Auditory middle latency response and phonological awareness in students with learning disabilities

Introduction Behavioral tests of auditory processing have been applied in schools and highlight the association between phonological awareness abilities and auditory processing, confirming that low performance on phonological awareness tests may be due to low performance on auditory processing tests. Objective To characterize the auditory middle latency response and the phonological awareness tests and to investigate correlations between responses in a group of children with learning disorders. Methods The study included 25 students with learning disabilities. Phonological awareness and auditory middle latency response were tested with electrodes placed on the left and right hemispheres. The correlation between the measurements was performed using the Spearman rank correlation coefficient. Results There is some correlation between the tests, especially between the Pa component and syllabic awareness, where moderate negative correlation is observed. Conclusion In this study, when phonological awareness subtests were performed, specifically phonemic awareness, the students showed a low score for the age group, although for the objective examination, prolonged Pa latency in the contralateral via was observed. Negative weak to moderate correlation for Pa wave latency was observed, as was positive weak correlation for Na-Pa amplitude.

Effect of auditory training on the middle latency response in children with (central) auditory processing disorder

The purpose of this study was to determine the middle latency response (MLR) characteristics (latency and amplitude) in children with (central) auditory processing disorder [(C)APD], categorized as such by their performance on the central auditory test battery, and the effects of these characteristics after auditory training. Thirty children with (C)APD, 8 to 14 years of age, were tested using the MLR-evoked potential. This group was then enrolled in an 8-week auditory training program and then retested at the completion of the program. A control group of 22 children without (C)APD, composed of relatives and acquaintances of those involved in the research, underwent the same testing at equal time intervals, but were not enrolled in the auditory training program. Before auditory training, MLR results for the (C)APD group exhibited lower C3-A1 and C3-A2 wave amplitudes in comparison to the control group [C3-A1, 0.84 µV (mean), 0.39 (SD - standard deviation) for the (C)APD group and 1.18 µV (mean), 0.65 (SD) for the control group; C3-A2, 0.69 µV (mean), 0.31 (SD) for the (C)APD group and 1.00 µV (mean), 0.46 (SD) for the control group]. After training, the MLR C3-A1 [1.59 µV (mean), 0.82 (SD)] and C3-A2 [1.24 µV (mean), 0.73 (SD)] wave amplitudes of the (C)APD group significantly increased, so that there was no longer a significant difference in MLR amplitude between (C)APD and control groups. These findings suggest progress in the use of electrophysiological measurements for the diagnosis and treatment of (C)APD.

Ear and electrode effects reduce within-group variability in middle latency response amplitude measures

Objectives: To establish normative amplitude values for relative difference measurements of the middle latency response (MLR) in normal-hearing pediatrics and to determine if these measurements provided a significant reduction of within-group variability when compared to raw, absolute amplitude measures. A relative amplitude difference is defined in the present paper as the difference in Na-Pa amplitude between two electrodes (e.g. vertical bar Na-Pa at C3 minus Na-Pa at C4 vertical bar, or electrode effects) or between two ears (e.g. vertical bar Na-Pa on left ear stimulation minus Na-Pa on right ear stimulation vertical bar, or ear effects). In contrast, an absolute amplitude is defined as a single Na-Pa measurement made at one electrode for stimulation of one ear (e.g. Na-Pa measured at C3 on left ear stimulation). Design: Cross-sectional study. Study sample: 155 pediatrics with normal peripheral and central hearing, and no history of psychological, neurological, or learning disability issues. Results: Within-group variability was significantly smaller for relative differences when compared to absolute amplitude measures. Electrode effects showed significantly less variability than ear effects. Normative values for ear and electrode effects were reported. Conclusions: Relative differences may provide better utility in the clinical diagnosis of central auditory pathology in pediatrics when compared to absolute amplitude measures because these difference measures show significantly lower variability when examined across subjects.

Potenciais evocados auditivos de média latência em adultos com epilepsia

Introdução Os potenciais evocados auditivos de média latência (PEAML) reflectem actividade neuronal mesencefáfica, mais precisamente da região tálamo-cortical, dos colículos inferiores e da formação reticular. A epilepsia é caracterizada por variadas manifestações anormais do comportamento cerebral, sendo descrita como uma perturbação da função cerebral, tendo origem numa descarga anómala de um conjunto ou da totalidade dos neurónios do córtice cerebral. Está documentado, que as descargas eléctricas provocadas pelas crises de epilepsia podem levar a perdas neuronais, pelo que poderão existir alterações nos PEAML. Objectivos A escassa existência de literatura sobre o tema e a não investigação na população portuguesa, originou a execução deste estudo, que teve como objectivo investigar e documentar a existência de alterações ou achados nos componentes neuronais de média latência (PEAML), numa amostra de portugueses com epilepsia. Metodologia Foram realizados PEAML a um grupo de controlo (GC) composto por 16 participantes e a um grupo clínico (GCL) de 8 participantes com epilepsia, sendo analisados os componentes Na, Pa e Na-Pa quanto à sua morfologia, latência e amplitude. Resultados A morfologia das ondas e a presença de epilepsia não estão associados, no entanto, contrariamente ao GC que evidenciou latências e amplitudes de Na, Pa e Na-Pa dentro dos padrões de normalidade, a alteração ou ausência de respostas por parte do GCL é significativa na totalidade das medidas investigadas. Conclusão Em epilepsias generalizadas e focais do lobo temporal os PEAML evidenciam alterações, tal achado poderá ser eventualmente justificado pela propagação ascendente e descendente da informação auditiva se encontrar comprometida, devido a sequelas deixadas pelas crises epilépticas nas vias auditivas mesencefálicas. As alterações verificadas foram uma morfologia anómala das ondas ou ausência das mesmas.

The clinical utility of the middle latency and 40Hz auditory evoked potentials in audiological electrodiagnosis

The two elcctrophysiological tests currently favoured in the clinical measurement of hearing threshold arc the brainstorm evoked potential (BAEP) and the slow vertex response (SVR). However, both tests possess disadvantages. The BAEP is the test of choice in younger patients as it is stable at all levels of arousal, but little information has been obtained to date at a range of frequencies. The SVR is frequency specific but is unreliable in certain adult subjects and is unstable during sleep or in young children. These deficiencies have prompted research into a third group of potentials, the middle latency response (MLR) and the 40HZ responses. This research has compared the SVR and 40HZ response in waking adults and reports that the 40HZ test can provide a viable alternative to the SVR provided that a high degree of subject relaxation is ensured. A second study examined the morphology of the MLR and 40HZ during sleep. This work suggested that these potentials arc markedly different during sleep and that methodological factors have been responsible for masking these changes in previous studies. The clinical possibilities of tone pip BAEPs were then examined as these components were proved to be the only stable responses present in sleep. It was found that threshold estimates to 5OOHz, lOOOHz and 4000Hz stimuli could be made to within 15dBSL in most cases. A final study looked more closely at methods of obtaining frequency specific information in sleeping subjects. Threshold estimates were made using established BAEP parameters and this was compared to a 40HZ procedure which recorded a series of BAEPs over a 100msec. time sweep. Results indicated that the 40mHz procedure was superior to existing techniques in estimating threshold to low frequency stimuli. This research has confirmed a role for the MLR and 40Hz response as alternative measures of hearing capability in waking subjects and proposes that the 40Hz technique is useful in measuring frequency specific thresholds although the responses recorded derive primarily from the brainstem.

Potencial evocado auditivo de média latência em crianças com dificuldades de aprendizagem

INTRODUÇÃO: Trata-se de uma semiologia laboratorial objetiva para avaliação do sistema auditivo de crianças com distúrbio de aprendizagem. OBJETIVO: Examinar os componentes do potencial evocado auditivo de média latência em uma amostra de crianças com distúrbio de aprendizagem e determinar suas propriedades. MÉTODO: O estudo realizado é do tipo prospectivo contemporâneo de corte transversal, quantitativo, descritivo e exploratório. 50 crianças de ambos os sexos com 8 a 14 anos de idade dividido em dois grupos iguais, com e sem distúrbio de aprendizagem. Causas orgânicas, ambientais ou genéticas foram excluídas do estudo. RESULTADOS E CONCLUSÃO: As ondas Na, Pa, Nb foram identificadas em todos os integrantes do estudo. Os valores de latência dos componentes foram Na= 19,2 ms, Pa= 32,5 ms, Nb= 46,4 ms (grupo controle) e Na= 19,7 ms, Pa= 35,1 ms, Nb= 49,6 ms (grupo pesquisa). O valor médio de amplitude Na-Pa foi 1,4 mV para ambos os grupos. As análises mostraram diferenças funcionais entre os grupos, foi observado o hemisfério esquerdo Nb latência mais longa de Nb no hemisfério esquerdo do grupo de estudo em relação ao controle. Tal estudo promoveu informações adicionais sobre PEAML e pode ser referência para outros estudos clínicos e experimentais nesta população.

Potencial evocado auditivo de média latência em crianças com dificuldades de aprendizagem

INTRODUÇÃO: Trata-se de uma semiologia laboratorial objetiva para avaliação do sistema auditivo de crianças com distúrbio de aprendizagem. OBJETIVO: Examinar os componentes do potencial evocado auditivo de média latência em uma amostra de crianças com distúrbio de aprendizagem e determinar suas propriedades. MÉTODO: O estudo realizado é do tipo prospectivo contemporâneo de corte transversal, quantitativo, descritivo e exploratório. 50 crianças de ambos os sexos com 8 a 14 anos de idade dividido em dois grupos iguais, com e sem distúrbio de aprendizagem. Causas orgânicas, ambientais ou genéticas foram excluídas do estudo. RESULTADOS E CONCLUSÃO: As ondas Na, Pa, Nb foram identificadas em todos os integrantes do estudo. Os valores de latência dos componentes foram Na= 19,2 ms, Pa= 32,5 ms, Nb= 46,4 ms (grupo controle) e Na= 19,7 ms, Pa= 35,1 ms, Nb= 49,6 ms (grupo pesquisa). O valor médio de amplitude Na-Pa foi 1,4 mV para ambos os grupos. As análises mostraram diferenças funcionais entre os grupos, foi observado o hemisfério esquerdo Nb latência mais longa de Nb no hemisfério esquerdo do grupo de estudo em relação ao controle. Tal estudo promoveu informações adicionais sobre PEAML e pode ser referência para outros estudos clínicos e experimentais nesta população.

Auditory evoked potential: a proposal for further evaluation in children with learning disabilities

The information presented in this paper demonstrates the author's experience in previews cross-sectional studies conducted in Brazil, in comparison with the current literature. Over the last 10 years, auditory evoked potential (AEP) has been used in children with learning disabilities. This method is critical to analyze the quality of the processing in time and indicates the specific neural demands and circuits of the sensorial and cognitive process in this clinical population. Some studies with children with dyslexia and learning disabilities were shown here to illustrate the use of AEP in this population.

The relationship between the auditory brain-stem response and its reconstructed waveforms following discrete wavelet transformation

Objective: To examine the relationship between the auditory brain-stem response (ABR) and its reconstructed waveforms following discrete wavelet transformation (DWT), and to comment on the resulting implications for ABR DWT time-frequency analysis. Methods: ABR waveforms were recorded from 120 normal hearing subjects at 90, 70, 50, 30, 10 and 0 dBnHL, decomposed using a 6 level discrete wavelet transformation (DWT), and reconstructed at individual wavelet scales (frequency ranges) A6, D6, D5 and D4. These waveforms were then compared for general correlations, and for patterns of change due to stimulus level, and subject age, gender and test ear. Results: The reconstructed ABR DWT waveforms showed 3 primary components: a large-amplitude waveform in the low-frequency A6 scale (0-266.6 Hz) with its single peak corresponding in latency with ABR waves III and V; a mid-amplitude waveform in the mid-frequency D6 scale (266.6-533.3 Hz) with its first 5 waves corresponding in latency to ABR waves 1, 111, V, VI and VII; and a small-amplitude, multiple-peaked waveform in the high-frequency D5 scale (533.3-1066.6 Hz) with its first 7 waves corresponding in latency to ABR waves 1, 11, 111, IV, V, VI and VII. Comparisons between ABR waves 1, 111 and V and their corresponding reconstructed ABR DWT waves showed strong correlations and similar, reliable, and statistically robust changes due to stimulus level and subject age, gender and test ear groupings. Limiting these findings, however, was the unexplained absence of a small number (2%, or 117/6720) of reconstructed ABR DWT waves, despite their corresponding ABR waves being present. Conclusions: Reconstructed ABR DWT waveforms can be used as valid time-frequency representations of the normal ABR, but with some limitations. In particular, the unexplained absence of a small number of reconstructed ABR DWT waves in some subjects, probably resulting from 'shift invariance' inherent to the DWT process, needs to be addressed. Significance: This is the first report of the relationship between the ABR and its reconstructed ABR DWT waveforms in a large normative sample. (C) 2004 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Auditory steady state response in pediatric audiology

The main issue regarding pediatric audiology diagnosis is determining procedures to configure reliable results which can be used to predict frequency-specific hearing thresholds. Aim: To investigate the correlation between auditory steady-state response (ASSR) with other tests in children with sensorineural hearing loss. Methods: Prospective cross-sectional contemporary cohort study. Twenty-three children (ages 1 to 7; mean, 3 years old) were submitted to ASSR, behavioral audiometry, click audiometry brain stem response (ABR), tone burst ABR, and predicting hearing level from the acoustic reflex. Results: the correlation between behavioral thresholds and ASSR was (0.70- 0.93), for the ABR tone burst it was (0.73 -0.93), for the ABR click it was (0.83-0.89) only at 2k and 4 kHz. The match between the ASSR and the hearing threshold prediction rule was considered moderate. Conclusion: there was a significant correlation between the ASSR and audiometry, as well as between ABR click (2k and 4 kHz) and for the ABR tone burst. The acoustic reflex can be used to add information to diagnosis in children.

Comparing auditory steady state response and auditory brainstem response in normal hearing adults

This paper presents a study examining auditory steady state response (ASSR) assessments compared to auditory brainstem response (ABR) assessments. The study examines the relationship between behavioral thresholds, click- and toneburst-ABR thresholds, and ASSR thresholds for normal hearing subjects using the commercially available GSI Audera instrument.

Comparing auditory steady-state response and auditory brainstem response in normal hearing adults

This paper compares the auditory steady state response (ASSR) thresholds with the click-evoked and tone burst auditory brainstem response (ABR) thresholds in their ability to predict known behavioral thresholds in normal-hearing adults.

Auditory steady state response in hearing assessment in infants with cytomegalovirus

OBJETIVO:Relatar o caso de um lactente com citomegalovírus congênito e disacusia neurossensorial progressiva, analisado por três métodos de avaliação auditiva.DESCRIÇÃO DO CASO:Na primeira avaliação auditiva, aos quatro meses de idade, o lactente apresentou ausência de Emissões Otoacústicas (EOA) e Potencial Evocado Auditivo de Tronco Encefálico (PEATE) dentro dos padrões de normalidade para a faixa etária, com limiar eletrofisiológico em 30dBnHL, bilateralmente. Com seis meses, apresentou ausência de PEATE bilateral em 100dBnHL. A avaliação comportamental da audição mostrou-se prejudicada devido ao atraso no desenvolvimento neuropsicomotor. Aos oito meses, foi submetido ao exame de Resposta Auditiva de Estado Estável (RAEE) e os limiares encontrados foram 50, 70, ausente em 110 e em 100dB, respectivamente para 500, 1.000, 2.000 e 4.000Hz, à direita, e 70, 90, 90 e ausente em 100dB, respectivamente para 500, 1.000, 2.000 e 4.000Hz, à esquerda.COMENTÁRIOS:Na primeira avaliação, o lactente apresentou alteração auditiva no exame de EOA e PEATE normal, que passou a ser alterado aos seis meses de idade. A intensidade da perda auditiva só pôde ser identificada pelo exame de RAEE, permitindo estabelecer a melhor conduta na adaptação de aparelho de amplificação sonora individual. Ressalta-se a importância do acompanhamento audiológico para crianças com CMV congênito.

Relação entre potenciais evocados auditivos de média latência e distúrbio de processamento auditivo: estudo de casos

The Auditory Evoked Middle Latency Response is one of the most promising objective tests in audiology and in revealing brain dysfunction and neuro-audiologic findings. The main advantages of its clinical use are precision and objectivity in evaluating children. This study aimed to analyze the auditory evoked middle latency response in two patients with auditory processing disorder and relate objective and behavioral measures. This case study was conducted in 2 patients (P1 = 12 years, female, P2 = 17 years old, male), both with the absence of sensory abnormalities, neurological and neuropsychiatric disorders. Both were submitted to anamnesis, inspection of the external ear canal, hearing test and evaluation of Auditory Evoked Middle latency Response. There was a significant association between behavioral test and objectives results. In the interview, there were complaints about the difficulty in listening in a noisy environment, sound localization, inattention, and phonological changes in writing and speaking, as confirmed by evaluation of auditory processing and Auditory Evoked Middle Latency Response. Changes were observed in the right decoding process hearing in both cases on the behavioral assessment of auditory processing; auditory evoked potential test middle latency shows that the right contralateral via response was deficient, confirming the difficulties of the patients in the assignment of meaning in acoustic information in a competitive sound condition at right, in both cases. In these cases it was shown the association between the results, but there is a need for further studies with larger sample population to confirm the data.

Auditory steady-state response in the first six months of life

Objective: To characterize the thresholds of the auditory steady-state response that relates to term newborns and infants. Design: The study was cross-sectional using auditory steadystate response assessment, and the real-ear-to-dial difference was measured in the external auditory canal. Study Sample: The study group included 60 newborns and infants between the age of 0 and 6 months. Results: A statistically significant difference was found in the carrier frequency variable for auditory steady-state response thresholds but not in comparison to ages. Furthermore, there is an association between auditory steady-state response thresholds and the real-ear-to-dial difference. Conclusion: The same threshold can be used as a normality reference for this age range, with distinct values for the different carrier frequencies. The influence of external auditory canal amplification should be taken into account.