Abnormal Brainstem Auditory Evoked Potentials Research Articles

From periphery to center, untold story of pure neuritic leprosy: an electrophysiological study.

Pure neuritic leprosy (PNL) is uncommon form of leprosy involving peripheral nerves. Some isolated case reports have shown imaging changes in the central nervous system (CNS) and also impairment in visual evoked potential (VEP), somatosensory evoked potential (SSEP) and brain stem auditory-evoked potentials (BAEPs) parameters in PNL, but there is lack of large study. This prospective observational study evaluates impairment in these central conduction studies among PNL patients. We screened patients with leprosy presenting with features of neuropathy and/or thickened nerves. Patients with bacilli-positive nerve biopsies were included in the study and subjected to routine tests along with nerve conduction study (NCS), VEP, tibial SSEP and BAEPs. Parameters of these studies were analyzed based on data from previous studies. Of 76 patients screened for PNL 49 had positive findings in biopsy. Most of patients were male and mean age group was 46.35 ± 15.35years. Mononeuritis multiplex was most common NCS pattern in 46.93% (23/49) patients. We found abnormal VEP in 13 out of 35 patients (37.14%). Similarly abnormal SSEP and BAEPs among 42.85% and 40% patients respectively. This study shows that in PNL significant number of patients have subclinical CNS involvement. Exact pathophysiology of CNS involvement is not known till now but study of VEP, SSEP and BAEPs parameter may help in early diagnosis of PNL.

Multimodal evoked potentials are useful for the diagnosis of pediatric acute disseminated encephalomyelitis.

The application of evoked potentials (EPs) to the diagnosis of acute disseminated encephalomyelitis (ADEM ) has not been investigated in detail. The aim of this study, therefore, was to analyze the value of multimodal EPs in the early diagnosis of pediatric ADEM. This was a retrospective study in which we enrolled pediatric ADEM patients and controls (Cs) from neurology units between 2017 and 2021. We measured indices in patients using brainstem auditory evoked potentials (BAEPs), visual evoked potentials (VEPs) and somatosensory evoked potentials (SEPs), and then we analyzed their early diagnostic value in ADEM patients. The mean age of the ADEM group was 6.15 ± 3.28 years (range,1-12 years) and the male/female ratio was 2.1:1 The mean age of the Cs was 5.97 ± 3.40 years (range,1-12 years) and the male/female ratio was 1.3:1. As we used magnetic resonance imaging (MRI) as the diagnostic criterion, the sensitivity, specificity, and accuracy (κ was 0.88) of multimodal EPs were highly consistent with those of MRI; and the validity could be ranked in the following order with respect to the diagnosis of ADEM: multimodal Eps > single SEP > single VEP > single BAEP. Of 34 patients with ADEM, abnormalities in multimodal EPs were 94.12%, while abnormalities in single VEPs, BAEPs and SEPs were 70.59%,64.71%and 85.3%, respectively. We noted significant differences between single VEP/BAEPs and multimodal EPs (χ2 = 6.476/8.995,P = 0.011/0.003). The combined application of multimodal EPs was superior to BAEPs, VEPs, or SEPs alone in detecting the existence of central nerve demyelination, and we hypothesize that these modalities will be applicable in the early diagnosis of ADEM.

Brainstem auditory evoked potential variability in unmedicated schizophrenic patients

Background: Schizophrenia (SCZ) is one of the most incapacitating and financially disastrous medical conditions and ranks among the most severe and burdensome diseases in the world due to the onset, progression, and frequency of disability. Few researches have been reported that SCZ is linked to a number of neurophysiological abnormalities, including changes in brainstem auditory evoked potentials (BAEPs). Aims and Objectives: The current study aimedto measure brainstem function using BAEPs in patients with SCZ and compare their findings with healthy controls. Materials and Methods: A cross-sectional case–control study was conducted on 51 schizophrenic drug-naive patients selected from the outpatient department of psychiatry, fulfilling the diagnostic criteria of DSM-IV, aged 18-28 years, male and female, with a matching control group of 50 subjects recruited from patients’ relatives. For assessing the severity of SCZ, the positive and negative syndrome scale was utilized. The BAEPs were recorded using a brainstem-evoked response audiometry (BERA) device (NeuroStim-NS 2). Data were analyzed using Independent t-test and Mann–Whitney test based on normality. P-value was considered significant at P < 0.05, P < 0.01 level. Results: A significant difference was observed in patients and control group BAEPs. The absolute latency of waves I and III in the right ear, waves I and V, IPL I-III in the left ear was shown to be significantly different. The results demonstrate that the patient group’s mean latency was higher than the controls. Conclusion: Based on findings, it was concluded that abnormal BAEPs in schizophrenic patients might be attributed to their primary symptom of discontinuity in perceptual and other cerebral functions and slower transmission in the lower brainstem auditory pathway and decreased activity at the brainstem level.

A multidisciplinary non-invasive approach to monitor response to intravenous immunoglobulin treatment in neurodegenerative Langerhans cell histiocytosis: a real-world study.

Early detection and treatment of neurodegenerative Langerhans cell histiocytosis (ND-LCH) have been suggested to prevent neurodegenerative progression. The aim of the study is to validate a standardized multidisciplinary diagnostic work-up to monitor the intravenous immunoglobulins (IVIG) treatment response and the natural course of the disease in untreated patients. Patients with abnormal somatosensory evoked potentials (SEPs) received monthly 0.5 g/kg IVIG. The diagnostic protocol included structural 3T MRI, neurological examination, brainstem auditory evoked potentials (BAEPs) and SEPs. Twenty-two patients were followed for 5.2 years (median) from the first MRI evidence of ND-LCH. Eleven patients received IVIG for 1.7 years (median). At treatment start neurological examination was abnormal in 10 patients, of whom two had severe clinical impairment and four had abnormal BAEPs. At last follow-up, 1/11 remained stable and 7/11 improved, while worsening of neurological or neurophysiological findings, or both, occurred in 3/11. Risk factors for worsening were a severe clinical or MRI ND-LCH at treatment initiation and prolonged exposure to LCH. Of the 11 untreated patients, none improved and three worsened. Using a standardized diagnostic protocol, we demonstrated that IVIG treatment can lead to clinical stabilization or improvement in all pauci-symptomatic patients with an MRI grading of less than 4.

Study of the peripheral and central auditory pathways in patients with mucopolysaccharidosis

ObjectiveTo investigate the peripheral and central auditory pathways in mucopolysaccharidosis (MPS) individuals. MethodThe research sample comprised 15 individuals (one female and 14 males), aged 8 to 46 years. The following procedures were used: medical history survey, otoscopy, speech and pure-tone threshold audiometry, acoustic immittance measures, and central auditory pathway assessment with brainstem auditory evoked potentials (BAEP) and long-latency auditory evoked potentials (LLAEP). ResultsThe pure-tone audiometry identified hearing loss in 13 individuals, and more than 90 % of the hearing loss was sensorineural. The degree of hearing loss was between mild to moderately severe with descendent configuration. Type A tympanogram predominated, and acoustic reflexes were present according to the types and degrees of hearing loss. Among the individuals with abnormal BAEP, longer wave III and V absolute latencies were the main findings. In addition, the unilateral absence of wave I was observed in two cases. In the LLAEP, longer latencies were observed in 14 individuals, and the most impaired components were the P1 and P3 in children and adolescents and the P2, N2 and P3 in adult individuals. ConclusionThe peripheral auditory pathway assessment revealed a predominantly sensorineural hearing loss, affecting mainly high frequencies, and in the central pathway was observed abnormal brainstem and cortical auditory processing in individuals with MPS.

Auditory central pathways in children and adolescents with multiple sclerosis.

Multiple sclerosis (MS) is an inflammatory demyelinating disease. Auditory evoked potential studies have demonstrated conduction and neural processing deficits in adults with MS, but little is known about the electrophysiological responses in children and adolescents. to evaluate the central auditory pathway with brainstem auditory evoked potentials (BAEP) and long-latency auditory evoked potentials (LLAEP) in children and adolescents with MS. The study comprised 17 individuals with MS, of both sexes, aged 9 to 18 years, and 17 healthy volunteers, matched for age and sex. All individuals had normal hearing and no middle ear impairments. They were assessed with click-BAEP and LLAEP through oddball paradigm and tone-burst stimuli. Abnormal responses were observed in 60% of electrophysiologic assessments of individuals with MS. In BAEP, 58.82% of MS patients had abnormal responses, with longer wave V latency and therefore longer III-V and I-V interpeak latencies than healthy volunteers. In LLAEP, 52.94% of MS patients had abnormal responses. Although statistical differences were found only in P2-N2 amplitude, MS patients had longer latencies and smaller amplitudes than healthy volunteers in all components. Children and adolescents with MS had abnormal BAEP responses, with delayed neural conduction between the cochlear nucleus and the lateral lemniscus. Also, abnormal LLAEP results suggest a decrease in neural processing speed and auditory sensory discrimination response.

Self-Perception of Hearing Difficulties and Quality of Life in Individuals with Hearing Loss.

Objectives: To characterize the results of the Short Form Health Survey-36 (SF-36), Abbreviated Profile of Hearing Aid Benefit (APHAB), and the Hearing Handicap Inventory for Adults (HHIA) questionnaires in individuals with mild to moderate sensorineural hearing loss and compare them with brainstem auditory evoked potentials (BAEPs). Methods: There were 26 individuals with mild to moderate bilateral symmetrical sensorineural hearing loss who participated in the study. They were aged between 13 and 59 years old, right-hand preference, of both sexes, and were assigned to one of two groups according to the result of a BAEP test: normal (n = 16) or altered (n = 10). All subjects underwent a brief, cognitive screening battery and answered the SF-36, APHAB, and HHIA self-assessment questionnaires. For analysis of results, descriptive measures and inferential analysis were used. Results: On the SF-36 questionnaire, scores below 80 points were found in both groups, signifying minimal impact in the domains of pain, general health, vitality, and mental health compared to the other domains. The results of the APHAB questionnaire showed worse scores on the environmental noise subscale, and evaluation with the HHIA revealed a perception of severe restriction in participation in daily life activities. In a comparison between the groups, normal or abnormal BAEPs, no significant differences were found for any of the questionnaires. Conclusions: The results of the self-assessment questionnaires indicate that individuals with hearing loss can experience reduced quality of life, with limitations and restrictions for participation in daily living. The use of BAEPs as a criterion for dividing the groups was not effective in isolating the central component in the results of the self-assessment questionnaires.

Exploring brainstem auditory evoked potentials and mental development index as early indicators of autism spectrum disorders in high-risk infants.

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 6months. MDI scores were compared in these infants from 1month 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 3months (ORAL I : 4.27; ORAL I : 4.13), and AL V at 6months (ORAL V : 7.85). Lower MDI scores (MDI < 80) in infants at 1, 3, and 6months 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.

Visual and Brainstem Auditory-evoked Potentials Correlate with Specific Motor and Non-motor Symptoms in Parkinson's Disease

Parkinson’s disease (PD) is a common and complex neurodegenerative disease characterized by progressive motor and non-motor symptoms. The current study investigated the dysfunction of brain hemispheres and brainstem of PD patients and its relation to motor and non-motor symptoms using brainstem auditory evoked potentials (BAEP) and pattern reversal visual evoked potentials (p-VEP). We hypothesized that some motor and non-motor symptoms of PD due to specific dysfunctions of brainstem and brain hemispheres could be related to changes in p-VEP and BAEP. Accordingly, the aim of this study was to explore the abnormalities of BAEPs and p-VEPs in patients with PD and its correlation to the motor and non-motor symptoms of PD. Seventy-six nondemented PD patients took part in the p-VEP evaluations and 66 nondemented PD patients were included in BAEP evaluation. In order to compare the p-VEP performance of PD group, we included a control group comprising 32 age-matched participants. A BAEP substudy involved 29 age-matched healthy controls. All patients underwent a comprehensive motor and non-motor neuropsychological assessment. We found significant changes in all tested parameters of p-VEPs in PD patients compared to control subjects. In addition, these lower scores in p-VEP correlate with the results of some tests for cognition related to frontal-striatal dysfunction and contralateral rigidity, but not with the results of overall motor evaluation or other non-motor symptoms studied. In BAEP, PD patients have a significant prolongation of III and V wave latencies compared to controls. In addition, when examining the possible associations of BAEP with other non-motor manifestations of the disease, such association was observed only by the apathy scale. In conclusion, the current study confirms the visual and auditory abnormalities among PD patients thatreflect brain hemispheres and brainstem pathological changes. It also correlates these abnormalities to some motor and non-motor features of the disease, providing a localizing tool for associated brain hemispheres and brainstem dysfunctions. Furthermore, abnormal visual evoked potentials are associated with motor and non-motor symptoms due to the basal ganglia dysfunction. In contrast, abnormal auditory evoked potentials are connected with apathy, which is considered to be related with brainstem raphe nuclei dysfunction.

Effectiveness of Brainstem Auditory Evoked Potentials Scoring in Evaluating Brainstem Dysfunction and Disability Among Individuals With Multiple Sclerosis.

Purpose The brainstem dysfunction in multiple sclerosis (MS) often causes significant functional impairment leading to disability. This study aims to explore modified brainstem auditory evoked potential (BAEP) scores based on the pattern of BAEP abnormalities and relate with brainstem symptoms, brainstem functional system scores (BFSS), brainstem lesions, and disability. Method Forty-five participants with relapsing-remitting MS and 45 age- and gender-matched healthy controls underwent case history assessment, otoscopic examination, pure-tone audiometry, and BAEP testing. Also, neurological examination (Expanded Disability Status Scale, FSS scales) and magnetic resonance imaging were carried out on MS participants. Patterns of BAEP abnormalities were categorized and converted to BAEP scores. Results Out of 45 participants' brainstem symptoms, BFSS > 1, brainstem lesions (magnetic resonance imaging), and BAEP abnormalities were observed in 75.6%, 42.2%, 62.2%, and 55.56% of participants, respectively. Waves V and III abnormalities were more common among MS participants and showed a significant difference from the control group in the Mann-Whitney U test. Chi-square test did not show a significant association of BAEP abnormalities with brainstem symptoms and lesions but showed significant association with BFSS. The mean and standard deviation of BAEP scores in MS participants were 1.73 + 2.37. All healthy controls showed BAEP scores of 0. BAEP scores in MS participants showed significant correlation with BFSS scores and predict Expanded Disability Status Scale scores. Conclusion BAEP scores based on the pattern of BAEP abnormality can be a valid and useful measure in evaluating brainstem functions and predicting disability in MS.

Electrophysiological Evaluation of Audiovestibular Pathway Dysfunction in Parkinson's Disease and Its Correlates: A Case Control Study.

Background:Parkinson's disease (PD) is associated with brainstem dysfunction causing non-motor symptoms. Vestibular evoked myogenic potential (VEMP) and brainstem auditory evoked potential (BAEP) are electrophysiological tests to assess the vestibular and auditory pathways in the brainstem.Objectives:To study the abnormalities of cervical VEMP (cVEMP) and BAEP in PD and to correlate the findings with the symptoms related to brainstem involvement.Patients and Methods:cVEMP and BAEP were recorded in 25 PD patients and compared 25 age matched controls. The PD patients were assessed with the following clinical scales: REM Sleep Disorder Screening Questionnaire (RBD-SQ), Epworth Sleepiness Scale (ESS), mini-BESTest, Geriatric Depression Scale (GDS-15) and MMSE (Mini-mental state examination). The P13 and N23 peak latencies and the P13/N23 amplitude of cVEMP, the latencies of waves I, III and V, and the inter-peak latencies (IPL) of waves I-III, III-V and I-V of BAEP were measured.Results:The PD patients showed prolonged latencies and reduced amplitude in cVEMP responses. They had abnormal BAEP in the form of prolonged absolute latencies of wave V, followed by wave III and I–V IPL with no significant difference in waves I and I–III IPL. The cVEMP abnormality was correlated directly with RBD-SQ and inversely with mini-BESTest scores. There were no correlations between cVEMP/BAEP abnormality and disease severity, GDS-15, ESS and MMSE.Conclusion:PD is associated with cVEMP and BAEP abnormalities that suggest auditory and vestibular pathway dysfunction in the brainstem and cVEMP correlates with the symptoms of brainstem degeneration like RBD and postural instability.

Evoked Potentials in Patients With Wilson Disease

Wilson disease (WD) is an inherited disorder of copper metabolism presenting with a variety of symptoms but commonly as a liver or neuropsychiatric disease. Abnormal evoked responses are constantly found among patients with neurologic manifestations and sometimes in patients with hepatic presentation or in presymptomatic siblings. The aim of our study was to assess visual and brainstem auditory evoked potentials (BAEP) in patients with various presentation of WD. Visual evoked potentials (VEP) were performed in 36 WD patients and BAEP were done in 37 WD patients. Brainstem auditory evoked potentials were normal in patients with isolated hepatic presentation, whereas they were abnormal in 93.5% of patients with neurologic symptoms. There was significant prolongation of the latencies of the III and V waves and of the interpeak III-V and I-V latencies in comparison with the healthy controls (T-test P = 0). Abnormal VEP were observed in 81% of the patients including six of seven neurologically asymptomatic patients. The values of N75, P100, and N145 latencies were significantly longer in all patients than in healthy controls (T-test). The data showed that VEP and BAEP are more frequently abnormal in WD than previously reported. The abnormal VEP and BAEP even without clinical signs and brain MRI abnormalities point to subclinical involvement of visual and auditory pathways caused by copper toxicity. Because VEP and BAEP are noninvasive and widely available, they should be performed in all patents with WD.

Brainstem auditory evoked potentials in patients with primary Sj\xf6gren\u2019s syndrome without central nervous system involvement

ObjectivesPrimary Sjögren’s syndrome (pSS) is an autoimmune, multisystem exocrinopathy characterized by dysfunction of the exocrine glands. Central nervous system (CNS) involvement is estimated to be present in 10–60% patients with pSS. The present study aimed to evaluate brainstem auditory evoked potentials (BAEP) in pSS patients without central nervous system involvement, and without otolaryngological abnormalities.MethodThirty-six pSS patients (35 women, 1 man, mean age 48 years old) and 40 healthy volunteers were investigated. BAEP, brain imaging, laboratory parameters, and clinical neurological and otolaryngological examinations were performed.ResultsAbnormal BAEP were recorded in 16.7% patients. The mean wave BAEP I and V latency and mean wave III-V and I-V interpeak latencies were significantly longer in pSS patients than the controls. There were no statistically significant correlations between BAEP parameters and laboratory tests. None of the patients was found having the abnormalities on brain imaging.ConclusionsThis study confirms that in pSS patients without clinical central nervous system impairment, auditory pathway disturbances could be found. Disorders of brain bioelectrical activity may be a consequence of ongoing autoimmune process.Key Points• BAEP abnormalities confirmed the clinically observed involvement of the central nervous system in patients with pSS.• Brain bioelectrical activity dysfunctions in pSS patients may be a consequence of ongoing inflammatory and/or immunological processes.

P35-F Brainstem auditory evoked potentials in patients with primary Sjögren’s syndrome

Background Primary Sjogren’s syndrome (pSS) is a chronic autoimmune exocrinopathy characterized by dysfunction of exocrine glands. Central nervous system (CNS) involvement is estimated to be present in 3–60% patients with pSS. The aim of our study was to evaluate parameters of brainstem auditory evoked potentials (BAEP) in pSS patients without clinical neurological deficit, and without otolaryngological abnormalities. Material and methods 36 patients with pSS (35 women, 1 man, mean age 49.3 years old) and 40 healthy controls, sex and age-matched were studied. They did not suffer from disease that could have affected the brain electrical activity. Clinical neurological and otolaryngological examinations, laboratory parameters (C3 and C4 component, ANA antibodies, RF levels), brain imaging (CT or MRI) and BAEP were performed. Statistical analysis was performed using the Statistica 10.0 PL software. Results In none of the patients were the abnormalities on brain imaging found. Abnormal BAEP were recorded in 6 patients (16.6%). pSS patients had a longer mean wave I and V latency and mean wave III-V and I-V interpeak latencies than the controls. There were no correlations between BAEP parameters and laboratory tests. Conclusions 1. In pSS patients without clinical central nervous system impairment the auditory pathway disturbances could be found. 2. Disorders of the brain bioelectrical activity in the course of pSS may be associated with an ongoing autoimmune process. item The analysis of BAEP may be useful methods of assessment of the CNS in patients without clinical neurological symptom.

Assessment of audiovestibular system in patients with vitiligo: a case\u2013control study

BackgroundVitiligo is characterized by loss of epidermal melanocytes. Alterations in melanocytes in extracutaneous sites have been reported in vitiligo and sometimes implied for the inner ear along with an associated compromise in function.AimThe aim of this study was to map the auditory and vestibular functions in patients with vitiligo.Materials and methodsA total of 30 patients with vitiligo vulgaris and 30 age-matched and sex-matched healthy controls were enrolled in this study. Pure tone audiometry and measurements of auditory brainstem responses, cervical vestibular-evoked myogenic potential (cVEMP), and videonystagmography (VNG) were carried out in all participants.ResultsMean hearing thresholds of patients with vitiligo were highly statistically significantly lowered at 4 and 8 kHz than the controls. Analysis of brainstem auditory-evoked potentials (BAEP) revealed statistically significantly prolonged wave III, wave V, and interpeaks of I–III and I–V latencies in both ears of 18 (60%) patients and in the left ear of two (6.6%) patients in the vitiligo group than the controls. VNG findings showed canal paresis in nine (30%) patients. There was a negative statistically significant correlation between disease duration and pure tone audiometry, BAEP, and latency of N23 of cVEMP.ConclusionThis study sheds light on the importance of melanocytes for proper functioning of the auditory and vestibular system. The presence of high-frequency hearing loss, BAEP abnormalities, and cVEMP changes are valuable findings in patients with vitiligo. This highlights the importance of follow-up along the disease course for early detection of auditory abnormality. cVEMP testing can be used for the evaluation of the vestibulocolic reflex in patients with vitiligo. Moreover, VNG testing can be an important tool for assessment of the vestibular system in patients with vitiligo.

Electrophysiology of Cranial Nerve Testing: Auditory Nerve.

The electrocochleogram and brainstem auditory evoked potentials (BAEPs) are electrophysiologic signals used to assess the auditory nerve. The electrocohleogram includes the cochlear microphonic, the cochlear summating potential, and the eighth nerve compound action potential. It is used predominantly for hearing assessment and for diagnosis of Ménière disease and auditory neuropathy. Brainstem auditory evoked potentials are used for hearing assessment, diagnosis of dysfunction within the cochlea, the auditory nerve, and the brainstem auditory pathways up to the level of the mesencephalon, and intraoperative monitoring of these structures. The earliest BAEP component, wave I, and the eighth nerve compound action potential reflect the same process-the initial depolarization in the distal auditory nerve. Brainstem auditory evoked potential wave II receives contributions from the region of the cochlear nucleus and from the second depolarization in the distal auditory nerve. Wave III and later components are entirely generated rostral to the auditory nerve. Interpretation of BAEP studies is based on waves I, III, and V; auditory nerve dysfunction is manifested as prolongation of the I-III interpeak interval or absence of waves III and V. Eighth nerve tumors can cause a variety of BAEP abnormalities depending on which structures they affect. Adverse intraoperative BAEP changes can have many etiologies, including direct mechanical or thermal injury of tissue, ischemia (including cochlear ischemia or infarction due to compromise of the internal auditory artery), eighth nerve stretch, systemic or localized hypothermia, and artifactual BAEP changes due to technical factors.

P286 Visual and brainstem auditory evoked potentials abnormalities in the patients with systemic lupus erythematosus

Objectives Lupus erythematosus (SLE) is a systemic disease with possible nervous system involvement, regarded as unfavorable prognostic factor. Evoked potentials (EP) are electrophysiological markers of disturbed central nervous system (CNS) function, even in subclinical stage of CNS disorders. The purpose of the study was to evaluate parameters of EP in the patients with SLE with or without neuropsychiatric manifestation (NPSLE). Methods The study comprised 53 patients with SLE (49 women, 4 men, aged 21–62, mean 38.3) and 40 healthy, age- and gender- matched controls. 33 patients were classified as having NPSLE. Visual evoked potentials (VEP) and brainstem auditory evoked potentials (BAEP) were performed in all the subjects. Latencies and amplitudes of VEP and BAEP components were compared between SLE patients and controls and between NPSLE and non-NPSLE patients. Results Mean latency of P100 component of VEP for the right eye was significantly longer (104.3 ms vs 102.06 ms; p = 0.05) and mean amplitude of the I component of BAEP for the right ear was significantly lowered (0.25 μ V vs 0.30 μ V; p = 0.04) in the SLE patients in comparison with the controls. No differences were found between NPSLE and non-NPSLE patients. Discussion Asymmetric abnormalities of EP correspond with multifocal brain damage in the course of SLE, although they are not specific for the background of the disease. Conclusions and significance Parameters of VEP and BAEP show asymmetric abnormalities in SLE patients, regardless of the clinical symptoms of CNS involvement. EP may be considered as electrophysiological markers of early CNS dysfunction in the course of SLE.

Auditory- and Vestibular-Evoked Potentials Correlate with Motor and Non-Motor Features of Parkinson's Disease.

Degeneration of several brainstem nuclei has been long related to motor and non-motor symptoms (NMSs) of Parkinson’s disease (PD). Nevertheless, due to technical issues, there are only a few studies that correlate that association. Brainstem auditory-evoked potential (BAEP) and vestibular-evoked myogenic potential (VEMP) responses represent a valuable tool for brainstem assessment. Here, we investigated the abnormalities of BAEPs, ocular VEMPs (oVEMPs), and cervical VEMPs (cVEMPs) in patients with PD and its correlation to the motor and NMSs. Fifteen patients diagnosed as idiopathic PD were evaluated by Unified Parkinson’s Disease Rating Scale and its subscores, Hoehn and Yahr scale, Schwab and England scale, and Non-Motor Symptoms Scale. PD patients underwent pure-tone, speech audiometry, tympanometry, BAEP, oVEMPs, and cVEMPs, and compared to 15 age-matched control subjects. PD subjects showed abnormal BAEP wave morphology, prolonged absolute latencies of wave V and I–V interpeak latencies. Absent responses were the marked abnormality seen in oVEMP. Prolonged latencies with reduced amplitudes were seen in cVEMP responses. Rigidity and bradykinesia were correlated to the BAEP and cVEMP responses contralateral to the clinically more affected side. Contralateral and ipsilateral cVEMPs were significantly correlated to sleep (p = 0.03 and 0.001), perception (p = 0.03), memory/cognition (p = 0.025), and urinary scores (p = 0.03). The oVEMP responses showed significant correlations to cardiovascular (p = 0.01) and sexual dysfunctions (p = 0.013). PD is associated with BAEP and VEMP abnormalities that are correlated to the motor and some non-motor clinical characteristics. These abnormalities could be considered as potential electrophysiological biomarkers for brainstem dysfunction and its associated motor and non-motor features.

Smoking-induced oxidant/antioxidant imbalance in chronic obstructive pulmonary disease: Assessment of auditory evoked potential: A comparative study of smokers and non-smokers with or without chronic obstructive pulmonary disease

Background: Oxidative stress, inflammation, and hypoxia, which are associated with chronic obstructive pulmonary disease (COPD) may contribute to auditory impairment. Aims and Objectives: The present study was undertaken to assess the brainstem auditory evoked potential (BAEP) of smokers and non-smokers with or without COPD. Materials and Methods: The study comprised smokers with (n = 25) or without COPD (n = 15) and also healthy non-smokers (n = 30). Oxidative stress was assessed by malondialdehyde (MDA) and ferric reducing antioxidant power (FRAP). Pulmonary functions were determined. Data were analyzed using ANOVA and Pearson’s correlation tests. P < 0.05 was considered statistically significant. Results: Spirometric values were significantly lower in COPD group in comparison with other two groups. Oxidant/antioxidant imbalance was more in smokers with COPD. BAEP result (both right and left ear) showed no significant difference between non-smokers and smokers without COPD in Wave I (P = 0.885 and 0.085, respectively) and in wave II (P = 0.554 and 0.396, respectively). Significant difference (both ears) was found between non-smokers and smokers with and without COPD in waves III, IV, V, and IPL I-V. MDA showed significant negative and positive correlations with FRAP, wave latencies, and IPL. Significant negative correlation was found between pack years and FRAP. However, non-significant positive correlation was found with MDA. Significant positive correlation was found between pack years and wave latencies III, IV, and V and interpeak latency I-V in both ears. Conclusion: Smoking-induced oxidative stress as well as increased susceptibility to COPD, which in turn led to hypoxia and effects the auditory mechanisms and these are responsible for BAEP abnormalities.

Brainstem auditory evoked potentials in neurophysiological assessment of brain stem dysfunction in patients with atherostenosis of vertebral arteries

To assess brain stem dysfunction in patients with hemodynamically significant stenosis of vertebral arteries (VA) using short latency brainstem auditory evoked potentials (BAEP). The study group included 50 patients (mean age 64±6 years) with hemodynamically significant extracranial VA stenosis. Patients with hemodynamically significant extracranial VA stenosis had BAEP abnormalities including the elongation of interpeak intervals I-V and peak V latency as well as the reduction of peak I amplitude. After transluminal balloon angioplasty with stenting of VA stenoses, there was a shortening of peak V latency compared to the preoperative period that reflected the improvement of brain stem conductive functions. Atherostenosis of vertebral arteries is characterized by the signs of brain stem dysfunction, predominantly in the pontomesencephal brain stem. After transluminal balloon angioplasty with stenting of VA, the improvement of brain stem conductive functions was observed.