Auditory Evoked Potentials and Cochlear Implants: Research Findings and Clinical Applications in Children

2009 ◽  
Vol 19 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Suzanne C Purdy ◽  
Kirsty Gardner-Berry

Abstract Auditory evoked potentials can be used to objectively assess hearing sensitivity, central auditory processing, and neural encoding of speech sounds up to the level of the auditory cortex. Evoked potentials have been of interest to clinicians and researchers in the cochlear implant field for a long time because of their potential for objectively predicting cochlear implant outcomes, as well as improving candidacy determination, and implant programming. Neural response telemetry and intra-operative electrical auditory brainstem recording have been routinely performed by implant programs for many years. Recently, there has been great interest in potential clinical applications of cortical auditory evoked potentials in the implant field. Research and clinical applications are reviewed and case studies are presented that illustrate clinical applications of cortical evoked potentials in children before and after implantation.

2019 ◽  
Vol 30 (06) ◽  
pp. 493-501
Author(s):  
Skylar Trott ◽  
Trey Cline ◽  
Jeffrey Weihing ◽  
Deidra Beshear ◽  
Matthew Bush ◽  
...  

AbstractEstrogen has been identified as playing a key role in many organ systems. Recently, estrogen has been found to be produced in the human brain and is believed contribute to central auditory processing. After menopause, a low estrogen state, many women report hearing loss but demonstrate no deficits in peripheral hearing sensitivity, which support the notion that estrogen plays an effect on central auditory processing. Although animal research on estrogen and hearing loss is extensive, there is little in the literature on the human model.The aim of this study was to evaluate relationships between hormonal changes and hearing as it relates to higher auditory function in pre- and postmenopausal (Post-M) females.A prospective, group comparison study.Twenty eight women between the ages of 18 and 70 at the University of Kentucky were recruited.Participants were separated into premenopausal and peri-/Post-M groups. Participants had normal peripheral hearing sensitivity and underwent a behavioral auditory processing battery and electrophysiological evaluation. An analysis of variance was performed to address the aims of the study.Results from the study demonstrated statistically significant difference between groups, where Post-M females had difficulties in spatial hearing abilities as reflected on the Listening in Spatialized Noise Test–Sentences test. In addition, measures on the auditory brainstem response and the middle latency response reflected statistically significant differences between groups with Post-M females having longer latencies.Results from the present study demonstrated significant differences between groups, particularly listening in noise. Females who present with auditory complaints in spite of normal hearing thresholds should have a more extensive audiological evaluation to further evaluate possible central deficits.


2002 ◽  
Vol 13 (07) ◽  
pp. 367-382 ◽  
Author(s):  
Suzanne C. Purdy ◽  
Andrea S. Kelly ◽  
Merren G. Davies

Auditory evoked potentials (AEPs) and behavioral tests were used to evaluate auditory processing in 10 children aged 7 to 11 years who were diagnosed as learning disabled (LD). AEPs included auditory brainstem responses (ABRs), middle latency responses (MLRs), and late cortical responses (P1, N1, P2, P3). Late cortical responses were recorded using an active listening oddball procedure. Auditory processing disorders were suspected in the LD children after a psychologist found phonologic processing and auditory memory problems. A control group of 10 age- and gender-matched children with no hearing or reported learning difficulties was also tested. Teacher ratings of classroom listening and SCAN Competing Words and Staggered Spondaic Word scores were poorer in the LD children. There were minor ABR latency differences between the two groups. Wave Na of the MLR was later and Nb was smaller in the LD group. The main differences in cortical responses were that P1 was earlier and P3 was later and smaller in the LD group.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Amineh Koravand ◽  
Benoît Jutras ◽  
Maryse Lassonde

Objective. This study examined the patterns of neural activity in the central auditory system in children with hearing loss.Methods. Cortical potentials and mismatch responses (MMRs) were recorded from ten children aged between 9 and 10 years: five with hearing loss and five with normal hearing in passive oddball paradigms using verbal and nonverbal stimuli.Results. Results indicate a trend toward larger P1 amplitude, a significant reduction in amplitude, and latency of N2 in children with hearing loss compared to control. No significant group differences were observed for the majority of the MMRs conditions.Conclusions. Data suggest that the reduced auditory input affects the pattern of cortical-auditory-evoked potentials in children with a mild to moderately severe hearing loss. Results suggest maturational delays and/or deficits in central auditory processing in children with hearing loss, as indicated by the neurophysiological markers P1 and N2. In contrast, negative MMR data suggest that the amplification provided by the hearing aids could have allowed children with hearing loss to develop adequate discriminative abilities.


2013 ◽  
Vol 24 (07) ◽  
pp. 564-571 ◽  
Author(s):  
Erin Plyler ◽  
Ashley W. Harkrider

Background: A boy, aged 2 1/2 yr, experienced sudden deterioration of speech and language abilities. He saw multiple medical professionals across 2 yr. By almost 5 yr, his vocabulary diminished from 50 words to 4, and he was referred to our speech and hearing center. Purpose: The purpose of this study was to heighten awareness of Landau-Kleffner syndrome (LKS) and emphasize the importance of an objective test battery that includes serial auditory-evoked potentials (AEPs) to audiologists who often are on the front lines of diagnosis and treatment delivery when faced with a child experiencing unexplained loss of the use of speech and language. Research Design: Clinical report. Results: Interview revealed a family history of seizure disorder. Normal social behaviors were observed. Acoustic reflexes and otoacoustic emissions were consistent with normal peripheral auditory function. The child could not complete behavioral audiometric testing or auditory processing tests, so serial AEPs were used to examine central nervous system function. Normal auditory brainstem responses, a replicable Na and absent Pa of the middle latency responses, and abnormal slow cortical potentials suggested dysfunction of auditory processing at the cortical level. The child was referred to a neurologist, who confirmed LKS. At age 7 1/2 yr, after 2 1/2 yr of antiepileptic medications, electroencephalographic (EEG) and audiometric measures normalized. Presently, the child communicates manually with limited use of oral information. Conclusions: Audiologists often are one of the first professionals to assess children with loss of speech and language of unknown origin. Objective, noninvasive, serial AEPs are a simple and valuable addition to the central audiometric test battery when evaluating a child with speech and language regression. The inclusion of these tests will markedly increase the chance for early and accurate referral, diagnosis, and monitoring of a child with LKS which is imperative for a positive prognosis.


Author(s):  
Josef P. Rauschecker

When one talks about hearing, some may first imagine the auricle (or external ear), which is the only visible part of the auditory system in humans and other mammals. Its shape and size vary among people, but it does not tell us much about a person’s abilities to hear (except perhaps their ability to localize sounds in space, where the shape of the auricle plays a certain role). Most of what is used for hearing is inside the head, particularly in the brain. The inner ear transforms mechanical vibrations into electrical signals; then the auditory nerve sends these signals into the brainstem, where intricate preprocessing occurs. Although auditory brainstem mechanisms are an important part of central auditory processing, it is the processing taking place in the cerebral cortex (with the thalamus as the mediator), which enables auditory perception and cognition. Human speech and the appreciation of music can hardly be imagined without a complex cortical network of specialized regions, each contributing different aspects of auditory cognitive abilities. During the evolution of these abilities in higher vertebrates, especially birds and mammals, the cortex played a crucial role, so a great deal of what is referred to as central auditory processing happens there. Whether it is the recognition of one’s mother’s voice, listening to Pavarotti singing or Yo-Yo Ma playing the cello, hearing or reading Shakespeare’s sonnets, it will evoke electrical vibrations in the auditory cortex, but it does not end there. Large parts of frontal and parietal cortex receive auditory signals originating in auditory cortex, forming processing streams for auditory object recognition and auditory-motor control, before being channeled into other parts of the brain for comprehension and enjoyment.


2018 ◽  
Vol 22 (04) ◽  
pp. 408-414 ◽  
Author(s):  
Signe Grasel ◽  
Mario Greters ◽  
Maria Goffi-Gomez ◽  
Roseli Bittar ◽  
Raimar Weber ◽  
...  

Introduction The P3 cognitive evoked potential is recorded when a subject correctly identifies, evaluates and processes two different auditory stimuli. Objective to evaluate the latency and amplitude of the P3 evoked potential in 26 cochlear implant users with post-lingual deafness with good or poor speech recognition scores as compared with normal hearing subjects matched for age and educational level. Methods In this prospective cohort study, auditory cortical responses were recorded from 26 post-lingual deaf adult cochlear implant users (19 with good and 7 with poor speech recognition scores) and 26 control subjects. Results There was a significant difference in the P3 latency between cochlear implant users with poor speech recognition scores (G-) and their control group (CG) (p = 0.04), and between G- and cochlear implant users with good speech discrimination (G+) (p = 0.01). We found no significant difference in the P3 latency between the CG and G+. In this study, all G- patients had deafness due to meningitis, which suggests that higher auditory function was impaired too. Conclusion Post-lingual deaf adult cochlear implant users in the G- group had prolonged P3 latencies as compared with the CG and the cochlear implant users in the G+ group. The amplitudes were similar between patients and controls. All G- subjects were deaf due to meningitis. These findings suggest that meningitis may have deleterious effects not only on the peripheral auditory system but on the central auditory processing as well.


Author(s):  
Pamela Papile Lunardelo ◽  
Marisa Tomoe Hebihara Fukuda ◽  
Patricia Aparecida Zuanetti ◽  
Ângela Cristina Pontes-Fernandes ◽  
Marita Iannazzo Ferretti ◽  
...  

2020 ◽  
Vol 24 (04) ◽  
pp. e399-e406
Author(s):  
Joyce Miranda Santiago ◽  
Cyntia Barbosa Laureano Luiz ◽  
Michele Garcia ◽  
Daniela Gil

Abstract Introduction The auditory structures of the brainstem are involved in binaural interaction, which contributes to sound location and auditory figure-background perception. Objective To investigate the performance of young adults in the masking level difference (MLD) test, brainstem auditory-evoked potentials (BAEPs) with click stimulus, and frequency-following response (FFR), as well as to verify the correlation between the findings, considering the topographic origin of the components of these procedures. Methods A total of 20 female subjects between 18 and 30 years of age, with normal hearing and no complaints concerning central auditory processing underwent a basic audiological evaluation, as well as the MLD test, BAEP and FFR. Results The mean result on the MLD test was of 10.70 dB. There was a statistically significant difference in the absolute latencies of waves I, III and V in the BAEPs of the ears. A change in the FFR characterized by the absence of the C, E and F waves was noticed. There was a statistically significant difference in the positive correlation of wave V in the BAEPs with the MLD. There was a statistically significant difference in the positive correlation of the mean MLD and the V, A and F components of the FFR. Conclusion The mean MLD was adequate. In the BAEPs, we observed that the click stimulus transmission occurred faster in the right ear. The FFR showed absence of some components. The mean MLD correlated positively with the BAEPs and FFR.


2010 ◽  
Vol 68 (4) ◽  
pp. 528-534 ◽  
Author(s):  
Carla Gentile Matas ◽  
Sandro Luiz de Andrade Matas ◽  
Caroline Rondina Salzano de Oliveira ◽  
Isabela Crivellaro Gonçalves

Multiple sclerosis (MS) is an inflammatory, demyelinating disease that can affect several areas of the central nervous system. Damage along the auditory pathway can alter its integrity significantly. Therefore, it is important to investigate the auditory pathway, from the brainstem to the cortex, in individuals with MS. OBJECTIVE: The aim of this study was to characterize auditory evoked potentials in adults with MS of the remittent-recurrent type. METHOD: The study comprised 25 individuals with MS, between 25 and 55 years, and 25 age- and gender-matched healthy controls (research and control groups). Subjects underwent audiological and electrophysiological evaluations. RESULTS: Statistically significant differences were observed between the groups regarding the results of the auditory brainstem response and the latency of the Na and P300 waves. CONCLUSION: Individuals with MS present abnormalities in auditory evoked potentials indicating dysfunction of different regions of the central auditory nervous system.


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