Privación sensorial temprana durante el neurodesarrollo y sus consecuencias cognitivas / Early sensory deprivation in neurodevelopment and its cognitive consequences / Privação sensorial precoce durante o neuro-desenvolvimento e suas consequências cognitivas

La aparición progresiva de habilidades sensoriales, motoras y cognitivo-afectivas en el humano a lo largo de su desarrollo es un reflejo de cambios fisiológicos que se gestan al interior del sistema nervioso. Dichos cambios hacen parte de procesos dinámicos y dependen, después del nacimiento, de la actividad eléctrica inducida por la experiencia. Considerando lo anterior, el sistema nervioso en desarrollo constituye una especie de protomapa, sobre el que la experiencia moldea características moleculares, neuroquímicas y de conectividad, que se reflejan en las actividades emergentes del sistema. La evidencia que soporta la importancia que la influencia experiencial tiene sobre el desarrollo del sistema nervioso viene en aumento. Esta revisión reúne información sobre estudios en modelos biológicos y en humanos sometidos a privación sensorial y ambiental. Se enfatiza en la caracterización de los rasgos cognitivos y sociales.

The progressive advent of sensory, motor, affective, and cognitive skills in the human being through its development, demonstrate physiological changes that are gestated within the nervous system. These processes are dynamic and dependent postnatally on electrical activity induced by experience. Taking this into account, the developing nervous system constitutes a protomap molded by experience dependent molecular, physiological and connectivity characteristics, which are reflected in the emergent principles of the system. The evidence that supports the importance of experience as influence over the development of this system has increased in the past years. This document gathers information about animal models and human studies enduring sensory and environmental deprivation, emphasizing in the characterization of their cognitive and social remarks.

O aparecimento progressivo de habilidades sensoriais, motoras e cognitivo-afetivas no humano ao longo do seu desenvolvimento é um reflexo de mudanças fisiológicas que se gestam no interior do sistema nervoso. Ditas mudanças fazem parte de processos dinâmicos e dependem, depois do nascimento, da atividade elétrica induzida pela experiência. Considerando o anterior, o sistema nervoso em desenvolvimento constitui uma espécie de "protomapa", sobre o que a experiência molda características moleculares, neuroquímicas e de conectividade, que se refletem nas atividades emergentes do sistema. A evidência que suporta a importância que a influência experiencial tem sobre o desenvolvimento do sistema nervoso vem em aumento. Esta revisão reúne informação sobre estudos em modelos biológicos e em humanos submetidos a privação sensorial e ambiental. Se enfatiza na caracterização das características cognitivas e sociais.

Correlação entre reconhecimento de fala, tempo de privação auditiva e tempo de uso de Implante Coclear em usuários com surdez pós-lingual / Correlation between speech recognition, time of auditory deprivation, and duration of cochlear implant use in people with postlingual deafness / Correlación entre el reconocimiento del habla, el tiempo de privación auditiva y el tiempo de uso del implante coclear em usuários com sorder apos lingual

Introdução: A mensuração do benefício proporcionado pelo Implante Coclear é fundamental e há vários métodos de avaliação descritos, mas, os testes de percepção de fala ainda são os mais utilizados, dentre eles a "Lista de Sentenças em Português" - LSP. Determinar os fatores que influenciam o reconhecimento de fala nos usuários de IC auxilia nas orientações da etapa pré-operatória, melhora a adaptação, reabilitação e evidencia mudanças necessárias no dispositivo. Objetivo: Verificar a correlação das variáveis: tempo de privação auditiva e tempo de uso de Implante Coclear (IC) com os resultados dos testes de percepção de fala no silêncio e no ruído em usuários de IC com deficiência auditiva pós-lingual e idade entre 14 e 60 anos. Método: Os 27 participantes foram submetidos às seguintes avaliações: levantamento de dados- para coleta de informações que caracterizem a perda auditiva prévia, como tempo de privação auditiva e início do uso do IC -, audiometria em campo livre com IC nas frequências sonoras de 250 a 4000 Hz e o reconhecimento de fala que foi avaliado por meio do teste "Listas de Sentenças em Português" - LSP aplicado na condição favorável (silêncio) e na condição desfavorável (ruído) de escuta. Na análise estatística foram utilizados o coeficiente de correlação linear de Pearson e gráficos de dispersão bidimensional, além disso, a análise descritiva dos dados. Resultados: Não houve relação estatisticamente significante entre a privação auditiva e a percepção de fala no silêncio e no ruído. Por outro lado, houve correlação positiva estatisticamente significante entre o Tempo de Uso do IC com o desempenho no teste de reconhecimento de sentenças no silêncio. Conclusão: Verificou-se correlação significante apenas entre tempo de uso de implante e reconhecimento de sentenças no silêncio em usuários de implante com surdez pós-lingual.

Introduction: It is essential to measure the benefits provided by the cochlear implant, to which end various assessment methods have been described. Of these, the speech perception tests are still the most used, including the List of Sentences in Portuguese ­ LSP. Determining the factors that influence the speech recognition of CI users helps in preoperative instructions, improves adaptation and rehabilitation, and reveals necessary changes to be made in the device. Purpose: To verify the correlation between time of auditory deprivation and duration of use of the cochlear implant (CI) with the results of the speech perception in silence and noise tests in CI users with post lingual hearing loss aged 14 to 60 years old. Method: The 27 participants were submitted to the following assessments: data collection to characterize the previous hearing loss, such as the time of auditory deprivation and beginning of CI use; free-field audiometry with CI at the frequencies of 250 to 4000 Hz; speech recognition assessed through the Lists of Phrases in Portuguese (LPP), presented in favorable (silence) and unfavorable (noise) hearing conditions. In the statistical analysis, Pearson's linear correlation coefficient was used, as well as bidimensional dispersion graphs and descriptive data analysis. Results: There was no statistically significant relationship between auditory deprivation and speech perception in silence and noise. On the other hand, there was a statistically significant positive correlation between the duration of CI use and the performance in sentence recognition in silence. Conclusion: A significant correlation was verified only between duration of implant use and sentence recognition in silence in implant users with post lingual deafness.

Introduccion: La medición del beneficio proporcionado por el implante coclear es esencial y existen varios métodos para evaluar lãs pruebas, pero lãs pruebas de percepción Del habla son aún más utilizadas, entre ellas la "Lista de oraciones em portugués" - LSP. Determinar los factores que influyen o El reconocimiento de lãs conversaciones em los usuários del IC auxiliar em lãs instrucciones pre-operatorias, mejora La adaptación, la rehabilitación y la evidencia de cambios alterados em el dispositivo.Objetivo: Verifique la correlación de las variables: tiempo de privación auditiva y tiempo de uso del implante coclear (CI) com los resultados de las pruebas de percepción del habla en silencio y el ruído em usuarios de CI com audición poslingual y edad entre 14 y 60 años. Método: los 27 participantes se sometieron a los siguientes pasos: recopilación de datos - para la recopilación de datos que caracteriza la pérdida auditiva previa, como el tiempo de privación auditiva y el comienzo del uso de CI -, audiometria e nel campo libre con CI a 250 a 4000 Hz frecuencias de sonido y El reconocimiento de voz se evaluó mediante la prueba "Lista de oraciones em portugués" - LSP aplicado em la condición favorable (silencio) y em la condición desfavorable (ruido) de la escucha. Em el análisis estadístico, se utilizaron coeficientes de correlación lineal de Pearson y gráficos de dispersión bidimensionales, además, um análisis descriptivo de los datos. Resultados: No hubo una relación estadísticamente significativa entre la privación auditiva y la percepción del habla en silencio y ruido. Por otro lado, hubo una correlación positiva estadísticamente significativa entre el tiempo de uso del implante coclear y el rendimento em la prueba de reconocimiento de oraciones en silencio. Conclusión: Hubo una correlación significativa solo entre el tiempo de uso del implante y el reconocimiento de oraciones en silencio em usuarios de implantes com sordera poslingual.

Ganho auditivo e influência do tempo de privação auditiva na percepção de fala em usuários de implante coclear / Hearing improvement and influence of hearing deprivation time on speech perception in cochlear implant users

RESUMO Objetivo Avaliar o ganho de percepção de fala na ausência e na presença de ruído competitivo; avaliar, após três meses de uso do implante coclear, se houve correlação entre a percepção de fala nas duas condições e correlacionar o tempo de privação auditiva e o lado implantado com a percepção de fala na ausência e na presença do ruído. Métodos Participaram deste ensaio clínico 12 indivíduos com perda auditiva de severa a profunda, submetidos à cirurgia de implante coclear. A percepção de fala foi avaliada através do teste Listas de Sentenças em Português, utilizando a direcionalidade Opti Omni, em situações de ausência e presença de ruído competitivo. Resultados A percepção de fala na ausência e na presença de ruído competitivo aumentou, em comparação com a percepção de fala pré-operatória com a utilização da direcionalidade Opti Omni e estes achados não tiveram associação com o tempo de privação auditiva ou o lado implantado. Conclusão Houve ganho na percepção de fala, tanto na ausência, como na presença do ruído competitivo, com forte correlação entre essas duas situações. Além disso, não houve associação entre tempo de privação auditiva sem o uso do aparelho de amplificação sonora individual ou o lado implantado com o desempenho na percepção de fala.

ABSTRACT Purpose To evaluate speech perception improvement in the absence and presence of competing noise; to evaluate, after three months using a cochlear implant, whether there was a correlation between speech perception in these two conditions, and to correlate the time of hearing deprivation and the implanted side with speech perception in the absence and presence of noise. Methods Twelve individuals with severe-to-profound hearing loss who underwent cochlear implant surgery participated in this clinical trial. Speech perception was assessed using the Lists of Phrases in Portuguese test, using the Opti Omni directionality, in situations of absence and presence of competing noise. Results Speech perception with the use of Opti Omni directionality in the absence and presence of competing noise increased when compared with preoperative speech perception; these findings were not associated with hearing deprivation time or implanted side. Conclusion There was an improvement in speech perception both in the absence and presence of competing noise, with a strong correlation between these two situations. Besides, there was no association between time of hearing deprivation without the use of hearing aid, or the implanted side, with performance in speech perception.

Treatment of refractory amblyopia with levodopa associated with full-time occlusion in the dominant eye / Tratamento da ambliopia refratária com o uso de levodopa associada à oclusão total do olho dominante

Abstract Purpose: To evaluate visual outcomes of levodopa treatment associated with full occlusion of the dominant eye in patients with refractory amblyopia. Methods: A prospective study of 19 attended patients who were subject to treatment with Levodopa and Carbidopa on doses of 0.7mg/kg/day, a ratio of 4:1 divided into three daily doses for 5 weeks, combined with full occlusion (24 hours/day) of the dominant eye. The ophthalmologic exam from previous consultations up to treatment and after 8 weeks of therapy were collected from medical record data. Patients who had completed treatment for more than 12 months were included for complete eye examination. Results: The mean age before treatment with levodopa was 11.0 ± 4.2 years old (varying from 7 to 23 years). The best-corrected visual acuity (Snellen chart) of the amblyopic eye before treatment was 0.24 (0.6 in logMAR) ± 0.16, after 8 weeks of treatment it was 0.47(0.3 in logMAR) ± 0.33, while during the final evaluation it was 0.46 (0.3 in logMAR) ± 0.34. There was a statistically significant improvement in vision after 8 weeks of therapy which was maintained until the final evaluation (p = 0.007). Conclusion: Levodopa/Carbidopa therapyat doses of 0.7 mg/kg/day at a ratio of 4:1 divided in three daily doses, associated with full occlusion of the dominant eye during 5 weeks had a significant improvement on the visual acuity of the amblyopic eye, and persisted up to 1 year after the treatment.

Resumo Objetivo: Avaliar os resultados visuais do tratamento com levodopa associada à oclusão total do olho dominante em pacientes amblíopes. Métodos: Estudo prospectivo de 19 pacientes atendidos e submetidos ao tratamento com levodopa e carbidopa na dose de 0,7 mg/kg/dia e proporção de 4:1, divididos em três doses diárias, durante cinco semanas, combinada a oclusão total (24 horas/dia) do olho dominante. Foram coletados dados do prontuário referentes ao exame oftalmológico da consulta anterior ao tratamento e após 8 semanas de terapia. Os pacientes com término do tratamento com mais de 12 meses foram reconvocados para exame oftalmológico completo. Resultados: A média de idade dos pacientes previamente ao tratamento com levodopa foi de 11,0 ± 4,2 anos (variando de 7 a 23 anos). A acuidade visual melhor corrigida (Snellen) do olho amblíope antes do tratamento foi de 0,24 (0,6 em logMAR) ± 0,16, após 8 semanas de tratamento foi de 0,47 (0,3 em logMAR) ± 0,33 e na avaliação final foi de 0,46 (0,3 em logMAR) ± 0,34. Houve melhora estatisticamente significante da visão após 8 semanas de tratamento que se manteve até a avaliação final (p = 0,007) Conclusão: A terapia com levodopa/carbidopa em doses de 0,7mg/kg/dia na proporção de 4:1 dividida em três doses diárias, associada à oclusão total do olho dominante durante 5 semanas, apresentou uma melhora significativa na acuidade visual do olho ambliópico e persistiu até 1 ano após o tratamento.

Treinamento auditivo: zumbido e habilidades auditivas em idosos com perda auditiva / Hearing Training: Tinnitus and Hearing Skills on Elderly People with Hearing Loss / Entrenamiento auditivo: zumbido y habilidad auditiva en ancianos con pérdida auditiva

Introdução: O zumbido juntamente com a perda auditiva, é uma percepção acústica anormal que pode levar a uma desorganização no Sistema Nervoso Auditivo Central. Por isso sujeitos portadores são suscetíveis ao Transtorno do Processamento Auditivo Central. O Treinamento Auditivo, baseado nos conceitos de neuroplasticidade pode auxiliar na redução do incômodo com o zumbido, por objetivar sincronia na via auditiva. Objetivo: Estimar os efeitos do Treinamento Auditivo Acusticamente Controlado Computadorizado na redução do incômodo com o zumbido e nas alterações das habilidades auditivas em idosos com perda auditiva usuários de próteses auditivas. Material e Método: Estudo transversal quantitativo e qualitativo, no qual foram reabilitados cinco idosos com zumbido, alteração em pelo menos uma habilidade auditiva e perda auditiva. Foram realizadas avaliações pré e pós intervenção, sendo elas: anamnese e avaliação audiológica básica, aplicação do questionário Tinnitus Handicap Inventory, testes comportamentais do processamento auditivo e avaliação eletrofisiológica. Realizou-se o tratamento com o software Escuta Ativa, em 16 sessões de em média 30 minutos cada. Resultados: Houve diferença estatisticamente significante em relação aos valores pré e pós tratamento no questionário Tinnitus Handicap Inventory e nos testes comportamentais. Não houve mudanças eletrofisiológicas pré e pós tratamento. Conclusão: Foi possível avaliar os efeitos do Treinamento Auditivo Acusticamente Controlado Computadorizado na redução do incômodo com o zumbido, por meio do questionário escolhido.

Auditory Nervous System. Subjects with hearing loss are susceptible to Auditory Processing Disorder, as by sensory deprivation also disorganize the Central Auditory Nervous System. Auditory Training can help in reducing the annoyance with tinnitus, by objectifying synchrony in the auditory pathway. Objective: To estimate the effects of Computerized Auditory Training on the reduction of annoyance with tinnitus and changes in auditory abilities in elderly people with hearing loss and hearing aids users. Material and Method: A quantitative and qualitative cross-sectional study in which five elderly people with tinnitus were rehabilitated with difficulty at least in one auditory ability and hearing loss. Evaluations Pre and PostAuditory Training were performed, such as: anamnesis and basic audiological evaluation, application of the Tinnitus Handicap Inventory, behavioral auditory processing tests and electrophysiological evaluation. The treatment was performed with Escuta Ativa software, in 16 sessions with approximately 30 minutes each one. Results: There was a statistically significant difference in relation to the pre and post treatment values in the Tinnitus Handicap questionnaire and Behavioral auditory processing tests. There were no pre and post treatment electrophysiological changes. Conclusion: It was possible to evaluate the effects of the Computerized Auditory Training in the reduction of annoyance with tinnitus, through the chosen questionnaire applied pre and post-intervention. Furthermore, some behavioral auditory abilities also.

Introducción: El zumbido junto con la pérdida auditiva, es una percepción acústica anormal que puede conducir a una desorganización en el Sistema Nervioso Auditivo Central. Por eso sujetos portadores son susceptibles al Trastorno del Procesamiento Auditivo Central. El Entrenamiento Auditivo, basado en los conceptos de neuroplasticidad puede auxiliar en la reducción de la incomodidad con el zumbido, por objetivar la sincronía en la vía auditiva. Objetivo: Estimar los efectos del Entrenamiento Auditivo Acústicamente Controlado Ordenado en la reducción de la incomodidad con el zumbido y los cambios de las habilidades auditivas en ancianos con pérdida auditiva usuarios de prótesis auditivas. Material y método: Estudio transversal cuantitativo y cualitativo, en el cual fueron rehabilitados cinco ancianos con zumbido, alteración en por lo menos una habilidad auditiva y pérdida auditiva. Se realizaron evaluaciones pre y post intervención, siendo ellas: anamnesis y evaluación audiológica básica, aplicación del cuestionario Tinnitus Handicap Inventory, pruebas conductuales del procesamiento auditivo y evaluación electrofisiológica. Se realizó el tratamiento con el software Escucha Activa, en 16 sesiones de en promedio 30 minutos cada una. Resultados: Hubo diferencia estadísticamente significativa en relación a los valores pre y post tratamiento en el cuestionario Tinnitus Handicap Inventory y en las pruebas de comportamiento. No hubo cambios electrofisiológicos pre y post tratamiento. Conclusión: Fue posible evaluar los efectos del Entrenamiento Auditivo Acusticamente Controlado Computadorizado en la reducción de la incomodidad con el zumbido, por medio del cuestionario escogido aplicado pre y post-intervención. Además, algunas habilidades auditivas de comportamiento también mejoraron con dicha intervención. Sólo no fue posible observar cambios electrofisiológicos en el Potencial Evocado Auditivo Larga Latencia.

Privação sensorial auditiva e sua relação com os potenciais evocados auditivos de longa latência / Auditory sensory deprivation and its relation with auditory evoked potentials of long latency / Privación sensorial auditiva y su relación con los potenciales evocados auditivos de larga latencia

Objetivo: verificar se o tempo de privação sensorial auditiva de até cinco anos em indivíduos com perda auditiva neurossensorial de grau leve ou moderado pode influenciar nas respostas dos Potenciais Evocados Auditivos de Longa Latência (PEALL). Métodos: Estudo prospectivo, transversal e quantitativo. Foram avaliados 14 sujeitos, com idade entre 52 e 76 anos, com perda auditiva neurossensorial de grau leve ou moderado simétrico, que estavam na fila de espera de um programa de concessão de próteses auditivas e possuíam entre dois e cinco anos de privação sensorial auditiva. Para apresentação do PEALL foram utilizados estímulos verbais e foram analisados os potenciais N1, P2 e P300. Resultados: A média de idade dos sujeitos foi de 63,5 anos e do tempo de privação auditiva foi de 3,3 anos. Houve diferença entre o número de sujeitos normais e alterados para N1, sendo maior o número de normais, já para P2 e P300 não houve diferença. Ao comparar o resultado normal e alterado nos potenciais com a idade e tempo de privação, não houve diferença significativa. Conclusão: O tempo de privação auditiva entre dois e cinco anos em indivíduos com perda auditiva neurossensorial de grau leve ou moderado, não influenciou nos resultados dos PEALL.

Objective: To verify whether auditory sensory deprivation time of up to five years, in individuals with mild to moderate sensorineural hearing loss may influence the Long-Latency Auditory Evoked Potential (LLAEP) responses. Methods: Prospective, cross-sectional, and quantitative study. Were assessed 14 subjects, aged 52 to 76 years, with symmetric mild or moderate sensorineural hearing loss, who were waiting for a hearing aid program and had between two and five years of auditory sensory deprivation. For the presentation of the LLAEP, verbal stimuli were used and the potentials N1, P2 and P300 were analyzed. Results: The mean age of the subjects was 63.5 years and the time of hearing deprivation was 3.3 years. There was a difference between the number of normal and altered subjects for N1, with a higher number of normal individuals, whereas for P2 and P300 there was no difference. When comparing the normal and altered outcome in the potentials with age and time of deprivation, there was no significant difference. Conclusion: The time of hearing deprivation between two and five years in individuals with mild or moderate sensorineural hearing loss did not influence the results of the LLAEP.

Objetivo: verificar si el tiempo de privación sensorial auditiva de hasta cinco años en individuos con pérdida auditiva neurosensorial de grado leve o moderado puede influir en las respuestas de los Potenciales Evocados Auditivos de Larga Latencia (PEALL). Métodos: estudio prospectivo, transversal y cuantitativo. Fueron evaluados 14 sujetos, con edad entre 52 y 76 años, con pérdida auditiva neurosensorial de grado leve o moderado simétrico, que estaban en línea de espera de un programa de concesión de prótesis auditivas y tenian entre dos y cinco años de privación sensorial auditiva. Para la presentación del PEALL fueron utilizados estímulos verbales y fueron analizados los potenciales N1, P2 y P300. Resultados: el promedio de edad de los sujetos fue de 63,5 años y del tiempo de privación auditiva fue de 3,3 años. Hubo diferencia entre el número de sujetos normales y alterados para N1, el mayor número siendo normales, ya para P2 y P300 no hubo diferencia. Al compararse el resultado normal y alterado en los potenciales con la edad y tiempo de privación, no hubo diferencia significativa. Conclusión: el tiempo de privación auditiva entre dos y cinco años en individuos con pérdida auditiva neurosensorial de grado lele o moderado, no influyó en los resultados de los PEALL.

Deficiência visual x habilidades auditivas: desempenho das habilidades do processamento auditivo central em deficientes visuais / Visual impairment x hearing abilities: performance of the central auditory processing abilities in the visually impaired / Deficiencia visual x habilidades auditivas: rendimiento de las habilidades del procesamiento auditivo central en deficientes visuales

Introdução: Na ausência da visão, o cérebro humano necessita compensar tal deficiência sensorial se ajustando para que outros sentidos venham a equilibrar percepções externas. Objetivo: Comparar o desempenho das habilidades do processamento auditivo central entre um grupo de deficientes visuais e um grupo com visão normal. Métodos: Os participantes foram divididos em dois grupos, sendo o grupo estudo (GE), composto por 13 deficientes visuais, que posteriormente foi subdividido de acordo com o grau e tipo da deficiência; e grupo controle (GC), formado pelo mesmo número de participantes, com visão normal. Ambos os grupos foram submetidos a um questionário sobre seu histórico auditivo, meatoscopia, avaliação auditiva básica, composta por audiometria tonal e vocal e imitanciometria, sendo que os participantes com integridade e acuidade auditiva adequada passaram à realização dos testes para avaliação do processamento auditivo central (SSW, MLD, TDCV, PPS e RGDT). Resultados: Observou-se que, no geral, o GE obteve melhor resultado apenas na orelha esquerda em condição competitiva, no teste SSW. No MLD, houve diferença estatisticamente significante com média geral superior no GE. No TDCV, em atenção livre, a ocorrência de acertos geral foi maior no GC, enquanto que, em escuta direcionada, o GE obteve média geral superior na atenção direita e o GC na atenção esquerda. Nos testes PPS e RGDT, observou-se que o GE mostrou desempenho geral superior. Conclusão: Através dos testes de processamento auditivo central, foi possível comprovar que o GE obteve desempenho mais eficiente nas habilidades auditivas avaliadas.

Introduction: In the absence of vision, the human brain needs to compensate this sensorial disability making adjustments so other senses equilibrate external perceptions. Objective: Compare the performance of the central auditory processing abilities between a group of visually impaired and a group with normal vision. Methods: Participants were divided in: study group (SG), composed by 13 visually impaired, that afterwards were subdivided accordingly with degree and type of the deficiency; and control group (CG), formed by the same number of participants with normal vision. Both were submitted to a questionnaire about their hearing history, meatoscopy, basic hearing assessment, composed by tonal and vocal audiometry, and impedance, being that participants with adequate auditory integrity and acuity passed to the execution of the tests for the central auditory processing assessment (SSW, MLD, DLCVS, PPS, RGDT). Results: It was observed that, in general, the SG obtained better result only in the left ear in competitive condition, in SSW test. In the MLD, there was statistical significant difference with higher overall average in the SG. In the DLCVS, in free attention, the occurrence of the general correct answers was higher in the CG, whereas, in directed attention, SG obtained higher overall average in the right attention and CG in the left attention. In the PPS and RGDT tests, it was observed that SG showed higher overall performance. Conclusion: Throughout the central auditory processing tests, it was possible to prove that the SG obtained more efficient performance in the auditory abilities assessed.

Introducción: En la ausencia de la visión, el cerebro humano necesita compensar tal deficiencia, haciendo ajustes para que otros sentidos vengan a equilibrar las percepciones externas. Objetivo: Comparar el rendimiento de las habilidades del procesamiento auditivo central entre un grupo de deficientes visuales y un grupo con visión normal. Métodos: Los participantes fueron divididos en dos grupos: grupo estudio (GE), compuesto por 13 deficientes visuales, siendo subdividido de acuerdo con el grado y tipo de la deficiencia; y grupo control (GC), formado por el mismo número de participantes con visión normal. Los grupos fueron sometidos a un cuestionario sobre su histórico auditivo, otoscopia, evaluación auditiva básica, compuesta por audiometría tonal y vocal e imitanciometría. Los participantes con integridad y acuidad auditiva normales pasaron a realización de las pruebas para evaluación del procesamiento auditivo central (SSW, MLD, TDCV, PPS y RGDT). Resultados: El GE obtuvo mejor resultado sólo en la oreja izquierda, en condición competitiva, en la prueba SSW. En el MLD hubo diferencia estadísticamente significante con media general superior en el GE. En el TDCV, con atención libre, la ocurrencia general de aciertos fue mayor para el GC, mientras que, en la escucha direccionada, el GE obtuvo media general superior en la atención derecha y el GC en atención izquierda. En las pruebas PPS y RGDT, se observo que el GE mostró resultado general superior. Conclusión: A través de las pruebas del procesamiento auditivo central, se comprobó que el GE obtuvo rendimiento más eficiente en las habilidades auditivas evaluadas.

Interictal abnormal fMRI activation of visual areas during a motor task cued by visual stimuli in migraine / Ativação interictal anormal de áreas visuais por ressonância magnética funcional durante uma tarefa visuo-motora em indivíduos com enxaqueca

ABSTRACT Objective To assess changes in blood-oxygen-level-dependent activity after light deprivation compared to regular light exposure in subjects with migraine in the interictal state and in controls. Methods Ten subjects with migraine and ten controls participated in two sessions of functional magnetic resonance imaging. In each session, they performed a finger-tapping task with the right hand, cued by visual stimuli. They were scanned before and after 30 minutes of light deprivation or light exposure. In subjects with migraine, functional magnetic resonance imaging was performed interictally. Analysis of variance was made with the factors time (before or after), session (light deprivation or exposure), and group (migraine or control). Results There were significant “group” effects in a cluster in the bilateral cuneus encompassing the superior border of the calcarine sulcus and extrastriate cortex. There were no significant effects of “time”, “session”, or interactions between these factors. Conclusion The main result of this study is consistent with aberrant interictal processing of visual information in migraine. Light deprivation did not modulate functional magnetic resonance imaging activity in subjects with or without migraine.

RESUMO Objetivo Avaliar mudanças na atividade cerebral por meio de ressonância magnética funcional após privação luminosa comparada à exposição à luz, em indivíduos com enxaqueca no estado interictal e em controles. Métodos Dez indivíduos com enxaqueca e dez controles participaram de duas sessões de ressonância magnética funcional. Em cada sessão, realizaram uma tarefa motora com a mão direita guiada por estímulos visuais. Foram colhidas imagens antes e após 30 minutos de privação luminosa ou exposição à luz. Em indivíduos com enxaqueca, a ressonância funcional foi realizada no período interictal. Foi feita a análise de variância com fatores tempo (antes ou depois), sessão (privação ou exposição à luz) e grupo (enxaqueca ou controle). Resultados Houve efeitos significativos de “grupo” em uma área no cúneo bilateral, incluindo a borda superior do sulco calcarino e o córtex extraestriado. Não houve efeitos significativos de “tempo”, “sessão” ou interações entre estes fatores. Conclusão O principal resultado deste estudo sugere um processamento interictal anormal das informações visuais em indivíduos com enxaqueca. A privação luminosa não modulou a atividade na ressonância magnética funcional em indivíduos com ou sem enxaqueca.

Postural balance in Alzheimer's disease patients undergoing sensory pitfalls

Despite consensus regarding the interference of cognitive processes on the human balance, the impact that different sensory stimuli have on the stabilometric measures remains unclear. Here, we investigated changes in the postural balance of individuals with Alzheimer's disease (AD) and in healthy controls undergoing different proprioceptive and somesthetic pitfalls. We included 17 subjects submitted to eight sensorimotor dynamics with differences in the support bases, contact surfaces, and visual clues. The measurements used to assess participants balance were as follows: position of the body in space, range of instability, area of the support base, and velocity of postural control. From a total of 56 cross-sectional analyses, 21.42% pointed out differences between groups. Longitudinal analyses showed that tasks with proprioceptive and somesthetic pitfalls similarly impact imbalance in both groups. The current results suggest that AD subjects and healthy controls had different patterns submitted to balance, but suffered similar interference when undergoing proprioceptive and somesthetic challenges

Refractive development and form-deprivation induced myopic refractive error in CBA/CaJ mice / 生理学报

Due to the advantages in genetic manipulation, mice have become one of the most commonly used mammalian models for the study of mechanisms underlying myopia development. However, the vast majority of laboratory mouse strains are incapable of synthesizing melatonin, a neurohormone that may play an important role in myopia generation in humans. The present study investigated refractive development profiles in the CBA/CaJ mouse, a strain proficient in melatonin, and determined whether and how its refractive development could be affected by form-deprivation. Eccentric infrared photoretinoscopy revealed that this animal could be stably refracted, and the refractive error underwent developmental changes, which increased with age in the hyperopic direction and eventually got stable approximately 9 weeks after birth. The absolute values of refractive error in CBA/CaJ mice were larger than those of age-matched C57BL/6 mice, whereas the time points when refractive error reached steady state were similar between the two strains. Five weeks of form-deprivation applied to 3-week-old CBA/CaJ mice by translucent occluder wear caused a significant myopic shift in refractive error, indicating that this strain could be adequately used as a myopia model.

Charles Bonnet Syndrome Following Trans-Sphenoidal Adenomectomy without Optic Nerve Atrophy

Charles Bonnet syndrome (CBS) can develop after trans-sphenoidal adenomectomy (TSA); however, the neural mechanisms remain unknown. Sensory deprivation and releasing phenomenon are both hypothetical explanations for this condition; however, there is no definite evidence that strongly supports either supposition. We report the first case of CBS after TSA without optic nerve atrophy. Postoperatively, the patient's vision seemed to be relatively well preserved, apart from the left-side hemianopsia in the right eye. Distinctive visual hallucinations only appeared when his eyes were closed, and these responded to quetiapine in a dose-dependent manner. Dose dependent change in colors and formation of hallucination was reported. Two weeks after quetiapine initiation, the patient's CBS was completely resolved. This unique case suggests that blocking sensory input from the periphery is more critical than neural damage of the bottom-up connection to the visual association cortex. In addition, quetiapine should be considered as a specific treatment for CBS.

Effects of monocular deprivation on the dendritic features of retinal ganglion cells / Efectos de la privación monocular sobre las características dendríticas de las células ganglionares de la retina

Monocular deprivation results in anatomical changes in the visual cortex in favor of the non-deprived eye. Although the retina forms part of the visual pathway, there is scarcity of data on the effect of monocular deprivation on its structure. The objective of this study was to describe the effects of monocular deprivation on the retinal ganglion cell dendritic features. The study design was quasi-experimental. 30 rabbits (18 experimental, 12 controls) were examined. Monocular deprivation was achieved through unilateral lid suture in the experimental animals. The rabbits were observed for three weeks. Each week, 6 experimental and 3 control animals were euthanized, their retina harvested and processed for light microscopy. Photomicrographs of the retina were taken using a digital camera then entered into FIJI software for analysis. The number of primary branches, terminal branches and dendritic field area among the non-deprived eyes increased by 66.7%(p=0.385), 400%(p=0.002), and 88.4%(p=0.523) respectively. Non-deprived eyes had 114.3% more terminal dendrites (p=0.002) compared to controls. Among deprived eyes, all variables measured had a gradual rise in the first two weeks followed by decline with further deprivation. There were no statistically significant differences noted between the deprived and control eyes. Monocular deprivation results in increase in synaptic contacts in the non-deprived eye, with reciprocal changes occurring in the deprived eye.

La privación monocular de la visión resulta en cambios anatómicos en la corteza visual en favor del ojo no privado. Aunque la retina forma parte de la vía visual, hay escasez de datos sobre el efecto de la privación monocular en su estructura. El objetivo de esta investigación fue describir los efectos de la privación monocular en las características de las dendritas de las células ganglionares de la retina. Se diseñó un estudio cuasi-experimental. Se examinaron 30 conejos (18 experimentales, 12 controles). La privación monocular se logró a través de la sutura unilateral del párpado en los animales de experimentación. Los conejos fueron observados durante tres semanas. Cada semana, 6 animales experimentales y 3 control fueron eutanasiados, donde se obtuvo la retina y fue procesada para realizar microscopía óptica. Las microfotografías de la retina fueron tomadas con una cámara digital y luego se utilizó el software FIJI para su análisis. El número de dendritas primarias, terminales y el área del campo de dendritas en los ojos no privados aumentó un 66,7% (p=0,385), 400% (p=0,002), y 88,4% (p=0,523), respectivamente. Los ojos no privados, tenían 114,3% más dendritas terminales (p=0,002) en comparación con los controles. Entre los ojos privados, todas las variables medidas tuvieron un aumento gradual en las dos primeras semanas, seguido de descenso con mayor privación. No se observaron diferencias estadísticamente significativas entre los ojos privados y el grupo control. En conclusion, la privación monocular produce un aumento de los contactos sinápticos en los ojos no privados, con cambios recíprocos que se manifiestan en los ojos privados de la visión.

Segurança do trabalho e ação sensório-motora: abordagem econômica da cognição (AEC) em atividade de trabalho / Work safety and sensorimotor action: economic approach of cognition (EAC) in work activity

Este artigo investigou a relação entre a abordagem sensório-motora da cognição e a segurança do trabalho. Os métodos de pesquisa adotados foram entrevistas e observações segundo o modelo da análise ergonômica do trabalho (AET). Um grupo de trabalhadores de uma indústria siderúrgica foi estudado. Os resultados indicaram que o acoplamento sensório-motor do operador com a situação é expresso em percepção e cognição e organiza a ação segura. Os resultados confirmam que a atividade sensório-motora é importante para o controle cognitivo dos riscos, em atividade de trabalho. Estruturas cognitivas emergem de padrões sensório-motores recorrentes na ação perceptivamente orientada. Este estudo integra a abordagem sensório-motora dinâmica da cognição com a segurança do trabalho. Conceitos importantes aqui são Umwelt e intencionalidade motora, segundo o principal objetivo deste artigo: esclarecer as relações teóricas entre cognição incorporada e controle cognitivo da ação em sistemas de produção.

This paper investigated the relation betweensensorimotor approach of cognition and worksafety. The methods of research adopted wereinterviews and observations following the modelof the ergonomic work analysis (EWA). A groupof workers from the steel industry was studied.The results indicates that sensorimotor couplingof operator with the situation is expressed inperception and cognition and organize the safetyaction. The results confirm that sensorimotoractivity is important to the cognitive controlof risks. Cognitive structures emerge fromthe recurrent sensorimotor patterns in theperceptually-guided-action. This study will beto link the dynamic sensorimotor approach ofcognition to work safety. Here, important conceptsare Umwelt and motor intentionality, accordingto the paper's primary goal: to shed new light onthe theoretical relations between an embodiedenactive approach of cognition and cognitivecontrol of action in production systems.

Development and evaluation of a patching treatment questionnaire for Chinese amblyopic children / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Amblyopia is a common disease for children. The main treatment approach for amblyopia is to patch the normally sighted eye and force the use of the amblyopic eye. However, patching treatment in children may negatively impact psychological well-being of both the child and family. At present, no specific questionnaire is available to assess the health-related quality of life (HRQoL) of amblyopic treatment for children and their families in China. The purpose of our study was to develop a Chinese version of patching treatment questionnaire, and evaluate its reliability and validity.</p><p><b>METHODS</b>The original patching treatment questionnaire of amblyopia treatment index (ATI) was translated into Chinese. Amblyopic patients aged 4-9 years receiving patching 4-8 hours per day or full-time were recruited. The reliability and validity of the Chinese version of the patching treatment questionnaire were determined by internal consistency, test-retest reliability, item-scale correlations, and construct validity. The associated baseline factors and the questionnaire responses were assessed.</p><p><b>RESULTS</b>One hundred and nine children with amblyopia treated with patching were enrolled. Distribution of response options for individual items and correlation with the respective subscale were calculated. Factor analysis revealed that 16 of the 21 items were loaded in the three subscales as follows: "adverse effects" of treatment, "difficulties with compliance" and "social stigma" of treatment. Internal consistency values measured by Cronbach's α coefficient (0.768) and split-half coefficient (0.790) were satisfactory for the total scales. The intra-class correlation coefficient for test-retest reliability was 0.998. No significant difference was found between the overall questionnaire scores and children's age, sex, baseline visual acuity of amblyopic eyes, improvement of the amblyopic eye, or patching time.</p><p><b>CONCLUSIONS</b>We developed a Chinese version of the patching treatment questionnaire with satisfactory reliability and validity. Validation in a patch-treated pediatric amblyopic population indicated that the questionnaire may be useful for Chinese children.</p>

Adaptação de prótese auditiva e a privação da audição unilateral: avaliação comportamental e eletrofisiológica / Hearing aid fitting and unilateral auditory deprivation: behavioral and electrophysiologic assessment

O fenômeno da Privação Auditiva Unilateral de Início Tardio foi reportado em 1984. No entanto, ainda se observa um expressivo número de adaptações de próteses auditivas unilaterais, nos casos de perdas auditivas bilaterais, justificadas por fatores não auditivos, tais como custo, vaidade, desinformação ou políticas públicas de saúde. OBJETIVO: Investigar, por meio de avaliação comportamental e eletrofisiológica, o desempenho auditivo de adultos que fazem uso de amplificação unilateral, comparados àqueles expostos à estimulação auditiva simétrica bilateral. MÉTODO: Participaram deste estudo 35 indivíduos adultos com perda auditiva sensorioneural bilateral simétrica, usuários regulares de prótese auditiva unilateral, bilateral e não usuários de prótese auditiva por meio de testes de avaliação comportamental e eletrofisiológica. RESULTADOS: A análise de variância revelou que, no grupo usuário de amplificação unilateral, a latência do P300 foi significantemente maior na orelha que sofreu a privação auditiva comparada a orelha com prótese auditiva (p < 0,05). Também foi encontrado desempenho significantemente pior deste grupo no reconhecimento de sentenças no ruído (LSP) realizado em campo livre. CONCLUSÃO: Os resultados reforçam os achados da literatura de que a privação auditiva unilateral pode levar a mudanças fisiológicas e perceptuais.

The phenomenon of Late-Onset Unilateral Auditory Deprivation was first reported in 1984. However, a high number of unilateral hearing aid fittings are still carried out in cases of bilateral hearing loss, justified by non-auditory factors such as cost, vanity, misinformation and public health policies. OBJECTIVE: To carry out behavioral and electrophysiological assessment of the auditory performance of adults using unilateral amplification compared with individuals exposed to bilateral symmetric auditory stimulation. METHOD: Thirty five adults, all with symmetric bilateral sensorineural hearing loss, regular users of unilateral hearing aid, bilateral hearing aids and not users of hearing aids, were assessed on behavioral and electrophysiological tests. RESULTS: Variance analysis revealed that in the unilaterally fitted group, P300 latency was significantly greater in ears with auditory deprivation compared with those fitted with the hearing aid (p < 0.05). This same group also had poorer performance on the Sentence Recognition Test in Noise held in free field. CONCLUSION: These results corroborate findings in the literature showing that unilateral auditory deprivation can lead to physiological and perceptual changes.

MK801 controls form-deprivation myopia by nitric oxide-cyclic GMP signaling pathway in guinea pig / 中南大学学报(医学版)

OBJECTIVE@#To investigate the mechanism of myopia following intravitreous injection of MK801 (dizocipine maleate) intravitreous injected.@*METHODS@#Three-week-old guinea pigs were divided into six groups: group A (control), group B (3 weeks form-deprivation in right eye), group C ( 3 weeks form-deprivation in right eye + saline), group D (3 weeks form-deprivation in right eye + MK801 1ng), group E (3 weeks form-deprivation in right eye + MK801 10 ng), group F (3 weeks form-deprivation in right eye + MK801 100 ng). The refraction and axial length of the eyes were measured. ncNOS was measured by hybridization in situ, and cyclic GMP (cGMP) concentrations by radioimmunochemistry. The correlation between MK801 concentration and diopter degree, axial length of the eyes, and levels of ncNOS or cyclic GMP were analyzed with linear correlation in the groups C-F.@*RESULTS@#Diopter degree was decreased, axial eye length was shorted and levels of ncNOS and c-GMP were decreased in groups C, D, E and F dependent on the concentration of MK801. The diopter degree had positive correlation with MK801 concentration (r=0.702, P<0.05), while the axial eye length and the levels of ncNOS and cGMP were negatively correlated (r=-0.736, -0.637, -0.725, P<0.05)@*CONCLUSION@#MK801 injected into the vitreous humor can restrain myopia by down-regulated the expression of the nitric oxide-cyclic GMP signaling pathway. The effect is concentration dependent.

Obese elderly women exhibit low postural stability: a novel three-dimensional evaluation system

OBJECTIVE: The aim of this study was to evaluate the multisegmental static postural balance of active eutrophic and obese elderly women using a three-dimensional system under different sensory conditions. METHODS: A cross-sectional study was conducted on 31 elderly women (16 eutrophic and 15 obese) aged 65 to 75 years. The following anthropometric measurements were obtained: weight, height, waist and hip circumference, and handgrip strength. The physical activity level was evaluated using the International Physical Activity Questionnaire. Body composition was measured using the deuterium oxide dilution technique. The Polhemus® Patriot (three-dimensional) equipment was used to measure the parameters of postural balance along the anteroposterior and laterolateral axes. The data acquisition involved one trial of 60 s to test the limit of stability and four trials of 90 s each under the following conditions: (1) eyes open, stable surface; (2) eyes closed, stable surface; (3) eyes open, unstable surface; and (4) eyes closed, unstable surface. RESULTS: For the limit of stability, significant differences were observed in the maximum anteroposterior and laterolateral displacement (p<0.01) and in the parameter maximum anteroposterior displacement in the eyes closed stable surface condition (p<0.01) and maximum anteroposterior and laterolateral displacement in the eyes open unstable surface (p<0.01 and p = 0.03) and eyes closed unstable surface (p<0.01 and p<0.01) conditions. CONCLUSIONS: Obese elderly women exhibited a lower stability limit (lower sway area) compared with eutrophic women, leaving them more vulnerable to falls.

Visual outcomes of Amblyopia Therapy

Objective@#To determine the visual outcome of amblyopia treatment and describe the relationship between age of onset and consult, compliance as measured by a patch diary, amblyopia subtype, and severity with the final visual outcome.@*Methods@#Thirty-two consecutive, newly-diagnosed cases of amblyopia, aged 3-8 years on initial consult, with no history of prior amblyopia treatment, were included. Patching was done based on current AAO recommendations and patients were followed up monthly for 6 months. Treatment success was defined as best corrected visual acuity (BCVA) better than 20/30 (0.17LogMAR), or a 3-line improvement from baseline, or stable isoacuity for at least 3 months. Treatment failure was defined as no improvement of BCVA after 3 months of occlusion therapy or a regression of 2 lines. Descriptive and correlation statistics were performed comparing age of onset and consult, amblyopia subtype, severity, and compliance with the main outcome measure of BCVA at 6 months. @*Results@#Sixteen (50%) attained treatment success. Patients seen earlier (age 2-5 years) had higher rates of success (75%) than those seen later (age 6-8 years) (35%). A moderately strong negative correlation (r=-0.48, p=0.01) existed between severity of amblyopia and final BCVA at 6 months. overall compliance to patching was 88±18%, with good compliance in the success group (92%) compared to fair compliance in the failure group (84%) and a moderate correlation between compliance and BCVA (r=0.37, p=0.05). @*Conclusion@#Treatment success was related to severity, compliance, and younger age of treatment. In the presence of good compliance, severity was a strong prognostic variable.

Expression of cyclic guanine monophosphate and the ultrastructure change in retina of guinea pig with form-deprivation myopia / 中南大学学报(医学版)

OBJECTIVE@#To explore the expression of cyclic guanine monophosphate (cGMP) and the ultrastructure change in retina of guinea pig with form-deprivation myopia and the underlying mechanisms.@*METHODS@#Three-weeks-old guinea pigs were distributed in 3 groups: an untreated group (Group I), a myopia 2-weeks group (Group II) and a myopia 3-weeks group (Group III), animals underwent monocular form-deprivation by facemask for 2 and 3 weeks. The right eyes were deprived and the left eyes were self-controlled. The refraction and axial length of the eyes was measured. Retina was observed by electron microscope. The expression of cGMP was detected by radioimmunochemistry.@*RESULTS@#Deprived eyes in guinea pig showed significant development of myopia, the refraction and axial length was increased. The pathological changes in ultrastructure of retina were aggravated with the development of myopia. The expression of cGMP was significantly up-regulated in the deprived eyes compared with self-control eyes(P<0.05).@*CONCLUSION@#Form-deprivation can up-regulate the expression of cyclic GMP, which might play an important role in the development of myopia.

Arranjos cognitivos: abrangências e limitações representacionais / Cognitive arrangements: scope and representational limitations

Este artigo avalia as características quantitativas (dimensões dos campos sensoriais) e qualitativas (padrões configuracionais, qualias e tempo/espaciais) das modalidades sensoriais faltantes e remanescentes e como elas afetam o arranjo cognitivo e a fluência representacional de indivíduos sensorialmente privados (cegos e surdos). Sugere-se que a utilização precoce e maciça do caráter predominantemente configuracional da modalidade sensorial visual, principal modalidade remanescente nos surdos congênitos, iniba a produção representacional nesses indivíduos, enquanto que o uso intensivo e precoce do caráter predominantemente insinuador da modalidade sensorial auditiva, principal modalidade nos cegos congênitos, incentive a produção representacional nesses últimos.

This study evaluates the quantitative (sensorial field's dimensions) and qualitative (configuration's patterns, qualias and spatial/time) characteristics of missing and remaining sensorial modalities and how they affect the cognitive arrangement and the representational fluency of sensorial impaired individuals (blindness and deafness). It is suggested that precocious and massive use of the predominantly configurational nature of the visual sensorial modality, the main modality remaining on born deaf subjects, inhibit their representational production, while the intensive and precocious use of the predominantly insinuating nature of the auditive sensorial modality, the main modality on born blind subjects, encourages representational production on them.