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Rossetti E, Pro S, Picardo S, Longo D, DI Capua M. Brain auditory evoked potentials in pediatric Intensive Care Unit: diagnostic role on encephalopathy and central respiratory failure on infants. Minerva Pediatr (Torino) 2024; 76:197-200. [PMID: 33820408 DOI: 10.23736/s2724-5276.21.05931-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Encephalopathy of different etiologies in infants is often the reason for central respiratory insufficiency which eventually leads patients to the Pediatric Intensive Care Unit. Magnetic resonance imaging (MRI) and brainstem auditory evoked potentials (BAEPs) may be useful to identify brainstem alterations among patients with respiratory insufficiency of central origin. MRI is a compulsory technique to identify brain abnormalities, but may fail to detect brainstem lesions of small dimensions. BAEPs play a highly sensitive role on brainstem dysfunction identification because of the generators of different peaks which are related to specific brainstem structures. METHODS The study included ten infants affected by encephalopathy of different etiologies and early neurological respiratory failure. To evaluate BAEPs, the surface electrodes were placed at the vertex (Cz) and on each mastoid side. RESULTS All subjects presented alteration of BAEPs. The brain MRI revealed selective injury of the brainstem in four patients and supratentorial alterations in six patients. CONCLUSIONS The early identification of brainstem lesions in mechanically ventilated infants with encephalopathy may reduce the weaning off mechanical ventilation's attempt numbers and provide early informative discussions with families and clinical caregivers about treatment options, such as tracheostomy, long term ventilation and the reduction of their length of PICU stay. Furthermore, this would support the evaluation process concerning the affected children, their families and the needs of other social groups, including health systems.
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Affiliation(s)
- Emanuele Rossetti
- Pediatric Emergency, Department of Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, Rome, Italy -
| | - Stefano Pro
- Unit of Neurophysiology, Department of Neurology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Sergio Picardo
- Pediatric Emergency, Department of Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Daniela Longo
- Department of Radiology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Matteo DI Capua
- Unit of Neurophysiology, Department of Neurology, Bambino Gesù Children's Hospital, Rome, Italy
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2
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Jiang ZD, Wang C, Jiang JK, Wang J. Infants with neonatal Chronic Lung Disease are associated with delayed auditory conduction in the rostral brainstem after term. Clinics (Sao Paulo) 2024; 79:100341. [PMID: 38457938 DOI: 10.1016/j.clinsp.2024.100341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/28/2023] [Accepted: 02/15/2024] [Indexed: 03/10/2024] Open
Abstract
AIMS Very Low Birthweight (VLBW) infants with neonatal Chronic Lung Disease (CLD) have been found to have functional impairment of the brainstem auditory pathway at term. This study investigated the functional status of the brainstem auditory pathway in VLBW infants with CLD after term for any abnormality. METHODS Fifty-two VLBW infants were recruited at 50 weeks of Postconceptional Age: 25 with neonatal CLD and 27 without CLD. None had any other major complications to minimize confounding effects. Brainstem Auditory Evoked Responses were studied at 21‒91/s click rates. RESULTS Compared with those without CLD, VLBW infants with CLD had relatively shorter latencies of BAER waves I and III, associated with a slightly lower BAER threshold. Wave V latency and I‒V interpeak interval did not differ significantly between the two groups of infants. The I‒III interval in infants with CLD was shorter than in those without CLD at 91/s clicks. However, the III‒V interval was significantly longer than in those without CLD at all click rates (all p < 0.05). There were no significant differences in the amplitudes of BAER wave components between the two groups of infants. CONCLUSIONS The main BAER abnormality in VLBW infants with CLD was a prolonged III‒V interval. Auditory conduction is delayed or impaired at more central regions of the brainstem in CLD infants. After term central auditory function is adversely affected by neonatal CLD. Monitoring post-term change is required to provide valuable information for post-term care of CLD infants.
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Affiliation(s)
- Ze Dong Jiang
- Division of Neonatology, Children's Hospital of Fudan University, China.
| | - Cui Wang
- Division of Neonatology, Children's Hospital of Fudan University, China
| | - James K Jiang
- Division of Neonatology, Children's Hospital of Fudan University, China
| | - Jin Wang
- Division of Neonatology, Children's Hospital of Fudan University, China
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3
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Park JH, Sahbaz BD, Pekhale K, Chu X, Okur MN, Grati M, Isgrig K, Chien W, Chrysostomou E, Sullivan L, Croteau DL, Manor U, Bohr VA. Early-Onset Hearing Loss in Mouse Models of Alzheimer's Disease and Increased DNA Damage in the Cochlea. AGING BIOLOGY 2024; 1:20240025. [PMID: 38500536 PMCID: PMC10948084 DOI: 10.59368/agingbio.20240025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
There is considerable interest in whether sensory deficiency is associated with the development of Alzheimer's disease (AD). Notably, the relationship between hearing impairment and AD is of high relevance but still poorly understood. In this study, we found early-onset hearing loss in two AD mouse models, 3xTgAD and 3xTgAD/Polβ+/-. The 3xTgAD/Polβ+/- mouse is DNA repair deficient and has more humanized AD features than the 3xTgAD. Both AD mouse models showed increased auditory brainstem response (ABR) thresholds between 16 and 32 kHz at 4 weeks of age, much earlier than any AD cognitive and behavioral changes. The ABR thresholds were significantly higher in 3xTgAD/Polβ+/- mice than in 3xTgAD mice at 16 kHz, and distortion product otoacoustic emission signals were reduced, indicating that DNA damage may be a factor underlying early hearing impairment in AD. Poly ADP-ribosylation and protein expression levels of DNA damage markers increased significantly in the cochlea of the AD mice but not in the adjacent auditory cortex. Phosphoglycerate mutase 2 levels and the number of synaptic ribbons in the presynaptic zones of inner hair cells were decreased in the cochlea of the AD mice. Furthermore, the activity of sirtuin 3 was downregulated in the cochlea of these mice, indicative of impaired mitochondrial function. Taken together, these findings provide new insights into potential mechanisms for hearing dysfunction in AD and suggest that DNA damage in the cochlea might contribute to the development of early hearing loss in AD.
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Affiliation(s)
- Jae-Hyeon Park
- DNA repair Section, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Burcin Duan Sahbaz
- DNA repair Section, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Komal Pekhale
- DNA repair Section, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Xixia Chu
- DNA repair Section, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Mustafa N. Okur
- DNA repair Section, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Mhamed Grati
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Kevin Isgrig
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
| | - Wade Chien
- National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Elena Chrysostomou
- Waitt Advanced Biophotonics Center, Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Lauren Sullivan
- Department of Cell & Developmental Biology School of Biological Sciences University of California, San Diego, La Jolla, CA, USA
| | - Deborah L. Croteau
- DNA repair Section, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
- Computational Biology & Genomics Core, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Uri Manor
- Department of Cell & Developmental Biology School of Biological Sciences University of California, San Diego, La Jolla, CA, USA
| | - Vilhelm A. Bohr
- DNA repair Section, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
- Danish Center for Healthy Aging, University of Copenhagen, Copenhagen N, Denmark
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Wang C, Jiang JK, Yin R, Jiang ZD. Suboptimal postnatal function of brainstem auditory pathway in late preterm infants who do not have major perinatal and postnatal complications. Neurophysiol Clin 2023; 53:102919. [PMID: 37984241 DOI: 10.1016/j.neucli.2023.102919] [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: 08/27/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES To examine postnatal functional status of the brainstem auditory pathway in late preterm infants and detect any postnatal auditory abnormality. METHODS Thirty preterm infants born at 33-36 weeks gestation were studied three months after term. None had major perinatal and postnatal complications to minimize confounding effects. Brainstem auditory evoked responses were recorded with 21-91/s clicks. RESULTS Compared with postnatal age-matched normal term infants, the late preterm infants did not manifest any major abnormalities in brainstem auditory evoked responses at conventionally used 21/s clicks. At higher click rates, however, the late preterm infants manifested a moderate prolongation in BAER wave V latency. All interpeak intervals tended to be prolonged at higher click rates. The I-V interval was significantly prolonged at 51/s and particularly at 91/s clicks. Both the I-III and III-V intervals were significantly prolonged at 91/s. The late preterm infants also manifested reduced amplitudes of BAER waves III and V at most click rates. CONCLUSION The central components of the brainstem auditory evoked responses were abnormal at higher click rates three months after term in the late preterm infants. Postnatal brainstem auditory function is suboptimal in late preterm infants without major complications. This suboptimal brainstem auditory function may not be clearly shown at term or an earlier stage, but can be shown later. Late preterm infants, although they may not have major complications, should be followed for later auditory development, providing valuable information for improving postnatal care.
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Affiliation(s)
- Cui Wang
- Division of Neonatology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai 201102
| | - James K Jiang
- Division of Neonatology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai 201102
| | - Rong Yin
- Division of Neonatology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai 201102
| | - Ze D Jiang
- Division of Neonatology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai 201102.
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Jiang ZD, Wang C, Ping LL, Yin R. Altered maturation in brainstem neural conduction in very premature babies with fetal growth restriction. Pediatr Res 2023; 94:1472-1479. [PMID: 36966269 DOI: 10.1038/s41390-023-02565-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/31/2023] [Accepted: 02/27/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND Using maximum length sequence brainstem auditory evoked response (MLS BAER) to study brainstem neural conduction and maturation in fetal growth restriction (FGR) babies born very prematurely and assess the effect of FGR on brainstem neural maturation. METHODS MLS BAER was recorded and analyzed at a mean 40 week postmenstrual age in babies born at 27-32 week gestation without other major perinatal conditions or problems. The data were compared between babies with FGR (n = 30) and age-matched babies without FGR (n = 34) to define any differences. RESULTS A notable difference in MLS BAER was found in interpeak intervals between the babies with FGR and those without FGR. The FGR babies manifested significantly shortened I-III interval, moderately prolonged III-V interval, and significantly decreased III-V/I-III interval ratio. The slope of the I-III interval-rate function in FGR babies was moderately decreased, relative to that in the babies without FGR. CONCLUSION FGR babies born very prematurely are associated with accelerated or precocial neural maturation at caudal brainstem regions, but moderately delayed maturation at rostral brainstem regions. The altered brainstem neural maturation is different from previously reported mildly delayed maturation in FGR babies born less prematurely, and may have important implication for neurodevelopmental outcome. IMPACT This first MLS BAER study in FGR found that brainstem neural maturation in very premature FGR babies differed from age-matched non-FGR babies. Neural maturation in very premature FGR babies is accelerated or precocial at caudal brainstem regions but moderately delayed at rostral brainstem regions. The altered maturation is different from previously reported mild delay in brainstem neural maturation in FGR babies born less prematurely. FGR exerts a major and differential effect on brainstem neural maturation in babies born very prematurely. This alteration in very premature FGR babies may have important implication for their neurodevelopment.
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Affiliation(s)
- Ze Dong Jiang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
| | - Cui Wang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Li Li Ping
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Rong Yin
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
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Tang H, Zhang S, Tian Y, Kang T, Zhou C, Yang S, Liu Y, Liu X, Chen Q, Xiao H, Chen W, Zang J. Bioinspired Soft Elastic Metamaterials for Reconstruction of Natural Hearing. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023:e2207273. [PMID: 37114826 PMCID: PMC10369269 DOI: 10.1002/advs.202207273] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/28/2023] [Indexed: 06/19/2023]
Abstract
Natural hearing which means hearing naturally like normal people is critical for patients with hearing loss to participate in life. Cochlear implants have enabled numerous severe hearing loss patients to hear voice functionally, while cochlear implant users can hardly distinguish different tones or appreciate music subject to the absence of rate coding and insufficient frequency channels. Here a bioinspired soft elastic metamaterial that reproduces the shape and key functions of the human cochlea is reported. Inspired by human cochlea, the metamaterials are designed to possess graded microstructures with high effective refractive index distributed on a spiral shape to implement position-related frequency demultiplexing, passive sound enhancements of 10 times, and high-speed parallel processing of 168-channel sound/piezoelectric signals. Besides, it is demonstrated that natural hearing artificial cochlea has fine frequency resolution up to 30 Hz, a wide audible range from 150-12 000 Hz, and a considerable output voltage that can activate the auditory pathway in mice. This work blazes a promising trail for reconstruction of natural hearing in patients with severe hearing loss.
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Affiliation(s)
- Hanchuan Tang
- School of Integrated Circuits and Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Shujie Zhang
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Ye Tian
- School of Integrated Circuits and Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Tianyu Kang
- School of Integrated Circuits and Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Cheng Zhou
- School of Integrated Circuits and Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Shuaikang Yang
- School of Integrated Circuits and Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Ying Liu
- School of Integrated Circuits and Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Xurui Liu
- School of Integrated Circuits and Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Qicai Chen
- School of Life Sciences, Central China Normal University, Wuhan, 430074, China
| | - Hongjun Xiao
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Wei Chen
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Jianfeng Zang
- School of Integrated Circuits and Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, 430074, China
- The State Key Laboratory of Digital Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan, 430074, China
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Jiang ZD, Wang C. Preterm babies treated with lengthy continuous positive airway pressure are associated with moderate auditory abnormality. Early Hum Dev 2023; 181:105774. [PMID: 37068439 DOI: 10.1016/j.earlhumdev.2023.105774] [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: 03/19/2023] [Accepted: 04/08/2023] [Indexed: 04/19/2023]
Abstract
AIMS Continuous positive airway pressure (CPAP) has been used for the prevention and treatment of neonatal respiratory distress for over four decades, but it remains very poorly understood whether there is any brainstem auditory abnormality in babies treated with CPAP. We aimed to detect brainstem auditory abnormality at 34-35 weeks of corrected age in preterm babies treated with CPAP and define any difference between different durations of CPAP treatment. STUDY DESIGN Preterm babies were recruited and dichotomized to those with CPAP treatment (CPAP group, n = 67) and those without CPAP treatment (n-CPAP group) (n = 49). Brainstem auditory evoked response (BAER) was studied at 34-35 weeks of corrected age. RESULTS Compared with the n-CPAP group, the CPAP group manifested moderately elevated BAER threshold and significantly prolonged latencies of BAER waves III and V and I-V interval. The prolongation was generally more significant in the babies with longer duration of CPAP treatment than those with shorter duration. The I-V interval in the babies with CPAP treatment for >30 days were significantly longer than those with fewer days of CPAP treatment. CONCLUSION At 34-35 weeks of corrected age, preterm babies treated with CPAP are associated with moderate auditory abnormality. Further study is warranted to explore more detail of the auditory abnormality in babies treated with CPAP.
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Affiliation(s)
- Ze Dong Jiang
- Division of Neonatology, Children's Hospital of Fudan University, China.
| | - Cui Wang
- Division of Neonatology, Children's Hospital of Fudan University, China
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Brainstem auditory pathway maturation in term neonates with congenital cytomegalovirus infection: a cohort study. Eur J Pediatr 2023; 182:95-100. [PMID: 36207473 DOI: 10.1007/s00431-022-04644-z] [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: 08/10/2022] [Revised: 09/24/2022] [Accepted: 09/30/2022] [Indexed: 01/12/2023]
Abstract
Congenital cytomegalovirus infection (cCMVi) is a leading cause of sensorineural hearing loss (SNHL) and developmental delay. Brainstem auditory evoked potentials (BAEPs) recording allows assessment of central auditory pathway maturation in neonates. We aimed to characterize the effect of cCMVi on the maturation of the brainstem auditory pathway in term neonates. We retrospectively reviewed medical records of neonates born with cCMVi in 2010-2018 and characterized their auditory pathway maturation using brainstem auditory-evoked potentials (BAEPs). We compared inter-peak latency differences (IPLDs) of the main BAEP components (I-V, I-III, and III-V) in terms of cCMVi patients and healthy controls and described their changes in cCMVi patients throughout the first year of life. Of 101 cCMVi patients, 57 (56.4%) were considered symptomatic, 6 (5.9%) were small for gestational age, 6 (5.9%) had microcephaly, 4 (4%) had thrombocytopenia, 5 (6.6%) had hepatitis, 2 (2.1%) had retinitis, 47 (49.5%) had typical abnormalities on head ultrasound, 9 (8.9%) developed SNHL, and 34 (59.6%) received antiviral therapy. No significant difference was found between IPLDs of full-term cCMVi patients compared to controls throughout the entire auditory pathway (I-III, III-V, and I-V IPLDs), for both ears (p > 0.05). On serial BAEP examinations, cCMVi patients presented decreased IPLDs throughout the first year of life (p < 0.05 of compared 1st, 2nd, and 3rd BAEPs in both ears). Conclusions: Intrauterine cytomegalovirus infection does not affect the auditory brainstem maturation process in term neonates. Our findings support previous studies noting the normal neurodevelopmental outcome of asymptomatic cCMVi patients, suggesting antiviral treatment is not warranted in these cases. What is Known: • cCMVi is a leading cause of developmental delay and hearing loss. Treatment is recommended for patients with symptomatic diseases who are at significant risk of long-term sequelae. • It is unknown whether cCMVi affects the central nervous system maturation process. What is New: • We performed a neurophysiological evaluation of brainstem conduction by recording the BAEPs. We found that cCMVi has no significant impact on central conduction times along the auditory pathways in the brainstem at birth nor changes the neuronal maturation process during the first year of life. • Our findings suggest that cCMVi does not universally affect central nervous system maturation, supporting a highly selective approach when considering the benefits of antiviral therapy.
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Normal reference values of low frequency specific air-conducted auditory brainstem responses among normal hearing children of different ages: A retrospective observational study. Int J Pediatr Otorhinolaryngol 2023; 164:111409. [PMID: 36516533 DOI: 10.1016/j.ijporl.2022.111409] [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: 09/15/2022] [Revised: 11/28/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To explore and compare the normal reference values (NRV) for low frequency specific air-conducted tone-burst auditory brainstem response (tb-ABR) among children of different ages and with normal hearing, because tb-ABR is often used to supplement the lack of click-evoked ABR (click-ABR) frequency but the NRV of this response threshold in different populations remain inconclusive. METHODS This retrospective observational study included children younger than 5 years of age with normal hearing in Hubei Province between November 2020 and September 2021. These children came to center of audiology for audiological examination including click-ABR due to different purposes and had accepted suggestion of tb-ABR test (0.5 kHz, 1 kHz). The children were divided into 5 groups according to age (0-12, 13-24, 25-36, 37-48, and 49-60 months of age), and 20 children (40 ears) met the inclusion criteria were selected from each group. The responding thresholds, peak latencies (PL), and inter-peak latencies (IPL) of the major waves were counted and compared in each group. RESULTS NRV of responding thresholds (dBnHL) in children aged 0-12, 13-24, 25-36, 37-48, and 49-60 months were 27.25 ± 9.47, 22.63 ± 5.31, 21.5 ± 5.33, 18.25 ± 5.83, and 21.63 ± 6.24 at 0.5 kHz, and 23.63 ± 7.16, 20.88 ± 7.06, 22 ± 4.21, 17.75 ± 6.09, and 21.38 ± 4.53 at 1 kHz, respectively. The response thresholds of children aged 0-12 months were significantly higher compared to children in other age groups at 0.5 kHz (all P < 0.05) and significantly higher than in children aged 37-48 months at 1 kHz (P < 0.05). There were significant differences among children of different ages in Wave III (P < 0.001) and Wave V (P < 0.001) in the peak latencies, and Waves I-III (P = 0.003) and Waves I-V (P < 0.001) in the inter-peak latencies at 0.5 kHz. Also, there were significant differences among children of different ages in Wave III and Wave V in the PL, and Waves I-III, Waves III-V, and Waves I-V in the IPL at 1 kHz (all P < 0.001). CONCLUSION The NRV of tb-ABR at 0.5 kHz and 1 kHz might differ among children of different ages. Newborn infants (<12 months old) might have a higher response threshold, while children aged 37-48 months might have a lower response threshold. However, it was a retrospective analysis with a small sample size, prospective contrast studies with larger samples are needed in the future.
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Wang X, Carroll X, Zhang P, du Prel JB, Wang H, Xu H, Leeper-Woodford S. Exploring brainstem auditory evoked potentials and mental development index as early indicators of autism spectrum disorders in high-risk infants. Autism Res 2022; 15:2012-2025. [PMID: 36135806 DOI: 10.1002/aur.2821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 09/10/2022] [Indexed: 12/15/2022]
Abstract
This study of infants from Hubei Province, China examined brainstem auditory evoked potentials (BAEP) and mental development index (MDI) as possible early indicators associated with autism spectrum disorders (ASD). The 34 ASD cases and 102 controls who had recovered from perinatal conditions were matched for age, sex, gestational age, birth weight and maternal age. BAEP absolute latencies (AL) I, III, V and interpeak latencies (IPL) I-III, III-V, I-V were compared in ASD cases and controls at ages 1, 3 and 6 months. MDI scores were compared in these infants from 1 month to 2 years old. Multiple logistic regression analysis was performed to test associations among ASD, BAEP and MDI. Results showed BAEP AL I, V and IPL III-V prolonged in the ASD group (p < 0.001), and MDI scores in ASD cases sharply declining from 12 to 24 months (p < 0.001). Regression analysis revealed odds ratios (OR) indicating that ASD was likely associated with abnormal values of BAEP AL I at 1 and 3 months (ORAL I : 4.27; ORAL I : 4.13), and AL V at 6 months (ORAL V : 7.85). Lower MDI scores (MDI < 80) in infants at 1, 3, and 6 months were likely associated with ASD (ORMDI : 2.58; ORMDI : 3.83; ORMDI : 4.87). These data show that abnormal BAEP values and low MDI scores are independent factors associated with ASD, and that monitoring of BAEP and MDI during infancy might facilitate screening for ASD development.
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Affiliation(s)
- Xiaoyan Wang
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Xianming Carroll
- Department of Public Health, Mercer University College of Health Professions, Atlanta, Georgia, USA
| | - Ping Zhang
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Jean-Baptist du Prel
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | - Hong Wang
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Haiqing Xu
- Department of Child Health Care, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Sandra Leeper-Woodford
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, Georgia, USA
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Jiang JK, Wang C, Jiang ZD. Postnatal abnormality in brainstem neural conduction in neonatal bronchopulmonary dysplasia survivors. Pediatr Res 2022; 93:1679-1686. [PMID: 36042331 DOI: 10.1038/s41390-022-02222-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/12/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate postnatal neural conduction in the auditory brainstem in neonatal bronchopulmonary dysplasia (BPD) survivors. METHODS Thirty-two very preterm BPD survivors were studied at 57-58 weeks of postconceptional age. Brainstem auditory-evoked response was studied using maximum length sequence. Wave latencies and intervals were analyzed in detail. The controls were 37 normal term infants and 35 very preterm non-BPD infants. RESULTS Compared with normal term controls, BPD survivors showed significantly shortened I-III interval but significantly prolonged III-V interval and greater III-V/I-III interval ratio. Compared with very preterm non-BPD controls, BPD survivors showed a significant shortening in waves III latency and I-III interval, moderate prolonged III-V interval, and significantly greater III-V/I-III interval ratio. These differences were generally similar at all click rates used. The slopes of latency- and interval-click rate functions in BPD survivors did not differ significantly from the two control groups. CONCLUSIONS Brainstem neural conduction in BPD survivors differed from normal term and age-matched non-BPD infants; neural maturation is accelerated in caudal brainstem regions but delayed in rostral regions. Neonatal BPD survivors are associated with differential maturation in neural conduction at caudal and rostral brainstem regions, which may constitute an important risk for postnatal neurodevelopment in BPD survivors. IMPACT We found that brainstem neural conduction at PCA 57-58 weeks in neonatal BPD survivors differs from normal term and age-matched non-BPD infants. No major differences were found between normal term and very preterm non-BPD infants in brainstem auditory conduction. Neural conduction in BPD survivors is accelerated in caudal brainstem regions but delayed in rostral regions. Neonatal BPD survivors are associated with differential maturation in neural conduction at caudal and rostral brainstem regions. The abnormality may constitute an important risk for postnatal neurodevelopment in BPD survivors.
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Affiliation(s)
- James Ken Jiang
- Division of Neonatology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201112, China
| | - Cui Wang
- Division of Neonatology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201112, China
| | - Ze Dong Jiang
- Division of Neonatology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, 201112, China.
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12
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Jiang JK, Wang C, Yin R, Jiang ZD. Functional status of brainstem auditory pathway in babies born below 30 week gestation with necrotizing enterocolitis. Brain Dev 2022; 44:263-270. [PMID: 35042649 DOI: 10.1016/j.braindev.2021.12.008] [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: 11/04/2021] [Revised: 12/24/2021] [Accepted: 12/27/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Recent studies showed that neonatal necrotizing enterocolitis (NEC) adversely affects the brainstem auditory pathway in babies born at 30-40 week gestation. We compared the functional status of the pathway between babies born below 30 week gestation with NEC and those without NEC for any differences to understand whether NEC also affects the pathway in babies born at a smaller gestation. METHOD Brainstem auditory evoked response was studied at term in NEC babies born below 30 week gestation. The data obtained were compared with age-matched non-NEC babies for any abnormalities, and then compared with previously reported NEC babies born at 30-34 week gestation for any differences. RESULTS Although the latencies of waves I and III did not differ significantly between NEC and non-NEC babies, wave V latency in NEC babies was longer than in non-NEC babies at all click rates used. In particular, I-V interpeak interval, reflecting brainstem conduction time, in NEC babies was significant longer than in non-NEC babies. Wave V amplitude and the V/I amplitude ratios in NEC babies was smaller than in non-NEC babies at some click rates. The I-V interval in our NEC babies born below 30 week gestation was longer than in previously reported NEC babies born at 30-34 week gestation at all click rates. CONCLUSION NEC babies born below 30 week gestation are associated with delayed brainstem conduction time. Functional status of the brainstem auditory pathway in NEC babies born below 30 week gestation is less favorable than that in those with greater gestation.
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Affiliation(s)
- James Ken Jiang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Cui Wang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Rong Yin
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Ze Dong Jiang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
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13
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Burstein O, Geva R. The Brainstem-Informed Autism Framework: Early Life Neurobehavioral Markers. Front Integr Neurosci 2021; 15:759614. [PMID: 34858145 PMCID: PMC8631363 DOI: 10.3389/fnint.2021.759614] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/18/2021] [Indexed: 12/27/2022] Open
Abstract
Autism spectrum disorders (ASD) have long-term implications on functioning at multiple levels. In this perspective, we offer a brainstem-informed autism framework (BIAF) that traces the protracted neurobehavioral manifestations of ASD to early life brainstem dysfunctions. Early life brainstem-mediated markers involving functions of autonomic/arousal regulation, sleep-wake homeostasis, and sensorimotor integration are delineated. Their possible contributions to the early identification of susceptible infants are discussed. We suggest that the BIAF expands our multidimensional understanding of ASD by focusing on the early involvement of brainstem systems. Importantly, we propose an integrated BIAF screener that brings about the prospect of a sensitive and reliable early life diagnostic scheme for weighing the risk for ASD. The BIAF screener could provide clinicians substantial gains in the future and may carve customized interventions long before the current DSM ASD phenotype is manifested using dyadic co-regulation of brainstem-informed autism markers.
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Affiliation(s)
- Or Burstein
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Ronny Geva
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
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14
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Sininger YS, Condon CG, Gimenez LA, Shuffrey LC, Myers MM, Elliott AJ, Thai T, Nugent JD, Pini N, Sania A, Odendaal HJ, Angal J, Tobacco D, Hoffman HJ, Simmons DD, Fifer WP. Prenatal Exposure to Tobacco and Alcohol Alters Development of the Neonatal Auditory System. Dev Neurosci 2021; 43:358-375. [PMID: 34348289 DOI: 10.1159/000518130] [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: 04/09/2021] [Accepted: 06/25/2021] [Indexed: 11/19/2022] Open
Abstract
Prenatal exposures to alcohol (PAE) and tobacco (PTE) are known to produce adverse neonatal and childhood outcomes including damage to the developing auditory system. Knowledge of the timing, extent, and combinations of these exposures on effects on the developing system is limited. As part of the physiological measurements from the Safe Passage Study, Auditory Brainstem Responses (ABRs) and Transient Otoacoustic Emissions (TEOAEs) were acquired on infants at birth and one-month of age. Research sites were in South Africa and the Northern Plains of the U.S. Prenatal information on alcohol and tobacco exposure was gathered prospectively on mother/infant dyads. Cluster analysis was used to characterize three levels of PAE and three levels of PTE. Repeated-measures ANOVAs were conducted for newborn and one-month-old infants for ABR peak latencies and amplitudes and TEOAE levels and signal-to-noise ratios. Analyses controlled for hours of life at test, gestational age at birth, sex, site, and other exposure. Significant main effects of PTE included reduced newborn ABR latencies from both ears. PTE also resulted in a significant reduction of ABR peak amplitudes elicited in infants at 1-month of age. PAE led to a reduction of TEOAE amplitude for 1-month-old infants but only in the left ear. Results indicate that PAE and PTE lead to early disruption of peripheral, brainstem, and cortical development and neuronal pathways of the auditory system, including the olivocochlear pathway.
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Affiliation(s)
- Yvonne S Sininger
- Department of Head & Neck Surgery, University of California, Los Angeles, California, USA
- C&Y Consultants, Santa Fe, New Mexico, USA
| | - Carmen G Condon
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York, USA
| | - Lissete A Gimenez
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York, USA
| | - Lauren C Shuffrey
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Michael M Myers
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
| | - Amy J Elliott
- Center for Pediatric & Community Research, Avera Research Institute, Sioux Falls, South Dakota, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, South Dakota, USA
| | - Tracy Thai
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York, USA
| | - James D Nugent
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Nicolò Pini
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Ayesha Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Hein J Odendaal
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Science, Stellenbosch University, Cape Town, South Africa
| | - Jyoti Angal
- Center for Pediatric & Community Research, Avera Research Institute, Sioux Falls, South Dakota, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, South Dakota, USA
| | - Deborah Tobacco
- Center for Pediatric & Community Research, Avera Research Institute, Sioux Falls, South Dakota, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, South Dakota, USA
| | - Howard J Hoffman
- Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | | | - William P Fifer
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA
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15
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Jiang ZD, Wang C. Postnatal functional status of the brainstem auditory pathway in term infants after perinatal hypoxia-ischemia. J Matern Fetal Neonatal Med 2021; 35:3653-3658. [PMID: 33530810 DOI: 10.1080/14767058.2020.1836618] [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: 10/22/2022]
Abstract
OBJECTIVES To examine postnatal changes in the impaired brainstem auditory pathway in term infants after perinatal hypoxia-ischemia (HI). METHODS Brainstem auditory evoked response (BAER) was studied at 2-4 months of age in term infants who suffered perinatal HI. The BAER data obtained at various click rates in these infants were compared with those in age-matched normal term controls to detect any abnormalities. RESULTS The infants after HI showed a slight elevation in BAER threshold. Four (9.8%) infants had threshold elevation. At 21/s clicks, there was a slight decrease in wave I latency, and a slight increase in wave III and V latencies. However, the I-V and I-III intervals in these infants were significantly increased (p < .05 and .05), whereas III-V interval was slightly increased. At higher click rates of 51 and 91/s, all BAER variables showed similar changes, with only small variations. An abnormal increase in the I-V and/or I-III intervals was seen in 4 (9.8%) infants, who were not associated with BAER threshold elevation. CONCLUSIONS At 2-4 months of age, around 20% of the infants after perinatal HI showed a moderate degree of either peripheral or central impairment of the brainstem auditor pathway. Monitoring postnatal changes could provide valuable information for postnatal care of infants after perinatal HI.
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Affiliation(s)
- Ze Dong Jiang
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China
| | - Cui Wang
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China
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16
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Gina A, Bednarczuk NF, Jayawardena A, Rea P, Arshad Q, Saman Y. Association between in utero HIV exposure and auditory brainstem response. Neurology 2020; 95:928-930. [PMID: 33004599 DOI: 10.1212/wnl.0000000000010969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/18/2020] [Indexed: 11/15/2022] Open
Affiliation(s)
- Ayanda Gina
- From the School of Clinical Medicine (A.G., Y.S.), University of KwaZulu-Natal, Durban, South Africa; inAmind Laboratory (N.F.B., Q.A., Y.S.), Department of Psychology, Neuroscience and Behaviour, University of Leicester, Leicester, UK; King's College Hospital London (N.F.B.), Denmark Hill, London UK; E.N.T Department (A.J.), Massachusetts Eye and Ear Infirmary, Harvard Medical School; andE.N.T Department (P.R., Y.S.), Leicester Royal Infirmary, Leicester, UK
| | - Nadja F Bednarczuk
- From the School of Clinical Medicine (A.G., Y.S.), University of KwaZulu-Natal, Durban, South Africa; inAmind Laboratory (N.F.B., Q.A., Y.S.), Department of Psychology, Neuroscience and Behaviour, University of Leicester, Leicester, UK; King's College Hospital London (N.F.B.), Denmark Hill, London UK; E.N.T Department (A.J.), Massachusetts Eye and Ear Infirmary, Harvard Medical School; andE.N.T Department (P.R., Y.S.), Leicester Royal Infirmary, Leicester, UK
| | - Asitha Jayawardena
- From the School of Clinical Medicine (A.G., Y.S.), University of KwaZulu-Natal, Durban, South Africa; inAmind Laboratory (N.F.B., Q.A., Y.S.), Department of Psychology, Neuroscience and Behaviour, University of Leicester, Leicester, UK; King's College Hospital London (N.F.B.), Denmark Hill, London UK; E.N.T Department (A.J.), Massachusetts Eye and Ear Infirmary, Harvard Medical School; andE.N.T Department (P.R., Y.S.), Leicester Royal Infirmary, Leicester, UK
| | - Peter Rea
- From the School of Clinical Medicine (A.G., Y.S.), University of KwaZulu-Natal, Durban, South Africa; inAmind Laboratory (N.F.B., Q.A., Y.S.), Department of Psychology, Neuroscience and Behaviour, University of Leicester, Leicester, UK; King's College Hospital London (N.F.B.), Denmark Hill, London UK; E.N.T Department (A.J.), Massachusetts Eye and Ear Infirmary, Harvard Medical School; andE.N.T Department (P.R., Y.S.), Leicester Royal Infirmary, Leicester, UK
| | - Qadeer Arshad
- From the School of Clinical Medicine (A.G., Y.S.), University of KwaZulu-Natal, Durban, South Africa; inAmind Laboratory (N.F.B., Q.A., Y.S.), Department of Psychology, Neuroscience and Behaviour, University of Leicester, Leicester, UK; King's College Hospital London (N.F.B.), Denmark Hill, London UK; E.N.T Department (A.J.), Massachusetts Eye and Ear Infirmary, Harvard Medical School; andE.N.T Department (P.R., Y.S.), Leicester Royal Infirmary, Leicester, UK
| | - Yougan Saman
- From the School of Clinical Medicine (A.G., Y.S.), University of KwaZulu-Natal, Durban, South Africa; inAmind Laboratory (N.F.B., Q.A., Y.S.), Department of Psychology, Neuroscience and Behaviour, University of Leicester, Leicester, UK; King's College Hospital London (N.F.B.), Denmark Hill, London UK; E.N.T Department (A.J.), Massachusetts Eye and Ear Infirmary, Harvard Medical School; andE.N.T Department (P.R., Y.S.), Leicester Royal Infirmary, Leicester, UK.
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17
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Raposo D, Orfão J, Menezes M, Trindade-Soares M, Guimarães A, Freire F. Auditory Brainstem Response in Preterm Infants in the Neonatal Intensive Care Unit. Otolaryngol Head Neck Surg 2020; 164:884-888. [PMID: 32928029 DOI: 10.1177/0194599820955181] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To analyze auditory brainstem response (ABR) findings of preterm and term infants in the neonatal intensive care unit (NICU) with perinatal problems. STUDY DESIGN Case series with chart review. SETTING Secondary care hospital. METHODS Analysis consisted of a consecutive series of 101 infants (69 preterm and 32 term) admitted in the NICU of Hospital Fernando Fonseca between 2016 and 2018 with perinatal problems who underwent an ABR evaluation. RESULTS The major perinatal problems identified were hyperbilirubinemia, intravenous gentamicin >5 days, mechanical ventilation >5 days, congenital cytomegalovirus infection, meningitis, and periventricular hemorrhage. Gentamicin use significantly increased the absolute latency of wave I in preterm infants (95% CI, 0.01-0.37; P = .037). Mechanical ventilation significantly decreased the latency of wave V and intervals I-V and III-V in preterm infants (95% CI, -0.35 to -0.22; P = .026; 95% CI, -0.33 to -0.00; P = .001; 95% CI, -0.46 to 0.12; P = .049). Congenital cytomegalovirus significantly decreased interval III-V in preterm infants (95% CI, -0.36 to -0.01; P = .042).Multivariate analysis revealed that gentamicin use, lower gestational age, and lower birth weight predicted an increased ABR threshold in preterm infants (95% CI, 1.64-15.31; P = .016; 95% CI -1.72 to -0.09; P = .030; 95% CI, -14.55 to -0.63; P = .033). ABR measurements in term infants were not significantly altered, with the exception of an increased latency of wave III with a lower gestational age (95% CI, -0.49 to -0.01; P = .038). CONCLUSIONS These findings suggest that perinatal problems in the NICU significantly impair the ABR threshold and the auditory pathway maturational process in preterm but not term infants.
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Affiliation(s)
- Diogo Raposo
- Department of Otorhinolaryngology, Hospital Prof Doutor Fernando Fonseca, Lisbon, Portugal
| | - João Orfão
- Department of Otorhinolaryngology, Hospital Prof Doutor Fernando Fonseca, Lisbon, Portugal
| | - Marco Menezes
- Department of Otorhinolaryngology, Hospital Prof Doutor Fernando Fonseca, Lisbon, Portugal
| | | | - Ana Guimarães
- Department of Otorhinolaryngology, Hospital Prof Doutor Fernando Fonseca, Lisbon, Portugal
| | - Filipe Freire
- Department of Otorhinolaryngology, Hospital Prof Doutor Fernando Fonseca, Lisbon, Portugal
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18
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Kamita MK, Silva LAF, Magliaro FCL, Kawai RYC, Fernandes FDM, Matas CG. Brainstem auditory evoked potentials in children with autism spectrum disorder. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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19
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Kamita MK, Silva LAF, Magliaro FCL, Kawai RYC, Fernandes FDM, Matas CG. Brainstem auditory evoked potentials in children with autism spectrum disorder. J Pediatr (Rio J) 2020; 96:386-392. [PMID: 30802422 PMCID: PMC9432277 DOI: 10.1016/j.jped.2018.12.010] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/04/2018] [Accepted: 12/13/2018] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study aimed to analyze the neural encoding of verbal and nonverbal stimuli in individuals with autism spectrum disorder using brainstem auditory evoked potentials. METHODOLOGY Thirty individuals between 7 and 12 years of age and of both genders participated in this study. Fifteen were diagnosed with autism spectrum disorder, and 15 had typical development. All subjects had normal hearing and no other impairments. An electrophysiological hearing assessment was performed using brainstem auditory evoked potentials with click and speech stimuli. RESULTS In the brainstem auditory evoked potentials with click stimuli, the mean wave I latency was longer for the right ear in both groups, and interpeak intervals III-V were greater for the individuals with autism spectrum disorder. For brainstem auditory evoked potentials with speech stimuli, wave V latency was shorter in individuals with autism spectrum disorder. CONCLUSION These data suggest that individuals with autism spectrum disorder may have a dysfunction of the central auditory nervous system for nonverbal stimuli and faster neural encoding of the initial part of the verbal stimulus, suggesting hypersensitivity to complex sounds such as speech.
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Affiliation(s)
- Mariana Keiko Kamita
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento de Terapia Física, Fonoaudiologia e Terapia Ocupacional, São Paulo, SP, Brazil.
| | - Liliane Aparecida Fagundes Silva
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento de Terapia Física, Fonoaudiologia e Terapia Ocupacional, São Paulo, SP, Brazil
| | - Fernanda Cristina Leite Magliaro
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento de Terapia Física, Fonoaudiologia e Terapia Ocupacional, São Paulo, SP, Brazil
| | - Rebeca Yuko Couto Kawai
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento de Terapia Física, Fonoaudiologia e Terapia Ocupacional, São Paulo, SP, Brazil
| | - Fernanda Dreux Miranda Fernandes
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento de Terapia Física, Fonoaudiologia e Terapia Ocupacional, São Paulo, SP, Brazil
| | - Carla Gentile Matas
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), Departamento de Terapia Física, Fonoaudiologia e Terapia Ocupacional, São Paulo, SP, Brazil
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20
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van Manen MA. Towards the Womb of Neonatal Intensive Care. THE JOURNAL OF MEDICAL HUMANITIES 2019; 40:225-237. [PMID: 29130125 DOI: 10.1007/s10912-017-9494-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Within the mother's womb, life finds its first stirrings. The womb shelters the fetus, the growing child within. We recognize the existential traces of a wombed existence when a newborn calms in response to being held; when a newborn stills in response to his or her mother's heartbeat; and, when a newborn startles in the presence of bright light. Yet, how does experiential human life begin within another human being? What are the conditions and paths of becoming for the fetus within the womb? And for the child born early, what "womb" welcomes the premature child in neonatal intensive care?
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Affiliation(s)
- Michael A van Manen
- John Dossetor Health Ethics Centre, University of Alberta, 5-16 University Terrace, 8303 - 112 Street, Edmonton, AB, T6G 2T4, Canada.
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21
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Li M, Zhu L, Yao D, Xu L, Ji C. Maturation of auditory brainstem response in early term infants at 6 weeks and 9 months. Int J Pediatr Otorhinolaryngol 2019; 116:70-74. [PMID: 30554712 DOI: 10.1016/j.ijporl.2018.10.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/14/2018] [Accepted: 10/16/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Emerging evidence indicates that infants who were born between 37 and 38 weeks of gestation are at higher risk of adverse long-term neurodevelopmental outcomes. Yet little is known about the auditory neural maturation during the first year of their life. AIM To compare the development of auditory brainstem response in early term (ET, 37-38 weeks gestational age, GA) and full term (FT, 39-41 weeks GA) infants. METHODS 126 infants received ABR testing at 6 weeks. 107 of them returned for the second assessment at 9 months, among which, 93 completed the ABR recordings. Comparison of the ABR variables were made depending on gestational age. RESULTS Analysis of covariance (ANCOVA) was used to identify the differences in ABR outcomes between two groups. After controlling for confounders, latencies for wave III, V and I-III, III-V and I-V intervals were prolonged in ET group compared with FT group at 6 weeks (all p<0.03). ABR parameters of both groups developed as the infants got older. At 9 months, ET infants remain showing the longer wave V latency and I-V interval (all p < 0.02) than FT infants. CONCLUSION During early postnatal life, ET has a different pattern of functional auditory brainstem development comparing with FT infants. The prolonged auditory conduction time suggests less mature of the central auditory system in ET infants before 9 months.
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Affiliation(s)
- Mingyan Li
- Children's Hospital Zhejiang University School of Medicine, China
| | - Li Zhu
- Children's Hospital Zhejiang University School of Medicine, China
| | - Dan Yao
- Children's Hospital Zhejiang University School of Medicine, China
| | - Lin Xu
- Children's Hospital Zhejiang University School of Medicine, China
| | - Chai Ji
- Children's Hospital Zhejiang University School of Medicine, China.
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Fontes AA, Carvalho SADS, Andrade GMQD, Carellos EV, Romanelli RC, Resende LMD. Study of brainstem auditory evoked potentials in early diagnosis of congenital toxoplasmosis. Braz J Otorhinolaryngol 2018; 85:447-455. [PMID: 29929810 PMCID: PMC9443022 DOI: 10.1016/j.bjorl.2018.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 02/14/2018] [Accepted: 03/19/2018] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Congenital toxoplasmosis is an infectious disease with high prevalence in tropical countries. It is characterized by neurological, ophthalmological and auditory sequelae. OBJECTIVE The aim of this study was to evaluate and describe the brainstem auditory evoked potential in infants aged 1-3 months diagnosed with congenital toxoplasmosis and to compare them with infants of the same age group without the infection. METHODS This is an observational, analytical and cross-sectional study in which brainstem auditory evoked potential was investigated in infants with congenital toxoplasmosis. The following audiological exams were performed: transient-evoked otoacoustic emissions, clinical and automatic brainstem auditory evoked potential. RESULTS 100 children participated in the study, but the final sample consisted of 76 children. Of the 37 children with toxoplasmosis included in the study, 28 completed the neurological imaging evaluation, and of these, 3 (10.7%) showed an altered neurological examination. At the brainstem auditory evoked potential assessment, two children without toxoplasmosis and 10 children with congenital toxoplasmosis had results suggestive of alterations in the brainstem auditory pathway maturation. CONCLUSION 10 (27%) children were identified with a possible unilateral alteration in the electrophysiological assessment. There was a 5-fold higher risk for a child between 1 and 3 months of age with toxoplasmosis to have an altered brainstem auditory evoked potential compared to a child of the same age range without the infection.
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Affiliation(s)
- Aline Almeida Fontes
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Programa de Pós-Graduação em Ciências Fonoaudiológicas, Belo Horizonte, MG, Brazil.
| | - Sirley Alves da Silva Carvalho
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Fonoaudiologia, Belo Horizonte, MG, Brazil
| | | | - Ericka Viana Carellos
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Roberta Castro Romanelli
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Luciana Macedo de Resende
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Fonoaudiologia, Belo Horizonte, MG, Brazil
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Jiang ZD, Chen C. Short-term outcome of brainstem auditory function in term infants after discharge from the neonatal intensive care unit. J Matern Fetal Neonatal Med 2017; 31:2231-2236. [PMID: 28573891 DOI: 10.1080/14767058.2017.1338262] [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
OBJECTIVES To examine short-term outcome of brainstem auditory function in term infants after discharge from the neonatal intensive care unit (NICU). METHODS Brainstem auditory evoked response (BAER) was recorded and analysed at various click rates at 2-4 months of age in 43 term NICU graduates. The data were compared with those in age-matched normal controls. RESULTS The threshold of BAER in the NICU graduates was marginally elevated. The graduates also showed an increase in wave III latency at 91/s and wave V latency at all 21-91/s. The I-V interval was increased at 51 and 91/s, whereas the I-III and III-V intervals were slightly increased, with no significant differences from normal controls at any click rates. The amplitudes of waves I and V in the NICU graduates were moderately reduced at all click rates. Wave III amplitudes were reduced at 51 and 91/s. None of the slopes of BAER variables-rate functions in the NICU graduates differed significantly from normal controls. CONCLUSIONS The BAER was moderately abnormal in the NICU graduates, suggesting that brainstem auditory function is moderately impaired at 2-4 months of age after discharge. There is a need to monitor postnatal auditory and neural development for NICU graduates.
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Affiliation(s)
- Ze Dong Jiang
- a Division of Neonatology , Children's Hospital, Fudan University , Shanghai , China
| | - Chao Chen
- a Division of Neonatology , Children's Hospital, Fudan University , Shanghai , China
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Jiang ZD. Auditory impairment in infants with neonatal chronic lung disease is alleviated after term. Acta Paediatr 2017; 106:926-929. [PMID: 28295623 DOI: 10.1111/apa.13831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 03/08/2017] [Indexed: 11/26/2022]
Abstract
AIM Very premature infants with neonatal chronic lung disease (CLD) have been reported to have major auditory impairment at term, and we examined the outcomes in 30 infants after term age. METHODS Brainstem auditory evoked response (BAER) was recorded at a postconceptional age of 46-61 weeks in 13 CLD cases and 14 controls from China and 17 CLD cases and 22 controls from the UK. RESULTS The BAER threshold in the CLD infants was slightly higher. Clicks at the normal hearing level (60 dB) showed no significant differences between the cases and controls in the latencies of BAER waves I, III and V and the I-V interval. However, the CLD infants demonstrated marginal shortening in the I-III interval and a marginal increase in the III-V interval. The amplitudes of BAER waves in the CLD infants were all slightly smaller than the controls. At 70 and 40 dB normal hearing level, the BAER findings were similar to those obtained at 60 dB normal hearing level, with only small variations. CONCLUSION There were minor BAER abnormalities in the CLD infants, suggesting minor auditory impairment. The auditory impairment previously detected at the term date was later alleviated.
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Affiliation(s)
- Ze D Jiang
- Division of Neonatology, Children's Hospital, 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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Small-for-gestation birth exerts a minor additional effect on functional impairment of the auditory brainstem in high-risk babies born at late preterm. Clin Neurophysiol 2016; 127:3187-3194. [PMID: 27287885 DOI: 10.1016/j.clinph.2016.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 04/11/2016] [Accepted: 05/08/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To address if small-for-gestational-age (SGA) significantly affects the developing auditory brainstem in late preterm babies with perinatal problems (i.e. high-risk), providing valuable information for management of such babies. METHODS SGA and appropriate-for-gestational age (AGA) babies born at 33-36weeks of gestation were studied at term using maximum length sequence brainstem auditory evoked response in response to 91-910/s clicks. RESULTS Compared with AGA late preterm babies without perinatal problems (i.e. low-risk), the high-risk SGA babies manifested a significant increase in wave V latency and I-V interval at all 91-910/s clicks, and III-V interval at 455 and 910/s. The amplitude was smaller for wave I at 227 and 910/s, wave III at 910/s and wave V at 227 and 910/s. Compared with low-risk SGA babies, the high-risk SGA babies showed similarly abnormalities. Compared with high-risk AGA babies, the high-risk SGA babies manifested slightly different abnormalities. CONCLUSIONS Brainstem auditory response was abnormal in high-risk SGA late preterm babies. The abnormalities, suggesting brainstem auditory impairment, were slightly different from high-risk AGA late preterm babies. SIGNIFICANCE SGA birth exerts a minor additional effect on the impaired auditory brainstem in high-risk babies born at late preterm. For these babies, neuroprotective measures should mainly target at associated perinatal problems, although the relatively minor adverse SGA effect cannot be ignored.
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Jiang ZD, Xu ZM, Wilkinson AR. Comparison of maturational process of hearing threshold in early life between at-risk and low-risk preterm infants. Early Hum Dev 2016; 96:21-25. [PMID: 26990449 DOI: 10.1016/j.earlhumdev.2016.02.007] [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: 07/19/2015] [Revised: 01/14/2016] [Accepted: 02/16/2016] [Indexed: 11/19/2022]
Abstract
AIM To detect any abnormality in the maturational process of hearing threshold during the early life in at-risk preterm infants. STUDY DESIGN The threshold of brainstem auditory evoked response was recorded and analyzed longitudinally from 30 to 42weeks of postconceptional age in 357 at-risk infants born at 23-36weeks of gestation. The results were compared with those in 82 low-risk infants born at 30-42weeks at various postconceptional ages. RESULTS From 31 to 42weeks, the response threshold in the at-risk infants was consistently slightly higher than that in the low-risk infants. No statistically significant difference was found between the two groups of infants at any designated postconceptional ages. The threshold in the at-risk infants born at 23-29weeks of gestation tended to be higher than those born at 30-36weeks at various postconceptional ages, but the difference did not reach statistical significance. There was also no significant difference in the slope of BAER threshold-age function between the at-risk infants, irrespective of gestational ages, and the low-risk infants. CONCLUSION During the early life, hearing threshold in at-risk preterm, mainly very preterm, infants is marginally elevated, but the maturational process of the threshold is generally similar to that in low-risk infants, without notable abnormality.
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Affiliation(s)
- Ze D Jiang
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China.
| | - Zheng M Xu
- Department of ENT, Children's Hospital, Fudan University, Shanghai, China
| | - Andrew R Wilkinson
- Neonatal Unit, Department of Paediatrics, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
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Lecoq L, Gains M, Blond L, Parent J. Brainstem auditory evoked responses in foals: reference values, effect of age, rate of acoustic stimulation, and neurologic deficits. J Vet Intern Med 2015; 29:362-7. [PMID: 25619523 PMCID: PMC4858096 DOI: 10.1111/jvim.12499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 09/04/2014] [Accepted: 10/13/2014] [Indexed: 12/01/2022] Open
Abstract
Background Age and rate of acoustic stimulation affect peak latencies in brainstem auditory evoked responses (BAER) in humans. Those effects are unknown in foals. Hypothesis/Objectives Our goals were to (1) establish reference values for BAER in foals by using 3 different stimulation protocols, (2) evaluate the effects of age and stimulation frequencies on BAER tracing in foals up to 6 months old, and (3) compare the data with BAER obtained from foals with central nervous system (CNS) disorders. Animals Thirty‐nine neurologically normal foals and 16 foals with neurologic diseases. Methods Prospective observational clinical study. BAER recorded by using 3 protocols of stimulation (11.33 repetitions per second [Hz]/70 decibel normal hearing level [dBNHL]; 11.33 Hz/90 dBNHL; 90 Hz/70 dBNHL). Results No effect of age was observed in normal foals (P > .005). No significant difference was observed for latencies and interpeak latencies (IPL) when comparing foals with neurologic diseases and normal foals (P > .05), but 78.6% of foals with neurologic diseases had an asymmetry in their tracing, reflecting a difference in conduction time between the left and right side of the brainstem. Increasing the stimulation rate did not improve detection of CNS disorders. Conclusions and Clinical Importance We propose BAER reference values for foals up to 6 months of age by using 3 protocols. Most foals with neurologic deficits had abnormal BAER tracing.
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Affiliation(s)
- L Lecoq
- Département de Sciences Cliniques, Université de Montréal, Saint-Hyacinthe, QC, Canada
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Functional integrity of rostral regions of the immature brainstem is impaired in babies born extremely preterm. Clin Neurophysiol 2015; 127:1581-1588. [PMID: 26481063 DOI: 10.1016/j.clinph.2015.09.132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 09/23/2015] [Accepted: 09/25/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Babies born extremely preterm are predisposed to brain damage. We test the hypothesis that functional integrity of the auditory brainstem, particularly the rostral regions, is impaired in extremely preterm babies. METHODS We recruited 68 babies who were born at 23-27 weeks of gestation. At term date, these babies were studied by recording and analysing maximum length sequence brainstem auditory evoked response (MLS BAER) with click rates 91-910/s. Detailed data analysis was performed in 65 babies from whom reliable MLS BAER measurements were obtained. RESULTS Compared with normal term controls, the extremely preterm babies showed a significant increase in wave V latency, and I-V interval at all rates 91-910/s (p<0.01-0.001). Of two small intervals, I-III interval showed no apparent abnormality, but III-V interval was significantly increased at all rates, which was supported by a significant increase in III-V/I-III interval ratio (all p<0.001). These abnormalities were more significant at higher than at lower rates. The slopes of wave V latency-, I-V interval- and particularly III-V interval-rate functions were all increased. The same was true for the slope of III-V/I-III interval ratio-rate function. CONCLUSIONS MLS BAER variables that mainly reflect central neural conduction in the extremely preterm babies were abnormally increased. The most important abnormality was a significant increase in III-V interval and its click rate-dependent change. The abnormalities tended to be more significant than those previously reported in late and very preterm babies. SIGNIFICANCE Babies born extremely preterm have a major impairment or maturational delay in functional integrity of the rostral regions of the immature brainstem, which is more significant than in less preterm babies.
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Revuelta M, Arteaga O, Montalvo H, Alvarez A, Hilario E, Martinez-Ibargüen A. Antioxidant Treatments Recover the Alteration of Auditory-Evoked Potentials and Reduce Morphological Damage in the Inferior Colliculus after Perinatal Asphyxia in Rat. Brain Pathol 2015; 26:186-98. [PMID: 25990815 DOI: 10.1111/bpa.12272] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/01/2015] [Indexed: 01/17/2023] Open
Abstract
Maturation of the auditory pathway is dependent on the central nervous system myelination and it can be affected by pathologies such as neonatal hypoxic ischemic (HI) encephalopathy. Our aim was to evaluate the functional integrity of the auditory pathway and to visualize, by histological and cellular methods, the damage to the brainstem using a neonatal rat model of HI brain injury. To carry out this morphofunctional evaluation, we studied the effects of the administration of the antioxidants nicotine, melatonin, resveratrol and docosahexaenoic acid after hypoxia-ischemia on the inferior colliculus and the auditory pathway. We found that the integrity of the auditory pathway in the brainstem was altered as a consequence of the HI insult. Thus, the auditory brainstem response (ABR) showed increased I-V and III-V wave latencies. At a histological level, HI altered the morphology of the inferior colliculus neurons, astrocytes and oligodendricytes, and at a molecular level, the mitochondria membrane potential and integrity was altered during the first hours after the HI and reactive oxygen species (ROS) activity is increased 12 h after the injury in the brainstem. Following antioxidant treatment, ABR interpeak latency intervals were restored and the body and brain weight was recovered as well as the morphology of the inferior colliculus that was similar to the control group. Our results support the hypothesis that antioxidant treatments have a protective effect on the functional changes of the auditory pathway and on the morphological damage which occurs after HI insult.
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Affiliation(s)
- Miren Revuelta
- Department of Cell Biology and Histology, School of Medicine and Dentistry, University of the Basque Country, Leioa, Spain
| | - Olatz Arteaga
- Department of Cell Biology and Histology, School of Medicine and Dentistry, University of the Basque Country, Leioa, Spain
| | - Haizea Montalvo
- Department of Cell Biology and Histology, School of Medicine and Dentistry, University of the Basque Country, Leioa, Spain
| | - Antonia Alvarez
- Department of Cell Biology and Histology, School of Medicine and Dentistry, University of the Basque Country, Leioa, Spain
| | - Enrique Hilario
- Department of Cell Biology and Histology, School of Medicine and Dentistry, University of the Basque Country, Leioa, Spain
| | - Agustin Martinez-Ibargüen
- Department of Otorhinolaryngology, School of Medicine and Dentistry, University of the Basque Country, Leioa, Spain
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Mild maturational delay of the brainstem at term in late preterm small-for-gestation age babies. Early Hum Dev 2015; 91:265-9. [PMID: 25754195 DOI: 10.1016/j.earlhumdev.2015.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 01/24/2015] [Accepted: 02/17/2015] [Indexed: 11/21/2022]
Abstract
AIMS To detect any functional abnormality in the brainstem auditory pathway in late preterm babies born of small-for-gestational age (SGA) using maximum length sequence brainstem evoked response. STUDY DESIGN The response was recorded and analyzed at term in 38 SGA (birthweight <3rd centile) babies born at 33-36 week gestation. The results were compared with 40 age-matched babies born of appropriate-for-gestational age (AGA) (birthweight >10th centile). None of the subjects had major perinatal problems. RESULTS All wave latencies and interpeak intervals in the SGA group were slightly longer than those in the AGA group at most click rates. Wave III latency was significantly longer than that in the AGA group at 227/s (P < 0.05), and wave V latency was at 227 and 910/s (P < 0.05 and 0.05). Of the interpeak intervals, only the I-V interval in the SGA group was significantly longer than that in the AGA group at the highest rate 910/s (P < 0.05). The amplitudes of waves I, III and V in the SGA group all tended to be smaller than those in the AGA group at all click rates 91-910/s. The wave V amplitude was significantly smaller at most click rates (227-910/s, all P < 0.05). The slopes of all wave latency-, interval-, and amplitude-rate functions were similar in SGA and AGA groups. CONCLUSIONS There were marginal abnormalities in MLS BAER of low-risk late preterm SGA babies, suggesting a mild degree of maturational delay in the brainstem. Intrauterine growth retardation occurring in late preterm babies has a minor effect on neural maturation of the immature brainstem.
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Jiang ZD, Yin R, Wilkinson AR. Changes in hearing threshold between 28 and 42 weeks of age in babies born at under 30 weeks of gestation. Acta Paediatr 2015; 104:e143-7. [PMID: 25559263 DOI: 10.1111/apa.12920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 11/08/2014] [Accepted: 12/30/2014] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to describe changes in hearing thresholds in babies born below 30 weeks of gestation at 28-42 weeks of postconceptional age, detect differences between gestational ages and explore the prevalence of hearing impairment. METHODS The threshold of brainstem auditory evoked response (BAER) was obtained longitudinally at 28-42 weeks of postconceptional age in 71 babies born at 23-29 weeks of gestation. RESULTS The BAER threshold was 28 decibels above normal hearing level (dB nHL) at 28 weeks of postconceptional age and decreased to 13 dB nHL at 39-42 weeks. The threshold was slightly higher in babies born at 23-26 weeks of gestation than in those born at 27-29 weeks at most postconceptional ages studied. From 28 to 36 weeks, the threshold decreased at 0.98 dB/week. At term, BAER threshold elevation (>20 dB nHL) occurred in 12 (16.9%) of the 71 babies. CONCLUSION The hearing threshold of babies born at 23-29 weeks of gestation decreased from 28 dB at 28 weeks of postconceptional age to 13 dB at 42 weeks. There were no major differences between gestational ages. During the preterm period, the threshold changed at around 1 dB/week. At term, one in six babies had hearing impairment.
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Affiliation(s)
- Ze D. Jiang
- Division of Neonatology; Children's Hospital; Fudan University; Shanghai China
- Neonatal Unit; Department of Paediatrics; John Radcliffe Hospital; Oxford UK
| | - Rong Yin
- Division of Neonatology; Children's Hospital; Fudan University; Shanghai China
| | - Andrew R. Wilkinson
- Neonatal Unit; Department of Paediatrics; John Radcliffe Hospital; Oxford UK
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Wang C, Jiang ZD. Brainstem auditory response findings in very preterm babies in the intensive care unit. Neonatology 2015; 107:157-60. [PMID: 25572176 DOI: 10.1159/000368957] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 10/08/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is a need to increase our understanding of whether there is compromised brainstem auditory function in very preterm babies in intensive care. OBJECTIVES To evaluate brainstem auditory function in preterm babies born at 32 weeks of gestation or earlier in the intensive care unit to detect any abnormality and the prevalence of the abnormality. METHODS We analyzed the brainstem auditory evoked response (BAER) at term in 156 babies born at 32 weeks of gestation or earlier in an intensive care unit. The data were compared to those of normal term babies to detect any differences. RESULTS The threshold of BAER was elevated in babies born at 32 weeks of gestation or earlier. All BAER wave latencies were significantly increased. The I-V interpeak interval was also increased. The amplitudes of BAER components tended to be reduced. Twenty-five (16.0%) babies in the intensive care unit had a BAER threshold elevation (>20 dB normal hearing level), suggesting peripheral auditory dysfunction. Thirty-three (21.1%) had an increased I-V interval, and 3 (1.9%) had a decreased V/I amplitude ratio, suggesting central or brainstem auditory dysfunction. Some babies had more than one BAER abnormality. As a whole, 51 (32.7%) babies had BAER abnormalities. CONCLUSION Very preterm babies in the intensive care unit are at a high risk for auditory dysfunction. At term, 1 in 3 of these babies has peripheral and/or central auditory dysfunction.
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Affiliation(s)
- Cui Wang
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China
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Neonatal carotid repair at ECMO decannulation: patency rates and early neurologic outcomes. J Pediatr Surg 2015; 50:64-8. [PMID: 25598095 PMCID: PMC5285515 DOI: 10.1016/j.jpedsurg.2014.10.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 10/06/2014] [Indexed: 11/21/2022]
Abstract
PURPOSE Neonates placed on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) undergo either carotid repair or ligation at decannulation. Study aims were to evaluate carotid patency rates after repair and to compare early neurologic outcomes between repaired and ligated patients. METHODS A retrospective study of all neonates without congenital heart disease (CHD) who had VA-ECMO between 1989 and 2012 was completed using our institutional ECMO Registry. Carotid patency after repair, neuroimaging studies, and auditory brainstem response (ABR) testing at time of discharge were examined. RESULTS 140 neonates were placed on VA-ECMO during the study period. Among survivors, 84% of carotids repaired and imaged remained patent at last study. No significant differences were observed between infants in the repaired and ligated groups regarding diagnosis, ECMO duration, or length of stay. A large proportion (43%) developed a severe brain lesion after VA-ECMO, but few failed their ABR testing. Differences in early neurologic outcomes between the two groups of survivors were not significant. CONCLUSIONS At this single institution, carotid patency is excellent following repair at ECMO decannulation. No increased incidence of severe brain lesions or greater neurosensory impairment in the repair group was observed. Further studies are needed to investigate the effects of ligation on longer-term neurocognitive outcomes.
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Neural conduction impairment in the auditory brainstem and the prevalence in term babies in neonatal intensive care unit. Clin Neurophysiol 2014; 126:1446-52. [PMID: 25468245 DOI: 10.1016/j.clinph.2014.10.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/04/2014] [Accepted: 10/15/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To detect neural conduction abnormality in the auditory brainstem in term babies in the neonatal intensive care unit (NICU), determine prevalence of the abnormality, and assess if maximum length sequence (MLS) technique improves early detection of the abnormality. METHODS One hundred and six term babies were recruited, and studied by recording and analysing MLS brainstem auditory evoked response (BAER). Interpeak intervals were analysed in detail, which were then compared with those in normal term babies. RESULTS Wave V latency and I-V and III-V intervals in MLS BAER were increased in the NICU term babies at all click rates 91-910/s, particularly at 455 and 910/s (p<0.05-0.001). No major abnormalities were found in wave I and III latencies and I-III interval. The abnormal increase in I-V and III-V intervals were seen in significantly more cases at 455 and 910/s in MLS BAER than at 21/s in conventional BAER (X(2)=10.92-13.88, all p<0.01). As a whole, 38 (35.8%) of the NICU babies had abnormal III-V and/or I-V intervals in MLS BAER, which was significantly more than 13 (12.2%) in conventional BAER (X(2)=16.14, p<0.01). CONCLUSION There is neural conduction impairment in the auditory brainstem in NICU term babies, which occurs in one-third of these babies. SIGNIFICANCE Term babies in NICU are at risk of neural conduction impairment in the auditory brainstem. High click rates in MLS BAER enhance early detection of the impairment.
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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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Abstract
The newborn human infant is conscious at a minimal level. It is aware of its body, itself and to some extent of the outside world. It recognizes faces and vowels to which it has been exposed. It expresses emotions like joy. Functional magnetic resonance imaging of the newborn brain shows highest activity in the somatosensory, auditory, and visual cortex but less activity in association area and the prefrontal cortex as compared with adults. There is an incomplete default mode network which is assumed to be related to consciousness. Although the fetus reacts to pain, maternal speaking, etc., it is probably not aware of this due to the low oxygen level and sedation. Assuming that consciousness is mainly localized in the cortex, consciousness cannot emerge before 24 gestational weeks when the thalamocortical connections from the sense organs are established. Thus the limit of legal abortion at 22-24 weeks in many countries makes sense. It should also be possible to withdraw or withhold life-saving therapy of extremely preterm infants, especially if they are severely brain-damaged. This may also apply to full-term infants with grade III hypoxic-ischemic encephalopathy, who show no signs of consciousness.
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Affiliation(s)
- Hugo Lagercrantz
- Karolinska Institute and Astrid Lindgren Children's Hospital, Karolinska University Hospital X5:01, 171 76 Stockholm, Sweden.
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38
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Jiang ZD, Chen C. Impaired neural conduction in the auditory brainstem of high-risk very preterm infants. Clin Neurophysiol 2014; 125:1231-7. [DOI: 10.1016/j.clinph.2013.11.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 11/12/2013] [Accepted: 11/19/2013] [Indexed: 10/26/2022]
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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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Impaired function of the auditory brainstem in term neonates with hyperbilirubinemia. Brain Dev 2014; 36:212-8. [PMID: 23587715 DOI: 10.1016/j.braindev.2013.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/09/2013] [Accepted: 03/13/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We studied maximum length sequence brainstem auditory evoked response in term neonates with hyperbilirubinemia to further our understanding of hyperbilirubinemia on the neonatal auditory brainstem and to determine if maximum length sequence technique improves detection of brainstem auditory impairment due to bilirubin neurotoxicity. METHODS Maximum length sequence brainstem auditory evoked response was recorded and analysed shortly after confirming total serum bilirubin levels greater than 15mg/dL in fifty-seven term neonates with hyperbilirubinemia. RESULTS Most wave latencies and interpeak intervals in maximum length sequence brainstem auditory evoked response in the neonates with hyperbilirubinemia were correlated with the level of total serum bilirubin at some or most click rates used. Compared with age-matched normal term controls, wave V latency in these neonates was increased significantly at all 91-910/s click rates (p<0.05-0.001). The I-V and I-III interpeak intervals were also increased significantly at all these rates, and the III-V interval increased at 227-910/s clicks (p<0.05-0.001). The differences between the neonates with hyperbilirubinemia and the controls were more significant at higher than at lower click rates. The slopes of wave V latency-rate function and I-V and III-V interval-rate functions were all significantly increased. By comparison, the abnormalities in conventional BAER were less significant, with only I-III and I-V intervals were increased (both p<0.05). CONCLUSIONS Functional status of the auditory brainstem is impaired in neonatal hyperbilirubinemia. Maximum length sequence technique at high click rates improves detection of bilirubin neurotoxicity to the neonatal auditory brainstem, particularly for the more rostral regions.
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Källstrand J, Lewander T, Baghdassarian E, Nielzén S. A new method for analyzing auditory brain-stem response waveforms using a moving-minimum subtraction procedure of digitized analog recordings. Neuropsychiatr Dis Treat 2014; 10:1011-6. [PMID: 24944514 PMCID: PMC4057334 DOI: 10.2147/ndt.s59178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The auditory brain-stem response (ABR) waveform comprises a set of waves (labeled I-VII) recorded with scalp electrodes over 10 ms after an auditory stimulation with a brief click sound. Quite often, the waves are fused (confluent) and baseline-irregular and sloped, making wave latencies and wave amplitudes difficult to establish. In the present paper, we describe a method, labeled moving-minimum subtraction, based on digitization of the analog ABR waveform (154 data points/ms) in order to achieve alignment of the ABR response to a straight baseline, often with clear baseline separation of waves and resolution of fused waves. Application of the new method to groups of patients showed marked differences in ABR waveforms between patients with schizophrenia versus patients with adult attention deficit/hyperactivity disorder versus healthy controls. The findings show promise regarding the possibility to identify ABR markers to be used as biomarkers as support for clinical diagnoses of these and other neuropsychiatric disorders.
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Affiliation(s)
| | - Tommy Lewander
- Department of Neuroscience, Medical Faculty, Uppsala University, Uppsala, Sweden
| | - Eva Baghdassarian
- Department of Neuroscience, Medical Faculty, Uppsala University, Uppsala, Sweden ; Department of Psychiatry, Uppsala University Hospital, Uppsala, Sweden
| | - Sören Nielzén
- Department of Psychiatry, Medical Faculty, University of Lund, Lund, Sweden
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Ping LL, Jiang ZD. Comparison of brainstem auditory evoked response at different click rates between preterm babies after neonatal necrotizing enterocolitis and healthy preterm babies. Neonatology 2014; 106:317-22. [PMID: 25247311 DOI: 10.1159/000363491] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 05/07/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Neonatal necrotizing enterocolitis (NEC) is associated with an increased incidence of poor neurodevelopment. The knowledge of underlying neurophysiology is very limited, and the influence of NEC on the preterm brainstem is very poorly understood. OBJECTIVE To assess the effect of NEC on the immature auditory brainstem by excluding any possible confounding effect of preterm birth. METHODS We recorded and analyzed brainstem auditory evoked response (BAER) at different click rates in preterm babies (30-34 weeks gestation) after NEC. The results were compared with those in age-matched healthy preterm babies who had no NEC. RESULTS At click rate 21/s, the latencies of BAER waves I and III in the preterm NEC babies were similar to those babies without NEC. However, wave V latency was longer in the NEC babies than in those without NEC. The I-V interpeak interval was also longer in the NEC babies than in those without NEC. These abnormalities were persistent at higher click rates 51 and 91/s. Wave I amplitude in the preterm NEC babies did not differ significantly from that in those without NEC, but wave III and V amplitudes were smaller than in those without NEC at all 21-91/s clicks. CONCLUSIONS Compared with healthy preterm babies, preterm babies after NEC showed a major increase in wave V latency and I-V interval at all 21-91/s clicks. Brainstem auditory function is impaired in preterm NEC babies after excluding the possible confounding effect of preterm birth. Neonatal NEC and associated perinatal conditions adversely affect the premature brainstem.
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Affiliation(s)
- Li L Ping
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China
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Skoe E, Krizman J, Anderson S, Kraus N. Stability and plasticity of auditory brainstem function across the lifespan. Cereb Cortex 2013; 25:1415-26. [PMID: 24366906 DOI: 10.1093/cercor/bht311] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The human auditory brainstem is thought to undergo rapid developmental changes early in life until age ∼2 followed by prolonged stability until aging-related changes emerge. However, earlier work on brainstem development was limited by sparse sampling across the lifespan and/or averaging across children and adults. Using a larger dataset than past investigations, we aimed to trace more subtle variations in auditory brainstem function that occur normally from infancy into the eighth decade of life. To do so, we recorded auditory brainstem responses (ABRs) to a click stimulus and a speech syllable (da) in 586 normal-hearing healthy individuals. Although each set of ABR measures (latency, frequency encoding, response consistency, nonstimulus activity) has a distinct developmental profile, across all measures developmental changes were found to continue well past age 2. In addition to an elongated developmental trajectory and evidence for multiple auditory developmental processes, we revealed a period of overshoot during childhood (5-11 years old) for latency and amplitude measures, when the latencies are earlier and the amplitudes are greater than the adult value. Our data also provide insight into the capacity for experience-dependent auditory plasticity at different stages in life and underscore the importance of using age-specific norms in clinical and experimental applications.
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Affiliation(s)
- Erika Skoe
- Auditory Neuroscience Laboratory Department of Communication Sciences Northwestern University, Evanston, IL 60208, USA Current address: Department of Speech, Language and Hearing Sciences, Faculty Affiliate of the Department of Psychology, Faculty Affiliate of the Cognitive Sciences Program, University of Connecticut, Storrs, CT 06269, USA
| | - Jennifer Krizman
- Auditory Neuroscience Laboratory Department of Communication Sciences Bilingualism and Psycholinguistics Research Group Northwestern University, Evanston, IL 60208, USA
| | - Samira Anderson
- Auditory Neuroscience Laboratory Department of Communication Sciences Northwestern University, Evanston, IL 60208, USA Current address: Department of Hearing and Speech Science, University of Maryland, College Park, MD 20742, USA
| | - Nina Kraus
- Auditory Neuroscience Laboratory Department of Communication Sciences Institute for Neuroscience Department of Neurobiology and Physiology Department of Otolaryngology Northwestern University, Evanston, IL 60208, USA
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Jiang ZD. Neural conduction abnormality in the brain stem and prevalence of the abnormality in late preterm infants with perinatal problems. Eur J Pediatr 2013; 172:1033-8. [PMID: 23559329 DOI: 10.1007/s00431-013-1989-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 03/13/2013] [Indexed: 11/30/2022]
Abstract
UNLABELLED Neurodevelopment in late preterm infants has recently attracted considerable interest. The prevalence of brain stem conduction abnormality remains unknown. We examined maximum length sequence brain stem auditory evoked response in 163 infants, born at 33-36 weeks gestation, who had various perinatal problems. Compared with 49 normal term infants without problems, the late preterm infants showed a significant increase in III-V and I-V interpeak intervals at all 91-910/s clicks, particularly at 455 and 910/s (p < 0.01-0.001). The I-III interval was slightly increased, without statistically significant difference from the controls at any click rates. These results suggest that neural conduction along the, mainly more central or rostral part of, auditory brain stem is abnormal in late preterm infants with perinatal problems. Of the 163 late preterm infant, the number (and percentage rate) of infants with abnormal I-V interval at 91, 227, 455, and 910/s clicks was, respectively, 11 (6.5%), 17 (10.2%), 37 (22.3%), and 31 (18.7%). The number (and percentage rate) of infants with abnormal III-V interval at these rates was, respectively, 10 (6.0%), 17 (10.2%), 28 (16.9), and 36 (21.2%). Apparently, the abnormal rates were much higher at 455 and 910/s clicks than at lower rates 91 and 227/s. In total, 42 (25.8%) infants showed abnormal I-V and/or III-V intervals. CONCLUSION Conduction in, mainly in the more central part, the brain stem is abnormal in late preterm infants with perinatal problems. The abnormality is more detectable at high- than at low-rate sensory stimulation. A quarter of late preterm infants with perinatal problems have brain stem conduction abnormality.
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Affiliation(s)
- Ze Dong Jiang
- Department of Paediatrics, Children's Hospital, Fudan University, Shanghai, China.
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Ping LL, Jiang ZD. Changes in brainstem auditory response threshold in preterm babies from birth to late term. Acta Otolaryngol 2013; 133:607-11. [PMID: 23675811 DOI: 10.3109/00016489.2012.762115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The hearing threshold in preterm infants was 23 dB above adult hearing level at 30 weeks gestation, and decreased to around 13 dB at term date. There was no major difference in the threshold for infants born at different gestations. At term, 9% had hearing threshold elevation. OBJECTIVE To examine changes in hearing threshold from preterm to term in infants born at 30-36 weeks gestation and to detect the prevalence of threshold elevation. METHODS The threshold in brainstem auditory evoked response (BAER) was obtained 656 times from postconceptional age (PCA) 30 to 42 weeks in 268 infants born at 30-36 weeks gestation. RESULTS The BAER threshold was 23 dB nHL at the youngest age (PCA 30 weeks), and then decreased to around 13 dB nHL at later preterm and term dates (PCA 35-42 weeks). The threshold was decreased with increasing age at a rate of 1.24 dB per week from PCA 30 to 36 weeks and 0.65 dB per week from PCA 30 to 42 weeks. At PCA 33-42 weeks, there were no significant differences in BAER threshold between the infants born at gestational age (GA) 30-32 weeks and those at GA 33-36 weeks. At term, 9% had threshold elevation (>20 dB nHL).
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Affiliation(s)
- Li L Ping
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China
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Ye HB, Wang J, Zhang WT, Shi HB, Yin SK. Taurine attenuates bilirubin-induced neurotoxicity in the auditory system in neonatal guinea pigs. Int J Pediatr Otorhinolaryngol 2013; 77:647-54. [PMID: 23273639 DOI: 10.1016/j.ijporl.2012.11.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 11/17/2012] [Accepted: 11/20/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Previous work showed that taurine protects neurons against unconjugated bilirubin (UCB)-induced neurotoxicity by maintaining intracellular calcium homeostasis, membrane integrity, and mitochondrial function, thereby preventing apoptosis from occurring, in primary neuron cultures. In this study, we investigated whether taurine could protect the auditory system against the neurotoxicity associated with hyperbilirubinemia in an in vivo model. METHODS Hyperbilirubinemia was established in neonatal guinea pigs by intraperitoneal injection of UCB. Hearing function was observed in electrocochleograms (ECochGs) and auditory brainstem responses (ABRs) recorded before and 1, 8, 24, and 72 h after UCB injection. For morphological evaluations, animals were sacrificed at 8h post-injection, and the afferent terminals beneath the inner hair cells (IHCs), spiral ganglion neurons (SGNs), and their fibers were examined. RESULTS It was found that UCB injection significantly increased latencies and inter-wave intervals, and thresholds of ABR and compound action potentials, and caused marked damage to type I SGNs, their axons, and terminals to cochlear IHCs. When baby guinea pigs were pretreated with taurine for 5 consecutive days and then injected with bilirubin, electrophysiological abnormalities and morphological damage were attenuated significantly in both the peripheral and central auditory system. CONCLUSIONS From these observations, it was concluded that taurine limited bilirubin-induced neural damage in the auditory system. These findings may contribute to the development of taurine as a broad-spectrum agent for preventing and/or treating hearing loss in neonatal jaundice.
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Affiliation(s)
- Hai-Bo Ye
- Department of Otorhinolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiaotong University, 600 Yishan Road, Shanghai 200233, China
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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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Jiang ZD, Ping LL, Chen C, Wilkinson AR. Brainstem auditory response findings in preterm infants after necrotizing enterocolitis. Acta Paediatr 2012; 101:e531-4. [PMID: 22924748 DOI: 10.1111/apa.12000] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To examine brainstem auditory function and detect any abnormality at term in preterm infants after neonatal necrotizing enterocolitis (NEC). METHODS Brainstem auditory evoked response (BAER) was recorded at 21/sec and 60 dB nHL in 37 preterm infants who had NEC. The data obtained at term equivalent age were analyzed and compared with those in normal term infants. RESULTS The threshold of BAER in infants after NEC, though slightly elevated, did not differ significantly from that in the controls. The latencies of waves I and III were slightly longer than in the controls, without any statistical significance. However, wave V latency was prolonged and differed significantly from the controls (p < 0.01). I-V interpeak interval was also prolonged (p < 0.05). The data point distribution of wave V latency and I-V interval was higher in the infants after NEC than in the controls. The amplitudes of BAER wave components in the infants after NEC did not differ significantly from those in the controls. CONCLUSION Preterm infants after NEC have no major abnormality in peripheral auditory function. However, neural conduction in the brainstem auditory pathway is abnormal, suggesting that NEC adversely affects brainstem auditory conduction.
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Affiliation(s)
- Ze D Jiang
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China Neonatal Unit, Department of Paediatrics, John Radcliffe Hospital, Headington, Oxford, UK.
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Jiang ZD, Chen C, Wilkinson AR. Brainstem auditory response findings in term neonates in intensive care unit. J Matern Fetal Neonatal Med 2012; 25:2746-9. [PMID: 22880629 DOI: 10.3109/14767058.2012.718385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Whether term infants in neonatal intensive care unit (NICU) have brainstem auditory abnormalities remains to be determined. This study aimed to detect any abnormality in brainstem auditory function in term neonates who are admitted to NICU. METHODS From a NICU, we recruited 55 term neonates with various perinatal problems. They were studied during the first week after birth using brainstem auditory evoked response (BAER), and the results were compared with normal term controls. RESULTS Wave I and III latencies and I-III interpeak interval of the evoked response in the NICU term neonates were similar to those in the controls. Wave V latency and I-V and III-V interpeak intervals tended to be increased at 21/s clicks. The increase was more obvious at higher rates 51 and 91/s. Analysis of variance revealed that at 21/s clicks only III-V interval was significantly increased (p < 0.05). At 51 and 91/s clicks, wave V latency and III-V and I-V intervals were significantly increased (p < 0.05-0.01). The rates of the abnormalities were seen more at higher than at lower click rates. The amplitudes of waves I, III, and V in the NICU neonates were all slightly reduced, but none differed significantly from the controls. CONCLUSIONS There are some abnormalities in BAER in term neonates in NICU, suggesting functional abnormality in the auditory brainstem in NICU infants.
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Affiliation(s)
- Ze D Jiang
- Division of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
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Jiang ZD, Zang Z, Wilkinson AR. Cochlear function in 1-year-old term infants born with hypoxia-ischaemia or low Apgar scores. J Paediatr Child Health 2012; 48:160-5. [PMID: 21470333 DOI: 10.1111/j.1440-1754.2011.02066.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To examine the influence of perinatal hypoxia-ischaemia (HI) or low Apgar scores on distortion product otoacoustic emissions (DPOAEs) in infants at 1 year and detect any postnatal changes. METHODS Eighty-eight term infants born with perinatal HI or low Apgar scores alone were recruited at 1 year of age. The ears with type A tympanogram (normal) were studied with DPOAEs at 10 frequencies between 0.5 kHz and 10 kHz. RESULTS DPOAE pass rates were decreased at all frequencies 1-10 kHz, particularly 1 and 2 kHz in both infants born with HI and those with low Apgar scores (χ(2) = 3.80-15.09, P < 0.05-0.01). Overall pass rates in the two groups were also decreased (X(2) = 10.78 and 12.12, P < 0.01 and 0.01). No marked differences were found between infants born with HI and those with low Apgar score. Compared with those recorded at 1 and 6 months, DPOAE pass rates at 1 year were increased slightly in infants born with HI, but showed no marked changes in those born with low Apgar scores. CONCLUSIONS DPOAE pass rates, mainly at 1 and 2 kHz, were decreased at 1 year in infants born with perinatal HI and low Apgar scores, suggesting a relative poor cochlear function. Further studies are needed to ascertain the hearing acuity.
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Affiliation(s)
- Ze D Jiang
- Children's Hospital, Fudan University, Shanghai, China.
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