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Choosing an Animal Model for the Study of Functional Dyspepsia. Can J Gastroenterol Hepatol 2018; 2018:1531958. [PMID: 29623262 PMCID: PMC5830275 DOI: 10.1155/2018/1531958] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 11/16/2017] [Indexed: 02/06/2023] Open
Abstract
Functional dyspepsia (FD) is a common functional gastrointestinal disorder with pain or discomfort in the upper abdomen as the main characteristic. The prevalence of FD worldwide varies between 5% and 11%. This condition adversely affects attendance and productivity in the workplace. Emerging evidence is beginning to unravel the pathophysiologies of FD, and new data on treatment are helping to guide evidence-based practice. In order to better understand the pathophysiologies of FD and explore better treatment options, various kinds of animal models of FD have been developed. However, it is unclear which of these models most closely mimic the human disease. This review provides a comprehensive overview of the currently available animal models of FD in relationship to the clinical features of the disease. The rationales, methods, merits, and disadvantages for modelling specific symptoms of FD are discussed in detail.
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Jiang ZD, Chen C. Short-term outcome of functional integrity of the auditory brainstem in term infants who suffer perinatal asphyxia. J Neurol Sci 2017; 376:219-224. [PMID: 28431617 DOI: 10.1016/j.jns.2017.03.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 03/02/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To assess short-term outcome of impaired functional integrity of the auditory brainstem in term infants who suffer perinatal asphyxia. METHODS Maximum length sequence brainstem auditory evoked response (MLS BAER) was recorded and analyzed at a mean age of 3months in term infants after perinatal asphyxia. The data were compared with age-matched normal term infants. RESULTS The infants after asphyxia showed an increase in the latency of MLS BAER wave III at 91, 455 and 910/s, and wave V at all click rates of 91-910/s. The interpeak intervals in the infants after asphyxia were increased at almost all click rates. The IV and I-III intervals were increased at all click rates, and the III-V interval was increased at 455 and 910/s. These increases were generally more significant at higher than at lower click rates. The amplitudes of waves I, III and V in the infants after asphyxia were reduced at all click rates. The V/I amplitude ratio was increased at 91-455/s clicks. The slope of III-V interval-rate function was abnormally increased. 17.1% of the infants after asphyxia had an abnormal increase in IV intervals. CONCLUSIONS MLS BAER was moderately abnormal at 3months of age in term infants after perinatal asphyxia, suggesting moderate impairment in the functional integrity of the auditory brainstem. The impairment occurs in 17.1% of the infants. Compared with that found at term, the impairment has improved, but not completely recovered.
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Affiliation(s)
- Ze D Jiang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
| | - Cao Chen
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
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Jiang ZD, Ping LL. Reduced wave amplitudes of brainstem auditory response in high-risk babies born at 28-32week gestation. Brain Dev 2016; 38:885-892. [PMID: 27287666 DOI: 10.1016/j.braindev.2016.05.006] [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: 02/03/2016] [Revised: 04/11/2016] [Accepted: 05/25/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine brainstem auditory electrophysiology in high-risk babies born at 28-32week gestation by analysing the amplitudes of wave components in maximum length sequence brainstem auditory evoked response (MLS BAER). METHODS 94 preterm babies, ranging in gestation 28-32weeks, with perinatal problems (high-risk) were recruited. The amplitudes of MLS BAER wave components were studied at term age (37-42weeks postconceptional age). RESULTS Compared with normal term controls, the amplitude in the high-risk preterm babies was significantly smaller at the highest click rate 910/s for wave I (p<0.01), at all 91-910/s for wave III (all p<0.01) and at 455 and 910/s (p<0.05 and 0.01) for wave V. Compared with age-matched low-risk preterm controls, the amplitude was significantly smaller at 455 and 910/s for wave I (p<0.05 and 0.05), 91-910/s for wave III (p<0.05-0.001), and 227-910/s (p<0.05 and 0.01) for wave V. No differences in the V/I and V/III amplitude ratios were found between the high-risk preterm babies and the controls. CONCLUSIONS The amplitudes of MLS BAER wave components, mainly more central components, were reduced in the high-risk preterm babies born at 28-32week gestation. Electrophysiological activity of the brainstem auditory neuron in such babies is depressed, mainly attributed to or related to the associated perinatal problems.
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Affiliation(s)
- Ze Dong Jiang
- Children's Hospital, Shanghai Medical University, Shanghai, China.
| | - Li Li Ping
- Children's Hospital, Shanghai Medical University, Shanghai, China
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Santarelli R, Rossi R, Scimemi P, Cama E, Valentino ML, La Morgia C, Caporali L, Liguori R, Magnavita V, Monteleone A, Biscaro A, Arslan E, Carelli V. OPA1-related auditory neuropathy: site of lesion and outcome of cochlear implantation. ACTA ACUST UNITED AC 2015; 138:563-76. [PMID: 25564500 PMCID: PMC4339771 DOI: 10.1093/brain/awu378] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Santarelli et al. reveal that hearing impairments in patients carrying OPA1 missense mutations are the result of disordered synchrony in auditory nerve fibre activity owing to degeneration of terminal dendrites. Cochlear implantation improves speech perception and synchronous activation of auditory pathways in these patients by bypassing the lesion site. Hearing impairment is the second most prevalent clinical feature after optic atrophy in dominant optic atrophy associated with mutations in the OPA1 gene. In this study we characterized the hearing dysfunction in OPA1-linked disorders and provided effective rehabilitative options to improve speech perception. We studied two groups of OPA1 subjects, one comprising 11 patients (seven males; age range 13–79 years) carrying OPA1 mutations inducing haploinsufficiency, the other, 10 subjects (three males; age range 5–58 years) carrying OPA1 missense mutations. Both groups underwent audiometric assessment with pure tone and speech perception evaluation, and otoacoustic emissions and auditory brainstem response recording. Cochlear potentials were recorded through transtympanic electrocochleography from the group of patients harbouring OPA1 missense mutations and were compared to recordings obtained from 20 control subjects with normal hearing and from 19 subjects with cochlear hearing loss. Eight patients carrying OPA1 missense mutations underwent cochlear implantation. Speech perception measures and electrically-evoked auditory nerve and brainstem responses were obtained after 1 year of cochlear implant use. Nine of 11 patients carrying OPA1 mutations inducing haploinsufficiency had normal hearing function. In contrast, all but one subject harbouring OPA1 missense mutations displayed impaired speech perception, abnormal brainstem responses and presence of otoacoustic emissions consistent with auditory neuropathy. In electrocochleography recordings, cochlear microphonic had enhanced amplitudes while summating potential showed normal latency and peak amplitude consistent with preservation of both outer and inner hair cell activities. After cancelling the cochlear microphonic, the synchronized neural response seen in both normally-hearing controls and subjects with cochlear hearing loss was replaced by a prolonged, low-amplitude negative potential that decreased in both amplitude and duration during rapid stimulation consistent with neural generation. The use of cochlear implant improved speech perception in all but one patient. Brainstem potentials were recorded in response to electrical stimulation in five of six subjects, whereas no compound action potential was evoked from the auditory nerve through the cochlear implant. These findings indicate that underlying the hearing impairment in patients carrying OPA1 missense mutations is a disordered synchrony in auditory nerve fibre activity resulting from neural degeneration affecting the terminal dendrites. Cochlear implantation improves speech perception and synchronous activation of auditory pathways by bypassing the site of lesion.
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Affiliation(s)
- Rosamaria Santarelli
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Roberta Rossi
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Pietro Scimemi
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Elona Cama
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Maria Lucia Valentino
- 3 Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy 4 IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Via Altura 3, 40139 Bologna, Italy
| | - Chiara La Morgia
- 3 Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy 4 IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Via Altura 3, 40139 Bologna, Italy
| | - Leonardo Caporali
- 3 Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy 4 IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Via Altura 3, 40139 Bologna, Italy
| | - Rocco Liguori
- 3 Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy 4 IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Via Altura 3, 40139 Bologna, Italy
| | - Vincenzo Magnavita
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Anna Monteleone
- 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Ariella Biscaro
- 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Edoardo Arslan
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Valerio Carelli
- 3 Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy 4 IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Via Altura 3, 40139 Bologna, Italy
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Jiang ZD, Wang C, Chen C. Neonatal necrotizing enterocolitis adversely affects neural conduction of the rostral brainstem in preterm babies. Clin Neurophysiol 2014; 125:2277-2285. [DOI: 10.1016/j.clinph.2014.03.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 03/13/2014] [Accepted: 03/15/2014] [Indexed: 11/16/2022]
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Wang JM, Zhang GF, Zhou WH, Jiang ZD, Shao XM. Changes in amplitude-integrated electroencephalograms in piglets during selective mild head cooling after hypoxia-ischemia. Pediatr Neonatol 2014; 55:282-90. [PMID: 24440513 DOI: 10.1016/j.pedneo.2013.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/26/2013] [Accepted: 09/30/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Amplitude-integrated electroencephalogram (aEEG) is a simplified, alternative means of monitoring cerebral function and may be more useful clinically in some situations than conventional EEG. The aim of this study is to evaluate newborn piglets as an animal model to examine the effect of selective mild head cooling (HC) on aEEG after hypoxia-ischemia (HI). METHODS Thirty-four piglets were randomly allocated to the following treatment groups: normothermic control group (NC, n = 7), selective HC control group (HC, n = 9), normothermic HI group (NHI, n = 9), and selective HC HI group (SHC-HI, n = 9). HI was induced by temporary occlusion of both carotid arteries and simultaneous reduction of the concentration of inspired oxygen to 6% for 30 minutes. Mild hypothermia (35°C) was induced after HI using a HC cap and was maintained for 24 hours. Changes in aEEG were monitored for 6 days after these treatments and the incidence of abnormalities analyzed. Physiological parameters were also measured during this period. RESULTS In the two HI groups, animals exhibited severely abnormal aEEGs [continuous low voltage (CLV), burst-suppression, or flat tracing (FT)] 20 minutes after the beginning of HI. At 2 hours, the aEEG returned to normal in most of these animals. From 12 hours to 6 days, all animals in the NHI group exhibited severely abnormal aEEGs. Fewer animals in the SHC-HI group exhibited severe abnormal aEEGs during this time period, and four out of nine (44.4%) animals had continuous normal voltage (CNV) at 6 days. CONCLUSIONS Selective mild HC decreases the incidence of severe abnormal aEEGs at late times after HI in newborn piglets.
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Affiliation(s)
- Ji-Mei Wang
- Department of Neonatology, Gynecology, and Obstetrics, Hospital of Fudan University, Shanghai 200011, China
| | - Guo-Fu Zhang
- Department of Radiology, Gynecology, and Obstetrics, Hospital of Fudan University, Shanghai 200011, China
| | - Wen-Hao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Ze-Dong Jiang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China; Neonatal Unit, Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Xiao-Mei Shao
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China.
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Jiang ZD, Liu TT, Chen C. Brainstem auditory electrophysiology is supressed in term neonates with hyperbilirubinemia. Eur J Paediatr Neurol 2014; 18:193-200. [PMID: 24309481 DOI: 10.1016/j.ejpn.2013.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 11/05/2013] [Accepted: 11/08/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Whether hyperbilirubinemia suppresses electrophysiological activity of the neonatal auditory brainstem remains to be investigated. AIM To determine whether hyperbilirubinemia suppresses the brainstem auditory electrophysiology in term neonates. METHODS Maximum length sequence brainstem auditory evoked response (MLS BAER) was recorded shortly after confirming hyperbilirubinemia in 58 term neonates. Wave amplitudes of the response were analyzed in detail. RESULTS Compared with age-matched term controls, the neonates with hyperbilirubinemia showed a significant reduction in the amplitudes of MLS BAER waves III and particularly V at all click rates 91-910/s. The reduction tended to be more significant at higher than lower rates. Wave I amplitude was reduced at 910/s. V/I amplitude ratio was decreased at all click rates. Therefore, the amplitudes of MLS BAER, particularly later, waves were all reduced. The amplitudes of all MLS BAER waves tended to be reduced with the increase in total serum bilirubin level. All wave amplitudes were correlated with the level of total serum bilirubin at some or most click rates. CONCLUSIONS Brainstem auditory electrophysiology is suppressed in neonates with hyperbilirubinemia, which related to the severity of hyperbilirubinemia. Wave amplitudes are valuable BAER variables to detect functional impairment of the brainstem and auditory pathway in neonatal hyperbilirubinemia, and are recommended to be used in assessing bilirubin neurotoxicity to the neonatal brain.
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Affiliation(s)
- Ze D Jiang
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China.
| | - T T Liu
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China
| | - Cao Chen
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China
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Santarelli R, del Castillo I, Starr A. Auditory neuropathies and electrocochleography. HEARING BALANCE AND COMMUNICATION 2013. [DOI: 10.3109/21695717.2013.815446] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Counter SA, Buchanan LH, Ortega F. Brainstem auditory evoked responses in children living at high altitude in the andes mountains. High Alt Med Biol 2013; 14:155-61. [PMID: 23795736 DOI: 10.1089/ham.2012.1058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This neurophysiological study compared brainstem auditory evoked responses (BAER) in children living at high elevations (2800 to 3000 meters) in the Andes Mountains of Ecuador with a reference group of children living at sea level in the U.S. METHODS BAER absolute latencies of waves I through V; interpeak latencies I-III, III-V, and I-V; amplitudes of waves I and V; and the V/I amplitude ratio were measured by scalp electrodes at acoustic click stimulus rates of 10 and 50 pulses per second (pps). RESULTS Statistical analysis showed that the high-altitude group had significantly longer absolute and interpeak BAER latencies than the sea-level reference group at both the 10 and 50 pps stimulus rates for most wave peaks. The amplitudes of waves I and V were significantly reduced for the high-altitude group at 10 and 50 pps, suggesting blood O2 saturation effects. CONCLUSIONS The BAER of children in the high-altitude group suggested physiological anomalies in auditory neural conduction and summation compared with the sea-level group. The results further suggest that small physiological effects of altitude on BAER, especially at elevations near 3000 meters and higher, should be taken into consideration in the evaluation of brainstem auditory function.
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Affiliation(s)
- S Allen Counter
- Department of Neurology, Harvard Medical School/The Biological Laboratories, 16 Divinity Avenue, Cambridge, MA 02138, USA.
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Jiang ZD, Zhou Y, Yin R, Wilkinson AR. Amplitude reduction in brainstem auditory response in term infants under neonatal intensive care. Clin Neurophysiol 2013; 124:1470-6. [PMID: 23608697 DOI: 10.1016/j.clinph.2013.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Revised: 01/08/2013] [Accepted: 02/10/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine brainstem auditory electrophysiology in term neonates under intensive care due to perinatal conditions other than hypoxia-ischemia. METHODS Maximum length sequence brainstem auditory evoked response was studied in term neonates in an intensive care unit. The amplitudes of wave components of the response were analysed to assess brainstem auditory electrophysiology. RESULTS The amplitudes of all wave components in the neonates under intensive care tended to be smaller than in those in normal term controls. Wave I amplitude was significantly reduced at all 91-910/s clicks (p < 0.05-0.01). The amplitudes of waves III and V were also reduced, respectively, at 227-910/s (all p < 0.05) and at 455 and 910/s (both p < 0.01). The amplitude reduction was slightly more significant at higher than lower click rates, but there were no significant differences in the slopes of wave I, III and V amplitude-rate functions between the neonates under intensive care and the controls. CONCLUSIONS Wave amplitudes of maximum length sequence brainstem auditory evoked response were reduced in term neonates under intensive care due to perinatal conditions other than hypoxia-ischemia. SIGNIFICANCE Brainstem auditory electrophysiology is depressed in term neonates under intensive care, possibly due to collective adverse effects of perinatal conditions. The impairment to the neonatal, particularly rostral, brainstem due to other perinatal conditions is less severe than that due to hypoxia-ischemia previously reported.
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Affiliation(s)
- Ze D Jiang
- Department of Pediatrics, Children's Hospital, Fudan University, Shanghai, China.
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Electrocochleography. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/b978-0-7020-5310-8.00005-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Jiang ZD, Ping LL, Wilkinson AR. Functional abnormality of the auditory brainstem in high-risk late preterm infants. Clin Neurophysiol 2012; 123:993-1001. [DOI: 10.1016/j.clinph.2011.08.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 07/08/2011] [Accepted: 08/16/2011] [Indexed: 11/30/2022]
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Jiang ZD, Wu YY, Liu XY, Wilkinson AR. Depressed brainstem auditory function in children with cerebral palsy. J Child Neurol 2011; 26:272-8. [PMID: 20823031 DOI: 10.1177/0883073810379913] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Brainstem auditory evoked responses were studied to examine brainstem auditory function in 80 children with cerebral palsy. The response waveform, particularly later waves, tended to be depressed. Thirty-three (41.3%) showed abnormal results. The main abnormality was reduced wave V amplitude. Other abnormalities were decreased V/I amplitude ratio, missing waves, prolonged I-V interval, and increased interaural difference in I-V interval. The abnormalities were persistent during the follow-up. In contrast to common findings in the responses in progressive neurologies, abnormalities in interpeak intervals were rare in children with cerebral palsy. There were some characteristic changes in the responses in certain etiologies. These results suggest that brainstem auditory function in children with cerebral palsy is depressed, which may be owing to decreased or altered neural firing or synchrony in the auditory brainstem. A detailed analysis of central components of the responses is valuable in detecting central auditory dysfunction in children with cerebral palsy.
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Affiliation(s)
- Ze D Jiang
- Children's Hospital, Fudan University, Shanghai, China.
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Differences in impaired brainstem conduction between neonatal chronic lung disease and perinatal asphyxia. Clin Neurophysiol 2010; 121:725-33. [PMID: 20097607 DOI: 10.1016/j.clinph.2009.12.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Revised: 11/06/2009] [Accepted: 12/08/2009] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To explore any differences in impaired brainstem function between preterm infants with neonatal chronic lung disease (CLD) and term infants after perinatal asphyxia. METHODS Brainstem auditory evoked responses (BAERs) collected using maximum length sequence (MLS) technique were compared at term equivalent age between 43 CLD infants and 117 asphyxiated infants. RESULTS In both CLD and asphyxiated infants there was a significant increase in wave V latency and I-V interval in MLS BAER. CLD infants showed a significant increased III-V interval but a normal I-III interval at all click rates. However, asphyxiated infants showed a significant increase in both III-V and I-III intervals. I-III interval was shorter and III-V/I-III interval ratio was greater in CLD infants than in asphyxiated infants. The slope of I-III interval-rate function was steeper in asphyxiated infants than in CLD infants, while the slope of III-V/I-III interval ratio-rate function was the other way around. CONCLUSIONS CLD infants had a major increase in more central components of MLS BAER, without appreciable abnormality in more peripheral components. However, asphyxiated infants had a significant increase in both central and peripheral components. SIGNIFICANCE Neonatal CLD affects more central regions of the brainstem, whereas perinatal asphyxia affects both peripheral and central regions. This difference, which is likely related to the different nature of hypoxia in CLD and asphyxia, may have some significance for neuroprotective interventions for the two problems.
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Jiang ZD, Brosi DM, Chen C, Wilkinson AR. Impairment of perinatal hypoxia-ischemia to the preterm brainstem. J Neurol Sci 2009; 287:172-7. [PMID: 19735922 DOI: 10.1016/j.jns.2009.07.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Accepted: 07/31/2009] [Indexed: 11/17/2022]
Abstract
Hypoxia-ischemia is a major perinatal problem that results in severe damage to the newborn brain. This study assessed functional integrity of the brainstem at term in preterm infants after perinatal hypoxia-ischemia to shed light on the influence of hypoxia-ischemia on the preterm brainstem. We recruited sixty-eight preterm infants after perinatal hypoxia-ischemia, ranging in gestation 28-35 weeks. Brainstem evoked response was studied at term age (37-42 weeks postconceptional age) with 91-910/s clicks using the maximum length sequence technique. Compared with healthy preterm infants, the preterm infants after perinatal hypoxia-ischemia showed a significant increase in I-V interval at very high rates 455 and 910/s of clicks (P<0.05, 0.05). III-V interval and III-V/I-III interval ratio also increased significantly at 455 and 910/s (P<0.05-0.01). The slope of III-V interval-rate function was significantly steeper than in the healthy preterm infants (P<0.05). Compared with normal term controls, the preterm infants after hypoxia-ischemia showed similar, but slightly more significant, abnormalities. The differences between the preterm infants after hypoxia-ischemia and the healthy preterm and term infants generally increased with increasing click rate. These results demonstrated that central components of brainstem auditory evoked response were abnormal at very high click rates in the preterm infants after perinatal hypoxia-ischemia. Click rate-dependent change in the more central part of the brainstem is also abnormal. Apparently, functional integrity of the brainstem, mainly in the more central part, is impaired. Hypoxic-ischemic damage to the preterm brainstem is unlikely to completely recover within a relatively short period after the insult, which is of clinical importance.
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Affiliation(s)
- Ze D Jiang
- Children's Hospital, Shanghai Medical University, Shanghai, China.
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Jiang ZD, Brosi DM, Wilkinson AR. Depressed brainstem auditory electrophysiology in preterm infants after perinatal hypoxia–ischaemia. J Neurol Sci 2009; 281:28-33. [DOI: 10.1016/j.jns.2009.02.378] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Revised: 02/26/2009] [Accepted: 02/26/2009] [Indexed: 11/16/2022]
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Jiang ZD, Brosi DM, Chen C, Wilkinson AR. Brainstem response amplitudes in neonatal chronic lung disease and differences from perinatal asphyxia. Clin Neurophysiol 2009; 120:967-73. [DOI: 10.1016/j.clinph.2009.02.166] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Revised: 01/24/2009] [Accepted: 02/16/2009] [Indexed: 11/16/2022]
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Does perinatal asphyxia induce apoptosis in the inner ear? Hear Res 2009; 250:1-9. [DOI: 10.1016/j.heares.2008.12.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Revised: 12/15/2008] [Accepted: 12/15/2008] [Indexed: 11/19/2022]
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