Peripheral hearing in Parkinson's disease: a systematic review.

OBJECTIVE: To investigate the implications of Parkinson's disease (PD) in the peripheral auditory system, a systematic survey of the scientific literature was conducted. DESIGN: Systematic review. STUDY SAMPLE: An electronic search of the non-gray literature in the last decade was conducted using the digital databases MEDLINE® (PubMed interface), LILACS® (Virtual Health Library), Web of Science® (CAPES publications portal), and SciELO®. Studies addressing peripheral auditory function as part of the range of nonmotor PD symptoms were selected for analysis. RESULTS: Pure tone audiometry data suggested that sensorineural hearing loss was more severe in the PD population than in the control groups. The effects of PD on cochlear function were evidenced by a decrease in the levels of otoacoustic emissions. CONCLUSIONS: Sensorineural hearing loss and cochlear impairment are more severe in the PD population than in the control groups. Additional studies are recommended to further understand the characteristics of the peripheral auditory system in PD patients, which constitutes an emerging subject in the scientific literature.

Severe obstructive sleep apnea is associated with cochlear function impairment.

PURPOSE: The purpose of this study is to investigate the association between obstructive sleep apnea (OSA) with middle ear acoustic transference and cochlear function. METHODS: Male individuals with and without mild, moderate, and severe OSA according to standard criteria of full polysomnography and no co-morbidities were studied. Subjects with BMI ≥40 kg/m2, present or past treatment for OSA, with heart failure, diabetes, hypertension, dyslipidemia, stroke, use of chronic medications, and previous history of risk for hearing loss were excluded. All subjects were submitted to full polysomnography, evaluation of wideband acoustic immittance by energy of absorbance (EA), and distortion product otoacoustic emissions (DPOAE). RESULTS: We studied 38 subjects (age 35.8 ± 7.2 years, BMI 28.8 ± 3.8 kg/m2) divided into no OSA (n = 10, age 33.6 ± 6.4 years, BMI 26.9 ± 4.1 kg/m2), mild (n = 11, age 32.8 ± 2.9 years, BMI 28.5 ± 3.5 kg/m2), moderate (n = 8, age 34.1 ± 6.8 years, BMI 29.6 ± 3.3 kg/m2), and severe OSA (n = 9, age 41.2 ± 9.2 years, BMI 30.5 ± 3.8 kg/m2). EA was similar between groups. In contrast, patients with severe OSA presented significantly lower DPOAE amplitudes when compared to the control, mild, and moderate OSA groups (p ≤ 0.03, for all comparisons). CONCLUSIONS: Acoustic transference function of middle ear is similar in adults with and without OSA. Severe OSA is independently associated with cochlear function impairment in patients with no significant co-morbidities.

Concordância entre Emissões Otoacústicas e Potencial Evocado de Tronco Encefálico (automático) em neonatos / Concordance between Otoacoustic Emissions and Automatic Auditory Brainstem Response in neonates / Concordancia entre las Emisiones Otoacústicas y Potenciales Evocados delTronco Cerebral (automatico) en neonatos

Introdução: A implementação do potencial auditivo de tronco encefálico automático (PEATE-A) nos protocolos de triagem auditiva neonatal é necessária, pois as Emissões Otoacústicas por Transientes (EOAT) não avaliam alterações retrococleares. Objetivo: Verificar a concordância entre EOAT e PEATE automáticos em recém-nascidos com o fator de risco pequeno para a idade gestacional (PIG) e sem fatores de risco para perda auditiva. Método: Fizeram parte deste estudo 31 neonatos de ambos os sexos. Os participantes foram divididos em dois grupos: Grupo I: Neonatos sem fator de risco para perda auditiva - adequados para a idade gestacional Grupo II: Neonatos que apresentam o fator de risco PIG. O recém-nascido foi avaliado após 24 horas de vida e o protocolo seguido foi a EOAT seguido do PEATE-A. A avaliação foi realizada com o recém-nascido em estado de sono. Resultados: Os dados foram submetidos à análise estatística. Foram realizadas análises descritivas para comparar o peso do neonato e a idade gestacional entre os grupos. Foi possível observar que os sujeitos de ambos os grupos tiveram o mesmo desempenho nos dois testes, sendo que apenas um neonato do Grupo II (3%) falhou para ambos na orelha esquerda. O teste exato de Fisher indica que há associação significante entre o desempenho nas EOAT e no PEATE-A (p=0,016). Conclusão: Neste estudo verificou-se que houve totalassociação entre os testes EOAT e PEATE-A...

The implementation of automatic auditory brainstem response (ABR) in newborn hearing screening protocols is necessary because the transient evoked otoacoustic emissions (TEOAE) do not evaluate retrocochlear alterations. Objective: To investigate the correlation between TEOAE and automated ABR in neonates with small risk factor for gestational age (SGA) and neonates with no risk factors for hearing loss. Methods: The sample comprised 31 neonates of both sexes. Participants were separatedinto two groups: Group I: Newborns without risk factor for hearing loss - appropriate for gestational age Group II: Neonates who have the risk factor SGA. The newborn was evaluated after 24 hours of life and the protocol was the TEOAE followed by automated ABR. The evaluation was performed with the neonate asleep. Results: Descriptive analysis were performed to compare the weight of the newborn and gestational age between the groups. It was observed that the subjects in both groups had thesame performance in both tests, and only one neonate in Group II (3%) failed both to the left ear. The Fisher exact test indicates a significant association between performance in TEOAE and automated ABR (p = 0.016). Conclusion: In this study it was found that in general there was an association between tests TEOAE and automated ABR...

Introducción: La aplicación del Potencial Auditivo Evocado de Tronco Encefálico Automatico (PEATE- A) en protocolos de screenig auditivo para recién nacidos es necesario porque las Emisiones Otoacusticas por Transientes (EOAT) no evalúan las alteraciones retrococleares. Objetivo: Comprobar el acuerdo entre EOAT y PEATE automáticos en recién nacidos con factor de riesgo pequeño para la edad gestacional (PIG), y sin factores de riesgo para la pérdida de audición. Métodos: Participaron de este estudio 31 recién nacidos de ambos sexos. Los participantes fueron divididos en dos grupos: Grupo I: Recién nacidos sin factor de riesgo para la pérdida de audición ? adecuados para la edad gestacional Grupo II: Recién nacidos que presentan el factor de riesgo PIG. Los recién nacidos fueron evaluados después de 24 horas de vida y el protocolo aplicado fue el EOAT seguido PEATE-A. La evaluación se realizó con el recién nacido en estadio de sueño. Resultados: Los datos se sometieron a análisis estadístico. Se realizaron análisis descriptivos para comparar el peso del recién nacido y la edad gestacional entre los grupos. Se observó que los sujetos de ambos grupos tuvieron el mismo desempeño en las dos pruebas, y sólo un recién nacido en el grupo II (3%) fracaso en ambos parael oído izquierdo. La prueba exacta de Fisher indica que hay una asociación significativa entre el desempeño en EOAT y PEATE-A (p = 0,016). Conclusión: En este estudio se encontró que hubo total asociación entre las pruebas EOAT y PEATE-A...

Concordância entre Emissões Otoacústicas e Potencial Evocado de Tronco Encefálico (automático) em neonatos / Concordance between Otoacoustic Emissions and Automatic Auditory Brainstem Response in neonates / Concordancia entre las Emisiones Otoacústicas y Potenciales Evocados delTronco Cerebral (automatico) en neonatos

Introdução: A implementação do potencial auditivo de tronco encefálico automático (PEATE-A) nos protocolos de triagem auditiva neonatal é necessária, pois as Emissões Otoacústicas por Transientes (EOAT) não avaliam alterações retrococleares. Objetivo: Verificar a concordância entre EOAT e PEATE automáticos em recém-nascidos com o fator de risco pequeno para a idade gestacional (PIG) e sem fatores de risco para perda auditiva. Método: Fizeram parte deste estudo 31 neonatos de ambos os sexos. Os participantes foram divididos em dois grupos: Grupo I: Neonatos sem fator de risco para perda auditiva - adequados para a idade gestacional Grupo II: Neonatos que apresentam o fator de risco PIG. O recém-nascido foi avaliado após 24 horas de vida e o protocolo seguido foi a EOAT seguido do PEATE-A. A avaliação foi realizada com o recém-nascido em estado de sono. Resultados: Os dados foram submetidos à análise estatística. Foram realizadas análises descritivas para comparar o peso do neonato e a idade gestacional entre os grupos. Foi possível observar que os sujeitos de ambos os grupos tiveram o mesmo desempenho nos dois testes, sendo que apenas um neonato do Grupo II (3%) falhou para ambos na orelha esquerda. O teste exato de Fisher indica que há associação significante entre o desempenho nas EOAT e no PEATE-A (p=0,016). Conclusão: Neste estudo verificou-se que houve totalassociação entre os testes EOAT e PEATE-A.(AU)(AU)

The implementation of automatic auditory brainstem response (ABR) in newborn hearing screening protocols is necessary because the transient evoked otoacoustic emissions (TEOAE) do not evaluate retrocochlear alterations. Objective: To investigate the correlation between TEOAE and automated ABR in neonates with small risk factor for gestational age (SGA) and neonates with no risk factors for hearing loss. Methods: The sample comprised 31 neonates of both sexes. Participants were separatedinto two groups: Group I: Newborns without risk factor for hearing loss - appropriate for gestational age Group II: Neonates who have the risk factor SGA. The newborn was evaluated after 24 hours of life and the protocol was the TEOAE followed by automated ABR. The evaluation was performed with the neonate asleep. Results: Descriptive analysis were performed to compare the weight of the newborn and gestational age between the groups. It was observed that the subjects in both groups had thesame performance in both tests, and only one neonate in Group II (3%) failed both to the left ear. The Fisher exact test indicates a significant association between performance in TEOAE and automated ABR (p = 0.016). Conclusion: In this study it was found that in general there was an association between tests TEOAE and automated ABR.(AU)(AU)

Introducción: La aplicación del Potencial Auditivo Evocado de Tronco Encefálico Automatico (PEATE- A) en protocolos de screenig auditivo para recién nacidos es necesario porque las Emisiones Otoacusticas por Transientes (EOAT) no evalúan las alteraciones retrococleares. Objetivo: Comprobar el acuerdo entre EOAT y PEATE automáticos en recién nacidos con factor de riesgo pequeño para la edad gestacional (PIG), y sin factores de riesgo para la pérdida de audición. Métodos: Participaron de este estudio 31 recién nacidos de ambos sexos. Los participantes fueron divididos en dos grupos: Grupo I: Recién nacidos sin factor de riesgo para la pérdida de audición ? adecuados para la edad gestacional Grupo II: Recién nacidos que presentan el factor de riesgo PIG. Los recién nacidos fueron evaluados después de 24 horas de vida y el protocolo aplicado fue el EOAT seguido PEATE-A. La evaluación se realizó con el recién nacido en estadio de sueño. Resultados: Los datos se sometieron a análisis estadístico. Se realizaron análisis descriptivos para comparar el peso del recién nacido y la edad gestacional entre los grupos. Se observó que los sujetos de ambos grupos tuvieron el mismo desempeño en las dos pruebas, y sólo un recién nacido en el grupo II (3%) fracaso en ambos parael oído izquierdo. La prueba exacta de Fisher indica que hay una asociación significativa entre el desempeño en EOAT y PEATE-A (p = 0,016). Conclusión: En este estudio se encontró que hubo total asociación entre las pruebas EOAT y PEATE-A.(AU)(AU)

Alteration of distortion product otoacoustic emission input/output functions in subjects with a previous history of middle ear dysfunction.

BACKGROUND: The aim of this study was to investigate the effects of sub-clinical alterations on the amplitudes and slopes of the DPOAE input-output responses from subjects with previous history of middle ear dysfunction. MATERIAL/METHODS: The study included 15 subjects with and 15 subjects without a history of otitis media in the last 10 years. All participants were assessed with acoustic immittance, pure-tone audiometry, and DPOAEs. For the later, I/O functions and I/O slopes were estimated at 1501, 2002, 3174, 4004 and 6384 Hz. RESULTS: No statistically significant differences were found between the 2 groups in terms of behavioral thresholds. The group with a previous history of middle ear dysfunction presented significantly lower mean DPOAE amplitudes at 2002, 3174 and 4004 Hz. In terms of DPOAE slopes, no statistically significant differences were observed at the tested frequencies, except at 3174 Hz. CONCLUSIONS: Middle ear pathologies can produce subclinical alterations that are undetectable with traditional pure-tone audiometry. The data from the present study show that reduced amplitude DPOAEs are associated with a previous history of middle ear complications. The corresponding DPOAE slopes were affected at only 1 tested frequency, suggesting that the cochlear non-linearity is preserved. Considering these results, it remains to be elucidated to what degree the DPOAE amplitude attenuation interferes with higher-order auditory tasks.

Audiological and electrophysiological assessment of professional pop/rock musicians.

In the present study, we evaluated peripheral and central auditory pathways in professional musicians (with and without hearing loss) compared to non-musicians. The goal was to verify if music exposure could affect auditory pathways as a whole. This is a prospective study that compared the results obtained between three groups (musicians with and without hearing loss and non-musicians). Thirty-two male individuals participated and they were assessed by: Immittance measurements, pure-tone air conduction thresholds at all frequencies from 0.25 to 20 kHz, Transient Evoked Otoacoustic Emissions, Auditory Brainstem Response (ABR), and Cognitive Potential. The musicians showed worse hearing thresholds in both conventional and high frequency audiometry when compared to the non-musicians; the mean amplitude of Transient Evoked Otoacoustic Emissions was smaller in the musicians group, but the mean latencies of Auditory Brainstem Response and Cognitive Potential were diminished in the musicians when compared to the non-musicians. Our findings suggest that the population of musicians is at risk for developing music-induced hearing loss. However, the electrophysiological evaluation showed that latency waves of ABR and P300 were diminished in musicians, which may suggest that the auditory training to which these musicians are exposed acts as a facilitator of the acoustic signal transmission to the cortex.

Maternal smoking during pregnancy: impact on otoacoustic emissions in neonates.

OBJECTIVES: To determine the effect of maternal smoking during pregnancy on transient evoked otoacoustic emissions levels in neonates. METHODS: This was a cross-sectional study investigating neonates in the maternity ward of a university hospital in the city of São Paulo, Brazil. A total of 418 term neonates without prenatal or perinatal complications were evaluated. The neonates were divided into two groups: a study group, which comprised 98 neonates born to mothers who had smoked during pregnancy; and a control group, which comprised 320 neonates born to mothers who had not. In order to compare the two ears and the two groups in terms of the mean overall response and the mean transient evoked otoacoustic emissions in response to acoustic stimuli delivered at different frequencies, we used analysis of variance with repeated measures. RESULTS: The mean overall response and the mean frequency-specific response levels were lower in the neonates in the study group (p<0.001). The mean difference between the groups was 2.47 dB sound pressure level (95% confidence interval: 1.47-3.48). CONCLUSIONS: Maternal smoking during pregnancy had a negative effect on cochlear function, as determined by otoacoustic emissions testing. Therefore, pregnant women should be warned of this additional hazard of smoking. It is important that smoking control be viewed as a public health priority and that strategies for treating tobacco dependence be devised.

Central auditory evaluation in multiple sclerosis: case report.

Herein, we report a case of multiple sclerosis in which peripheral and central hearing, were evaluated through early (brainstem), middle and late auditory evoked potentials before and after corticosteroid therapy. Auditory evaluation revealed better performance on all post-treatment tests. In this case, central auditory function tests (behavioral and electrophysiological) identified the location of the impairment (brainstem), which was in agreement with the patient complaint. The speech in noise test and brainstem auditory evoked potentials are definitely appropriate in confirming brainstem lesions.

Central auditory evaluation in multiple sclerosis: case report / Avaliação auditiva central na esclerose múltipla: relato de caso

Herein, we report a case of multiple sclerosis in which peripheral and central hearing, were evaluated through early (brainstem), middle and late auditory evoked potentials before and after corticosteroid therapy. Auditory evaluation revealed better performance on all post-treatment tests. In this case, central auditory function tests (behavioral and electrophysiological) identified the location of the impairment (brainstem), which was in agreement with the patient complaint. The speech in noise test and brainstem auditory evoked potentials are definitely appropriate in confirming brainstem lesions.

Relatamos caso de esclerose múltipla em que foi feita avaliação da audição periférica e central utilizando os potenciais evocados auditivos de curta, média e longa latência antes e depois da terapia com corticosteróides. A avaliação auditiva revelou melhor desempenho em todos os testes após o tratamento. Neste caso, os testes que avaliam a função central da audição (comportamental e eletrofisiológico) foram capazes de identificar o local da lesão (tronco encefálico), o que estava de acordo com as queixas do paciente. Os testes de fala com ruído e os potenciais evocados auditivos de curta latência são apropriados para revelar lesões de tronco encefálico.

Reduction of acoustic reflex threshold in neonates without auditory risk.

UNLABELLED: The auditory sensitization, a tool used in the investigation of acoustic reflex, allows the decrease of acoustic reflex thresholds from a facilitating stimulus. It may be presented before or simultaneously with the elicitor tone. The thresholds after and before the facilitating stimulus are compared and it is expected to see the decreased threshold. From the study of the acoustic reflex it is possible to obtain information about the auditory pathways, such as structures of the brainstem, since the acoustic reflex pathway is related to the auditory nuclei in this site. They are also involved in auditory processing. Thus, alterations of the acoustic reflex could be related to deficits in auditory processing skills. AIM: This study aims at investigating the acoustic reflex sensitization from a high-frequency facilitating tone (6 kHz) in newborns without risk factors to hearing impairment. RESULTS: The acoustic reflex threshold decreased in males and females for all studied frequencies. CONCLUSION: A high-frequency facilitating tone presented simultaneously produced a decrease of the acoustic reflex threshold in newborns without risk factors to hearing impairment.

Redução do limiar de reflexo acústico em neonatos sem risco auditivo / Reduction of acoustic reflex threshold in neonates without auditory risk

A sensibilização auditiva, ferramenta utilizada na pesquisa dos reflexos acústicos, provoca a redução do limiar de reflexo acústico a partir de um estímulo facilitador, que pode ser apresentado antes ou simultaneamente ao tom eliciador do reflexo acústico. São comparados os limiares pré e pósexposição ao estímulo, esperando-se obter a redução do limiar. A partir do estudo dos reflexos acústicos é possível obter maiores informações a respeito das vias auditivas, como estruturas do tronco encefálico, visto que o arco reflexo está relacionado a núcleos auditivos nessa região. Eles também estão envolvidos no processamento auditivo. Assim, alterações do reflexo acústico poderiam estar relacionadas a falhas em habilidades de processamento auditivo. OBJETIVO: Esta pesquisa teve o objetivo de estudar a sensibilização do reflexo acústico a partir de um estímulo facilitador de 6 kHz em neonatos nascidos a termo, sem risco para alteração auditiva. RESULTADOS: Foi encontrada redução significativa do limiar de reflexo acústico para todas as freqüências pesquisadas em ambos os sexos. CONCLUSÃO: A apresentação simultânea de um estímulo facilitador de alta freqüência gera redução do limiar de reflexo acústico em neonatos sem risco para perda auditiva.

The auditory sensitization, a tool used in the investigation of acoustic reflex, allows the decrease of acoustic reflex thresholds from a facilitating stimulus. It may be presented before or simultaneously with the elicitor tone. The thresholds after and before the facilitating stimulus are compared and it is expected to see the decreased threshold. From the study of the acoustic reflex it is possible to obtain information about the auditory pathways, such as structures of the brainstem, since the acoustic reflex pathway is related to the auditory nuclei in this site. They are also involved in auditory processing. Thus, alterations of the acoustic reflex could be related to deficits in auditory processing skills. AIM: This study aims at investigating the acoustic reflex sensitization from a high-frequency facilitating tone (6 kHz) in newborns without risk factors to hearing impairment. RESULTS: The acoustic reflex threshold decreased in males and females for all studied frequencies. CONCLUSION: A high-frequency facilitating tone presented simultaneously produced a decrease of the acoustic reflex threshold in newborns without risk factors to hearing impairment.

Efeito do estímulo facilitador no limiar de reflexo acústico / The facilitating stimulus effect in the acoustic reflex threshold

A sensibilização auditiva, ferramenta utilizada na pesquisa dos reflexos acústicos, permite a redução do limiar de reflexo acústico a partir de um estímulo facilitador. Ele pode ser apresentado antes ou simultaneamente ao tom eliciador do reflexo acústico. São comparados os limiares pré e pós-exposição ao estímulo, esperando-se obter a redução do limiar. A partir do estudo dos reflexos acústicos é possível obter maiores informações a respeito das vias auditivas, como estruturas do tronco encefálico, visto que o arco reflexo está relacionado a núcleos auditivos nessa região. Eles também estão envolvidos no processamento auditivo. Assim, alterações do reflexo acústico poderiam estar relacionadas a falhas em habilidades de processamento auditivo. OBJETIVO: Esta pesquisa teve o objetivo de estudar a sensibilização do reflexo acústico a partir de um estímulo facilitador de 6 KHz. FORMA DE ESTUDO: Estudo clínico com coorte transversal. MATERIAL E MÉTODO: jovens mulheres com idade entre 20 e 25 anos, sem queixas audiológicas e limiares auditivos dentro dos limites da normalidade. RESULTADOS:Foi encontrada redução significativa do limiar de reflexo acústico entre 6,71 e 17,23 dB nas orelhas em que houve a sensibilização. CONCLUSÃO: A apresentação simultânea de um estímulo facilitador de alta freqüência gera redução do limiar de reflexo acústico em pessoas com audição dentro dos limites da normalidade.

Amplitudes das emissöes otoacústicas transientes e por distorçäo, em jovens e idosos / Amplitude of Transient and distortion product otoacoustic emissions, in young and elderly people

Introduçäo: As emissöes otoacústicas refletem, preferencialmente, o status funcional da cóclea. Como a passagem da informaçäo sonora, tanto em sua direçäo aferente quanto na eferente, depende também das condiçöes da orelha média, säo vários os fatores que podem regular o registro final das emissöes otoacústicas. Objetivos: Este estudo teve o objetivo de verificar o comportamento das respostas cocleares captadas através de EOAT e de EOAPD em adultos jovens e em idosos com funçäo normal de orelha média, observando-se a amplitude das respostas nas duas condiçöes. Resultados: Foram analisados os resultados obtidos em 40 orelhas de 20 adultos jovens entre 20 e 25 anos de idade, e de 30 orelhas de 15 idosos entre 60 e 75 anos de idade, ambos os grupos sem queixa auditiva e com nível de audiçäo dentro dos limites da normalidade. Conclusäo: Comparando-se as emissöes otoacústicas transientes (EOATs) com as emissöes otoacústicas por produto de distorçäo (EOAPD), as primeiras sofreram maiores impedimentos em sua captaçäo, tanto em adultos jovens quanto em idosos