Diagnóstico del desorden del procesamiento auditivo central / Diagnosis of central auditory processing disorder

CONTEXTO CLÍNICO: Una alteración en el lenguaje se refiere a un impedimento en la capacidad de recibir, enviar, processar y comprender conceptos o sistemas de símbolos verbales, no verbales y gráficos. El desarrollo normal de la comunicación requiere la interacción de un mecanismo intacto con un entorno favorable. Dentro de los componentes responsables de este mecanismo se incluyen la sensibilidad auditiva, percepción, inteligencia, integridad estructural, habilidad motora y estabilidad emocional. Los desórdenes del procesamiento auditivo central (DPAC) se definen como un déficit en el procesamiento de la información relacionada en forma específica a la modalidad auditiva, este déficit puede verse exacerbado en ambientes en donde las condiciones acústicas son desfavorables. Estos déficits pueden estar asociados a dificultades auditivas, de comprensión del habla, desarrollo del lenguaje y aprendizaje. Un DPAC es resultado de una disfunción en el procesamiento de la información auditiva pudiendo o no coexistir con una disfunción global que afecte el desempeño a través de otras modalidades (por ejemplo: déficit de atención, déficit en la representación del lenguaje, entre otros). La prevalencia de este desorden varía levemente según diferentes investigadores, los datos más recientes señalan este rango entre 2% y 3% de los niños a una razón de 2:1 entre hombre y mujeres. TECNOLOGÍA: El profesional a cargo debe seleccionar la batería de pruebas adecuadas para el diagnóstico de DPAC. La selección de éstas debe basarse en los hallazgos de la historia del caso, la evaluación interdisciplinaria (por ejemplo, los resultados del lenguaje y las evaluaciones cognitivas) y la evaluación audiológica periférica. La batería de pruebas se puede usar para diagnosticar una alteración en uno o más processos neurofisiológicos que ocurren cuando las señales auditivas viajan a través del SNAC. La identificación de déficits específicos en los SNAC puede llevar a recomendaciones específicas y planes de tratamiento. OBJETIVO: El objetivo del presente informe es evaluar la evidencia disponible acerca de la capacidad diagnóstica y los aspectos relacionados a las políticas de cobertura del uso de las pruebas diagnósticas en el desorden del procesamiento auditivo central. MÉTODOS: Se realizó una búsqueda en las principales bases de datos bibliográficas, en buscadores genéricos de internet, y financiadores de salud. Se priorizó la inclusión de revisiones sistemáticas (RS), ensayos clínicos controlados aleatorizados (ECAs), evaluaciones de tecnologías sanitarias (ETS), evaluaciones económicas, guías de práctica clínica (GPC) y políticas de cobertura de diferentes sistemas de salud. RESULTADOS: Se incluyeron una RS, siete GPC y siete informes de políticas de cobertura sobre pruebas diagnósticas para el desorden del procesamiento auditivo central. CONCLUSIONES: Evidencia de baja calidad sugiere que las pruebas diagnósticas utilizadas actualmente en el desorden del procesamiento auditivo central (DPAC) podrían ser de utilidad para su abordaje diagnóstico. No se hallaron estudios que evalúen la precisión diagnóstica de un conjunto de pruebas en pacientes con sospecha de DPAC. Las guías de práctica clínica (GPC) relevadas expresan que no existe un patrón de oro para realizar el diagnóstico de DPAC, por lo tanto, la selección de las distintas pruebas debería ajustarse a las características y condiciones del paciente. Las mismas GPC recomiendan el uso de una batería de pruebas (de comportamiento o electrofisiológicas) para el abordaje diagnóstico del DPAC, debido a que en su conjunto mejorarían la precisión diagnóstica. Una GPC intersociedades de Europa recomienda una batería determinada de pruebas para iniciar el abordaje diagnóstico, constituído por la prueba de dígitos dicóticos, las de patrones de frecuencia y de duración, Gaps-In-Noise (GIN), prueba de habla en ruido, diferencia de umbrales binaurales enmascarados, y la prueba de inteligibilidad del habla pediátrica. Los financiadores públicos de salud que han sido relevados no contemplan la cobertura de las pruebas para el diagnóstico de DPAC. Dentro de los financiadores privados de salud de los Estados Unidos, dos no brindan cobertura ya que la consideran en fase experimental, mientras que otros dos otorgan cobertura para el abordaje diagnóstico del DPAC, y en esos casos, la batería de pruebas será seleccionada según criterio del profesional tratante.

Adverse effects of pesticides on central auditory functions in tobacco growers.

OBJECTIVE: To investigate the effects of exposure to pesticides on the central auditory functions (CAF) of Brazilian tobacco growers. DESIGN: This was a cross-sectional study carried out between 2010 and 2012. Participants were evaluated with two behavioural procedures to investigate CAF, the random gap detection test (RGDT) and the dichotic digit test in Portuguese (DDT). STUDY SAMPLE: A total of 22 growers exposed to pesticides (study group) and 21 subjects who were not exposed to pesticides (control group) were selected. RESULTS: No significant differences between groups were observed for pure-tone thresholds. A significant association between pesticide exposure and the results for RGDT and DDT was found. Significant differences between pesticide-exposed and nonexposed subjects were found for RGDT frequency average and DDT binaural average, when including age and hearing level as covariates. Age was significantly associated with RGDT frequency average, DDT left ear score, DDT binaural average and DDT right ear advantage. Hearing levels were not significantly associated with any of the test scores. The relative risk of failing the DDT and RGDT for the study group was 1.88 (95% CI: 1.10-3.20) and 1.74 (95% CI: 1.06-2.86), respectively, as compared with the control group. CONCLUSIONS: The results showed that tobacco growers exposed to pesticides exhibited signs of central auditory dysfunction characterised by decrements in temporal processing and binaural integration processes/abilities.

Potencial cortical P3: nível de dificuldade para diferentes estímulos / P3 cortical potential: difficulty level for different stimulus

Objetivo Avaliar o nível de dificuldade de identificação dos estímulos verbais e não verbais, segundo classificação dos próprios participantes, e comparar com a latência do potencial cortical P3. Métodos Foram avaliados 30 sujeitos, com média de idade de 23 anos, normo-ouvintes. O potencial P3 foi pesquisado com estímulos não verbais (tone burst)e verbais (/ba/ x /di/, /ba/ x /ga/, /ba/ x /da/). Cada sujeito classificou os estímulos em "mais fácil" e "mais difícil".Resultados : A maioria dos indivíduos classificou o contraste /ba/ x /di/ como sendo o mais fácil de identificar e o contraste /ba/ x /ga/, como o mais difícil. Os sujeitos referiram que os estímulos de fala foram mais fáceis de identificar quando comparados com tone burst. O nível de dificuldade descrito pelos indivíduos influenciou nas latências dos estímulos /Di/ e /Da/, classificados como mais fáceis, e evidenciados na menor latência do P3.Conclusão O contraste /Ba/ x /Di/ foi considerado o de maior facilidade de percepção, sendo evidenciado pela menor latência do P3. Os contrastes de fala foram classificados mais fáceis quando comparados com os estímulos tonais. Essas comparações auxiliam o clínico na escolha do estímulo utilizado e no correto diagnóstico audiológico.

Purpose Evaluating the level of difficulty of identifying verbal and non-verbal stimuli, according to the classification of the participants, as well as comparing the latency of the P3 cortical potential.Methods Thirty subjects, with a mean age of 23 years and normal hearing, were evaluated. The P3 potential was performed with non-verbal stimuli (tone burst) and verbal (/ba/ x /di/, /ba/ x /ga/, /ba/ x /da/). Each subject had to classify stimulus in "the easiest" and "the most difficult".Results Most subjects rated the /ba/ x /di/ contrast as the easiest to identify and the contrast /ba/ x /ga/ the most difficult. The subjects reported that the speech stimulus were easier to identify when compared to tone burst. The difficulty level described by the subjects influenced the latencies of stimuli /Di/ and /Da/, ranked as the easiest and they were evidenced in the lowest latency of P3.Conclusion The /Ba/ x /Di/ contrast was considered the easiest for perception, being evidenced by the lowest latency of P3. The speech contrasts were classified as the easiest when compared with the tonal stimuli. These comparisons help the clinician in selecting the stimuli and in the correct audiological diagnosis.

Xylene-induced auditory dysfunction in humans.

OBJECTIVES: Animal data indicate that xylene induces cochlear dysfunction, characterized by the loss of outer hair cells. There is little evidence regarding xylene-induced ototoxicity in humans. The aim of the study was to investigate the possible adverse effects of xylene on the peripheral and central auditory system in humans. DESIGN: A total of 30 medical laboratory workers who had been exposed to a mixture of xylene isomers, together with 30 nonexposed control participants matched for gender, age, and educational level were selected. Participants of both groups were not exposed to noise levels above 85 dBA time-weighted average. All participants were evaluated with a comprehensive audiological test battery, which included measures of peripheral and central auditory function. Peripheral auditory measures included pure-tone audiometry and distortion product otoacoustic emissions. Behavioral measures of central auditory function included a pitch pattern sequence test, an adaptive test of temporal resolution, a dichotic digit test, and a masking level difference test. The auditory brainstem response was used to objectively evaluate the function of the auditory pathways at the brainstem level. Speech perception in quiet and in noise was evaluated using the Hearing In Noise Test (HINT). The xylene-exposed participants were extensively evaluated with regard to their exposure to both noise and xylene. Noise dosimetry was conducted over an 8-hr work shift to obtain noise-exposure levels for each xylene-exposed worker. Airborne xylene concentrations were obtained at 11 different workstations throughout the medical laboratories, and methyl hippuric acid levels per gram of creatinine in urine were obtained for each xylene-exposed subject. Finally, a detailed interview exploring current and past solvent and noise exposure was conducted. RESULTS: The xylene-exposed participants showed significantly worse pure-tone thresholds in comparison with the nonexposed participants. The xylene-exposed participants demonstrated significantly worse results than the control group participants for the pitch pattern sequence test, dichotic digit test, HINT, and the auditory brainstem response (absolute and interpeak latencies). No significant differences between the xylene-exposed and nonexposed participants were observed for distortion product otoacoustic emissions, adaptive test of temporal resolution, or the masking level difference test. A significant correlation between the concentrations of methyl hippuric acid in urine and pure-tone thresholds (2 to 8 kHz) was found in xylene-exposed workers. Also, participants with high cumulative dose of xylene exposure presented with poorer test results than participants with low cumulative dose of xylene exposure. CONCLUSIONS: The results of the present research suggest that xylene is associated with adverse central auditory effects and poorer sound detection abilities in humans. A major limitation of the study is that the results found among xylene-exposed participants cannot be proved to be permanent, and thus further research should be conducted to clarify this limitation. Workers exposed to this chemical should be routinely evaluated with a comprehensive audiological test battery, to detect early signs of auditory dysfunction.

Sensitivity and specificity of auditory steady-state response testing.

INTRODUCTION: The ASSR test is an electrophysiological test that evaluates, among other aspects, neural synchrony, based on the frequency or amplitude modulation of tones. OBJECTIVE: The aim of this study was to determine the sensitivity and specificity of auditory steady-state response testing in detecting lesions and dysfunctions of the central auditory nervous system. METHODS: Seventy volunteers were divided into three groups: those with normal hearing; those with mesial temporal sclerosis; and those with central auditory processing disorder. All subjects underwent auditory steady-state response testing of both ears at 500 Hz and 2000 Hz (frequency modulation, 46 Hz). The difference between auditory steady-state response-estimated thresholds and behavioral thresholds (audiometric evaluation) was calculated. RESULTS: Estimated thresholds were significantly higher in the mesial temporal sclerosis group than in the normal and central auditory processing disorder groups. In addition, the difference between auditory steady-state response-estimated and behavioral thresholds was greatest in the mesial temporal sclerosis group when compared to the normal group than in the central auditory processing disorder group compared to the normal group. DISCUSSION: Research focusing on central auditory nervous system (CANS) lesions has shown that individuals with CANS lesions present a greater difference between ASSR-estimated thresholds and actual behavioral thresholds; ASSR-estimated thresholds being significantly worse than behavioral thresholds in subjects with CANS insults. This is most likely because the disorder prevents the transmission of the sound stimulus from being in phase with the received stimulus, resulting in asynchronous transmitter release. Another possible cause of the greater difference between the ASSR-estimated thresholds and the behavioral thresholds is impaired temporal resolution. CONCLUSIONS: The overall sensitivity of auditory steady-state response testing was lower than its overall specificity. Although the overall specificity was high, it was lower in the central auditory processing disorder group than in the mesial temporal sclerosis group. Overall sensitivity was also lower in the central auditory processing disorder group than in the mesial temporal sclerosis group.

Sensitivity and specificity of auditory steady-state response testing

INTRODUCTION: The ASSR test is an electrophysiological test that evaluates, among other aspects, neural synchrony, based on the frequency or amplitude modulation of tones. OBJECTIVE: The aim of this study was to determine the sensitivity and specificity of auditory steady-state response testing in detecting lesions and dysfunctions of the central auditory nervous system. METHODS: Seventy volunteers were divided into three groups: those with normal hearing; those with mesial temporal sclerosis; and those with central auditory processing disorder. All subjects underwent auditory steady-state response testing of both ears at 500 Hz and 2000 Hz (frequency modulation, 46 Hz). The difference between auditory steady-state response-estimated thresholds and behavioral thresholds (audiometric evaluation) was calculated. RESULTS: Estimated thresholds were significantly higher in the mesial temporal sclerosis group than in the normal and central auditory processing disorder groups. In addition, the difference between auditory steady-state response-estimated and behavioral thresholds was greatest in the mesial temporal sclerosis group when compared to the normal group than in the central auditory processing disorder group compared to the normal group. DISCUSSION: Research focusing on central auditory nervous system (CANS) lesions has shown that individuals with CANS lesions present a greater difference between ASSR-estimated thresholds and actual behavioral thresholds; ASSR-estimated thresholds being significantly worse than behavioral thresholds in subjects with CANS insults. This is most likely because the disorder prevents the transmission of the sound stimulus from being in phase with the received stimulus, resulting in asynchronous transmitter release. Another possible cause of the greater difference between the ASSR-estimated thresholds and the behavioral thresholds is impaired temporal resolution. CONCLUSIONS: The overall sensitivity of auditory steady-state response testing was lower than its overall specificity. Although the overall specificity was high, it was lower in the central auditory processing disorder group than in the mesial temporal sclerosis group. Overall sensitivity was also lower in the central auditory processing disorder group than in the mesial temporal sclerosis group.

Electrophysiological manifestations in adults with HIV/AIDS submitted and not submitted to antiretroviral therapy.

BACKGROUND: auditory evoked potentials (AEP) assess the neuroelectric activity on the auditory pathway -from the auditory nerve to the cerebral cortex - in response to an acoustic stimulus or event. Studies have demonstrated electrophysiological abnormalities in individuals with HIV/AIDS. AIM: to characterize the hearing electrophysiological manifestations in adults with HIV/AIDS by comparing the results obtained in the group exposed to antiretroviral therapy with those obtained in the group not exposed to such treatment. METHOD: electrophysiological evaluation of hearing (Auditory Brainstem Response - ABR, Auditory Middle Latency Response - AMLR and P300) was conducted in 56 individuals with HIV/AIDS: 24 participants composed group I (not exposed to antiretroviral treatment) and 32 participants composed group II (exposed to treatment). RESULTS: alterations in every AEP were observed in individuals with HIV/ AIDS, especially in the ABR. Indeed, the group exposed to antiretroviral treatment presented more alterations. CONCLUSION: individuals with HIV/AIDS may present alterations on the central and peripheral auditory nervous system. The group exposed to antiretroviral therapy presents more alterations on the brainstem auditory pathway.

Manifestações eletrofisiológicas em adultos com HIV/AIDS submetidos e não-submetidos à terapia anti-retroviral / Electrophysiological manifestations in adults with HIV/AIDS submitted and not submitted to antiretroviral therapy

BACKGROUND: auditory evoked potentials (AEP) assess the neuroelectric activity on the auditory pathway -from the auditory nerve to the cerebral cortex - in response to an acoustic stimulus or event. Studies have demonstrated electrophysiological abnormalities in individuals with HIV/AIDS. AIM: to characterize the hearing electrophysiological manifestations in adults with HIV/AIDS by comparing the results obtained in the group exposed to antiretroviral therapy with those obtained in the group not exposed to such treatment. METHOD: electrophysiological evaluation of hearing (Auditory Brainstem Response - ABR, Auditory Middle Latency Reponse - AMLR and P300) was conducted in 56 individuals with HIV/AIDS: 24 participants composed group I (not exposed to antiretroviral treatment) and 32 participants composed group II (exposed to treatment). RESULTS: alterations in every AEP were observed in individuals with HIV/ AIDS, especially in the ABR. Indeed, the group exposed to antiretroviral treatment presented more alterations. CONCLUSION: individuals with HIV/AIDS may present alterations on the central and peripheral auditory nervous system. The group exposed to antiretroviral therapy presents more alterations on the brainstem auditory pathway.

TEMA: os potenciais evocados auditivos (PEA) avaliam a atividade neuroelétrica na via auditiva, desde o nervo auditivo até o córtex cerebral, em resposta a um estímulo ou evento acústico. Estudos demonstram anormalidades eletrofisiológicas em indivíduos com HIV/AIDS. OBJETIVO: caracterizar as manifestações eletrofisiológicas da audição em adultos com HIV/AIDS, comparando os resultados obtidos no grupo exposto a tratamento anti-retroviral com os obtidos no grupo não exposto a tratamento. MÉTODO: realizada avaliação eletrofisiológica da audição (PEATE, PEAML e P300) em 56 indivíduos portadores do HIV/AIDS, sendo 24 do Grupo I (não expostos ao tratamento anti-retroviral) e 32 do Grupo II (expostos ao tratamento). RESULTADOS: foram encontradas alterações em todos os PEA nos indivíduos com HIV/AIDS, principalmente no PEATE; sendo que neste, o grupo exposto ao tratamento antiretroviral apresentou mais alterações. CONCLUSÃO: indivíduos com HIV/AIDS podem apresentar alterações no sistema nervoso auditivo periférico e central, sendo que o grupo exposto a tratamento anti-retroviral apresenta mais alterações na via auditiva em tronco encefálico.

Neuropatía auditiva, diagnóstico y manejo audiológico / Auditory neuropathy / dyssychrony, assessment and audiologic management

Los hallazgos clínicos que definen una neuropatía/des sincronía (NA/DA) son la integridad de las células ciliadas evidenciado, mediante la presencia de emisiones otoacústicas evocadas (EOAe) y/o la presencia de potenciales microfónicos cocleares (PMIC), junto con la ausencia de actividad neural evocada a nivel del VIII par craneano (potencial de acción compuesto) y tronco cerebral (potencial evocado auditivo de tronco (PEAT)). Las condiciones clínicas relacionadas con una NA/DA incluyen a la hiperbilirrubinemia, enfermedades neurovegetativas (ejemplo ataxia de Friedreich), síndrome de Charcot-Marie-Tooth así como otras neuropatías sensoriomotoras, desórdenes mitocondriales y neuropatías isquémica-hipóxicas como resultados de asfixia. El desarrollo de las habilidades auditivas y comunicacionales pueden estar comprometidas en forma importante en los niños con aparición prelingual de una NA/DA, mayor es aún este compromiso al no existir un perfil pronóstico preestablecido del desarrollo y resultados en el tratamiento de este desorden. En la actualidad existen múltiples estudios en donde se ha observado que hasta 50 por ciento de los pacientes con NA/DA presentan algún grado de beneficio al usar audífonos por lo que se sugiere que sistemas de amplificación como los audífonos o incluso implante coclear deberían ser el primer paso en el proceso de (re)habilitación.

The clinical findings that define an auditory neuropathy/dyssynchrony (AN/Dys) are the integrity of the outer hair cells demonstrated by the presence of evoked otoacoustics emissions (OAEe) and/or the presence of cochlear microphonic potential (CMP) along with the absence of neural activity evoked at level of VIII nerve (action potential compound) and brainstem (Auditory Brainstem Response, ABR). The clinical conditions related to an AN they include hiperbilirrubinemia, neurodegenerative diseases (eg ataxia of Friedreich), Charcot-Marie-Tooth syndrome as well as other sensoriomotor neuropathies, mitocondrial disorders and hypoxic neuropathy as perinatal asphyxia. The development of the auditory and communicational abilities can be compromise in children with prelingual onset of an AN/Dys, the development and results of treatment of this disorder is still this commitment when not existing a profile prognosis. At the present time multiple studies have been observed that until a 50 percent of the patients with AN present some degree of benefit using hearing aids, reason why it suggests amplification systems as the hearing aids or even cochlear implant would have to be the first step in the process of (re) habilitation of these patients.

Migraine associated with auditory-vestibular dysfunction.

UNLABELLED: The association between hearing and balance disorders with migraine is known since the times of the ancient Greeks, when Aretaeus from Cappadocia in 131 B.C, made an accurate and detailed description of this occurrence during a migraine episode. We present a broad review of migraine neurotological manifestations, using the most recent publications associated with epidemiology, clinical presentation, pathophysiology, diagnostic methods and treatment for this syndrome. AIM: To describe the clinical entity: "Migraine associated with auditory-vestibular dysfunction" in order to help otorhinolaryngologists and neurologists in the diagnosis and management of such disorder. FINAL REMARKS: There is a strong association between neurotological symptoms and migraine, and the auditory-vestibular dysfunction-associated migraine is the most common cause of spontaneous episodic vertigo (non-positional). Symptoms may vary broadly among patients, making it a diagnostic challenge to the otorhinolaryngologist. This entity usually presents with positional or spontaneous vertigo spells, lasting for seconds or days, associated with migraine symptoms. A better understanding of the relationship between central vestibular mechanisms and migraine mechanisms, besides the discovery of ionic channel disorders in some cases of migraine, ataxia and vertigo, may lead to a better understanding of migraine pathophysiology associated with audio-vestibular disorder.

Enxaqueca associada a disfunção auditivo-vestibular: [revisão] / Migraine associated with auditory-vestibular dysfunction: [review]

A associação de distúrbios da audição e equilíbrio com enxaqueca é reconhecida desde a Grécia antiga quando Aretaeus da Capadócia em 131 a.C., fez uma descrição precisa e com detalhes desta ocorrência durante uma crise de enxaqueca. Uma revisão ampla das manifestações otoneurológicas da enxaqueca é apresentada, usando as mais recentes publicações com respeito à epidemiologia, apresentação clínica, fisiopatologia, métodos diagnósticos e manejo desta síndrome. OBJETIVO: Descrever a entidade clínica "Enxaqueca associada a Disfunção Auditivo-vestibular" no intuito de ajudar médicos otorrinolaringologistas e neurologistas no diagnóstico e no manejo clínico dessa doença. COMENTÁRIOS FINAIS: Uma forte associação existe entre sintomas otoneurológicos e enxaqueca, sendo a enxaqueca associada a disfunção auditivo-vestibular a causa mais comum de vertigem episódica espontânea (não-posicional). Os sintomas podem variar bastante entre pacientes tornando um desafio diagnóstico para o otorrinolaringologista. Esta entidade geralmente se apresenta com ataques de vertigem espontâneos ou posicionais, durando de segundos a dias com sintomas de enxaqueca associados. Uma melhor elucidação da ligação entre os mecanismos vestibulares centrais e os mecanismos da enxaqueca em si, além da descoberta de defeitos em canais iônicos em algumas causas de enxaqueca, ataxia e vertigem, podem levar a um entendimento maior da fisiopatologia da enxaqueca associada a disfunção auditivo-vestibular.

The association between hearing and balance disorders with migraine is known since the times of the ancient Greeks, when Aretaeus from Cappadocia in 131 B.C, made an accurate and detailed description of this occurrence during a migraine episode. We present a broad review of migraine neurotological manifestations, using the most recent publications associated with epidemiology, clinical presentation, pathophysiology, diagnostic methods and treatment for this syndrome. AIM: to describe the clinical entity: "Migraine associated with auditory-vestibular dysfunction" in order to help otorhinolaryngologists and neurologists in the diagnosis and management of such disorder. FINAL REMARKS: There is a strong association between neurotological symptoms and migraine, and the auditory-vestibular dysfunction-associated migraine is the most common cause of spontaneous episodic vertigo (non-positional). Symptoms may vary broadly among patients, making it a diagnostic challenge to the otorhinolaryngologist. This entity usually presents with positional or spontaneous vertigo spells, lasting for seconds or days, associated with migraine symptoms. A better understanding of the relationship between central vestibular mechanisms and migraine mechanisms, besides the discovery of ionic channel disorders in some cases of migraine, ataxia and vertigo, may lead to a better understanding of migraine pathophysiology associated with audio-vestibular disorder.

[Performance of normal young adults in two temporal resolution tests]. / Desempenho de adultos jovens normais em dois testes de resolução temporal.

BACKGROUND: temporal auditory processing is defined as the perception of sound or of sound alteration within a restricted time interval and is considered a fundamental ability for the auditory perception of verbal and non verbal sounds, for the perception of music, rhythm, periodicity and in the discrimination of pitch, duration and of phonemes. AIM: to compare the performance of normal Brazilian adults in two temporal resolution tests: the Gaps-in-Noise Test (GIN) and the Random Gap Detection Test (RGDT), and to analyze potential differences of performance in these two tests. METHOD: twenty-five college students with normal hearing (11 males and 14 females) and no history of educational, neurological and/or language problems, underwent the GIN and RGDT at 40dB SL. RESULTS: statistically significant gender effects for both tests were found, with female participants showing poorer performance on both temporal processing tests. In addition, a comparative analysis of the results obtained in the GIN and RGDT revealed significant differences in the threshold measures derived for these two tests. In general, significantly better gap detection thresholds were observed for both male and female participants on the GIN test when compared to the results obtained for the RGDT. CONCLUSION: male participants presented better performances on both RGDT and GIN, when compared to the females. There were no differences in performance between right and left ears on the GIN test. Participants of the present investigation, males and females, performed better on the GIN when compared to the RGDT. The GIN presented advantages over the RGDT, not only in terms of clinical validity and sensibility, but also in terms of application and scoring.

Desempenho de adultos jovens normais em dois testes de resolução temporal / Performance of normal young adults in two temporal resolution tests

TEMA: o processamento auditivo temporal se refere a percepção de um evento sonoro ou de uma alteração no mesmo, dentro de um intervalo definido de tempo e é considerado uma habilidade fundamental na percepção auditiva de sons verbais e não verbais, na percepção de música, ritmo e pontuação e na discriminação de pitch, de duração e de fonemas. OBJETIVO: realizar um estudo comparativo do desempenho de adultos jovens normais nos testes de resolução temporal, Random Gap Detection Test (RGDT) e Gaps-in-Noise (GIN) e analisar diferenças entre esses dois métodos de avaliação. MÉTODO: 25 universitários, 11 homens e 14 mulheres, com audição normal e sem histórico de alterações educacionais, neurológicas e/ou linguagem, foram submetidos ao RGDT e ao GIN, a 40dB NS. RESULTADO: observou-se diferença estatisticamente significante entre os sexos sendo que as mulheres apresentaram pior desempenho nos dois testes. No estudo comparativo dos resultados do RGDT e GIN, observaram-se diferenças significativas no desempenho da amostra. De maneira geral, os limiares de detecção de gap no teste GIN foram melhores do que os limiares obtidos no RGDT. CONCLUSÃO: o sexo masculino teve melhor desempenho tanto no teste RGDT quanto no GIN, quando comparado ao feminino. Além disso, não houve diferença significante nas repostas do GIN nas orelhas direita e esquerda. Os sujeitos deste estudo tiveram melhor desempenho no teste GIN, quando comparado ao RGDT, tanto no sexo masculino quanto no feminino. Portanto, o teste GIN apresentou vantagens sobre o RGDT não apenas quanto à sua validade e sensibilidade, mas também com relação a sua aplicação e correção dos resultados.

BACKGROUND: temporal auditory processing is defined as the perception of sound or of sound alteration within a restricted time interval and is considered a fundamental ability for the auditory perception of verbal and non verbal sounds, for the perception of music, rhythm, periodicity and in the discrimination of pitch, duration and of phonemes. AIM: to compare the performance of normal Brazilian adults in two temporal resolution tests: the Gaps-in-Noise Test (GIN) and the Random Gap Detection Test (RGDT), and to analyze potential differences of performance in these two tests. METHOD: twenty-five college students with normal hearing (11 males and 14 females) and no history of educational, neurological and/or language problems, underwent the GIN and RGDT at 40dB SL. RESULTS: statistically significant gender effects for both tests were found, with female participants showing poorer performance on both temporal processing tests. In addition, a comparative analysis of the results obtained in the GIN and RGDT revealed significant differences in the threshold measures derived for these two tests. In general, significantly better gap detection thresholds were observed for both male and female participants on the GIN test when compared to the results obtained for the RGDT. CONCLUSION: male participants presented better performances on both RGDT and GIN, when compared to the females. There were no differences in performance between right and left ears on the GIN test. Participants of the present investigation, males and females, performed better on the GIN when compared to the RGDT. The GIN presented advantages over the RGDT, not only in terms of clinical validity and sensibility, but also in terms of application and scoring.

Potenciais evocados auditivos de longa latência em adultos com HIV/Aids / Long latency auditory evoked potentials in adults with HIV/Aids

TEMA: potenciais evocados auditivos de longa latência. OBJETIVO: caracterizar os potenciais evocados auditivos de longa latência (Peall) de indivíduos com HIV/Aids comparando com os obtidos no grupo controle. MÉTODO: a casuística foi composta por 21 indivíduos com HIV/Aids pertencentes ao grupo pesquisa (14 do gênero masculino e sete do gênero feminino) com idade entre 31 e 48 anos e 21 indivíduos saudáveis pertencentes ao grupo controle (cinco do gênero masculino e 16 do gênero feminino) com idade entre 19 e 36 anos. Foram analisados os valores de latência e amplitude da onda P300, latência das ondas N1 e P2 e amplitude N1-P2. Os eletrodos foram colocados nas posições A1, A2, Cz e Fpz. RESULTADOS: no P300 observou-se que o grupo com HIV/Aids apresentou maiores valores de latência (p-valor = 0,010) e menores de amplitude (p-valor = 0,021) quando comparados com o grupo controle. Na análise do complexo N1-P2, ao comparar os grupos, verificou-se que o grupo pesquisa apresentou maiores valores de latência tanto para a onda N1 (p-valor = 0,035) como para a onda P2, porém esta última sem diferença estatisticamente significante. Com relação à análise da amplitude N1-P2, verificou-se que o grupo controle apresentou maiores valores, sendo esta diferença estatisticamente significante quando comparada ao grupo pesquisa. CONCLUSÃO: os achados do presente estudo mostraram que indivíduos com HIV/Aids apresentam alterações nos Peall, sugerindo comprometimento nas áreas corticais do sistema auditivo e mostrando a importância destes testes na avaliação audiológica de indivíduos com HIV/Aids.

BACKGROUND: Long Latency Auditory Evoked Potentials. AIM: to characterize the Long Latency Auditory Evoked Potentials (LLAEP) in individuals with HIV/AIDS in comparison to a control group. METHOD: the research sample was composed by 21 individuals with HIV/AIDS - research group (14 male and 7 female), with ages ranging from 31 to 48 years, and 21 healthy individuals - control group (5 male and 16 female), with ages ranging from 19 to 36 years. The latency and amplitude values of the P300 wave were analyzed; latency of N1 and P2 waves, and amplitude N1-P2. The electrodes were placed on the following positions: A1, A2, Cz and Fpz. RESULTS: the T-student test was used to analyze the results and the adopted significance level was of 5 percent. In the analyzes of P300 it was observed that the group with HIV/AIDS presented greater latency values (p-value = 0,010) and lower amplitude values (p-value = 0,021) when compared to the control group. The analysis of the N1-P2 complex revealed that the research group presented higher latency values for both, N1 wave (p-value = 0,035) and P2 wave, however for this last one, there was no significant statistical difference when compared to the control group. Concerning the amplitude analysis of the N1-P2 complex, it was verified that the control group presented significantly higher values when compared to the research group. CONCLUSION: the findings of this study indicates that individuals with HIV/AIDS present alterations in the Long Latency Auditory Evoked Potentials (higher latencies and lower amplitudes of N1, P2 and P300 waves), suggesting a disorder in the cortical regions of the auditory pathway, and therefore stressing the importance of such tests in the evaluation of these individuals.

[Long latency auditory evoked potentials in adults with HIV/Aids]. / Potenciais evocados auditivos de longa latência em adultos com HIV/Aids.

BACKGROUND: Long Latency Auditory Evoked Potentials. AIM: to characterize the Long Latency Auditory Evoked Potentials (LLAEP) in individuals with HIV/AIDS in comparison to a control group. METHOD: the research sample was composed by 21 individuals with HIV/AIDS - research group (14 male and 7 female), with ages ranging from 31 to 48 years, and 21 healthy individuals - control group (5 male and 16 female), with ages ranging from 19 to 36 years. The latency and amplitude values of the P300 wave were analyzed; latency of N1 and P2 waves, and amplitude N1-P2. The electrodes were placed on the following positions: A1, A2, Cz and Fpz. RESULTS: the T-student test was used to analyze the results and the adopted significance level was of 5%. In the analyzes of P300 it was observed that the group with HIV/AIDS presented greater latency values (p-value = 0,010) and lower amplitude values (p-value = 0,021) when compared to the control group. The analysis of the N1-P2 complex revealed that the research group presented higher latency values for both, N1 wave (p-value = 0,035) and P2 wave, however for this last one, there was no significant statistical difference when compared to the control group. Concerning the amplitude analysis of the N1-P2 complex, it was verified that the control group presented significantly higher values when compared to the research group. CONCLUSION: the findings of this study indicates that individuals with HIV/AIDS present alterations in the Long Latency Auditory Evoked Potentials (higher latencies and lower amplitudes of N1, P2 and P300 waves), suggesting a disorder in the cortical regions of the auditory pathway, and therefore stressing the importance of such tests in the evaluation of these individuals.

Macrossomia e habilidades auditivas: estudo comparativo / Macrosomia and auditory abilities: a comparative study

TEMA:macrossomia é o desvio positivo dos padrões de crescimento normal. OBJETIVO: devido à escassez de estudos das habilidades auditivas nas síndromes macrossômicas, este trabalho objetivou verificar e comparar o desempenho auditivo de dois pacientes e correlacioná-los aos achados complementares. MÉTODO: anamnese, avaliação audiológica, de linguagem, psicológica e de neuroimagem em dois sujeitos do gênero feminino, de oito e dezessete anos. RESULTADOS: sujeito I - normal, sujeito II - alterado. CONCLUSÃO: há uma crescente necessidade em investigar a neurofisiologia da audição nessa população, visto que estudos fonoaudiológicos poderiam propiciar o diagnóstico precoce, favorecendo o processo de intervenção.

[Macrosomia and auditory abilities: a comparative study]. / Macrossomia e habilidades auditivas: estudo comparativo.

BACKGROUND: Macrosomia is the positive deviation of normal growing standards. AIM: Due to the lack of studies related to the auditory abilities in macrosomic syndromes, the aim of the present study was to verify and compare the auditory abilities of two patients and to correlate these results with other complementary findings. METHOD: Anamneses, hearing, language, psychologic and neuroimage evaluation in two female subjects, eight and seventeen years old. RESULTS: Subject I - normal; subject II - impaired. CONCLUSION: There is a growing need for more investigations of the neurophysiology of the auditory system in this population. Studies in the area of hearing can favor the early diagnosis and therefore the intervention process.

Contribuição de uma avaliação de audição dicótica para diagnóstico da doença de Alzheimer / Contribution of a dichotic listening evaluation to diagnose Alzheimer’s disease

O objetivo deste estudo é analisar a eficiência do exame de audição dicótica multi-classe e compará-la à eficiência do teste dicótico de dígitos para verificar se pacientes com doença de Alzheimer apresentam diferente desempenho quando comparados a indivíduos idosos normais. Foram examinados 10 indivíduos com doença de Alzheimer, 15 idosos normais e 27 adultos jovens, controlados de acordo com idade; gênero; escolaridade; nível sócio-econômico; e quociente intelectual. Houve correlação significante entre os procedimentos e evidenciou-se a praticidade do uso do índice percentual de acertos da orelha esquerda competitiva como fator preditivo para auxílio diagnóstico da doença de Alzheimer / The purpose of this study is to analyze and compare the efficiency of dichotic multi class exam and dichotic digits test to verify difference in performance among Alzheimer’s disease patients and normal elderly individuals. Ten Alzheimer’s disease patients, 15 normal elderly individuals and 27 young adults, matched for age; gender; years of education; socioeconomic level; and intellectual quotient, were evaluated. A significant correlation between procedures was identified showing that a competitive left ear correct responses index can be a predictive factor to help Alzheimer’s disease diagnosis...

Benefícios do esclarecimento da comorbidade de trantorno de déficit de atençäo/hiperatividade (TDAH) e distúrbio de processamento auditivo central (CAPD): estudo de caso / Benefits of cleareance in comorbidity of attention deficit disorder with hyperactivity (ADHD) and central audutory processing disorder (CAPD): case report

Este artigo apresenta o estudo de caso de uma jovem de 15 anos de idade, primeiramente diagnosticada como portadora de transtorno de déficit de atenção/hiperatividade-tipo predominantemente desalento. A comorbidade de distúrbio de processamento auditivo central foi diagnosticada posteriormente. As autoras pretendem mostrar os benefícios de análise quantitativa e qualitativa da avaliação comportamental da função auditiva central na determinação de programas de habilitação individualizados.