Brainstem Auditory Evoked Potentials Research Articles

Novel standardized indexes of brainstem auditory evoked potentials for predicting hearing preservation in vestibular schwannomas

Hearing preservation (HP) during vestibular schwannomas (VSs) surgery poses a significant challenge. Although brainstem auditory evoked potentials (BAEPs) on the affected side are commonly employed to monitor cochlear nerve function, their low signal-to-noise ratio (SNR) renders them susceptible to interferences, compromising their reliability. We retrospectively analyzed the data of patients who underwent tumor resection, while binaural brainstem auditory evoked potentials (BAEPs) were simultaneously recorded during surgery. To standardize BAEPs on the affected side, we incorporated the synchronous healthy side as a reference (interval between affected and healthy side ≤ 3 min). A total of 127 patients were enrolled. Comparison of the raw BAEPs data pre- and post-tumor resection revealed that neither V-wave amplitude (Am-V) nor latency (La-V) could serve as reliable predictors of HP simultaneously. However, following standardization, V-wave latency (STIAS-La-V) and amplitude (STIAS-Am-V) emerged as stable predictors of HP. Furthermore, the intraoperative difference in V-wave amplitude (D-Am-V) predicted postoperative HP in patients with preoperative HP and remained predictive after standardization. The utilization of intraoperative synchronous healthy side BAEPs as a reference to eliminate interferences proves to be an effective approach in enhancing the reliability of BAEPs for predicting HP in VSs patients.

Evaluation of audiovestibular functions in patients with posterior circulation cerebrovascular stroke

BackgroundIt has been found that 25% of posterior circulation stroke patients experience vertigo. Sudden hearing loss due to a vascular source is typically caused by infarction in the anterior inferior cerebellar artery territory. However, it is uncommon in the posterior inferior cerebellar artery territory infarction.Aim of the workThe objective of the proposed study is to evaluate the function of the auditory and vestibular system in patients with posterior circulation cerebrovascular stroke.MethodsFifty patients with posterior circulation stroke, diagnosed by MRI at least 3 months after onset, were included. The controls consisted of fifty healthy people. The average age in cases was 58.68 ± 8.60 years, while in controls, it was 55.44 ± 11.72. The Health Stroke Scale (NIHSS) was used to conduct clinical assessments. All study groups were investigated using pure tone audiometry, auditory brain stem-evoked potential (ABR), videonystagmography (VNG), and vestibular-evoked myogenic potential (VEMP).ResultsMRI findings revealed that pontine infarction was the most frequent lesion in 36 (72%) patients. The latencies of ABR waves I, III, V, 1–III, I–V, and III–V were all considerably longer in cases than controls. Cervical VEMP P1 latency was considerably delayed in cases compared to controls, as the amplitude was lower. VNG data found abnormalities in all test parameters, indicating central disease.ConclusionPosterior circulation stroke causes acute sensorineural hearing loss with varying degrees. Videonystagmography is an accurate assessment of oculomotor function that can be combined with vestibular-evoked myogenic potential to objectively assess posterior circulation stroke patients.

Genetic and phenotypic analysis of 225 Chinese children with developmental delay and/or intellectual disability using whole-exome sequencing

Developmental delay (DD), or intellectual disability (ID) is a very large group of early onset disorders that affects 1–2% of children worldwide, which have diverse genetic causes that should be identified. Genetic studies can elucidate the pathogenesis underlying DD/ID. In this study, whole-exome sequencing (WES) was performed on 225 Chinese DD/ID children (208 cases were sequenced as proband-parent trio) who were classified into seven phenotype subgroups. The phenotype and genomic data of patients with DD/ID were further retrospectively analyzed. There were 96/225 (42.67%; 95% confidence interval [CI] 36.15–49.18%) patients were found to have causative single nucleotide variants (SNVs) and small insertions/deletions (Indels) associated with DD/ID based on WES data. The diagnostic yields among the seven subgroups ranged from 31.25 to 71.43%. Three specific clinical features, hearing loss, visual loss, and facial dysmorphism, can significantly increase the diagnostic yield of WES in patients with DD/ID (P = 0.005, P = 0.005, and P = 0.039, respectively). Of note, hearing loss (odds ratio [OR] = 1.86%; 95% CI = 1.00-3.46, P = 0.046) or abnormal brainstem auditory evoked potential (BAEP) (OR = 1.91, 95% CI = 1.02–3.50, P = 0.042) was independently associated with causative genetic variants in DD/ID children. Our findings enrich the variation spectrums of SNVs/Indels associated with DD/ID, highlight the value genetic testing for DD/ID children, stress the importance of BAEP screen in DD/ID children, and help to facilitate early diagnose, clinical management and reproductive decisions, improve therapeutic response to medical treatment.

The effects of upper cervical spine manual therapy on central sensitization and brainstem auditory evoked potentials in subjects with migraine and neck pain

BackgroundMigraine is an important disease due to its impact on global health. Due to association of neck pain with migraine, manual therapy (MT) often used in management. The aim of this study was to evaluate the effects of upper cervical spine MT on specific mechanisms including central sensitization (CS) and brainstem auditory evoked potentials (BAEPs) in subjects with migraine and neck pain. Methods30 subjects with migraine and neck pain (30 female, mean age 43.10 ± 8.13) were randomly assigned to a medication plus MT (MedMT) group, a medication plus sham manual therapy (sham MT) group, and a medication alone (Med) group. CS was evaluated using the Central Sensitization Inventory (CSI) and BAEP determined electrophysiologically in all subjects pre and post intervention. Subjects in MedMT and sham MT groups received either 4 sessions of MT or sham MT. All subjects received medication. ResultsSubjects in MedMT group had a significant reduction in CSI score (P < 0.05) compare to the other 2 groups. For BAEPs, MedMT and sham MT groups had significantly decreased wave V latency on the right side (P < 0.05) compared to Med group. DiscussionManual therapy plus medication may have beneficial effects in people with migraine and neck pain by normalizing central sensitization levels. Additionally, upper cervical manual therapy or sham manual therapy have demonstrable neurophysiological effects reflected by changes in the auditory transmission pathways in the brainstem. Further research is required to investigate the mechanisms of action of MT in migraine.

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.

Characteristics of Auditory Brainstem Response in Night-shift Health Workers

Background: With technological advancement and economic competitiveness there is an exponential rise in the number of shift workers. Worldwide, healthcare workers constitute the single largest proportion of workers who work on shift duty in order to provide round-the-clock healthcare services to patients. Various studies have demonstrated an association between circadian cycle disturbance due to shift work and adverse health impacts. Purpose: The purpose of the study was to investigate the impact of night shift work on the brainstem-evoked auditory potentials in nursing interns who had been assigned to their first night shift after working day shifts. Methods: A longitudinal, self-case-control study was designed with a sample of 67 nursing interns. Brainstem evoked response audiometry (BERA) had been done after completion of their first posting in Day-shift and then after completion of Night-shift. The paired t-test was used for data analysis. Results: The findings of the study showed significant changes in latencies of wave II ( p &lt; .0001), wave IV ( p &lt; .0001), wave V ( p = .012 &amp; .30), interpeak latency III-V ( p = .009 &amp; .003) and V/I ratio ( p &lt; .0001) for both ears. Conclusions: BERA is an objective non-invasive test to evaluate hearing ability by measuring increased latency and interaural latency difference. After night shift, there were significant changes in auditory acuity which was highly suggestive of delayed transmission in auditory pathway. Hearing impairment has a cascading effect on cognition which may affect night-shift workers’ daily activities and may lead to medical error and risk to patient safety.

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 &lt; 0.05, P &lt; 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.

Late-onset of Labyrinthine Dysfunction in Chronic Brucella-induced Encephalitis

Brucellosis, caused by Brucella, dominates in the Middle East. Acute or chronic brucellosis can involve any organ system, and the involvement of the central nervous system leads to encephalitis, called neurobrucellosis (NB). We report a rare case from north India where a variant of Brucella caused NB led to progressive labyrinthine dysfunction; who developed vertigo, disequilibrium, and gradual progressive sensorineural (SN) hearing loss. Audiological tests pure-tone audiometry (PTA), otoacoustic emissions (OAE), stapedial muscle reflexes, auditory evoked brainstem responses (ABR), and vestibular evoked myogenic potentials (VEMPs) were conducted on the patients. PTA showed a bilateral profound SN hearing loss, an absent OAE, and ABR suggestive of cochlear dysfunction. The cervical and ocular VEMP showed delayed n1 and p1 latencies, suggesting superior and inferior nerve branch involvement. Vertigo or disequilibrium and SN hearing loss can be the late-onset manifestations of labyrinthine dysfunction in chronic Brucella-induced encephalitis.

A Comparative Study on Brainstem Auditory-Evoked Response between Dogs and Cats

A Comparative Study on Brainstem Auditory-Evoked Response between Dogs and Cats

Evoked potential response in patients with idiopathic Parkinson’s disease and atypical parkinsonian syndromes: A comparative study

Patients with idiopathic Parkinson&amp;rsquo;s disease (IPD) and atypical parkinsonian syndromes (APSs) suffer from a range of disorders, especially in balance and locomotion, which necessitate visual, auditory, and somatosensory inputs. In this study, IPD patients, APS patients, and healthy controls (HCs) (n = 50 per group) underwent a series of assessments for visual evoked potentials (VEP), brainstem auditory evoked response (BAER), and short-latency somatosensory evoked potentials (SSEP). Results showed that VEP P100 latency was prolonged in multiple system atrophy-cerebellar type (MSA-C), multiple system atrophy-parkinsonian type (MSA-P), and corticobasal ganglionic degeneration (CBD) patients. The latency of peaks III and V was prolonged in IPD, MSA-C, dementia with Lewy bodies (DLB), and Parkinson&amp;rsquo;s disease dementia (PDD). BAER I-III and I-V interpeak latency were prolonged in IPD, DLB, and PDD, whereas BAER I-III, III-V, and I-V interpeak latencies were increased and the V/I amplitude ratio was decreased in MSA-C. The central sensory conduction time (N20-N13) was increased in MSA-P and MSA-C in SSEP. IPD patients had prolonged VEP P100 latency (P &lt; 0.001), lower VEP N75-P100 amplitude (P &lt; 0.001), prolonged BAER I, II, II, IV, V peak latencies (P &lt; 0.001), I-III, I-V interpeak latencies (P &lt; 0.001), lower BAER V/I amplitude ratio (P &lt; 0.001), and prolonged SSEP N13, N20, central sensory conduction time (N20-N13) (P &lt; 0.001) than HCs. IPD patients also had prolonged BAER I, II, II, IV, V peak latencies (P &lt; 0.001), prolonged I-III, I-V interpeak latencies (P &lt; 0.001), and shorter SSEP N13, N20, central sensory conduction time (N20-N13) (P &lt; 0.001) than APS patients. Moreover, APS patients had prolonged VEP P100 and N145 latencies (P &lt; 0.001) and decreased N75-N145 amplitude (P &lt; 0.001) compared to HCs. APS patients also had prolonged BAER II, II, IV, V peak latencies (P &lt; 0.001), prolonged I-III, III-V, I-V interpeak latencies (P &lt; 0.001), decreased V/I amplitude ratio, and prolonged SSEP N13, N20, central sensory conduction time (N20-N13) (P &lt; 0.001) than HCs. Postural instability and gait disorder (PIGD) IPD had significantly prolonged BAER III, V peak latencies (P &lt; 0.05), and prolonged III-V interpeak latencies (P &lt; 0.05) compared to tremor-dominant IPD. Overall, the IPD and APS patients had significant VEP, BAER, and SSEP abnormalities of demyelination and axonal variety in the visual, auditory, and somatosensory pathways. The changes were also correlated with the disease duration and severity. Although the diseases are predominantly motor disorders with significant non-motor components, these electrophysiological abnormalities might open a new avenue to assess the non-motor symptoms.

The efficacy and safety of transcutaneous auricular vagus nerve stimulation for patients with minimally conscious state: a sham-controlled randomized double-blind clinical trial.

Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a potentially effective neuromodulation technique for addressing neurological disorders, including disorders of consciousness. Expanding upon our prior clinical study, which demonstrated the superior effectiveness of a 4-week taVNS treatment in patients with minimally conscious state (MCS) compared to those in a vegetative state/unresponsive wakefulness state, the aim of this investigation was to evaluate the safety and therapeutic efficacy of taVNS in individuals with MCS through a sham-controlled randomized double-blind clinical trial. A cohort of 50 adult patients (male = 33, female = 17) diagnosed with a MCS were randomly assigned to either the active taVNS (N = 25) or sham taVNS (N = 25) groups. The treatment period lasted for 4 weeks, followed by an 8-week follow-up period. The Coma Recovery Scale-Revised (CRS-R) and Glasgow Coma Scale (GCS) were administered at baseline and weekly during the initial 4 weeks. Additionally, the Disability Rating Scale (DRS) was used to assess the patients' functional abilities via telephone at week 12. Furthermore, various neurophysiological measures, including electroencephalogram (EEG), upper-limb somatosensory evoked potentials (USEP), brainstem auditory evoked potentials (BAEP), and P300 event-related potentials (P300), were employed to monitor changes in brain activity and neural conduction pathways. The scores for the active taVNS group in the CRS-R and GCS showed greater improvement over time compared to the sham taVNS group (CRS-R: 1-week, Z = -1.248, p = 0.212; 2-week, Z = -1.090, p = 0.276; 3-week, Z = -2.017, p = 0.044; 4-week, Z = -2.267, p = 0.023. GCS: 1-week, Z = -1.325, p = 0.185; 2-week, Z = -1.245, p = 0.213; 3-week, Z = -1.848, p = 0.065; 4-week, Z = -1.990, p = 0.047). Additionally, the EEG, USEP, BAEP, and P300 also demonstrated significant improvement in the active taVNS group compared to the sham taVNS group at week 4 (EEG, Z = -2.086, p = 0.037; USEP, Z = -2.014, p = 0.044; BAEP, Z = -2.298, p = 0.022; P300 amplitude, Z = -1.974, p = 0.049; P300 latency, t = 2.275, p = 0.027). Subgroup analysis revealed that patients with MCS derived greater benefits from receiving taVNS treatment earlier (CRS-R, Disease duration ≤ 1-month, mean difference = 8.50, 95% CI = [2.22, 14.78], p = 0.027; GCS, Disease duration ≤ 1-month, mean difference = 3.58, 95% CI = [0.14, 7.03], p = 0.044). By week 12, the active taVNS group exhibited lower Disability Rating Scale (DRS) scores compared to the sham taVNS group (Z = -2.105, p = 0.035), indicating a more favorable prognosis for MCS patients who underwent taVNS. Furthermore, no significant adverse events related to taVNS were observed during treatment. The findings of this study suggest that taVNS may serve as a potentially effective and safe intervention for facilitating the restoration of consciousness in individuals diagnosed with MCS. This therapeutic approach appears to enhance cerebral functioning and optimize neural conduction pathways. http://www.chictr.org.cn, Identifier ChiCTR2200066629.

Neuroprotective Effects of Artificial Cerebrospinal Fluid: Analysis of Brainstem Auditory-Evoked Potential Monitoring During Microvascular Decompression in 117 Consecutive Patients.

To study the efficacy of irrigation with artificial cerebrospinal fluid (aCSF) for protection of cranial nerves during surgery; the time required for recovery of brainstem auditory-evoked potentials (BAEPs) that would reflect cochlear function was analyzed in comparison with that for saline irrigation. This retrospective study included 117 consecutive patients (95 women, mean age 51.5 ± 11.4 year) who underwent microvascular decompression for hemifacial spasm. During surgery, BAEPs were monitored to avoid damage to the auditory pathways. When a delayed latency of >1 ms or a decrease in amplitude of >50% was detected in BAEP wave V, surgical maneuvers were halted, and the operative field was irrigated with saline or aCSF. Saline was used for irrigation in 58 patients and aCSF in the other 59. The time required for BAEP recovery at the first halt in each patient was analyzed, and the results were compared between the groups. Surgical procedures were interrupted because of BAEP latency delays or decreases in amplitude in 51 of the patients in the saline group and 54 in the aCSF group. In both groups, the latencies and amplitudes recovered significantly with time and both recovered earlier after aCSF irrigation than after saline irrigation. Hearing outcome was not significantly different between 2 groups. aCSF is effective for protection of cochlear nerve and promotes recovery from transient dysfunction during surgery. The protective effect may be attributed to multiple factors including conditioned pH, electrolyte composition, glucose, and microelements, such as magnesium and phosphate.

Histological Reaction in the Round Window Membrane after Cochlear Implant Insertion in Nonhuman Primates

Introduction: The primary objective of this article was to determine if any histological alterations occur in the round window (RW) and adjacent anatomical structures of an animal model with normal hearing when a cochlear implant (CI) electrode array is inserted. Furthermore, this article aims to relate these histological alterations to the auditory changes generated. Methods: Cochlear implantation was performed, following the principles of minimally traumatic surgery (MTS), in 15 ears of nonhuman primates (Macaca fascicularis) (Mf) with normal hearing. Auditory brainstem-evoked potentials (ABR) using clicks and tones were used prior to surgery and during a 6-month follow-up period. Histological evaluation was carried out, analyzing the position of the electrode array with respect to the round window membrane (RWM), its percentage of occupation and integrity, the presence of intracochlear damage, and the tissue reaction provoked, the latter of which was quantified in the temporal bones. Results: Surgery was performed on all 15 ears without relevant incidences. Regarding histology, the electrode array in the RW of all ears presented a lateral position with respect to the modiolus. No lesions affecting the integrity of the RW were observed. The mean value of the array’s occupation in the RW was 25%. Tissue reaction, in the form of fibrosis, was observed in all ears and more intensely in the trans-RWM and post-RWM areas. In all ears, the electrodes remained on the scala tympani. No profound hearing impairment was recorded in any ear, being the mean loss of 25.4 dB when comparing presurgical thresholds with those collected 6 months after implantation in ABR click and 24.4 dB in ABR tone burst. Conclusions: The animal model and Hybrid L-14 (HL14) electrode array were optimal for implementing a surgical technique similar to that routinely performed on humans. Mild histological alterations were observed in the round window membrane and adjacent anatomical structures from the insertion of a cochlear implant electrode array. Following the minimally invasive technique, levels of hearing preservation were satisfactory, reaching a pre-post difference of 25.4 dB in the ABR click and 24.4 dB for a high-frequency tone burst. Complete hearing impairment was not observed in either ear. Correlation between the severity of histological alterations and hearing changes recorded in the ABR studies was observed.

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.

Frequency of hearing loss in children with cerebral palsy and parents’ perception regarding their child’s hearing.

Objective: To determine frequency of hearing loss in cerebral palsy (CP) children and perception of child’s hearing and brain evoked response auditory (BERA) / brainstem auditory evoked potential (BAEP) results in CP patients. Study Design: Cross-sectional study. Setting: Department of Pediatric Neurology, Liaquat National Hospital, Karachi. Period: January 2022 to December 2022. Material &amp; Methods: The parents of all the CP children having cerebral palsy and who were nor assessed for hearing screening at birth (newborn hearing screening) were included. In child neurology clinic, parents were interviewed for the perception of the hearing of the child. Parental perception, CP type and the BERA results were recorded. Results: Total 102 patients were studied with median age of 27.9 (IQR= 17 – 48) months. Majority of the patients were normally delivered (n=59, 57.8%). Nearly quarter of them underwent neonatal screening (n=22, 21.6%). Majority of mothers (n=85, 83.3%) and father (n=80, 78.4%) had perception of hearing. BERA test was normal for 44 (43.1%) children. Age was significantly higher among patients with abnormal results. Frequency mothers’ perception of normal hearing was higher in abnormal BERA result. Frequency of difficult speech was higher in patients with abnormal BERA results. Conclusion: The frequency of hearing loss was high among children with CP. Frequency of mothers’ perception of their CP child’s normal hearing was higher when compared to the father’s perception.

Brainstem auditory evoked potentials in microvascular decompression for hemifacial spasm: A prospective study

ObjectiveThe aim of this prospective study is to identify the factors influencing postoperative hearing loss (HL) and explore effective strategies for reducing postoperative hearing complications following microvascular decompression (MVD) for hemifacial spasm (HFS). MethodsFrom January 2018 to January 2023, we enrolled a total of 55 patients who underwent MVD for HFS at our institution. Intraoperative monitoring of brainstem auditory evoked potentials (BAEPs) was conducted in all surgeries, beginning from the induction of general anesthesia and continuing until skin closure. Prior to surgery and one month after, pure-tone audiometry (PTA) evaluations were performed to evaluate HL. We conducted an analysis to identify factors that influenced postoperative HL. Our examination focused on the occurrence of postoperative HL, considering changes in BAEPs, and we evaluated the diagnostic accuracy of significant warning criteria. ResultsIn this study, a total of 55 patients (37 women and 18 men) with a mean age of 52.5 ± 13.4 years (range 24–80) were included. Among them, 5 patients (9.1 %) experienced postoperative HL. The variations in other risk factors based on the pattern of HL were not statistically significant (p > 0.05), whereas surgical experience showed significance (p = 0.028). Notably, the group of patients who showed wave V loss in intraoperative BAEPs was found to be significantly associated with postoperative HL. ConclusionSurgical experience is a factor influencing postoperative HL. Intraoperative changes in BAEPs, particularly loss of wave V, were found to be a significant indicator of poorer recovery of hearing capacity after MVD for HFS.

Subclinical neural hearing alterations in school children with type 1 diabetes mellitus

Background and objectivesEvidence has shown a cause-and-effect relationship between type 1 diabetes mellitus and auditory and cognitive dysfunctions. This study aimed to investigate the effect of type 1 diabetes mellitus (T1DM) on central auditory and cognitive functions in school-age children and adolescents. MethodsThe study sample consisted of 101 children and adolescents, 50 with T1DM, of both sexes, aged between 7 and 18 years. All participants were selected for a structured interview on hearing, behavioral, and cognitive health and assessment of brainstem auditory evoked potentials (BAEP) and event-related potentials (P300). ResultsSignificant differences were observed in memory (p=0.002) and attention (p=0.021) complaints between participants with and without T1DM. In the BAEP responses, there were differences between wave III latencies in the right (p=0.017) and left (p=0.019) ears and in wave V latencies in the left ear (p=0.001) between the evaluated groups. In addition, there was an association between BAEP findings and metabolic control in the T1DM group in the left ear in waves III (p=0.006) and V (p=0.005) and in the right ear in wave V (p=0.026). No differences were observed in the latencies of P300 between the evaluated groups. ConclusionThis study demonstrated the existence of a subclinical finding in the central auditory pathway, offering an increased risk for retrocollear alterations, which may be a consequence of poor metabolic control.

Acoustic differences in tinnitus between noise-induced and non-noise-induced hearing loss

Background Tinnitus, the perception of sound without external stimuli, varies across hearing loss types. The present study compared the acoustic characteristics of tinnitus in patients with noise-induced hearing loss (NIHL) and in those with hearing loss unrelated to noise exposure. Objective This study compared the acoustic characteristics of tinnitus in patients with noise-induced and non-noise-induced hearing loss. Methods A total of 403 patients with tinnitus were divided into those with noise-induced and non-noise-induced hearing loss. Patients were evaluated by pure tone audiometry (PTA), tinnitogram, transient evoked otoacoustic emission (TEOAE), distortion product otoacoustic emission (DPOAE), and auditory brainstem evoked response (ABR) tests. Results Patients with NIHL exhibited significantly higher hearing thresholds across all frequencies (125–8000 Hz) (p < .05) and reported significantly higher tinnitus intensity (p < .05). Otoacoustic emission tests showed that response rates were significantly lower (p < .05), and ABR tests found that latency periods were significantly more prolonged (p < .05), in patients with NIHL. Conclusions Tinnitus differs acoustically between patients with NIHL and those with non-noise-induced hearing loss, with specific patterns of intensity and auditory responses. These findings emphasize the need for tailoring the management of tinnitus according to the underlying type of hearing loss.

Patogenesis of tinnitus in patients with post-COVID syndrome - preliminary report.

&lt;b&gt;&lt;br&gt;Introduction:&lt;/b&gt; Similarly to hearing loss and dizziness, tinnitus is a frequently reported complication of COVID-19 and remains the subject of numerous scientific reports. However, the exact impact of SARS-CoV-2 on the pathophysiology of tinnitus observed in post-COVID syndrome remains unclear. One suspected cause behind the development of vestibulocochlear symptoms is the inflammation of neural tissue triggered by SARS-CoV-2 infection.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Aim:&lt;/b&gt; The aim of this study was to analyze the results of Brainstem Auditory Evoked Potentials (BAEP) in the context of tinnitus development among patients diagnosed with post-COVID syndrome.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Material and methods:&lt;/b&gt; This retrospective study involved the analysis of BAEP test results of patients admitted to the Audiology Clinic of the Military Institute of Medicine at the National Research Institute and diagnosed with the post-COVID syndrome. The study compared the average latency values of waves I, II, III, IV, V, and intervals I-III, III-V, I-V. The statistical analysis of the obtained data was performed.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Results:&lt;/b&gt; Out of 18 patients (9 female, 9 male) with an average age of 54.22 years (9.65) diagnosed with post-COVID syndrome, tinnitus was identified in 5 individuals (27.78%). A statistically significant increase in wave V latency (5.98 vs. 5.63 [ms]; P &lt; 0.05) and interval III-V (1.99 vs. 1.71 [ms]; P&lt;0.05) was observed between the groups of patients with and without tinnitus.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Discussion:&lt;/b&gt; Study results analyzing BAEP changes in patients with post-COVID syndrome in the context of tinnitus are insufficient in current literature. The only available report linking post-COVID syndrome with sensorineural hearing loss demonstrated a statistically significant increase in latency values of waves III, V, and an increase in intervals I-III, III-V.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Conclusions:&lt;/b&gt; Tinnitus in patients suffering from post-COVID syndrome may be related to prolonged conduction of nerve impulses within the brainstem auditory pathway. Detailed pathophysiology of these changes requires further research.&lt;/br&gt.