Evaluación de pruebas psicoacústicas y de potenciales relacionados a eventos P300 en adultos mayores con hiperhomocisteinemia / Evaluation of psychoacoustic tests and P300 event-related potentials in elderly patients with hyperhomocysteinemia

Introducción y objetivos: La hiperhomocisteinemia como un factor de riesgo para el daño auditivo, el daño neuronal y el deterioro cognitivo en los pacientes adultos mayores es controvertido y se encuentra limitado por un pequeño número de estudios. El objetivo de este trabajo es determinar si los pacientes adultos mayores con hiperhomocisteinemia presentan mayor riesgo de desarrollar alteraciones en los procesos centrales de la audición frente a un grupo de pacientes con niveles de homocisteína adecuados, y definir el comportamiento de las pruebas psicoacústicas y de potenciales de latencia larga (P300) en estos grupos. Método: Estudio transversal, comparativo y analítico. Se formó un grupo de pacientes con hiperhomocisteinemia y un grupo control con valores normales de homocisteína. A todos los pacientes se les realizó audiometría tonal, impedanciometría y una selección de pruebas psicoacústicas (dígitos dicóticos, palabras filtradas pasa bajo, palabra en ruido y diferencia en niveles de enmascaramiento), así como potenciales evocados auditivos de tallo cerebral y P300. Resultados: Los pacientes con hiperhomocisteinemia presentaron valores en la prueba de diferencia en los niveles de enmascaramiento superiores a los del grupo control (p = 0,049), así como latencias más prologadas en los P300 (p = 0,000). Conclusiones: La hiperhomocisteinemia es un factor que altera las funciones auditivas centrales. Las pruebas psicoacústicas alteradas junto con la alteración en las pruebas electrofisiológicas sugieren que la porción central de la vía auditiva está afectada en los pacientes con hiperhomocisteinemia (AU)

Introduction and objectives: Hyperhomocysteinemia as a risk factor for hearing impairment, neuronal damage and cognitive impairment in elderly patients is controversial and is limited by the small number of studies. The aim of this work was determine if elderly patients detected with hyperhomocysteinemia have an increased risk of developing abnormalities in the central auditory processes as compared with a group of patients with appropriate homocysteine levels, and to define the behaviour of psychoacoustic tests and long latency potentials (P300) in these patients. Methods: This was a cross-sectional, comparative and analytical study. We formed a group of patients with hyperhomocysteinemia and a control group with normal levels of homocysteine. All patients underwent audiometry, tympanometry and a selection of psychoacoustic tests (dichotic digits, low-pass filtered words, speech in noise and masking level difference), auditory evoked brainstem potentials and P300. Results: Patients with hyperhomocysteinemia had higher values in the test of masking level difference than did the control group (P=0.049) and more protracted latency in P300 (P=0.000). Conclusions: Hyperhomocysteinemia is a factor that alters the central auditory functions. Alterations in psychoacoustic tests and disturbances in electrophysiological tests suggest that the central portion of the auditory pathway is affected in patients with hyperhomocysteinemia (AU)

Evaluation of psychoacoustic tests and P300 event-related potentials in elderly patients with hyperhomocysteinemia.

INTRODUCTION AND OBJECTIVES: Hyperhomocysteinemia as a risk factor for hearing impairment, neuronal damage and cognitive impairment in elderly patients is controversial and is limited by the small number of studies. The aim of this work was determine if elderly patients detected with hyperhomocysteinemia have an increased risk of developing abnormalities in the central auditory processes as compared with a group of patients with appropriate homocysteine levels, and to define the behaviour of psychoacoustic tests and long latency potentials (P300) in these patients. METHODS: This was a cross-sectional, comparative and analytical study. We formed a group of patients with hyperhomocysteinemia and a control group with normal levels of homocysteine. All patients underwent audiometry, tympanometry and a selection of psychoacoustic tests (dichotic digits, low-pass filtered words, speech in noise and masking level difference), auditory evoked brainstem potentials and P300. RESULTS: Patients with hyperhomocysteinemia had higher values in the test of masking level difference than did the control group (P=.049) and more protracted latency in P300 (P=.000). CONCLUSIONS: Hyperhomocysteinemia is a factor that alters the central auditory functions. Alterations in psychoacoustic tests and disturbances in electrophysiological tests suggest that the central portion of the auditory pathway is affected in patients with hyperhomocysteinemia.