Effects of Hearing Aid Use on Individuals Diagnosed with Hearing Loss and Dementia: A Systematic Review.

Background: The assumption that hearing rehabilitation could improve quality of life and reduce dementia risk in people with hearing loss is a subject that needs further studies, especially clinical trials. It is necessary to determine the effects of hearing aid use, as part of hearing rehabilitation, among people diagnosed with dementia. Objective: To systematically review the literature to evaluate the effects of hearing aid use on cognition and quality of life of people with dementia. Methods: Protocol for this systematic review was registered (CRD42023387187). The Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Scopus, CINAHL, and Web of Science databases, as well as grey literature, including Google Scholar and ResearchGate, were systematically searched for clinical trials using MeSH terms. The PICOS principle was used to develop the inclusion criteria: population (P): adults and older adults, individuals diagnosed with dementia and hearing loss; intervention (I): rehabilitation with hearing aids; control (C): not using a hearing aid; outcome (O): cognitive and/or quality of life assessment using validated tests; study design (S): clinical trial. Results: The initial search yielded 576 studies, five of which met the inclusion criteria for qualitative analyses. Two of the included studies were randomized clinical trials, and three were crossover clinical trials, demonstrating the lack of studies on the subject. Four studies included participants with Alzheimer's disease. Quality of life was found to improve with the use of hearing aids, and hearing rehabilitation was not shown to affect cognitive outcomes. Conclusions: Hearing aid use appears to have a positive impact on quality of life.

Auditory and academic skills self-perception in adults. / Autopercepção sobre habilidades auditivas e acadêmicas de adultos.

OBJECTIVE: To describe and analyze auditory and academic complaints of students and employees of a federal public university. METHODS: The study was carried out using a non-probabilistic. The EAPAC Scale with adaptations was used to fulfill the research objectives. It has 14 questions about complaints related to listening skills and 12 questions related to the academic environment. Descriptive data analysis was performed through the frequency distribution of categorical variables and Pearson's chi-square test was used for association analyses. RESULTS: 646 individuals aged between 17 and 67 years old participated in the research. The most prevalent complaints were academic difficulty related to memory, concentration, and planning, hearing and understanding speech in noise, and memorization of tasks that were only heard. There was an association with bidirectional statistical significance between academic and auditory complaints. CONCLUSION: It was possible to observe that there is an association between auditory and academic complaints in adults, marked by the relationship between cognitive and auditory aspects. It is relevant that these factors are considered when performing assessments of Central Auditory Processing when intervening in patients with auditory complaints, and in student life.

OBJETIVO: Descrever e analisar queixas auditivas e acadêmicas de universitários e funcionários de uma universidade pública federal. MÉTODOS: O estudo foi realizado por amostra não-probabilística. A Escala de Autopercepção de Habilidades do Processamento Auditivo Central com adaptações foi utilizada para cumprir os objetivos da pesquisa. Esta possui 14 questões sobre queixas relacionadas às habilidades auditivas e 12 relacionadas ao ambiente acadêmico. Foi realizada a análise descritiva dos dados por meio da distribuição de frequência das variáveis categóricas e, para as análises de associação, foi utilizado o teste Qui-quadrado de Pearson. RESULTADOS: Participaram da pesquisa 646 indivíduos com faixa etária entre 17 e 67 anos. As queixas mais prevalentes foram: dificuldade acadêmica relacionada à memória, concentração e planejamento, ouvir e compreender a fala no ruído, e memorização de tarefas que foram apenas ouvidas. Houve associação com significância estatística bidirecional entre as queixas acadêmicas e auditivas. CONCLUSÃO: Foi possível observar que há associação entre queixas auditivas e acadêmicas em adultos, marcada pela relação de aspectos cognitivos com aspectos auditivos. É relevante que esses fatores sejam considerados ao realizar avaliações do Processamento Auditivo Central, ao se intervir em pacientes com queixas auditivas, e na vida estudantil.

Psychometric Validation of a Hearing Screening Questionnaire for Preschoolers Based on Language Development Evaluation by Caregivers.

INTRODUCTION: This study aimed to validate three age-adjusted versions of a Hearing Screening Questionnaire for Preschoolers, in Brazilian Portuguese, based on parents' perception of their children's hearing and oral language. METHODS: Psychometric validation was conducted on three questionnaires, each comprising nine items with yes/no responses. Three items focused on hearing screening at birth, and six assessed hearing and oral language. The study included 152 parents and their children, who attended daycare centers in Belo Horizonte, Brazil. The children were categorized into three age bands: 12-18 months, 19-35 months, and 36-48 months. Audiological assessments, including tympanometry, transient-evoked otoacoustic emissions (TEOAE), and pure-tone audiometry (when applicable), were performed on the children. In case of abnormal findings in the previous exams, auditory brainstem response (ABR) testing was conducted. Descriptive data, false alarm, and false-negative analyses were carried out. RESULTS: Considering any type of hearing loss, whether unilateral or bilateral, the questionnaires showed a false-negative rate of 41.17% (7/17 children). However, when considering only bilateral hearing loss, the questionnaire showed a false alarm rate of 31.69% (45/142) and a false-negative rate of 30.0% (3/10). When focusing exclusively on sensorineural hearing loss, the questionnaire identified two children (1.31%), with a false-negative rate of 0% but a false-positive rate of 33.33%. CONCLUSION: Language-development-oriented questionnaires allowed quick screening of potential hearing loss in preschoolers. This study found a robust hit rate with these questionnaires. Their validation signifies a promising and cost-effective tool for conducting hearing screenings in preschool children, especially in nations lacking a comprehensive school screening policy. The validated questionnaire affords an easy-to-apply, low-cost, and effective instrument for preschool hearing screening.

Histomorphometric Changes of the Masseter Muscle of Rats After a Single Injection of Botulinum Toxin Type A.

BACKGROUND: It has been reported that botulinum toxin type A (BoNT-A) produces structural changes in masticatory muscles. However, not all histomorphometric parameters affected by BoNT-A parameters have been assessed. This study investigated the histomorphometric changes in the masseter muscle of rats after a single injection of BoNT-A. METHODS: Forty-four adult animals were randomly divided into control group (n = 22) and BoNT-A group (n = 22). Controls received a single dose of 0.14 mL/kg of saline in masseter muscles, and the BoNT-A group received a 7 U/Kg of BoNT-A. The groups received the same volume of injected substances. Animals were sacrificed on 7th (n = 5), 14th (n = 5), 21st (n = 5), 28th (n = 4) and 90th (n = 3) days post-treatment. Histological masseter tissue slides were obtained from hematoxylin-eosin treatment and analyzed in optical microscopy regarding muscle cross-sectional area, amount of connective tissue and quantity and diameter of myocytes. For statistical analysis, generalized linear models were used to compare the data (ANOVA). In all test, the significance level of 5% was set. RESULTS: BoNT-A values of cross-sectional area of the masseter muscle were significantly lower than controls (p < 0.01) throughout the study. Regarding myocytes quantity, BoNT-A subgroups presented higher values than controls (p < 0.0001) since the 14th day until the end of the study; however, the diameter of myocytes was smaller in all BoNT-A subgroups (p < 0.0001) in all assessment points. The amount of connective tissue was higher in BoNT-A subgroups (p < 0.0001) throughout the study. CONCLUSION: A single injection of BoNT-A altered the structure of masseter muscle of rats, regarding its histomorphometric parameters. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Autopercepção sobre habilidades auditivas e acadêmicas de adultos / Auditory and academic skills self-perception in adults

RESUMO Objetivo Descrever e analisar queixas auditivas e acadêmicas de universitários e funcionários de uma universidade pública federal. Métodos O estudo foi realizado por amostra não-probabilística. A Escala de Autopercepção de Habilidades do Processamento Auditivo Central com adaptações foi utilizada para cumprir os objetivos da pesquisa. Esta possui 14 questões sobre queixas relacionadas às habilidades auditivas e 12 relacionadas ao ambiente acadêmico. Foi realizada a análise descritiva dos dados por meio da distribuição de frequência das variáveis categóricas e, para as análises de associação, foi utilizado o teste Qui-quadrado de Pearson. Resultados Participaram da pesquisa 646 indivíduos com faixa etária entre 17 e 67 anos. As queixas mais prevalentes foram: dificuldade acadêmica relacionada à memória, concentração e planejamento, ouvir e compreender a fala no ruído, e memorização de tarefas que foram apenas ouvidas. Houve associação com significância estatística bidirecional entre as queixas acadêmicas e auditivas. Conclusão Foi possível observar que há associação entre queixas auditivas e acadêmicas em adultos, marcada pela relação de aspectos cognitivos com aspectos auditivos. É relevante que esses fatores sejam considerados ao realizar avaliações do Processamento Auditivo Central, ao se intervir em pacientes com queixas auditivas, e na vida estudantil.

ABSTRACT Objective To describe and analyze auditory and academic complaints of students and employees of a federal public university. Methods The study was carried out using a non-probabilistic. The EAPAC Scale with adaptations was used to fulfill the research objectives. It has 14 questions about complaints related to listening skills and 12 questions related to the academic environment. Descriptive data analysis was performed through the frequency distribution of categorical variables and Pearson's chi-square test was used for association analyses. Results 646 individuals aged between 17 and 67 years old participated in the research. The most prevalent complaints were academic difficulty related to memory, concentration, and planning, hearing and understanding speech in noise, and memorization of tasks that were only heard. There was an association with bidirectional statistical significance between academic and auditory complaints. Conclusion It was possible to observe that there is an association between auditory and academic complaints in adults, marked by the relationship between cognitive and auditory aspects. It is relevant that these factors are considered when performing assessments of Central Auditory Processing when intervening in patients with auditory complaints, and in student life.

Impaired auditory neural performance, another dimension of hearing loss in type-2 diabetes mellitus.

AIM: To evaluate auditory performance in subjects with poorly controlled type-2 diabetes mellitus, using a simple test battery assessing sensitivity to pure tones and neuronal function. METHODS: Enrolled subjects, aged between 23 and 79 years, reported several auditory dysfunctions. They were tested using pure-tone audiometry, otoacoustic emissions for cochlear-function evaluation, and measurement of middle-ear muscle-reflex thresholds in search of an auditory neuropathy. RESULTS: Compared to the standard established for an age-matched normative population, the distribution of averaged pure-tone thresholds in enrolled subjects shifted by about one standard deviation with respect to the normal distribution, in line with past reports of mild sensorineural hearing impairment in diabetes, even though many diabetic subjects fell well within the normative interval of audiometric thresholds. Otoacoustic emissions showed that pure-tone thresholds correctly predicted the status of cochlear sensory cells that, by amplifying sound, ensure normal hearing sensitivity. Whereas the observed hearing losses should not have affected the acoustic levels above which the protective middle-ear muscle reflex is triggered by intense sounds, this reflex was undetectable in around 40% enrolled subjects, a marker of auditory neuropathy. CONCLUSION: Auditory-neural function should be evaluated to identify diabetic subjects whose hearing is impaired. Simple automatic tests are available for this purpose, for example middle-ear muscle reflex detection, which turns out to be more sensitive than the standard audiogram.

Reliability of Contralateral Suppression in Evoked Distortion Product Otoacoustic Emissions

Abstract Introduction Distortion product otoacoustic emissions (DPOAE) and their suppression may be considered useful in monitoring cochlear function and the efferent auditory pathway inhibitory effect. Nonetheless, the establishment of reliable parameters of response variations is of great importance. Objectives To verify the replicability of test and retest in the research of the inhibitory effect of the efferent pathway using contralateral suppressing stimulus during DPOAE recording for clinical applicability. Methods Cross-sectional study with 48 volunteers, aged 18 to 30 years, with normal audiometric thresholds. The procedures included were audiometric and immittance measures to overrule any conductive or sensorineural conditions and DPOAE recordings without and with contralateral suppression with a 60 dBHL white noise. Distortion product otoacoustic emissions amplitudes were analyzed and compared in both conditions with Wilcoxon test, and the Spearman correlation test was used to assess test-retest reliability. Results The comparative analysis showed differences between amplitudes in test and retest conditions only in 1,500 Hz for DPOAE measures with all other tested frequencies showing no differences, and no difference was observed in all recorded frequencies in the test and retest comparison for DPOAE suppression. The degree of correlation between test and retest of DPOAE amplitude was good at 6,000 Hz and strong (r > 0.880) at the other frequencies. For DPOAE with suppression, all frequencies presented strong correlation between test and retest: 1,500 Hz (r = 0.880), 2,000 Hz (r = 0.882), 3,000 Hz (r = 0.940), and 6,000 Hz (r = 0.957). Conclusions The study found good replicability in contralateral suppression of DPOAE with potential clinical applicability, and we recommend conducting the test from 2000Hz to higher frequencies for more reliable results.

Reliability of Contralateral Suppression in Evoked Distortion Product Otoacoustic Emissions.

Introduction Distortion product otoacoustic emissions (DPOAE) and their suppression may be considered useful in monitoring cochlear function and the efferent auditory pathway inhibitory effect. Nonetheless, the establishment of reliable parameters of response variations is of great importance. Objectives To verify the replicability of test and retest in the research of the inhibitory effect of the efferent pathway using contralateral suppressing stimulus during DPOAE recording for clinical applicability. Methods Cross-sectional study with 48 volunteers, aged 18 to 30 years, with normal audiometric thresholds. The procedures included were audiometric and immittance measures to overrule any conductive or sensorineural conditions and DPOAE recordings without and with contralateral suppression with a 60 dBHL white noise. Distortion product otoacoustic emissions amplitudes were analyzed and compared in both conditions with Wilcoxon test, and the Spearman correlation test was used to assess test-retest reliability. Results The comparative analysis showed differences between amplitudes in test and retest conditions only in 1,500 Hz for DPOAE measures with all other tested frequencies showing no differences, and no difference was observed in all recorded frequencies in the test and retest comparison for DPOAE suppression. The degree of correlation between test and retest of DPOAE amplitude was good at 6,000 Hz and strong (r > 0.880) at the other frequencies. For DPOAE with suppression, all frequencies presented strong correlation between test and retest: 1,500 Hz (r = 0.880), 2,000 Hz (r = 0.882), 3,000 Hz (r = 0.940), and 6,000 Hz (r = 0.957). Conclusions The study found good replicability in contralateral suppression of DPOAE with potential clinical applicability, and we recommend conducting the test from 2000Hz to higher frequencies for more reliable results.

Cognitive screening in HTLV-1-infected people using a self-perceived memory score and auditory P300.

The HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is the most common neurological manifestation associated with human T-cell lymphotropic virus type-1 (HTLV-1) infection. Although cognitive impairment has been highlighted in the spectrum of HTLV-1 neurological manifestations, it may go unnoticed in those who do not spontaneously report it. We aimed at evaluating the applicability of a self-perceived memory score (SMS) and the cognitive event-related potential (P300) for early detection of cognitive impairment in HTLV-1-infected people. The SMS was measured by a 0-10 point numeric scale combined with a sad-happy face rating scale. The higher the number, the better was the SMS. The P300 was obtained through an oddball paradigm with a mental counting task. The participants were 15 (21.4%) individuals with HAM/TSP, 20 (28.6%) HTLV-1 asymptomatic carriers, and 35 (50%) seronegative controls. We found that SMS (p < 0.001) and P300 latency (p < 0.001) got progressively worse from the seronegative controls to the asymptomatic carriers and then to the HAM/TSP. The results that indicated cognitive impairment were SMS < 7.2 points and P300 latency > 369.0 ms. The HAM/TSP group showed the highest prevalence of altered P300 (80%) and SMS (87%). Interestingly, the asymptomatic group also presented significantly higher prevalence of altered SMS (60%) and P300 (35%) when compared to controls (< 10%). The frequency of cognitive impairment was 16 times higher in the HTLV-1 asymptomatic group and 69 times higher in the HAM/TSP group when compared to controls. The use of SMS in the medical consultation was a useful and easy-to-apply method to screen HTLV-1-infected subjects for everyday memory complaints.

Auditory Brainstem Response with chirp stimuli in newborns: an integrative review / PEATE por estímulo chirp em recém-nascidos: uma revisão integrativa

ABSTRACT Purpose: to review the literature available on electrophysiological findings on ABR with chirp stimuli in newborns. Methods: articles were searched in PubMed, MEDLINE, Scopus, Web of Science, LILACS, and SciELO. Papers published in English and Portuguese between 2010 and 2020 were selected, including those that addressed ABR with air-conduction broadband chirp stimuli in newborns, that assessed ABR with a specific frequency, and that compared ABR results with chirp and click stimuli. Articles that assessed only bone-conduction results, duplicates, literature reviews, case reports, letters, and editorials were excluded. Literature review: the search strategy resulted in nine selected articles. Four studies (44.4%) analyzed ABR wave amplitude and latency with chirp stimuli, three studies (33.3%) compared the time of ABR procedures between chirp and click stimuli, two studies (22.2%) analyzed only amplitude, and two (22.2%), verified the specificity of ABR with chirp stimuli in neonatal hearing screening. Conclusion: chirp stimuli elicit responses with greater amplitudes, lower latencies, and shorter examination time than those with click stimuli in newborns.

RESUMO Objetivo: revisar a literatura disponível sobre os achados eletrofisiológicos do PEATE por estímulo chirp em recém-nascidos. Métodos: a busca dos artigos foi realizada nas bases de dados PubMed, Medline, Scopus, Web of Science, LILACS e Scielo. Foram selecionados artigos publicados em Inglês e Português, entre 2010 e 2020. Foram incluídos artigos que contemplavam o uso do PEATE por estímulo chirp banda larga por via aérea em recém-nascidos; que avaliavam o PEATE por frequência específica e que comparavam os resultados do PEATE por estímulo chirp e clique. Aqueles que avaliavam somente resultados por via óssea, artigos repetidos nas bases de dados, artigos de revisão de literatura, relato de casos, cartas e editoriais foram excluídos. Revisão da Literatura: a estratégia de busca resultou na seleção de nove artigos. Quatro estudos (44,4%) analisaram amplitude e latência das ondas do PEATE por estímulo chirp, três (33,3%) compararam o tempo de realização do PEATE por clique e chirp, dois estudos (22,2%) analisaram somente o parâmetro amplitude e dois (22,2%) verificaram a especificidade do PEATE por chirp na triagem auditiva neonatal. Conclusão: o estímulo chirp possibilita respostas com maiores amplitudes, maiores latências e menor tempo de realização do exame quando comparado ao estímulo clique em recém-nascidos.

Validação da Escala de Autopercepção de Habilidades do Processamento Auditivo Central (EAPAC) para adultos / Validation of the Central Auditory Processing Skill Self-Perception Scale (CAPSSPS) for adults

RESUMO Objetivo validar um questionário autorreferido para avaliação do processamento auditivo central para adultos. Métodos o instrumento foi testado e validado com 123 estudantes universitários de 18 a 59 anos, sem alteração auditiva e sem histórico de tratamento para transtorno do processamento auditivo central. Os participantes realizaram os testes Gaps in Noise e Fala com Ruído. Por meio da análise estatística, foi definido o ponto de corte para alterações, a sensibilidade e a especificidade. Resultados o instrumento foi elaborado contendo 21 questões relacionadas ao histórico de saúde, aos hábitos de vida, às queixas auditivas e de aprendizagem. Após a análise fatorial, as questões relacionadas ao hábito de vida e condições de saúde foram retiradas por apresentarem carga fatorial baixa. Assim, a versão final da escala foi composta por 13 questões. Os constructos de primeira ordem e o indicador diagnóstico apresentaram níveis de confiabilidade exigidos. Foram definidos os pontos de corte 6 e 5 que indicassem alteração nos testes Gaps in Noise e Fala com Ruído branco, respectivamente. Conclusão a escala apresentou resultados válidos, confiáveis e consistentes e foi capaz de realizar inferências sobre o processamento auditivo.

ABSTRACT Purpose To validate a self-report questionnaire to assess the central auditory processing in adults. Methods The instrument was tested and validated with 123 university students aged 18 to 59 years, without hearing changes or history of treatment for central auditory processing disorder. The participants were submitted to the Gaps-in-Noise and speech-in-white-noise tests. The cutoff scores for changes, sensitivity, and specificity were defined with statistical analysis. Results The instrument was developed with 21 questions related to health history, life habits, and hearing and learning complaints. After factor analysis, the questions related to life habits and health conditions were removed because they had a low factor loading. Thus, the final version of the scale comprised 13 questions. The first-order constructs and the diagnostic indicator achieved the required levels of reliability. The cutoff scores to indicate abnormal results in the Gaps-in- Noise and speech-in-white-noise tests were defined respectively as 6 and 5. Conclusion The scale obtained valid, reliable, and consistent results and enabled professionals to make inferences about auditory processing.

Estudo das emissões otoacústicas residuais nas perdas auditivas neurossensoriais com diferenciação de artefatos e respostas fisiológicas / Study of residual otoacoustic emissions in hearing loss with artifact differentiation and physiological responses

RESUMO Objetivo avaliar o efeito da variação da intensidade de estimulação sobre as respostas das emissões otoacústicas produto de distorção em indivíduos com perda auditiva neurossensorial, utilizando um protocolo de gradiente de fase das emissões. Métodos estudo observacional transversal. Participaram 38 indivíduos com diagnóstico de perda auditiva neurossensorial de grau leve, moderado ou severo. Foram realizadas anamnese, meatoscopia, audiometria tonal liminar, logoaudiometria, imitanciometria, emissões otoacústicas produto de distorção e emissões otoacústicas residuais. As emissões otoacústicas residuais foram coletadas com o equipamento Echodia, modelo Elios®. O protocolo utilizado permite a variação dos parâmetros frequência e intensidade e as respostas são analisadas por meio do teste do Gradiente de Fase. As respostas registradas nas emissões residuais foram consideradas como "presente", "ausente" e "artefato", considerando a variação da fase em função de f1. Resultados Foram incluídas 72 orelhas. Houve diferença estatisticamente significativa nas frequências de 1300 Hz e 2000 Hz, ao comparar os resultados das emissões residuais. Ao correlacionar o resultado da audiometria e a intensidade de estimulação que evocou a emissão residual, houve correlação positiva para as frequências de 1000 Hz e 4000Hz. O "artefato" foi registrado, principalmente, nas frequências mais agudas: 56,2% em 3000 Hz e 58,2% em 4000 Hz. A emissão otoacústica residual presente foi registrada em 18,6% em 1000 Hz, 13,4% em 2000 Hz, 6,3% em 3000 Hz e 7,5% em 4000 Hz. Conclusão o aumento da intensidade de estimulação no exame de emissões pode auxiliar no estudo das células ciliadas residuais, desde que seja utilizado um protocolo capaz de diferenciar respostas fisiológicas de artefatos.

ABSTRACT Purpose To study the effect of stimulation intensity variation on the responses of distortion products in subjects with sensorineural hearing loss using a new protocol to register the otoacoustic emissions. Methods This is a cross-sectional observational study. The following procedures were performed: anamnesis, otoscopy, pure tone audiometry, speech audiometry, tympanometry, distortion product and residual otoacoustic emissions. The residual DPOAE were collected with the Echodia equipment, Elios®. The protocol that was developed allows the variation of frequency and intensity parameters and the responses are analyzed by phase gradient test. Responses recorded in residual otoacoustic emissions were considered "present", "absent" or "artifact". Results The total included ears was 72. On residual otoacoustic emissions test, at a frequency of 1300Hz and 2000Hz, there was statistically significant difference. By analyzing the average found in the audiometry and the results of residual emissions, only the frequency of 1300Hz showed a statistically significant association in all groups. By correlating the results of the audiometry and the stimulation intensity used to evoke the residual emission, there was positive correlation for the frequencies of 1000Hz and 4000Hz. The "artifact" was mostly recorded in the higher frequencies: 56.2% in 3000Hz and 58.2% in 4000 Hz. Residual EOAPD present was recorded as 18.6% at 1000Hz, 13.4% at 2000Hz, 6.3% at 3000Hz and 7.5% at 4000Hz. Conclusion The increased stimulation intensity in the otoacoustic emissions test can aid in the study of residual outer hair cells, as long as a protocol is used to check the correctness of the responses.

Hearing function, perception of disability (handicap) and cognition in the elderly: a relation to be elucidated. / Função auditiva, percepção da incapacidade e cognição em idosos: uma relação a elucidar.

PURPOSE: To analyze auditory perception, hearing and cognition in the elderly referred for audiological evaluation and search for correlations between hearing and cognitive abilities. METHOD: An observational and descriptive study, carried out with 135 elderly people. The participants did the auditory (tonal audiometry, speech audiometry, immittance measures, HHIE Questionnaire - Hearing Handicap Inventory for the Elderly) and the cognitive (MMSE - Mini Mental State Examination) assessments. RESULTS: There is a high prevalence of hearing complaints (91.85%) and hearing loss (91.85%) in the elderly referred for audiological assessment, but there was no relation between the degree of hearing loss (p = 0.537) and the auditory perception (p = 0.930) in relation to cognitive performance. CONCLUSION: In this study, the degree of hearing loss did not influence the cognitive performance of the elderly, and the auditory handicap perception did not differ between individuals with normal or altered cognition.

OBJETIVO: Analisar a percepção da incapacidade auditiva, a audição e a cognição em idosos encaminhados para avaliação audiológica e verificar a existência de correlação entre a audição e as habilidades cognitivas. MÉTODO: Estudo observacional e descritivo, realizado com 135 idosos. Os participantes realizaram a avaliação auditiva (Audiometria Tonal Limiar, Logoaudiometria, Imitanciometria) responderam a um inventário que avalia a percepção da incapacidade auditiva (questionário HHIE - Hearing Handicap Inventory for the Elderly) e foram submetidos a um rastreio cognitivo (teste Mini Exame do Estado Mental - MEEM). RESULTADOS: Houve elevada prevalência de queixa auditiva e perda da audição nos idosos encaminhados para avaliação auditiva, mas não houve relação do grau da perda auditiva e da percepção da incapacidade auditiva em relação ao desempenho cognitivo. CONCLUSÃO: Neste estudo, o grau da perda auditiva não influenciou o desempenho cognitivo dos idosos, e a percepção da incapacidade auditiva não diferiu entre indivíduos com cognição normal ou alterada.

Hearing brain evaluated using near-infrared spectroscopy in congenital toxoplasmosis.

Congenital toxoplasmosis (CT) is a known cause of hearing loss directly caused by Toxoplasma gondii. Hearing loss might result from sensory, neural, or sensorineural lesions. Early treated infants rarely develop hearing loss, but retinochoroidal lesions, intracranial calcifications and hydrocephalus are common. In this study, we aimed to evaluate the brain evoked hemodynamic responses of CT and healthy infants during four auditory stimuli: mother infant directed speech, researcher infant directed speech, mother reading and researcher recorded. Children underwent Transitionally Evoked Otoacoustic Emission Auditory Testing and Automated Brainstem Auditory Response tests with normal auditory results, but with a tendency for greater latencies in the CT group compared to the control group. We assessed brain hemodynamics with functional near-infrared spectroscopy (fNIRS) measurements from 61 infants, and we present fNIRS results as frequency maps of activation and deactivation for each stimulus. By evaluating infants in the three first months of life, we observed an individual heterogeneous brain activation pattern in response to all auditory stimuli for both groups. Each channel was activated or deactivated in less than 30% of children for all stimuli. There is a need of prospective studies to evaluate if the neurologic or auditory changes course with compromise of children outcomes.

Effect of Tinnitus Habituation Therapy on Auditory Abilities.

Introduction Research with tinnitus patients presenting with hearing loss and normal hearing subjects have verified that tinnitus interferes with auditory processing. One treatment option for this symptom consists of tinnitus habituation therapy. Objective To determine the influence of tinnitus habituation therapy on auditory abilities, on the self-perception of tinnitus regarding loudness and discomfort, and its impact on the quality of life. Methods A quasi-experimental study was conducted with 19 individuals with tinnitus. Audiological tinnitus and auditory processing evaluations were performed. Subsequently, the volunteers underwent tinnitus habituation therapy for 6 months. Ultimately, all of the individuals were reevaluated. Results A statistically significant reduction in tinnitus self-perception was observed in relation to loudness, discomfort, and its impact on the quality of life ( p = 0.001, 0.001, 0.023, respectively). However, the influence of tinnitus habituation therapy on auditory abilities was not verified. Conclusion Tinnitus habituation therapy was effective in reducing the self-perception of tinnitus loudness and discomfort, as well as the impact of the symptom on the quality of life. However, these factors did not improve the auditory processing skills in tinnitus patients.

Effect of Tinnitus Habituation Therapy on Auditory Abilities

Abstract Introduction Research with tinnitus patients presenting with hearing loss and normal hearing subjects have verified that tinnitus interferes with auditory processing. One treatment option for this symptom consists of tinnitus habituation therapy. Objective To determine the influence of tinnitus habituation therapy on auditory abilities, on the self-perception of tinnitus regarding loudness and discomfort, and its impact on the quality of life. Methods A quasi-experimental study was conducted with 19 individuals with tinnitus. Audiological tinnitus and auditory processing evaluations were performed. Subsequently, the volunteers underwent tinnitus habituation therapy for 6 months. Ultimately, all of the individuals were reevaluated. Results A statistically significant reduction in tinnitus self-perception was observed in relation to loudness, discomfort, and its impact on the quality of life (p = 0.001, 0.001, 0.023, respectively). However, the influence of tinnitus habituation therapy on auditory abilities was not verified. Conclusion Tinnitus habituation therapy was effective in reducing the self-perception of tinnitus loudness and discomfort, as well as the impact of the symptom on the quality of life. However, these factors did not improve the auditory processing skills in tinnitus patients.

Função auditiva, percepção da incapacidade e cognição em idosos: uma relação a elucidar / Hearing function, perception of disability (handicap) and cognition in the elderly: a relation to be elucidated

RESUMO Objetivo Analisar a percepção da incapacidade auditiva, a audição e a cognição em idosos encaminhados para avaliação audiológica e verificar a existência de correlação entre a audição e as habilidades cognitivas. Método Estudo observacional e descritivo, realizado com 135 idosos. Os participantes realizaram a avaliação auditiva (Audiometria Tonal Limiar, Logoaudiometria, Imitanciometria) responderam a um inventário que avalia a percepção da incapacidade auditiva (questionário HHIE - Hearing Handicap Inventory for the Elderly) e foram submetidos a um rastreio cognitivo (teste Mini Exame do Estado Mental - MEEM). Resultados Houve elevada prevalência de queixa auditiva e perda da audição nos idosos encaminhados para avaliação auditiva, mas não houve relação do grau da perda auditiva e da percepção da incapacidade auditiva em relação ao desempenho cognitivo. Conclusão Neste estudo, o grau da perda auditiva não influenciou o desempenho cognitivo dos idosos, e a percepção da incapacidade auditiva não diferiu entre indivíduos com cognição normal ou alterada.

ABSTRACT Purpose To analyze auditory perception, hearing and cognition in the elderly referred for audiological evaluation and search for correlations between hearing and cognitive abilities. Method An observational and descriptive study, carried out with 135 elderly people. The participants did the auditory (tonal audiometry, speech audiometry, immittance measures, HHIE Questionnaire - Hearing Handicap Inventory for the Elderly) and the cognitive (MMSE - Mini Mental State Examination) assessments. Results There is a high prevalence of hearing complaints (91.85%) and hearing loss (91.85%) in the elderly referred for audiological assessment, but there was no relation between the degree of hearing loss (p = 0.537) and the auditory perception (p = 0.930) in relation to cognitive performance. Conclusion In this study, the degree of hearing loss did not influence the cognitive performance of the elderly, and the auditory handicap perception did not differ between individuals with normal or altered cognition.

Vestibular Evoked Myogenic Potential on Ocular, Cervical, and Soleus Muscles to Assess the Extent of Neurological Impairment in HTLV-1 Infection.

Introduction: Vestibular Evoked Myogenic Potential (VEMP) can be used to test central vestibular pathways from the midbrain to the lumbar spine, according to the muscle tested. Purpose: to compare the spinal cord alteration in individuals with HTLV-1-associated myelopathy (HAM) and with HTLV-1-asymptomatic infection using the VEMP recorded from different muscles. Methods: VEMP was recorded in 90 individuals of whom 30 had HAM, 30 were HTLV-1 asymptomatic carriers, and 30 negative controls. VEMP was recorded in the oculomotor muscle (oVEMP), testing the vestibulo-ocular reflex, and in the cervical muscle (cVEMP) and soleus muscle (sVEMP), testing the vestibulospinal reflex, respectively, in the cervical and in the lumbar spinal level. The type of stimulation was auditory for oVEMP and cVEMP, and galvanic for sVEMP. The compared variables were the latencies of the electrophysiological waves. Results: HTLV-1-asymptomatic group was similar to the controls regarding oVEMP (p = 0.461), but different regarding cVEMP (p < 0.001) and sVEMP (p < 0.001). HAM group has presented the worst latencies and was different from the HTLV-1-asymptomatic group in the VEMP of all the tested muscles (p < 0.001). The concomitant occurrence of VEMP alterations in the three recorded muscles of the same individual was found in 2 (6.7%) asymptomatic carriers and in 20 (66.7%) patients with HAM (p = 0.001). The analysis of VEMP alteration per group and per muscle has showed that, in HTLV-1-asymptomatic group, oVEMP was altered in 3 (10.0%) individuals, cVEMP in 10 (33.3%) and sVEMP in 13 (43.3%). In HAM group, oVEMP was altered in 23 (76.6%) individuals, cVEMP in 27 (90%), and sVEMP in 30 (100%). Conclusion: HTLV-1-neurological damage has followed an ascendant progression beginning at the lumbar spine in the stage of a clinically asymptomatic infection, whereas HAM has affected not only the spine, but also the midbrain.

Case Report: Cognitive Impairment without Clinical Spinal Disease May Be the First Sign of HTLV-1 Neurological Alteration.

Human t-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy (HAM) is a progressive neurological disease whose diagnosis is defined by clinical manifestations and seropositivity for HTLV-1 infection. Cognitive impairment (CI) is considered to occur after spinal impairment. A 51-year-old HTLV-1-infected man classified as an asymptomatic carrier presented difficulties in listening comprehension and executive memory. He was assessed for central auditory processing (CAP), cognition (event-related auditory evoked potential [P300]), and otoneurological functions (galvanic vestibular-evoked myogenic potential [gVEMP]). Altered responses were found in CAP, P300, and gVEMP, but the neurological examination and cognitive screening were normal. After a 2-year follow-up, we disclosed a positive Babinski sign, a mild CI, worsened P300, and gVEMP latencies, and the patient reported progressive lumbar pain and difficulty running. He was, then, reclassified as HAM. The first examination, in 2016, had already shown abnormal results in P300 and gVEMP despite the HTLV-1-asymptomatic carrier status. Therefore, tests that provide subclinical measures of neurological disease progression can be useful tools for an early diagnosis and intervention in HTLV-1 patients. Electrophysiological results had worsened as well as the clinical status and the cognitive function and the progression from asymptomatic status to an HTLV-1-associated neurological disease occurred within 2 years. Thus, HTLV-1-infected individuals with complaints of CI, hearing, or otoneurological manifestations should be submitted to neuropsychological and electrophysiological tests, allowing them to be properly cared in case of HAM progression.

Ocular vestibular evoked myogenic potential (VEMP) reveals mesencephalic HTLV-1-associated neurological disease.

PURPOSE: Vestibular Myogenic Evoked Potential (VEMP) evaluates vestibulo-ocular and vestibulo-collic reflexes involved in the function of the otolithic organs and their afferent pathways. We compared the results of cervical and ocular VEMP in HTLV-1 associated myelopathy (HAM) and HTLV-1-asymptomatic infection. PARTICIPANTS AND METHODS: This cross-sectional study included 52 HTLV-1-infected individuals (26 HAM and 26 asymptomatic carriers) and 26 seronegative controls. The groups were similar regarding age and gender. Participants underwent simultaneous ocular and cervical VEMP. The stimulus to generate VEMP was a low-frequency tone burst sound tone burst, with an intensity of 120 decibels normalized hearing level, bandpass filter from 10 to 1,500 Hertz (Hz), with 100 stimuli at 500 Hz and 50 milliseconds recording time. The latencies of the electrophysiological waves P13 and N23 for cervical VEMP and N10 and P15 waves for ocular VEMP were compared among the groups. The absence or delay of the electrophysiological waves were considered abnormal results. RESULTS: Ocular VEMP was similar among the groups for N10 (p = 0.375) and different for P15 (p≤0.001). Cervical VEMP was different for P13 (p = 0.001) and N23 (p = 0.003). About ocular VEMP, in the HTLV-1-asymptomatic group, normal waves were found in 23(88.5%) individuals; in HAM group, normal waves were found in 7(26.9%). About cervical VEMP, 18(69.2%) asymptomatic carriers presented normal waves and only 3(11.5%) patients with HAM presented normal waves. Abnormalities in both VEMPs were found in 1(3.8%) asymptomatic carrier and in 16(61.5%) patients with HAM. CONCLUSION: Neurological impairment in HAM was not restricted to the spinal cord. The mesencephalic connections, tested by ocular VEMP, have been also altered. Damage of the oculomotor system, responsible for eye stabilization during head and body movements, may explain why dizziness is such a frequent complaint in HAM.