The effectiveness of acupuncture as a treatment for tinnitus: a randomized controlled trial using (99m)Tc-ECD SPECT.

OBJECTIVE: Investigate the effect of acupuncture on brain perfusion using ethyl cysteinate dimer single-photon emission computed tomography ((99m)Tc-ECD SPECT) in patients with tinnitus. METHODS: This randomized, single-blind, sham-control study examined patients (18-60 years old) with normal hearing and chronic, idiopathic, continuous tinnitus. Fifty-seven subjects were randomly assigned to true (n = 30) or sham (n = 27) acupuncture (ACP); (99m)Tc-ECD SPECT examinations were performed before and after 12 twice-weekly ACP sessions. Secondary outcomes included changes in the Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), Hamilton Anxiety Scale (HAS) and Beck Depression Inventory (BDI). Imaging data were analysed using Statistical Parametric Mapping (SPM8) software. Regression models were used to examine secondary outcomes via two paradigms: intention-to-treat (ITT; where multiple imputations were conducted because of study attrition) and complete cases. RESULTS: No between-group brain perfusion differences were observed. However, a significant improvement in THI scores was observed at the end of true ACP treatment for all domains (all p values < 0.01) except the catastrophic scale. CONCLUSIONS: ACP might reduce the effects of tinnitus on daily life; however, additional studies should be conducted to verify the effects of ACP on the neural architecture and brain function of tinnitus patients. KEY POINTS: • Efficacy of acupuncture on brain perfusion and symptoms of tinnitus patients. • Acupuncture improved the Tinnitus Handicap Inventory scores in tinnitus patients. • No significant changes in brain perfusion were observed after 12 twice-weekly sessions. • Perfusion changes would reflect changes in neuronal function.

Evidence of validity and reliability of the Compressed Speech Test with Figures. / Evidências de validade e fidedignidade do Teste de Fala Comprimida com Figuras.

PURPOSE: To seek evidence of validity and reliability for the Compressed Speech Test with Figures. METHODS: The study was subdivided into three stages: construct validation, criteria and reliability. All participants were aged between 6:00 and 8:11. For the construct, Compressed Speech with Figures and the gold standard Adapted Compressed Speech test were applied to children with typical phonological development. For criterion analysis, Compressed Speech with Figures was applied in two groups, with typical (G1) and atypical (G2) phonological development. Finally, the application protocols underwent analysis by two Speech Therapists, with experience in the area of Central Auditory Processing, seeking to obtain an inter-evaluator reliability analysis. RESULTS: The correlation test indicated an almost perfect construct (correlation 0.843 for the right ear and 0.823 for the left ear). In the criterion analysis, it was noticed that both groups presented satisfactory results (G1 = 99.6 to 100%; G2 = 96 to 96.5%). The reliability analysis demonstrated that the protocol is easy to analyze, as both professionals presented unanimous responses. CONCLUSION: It was possible to obtain evidence of validity and reliability for the Compressed Speech with Figures instrument. The construct analysis showed that the instrument measures the same variable as the gold standard test, with an almost perfect correlation. In the criterion analysis, both groups presented similar performance, demonstrating that the instrument does not seem to differentiate populations with and without mild phonological disorder. The inter-evaluator reliability analysis demonstrated that the protocol is easy to analyze and score.

OBJETIVO: Buscar evidências de validade e fidedignidade para o Teste de Fala Comprimida com Figuras. MÉTODO: O estudo foi subdividido em três etapas: validação de construto, critério e fidedignidade. Todos os participantes tinham idade entre 6:00 e 8:11. Para o construto, aplicou-se o Fala Comprimida com Figuras e o teste padrão ouro Fala Comprimida Adaptado em crianças com desenvolvimento fonológico típico. Para análise de critério, aplicou-se o Fala Comprimida com Figuras em dois grupos, com desenvolvimento fonológico típico (G1) e atípico (G2). Por fim, os protocolos de aplicação passaram pela análise de duas Fonoaudiólogas, com experiência na área do Processamento Auditivo Central, buscando obter uma análise de fidedignidade interavaliadores. RESULTADOS: O teste de correlação indicou um construto quase perfeito (Rho=0,843 para orelha direita e Rho=0,823 para orelha esquerda). Na análise de critério, percebeu-se que ambos os grupos apresentaram resultados satisfatórios (G1 = 99,6 a 100%; G2 = 96 a 96,5%). Já a análise de fidedignidade demonstrou que o protocolo é de fácil análise, pois ambos os profissionais apresentaram respostas unânimes. CONCLUSÃO: Foi possível obter evidências de validade e fidedignidade para o instrumento de Fala Comprimida com Figuras. A análise de construto evidenciou que o instrumento mede a mesma variável que o teste padrão outro, com correlação quase perfeita. Na análise de critério, ambos os grupos apresentaram desempenho semelhante, demonstrando que o instrumento não parece diferenciar populações com e sem transtorno fonológico leve. A análise de fidedignidade interavaliador demonstrou que o protocolo é de fácil análise e pontuação.

Aging process and central auditory pathway: a study based on auditory brainstem evoked potential and frequency-following response.

OBJECTIVE: To analyze age-related changes in the central auditory pathway in healthy elderly individuals. METHODS: A prospective, quantitative cross-sectional study. The caseload comprised 18 adults (mean age, 22.78 years) and 18 elderly individuals (mean age, 66.72 years) of both sexes, who met inclusion criteria. Subjects were submitted to basic audiological evaluation and related electrophysiologic tests: brainstem auditory evoked potential with click stimulus and frequency-following response. RESULTS: Elderly individuals had higher wave and interpeak latencies (waves I, III and V and interpeaks I-V and III-V) of brainstem auditory evoked potential. Latencies of frequency following response waves A, E, F and O were also higher in elderly individuals. Frequency following response amplitudes were better in A than in D, F and O waves in these subjects. Likewise, interpeak intervals (V-A and V-O) were larger in elderly relative to adult individuals. Lower slope values were observed in elderly individuals. CONCLUSION: Brainstem auditory evoked potential and frequency-following response allowed appropriate assessment of age-related changes in the auditory pathway. Slower neural response to auditory stimuli suggests reduced synchrony between neural structures.

Supplementation with açaí (Euterpe Oleracea Martius) for the treatment of chronic tinnitus: effects on perception, anxiety levels and oxidative metabolism biomarkers. / Suplementação com açaí (Euterpe Oleracea Martius) para o tratamento do zumbido crônico: efeitos na percepção, níveis de ansiedade e biomarcadores de metabolismo oxidativo.

PURPOSE: To investigate the effects of antioxidant supplementation with açaí extract on the discomfort with chronic tinnitus and the relationship with the levels of anxiety and oxidative metabolism, not excluding the overlap of diseases. METHODS: Randomized, placebo-controlled clinical trial. 30 individuals participated, with an average of 50.5 years, 14 males and 16 females, with normal hearing thresholds or sensorineural hearing loss up to mild degree, divided into two groups: Placebo Group (without active) and, Açaí Group (100mg of açaí extract). The following procedures were applied before and after three months of treatments: Tinnitus Handicap Inventory (THI), Beck's Anxiety Inventory (BAI) and blood samples for evaluation of oxidative stress biomarkers (Lipid Peroxidation and Protein Carbonylation). RESULTS: There was a reduction in the discomfort of tinnitus for the açaí group verified through THI (p = 0.006). Significant differences were found in the score of common symptoms for anxiety disorders in the placebo group (p = 0.016), however, the same was not observed for oxidative metabolism biomarkers, although there was a decrease in post-treatment values for all groups. CONCLUSION: Oral antioxidant supplementation, with açaí extract, showed favorable effects on tinnitus, reducing discomfort with the symptom, regardless of the underlying etiology, and can be considered a treatment modality. However, the effect of this supplementation on anxiety symptoms and oxidative stress biomarkers needs further investigation.

OBJETIVO: Investigar os efeitos da suplementação antioxidante com extrato de açaí no incômodo com o zumbido crônico e a relação com os níveis de ansiedade e metabolismo oxidativo, não excluindo a sobreposição de enfermidades. MÉTODO: Ensaio clínico, randomizado, controlado por placebo. Participaram 30 indivíduos, com média de 50,5 anos, 14 do sexo masculino e 16 do feminino, com limiares auditivos normais ou perda auditiva sensorioneural até grau leve bilateralmente, divididos em dois grupos: Grupo Placebo (sem ativo) e Grupo Açaí (100mg de extrato de açaí). Aplicaram-se os seguintes procedimentos antes e após três meses dos tratamentos: Tinnitus Handicap Inventory (THI), Inventário de Ansiedade de Beck (BAI) e amostras de sangue para avaliação de biomarcadores de estresse oxidativo (Peroxidação Lipídica e Carbonilação de proteínas). RESULTADOS: Houve redução do incômodo do zumbido para o grupo açaí, verificado por meio do THI (p=0,006). Diferenças significativas foram constatadas na pontuação dos sintomas comuns para os quadros de ansiedade no grupo placebo (p=0,016) porém, o mesmo não foi observado para os biomarcadores de metabolismo oxidativo, apesar de haver uma diminuição dos valores pós-tratamento para os grupos. CONCLUSÃO: A suplementação antioxidante oral, com extrato de açaí, manifestou efeitos favoráveis no zumbido, reduzindo o desconforto com o sintoma, independente da etiologia de base, podendo ser considerada uma modalidade de tratamento. Entretanto, o efeito dessa suplementação nos sintomas de ansiedade e em biomarcadores de estresse oxidativo precisa de maior investigação.

Mismatch negativity in older adults and its relationship with the cognitive and behavioral aspects of central auditory processing.

OBJECTIVES: This study aimed to describe and compare the performance of older adults with normal hearing and hearing impairments in mismatch negativity (MMN), correlate MMN with cognitive tasks and central auditory processing (CAP), and identify normal values for MMN in older adults. METHODS: This study had 54 participants. The Montreal Cognitive Assessment (MoCA) was used to assess cognition and the random gap detection test (RGDT), dichotic digit test (DDT), and speech to noise (SN) test were used to evaluate CAP. MMN was elicited with the verbal stimulus /da/ (frequent) and /ta/ (rare), and the latency, amplitude, duration, and area were analyzed. RESULTS: When comparing the normal-hearing group to those with hearing loss, there was no significant difference in MMN. When correlating MMN with MoCA, RGDT, DDT, and the SN test, there was a weak correlation between the MMN amplitude and the RGDT and DDT. When comparing the MMN of participants with normal and altered cognitive aspects and those with normal and altered DDT, the MMN duration was found to be affected by the DDT. The mean latency value of the MMN in the normal-hearing group was 199.8 ms, the amplitude was -2.2 µV, area was 116.1 µV/ms, and duration was 81.2 ms. CONCLUSION: Mild hearing loss did not influence MMN. There was no correlation between MMN and cognitive aspects, and there were weak correlations with CAP. Alterations in CAP led to longer durations in MMN. Normal values for MMN in adults aged between 60 and 77 years were generated.

Cortical auditory-evoked potential as a biomarker of central auditory maturation in term and preterm infants during the first 3 months.

OBJECTIVES: To analyze central auditory maturation in term and preterm infants during the first 3 months of life by comparing the latency and amplitude of cortical auditory-evoked potential at different frequencies. METHODS: In this study, 17 term and 18 preterm infants were examined; all had tested positive on the neonatal hearing screening test. Cortical auditory potential was investigated during the first and third months of life. The response of the cortical auditory-evoked potential was investigated at frequencies of 500, 1000, 2000, and 4000 Hz. The latency and amplitude of the cortical response were automatically detected and manually analyzed by three researchers with experience in electrophysiology. The results were compared using analysis of variance and the Bonferroni test. A significance level of 5% was used for all analyses. RESULTS: Latency values of cortical auditory-evoked potential in the first month of birth were significantly higher than those in the third month, and latency values of the preterm group were higher than those of the term group, regardless of the frequency and time of evaluation. In general, the latency of the cortical auditory-evoked potential was higher at high frequencies. Amplitude values in the third month of life were significantly higher than those in the first month for term and preterm infants. CONCLUSION: Central auditory maturation was observed in both groups but with different results between those born at term and preterm, with latencies of cortical auditory-evoked potential higher for the preterm group and at high frequencies.

Mismatch Negativity Elicited by Verbal and Nonverbal Stimuli: Comparison with Potential N1.

Introduction Mismatch negativity (MMN) is a long latency auditory evoked potential, represented by a negative wave, generated after the potential N1 and visualized in a resulting wave. Objective To identify the time of occurrence of MMN after N1, elicited with verbal and nonverbal stimuli. Methods Ninety individuals aged between 18 and 56 years old participated in the study, 39 of whom were male and 51 female, with normal auditory thresholds, at least 8 years of schooling, and who did not present auditory processing complaints. All of them underwent audiologic anamnesis, visual inspection of external auditory meatus, pure tone audiometry, speech audiometry, acoustic immittance measures and the dichotic sentence identification test as a screening for alterations in auditory processing, a requirement to participate in the sample. The MMN was applied with two different stimuli, with these being da/ta (verbal) and 750 Hz and 1,000 Hz (nonverbal). Results There was a statistically significant difference between the latency values of the N1 potential and the MMN with the two stimuli, as well as between the MMN with verbal and nonverbal stimuli, and the latency of the MMN elicited with da/ta being greater than that elicited with 750 Hz and 1,000 Hz, which facilitated its visualization. Conclusion The time of occurrence of MMN after the N1 elicited with verbal stimuli was 100.4 ms and with nonverbal stimuli 85.5 ms. Thus, the marking of the MMN with verbal stimuli proved to be more distant from N1 compared with the nonverbal stimuli.

Mismatch Negativity Occurrence with Verbal and Nonverbal Stimuli in Normal-Hearing Adults.

Introduction The mismatch negativity (MMN) is a long-latency auditory evoked potential related to a passive elicited auditory event. Objective To verify the occurrence of MMN with different stimuli, to describe reference values in normal-hearing adults with verbal and nonverbal stimuli and to compare them with each other, besides analyzing the latency, area, and amplitude regarding gender and between the ears. Method Normal-hearing individuals, aged between 18 and 59 years old, participated in the study. As inclusion criterion in the study, all of them underwent tone threshold audiometry, logoaudiometry, tympanometry, and the Dichotic Sentence Identification (DSI) test, and later the MMN with 4 different stimuli, being 2 verbal (da/ta and ba/di) and 2 nonverbal stimuli (750/1,000Hz and 750/4,000Hz), which are considered stimuli with low and high contrast. Results A total of 90 individuals composed the sample, being 39 males and 51 females, with an average age of 26.9 years old. In the analysis of the latency, amplitude, and area of the four stimuli between the ears, they were not considered statistically different. There was a significant difference between all of the stimuli in terms of latency, amplitude and area, with the highest latency found in da/ta, and the greatest amplitude and area in ba/di. Regarding gender, there was only difference in the latency of the da/ta stimulus. Conclusion The da/ta and 750/1,000Hz stimuli elicited the most MMN in the population of normal-hearing adults. Among the genders, there was difference only regarding the latency of the verbal stimulus da/ta, and there was no difference between the ears.

Cortical auditory evoked potential in assessment of neonates: a study about minimum level of responses in term and preterm newborns.

INTRODUCTION: The study of the threshold level of cortical auditory response in adults has been investigated in previous studies. Due to maturational issues, little is known about these responses in neonates. Technological advances with automatic analysis devices now allow investigation in specific populations. Thus, new studies are needed to establish the feasibility of using this auditory potential to identify the lowest levels of responses in children. OBJECTIVE: Verify and compare latency and amplitude in 80dBnNA and the minimum level of cortical auditory response in term and preterm neonates. METHODS: A cross-sectional, comparative study involving 59 neonates, 35 full-term births and 24 preterm births, with positive results in the Neonatal Hearing Screening. The Hearlab system was used to investigate the P1i auditory potential with tone burst stimulus at frequencies of 500, 1000, 2000 and 4000Hz. The minimum response level search ranged from 80 to 0dBNA and was detected automatically. The results were compared between groups, evaluating the latency and amplitude in 80dBNA and the minimum level of cortical auditory response. RESULTS: The mean values obtained for the minimum level of cortical auditory response in term group were 26±8.81; 26.14±6.97; 29±7.65 and 29.43±7.04dBNA and for preterm neonates of 31.96±10.41; 34.13±11.34; 33.64±11.03 and 37.73±11.92dBNA, for the frequencies of 500, 1000, 2000 and 4000Hz, respectively. There was a difference between groups for the latency of P1i at 4000Hz and the minimum response levels at 500, 1000 and 4000Hz, with higher values for preterm infants. CONCLUSION: It was possible to obtain latency and amplitude values at 80dBnNA and the minimum level of cortical response in term and preterm newborns, with different results between groups, with higher values in those born preterm.

Accoustic immitance measures in infants with 226 and 1000 hz probes: correlation with otoacoustic emissions and otoscopy examination.

UNLABELLED: Audiological evaluation in infants should include the middle ear (immitance measures and otoscopy) and also a cochlear evaluation. AIM: To check which tympanometry tone test (226 Hz or 1000 Hz), transient otoacoustic emissions and otoscopy. METHODS: Transient otoacoustic emissions were taken from sixty infants ranging from zero to four months of age. The babies were assigned to two groups of 30 infants each, according to the presence or absence of otoacoustic emissions (OAE). All babies have undergone tympanometry with probe tones of 226 and 1000 Hz and ENT evaluation. RESULTS: Tests performed with 1000 Hz probe tone were more sensitive in identifying middle ear disorders. In children with normal tympanograms, both probe tones (226 and 1000 Hz) showed high specificity. All correlations were significant when the 1000 Hz probe tone was used. CONCLUSION: The high frequency probe tone (1000 Hz) presented the most significant correlation with OAE and otoscopy in infants from zero to four months of age.

A study on otoacoustic emissions and supression effects in patients with vitiligo.

UNLABELLED: Vitiligo is a skin disease characterized by absence of melanin due to melanocytes destruction. AIM: to study the incidence of hearing alterations in patients with vitiligo. METHOD: prospective audiological evaluation, transient-evoked otoacoustic emission recordings and study the effects of suppression in 24 patients with vitiligo. Their ages ranged from 15 to 45 years. RESULTS: 21 patients (87.5%) had normal audiometry; 2 had unilateral hearing loss in the high frequencies and 1 had cochlear moderate hearing loss in the left ear. Of these 21 subjects, 66.7% had no otoacoustic emissions, suggesting cochlear dysfunction. Only 7 patients had otoacoustic emissions present in all frequencies (29.2%) and 17 (70.8%) did not have them, and the highest rate of no otoacoustic emissions happened in the right ear of males. Regarding the suppression study, 6 subjects failed, all of them were females, and their left ears were the most affected. CONCLUSION: the findings show that patients with vitiligo, particularly males, have a greater predisposition to cochlear dysfunction, especially in the right ear. As far as the suppression effect was concerned, there was a greater alteration in the female efferent system, particularly in the left ear. Hearing alterations did not vary as far as age is concerned, type of vitiligo and time of disease progression.

Frequency-Following Response with Speech Stimulus: Comparison between Two Methods of Stimulation.

Introduction Frequency-following response with speech stimulus (FFR-speech) is a subcortical potential that satisfactorily evaluates the processing of verbal information. However, there still are differences in the literature regarding its analysis and stimulation protocol. Objective To compare two stimulation protocols for the capture of FFR-speech, to identify the percentage of occurrence of the waves among them and to compare it with the specialized literature, as well as to describe the interpeaks of its waves. Method Considering the eligibility criteria, the sample consisted of 30 normal-hearing adults, with no complaints of speech comprehension. All of them were submitted to a basic audiological evaluation, to brainstem auditory evoked potential with click stimulus, and to FFR-speech. In the latter, 2 types of stimulation were performed, 3 series of 1,000 sweeps, and 2 series of 3,000 sweeps, for subsequent analysis of the resulting wave, in which we tried to mark the peak V followed by valleys A, C, D, E, F, and O. Results Differences in latency and interpeaks were not found between the protocols. In general, a higher occurrence of waves in the stimulation of 2 series of 3,000 sweeps was observed, but only the A valley presented a significant difference. When the values of the waves were compared with the literature, the V and A waves showed fewer occurrences in the present study. Conclusion The protocol of 2 series of 3,000 sweeps was better for FFR-speech in the studied equipment, considering the higher occurrence of waves, even though it is inferior to the specialized literature. Furthermore, it was possible to describe interpeak values and to observe no difference between the studied protocols.

Bilingualism and speech recognition in silence and noise in adults. / Bilinguismo e reconhecimento de fala no silêncio e no ruído em adultos.

PURPOSE: To compare the ability to recognize sentences in silence and in noise in monolingual normal-hearing Brazilian Portuguese speakers, and bilingual speakers of Brazilian Portuguese and German, and bilingual speakers of Brazilian Portuguese and Italian, as well as to analyze the influence of age of second language acquisition on the performance of bilinguals. METHODS: 87 normal-hearing individuals aged between 18 and 55 years participated of this research. They were categorized into: Control Group, composed by 30 monolingual Brazilian Portuguese speakers; German Research Group, 31 simultaneous bilingual native speakers of Portuguese and speakers of German as a second language and; Italian Research Group, consisting of 26 successive bilinguals, native speakers of Portuguese and speakers of Italian as a second language. The Sentence List Test in Brazilian Portuguese was used to measure their Sentence Recognition Thresholds in Silence and Noise. RESULTS: In silence, there were no statistically significant differences in performance when comparing the bilingual to the monolingual individuals, and when comparing the bilingual speakers among themselves. On the other hand, in noise, there was a significant difference between the bilingual groups and the monolingual one. However, there were no significant differences between the bilingual groups when their performance was compared. CONCLUSION: Bilingualism positively influenced the development of language and listening skills, which led the bilinguals to outperform in speech recognition in the presence of noise. Also, the period of a second language acquisition did not influence bilingual performance.

OBJETIVO: Comparar a habilidade de reconhecimento de sentenças no silêncio e no ruído em indivíduos normo-ouvintes monolíngues, falantes do português brasileiro e, bilíngues, falantes do português brasileiro e do alemão, e do português brasileiro e italiano, bem como analisar a influência do período de aquisição da segunda língua no desempenho dos bilíngues. MÉTODO: Participaram da pesquisa 87 indivíduos entre a faixa etária de 18 e 55 anos de idade, normo-ouvintes, os quais foram distribuídos em: grupo controle, composto de 30 monolíngues falantes do português brasileiro; grupo estudo alemão, 31 bilíngues simultâneos falantes do português e do alemão como segunda língua; grupo estudo italiano, formado por 26 bilíngues sucessivos, falantes do português e do italiano como segunda língua. Por meio do teste Listas de Sentenças em Português Brasileiro, foram obtidos seus Limiares de Reconhecimento de Sentenças no Silêncio e no Ruído. RESULTADOS: No silêncio, não houve diferenças estatisticamente significantes de desempenho tanto quando comparados os indivíduos bilíngues e monolíngues como quando comparados os grupos bilíngues. Por sua vez, no ruído, verificou-se diferença significante entre os grupos bilíngues, em relação ao monolíngue. Entretanto, quando comparado o desempenho dos grupos bilíngues, não se observou diferença significante entre eles. CONCLUSÃO: O bilinguismo influenciou positivamente o desenvolvimento de habilidades auditivas, que repercutiram em desempenhos superiores dos bilíngues no reconhecimento de fala na presença de ruído, e o período de aquisição da segunda língua não influenciou o desempenho dos bilíngues.

Evidências de validade e fidedignidade do Teste de Fala Comprimida com Figuras / Evidence of validity and reliability of the Compressed Speech Test with Figures

RESUMO Objetivo Buscar evidências de validade e fidedignidade para o Teste de Fala Comprimida com Figuras. Método O estudo foi subdividido em três etapas: validação de construto, critério e fidedignidade. Todos os participantes tinham idade entre 6:00 e 8:11. Para o construto, aplicou-se o Fala Comprimida com Figuras e o teste padrão ouro Fala Comprimida Adaptado em crianças com desenvolvimento fonológico típico. Para análise de critério, aplicou-se o Fala Comprimida com Figuras em dois grupos, com desenvolvimento fonológico típico (G1) e atípico (G2). Por fim, os protocolos de aplicação passaram pela análise de duas Fonoaudiólogas, com experiência na área do Processamento Auditivo Central, buscando obter uma análise de fidedignidade interavaliadores. Resultados O teste de correlação indicou um construto quase perfeito (Rho=0,843 para orelha direita e Rho=0,823 para orelha esquerda). Na análise de critério, percebeu-se que ambos os grupos apresentaram resultados satisfatórios (G1 = 99,6 a 100%; G2 = 96 a 96,5%). Já a análise de fidedignidade demonstrou que o protocolo é de fácil análise, pois ambos os profissionais apresentaram respostas unânimes. Conclusão Foi possível obter evidências de validade e fidedignidade para o instrumento de Fala Comprimida com Figuras. A análise de construto evidenciou que o instrumento mede a mesma variável que o teste padrão outro, com correlação quase perfeita. Na análise de critério, ambos os grupos apresentaram desempenho semelhante, demonstrando que o instrumento não parece diferenciar populações com e sem transtorno fonológico leve. A análise de fidedignidade interavaliador demonstrou que o protocolo é de fácil análise e pontuação.

ABSTRACT Purpose To seek evidence of validity and reliability for the Compressed Speech Test with Figures. Methods The study was subdivided into three stages: construct validation, criteria and reliability. All participants were aged between 6:00 and 8:11. For the construct, Compressed Speech with Figures and the gold standard Adapted Compressed Speech test were applied to children with typical phonological development. For criterion analysis, Compressed Speech with Figures was applied in two groups, with typical (G1) and atypical (G2) phonological development. Finally, the application protocols underwent analysis by two Speech Therapists, with experience in the area of Central Auditory Processing, seeking to obtain an inter-evaluator reliability analysis. Results The correlation test indicated an almost perfect construct (correlation 0.843 for the right ear and 0.823 for the left ear). In the criterion analysis, it was noticed that both groups presented satisfactory results (G1 = 99.6 to 100%; G2 = 96 to 96.5%). The reliability analysis demonstrated that the protocol is easy to analyze, as both professionals presented unanimous responses. Conclusion It was possible to obtain evidence of validity and reliability for the Compressed Speech with Figures instrument. The construct analysis showed that the instrument measures the same variable as the gold standard test, with an almost perfect correlation. In the criterion analysis, both groups presented similar performance, demonstrating that the instrument does not seem to differentiate populations with and without mild phonological disorder. The inter-evaluator reliability analysis demonstrated that the protocol is easy to analyze and score.

Masking Level Difference in schoolchildren: environmental analysis. / Masking Level Difference em escolares: análises ambientais.

PURPOSE: To investigate the auditory ability of selective attention in the school population and to identify reference values to the age group from seven to ten years old through the Masking Level Difference Test, and to identify if the parents' schooling, as well as the family income can influence the test results. METHODS: Thirty-one schoolchildren who match the eligibility criteria attended the study, being 20 female and 11 male. An anamnesis was conducted to question the familiar income and the schooling of the children´s parents; we also performed visual inspection of the External Acoustic Meatus, Pure Tone Audiometry, Speech Audiometry, Acoustic Immittance Measures, Dichotic Digits Test and Masking Level Difference test. RESULTS: The mean age of the individuals was 8.67 years. There were no observed differences between genders and between the evaluated ages in the MLD performance. There was no relation between the parents' schooling and the average monthly income with the performance of the children in MLD Test. The MLD mean was 7.65 dB and standard deviation of 2.51 dB. CONCLUSION: The Masking Level Difference in schoolchildren from seven to ten years old is 7.65 dB and is independent of the gender, parents' schooling and the average monthly income of the schoolchild.

OBJETIVO: Pesquisar a habilidade auditiva de atenção seletiva na população escolar e identificar valores de referência para a faixa etária de sete a dez anos por meio do teste Masking Level Difference, além de identificar se a escolaridade dos pais, bem como a renda familiar, pode influenciar os resultados do teste. MÉTODO: Participaram do estudo 31 escolares que se encaixaram nos critérios de elegibilidade da pesquisa, sendo 20 do gênero feminino e 11 do gênero masculino. Realizou-se anamnese para questionamento da renda familiar e escolaridade dos pais do escolar, inspeção visual do meato acústico externo, audiometria tonal liminar, logoaudiometria, medidas de imitância acústica, teste Dicótico de Dígitos e teste Masking Level Difference. RESULTADOS: A idade média dos indivíduos foi de 8,67 anos. Não foi observada diferença entre os gêneros e entre as idades avaliadas, no desempenho do MLD. Não houve relação entre a escolaridade dos pais e a renda mensal média com o desempenho das crianças no MLD. A média do MLD foi de 7,65 dB, com desvio padrão de 2,51 dB. CONCLUSÃO: O Masking Level Difference em escolares de sete a dez anos é de 7,65 dB e independe do gênero, do nível de escolaridade dos pais ou da renda mensal média da família do escolar.

Short- and long-latency auditory evoked potentials in individuals with vestibular dysfunction. / Potenciais evocados auditivos de curta e longa latência em indivíduos com disfunção vestibular.

Purpose Evaluate the auditory pathway at the brainstem and cortical levels in individuals with peripheral vestibular dysfunction. Methods The study sample was composed 19 individuals aged 20-80 years that presented exam results suggestive of Peripheral Vestibular Disorder (PVD) or Vestibular Dysfunction (VD). Participants underwent evaluation of the auditory pathway through Brainstem Auditory Evoked Potentials (BAEP) (short latency) and P1, N1, P2, N2, and P300 cortical potentials (long latency). Results Nine individuals presented diagnosis of VD and 10 participants were diagnosed with PVD. The overall average of the long latency potentials of the participants was within the normal range, whereas an increased mean was observed in the short latency of waves III and V of the left ear, as well as in the I - III interpeak interval of both ears. Association of the auditory potentials with VD and PVD showed statistically significant correlation only in the III - V interpeak interval of the right ear for short latency. Comparison between the long and short latencies in the groups showed differences between VD and PVD, but without statistical significance. Conclusion No statistically significant correlation was observed between VD/PVD and the auditory evoked potentials; however, for the long latency potentials, individuals with VD presented higher latency in P1, N1, P2, and N2, where as participants with PVD showed higher latency in P300. In the short latency potentials, there was an increase in the absolute latencies in the VD group and in the interpeak intervals in the PVD group.

Computerized Auditory Training in Students: Electrophysiological and Subjective Analysis of Therapeutic Effectiveness.

Introduction Computerized auditory training (CAT) has been building a good reputation in the stimulation of auditory abilities in cases of auditory processing disorder (APD). Objective To measure the effects of CAT in students with APD, with typical or atypical phonological acquisition, through electrophysiological and subjective measures, correlating them pre- and post-therapy. Methods The sample for this study includes14 children with APD, subdivided into children with APD and typical phonological acquisition (G1), and children with APD and atypical phonological acquisition (G2). Phonological evaluation of children (PEC), long latency auditory evoked potential (LLAEP) and scale of auditory behaviors (SAB) were conducted to help with the composition of the groups and with the therapeutic intervention. The therapeutic intervention was performed using the software Escuta Ativa (CTS Informática, Pato Branco, Brazil) in 12 sessions of 30 minutes, twice a week. For data analysis, the appropriate statistical tests were used. Results A decrease in the latency of negative wave N2 and the positive wave P3 in the left ear in G1, and a decrease of P2 in the right ear in G2 were observed. In the analysis comparing the pre- and post-CAT groups, there was a significant difference in P1 latency in the left ear and P2 latency in the right ear, pre-intervention. Furthermore, eight children had an absence of the P3 wave, pre-CAT, but after the intervention, all of them presented the P3 wave. There were changes in the SAB score pre- and post-CAT in both groups. The presence of correlation between the scale and some LLAEP components was observed. Conclusion The CAT produced an electrophysiological modification, which became evident in the effects of the effects of neural plasticity after CAT. The SAB proved to be useful in measuring the therapeutic effects of the intervention. Moreover, there were behavioral changes in the SAB (higher scores) and correlation with LLAEP.

High-frequency auditory thresholds in normal hearing adults. / Limiares de audibilidade de altas frequências em indivíduos adultos normo-ouvintes.

PURPOSE: Evaluate high-frequency auditory thresholds, seeking to compare responses between the ears, to verify the correlation between hearing level and aging and analyze frequency responses in normal hearing adults. METHODS: This is a prospective, quantitative, transversal study conducted with a convenience sample. Study participants were 60 individuals aged 18 to 58 years (mean=25.82) with auditory thresholds within normality standards (250-8000 Hz) and normal results in acoustic immittance measurements. High-frequency pure-tone hearing thresholds were determined using an Interacoustics AS10HF audiometer with electrodynamic high-fidelity KOSS R/80 headphones, with thresholds expressed in dBNPS. RESULTS: Hearing thresholds showed an increase for the right ear with statistical significance at the 10, 11 and 14 kHz frequencies and a tendency to significance at 13 kHz. As of the 14 kHz frequency, a progressive increase directly proportional to the frequency was observed bilaterally, with the thresholds increasing proportionally to age advancement for all frequencies. CONCLUSION: High-frequency auditory thresholds progressively increase proportionally to frequency and age advancement in normal hearing individuals, with higher values ​​for the right ear.

OBJETIVO: Avaliar os limiares auditivos nas altas frequências, buscando comparar as respostas entre as orelhas, verificar a correlação do nível de audibilidade com o aumento da idade e analisar as respostas por frequência para adultos normo-ouvintes. MÉTODO: Este estudo foi prospectivo, quantitativo e transversal, com amostra por conveniência. Fizeram parte da amostra 60 sujeitos, com idade entre 18 e 58 anos, média de idade de 25,8 anos, com limiares auditivos dentro dos padrões de normalidade de 250 a 8000 Hz e normalidade de resultados nas medidas de imitância acústica. Para a pesquisa das altas frequências foi utilizado o equipamento de modelo AS10 HF da marca Interacoustics com fones de ouvido do tipo KOSS R/80 e com limiares expressos em dBNPS. RESULTADOS: Quanto aos limiares de audibilidade há um aumento para a orelha direita, com significância estatística em 10, 11 e 14 kHz e uma tendência à significância em 13 kHz, assim como a partir da frequência de 14 kHz há um aumento progressivo diretamente proporcional à frequência bilateralmente e quanto maior for a idade dos indivíduos, maiores serão os limiares para todas as frequências. CONCLUSÃO: Os limiares de audibilidade de altas frequências tornam-se maiores com um aumento progressivo proporcional ao avanço de frequência e idade de indivíduos normo-ouvintes com valores mais elevados para a orelha direita.

Speech-evoked Brainstem Auditory Responses and Auditory Processing Skills: A Correlation in Adults with Hearing Loss.

Introduction The auditory system consists of sensory structures and central connections. The evaluation of the auditory pathway at a central level can be performed through behavioral and electrophysiological tests, because they are complementary to each other and provide important information about comprehension. Objective To correlate the findings of speech brainstem-evoked response audiometry with the behavioral tests Random Gap Detection Test and Masking Level Difference in adults with hearing loss. Methods All patients were submitted to a basic audiological evaluation, to the aforementioned behavioral tests, and to an electrophysiological assessment, by means of click-evoked and speech-evoked brainstem response audiometry. Results There were no statistically significant values among the electrophysiological test and the behavioral tests. However, there was a significant correlation between the V and A waves, as well as the D and F waves, of the speech-evoked brainstem response audiometry peaks. Such correlations are positive, indicating that the increase of a variable implies an increase in another and vice versa. Conclusion It was possible to correlate the findings of the speech-evoked brainstem response audiometry with those of the behavioral tests Random Gap Detection and Masking Level Difference. However, there was no statistically significant correlation between them. This shows that the electrophysiological evaluation does not depend uniquely on the behavioral skills of temporal resolution and selective attention.

Treinamento auditivo cognitivo em sujeitos após COVID-19: uma análise dos efeitos da intervenção em adultos / Cognitive auditory training in subjects after COVID-19: an analysis of the effects of the intervention in adults

RESUMO Objetivo analisar a eficácia de um plano de intervenção terapêutica por meio de um programa de treinamento auditivo cognitivo já existente, adaptado para adultos, após um ano de infecção por COVID-19. Métodos participaram do estudo 13 sujeitos, entre 18 e 59 anos de idade, quatro do gênero masculino e nove do gênero feminino. Todos foram submetidos a um questionário, inspeção visual do meato acústico externo, audiometria tonal liminar, logoaudiometria e medidas de imitância acústica, como procedimentos de seleção. Foram realizados, na avaliação e na reavaliação, os seguintes procedimentos: avaliação do processamento auditivo central, avaliação neuropsicológica breve-NEUPSILIN, Speech, Spatial and Qualities of Hearing Scale e o Potencial Cognitivo - P300, com estímulo de fala. O treinamento auditivo cognitivo foi realizado em seis sessões consecutivas, em campo aberto, com duração de, aproximadamente, 50 minutos. Em todas as análises foi considerado o nível de significância de 5% (p≤0,05). Resultados na comparação das variáveis entre os períodos, pré e pós-intervenção, houve diferença estatisticamente significativa no Teste Dicótico de Dígitos (p = 0,009), no Teste Padrão de Frequência (p = 0,020) e no Speech, Spatial and Qualities of Hearing Scale (p = 0,001). Houve tendência à significância (p < 0,10) no teste Gap in Noise e na Atenção Total. Conclusão o treinamento auditivo cognitivo demonstrou ser uma estratégia terapêutica eficaz para o tratamento de adultos com queixas de compreensão de fala e de cognição após infecção por COVID-19.

ABSTRACT Purpose To analyze the effectiveness of a therapeutic intervention plan through an existing cognitive auditory training program, adapted for adults, after one year of COVID-19 infection. Methods 13 subjects, between 18 and 59 years old, four males and nine females participated in the study. All underwent anamnesis, visual inspection of the external acoustic meatus, pure tone audiometry, speech audiometry and acoustic immitance measurements as selection procedures. For the research, the following procedures were carried out in the evaluation and reassessment: evaluation of central auditory processing, brief neuropsychological evaluation - NEUPSILIN, Speech, Spatial and Qualities of Hearing Scale and the Cognitive Potential - P300 with speech stimulus. Cognitive auditory training was carried out in six consecutive sessions, in an open field, lasting approximately 50 minutes. In all analyses, a significance level of 5% (p≤0.05) was considered. Results When comparing the variables between the periods, pre and post intervention, there was a statistically significant difference in the Dichotic Digit Test (p = 0.009), in the Frequency Pattern Test (p = 0.020) and in Speech, Spatial and Qualities of Hearing Scale (p = 0.001). And a tendency to significance (p < 0.10) in the Gap in Noise test and Total Attention. Conclusion Cognitive auditory training proved to be an effective therapeutic strategy for the treatment of adults with speech comprehension and cognition complaints after COVID-19 infection.