Central auditory processing: behavioral and electrophysiological assessment of children and adolescents diagnosed with stroke.

INTRODUCTION: Central auditory processing refers to the efficiency and effectiveness with which the central nervous system uses auditory information: it may be altered in neurological disorders and brain injuries, such as strokes. However, despite evidence of probable alterations in the pediatric population, functional abilities and post-stroke limitations are still not well documented in the literature. OBJECTIVE: To analyze the findings of the electrophysiological and behavioral evaluations of central auditory processing of children and adolescents diagnosed with stroke from a reference outpatient clinic, as well as to investigate possible associations with the variables: type and location of the stroke and age group. METHODS: The present study is characterized as comparative cross-sectional. The sample, for convenience, included individuals aged 7-18 years divided into two groups: study group, composed of individuals with a diagnosis of stroke, and control group, composed of individuals with typical development. The evaluation consisted of the following procedures: anamnesis, basic audiological evaluation, behavioral evaluation of the auditory processing disorder (dichotic digit test, dichotic consonant-vowel, synthetic sentence identification/pediatric speech intelligibility, gaps in noise, pitch pattern sequence, masking level difference), and electrophysiological evaluation (P300 and mismatch negativity). RESULTS: Nineteen children and adolescents were included in the study group. The control group was composed of 19 children and adolescents with typical development. In the comparison between the groups, a worse performance is observed for the study group in all the evaluated tests, behavioral and electrophysiological. In the behavioral evaluation of central auditory processing, there was a statistical difference for all tests, except for masking level difference and dichotic digit test, binaural separation step on the left. In the electrophysiological evaluation, there was a statistical difference in the latency of mismatch negativity and P300. No associations were found between the behavioral and electrophysiological findings and the location of the stroke and age group variables. CONCLUSION: Children and adolescents diagnosed with stroke present a worse performance in the electrophysiological and behavioral evaluations of central auditory processing when compared to a control group.

Potencial Evocado Auditivo de Longa Latência – P3 em crianças com e sem queixas de dificuldade de aprendizagem / Auditory Latency Response – P3 in children with and without learning complaints

RESUMO Introdução Crianças com queixas de dificuldades de aprendizagem podem apresentar alterações no funcionamento do sistema auditivo central. O Potencial Evocado Auditivo de Longa Latência - P3 é útil na avaliação funcional das estruturas auditivas centrais, podendo ser utilizado como método auxiliar na identificação precoce das dificuldades de aprendizagem. Objetivo Analisar e comparar latências e amplitudes obtidas no P3 de crianças com e sem queixa de dificuldades de aprendizagem, com limiares auditivos normais. Métodos A amostra foi composta por 30 crianças com queixa de dificuldades de aprendizagem (grupo estudo) e 14 crianças sem queixa (grupo controle), com idades entre 9 anos e 12 anos e 11 meses. Todas as crianças realizaram avaliação audiológica periférica e a pesquisa do P3. Resultados Verificou-se que a média da latência do P3 do grupo estudo mostrou-se significativamente mais elevada que no grupo controle. Quando comparados os valores de amplitude do P3, não houve diferença, embora a média do grupo estudo tenha se mostrado menor, quando comparada ao grupo controle. Observou-se que, entre idade e latência do P3, não foi detectada correlação significativa. Situação semelhante foi evidenciada na relação entre a idade e a amplitude, que, mesmo tendo sido negativa, não foi significante. Conclusão O grupo de crianças com queixas de dificuldades de aprendizagem apresentou valores de latência do P3 maiores que as crianças do grupo sem queixas. Não foi evidenciada correlação nos valores de amplitude das ondas do P3 entre os grupos.

ABSTRACT Introduction Children with learning impairment complaints may show changes in the functioning of the central auditory system. The Long Latency Auditory Evoked Potential - P3 is useful in the functional evaluation of the central auditory structures, and can be used as an auxiliary method in the early identification of learning impairment. Purpose To analyze and compare latencies and amplitudes obtained in P3 of children that complained or not of learning impairment with normal hearing. Methods The sample consisted of 30 children complaining of learning impairment (study group) and 14 children that did not complain (control group), aged 9 years and 12 years and 11 months. All the children underwent peripheral audiologic evaluation and the P3 study. Results It was found that the mean P3 latency of the study group was significantly higher than the control group. When comparing P3 amplitude values, there was no difference, although the mean of the study group was lower when compared to the control group. It was observed that, for age and P3 latency, no significant correlation was detected. A similar situation was observed in the relation of age and amplitude, which, even though negative, it was not significant. Conclusion The group of children with learning impairment complaints presented P3 latency values greater than the children in the group of children that did not complain. No correlation was found in the P3 wave amplitude values between groups.

Potencial Evocado Auditivo de Longa Latência e Cognitivo em Adolescentes com Síndrome de Down / Evoked Auditory Potentialof Late Latency and Cognitive in Down's Syndrome Teenagers

A realização dos Potencias Evocados Auditivos de Longa Latência - PEALL em indivíduos com síndrome de Down - SD podem fornecer dados importantes sobre o processamento cerebral da audição e suas associações necessária para um bom desenvolvimento da linguagem. Analisar latências e amplitudes obtidas no registro dos componentes exógenos e endógeno dos PEALL, em adolescentes com SD, assim como correlacionar os achados entre os gêneros. Foram incluídos no estudo onze adolescentes com SD, que não apresentassem perdas auditivas, sete do gênero feminino e quatro do masculino, com idade mínima de 13 e máxima de 17 anos. Foi realizada avaliação auditiva periférica básica e pesquisa dos PEALL, incluindo o potencial cognitivo (P3). As médias encontradas para as latências dos componentes exógenos P1, N1, P2, N2 foram, respectivamente, de 110,2ms; 180,3ms; 322,2ms e 492,5ms para orelha direita e 100,2ms; 168,3ms; 323,1ms e 497,5ms para orelha esquerda. As amplitudes médias encontradas para P1N1 e N1P2 foram, respectivamente, 15,0µV e 16,0µV para orelha direita e 16,8µV e 18,7µV para orelha esquerda. A média encontrada para a latência da onda P3 foi 651,7ms e amplitude média foi 10,0µV. Houve diferença significativa entre gêneros para a latência de N1 na orelha direita (p=0,020). Na análise das ondas P1, N1, P2, N2 e P3 foi possível observar aumento das latências e amplitudes dentro dos padrões de normalidade. Foi verificada correlação significativa entre gêneros somente para as latências de N1 na orelha direita, tendo o gênero feminino latências superiores. Sugere-se a realização de estudos, que usem os procedimentos de PEALL para avaliar e monitorar, objetivamente, as intervenções e evoluções terapêuticas na SD. (AU).

The accomplishment of Late Latency Auditory Evoked Potential - LLAEP in individuals with Down syndrome - DS can provide important data from brain processing of hearing and their associations necessary for a good language development. To evaluate latencies and amplitudes obtained from exogenous and endogenous components of LLAEP in teenagers with DS and correlate the findings between genders. This study included 11 teenagers with DS and without hearing loss, seven females and four males with minimum age 13 and maximum 17 years. Hearing evaluation and research of the LLAEP were performed, including cognitive potential (P3). The averages found for the latencies of exogenous components P1, N1, P2, N2 were respectively 110,2ms; 180,3ms; 322,2ms and 492,5ms to right ear and 100,2ms; 168,3ms; 323,1ms and 497,5ms to left ear. The averages found for the amplitudes P1N1 and N1P2 were respectively 15.00µV and 16.0 µV to right ear and 16.8µV and 18.7µV to left ear. The mean found for the latency of the P3 wave was 651.7 ms and mean amplitude 10.0µV. There was a significant difference between genders for N1 latency in the right ear (p=0.020). Analyzing P1, N1, P2, N2 and P3 waves, it was observed increased latencies and amplitudes within the normal range. Significant correlation was observed between genders only for N1 latencies for the right ear, females had higher latencies. It is suggested to carry out studies that use the LLAEP procedures to evaluate and objectively monitor the interventions and therapeutics evolutions in DS. (AU)