Evaluation of vinpocetine as a therapy in patients with sensorineural hearing loss: A phase II, open-label, single-center study.

The progressive degeneration of the excitable cells of the ear depends on the sustained excitation of the voltage-sensitive sodium channels, so the negative pharmacological modulation could be a rational therapeutic strategy against the damage of these cells. The objective was to demonstrate the effectiveness of Vinpocetine (VPC), a potent sodium channel blocker, as a treatment for acquired sensorineural hearing loss. A phase II, longitudinal and prospective open clinical study, was conducted over a period of 12 months with patients older than 18 years, to demonstrate the effectiveness of Vinpocetine (VPC) as a treatment for acquired sensorineural hearing loss, using evoked potentials, otoacoustic emissions, audiometry and logoaudiometry, analyzing the results at 6 and 12 months of treatment with Vinpocetine (30 mg/day in 3 doses). It was observed that from 0 to 6 months there was hearing impairment (which was already expected due to the age of the patients). From 6 to 12 months and from 0 to 12 months there were significant differences with a tendency towards improvement, indicating that the aforementioned deterioration not only stopped, but that with the use of vinpocetine, the hearing capacity improved. It is concluded that Vinpocetine helps to stop hearing impairment and even improve hearing.

Dopamine D1 receptor activation maintains motor coordination and balance in rats.

Dopamine (DA) modulates motor coordination, and its depletion, as in Parkinson's disease, produces motor impairment. The basal ganglia, cerebellum and cerebral cortex are interconnected, have functional roles in motor coordination, and possess dopamine D1 receptors (D1Rs), which are expressed at a particularly high density in the basal ganglia. In this study, we examined whether the activation of D1Rs modulates motor coordination and balance in the rat using a beam-walking test that has previously been used to detect motor coordination deficits. The systemic administration of the D1R agonist SKF-38393 at 2, 3, or 4 mg/kg did not alter the beam-walking scores, but the subsequent administration of the D1R antagonist SCH-23390 at 1 mg/kg did produce deficits in motor coordination, which were reversed by the full agonist SKF-82958. The co-administration of SKF-38393 and SCH-23390 did not alter the beam-walking scores compared with the control group, but significantly prevented the increase in beam-walking scores induced by SCH-23390. The effect of the D1R agonist to prevent and reverse the effect of the D1R antagonist in beam-walking scores is an indicator that the function of D1Rs is necessary to maintain motor coordination and balance in rats. Our results support that D1Rs mediate the SCH-23390-induced deficit in motor coordination.

Methylphenidate Efficacy: Immediate versus Extended Release at Short Term in Mexican Children with ADHD Assessed by Conners Scale and EEG.

Attention deficit hyperactivity disorder (ADHD) affects 5-6% of school aged children worldwide. Pharmacological therapy is considered the first-line treatment and methylphenidate (MPH) is considered the first-choice medication. There are two formulations: immediate release (IR) MPH and long-acting (or extended release) formulation (MPH-ER). In this work, we measure the efficacy of treatment for both presentations in one month with Conners' scales and electroencephalography (EEG). Results. for IR group, in parents and teachers Conners test, all items showed significant differences, towards improvement, except for teachers in perfectionism and emotional instability. For ER group in parent's Conners test, the items in which there were no significant differences are psychosomatic and emotional instability. For teachers, there were no significant differences in: hyperactivity and perfectionism. Comparing the Conners questionnaires (parents versus teachers) we find significant differences before and after treatment in hyperactivity, perfectionism, psychosomatics, DSM-IV hyperactive-impulsive, and DSM-IV total. In the EEG the Wilcoxon test showed a significant difference (P < 0.0001). As we can see, both presentations are suitable for managing the ADHD and have the same effect on the symptomatology and in the EEG.

Emisiones otoacústicas como analizador de la función coclear en niños con problemas de lenguaje / Otoacoustic emissions as cochlear function analyser in children with language disorders

Introducción y objetivos: La percepción del sonido que se lleva a cabo en la cóclea está involucrada en el lenguaje. El objetivo fue describir los hallazgos encontrados en las emisiones otoacústicas transitorias (EOT) en niños con problemas de lenguaje antes y después de 6 meses de terapia. Métodos: A 17 niños diagnosticados como anártricos, se les realizó historia clínica, escala de inteligencia, prueba de lenguaje inicial y estudios audiológicos. Resultados: Al hacer la comparación del inicio y después de 6 meses de terapia, encontramos, en el análisis frecuencial de las EOT una p ≤ 0,05 en 1 kHz en el oído derecho, en la audiometría; se encontró una p ≤ 0,05 en las frecuencias de 0,5, 1,5, 2, 3, 4 y 8 kHz en el oído derecho y en las frecuencias de 2, 3, 4 y 8 kHz en el oído izquierdo. Conclusiones: El análisis del sonido a través de la cóclea está involucrado en el proceso de adquisición del lenguaje. Un mal procesamiento de los sonidos del lenguaje en el sistema periférico podría dar como resultado un mal procesamiento a nivel central. Por esto, es importante tener nuestros resultados en consideración al realizar el diagnóstico y el tratamiento rehabilitador en los niños con trastornos de lenguaje (AU)

Introduction and objectives: Speech perception that takes place in the cochlea is involved in the process of language. The objective was to describe the findings in transient otoacoustic emissions in children with language problems before and after 6 months of speech therapy. Methods: There were 17 children with language problems between 3 and 6 years of age diagnosed with anarthric language delay (expressive and mixed language disorder). They underwent medical history, otoscopy, intelligence level testing, initial language test, tympanometry of 226 Hz, audiometry and transient otoacoustic emission test. Results: We evaluated the 17 patients again after 6 months of attending speech therapy. The percentage of overall reproducibility of transient otoacoustic emissions in both ears was adequate to perform frequency analysis. We found a statistically significant difference (P≤0.01) in the frequency of 1 kHz reproducibility when comparing results before and after therapy in the right ear. There was a significant difference (P≤0.05) when comparing the results of audiometry at frequencies of 0.5, 1.5, 2, 4 and 8 kHz in the right ear and a highly significant difference (P = 0.001) in the frequency of 3 kHz in the left ear. Conclusions: The analysis of sound through the cochlea is involved in the process of language acquisition. A poor processing of speech sounds in the peripheral system could result in poor processing at the central level. Consequently, it is important to consider our results when making a diagnosis and carrying out rehabilitation treatment in children with language disorders (AU)

Spinocerebellar ataxia type 7: a neurodegenerative disorder with peripheral neuropathy.

BACKGROUND: Autosomal dominant spinocerebellar ataxias (SCA) are a group of inherited neurodegenerative disorders that typically show peripheral neuropathy. SCA7 is one of the rarest forms of SCA (<1/100,000 individuals). However, the disease shows a prevalence of ∼800/100,000 inhabitants in certain regions of Mexico. This low global prevalence may explain, at least in part, the isolated anecdotal and limited clinical data regarding peripheral neuropathy in SCA7 patients. AIM: To assess sensory and motor peripheral nerve action potentials in an SCA7 patients group and in healthy volunteers, and subsequently correlate the electrophysiological findings with clinical and genetic features. MATERIALS AND METHODS: We enrolled in our study, 13 symptomatic SCA7 patients with a confirmed molecular and clinical diagnosis, and 19 healthy volunteers as the control group. Nerve conduction studies were carried out using standard electromyography recording methods. The sensory and motor latency, amplitude and conduction velocity were recorded in both experimental groups and analyzed using the Student's t-test. RESULTS: SCA7 patients showed a significant prolongation of sensory nerve conduction latencies, as well as a decrease in sensory amplitudes. Decreases in motor amplitudes and peroneal conduction velocity were also observed. Finally, we found an association between CAG repeats and the severity of cerebellar and non-cerebellar symptoms with electrophysiological signs of demyelinization. DISCUSSION: Our results reveal the existence of a critical sensorimotor peripheral neuropathy in SCA7 patients. Moreover, we show that using sensitive electrophysiological tools to evaluate nerve conduction can improve the diagnosis and design of therapeutic options based on pharmacological and rehabilitative strategies. CONCLUSION: These findings demonstrate that SCA7 is a disease that globally affects the peripheral nervous system.

[Otoacoustic emissions as cochlear function analyser in children with language disorders]. / Emisiones otoacústicas como analizador de la función coclear en niños con problemas de lenguaje.

INTRODUCTION AND OBJECTIVES: Speech perception that takes place in the cochlea is involved in the process of language. The objective was to describe the findings in transient otoacoustic emissions in children with language problems before and after 6 months of speech therapy. METHODS: There were 17 children with language problems between 3 and 6 years of age diagnosed with anarthric language delay (expressive and mixed language disorder). They underwent medical history, otoscopy, intelligence level testing, initial language test, tympanometry of 226Hz, audiometry and transient otoacoustic emission test. RESULTS: We evaluated the 17 patients again after 6 months of attending speech therapy. The percentage of overall reproducibility of transient otoacoustic emissions in both ears was adequate to perform frequency analysis. We found a statistically significant difference (P≤0.01) in the frequency of 1kHz reproducibility when comparing results before and after therapy in the right ear. There was a significant difference (P≤0.05) when comparing the results of audiometry at frequencies of 0.5, 1.5, 2, 4 and 8kHz in the right ear and a highly significant difference (P=0.001) in the frequency of 3kHz in the left ear. CONCLUSIONS: The analysis of sound through the cochlea is involved in the process of language acquisition. A poor processing of speech sounds in the peripheral system could result in poor processing at the central level. Consequently, it is important to consider our results when making a diagnosis and carrying out rehabilitation treatment in children with language disorders.

[Modification of thresholds T in cochlear implant patients as an alternative programming time in relation to the time].

INTRODUCTION: Programming the cochlear implant (CI) has always been a challenge for all medical specialists in audiology, especially in pediatric patients without language secondary profound hearing loss. For this reason are searched alternatives to achieve normal hearing with the implant during programming in the shortest time possible. OBJECTIVE: To analyze whether through modification threshold T we get faster audiological threshold, describe the differences in time found in patients with sensorineural hearing loss IC users with thresholds T at 10% modified, and T thresholds modified according to clinical responses after obtaining audiological threshold within normal parameters and report the speech coding strategies commonly used at the start of the program and to reach above the hearing threshold to language area. MATERIAL AND METHODS: We performed an observational, cross-sectional, descriptive, comparative study in which we evaluated a total of 31 patients with sensorineural hearing loss, under six years, and both sexes, of cochlear implant users of Advanced Bionics, which were divided in two groups: Group I: 15 patients with modification of thresholds T to 10%, following the manufacturer's recommendations (unmodified) and Group II: 16 patients with T threshold modification according to clinical response cochlear (modified). Were reported strategies most used speech coding in both groups at the start of the program and to reach the threshold audiological within normal parameters. RESULTS: In patients in group I (not modified) were 256 days on average to reach threshold audiological and group II (modified) was 335.6 days. Without statistic significant p = 0.197, with an average of 295.8 days for both groups and the speech coding strategy more used was the Hi-Res P with Fidelity 120, modifying both groups only one patient from power up obtaining threshold. CONCKUSIONS: It was established that thresholds T patient's subjective threshold as compared to T of 10% automatically obtained by SoundWave is not necessary since there are no statistically significant differences in relation to time to take patients implanted normal hearing threshold. The speech coding strategies more widely used and accepted by the patient was the Hi-Res P with Fidelity 120.

Audiometric evaluation short and medium term in cochlear implants.

OBJECTIVE: Our purpose is report the results of cochlear implant program in this Institute, since our first surgery from November 2007, until December 2012. MATERIAL AND METHODS: A cross-sectional study, observational, descriptive, analyzing the information about thresholds before and after implantation, using patients files (diagnosis, onset of hearing loss, brainstem auditory evoked potential (BAEP), computed tomography (CT), magnetic resonance imaging (MRI), implanted ear, brand and model of cochlear implants (CI) and audiometric studies before and after the CI. RESULTS: We report the evolution of 68 patients, age ranged 1 year 8 months to 39 years 3 months old. 94% patients (n = 64) had pre-lingual hearing loss being hereditary non-syndromic hearing loss the most common etiology (29.4%). 100% patients had auditory brainstem responses showing bilateral profound hearing loss, in the 77.9% type A tympanograms were obtained (Jerger's classification), and 100% had absence of stapedial reflexes and otoacoustic emissions with low reproducibility. CT reported as normal in 85.2% of patients, the findings: 5.8% had chronic mastoiditis changes, other findings reported in 1.4% of patients were: digastric right facial nerve, facial nerve canal dehiscence, enlarged vestibular aqueduct, occupation and poor pneumatization of mastoid air cells, lateral semicircular canals agenesis, incomplete partition of the cochlea with wide vestibular and vestibular aqueduct dilatation. Most frequent MR findings of skull with cerebellopontine angle approach were vascular loops of internal auditory canals unilaterally. In 10.2%, 55.8% of patients (n = 38) were implanted in the right ear, 56 (82.3%) with a CI from Advanced Bionics, HiRes 90K model, the remaining with Cochlear, Freedom and Nucleus 5 models. Developments in CI results by audiometric tests: prior to placement was 106.2 dB averages at frequencies assessed, one month later 62.4 dB, at 6 months 44 dB, and with satisfactory threshold 32.9 dB. 55.8% of patients (n = 38) with P + HiRes Fidelity 120 strategy, the remaining with Hires S + Fidelity 120, Hires S and ACE RE. DISCUSSION: Audiology service proposed to place the CI in the worst ear by threshold in audiometric tests, the otolaryngology service proposed the best ear from anatomical point view. Implanted in the INR more Advanced Bionics CI faq frequently due to the donation by the insurance for a new generation. Hearing thresholds using CI have improved since activation.

A potential "tuning" role for the outer hair cells in children with language disorders.

The cochlear outer hair cells serve a tuning function, and any dysfunction of their electromotile response can be reflected in language disorders. Otoacoustic emissions can be used to determine any dysfunction of these cells. A set of clinical records was established to register the neurological and auditory functioning in 42 children, followed by assessment with the Wechsler Intelligence Scale for Children (WISC), the Initial Language Test (ILT), the Auditory and Phonetic Discrimination Evaluation (APDE), tests for measuring Brainstem Auditory Evoked Potential (BAEP) and Transient Otoacoustic Emissions (TOAE). Subjects were classified into 3 groups in this study: Control (C; n = 20), Syntactic Phonological Disorder (SPD; n = 17), and those with Phonological Disability (PD; n = 5). BAEP studies showed a clear response when all children were stimulated to 20 dB. TOAE responses displayed clear and significant differences with half-octave band reproducibility for both ears, the largest effect being observed in the right ear. The results that were compared using ANOVA tests, showed that cochlear processing affects the brain language function, playing a critical role in the language phonetic process.

Preliminary studies of neurosensory and cardiopulmonary health compromise in captive- bred Rhesus macaques (Macaca mulatta) suffering scoliosis.

BACKGROUND: It has been widely documented that quadrupedal animals rarely display natural spontaneous scoliotic rachis deviations of the spinal column. The objective was to determine spinal deformities developed by geriatric monkeys of the Macaca mulatta species, by radiographical and tomographical studies of the vertebral column correlating morphological changes with altered physiological parameters and electrical neurosensorial conductivity of somatosensory-evoked potentials (SEPs). MATERIALS AND METHODS: A cohort of six geriatric monkeys was used: three non-scoliotic subjects and three monkeys with naturally acquired true scoliosis. RESULTS: Radiographic and tomographic studies depicted a thoracic curvature displaying a left-sided thoracic vertebral rotation. The evaluation of physiological parameters demonstrated significant differences in the respiratory rate, as it was observed for the diastolic blood pressures, which showed a decrease in the monkeys with scoliosis compared with healthy monkeys. Regarding the SEPs studies, the non-parametric test for independent samples Mann-Whitney U test displayed a significant difference observed at the left and right thoracic derivative in P1; while regarding the study of upper limbs, a significant difference was seen at the Erb's point derivative, left afferency in P1, showing in all the derivatives an increase in latency in monkeys with scoliosis versus monkeys in the control group. CONCLUSIONS: This study has demonstrated that quadrupedal animals can develop true scoliosis showing an analogous way to that occurring in humans.

Somatosensory evoked potentials of median and tibial nerves in rhesus monkeys (Macaca mulatta) under captivity: influence of ontogenic status in neonatal, infant, young, adult, and senile stages.

BACKGROUND: Somatosensory evoked potentials (SEPs) constitute a useful neurophysiologic tool commonly used to assess the functionality and developmental degree of the nervous system. OBJECTIVE: To analyze somatosensory pathways of the Macaca mulatta species throughout different ontogenetic statuses. METHODS: Twenty non-human primates were divided into five age-dependant groups. Recording of SEPs was executed by stimulation of lower limb at the tibial nerve and upper limb and recorded at the median nerve. RESULTS: Two wave series were observed for all groups for both limbs studied. Significant differences were found at the upper right limb at C4, C7 and also for the antecubital fossa site. The lower limbs showed a single significant right-wing deflection. CONCLUSIONS: Differences found in signals generated by the nervous system in response to somatosensory stimuli among the studied groups are thought to be developmental in origin, as the most remarkable deviations were seen in younger monkeys.

Latencies obtained of the somatosensory evoked potentials of the median and tibial nerve in rhesus monkey undergoing intrauterine laminectomy to simulate myelomeningocele.

BACKGROUND: Somatosensory evoked potentials (SSEP) have been described as excellent indicators of the degree of medullar injury in degenerative and metabolic diseases of the central nervous system (CNS). The prevalence of neural tube defects (NTD) is 6 cases/10,000 live newborns worldwide. It is thought that genetic as well as environmental factors contribute to the etiology of NTD. The objective of this study was to analyze and compare the latencies obtained by means of SSEP in a clinically healthy monkey vs. rhesus monkeys with intrauterine surgery in order to simulate surgically the neural tube defect (myelomengocele) by performing an intrauterine laminectomy and in which later the defect was corrected. METHODS: This study was performed using three non-human primates of the Macaca mulatta species. There were practice intrauterine surgeries in two monkeys to simulate the neurological defect produced by myelomeningocele, using the third monkey as control. For statistical methodology four monkeys were used. They were born by natural birth without any surgical manipulation. With the cesarean-obtained products, stimulation was performed of the tibial and median nerve. RESULTS: We observed that the hind limbs were the most affected, in particular, the left afferent of the monkey. The spinal cord was exposed to amniotic fluid, and there were no significant differences in the forelimbs. CONCLUSIONS: The use of SSEP provides valuable information regarding preservation of sensorial functions in a variety of experimental neurological abnormalities.

Recovery of motor deficit, cerebellar serotonin and lipid peroxidation levels in the cortex of injured rats.

The sensorimotor cortex and the cerebellum are interconnected by the corticopontocerebellar (CPC) pathway and by neuronal groups such as the serotonergic system. Our aims were to determine the levels of cerebellar serotonin (5-HT) and lipid peroxidation (LP) after cortical iron injection and to analyze the motor function produced by the injury. Rats were divided into the following three groups: control, injured and recovering. Motor function was evaluated using the beam-walking test as an assessment of overall locomotor function and the footprint test as an assessment of gait. We also determined the levels of 5-HT and LP two and twenty days post-lesion. We found an increase in cerebellar 5-HT and a concomitant increase in LP in the pons and cerebellum of injured rats, which correlated with their motor deficits. Recovering rats showed normal 5-HT and LP levels. The increase of 5-HT in injured rats could be a result of serotonergic axonal injury after cortical iron injection. The LP and motor deficits could be due to impairments in neuronal connectivity affecting the corticospinal and CPC tracts and dysmetric stride could be indicative of an ataxic gait that involves the cerebellum.