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Rance G, Tomlin D, Yiu EM, Zanin J. Remediation of Perceptual Deficits in Progressive Auditory Neuropathy: A Case Study. J Clin Med 2024; 13:2127. [PMID: 38610891 PMCID: PMC11012630 DOI: 10.3390/jcm13072127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Auditory neuropathy (AN) is a hearing disorder that affects neural activity in the VIIIth cranial nerve and central auditory pathways. Progressive forms have been reported in a number of neurodegenerative diseases and may occur as a result of both the deafferentiation and desynchronisation of neuronal processes. The purpose of this study was to describe changes in auditory function over time in a patient with axonal neuropathy and to explore the effect of auditory intervention. METHODS We tracked auditory function in a child with progressive AN associated with Charcot-Marie-Tooth (Type 2C) disease, evaluating hearing levels, auditory-evoked potentials, and perceptual abilities over a 3-year period. Furthermore, we explored the effect of auditory intervention on everyday listening and neuroplastic development. RESULTS While sound detection thresholds remained constant throughout, both electrophysiologic and behavioural evidence suggested auditory neural degeneration over the course of the study. Auditory brainstem response amplitudes were reduced, and perception of auditory timing cues worsened over time. Functional hearing ability (speech perception in noise) also deteriorated through the first 1.5 years of study until the child was fitted with a "remote-microphone" listening device, which subsequently improved binaural processing and restored speech perception ability to normal levels. CONCLUSIONS Despite the deterioration of auditory neural function consistent with peripheral axonopathy, sustained experience with the remote-microphone listening system appeared to produce neuroplastic changes, which improved the patient's everyday listening ability-even when not wearing the device.
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Affiliation(s)
- Gary Rance
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC 3053, Australia; (D.T.); (J.Z.)
| | - Dani Tomlin
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC 3053, Australia; (D.T.); (J.Z.)
| | - Eppie M. Yiu
- Department of Neurology, Royal Children’s Hospital, Parkville, VIC 3052, Australia
- Neurosciences Research, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Julien Zanin
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC 3053, Australia; (D.T.); (J.Z.)
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Qiu Y, Wang H, Pan H, Ding X, Guan J, Zhuang Q, Wu K, Lei Z, Cai H, Dong Y, Zhou H, Lin A, Wang Q, Yan Q. NADH improves AIF dimerization and inhibits apoptosis in iPSCs-derived neurons from patients with auditory neuropathy spectrum disorder. Hear Res 2024; 441:108919. [PMID: 38043402 DOI: 10.1016/j.heares.2023.108919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
Auditory neuropathy spectrum disorder (ANSD) is a hearing impairment involving disruptions to inner hair cells (IHCs), ribbon synapses, spiral ganglion neurons (SGNs), and/or the auditory nerve itself. The outcomes of cochlear implants (CI) for ANSD are variable and dependent on the location of lesion sites. Discovering a potential therapeutic agent for ANSD remains an urgent requirement. Here, 293T stable transfection cell lines and patient induced pluripotent stem cells (iPSCs)-derived auditory neurons carrying the apoptosis inducing factor (AIF) p.R422Q variant were used to pursue a therapeutic regent for ANSD. Nicotinamide adenine dinucleotide (NADH) is a main electron donor in the electron transport chain (ETC). In 293T stable transfection cells with the p.R422Q variant, NADH treatment improved AIF dimerization, rescued mitochondrial dysfunctions, and decreased cell apoptosis. The effects of NADH were further confirmed in patient iPSCs-derived neurons. The relative level of AIF dimers was increased to 150.7 % (P = 0.026) from 59.2 % in patient-neurons upon NADH treatment. Such increased AIF dimerization promoted the mitochondrial import of coiled-coil-helix-coiled-coil-helix domain-containing protein 4 (CHCHD4), which further restored mitochondrial functions. Similarly, the content of mitochondrial calcium (mCa2+) was downregulated from 136.7 % to 102.3 % (P = 0.0024) in patient-neurons upon NADH treatment. Such decreased mCa2+ levels inhibited calpain activity, ultimately reducing the percentage of apoptotic cells from 30.5 % to 21.1 % (P = 0.021). We also compared the therapeutic effects of gene correction and NADH treatment on hereditary ANSD. NADH treatment had comparable restorative effects on functions of ANSD patient-specific cells to that of gene correction. Our findings offer evidence of the molecular mechanisms of ANSD and introduce NADH as a potential therapeutic agent for ANSD therapy.
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Affiliation(s)
- Yue Qiu
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China; Institute of Brain Science, Wannan Medical College, Wuhu, Anhui 241000, China
| | - Hongyang Wang
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, the Sixth Medicine Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Huaye Pan
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Xue Ding
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Jing Guan
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, the Sixth Medicine Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Qianqian Zhuang
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Kaiwen Wu
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, the Sixth Medicine Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Zhaoying Lei
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Huajian Cai
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Yufei Dong
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Hui Zhou
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Aifu Lin
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Qiuju Wang
- Department of Audiology and Vestibular Medicine, Senior Department of Otolaryngology, Head and Neck Surgery, Chinese PLA Institute of Otolaryngology, the Sixth Medicine Center of Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
| | - Qingfeng Yan
- College of Life Science, Zhejiang University, Hangzhou, Zhejiang 310058, China; Department of Pediatrics, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China; Key Laboratory for Cell and Gene Engineering of Zhejiang Province, Hangzhou, Zhejiang 310058, China.
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Morlet T, Valania J, Walter C, Morini G, O'Reilly RC, Parkes W, Pritchett C. Cortical Auditory Evoked Potential Testing in Children With Auditory Neuropathy Spectrum Disorder. Am J Audiol 2023:1-12. [PMID: 38048283 DOI: 10.1044/2023_aja-23-00051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
PURPOSE In the present report, we reviewed the role of cortical auditory evoked potentials (CAEPs) as an objective measure during the evaluation and management process in children with auditory neuropathy spectrum disorder (ANSD). METHOD We reviewed the results of CAEP recordings in 66 patients with ANSD aged between 2 months and 12 years and assessed the relationship between their characteristics (prevalence, morphology, latencies, and amplitudes) and various clinical features, including the mode of medical management. RESULTS Overall, the CAEPs were present in 85.2% of the ears tested. Factors such as prematurity, medical complexity, neuronal issues, or presence of syndromes did not have an effect on the presence or absence of CAEPs. CAEP latencies were significantly shorter in ears with cochlear nerve deficiency than in ears with a normal caliber nerve. Three different patterns of CAEP responses were observed in patients with bilateral ANSD and present cochlear nerves: (a) responses with normal morphology and presence of both P1-P2complex and N2 components, (b) responses with abnormal morphology and presence of the N2 component but undefined P1-P2complex peak, and (c) entirely absent responses. None of the patients with normal, mild, or moderate degree of hearing loss had a complete absence of CAEP responses. No significant differences were uncovered when comparing the latencies across unaided and aided children and children who later received cochlear implants. CONCLUSIONS The CAEP protocol used in our ANSD program did inform about the presence or absence of central auditory stimulation. Absent responses typically fit into an overall picture of complete auditory deprivation and all of these children were ultimately offered cochlear implants after failing to develop oral language. Present responses, on the other hand, were acknowledged as a sign of some degree of auditory stimulation but always interpreted with caution given that prognostic implications remain unclear.
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Affiliation(s)
- Thierry Morlet
- Auditory Physiology and Psychoacoustics Research Laboratory, Nemours Children Hospital, Wilmington, DE
- Department of Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark
- Osborne College of Audiology, Salus University, Elkins Park, PA
| | | | - Cassidy Walter
- Department of Speech, Language and Hearing Sciences, The George Washington University, Washington, DC
| | - Giovanna Morini
- Department of Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark
| | | | - William Parkes
- Department of Otolaryngology, Nemours Children Hospital, Wilmington, DE
| | - Cedric Pritchett
- Department of Otolaryngology, Nemours Children Hospital, Orlando, FL
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