The Effect of Different Stimulation Rates on Brainstem Auditory-Evoked-Potential Responses

Abstract Introduction Auditory-evoked potentials are influenced by several factors, including polarity, filter, stimulus intensity and stimulation rate. The presentation of higher rates of stimuli per second enables the collection of a greater number of responses in a given period of time, promoting a shorter testing time; however, the collected recordings are subject to changes related to wave morphology. Objectives To compare the brainstem auditory-evoked-potential responses with click stimulus with the most commonly used stimulation rates in the clinical practice. Methods The present cross-sectional analytical study was performed with fifteen participants of both genders and normal hearing thresholds. The brainstem auditoryevoked potential was performed at four different stimulation rates (21.1, 26.7, and 27.7 stimuli/s, and a rate determined based on a mathematical calculation using the a measurement of the transmission frequency of the power grid at the time of the examination). Results We observed that the rate of 21.1 stimuli/s showed the highest amplitudes for waves I, III, and V when compared with the other rates. The rate of 26.7 stimuli/s, when compared with 27.7 stimuli/s, showed a higher amplitude for wave V. The latency if wave V was significantly lower with the rate of 21.1 stimuli/s than with 27.7 stimuli/s. Conclusions The stimulation rate interferes with wave latencies and amplitudes; its decrease from 27.7 to 21.1 stimuli/s decreases the latency of wave V and increases the amplitues and improves the morphology of waves I, III and V. In addition, we found evidence that suggests an improvement in the visualization of wave III by adjusting the stimulation rate based on a measurement of the local transmission frequency of the power grid.

Study of aged central auditory function using the auditory middle latency response

Abstract Objective Investigate the auditory function of the elderly using the middle latency potentials. Methodology Group 1 (G1): 20 healthy individuals of both genders, older than 60 years, without hearing loss. Group 2 (G2): 20 healthy individuals of both sexes, older than 60 years, with hearing loss in frequencies from 4 to 8 kHz. Potential recording was performed with unilateral and bilateral stimulation and the Binaural Interaction Component was calculated. Results Na latency in C3A1 was greater in the stimulation of the right ear in G2 and the amplitude of Na-Pa was greater in the stimulation of the right ear and recording in C3A1 in G1. The latency of the Pa component was higher in the stimulation of the right ear recorded in C4A2. The Pb component in G2 by bilateral stimulation and recorded in C4A2 had higher latency. The first and second negative and positive peaks presented greater amplitude in G1. In C3A1, the 1st negative peak was more negative in G1 and the 2nd positive peak showed greater amplitude in C4A2 in both groups. Conclusion The transmission of auditory information to the primary auditory cortex is impaired with aging, especially in unilateral stimulation, reinforced by losses in elderly people with peripheral hearing loss, such as in the binaural interaction at the cortical and subcortical levels. Thus, the AMLR has shown to be a sensitive examination to investigate neuroauditory disorders in the elderly, especially related to high-frequency hearing loss and primary auditory cortex dysfunctions caused by the aging process.

O benefício do mascaramento modulado nos potenciais evocados auditivos corticais com estímulo de fala / Masking release in cortical auditory evoked potentials with speech stimulus

RESUMO Objetivo analisar o efeito do mascaramento estável e modulado no Potencial Evocado Auditivo Cortical com estímulo de fala em adultos-jovens. Método participaram 14 indivíduos com idades entre 19 e 28 anos de ambos os sexos e sem perda auditiva. O exame de Potencial Evocado Auditivo Cortical foi realizado com estímulo de fala sintética /ba/ simultâneo ao ruído Speech Shaped Noise apresentado em três condições: ruído estável com intensidade de 30 dB NPSpe (ruído estável fraco), ruído estável com intensidade de 65 dB NPSpe (ruído estável forte) e ruído modulado em intensidade de 30 dB NPSpe e 65 dB NPSpe em 25Hz e com período de modulação de 40 ms. Resultados foram observadas maiores latências nos componentes corticais, exceto P2, na condição de ruído estável forte e medidas mais robustas de amplitude dos componentes corticais P1, N1 e P2 na condição de ruído modulado com diferença estatística significativa na comparação com a condição de ruído estável forte. Houve pior morfologia na condição de ruído estável forte, quando comparado aos demais registros. Os limiares eletrofisiológicos médios para as condições de ruído estável forte e ruído modulado foram 60 dB NPSpe e 49 dB NPSpe, respectivamente, mostrando 11,7 dB de diferença média. Conclusão podemos inferir que houve um menor efeito mascarante do ruído modulado, comparado à condição de ruído estável forte, nas medidas de amplitude dos componentes corticais e uma diferença média de 11,7 dB entre os limiares eletrofisiológicos (interpretado como a medida do Benefício do Mascaramento Modulado).

ABSTRACT Purpose To analyze the effect of masking on the Cortical Auditory Evoked Potential with speech stimulus in young adults. Methods Fourteen individuals aged between 19 and 28 years of both sexes with no hearing loss participated in the study. The Cortical Auditory Evoked Potential examination was performed with synthetic speech stimulus /ba/ simultaneous to Speech Shaped Noise presented under three conditions: steady noise with a 30 dB SPLep intensity (weak steady noise), steady noise with a 65 dB SPLep intensity o (strong steady noise) and modulated noise with 30 dB SPLep and 65 dB SPLep intensities at 25Hz and modulation period of 40 ms. Results Higher latencies were observed in the cortical components, except P2, in the condition of strong steady noise and more meaningful measures of amplitude of the cortical components P1, N1 and P2 in the condition of modulated noise with statistically significant difference in comparison to the strong steady noise condition. There was worse wave morphology in the condition of strong steady noise, when compared to the other records. The average electrophysiological thresholds for the conditions of strong steady noise and modulated noise were 60 dB SPLep and 49 dB SPLep, respectively, showing a 11.7 dB mean difference. Conclusion We could infer that there was a lower masking effect of modulated noise when compared to the strong steady noise condition, in the amplitude measurements of the cortical components and an average difference of 11.7 dB between the electrophysiological thresholds (interpreted as the measure of the Masking Release).

Cortical auditory evoked potentials using the speech stimulus /ma/

ABSTRACT Purpose: to compare cortical auditory evoked responses using two speech stimuli, /ma/ and /da/, in normally hearing young adults. Methods: a cross-sectional, observational and analytical study, with a sample composed of nineteen normally hearing young adults, recruited by convenience, ages between 18 and 25 years old, from both genders, participated in the study. Cortical auditory evoked potentials (CAEP) were monaurally recorded in two conditions: 1) with a pair of speech stimuli /ba/ and /da/, and 2), with a pair of speech stimuli /ba/ and /ma/. The order of the experiments was randomized in a proportion of 50% for each of the two stimuli, totaling 100 stimuli for each experiment. Speech sounds were presented at 70 dB SPL. Descriptive and analytical statistical tests were performed. Results: mean latency values of the complex P1, N1, P2, N2 and P3 were lower for the /ma/ when compared to those of /da/ (p <0,05). There was no difference in amplitude values between responses evoked using /ma/ and /da/. Conclusion: cortical auditory evoked potentials, elicited by the speech stimulus /ma/ had, on average, lower latency peaks of P1-N1-P2-N2 and P3, when compared to those of speech stimulus /da/.

Cognitive performance and long-latency auditory evoked potentials: a study on aging

OBJECTIVE: To evaluate the relationship between cognitive performance and long-latency auditory evoked potentials in an elderly population. METHODS: The sample consisted of adults between 20 and 58 years of age and elderly adults between 60 and 70 years of age. The screening procedures adopted were an inspection of the external auditory canal, tonal and vocal audiometry, tympanometry, brain stem auditory evoked potential, the Montreal Cognitive Assessment test, and long-latency auditory evoked potential. RESULTS: The latency and amplitude values of cortical components by age group showed significant differences under the following conditions: (i) signals evoked by the speech stimulus /da/ and by the pure-tone stimulus at 2,000 Hz for the N2 amplitude (p=0.008 and p=0.001, respectively) , which were both higher for adults, and (ii) signals evoked by the speech stimulus /da/ for N1 latency (p=0.018) and by the pure-tone stimulus at 2,000 Hz for P2 latency (p=0.017), which were both higher in the elderly population. The cognitive component (P300) showed a significant difference when evoked by speech stimuli, with higher latency in the elderly population (p=0.013). When correlated with cognitive processes, the latency and amplitude of cortical potentials showed direct and medium-strength correlations between abnormal scores obtained on the Montreal Cognitive Assessment test and P2 amplitude (p<0.001 and r=0.452). CONCLUSION: There is a relationship between long-latency potentials and cognitive performance in the elderly, which was observed by the increase in the P2 amplitude and the impairment of the process of sound decoding.

Cortical auditory evoked potential in babies and children listeners / Potencial evocado auditivo cortical em lactentes e crianc¸as ouvintes

Abstract Introduction Cortical auditory evoked potentials have been increasingly used in research and audiological routines. However, there is a lack of studies with a large number of children who are stratified by age group. These would help clarify the variations in latency and amplitude of cortical auditory evoked potentials, and thus help establish reference values in children of different ages. Objective To identify the variation in latency and amplitude of the cortical auditory evoked potentials and to establish reference values for the pediatric population. Methods This was a cross-sectional study. Subjects were born at term and presented with no auditory complaints. A total of 105 children, of up to 6 years and eleven months old, who were divided into 7 age groups, named 1, 2, 3, 4, 5, 6 and 7, participated in the study. The tests were carried out using Biologic Navigator Pro. Initially, brainstem auditory evoked potential testing was performed in order to investigate the electrophysiological threshold of the subjects. Then, cortical auditory evoked potentials were elicited through oddball paradigm with tone burst differing in frequency, 750 Hz (frequent) and 1000 Hz (rare), and stimuli differing in speech: /ba/ (frequent) and /da/ (rare). In this study, descriptive and comparative analyzes of tonal and speech stimuli were performed for the age groups. Results Significant differences were observed when comparing cortical auditory evoked potentials with speech stimulus in the right ear for P2 amplitude, for P1 latency the left ear, for P2 amplitude of the left ear; and for P1 amplitude of the left ear when performed with tonal stimuli. Conclusion The obtained results can be considered as reference values of latency and amplitude of cortical auditory potentials in infants and children, and be used for monitoring their cortical auditory development.

Resumo Introdução Os potenciais evocados auditivos corticais têm sido cada vez mais usados em pesquisas e rotinas audiológicas. É importante que mais pesquisas sejam realizadas com maior número de crianças por faixa etária, a fim de contribuir para o conhecimento e descrever a variação das medidas de latência e amplitude, permitir estabelecer valores de referência desse potencial para crianças de diferentes grupos etários. Objetivo Identificar a variação das medidas de latência e amplitude e estabelecer os valores de referência desse potencial para a população pediátrica. Método Estudo do tipo transversal. Os indivíduos nasceram a termo, com ausência de queixas auditivas. Participaram do estudo 105 crianças de até 6 anos e 11 meses, divididas em 7 grupos de idade, denominados 1, 2, 3, 4, 5, 6 e 7. Os testes foram feitos com o Biologic Navigator Pro. Inicialmente, foi realizado o potencial evocado auditivo de tronco encefálico para investigar o limiar eletrofisiológico dos indivíduos. Em seguida, o potencial evocado auditivo cortical foi feito através do paradigma de oddball com toneburst diferindo em frequência, 750 Hz (frequente) e 1.000 Hz (raro) e o estímulo na fala: / ba / (frequente) e / da / (raro). Neste estudo, foram realizadas análises descritivas e comparativas dos estímulos tonais e de fala para os grupos etários. Resultados Diferenças significantes foram observadas na comparação do potencial evocado auditivo cortical com estímulo de fala da orelha direita para amplitude de P2, para latência de P1 da orelha esquerda, para amplitude de P2 da orelha esquerda e para amplitude de P1 da orelha esquerda quando feita com estímulo tonal. Conclusão Os resultados obtidos podem ser usados como medidas de referência de latência e amplitude dos potenciais auditivos corticais em lactentes e crianças, bem como para monitorar o desenvolvimento auditivo cortical.

Influence of speech-language therapy on P300 outcome in patients with language disorders: a meta-analysis / Influência da terapia fonoaudiológica no resultado do P300 em pacientes distúrbio de linguagem: uma metanálise

Abstract Introduction: The patient's evolution in the audiology and speech-language clinic acts as a motivator of the therapeutic process, contributing to patient adherence to the treatment and allowing the therapist to review and/or maintain their clinical therapeutic conducts. Electrophysiological measures, such as the P300 evoked potential, help in the evaluation, understanding and monitoring of human communication disorders, thus facilitating the prognosis definition in each case. Objective: To determine whether the audiology and speech-language therapy influences the variation of P300 latency and amplitude in patients with speech disorders undergoing speech therapy. Methods: This is a systematic review with meta-analysis, in which the following databases were searched: Pubmed, ScienceDirect, SCOPUS, Web of Science, SciELO and LILACS, in addition to the gray literature bases: OpenGrey.eu and DissOnline. The inclusion criteria were randomized or non-randomized clinical trials, without language or date restriction, which evaluated children with language disorders undergoing speech therapy, monitored by P300, compared to children without intervention. Results: The mean difference between the latencies in the group submitted to therapy and the control group was −20.12 ms with a 95% confidence interval of −43.98 to 3.74 ms (p = 0.08, I 2 = 25% and p value = 0.26). The mean difference between the amplitudes of the group submitted to therapy and the control group was 0.73 uV with a 95% confidence interval of −1.77 to 3.23 uV (p = 0.57, I 2 = 0% and p value = 0.47). Conclusion: The present meta-analysis demonstrates that speech therapy does not influence the latency and amplitude results of the P300 evoked potential in children undergoing speech therapy intervention.

Resumo Introdução: A evolução do paciente na clínica fonoaudiológica atua como fator motivador do processo terapêutico, contribui para a sua adesão ao tratamento e possibilita ao terapeuta a revisão e/ou a manutenção de suas condutas. As medidas eletrofisiológicas, como o potencial evocado P300, auxiliam na avaliação, na compreensão e no monitoramento dos distúrbios da comunicação humana, facilitam, dessa forma, a definição do prognóstico de cada caso. Objetivo: Determinar se a terapia fonoaudiológica influencia na variação da latência e da amplitude do P300 em pacientes com distúrbio de linguagem submetidos à terapia fonoaudiológica. Método: Revisão sistemática com metanálise, na qual foram feitas buscas nas seguintes bases de dados: Pubmed, ScienceDirect, Scopus, Web of Science, SciELO e Lilacs, além das bases de literatura cinzenta: OpenGrey.eu e DissOnline. Foram considerados critérios de inclusão: ensaios clínicos aleatórios ou não, sem restrição de idiomas ou data, que submeteram crianças com distúrbio de linguagem à terapia fonoaudiológica, monitoradas pelo P300, comparadas a crianças sem intervenção. Resultados: A diferença média entre as latências do grupo submetido à terapia e do grupo controle foi de -20,12 ms com intervalo de confiança 95% entre -43,98 e 3,74 ms (p = 0,08; I2 = 25% e o valor de p = 0,26). A diferença média entre as amplitudes do grupo submetido à terapia e do grupo controle foi de 0,73 uV com intervalo de confiança de 95% entre -1,77 e 3,23 uV (p = 0,57; I2 = 0% e o valor de p = 0,47). Conclusão: A terapia fonoaudiológica não influencia nos resultados de latência e amplitude do potencial evocado P300 em crianças submetidas à intervenção fonoaudiológica.

Analysis of the Effect of Musical Stimulation on Cortical Auditory Evoked Potentials

Abstract Introduction Cortical auditory evoked potentials (CAEPs) are bioelectric responses that occur from acoustic stimulations, and they assess the functionality of the central auditory system. Objective The objective of the present study was to analyze the effect of musical stimulation on CAEPs. Methods The sample consisted of 42 healthy female subjects, aged between 18 and 24 years, divided into two groups - G1: without musical stimulation prior to the CAEP examination; and G2: with stimulation prior to the examination. In both groups, as a pre-collection procedure, the complete basic audiological evaluation was performed. For the musical stimulation performed in G2, we used an MP4 player programmed to play Pachelbel's "Canon in D Major" for five minutes prior to the CAEP examination. To analyze the effect on the groups, the ear side and the ide-group interaction , a mixed analysis of variance (ANOVA) of repeated measures was performed. Box M test and Mauchly sphericity test were also performed. Results Test differences were considered statistically significant when the p-value was < 0.05 (5%). Thus, it was possible to observe that there was a statistically significant difference of the P2 component characterized by the decrease in the amplitude of response in the left ear in G2 when comparing the responses of CAEP with and without prior musical stimulation. Conclusion The result of the present study enabled us to conclude that there was a change in the response of CAEPs with musical stimulation. (AU)

Team Based Learning in Speech, Language and Hearing Sciences: experience in the Public Health qualification / Aprendizagem Baseada em Equipes na Fonoaudiologia: experiência na formação em Saúde Coletiva

ABSTRACT Purpose: to present an experience report about Team-Based Learning utilization as an active methodology of learning in a Speech, Language and Hearing Sciences graduation course. Methods: students enrolled in the public health II subject in the graduation course received the material about breastfeeding by e-mail in advance and were informed about how the activity using Team-Based Learning would be developed. In class, they initially answered to a questionnaire, individually, which was later discussed in teams formed, randomly, by the professor. The answers were placed in charts, to compare individual and teams performances. Results: 25 female students participated in this study, with ages varying from 18 to 25 years, and differences were found between the individual and the team answers, since the answers chosen by the teams corresponded more to the template elaborated by the teacher. The percentage of correct individual answers was 69,6% and the percentage of correct team answers was 96%. Conclusion: the Team-Based Learning utilization showed to be viable from a pedagogical perspective, promoted greater engagement by the students and contributed in the development of teamwork.

RESUMO Objetivo: apresentar um relato de experiência sobre a utilização da Aprendizagem Baseada em Equipes enquanto metodologia ativa de ensino-aprendizagem em um curso de graduação em Fonoaudiologia. Métodos: estudantes matriculadas na disciplina de Saúde Coletiva II do curso de Graduação em Fonoaudiologia receberam material sobre o tema da aula de aleitamento materno por e-mail com antecedência e foram informadas sobre como a atividade da Aprendizagem Baseada em Equipes seria desenvolvida. Em aula, as estudantes inicialmente responderam a um questionário de maneira individual e o mesmo foi discutido posteriormente em equipes formadas de maneira aleatória pela professora. As respostas foram tabeladas para análise, para comparar os desempenhos individuais e em equipe. Resultados: 25 estudantes do sexo feminino, de 18 a 25 anos, participaram da atividade e foram encontradas diferenças entre as respostas individuais e das equipes, pois as respostas das equipes foram mais correspondentes com o gabarito elaborado pela docente. A porcentagem de acertos individuais foi de 69,6%, já a porcentagem de acertos em equipe foi de 96%. Conclusão: o uso da Aprendizagem Baseada em Equipes mostrou-se viável do ponto de vista pedagógico, além de promover maior participação por parte das alunas e contribuir com o trabalho em equipe.

Vectoelectronystagmography in children with dyslexia and learning disorder / Vectoeletronistagmografia em crianças com dislexia e transtorno de aprendizagem

ABSTRACT Objective: to describe and compare the results of ocular (saccadic, screening, and optokinetic) tests of vectoelectronystagmography among the groups with dyslexia, learning disorder and control. Methods: 28 male and female students aged 8 to 11 years participated in this study. They were divided into three groups: Group I, 10 students with dyslexia, Group II, 9 students with learning disorders and Group III, 9 students with no learning disorders. In this research, digital vectoelectronystagmography - ocular test - was performed. Results: saccadic movement, optokinetic nystagmus, and pendular tracking tests were found to show subtle differences among the three groups. Comparing the saccadic eye movements and the optokinetic nystagmus tests, it was observed that the movement in the left eye was slower for Group I, and even slower for Group II. It was also observed that GI and GII were slower for the pendular tracking of luminous stimulus in relation to the control group. Conclusion: in general, there are differences among the groups in the vectoelectronystagmography, which indicated slower tracking and vestibulo-ocular reflex in children with dyslexia and learning disorders.

RESUMO Objetivo: descrever e comparar os resultados das provas oculares (sacádicos, rastreio, e optocinético) da vectoeletronistagmografia entre os grupos com dislexia, transtorno de aprendizagem e controle. Métodos: participaram deste estudo 28 estudantes do sexo masculino e feminino, com idade entre 8 e 11 anos. Foram divididos em três grupos, sendo Grupo I: Dez escolares com Dislexia, Grupo II: Nove escolares com Transtornos de Aprendizagem e Grupo III: Nove escolares sem dificuldades de aprendizagem. Nesta pesquisa foi realizada avaliação da vectoeletronistagmografia digital: provas oculares (sacádicos, rastreio, e optocinético). Resultados: verificou-se que as provas de movimento sacádico, nistagmo optocinético e rastreio pendular mostraram diferenças sutis entre os três grupos. Na comparação das provas de movimentos sacádicos dos olhos e pesquisa do nistagmo optocinético foi observada que a velocidade do movimento do olho esquerdo que se mostrou mais lento para o Grupo I, e ainda mais lentos para o Grupo II. Foi observado também que os grupos GI e GII foram mais lentos para o rastreio em pêndulo do estímulo luminoso em relação ao grupo controle. Conclusão: de modo geral, foi observada diferença entre os grupos para a medida da vectoeletronistagmografia, que indicam rastreios e reflexo vestibular-ocular mais lentos nas crianças com dislexia e transtornos de aprendizagem.

P300: Waves Identification with and without Subtraction of Traces

Abstract Introduction The P300 test requires well-defined and unique criteria, in addition to training for the examiners, for a uniform analysis of studies and to avoid variations and errors in the interpretation of measurement results. Objectives The objective of this study is to verify whether there are differences in P300 with and without subtraction of traces of standard and nonstandard stimuli. Method We conducted this study in collaboration with two research electrophysiology laboratories. From Laboratory 1, we selected 40 tests of subjects between 7 44 years, from Laboratory 2, we selected 83 tests of subjects between 18 44 years. We first performed the identification with the nonstandard stimuli; then, we subtracted the nonstandard stimuli fromthe standard stimuli. The examiners identified the waves, performing a descriptive and comparative analysis of traces with and without subtraction. Results After a comparative analysis of the traces with and without subtraction, there was no significant difference when compared with analysis of traces in both laboratories, within the conditions, of right ears (p = 0.13 and 0.28 for differences between latency and amplitude measurements) and left ears (p = 0.15 and 0.09 for differences between latency and amplitude measurements) from Laboratory 1. As for Laboratory 2, when investigating both ears, results did not identify significant differences (p = 0.098 and 0.28 for differences between latency and amplitude measurements). Conclusion There was no difference verified in traces with and without subtraction. We suggest the identification of this potential performed through nonstandard stimuli.

Auditory Alterations in Children Infected by Human Immunodeficiency Virus Verified Through Auditory Processing Test

Abstract Introduction The auditory system of HIV-positive children may have deficits at various levels, such as the high incidence of problems in the middle ear that can cause hearing loss. Objective The objective of this study is to characterize the development of children infected by the Human Immunodeficiency Virus (HIV) in the Simplified Auditory Processing Test (SAPT) and the Staggered Spondaic Word Test. Methods We performed behavioral tests composed of the Simplified Auditory Processing Test and the Portuguese version of the Staggered SpondaicWord Test (SSW). The participants were 15 children infected by HIV, all using antiretroviral medication. Results The children had abnormal auditory processing verified by Simplified Auditory Processing Test and the Portuguese version of SSW. In the Simplified Auditory Processing Test, 60% of the children presented hearing impairment. In the SAPT, the memory test for verbal sounds showed more errors (53.33%); whereas in SSW, 86.67% of the children showed deficiencies indicating deficit in figure-ground, attention, and memory auditory skills. Furthermore, there aremore errors in conditions of background noise in both age groups, where most errors were in the left ear in the Group of 8-yearolds, with similar results for the group aged 9 years. Conclusion The high incidence of hearing loss in children with HIV and comorbidity with several biological and environmental factors indicate the need for: 1) familiar and professional awareness of the impact on auditory alteration on the developing and learning of the children withHIV, and 2) access to educational plans and follow-up with multidisciplinary teams as early as possible to minimize the damage caused by auditory deficits.

Potenciais corticais auditivos: uso de diferentes estímulos de fala em populações infantis / Auditory cortical potential: using different types of speech stimuli in children

RESUMO Introdução Os potenciais evocados auditivos são respostas elétricas que ocorrem nas vias auditivas centrais, resultantes de estimulação acústica. O uso de estímulos de fala para eliciar a resposta desses potenciais possibilita a compreensão de informações sobre codificação e decodificação da fala no sistema nervoso central. Objetivo Comparar o resultado do potencial evocado auditivo de latência longa com dois diferentes estímulos de fala. Métodos Participaram do estudo 30 escolares saudáveis, de ambos os sexos, com idade entre 8 e 12 anos. Para os potenciais evocados auditivos, foram utilizados dois diferentes estímulos de fala para a discriminação auditiva: Teste 1 /ba/ x /da/ e Teste 2 /pa/ x /da/. Os estímulos foram aleatoriamente apresentados, sendo 20% raros e 80% frequentes. Os escolares participaram de uma tarefa auditiva ativa e disseram [da] para identificar os estímulos raros. A normalidade dos dados foi determinada utilizando o teste de Shapiro-Wilk. Para comparar a média com o Teste 1 e Teste 2, foi realizada a estimulação t de Student. Resultados Houve diferença significativa na latência P3 na orelha direita, amplitude P2 na orelha direita e amplitude P3 na orelha esquerda. Ocorreram valores mais longos com estímulo /ba/ x /da/. Conclusão As respostas dos potenciais evocados auditivos de latência longa variam em função do estímulo e do cuidado em sua análise, quando se utilizam estímulos de fala na avaliação.

ABSTRACT Introduction Auditory Evoked Potentials are electrical responses that occur in the central auditory pathways, resulting from acoustic stimulation. The use of speech stimuli to elicit the response of these potentials allows to understand information about speech coding and decoding in the central nervous system. Purpose To compare the Long Latency Auditory Evoked Potential of two different speech stimuli. Methods Thirty healthy school children of both genders, aged between 8 and 12 years, participated in the study. For the auditory evoked potentials, different speech stimuli were used for the auditory discrimination: Test 1 /ba/ x /da/ and Test 2 /pa/ x /da/. The stimuli were randomly presented: 20% infrequent and 80% frequent. The school children participated in an active auditory task and said [da] to identify the infrequent stimuli. The normality of the data was determined using the Shapiro-Wilk test. To compare the mean with Test 1 and Test 2, stimulation was performed using Student t test. Results There was a significant difference in P3 latency in the right ear, P2 amplitude in the right ear and P3 amplitude in the left ear. Longer values occurred with stimulus /ba/ x /da/. Conclusion The responses of long latency auditory evoked potentials vary depending on the stimulus and care in the analysis when using speech stimuli in the evaluation.

Variables in P300 recording: task type and electrode position

ABSTRACT Purpose To analyze the latency and amplitude of P300 responses obtained with electrodes positioned at Cz and Fz and in different tasks of infrequent stimulus identification in normal hearing individuals. Methods Forty adults of both genders participated in the study. Three recordings with three different tasks were obtained for the identification of the infrequent stimulus; simultaneous recordings were obtained from Cz and Fz positions. Results Cz position showed significantly greater amplitudes and lower latencies than Fz. Regarding the three tasks, only “pronouncing the word ’thin’” was different from “raising a finger”, with lowest latencies for the verbal task. Regarding amplitude, significantly higher values were observed for “raising a finger”, followed by “pronouncing the word ‘thin’” and mental counting. Conclusion Cz obtained the best values, highest amplitude and lowest latency. Lowest latencies were obtained for the task of “pronouncing the word ‘thin’” and the highest amplitudes were obtained for “raising a finger”.

Uso do potencial evocado auditivo de média latência em populações infantis: uma revisão integrativa / Use of middle latency auditory evoked potentials in children: an integrative review

RESUMO Este estudo teve como objetivo investigar na literatura a utilidade do Potencial evocado auditivo de média latência na população infantil para o estudo do sistema auditivo em seus processos normais e desviantes. A revisão integrativa da literatura científica consistiu na busca de estudos utilizando as bases de dados: PubMed, Scopus e Scielo. Como descritores para a pesquisa foram utilizados os termos: "auditory middle latency response" "auditory middle latency potential" , "children", "child", "childhood", "maturation' e "development". Os estudos eram artigos completos, cujos participantes foram crianças, submetidas ao exame de Potencial evocado auditivo de média latência. A análise dos estudos individualmente verificou aspectos relacionados ao objetivo da pesquisa, a metodologia utilizada e a conclusão de cada estudo. Foram selecionados e lidos na íntegra um total de 11 estudos da base bibliográfica PubMed, oito estudos da Scopus e dois estudos da Scielo. Do total de 21 artigos, seis deles foram realizados com crianças saudáveis, quatro examinaram os componentes desse potencial em crianças com distúrbio de linguagem ou distúrbio específico de linguagem, quatro estudos avaliaram crianças usuárias de implante coclear, e sete crianças com outras alterações. Esta revisão integrativa mostrou a importância da investigação dos potenciais evocados auditivos de média latência em crianças. Tal avaliação vem permitindo um diagnóstico mais precoce e preciso de pacientes com alterações de linguagem, fala ou de aprendizado e de distúrbios do processamento auditivo além do monitoramento de evolução terapêutica.

ABSTRACT This study aimed to investigate, in the literature, the use of middle latency auditory evoked potentials in children to study the auditory system in its normal and deviant processes. The integrative scientific literature review consisted of searching studies using PubMed, Scopus and Scielo databases. The search terms descriptors were: "auditory middle latency response ", "auditory middle latency potential", "children", "child", "childhood", "maturation" and "development". The selected studies were full papers whose participants were children who underwent middle latency auditory evoked potentials exams. The analysis of the studies, individually, verified aspects related to the aim of the research, the methodology used and the conclusion of each study. A total of 11 studies retrieved from PubMed, eight from Scpus and two studies from Scielo were selected and read in full. Out of the 21 articles, six investigations had been carried out with healthy children, four of them examined the components of this potential in children with language disorders or specific language disorders, four studies assessed children with cochlear implants and seven investigations with children with other changes. This integrative review showed the importance of research of Middle Latency Auditory Evoked Potentials in children. Such an assessment has allowed earlier and accurate diagnosis of patients with language, speech or learning disorders as well as auditory processing disorders, in addition to monitoring therapeutic evolution.

Potencial evocado auditivo de média latência em populações infantis / Middle latency auditory evoked potential in child population

INTRODUCTION: The middle-latency auditory evoked potential is used to evaluate any abnormality that might impair the central auditory pathways, which are situated between the brain stem and the primary auditory cortex OBJECTIVE: To analyse the middle-latency auditory evoked potentials in children Methods : This is a descriptive and cross-sectional study. Pure-tone audiometry was performed, and if no change was detected, Biologic's portable Evoked Potential System (EP) was used to measure auditory evoked potentials. The identification of the responses was performed using electrodes positioned at C3 and C4 (left and right hemispheres) in reference to ears A1 and A2 (left and right earlobe). These were ipsilaterally and contralaterally paired and landed at Fpz (forehead), in two steps, with alternating stimulation of the right and left ears. RESULTS: In this study, there was 100% detectability of the Na, Pa, and Nb components and interamplitude Na-Pa. This study compared different electrode leads, and there was no significant difference between the different electrode positions studied for the right and left ears in the studied population CONCLUSION: It was concluded that the examination of middle-latency evoked potential is steady and feasible for the studied age group regardless of electrode position

INTRODUÇÃO: O potencial evocado auditivo de média latência é utilizado na avaliação de qualquer anomalia que possa comprometer as vias auditivas centrais, situadas entre o tronco encefálico e córtex auditivo primário OBJETIVO: Analisar os potenciais evocados auditivos de média latência em escolares MÉTODO: Esse estudo é descritivo transversal. Como procedimento foi realizado a audiometria tonal, e caso não fosse detectada nenhuma alteração, foi utilizado o equipamento portátil de potencial evocado auditivo Biologic's Evoked Potencial System (EP). O registro das respostas foi efetuado com eletrodos posicionados em C3 e C4 (hemisfério esquerdo e direito, respectivamente) em referência às orelhas A1 (lóbulo da orelha esquerda) e A2 (lóbulo da orelha direita), pareados ipsilateralmente e contralateralmente e terra em Fp (fronte), em duas etapas, alternando as estimulações das orelhas direita e esquerda RESULTADOS: Neste estudo houve 100% de detectabilidade dos componentes Na, Pa, Nb e interamplitude Na-Pa. Foram comparadas diferentes derivações de eletrodo e não foi observada diferença significativa entre diferentes posições de eletrodos pesquisadas tanto para orelha direita quanto para orelha esquerda nesta população de estudo CONCLUSÃO: O exame de potencial evocado auditivo de média latência é estável e viável para faixa etária estudada independente da posição dos eletrodos

Auditory Middle Latency Response and Phonological Awareness in Students with Learning Disabilities

Introduction Behavioral tests of auditory processing have been applied in schools and highlight the association between phonological awareness abilities and auditory processing, confirming that low performance on phonological awareness tests may be due to low performance on auditory processing tests. Objective To characterize the auditory middle latency response and the phonological awareness tests and to investigate correlations between responses in a group of children with learning disorders. Methods The study included 25 students with learning disabilities. Phonological awareness and auditory middle latency response were tested with electrodes placed on the left and right hemispheres. The correlation between the measurements was performed using the Spearman rank correlation coefficient. Results There is some correlation between the tests, especially between the Pa component and syllabic awareness, where moderate negative correlation is observed. Conclusion In this study, when phonological awareness subtests were performed, specifically phonemic awareness, the students showed a low score for the age group, although for the objective examination, prolonged Pa latency in the contralateral via was observed. Negative weak tomoderate correlation for Pa wave latency was observed, as was positive weak correlation for Na-Pa amplitude.(AU)

Avaliação eletrofisiológica do sistema auditivo em indivíduos com gagueira desenvolvimental persistente / Electrophysiology assessment of auditory system in individuals with developmental persistent stuttering

RESUMO: Objetivo: descrever os achados dos exames eletrofisiológicos de indivíduos com gagueira e comparar com indivíduos com desenvolvimento típico. Métodos: participaram desta pesquisa 34 indivíduos, de ambos aos gêneros, com idade entre 7 e 31 anos. O grupo pesquisa foi constituído por 13 crianças (G1a) e 4 adultos (G1b) diagnosticadas com gagueira e o grupo controle por 13 crianças (G2a) com bom desempenho acadêmico e 4 adultos (G2b) com desenvolvimento típico. Foi realizada a avaliação dos potenciais auditivos, na varredura de frequência e de duração. Resultado: quando comparados os grupos de crianças gagas e controle, foi observado que as crianças gagas apresentaram na varredura de frequência, aumento da latência dos componentes P2, N2 em Cz na orelha direita e N2 e P3 em Fz na orelha esquerda, e diferença na amplitude de P2 e P3 em Cz na orelha direita. Na varredura de duração, houve redução da amplitude dos componentes N2 em Cz e P3 em Fz na orelha direita. Já no grupo de adultos gagos, observou-se na varredura de frequência, aumento da latência no componente P3 em Cz e Fz na orelha direita e amplitude reduzida no P3 em Cz na orelha esquerda, e na varredura de duração, aumento de latência de N2 e P3 em Cz na orelha direita e N2 em Cz na orelha esquerda, quando comparados ao grupo controle. Conclusão: há diferenças entre os exames eletrofisiológicos de indivíduos com gagueira comparados aqueles com desenvolvimento típico. No entanto, novos estudos neste âmbito ainda são necessários para que os achados aqui apresentados possam ser confirmados.

ABSTRACT: Purpose: to describe the findings of electrophysiological examinations of individuals who stutter and compare with typically developing individuals. Methods: 34 subjects participated in this study, both genders, aged between 7 and 31 years. The research group consisted of 13 children (G1a) and 4 adults (G1b) diagnosed with stuttering and the control group of 13 children (G2a) with good academic performance and 4 fluent adults (G2b). The auditory potentials assessment was performed on frequency and duration discrimination tests. Result: when compared groups of stuttering children and control group, it was observed that the stuttering children had the scan frequency, increased latencies of P2, N2 components at Cz in the right ear and N2 and P3 at Fz in the left ear, and the difference amplitude P2 and P3 in the right ear Cz. In the scan duration, decreased the amplitude of the N2 and P3 components in Cz Fz in the right ear. In the group of adult stutterers was observed in the frequency sweep, increased latency P3 component at Cz and Fz in the right ear and reduced P3 amplitude at Cz in the left ear, and scan duration, increased latency of N2 Cz and P3 in the right ear and N2 at Cz in the left ear, when compared to the control group. Conclusion: there are differences between the electrophysiological examinations of individuals who stutter compared with those with typical development. However, further studies in this area are still needed for the findings presented here can be confirmed.

Neonatal hearing screening in a low-risk maternity hospital in São Paulo state / Triagem auditiva neonatal em uma maternidade de baixo risco do interior paulista

ABSTRACT INTRODUCTION: The literature indicates that neonatal hearing screening should be universal, so a description of programs that adopt this recommendation is relevant. OBJECTIVE: To describe the results of newborn hearing screening and the profile of mothers and newborns attended to in a low-risk maternity setting, and to correlate the characteristics of this population with the results of transient evoked otoacoustic emissions. METHODS: A contemporary cross-sectional cohort study. The sample consisted of 670 infants and the procedures performed were audiological history, transient-evoked otoacoustic emissions (TEOAE), distortion product-evoked otoacoustic emissions (DPEOAE), and automated-brainstem auditory evoked potential (ABSAEP). RESULTS: The rate of success in this program was 98.5%, the failure rate was 0.62%, and that of non-attendance to finalize the diagnostic process, 0.93%. When correlating the variables studied with the results of transient evoked otoacoustic emissions, there was a significant negative correlation only for age of infant. CONCLUSION: The program of this maternity hospital was effective and complies with national and international recommendations. The population consisted of young mothers with few pregnancy complications and healthy infants. The only variable that influenced transient evoked otoacoustic emission results, after hospital discharge, was the age at which infants were evaluated.

RESUMO Introdução: A literatura relata que a triagem auditiva neonatal deve ser universal, o que torna relevante a descrição de programas que adotam esta recomendação. Objetivo: Descrever os resultados da triagem auditiva neonatal e o perfil das mães e recémnascidos atendidos em uma maternidade de baixo risco e correlacionar as características desta população com os resultados das emissões otoacústicas evocadas transientes. Método: Estudo coorte contemporâneo com corte transversal. A amostra foi composta por 670 bebês e os procedimentos realizados foram: anamnese audiológica, emissões otoacústicas (EOA) transientes, EOA produto de distorção, e potencial evocado auditivo de tronco encefálico automático. Resultados: O índice de passa neste programa foi de 98,5%; de falha de 0,62% e o de não comparecimento para finalização do processo diagnóstico de 0,93%. Ao correlacionar as variáveis estudadas com os resultados das emissões otoacústicas transiente houve correlação negativa significante apenas para a idade do bebê. Conclusão: O programa desta maternidade mostrou-se efetivo e atende a recomendações nacionais e internacionais. A população foi composta por mães jovens com poucas intercorrências gestacionais e bebês saudáveis. A única variável que influenciou nos resultados das emissões otoacústicas por transiente, após a alta hospitalar, foi à idade em que os bebês foram avaliados.