Development and Evaluation of the Italian Version of the Dichotic Digit Test: Insights from 39 Normal-Hearing Children Aged 11 to 13 years.

BACKGROUND The dichotic digit test (DDT) is one of the tests for the behavioral assessment of central auditory processing. Dichotic listening tests are sensitive ways of assessing cortical structures, the corpus callossum, and binaural integration mechanisms, showing strong correlations with learning difficulties. The DDT is presently available in a number of languages, each appropriate for the subject's native language. However, there is presently no test in the Italian language. The goal of this study was to develop an Italian version of the one-pair dichotic digit test (DDT-IT) and analyze results in 39 normal-hearing Italian children 11 to 13 years old. We used 2 conditions of presentation: free recall and directed attention (left or right ear), and looked at possible effects of sex and ear side. MATERIAL AND METHODS This study involved 3 steps: creation of the stimuli, checking their quality with Italian speakers, and assessment of the DDT-IT in our subject pool. The study involved 39 children (26 girls and 13 boys), aged 11-13 years. All participants underwent basic audiological assessment, auditory brainstem response, and then DDT-IT. RESULTS Results under free recall and directed attention conditions were similar for right and left ears, and there were no sex or age effects. CONCLUSIONS The Italian version of DDT (DDT-IT) has been developed and its performance on 39 normal-hearing Italian children was assessed. We found there were no age or sex effects for either the free recall condition or the directed attention condition.

Wideband Tympanometry and Pressurized Otoacoustic Emissions in Children with Surgical Excision of Palatine and/or Pharyngeal Tonsils.

Palatine and pharyngeal tonsil hypertrophy may lead to dysfunction of the auditory tube due to a propensity for infection, potentially giving rise to otitis media. This is a quantitative and longitudinal study, developed from 2019 to 2021, at the State University of Campinas (UNICAMP). The studied sample comprised 15 participants aged 5 to 12 years (mean 7.9 years), 12 male and 3 female, arranged into two groups: children diagnosed with pharyngeal and/or palatine tonsil hypertrophy who were candidates for surgery (G1), and children who were later evaluated after surgery (G2). As part of the test, an otoscopy and measurements of logoaudiometry, pure-tone threshold audiometry, wideband tympanometry (ambient and peak pressure), and otoacoustic emissions (TEOAEs and DPOAEs, both at ambient and peak pressure) were all performed. There were statistically significant differences between phases in pure-tone audiometry, in terms of 226 Hz tympanometry, wideband tympanometry in peak pressure conditions, in the amplitude measurement TEOAEs in both pressure conditions, in DPOAEs in ambient pressure conditions, and in the signal/noise measurement in both pressures in DPOAEs. Overall, it was found that hearing tests were different for subjects with palatine and pharyngeal tonsil hypertrophy compared to the post-surgical group.

Encoding of speech sounds with frequency-following response in infants with Congenital Zika Syndrome: A case-controlled study

ABSTRACT Purpose: to investigate the frequency-following response (FFR) for sustained neural activity. Methods: 39 individuals, aged between 20 to 47 months old were divided into 2 groups: (i) 20 individuals without prenatal exposure to the congenital Zika syndrome (CZS) or hydrocephaly, normal development, no risk factors for hearing loss or syndromic hearing impairment and (ii) 19 individuals diagnosed with CZS and microcephaly - based on imaging studies linked to the clinical presentation of the condition. All participants exhibited normal click-ABR tests. FFR waveforms were documented using the /da/ syllable employing the Navigator Pro. The statistical analysis used was ANOVA (p-value <0.05). Results: no distinctions were observed concerning the variables of group, age, or gender with respect to FFR latency values, except for an interaction between gender and group for latency values associated with waves V and F. Children with CZS and microcephaly showed a difference for latency values in wave V for both males and females, when compared to the control group. Conclusion: children presented with CZS and microcephaly showed higher average latencies for waves V, A, C, D and F (male) compared to the control group, whereas, in waves E, F (female) and O they showed higher values in the control group.

Skarzynski Tinnitus Scale: Cultural Adaptation and Validation to Brazilian Portuguese

Abstract Introduction Tinnitus is a prevalent condition among many different populations. Since tinnitus is subjective, self-report questionnaires are one way of assessing how much the condition interferes with the quality of life of an individual. Objective The aim of the present study was to translate and cross-culturally adapt the Skarzynski Tinnitus Scale (STS) into Brazilian Portuguese and validate its psychometric properties. Methods The STS was translated and cross-culturally adapted using five main steps. Fifty-eight individuals who had continuous tinnitus were invited to complete the questionnaire. Pure tone audiometry (air and bone conduction) were also done. Results No major changes were necessary in translating the scale. The overall score was 1.3 (range 0-4). Internal consistency was tested by Cronbach α, which ranged from 0.54 to 0.85. Differences between genders and between subscales and the total score were not significant. A statistically significant difference was only found in the coping subscale, in which normal hearing subjects had higher scores than those with hearing loss. Conclusion The translation and adaptation of the STS established linguistic and cultural equivalence with the original. In addition, it exhibited good internal consistency. Our results suggest that the STS is suitable for use in a clinical setting.

Skarzynski Tinnitus Scale: Cultural Adaptation and Validation to Brazilian Portuguese.

Introduction Tinnitus is a prevalent condition among many different populations. Since tinnitus is subjective, self-report questionnaires are one way of assessing how much the condition interferes with the quality of life of an individual. Objective The aim of the present study was to translate and cross-culturally adapt the Skarzynski Tinnitus Scale (STS) into Brazilian Portuguese and validate its psychometric properties. Methods The STS was translated and cross-culturally adapted using five main steps. Fifty-eight individuals who had continuous tinnitus were invited to complete the questionnaire. Pure tone audiometry (air and bone conduction) were also done. Results No major changes were necessary in translating the scale. The overall score was 1.3 (range 0-4). Internal consistency was tested by Cronbach α, which ranged from 0.54 to 0.85. Differences between genders and between subscales and the total score were not significant. A statistically significant difference was only found in the coping subscale, in which normal hearing subjects had higher scores than those with hearing loss. Conclusion The translation and adaptation of the STS established linguistic and cultural equivalence with the original. In addition, it exhibited good internal consistency. Our results suggest that the STS is suitable for use in a clinical setting.

A Systematic Review of the Literature Between 2009 and 2019 to Identify and Evaluate Publications on the Effects of Age-Related Hearing Loss on Speech Processing.

Changes in central auditory processing due to aging in normal-hearing elderly patients, as well as age-related hearing loss, are often associated with difficulties in speech processing, especially in unfavorable acoustic environments. Speech processing depends on the perception of temporal and spectral features, and for this reason can be assessed by recordings of phase-locked neural activity when synchronized to transient and periodic sound stimuli frequency-following responses (FFRs). An electronic search of the PubMed and Web of Science databases was carried out in July 2019. Studies that evaluated the effects of age-related hearing loss on components of FFRs were included. Studies that were not in English, studies performed on animals, studies with cochlear implant users, literature reviews, letters to the editor, and case studies were excluded. Our search yielded 6 studies, each of which included 30 to 94 subjects aged between 18 and 80 years. Latency increases and significant amplitude reduction of the onset, offset, and sloop V/A components of FFRs were observed. Latency and amplitude impairment of the fundamental frequency, first formant, and high formants were related to peripheral sensorineural hearing loss in the elderly population. Conclusions: Temporal changes in FFR tracing were related to the aging process. Hearing loss also impacts the envelope fine structure, producing poorer speech comprehension in noisy environments. More research is needed to understand aspects related to hearing loss and cognitive aspects common to the elderly.

Latency and Interpeak Interval Values of Auditory Brainstem Response in 73 Individuals with Normal Hearing.

BACKGROUND Auditory brainstem response (ABR) potential is important for audiological diagnosis, reflecting the integrity of the structures of the auditory system up to the brainstem. The click stimulus is the best known and is most used in clinical practice. However, different devices and examiners may yield distinct results, and each institution tends to use its own parameters. We aimed to analyze the latency values of wave I, III, V, and interpeak intervals I-III, III-V, I-V values obtained in assessing ABR using a new device. MATERIAL AND METHODS We performed a cross-sectional study of 73 participants with normal hearing thresholds and no hearing problems. All underwent basic audiological (air and bone conduction, Speech Recognition Threshold, Speech Recognition Index, acoustic reflex, and tympanometry) and electrophysiological evaluation (ABR assessment). RESULTS Absolute latency and interpeak values from ABR showed earlier responses in women, faster than international standards suggest. The responses were similar to other studies carried out previously, with the exception of wave I values, which were a little earlier in females. CONCLUSIONS We assessed normative data from measurement of latency values of wave I, III, V, and interpeak intervals I-III, III-V, and I-V applying 2 standard deviations in the assessment of ABR using the new Neuro-Audio/ABR device created by Neurosoft.

The Application of P300-Long-Latency Auditory-Evoked Potential in Parkinson Disease

Abstract Introduction Parkinson disease (PD) is a degenerative and progressive neurological disorder characterized by resting tremor, stiffness, bradykinesia, and postural instability. Despite the motor symptoms, PD patients also consistently show cognitive impairment or executive dysfunction. The auditory event-related potential P300 has been described as the best indicator of mental function, being highly dependent on cognitive skills, including attention and discrimination. Objective To review the literature on the application and findings of P300 as an indicator of PD. Data Analysis The samples ranged from 7 to 166 individuals. Young adult and elderly male patients composed most study samples. The Mini-Mental State Examination test, the Unified Parkinson Disease Rating Scale, and the Hoehn and Yahr Scale were used to assess neurological and cognitive function. In terms of testing hearing function, few studies have focused on parameters other than the P300. The factors we focused on were how the P300 was modified by cognitive effects, its correlation with different PD scales, the effect of performing dual tasks, the effect of fatigue, and the influence of drug treatments. Conclusion The use of the P300 appears to be an effective assessment tool in patients with PD. This event-related potential seems to correlate well with other neurocognitive tests that measure key features of the disease.

The Application of P300-Long-Latency Auditory-Evoked Potential in Parkinson Disease.

Introduction Parkinson disease (PD) is a degenerative and progressive neurological disorder characterized by resting tremor, stiffness, bradykinesia, and postural instability. Despite the motor symptoms, PD patients also consistently show cognitive impairment or executive dysfunction. The auditory event-related potential P300 has been described as the best indicator of mental function, being highly dependent on cognitive skills, including attention and discrimination. Objective To review the literature on the application and findings of P300 as an indicator of PD. Data Analysis The samples ranged from 7 to 166 individuals. Young adult and elderly male patients composed most study samples. The Mini-Mental State Examination test, the Unified Parkinson Disease Rating Scale, and the Hoehn and Yahr Scale were used to assess neurological and cognitive function. In terms of testing hearing function, few studies have focused on parameters other than the P300. The factors we focused on were how the P300 was modified by cognitive effects, its correlation with different PD scales, the effect of performing dual tasks, the effect of fatigue, and the influence of drug treatments. Conclusion The use of the P300 appears to be an effective assessment tool in patients with PD. This event-related potential seems to correlate well with other neurocognitive tests that measure key features of the disease.

Long-term Effects of Unilateral and Bilateral Otitis Media and Myringotomy on Long-Latency Verbal and Non-Verbal Auditory-Evoked Potentials

Abstract Introduction Otitis media (OM) is considered one of the most common reasons patients seek medical care in childhood. The fluctuating nature of hearing loss in cases of OM leads to irregular sound stimulation of the central auditory nervous system. Objectives To analyze the long-latency auditory-evoked potential (LLAEP) by verbal and nonverbal sounds in children with a history of OM in the first six years of life. Methods A total of 106 schoolchildren participated in the study, 55 females and 51 males, aged between 8 and 16 years, who were divided into 3 groups: the control group (CG), the bilateral experimental group (BEG), and the unilateral experimental group (UEG). All children underwent a complete audiological evaluation (audiometry, logoaudiometry and immitance testing) and an electrophysiological evaluation (LLAEP with toneburst stimulus - LLAEP-TB, and LLAEP with speech stimulus - LLAEP-S). Results Both study groups (BEG and UEG) presented a statistically lower performance (p < 0.005) when compared with the CG regarding all of the electrophysiological tests with the prolongation of the latency values and decrease in the amplitude values: LLAEP-TB (BEG: latency - N1, P2, N2 [females] and P300, amplitude - N1 and P2), LLAEP-S (BEG: latency - P2 and N2 [females], amplitude - P2 /UEG: latency - P2 and P300, amplitude: N1 and P2). Conclusion Children who had suffered secretory OM in the first six years of life and who had undergone myringotomy for the placement of a ventilation tube, either unilaterally or bilaterally, presented worse performance in their electrophysiological responses to verbal and nonverbal LLAEPs.

Otoacoustic Emissions in Children with Long-Term Middle Ear Disease.

INTRODUCTION: Otoacoustic emissions (OAEs) evaluate the functional status of the cochlea. Repeated otitis media (OM) can cause changes in the peripheral structures of the auditory system, and, in this way, middle ear infection may irreversibly damage the middle ear, or even the cochlea. OBJECTIVES: To analyze the results of transiently evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) in individuals with a history of OM. METHOD: Participants with 8 to 16 years of schooling were split into two groups: a control group (CG) of 50 subjects who had no history of otological disease and an experimental group (EG) of 50 subjects who had a history of recurrent otitis in childhood and had consequently undergone myringotomy to insert bilateral ventilation tubes. All children underwent basic audiological assessment (tonal audiometry, speech audiometry, and immittance testing) and otoacoustic emission testing (TEOAEs and DPOAEs). RESULTS: There were no significant differences between the groups when audiometrically tested via air and bone conduction. OAEs were found in all CG subjects. For the EG, there were no TEOAE responses in 17 ears and no DPOAEs in nine ears; response amplitudes were lower at all frequencies. The emission level and the signal-to-noise ratio were statistically different between the two groups, and OAEs in the EG were statistically smaller compared to the GC. CONCLUSION: In the EG, responses were more likely to be absent and were of statistically smaller amplitude compared to the CG. A history of repeated OM apparently interferes with the generation and transmission of TEOAEs and DPOAEs.

Long-term Effects of Unilateral and Bilateral Otitis Media and Myringotomy on Long-Latency Verbal and Non-Verbal Auditory-Evoked Potentials.

Introduction Otitis media (OM) is considered one of the most common reasons patients seek medical care in childhood. The fluctuating nature of hearing loss in cases of OM leads to irregular sound stimulation of the central auditory nervous system. Objectives To analyze the long-latency auditory-evoked potential (LLAEP) by verbal and nonverbal sounds in children with a history of OM in the first six years of life. Methods A total of 106 schoolchildren participated in the study, 55 females and 51 males, aged between 8 and 16 years, who were divided into 3 groups: the control group (CG), the bilateral experimental group (BEG), and the unilateral experimental group (UEG). All children underwent a complete audiological evaluation (audiometry, logoaudiometry and immitance testing) and an electrophysiological evaluation (LLAEP with toneburst stimulus - LLAEP-TB, and LLAEP with speech stimulus - LLAEP-S). Results Both study groups (BEG and UEG) presented a statistically lower performance ( p < 0.005) when compared with the CG regarding all of the electrophysiological tests with the prolongation of the latency values and decrease in the amplitude values: LLAEP-TB (BEG: latency - N1, P2, N2 [females] and P300, amplitude - N1 and P2), LLAEP-S (BEG: latency - P2 and N2 [females], amplitude - P2 /UEG: latency - P2 and P300, amplitude: N1 and P2). Conclusion Children who had suffered secretory OM in the first six years of life and who had undergone myringotomy for the placement of a ventilation tube, either unilaterally or bilaterally, presented worse performance in their electrophysiological responses to verbal and nonverbal LLAEPs.

Long-term effect of middle ear disease on temporal processing and P300 in two different populations of children.

BACKGROUND/OBJECTIVE: The effects of otitis media on the function of the central auditory nervous system in different populations is unknown. Understanding how the history of otitis media affects children from different nations will guide health professionals worldwide on the importance of adequate auditory stimulus in childhood. For this reason, the aim of the present study was to investigate the long-term auditory effects of middle ear disease on temporal processing and P300 in two different populations of children: Australian and Brazilian. METHODS: Temporal processing tests (Frequency Pattern Tests-FPT and Gaps in noise-GIN) and P300 were measured in 68 Brazilian and Australian children, aged between 8 to 14 years. The Brazilian otitis media group (BrOM) and Australian otitis media group (AusOM) consisted of 20 children each who had a documented history of otitis media. Control groups of 14 children (BrControl and AusControl) were also recruited from each country, all with no documented history of otitis media. RESULTS: The BrOM group showed significantly poorer performance (p<0.001) for FPT and the GIN compared to BrControl. The P300 response showed significantly longer mean latencies (p = 0.02) compared to BrControls. The AusOM group also showed significant delayed latency of P300 (p = 0.04) compared to the AusControl. The FPT showed significantly poorer performance (p = 0.04) compared to AusControls. The two otitis media groups showed no significant differences between each other on P300. Significant differences were seen however in temporal processing tests performance between the two cohorts for the otitis media groups. The BrOM group had significantly poorer responses (p<0.001) for FPT and GIN compared to the AusOM group. CONCLUSIONS: These findings support that although differences exist between BrOM and AusOM groups, otitis media can be demonstrated to affect the underlying mechanisms of the P300 measures and behavioral auditory responses in two different populations of children.

The effects of otitis media with effusion on the measurement of auditory evoked potentials.

OBJECTIVE: The aim of this study was to explore the impact of otitis media on auditory evoked potentials in children with a history of otitis media in comparison to a control group. DESIGN: 90 children, with normal hearing and middle ear status at time of assessment, aged between 8 and 14 years (44 boys and 46 girls) were enrolled in this study. 50 children (28 boys and 22 girls) had a documented history of Otitis Media. The control group consisted of 40 children (17 boys and 23 girls) with no documented history of otitis media. All children completed the auditory evoked potentials tasks of Auditory Brainstem Response (ABR) and P300. RESULTS: Auditory Evoked Potentials results demonstrated significantly increased latencies and decreased amplitudes in the otitis media group. ABR showed significantly latency delay of waves III and V by 0.1 msec (p < 0.001) and reduced amplitude (0.06 µV, p = 0.002 and 0.05 µV, p = 0.008, respectively) in the otitis media group compared to control group. P300 also showed significant latency delays (13,41 ms, p = 0.008) in otitis media group. No significant difference was seen for amplitude between CG and otitis media group for P300. CONCLUSION: The results demonstrate the negative effects of otitis media on auditory evoked potentials in children with a history of middle ear disease as can be seen by changes on the ABR and P300 measures.

Otitis Media: Long-Term Effect on Central Auditory Nervous System.

OBJECTIVES: To analyze the central auditory nervous system function through behavioral and electrophysiological tests in children with a history of otitis media and subsequent bilateral tubes placement surgery. METHODS: The participants were divided into two groups between eight and 14 years old: control group (CG) consisted of 40 children with no history of otitis media; experimental group (EG) consisted of 50 children with documented history of otitis media and undertook a surgery for bilateral tubes placement. All children completed audiological evaluation (audiometry, speech audiometry, and immittance audiometry), behavioral evaluation (tests: dichotic digits, synthetic sentence identification with ipsilateral competing message, gaps-in-noise, frequency pattern), and electrophysiological evaluation (Auditory Brainstem Response, ABR, Frequency Following Response, FFR (verbal), and Long Latency Auditory Evoked Potential, LLAEP). RESULTS: The EG group showed significantly poorer performance (p<0.001) than the CG for all auditory abilities studied. The results revealed significant latency delays and reduced amplitude (p<0.05) of waves III and V for ABR; significant latency delay was seen of potentials P2, N2, and P300 for LLAEP; significant latency delays and reduced amplitude (p<0.05) were observed for FFR in children with a history of otitis media. CONCLUSION: The results demonstrate negative effect of otitis media in the auditory abilities and electrophysiological measures in children with a history of otitis media.

An Analysis of The Parameters Used In Speech ABR Assessment Protocols.

The aim of this study was to assess the parameters of choice, such as duration, intensity, rate, polarity, number of sweeps, window length, stimulated ear, fundamental frequency, first formant, and second formant, from previously published speech ABR studies. To identify candidate articles, five databases were assessed using the following keyword descriptors: speech ABR, ABR-speech, speech auditory brainstem response, auditory evoked potential to speech, speech-evoked brainstem response, and complex sounds. The search identified 1288 articles published between 2005 and 2015. After filtering the total number of papers according to the inclusion and exclusion criteria, 21 studies were selected. Analyzing the protocol details used in 21 studies suggested that there is no consensus to date on a speech-ABR protocol and that the parameters of analysis used are quite variable between studies. This inhibits the wider generalization and extrapolation of data across languages and studies.

Speech-evoked brainstem response in normal adolescent and children speakers of Brazilian Portuguese.

This study aimed to analyze the coding responses of speech sounds (syllable/da/) in children and adolescent speakers of Brazilian Portuguese with typical development and normal hearing, aged between 8 and 16 years, in order to establish normative data of speech ABR response. This normative data can be used as a reference for speech ABR responses and also to enable the diagnosis in individuals with different pathologies. The analyze for absolute latency of speech sounds, more specifically the syllable/da/, for speech-ABR in children and adolescent speakers of Brazilian Portuguese with typical development were: right ear - wave V (6,43-6,57), wave A (7,35-7,57), wave C (18,19-18,46), wave D (21,99-22,42), wave E (30,73-31,05), wave F (39,19-39,55) and wave O (47,75-48,24) and left ear - wave V (6,44-6,57), wave A (7,36-7,59), wave C (18,26-18,55), wave D (22,22 -22,50), wave E (30,58-30,97), wave F (39,05-39,35) and wave O (47,78-48,13). For the amplitude values (µv), the responses were within the following ranges: right ear - wave V (0,10-0,14), wave A (0,19-0,25), wave C (0,08-0,13), wave D (0,11-0,17), wave E (0,17-0,42), wave F (0,14-0,33) and wave O (0,11-0,31) and left ear - wave V (0,09-0,13), wave A (0,08-0,23), wave C (0,08-0,14), wave D (0,10-0,15), wave E (0,20-0,26), wave F (0,16-0,22) and wave O (0,12-0,20). For the values of complex VA (slope: µv/ms and area µv x ms) the follow values obtained were: right ear - slope (0,32-0,42) and area (0,29-0,38) and left ear - slope (0,30-0,39) and area (0,27-0,35).