - Fen Xiong
- College of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
| | - Jing Guan
- College of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
| | - Hongyang Wang
- College of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
| | - Qiuju Wang
- College of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
| |
Collapse
|
47
|
Abstract
Patients with auditory neuropathy (AN)/auditory synaptopathy (AS) present unique evaluation and management challenges. Communication ability using auditory stimuli varies among patients, with particular difficulty understanding speech in noise. Auditory physiologic responses are key to accurate identification and monitoring of patients with AN/AS. Management approaches should consider individual variation and the possibility of change over time. Many patients with accurately characterized AN/AS demonstrate success with cochlear implants. Areas of discovery, including understanding of synaptic and neural mechanisms, genotype/phenotype relationships, and use of cochlear and cortical evoked potentials, will promote accurate clinical evaluation and management of infants, children, and adults with AN/AS.
Collapse
|
48
|
The audiovestibular profile of Brown-Vialetto-Van Laere syndrome. The Journal of Laryngology & Otology 2021; 135:1000-1009. [PMID: 34496984 DOI: 10.1017/s0022215121002395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Brown-Vialetto-Van Laere syndrome, a rare disorder associated with motor, sensory and cranial nerve neuropathy, is caused by mutations in riboflavin transporter genes SLC52A2 and SLC52A3. Hearing loss is a characteristic feature of Brown-Vialetto-Van Laere syndrome and has been shown in recent studies to be characterised by auditory neuropathy spectrum disorder. METHOD This study reports the detailed audiovestibular profiles of four cases of Brown-Vialetto-Van Laere syndrome with SLC52A2 and SLC52A3 mutations. All of these patients had auditory neuropathy spectrum disorder. RESULTS There was significant heterogeneity in vestibular function and in the benefit gained from cochlear implantation. The audiological response to riboflavin therapy was also variable, in contrast to generalised improvement in motor function. CONCLUSION We suggest that comprehensive testing of vestibular function should be conducted in Brown-Vialetto-Van Laere syndrome, in addition to serial behavioural audiometry as part of the systematic examination of the effects of riboflavin.
Collapse
|
49
|
Vijayasarathy S, Shetty HN. Perception of temporally enhanced and hearing aid processed speech in children with late-onset Auditory Neuropathy Spectrum Disorder. Int J Pediatr Otorhinolaryngol 2021; 148:110813. [PMID: 34198226 DOI: 10.1016/j.ijporl.2021.110813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/13/2021] [Accepted: 06/24/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate phrase perception and subjective quality preference of temporal enhancement-based speech processing strategies: Deep-band modulation and Stretching, and hearing aid processed speech in adolescents with late-onset Auditory Neuropathy. METHODS 15 participants with Auditory Neuropathy Spectrum Disorder were involved. Speech perception was assessed using unprocessed, deep-band modulated, stretched, and hearing aid processed conditions. Subjective preference was also assessed using the pair-wise comparison technique. Gap detection test was done using broadband noise to investigate the possible correlation with benefit from processing strategies. RESULTS As a group, no significant benefits were found with processed speech. Clinically relevant trends emerged on subdividing the group into good and poor performers. Deep-band modulation processing was significantly better than unprocessed speech in those with poorer speech recognition abilities. There was a trend for those with poorer temporal processing abilities to benefit more with deep-band modulation processing. In those with relatively better speech recognition abilities, processing showed no benefit, and hearing aid processed speech was inferior to unprocessed speech. Quality-wise, the unprocessed speech was preferred by all the participants. Among the processed conditions, deep-band modulation was preferred by most, followed by stretching and hearing aid processed speech. CONCLUSION Results indicate that temporal enhancement strategies may be beneficial for a subset of individuals with ANSD with poorer temporal processing and speech perception abilities. However, processing strategies need to take into account the quality aspect and not just intelligibility.
Collapse
Affiliation(s)
- Srikar Vijayasarathy
- Department of Audiology,JSS Institute of Speech and Hearing, Mysuru- 570004, India.
| | | |
Collapse
|
50
|
Zanin J, Dhollander T, Rance G, Yu L, Lan L, Wang H, Lou X, Connelly A, Nayagam B, Wang Q. Fiber-Specific Changes in White Matter Microstructure in Individuals With X-Linked Auditory Neuropathy. Ear Hear 2021; 41:1703-1714. [PMID: 33136644 DOI: 10.1097/aud.0000000000000890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Auditory neuropathy (AN) is the term used to describe a group of hearing disorders, in which the hearing impairment occurs as a result of abnormal auditory nerve function. While our understanding of this condition has advanced significantly over recent years, the ability to determine the site of lesion and the extent of dysfunction in affected individuals remains a challenge. To this end, we investigated potential axonal degeneration in the white matter tracts of the brainstem in individuals with X-linked AN. We hypothesized that individuals with X-linked AN would show focal degeneration within the VIII nerve and/or auditory brainstem tracts, and the degree of degeneration would correlate with the extent of auditory perceptual impairment. DESIGN This was achieved using a higher-order diffusion magnetic resonance imaging (dMRI)-based quantitative measure called apparent fiber density as obtained from a technique called single-shell 3-tissue constrained spherical deconvolution and analyzed with the fixel-based analysis framework. Eleven subjects with genetically confirmed X-linked AN and 11 controls with normal hearing were assessed using behavioral and objective auditory measures. dMRI data were also collected for each participant. RESULTS Fixel-based analysis of the brainstem region showed that subjects with X-linked AN had significantly lower apparent fiber density in the VIII nerve compared with controls, consistent with axonal degeneration in this region. Subsequent analysis of the auditory brainstem tracts specifically showed that degeneration was also significant in these structures overall. The apparent fiber density findings were supported by objective measures of auditory function, such as auditory brainstem responses, electrocochleography, and otoacoustic emissions, which showed VIII nerve activity was severely disrupted in X-linked AN subjects while cochlear sensory hair cell function was relatively unaffected. Moreover, apparent fiber density results were significantly correlated with temporal processing ability (gap detection task) in affected subjects, suggesting that the degree of VIII nerve degeneration may impact the ability to resolve temporal aspects of an acoustic signal. Auditory assessments of sound detection, speech perception, and the processing of binaural cues were also significantly poorer in the X-linked AN group compared with the controls with normal hearing. CONCLUSIONS The results of this study suggest that the dMRI-based measure of apparent fiber density may provide a useful adjunct to existing auditory assessments in the characterization of the site of lesion and extent of dysfunction in individuals with AN. Additionally, the ability to determine the degree of degeneration has the potential to guide rehabilitation strategies in the future.
Collapse
Affiliation(s)
- Julien Zanin
- The HEARing Cooperative Research Centre (HEARing CRC), Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Australia
| | - Thijs Dhollander
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Gary Rance
- The HEARing Cooperative Research Centre (HEARing CRC), Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Australia
| | - Lan Yu
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital 301, Beijing, China
- China National Clinical Research Centre for Otolaryngologic Diseases, Chinese People's Liberation Army General Hospital 301, Beijing, China
| | - Lan Lan
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital 301, Beijing, China
- China National Clinical Research Centre for Otolaryngologic Diseases, Chinese People's Liberation Army General Hospital 301, Beijing, China
| | - Hongyang Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital 301, Beijing, China
- China National Clinical Research Centre for Otolaryngologic Diseases, Chinese People's Liberation Army General Hospital 301, Beijing, China
| | - Xin Lou
- Department of Radiology, Chinese People's Liberation Army General Hospital 301, Beijing, China
| | - Alan Connelly
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
- The Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Bryony Nayagam
- Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Australia
- These authors contributed equally to this work
| | - Qiuju Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese People's Liberation Army General Hospital 301, Beijing, China
- China National Clinical Research Centre for Otolaryngologic Diseases, Chinese People's Liberation Army General Hospital 301, Beijing, China
- Key Lab of Hearing Impairment Science of Ministry of Education, Beijing, China
- These authors contributed equally to this work
| |
Collapse
|