Evaluation of effect of brainstem evoked response audiometry in hyperlipidemic patients

<p class="abstract"><strong>Background:</strong> Brain stem evoked response audiometry (BERA) is a useful objective assessment of hearing. The major advantage of this procedure is its ability to test even infants in whom conventional audiometry may not be useful. This investigation can be used as a screening test for deafness at high risk. This study is to correlate changes in brainstem evoked response audiometry parameters concerning lipid profile.</p><p class="abstract"><strong>Methods:</strong> The study was conducted between January 2019 to June 2020 on 50 patients attending ENT OPD in Vinayaka Mission’s Kirupanandha Variyar Medical College and Hospital, Salem. All patients with auditory and/or vestibular complaints were seen at the otorhinolaryngology OPD and underwent an otorhinolaryngological examination, audiological studies (pure tone audiometry) and an electrophysiological assessment BERA. </p><p class="abstract"><strong>Results:</strong> The results of BERA was considered. A total of 5 waveforms and 3 interpeak latency waves were calculated. It was recorded from both the ears. There was a significant increase in the values of absolute waves II, III, IV, and V and interpeak latency wave values I-II and I-V.</p><p class="abstract"><strong>Conclusions:</strong> Early identification of hyperlipidemic patients is useful in preventing disease progression and associated morbidity and mortality. BERA is a non-invasive method which can help us to detect central auditory pathway dysfunction at early stages in hyperlipidemic patients even before the patient's experience symptomatic hearing loss.</p>

Hidden hearing deficits in military service members with persistent post concussive symptoms

Introduction: Individuals with persistent symptoms after mild traumatic brain injury (mTBI) often have auditory complaints. In this study, we used the auditory brainstem response (ABR) to determine whether cochlear synaptopathy could explain auditory symptoms. Methods: 69 adult military service members with mTBI and 25 adults without brain injury (NCT01611194 and NCT01925963) completed pure-tone audiometry, ABR, and central auditory processing tests. All participants were male, ages 21-50. Results: 37/69 mTBI participants had measurable hearing loss, while another 20-30% had hearing complaints or tinnitus. While mTBI participants with measurable hearing loss had reduced wave I and III amplitude and decreased III-V interpeak latency, those with no measurable hearing loss did not significantly differ from controls on any ABR parameter. Those with measurable hearing loss were also more likely to have abnormal central auditory processing. mTBI participants with no measurable hearing loss but who reported hearing concerns had some ABR findings (III-V interpeak latency, I and V amplitudes, V/I amplitude ratio) more like the measurable hearing loss mTBI group than normative controls. Conclusion: Cochlear synaptopathy may have contributed to some of the auditory impairment in service members with mTBI with measurable hearing loss. However, these results are likely confounded by cochlear hair cell damage.

Study of brainstem auditory evoked potentials in early (grade I) essential hypertensive patients

Background: Essential hypertension is one of the most common world’s health diseases. It frequently affects central nervous system (CNS) by producing micro-infarctions which results into altered evoked potentials. Previous studies have shown correlation between hypertension and brain stem auditory evoked potentials. But very scarce data is available on all the parameters of BAEP and essential hypertension especially “amplitude ratio” which distinguishes between central and peripheral impairment. This study was undertaken to evaluate the brain stem auditory evoked potentials (BAEPs) as early marker of cognitive damage in essential hypertension.Methods: BAEPs were recorded in 50 hypertensive subjects and in 50 normotensive controls. Absolute peak latencies, interpeak latencies of different waves and amplitude ratio were compared in both the groups by using unpaired student’s T test.Results: Significant changes in absolute latencies of wave I and V, Interpeak latency I-III, III-V and I-V and amplitude ratio V/I was observed in hypertensive group as compared to control group.Conclusions: Findings of the current study suggests that hypertension does affect the neuronal excitation in the auditory pathways, thereby suggesting that BAEP may provide the early evidence for the presence of CNS dysfunction in the patients of essential hypertension.

Parameters of Somatosensory Evoked Potentials in Patients with Primary Sjӧgren’s Syndrome: Preliminary Results

Primary Sjogren’s syndrome (pSS) is a chronic autoimmune disease. The aim of the study was to establish whether in patients with pSS without central nervous system (CNS) involvement, the function of the central portion of the sensory pathway can be challenged. In 33 patients with pSS without clinical features of CNS damage and normal head computed tomography scan, somatosensory evoked potentials (SEP) were studied. The results were compared to other clinical parameters of the disease, particularly to immunological status. The control group consisted of 20 healthy volunteers. Mean latency of all components of SEP was considerably prolonged in patients compared to the control group. Mean interpeak latency N20-N13 (duration of central conduction TT) did not differ significantly between the groups. However, in the study group, mean amplitude of N20P22 and N13P16 was significantly higher compared to healthy individuals. In patients with pSS, significant differences in SEP parameters depending on the duration of the disease and presence of SSA and SSB antibodies were noted. The authors confirmed CNS involvement often observed in patients with pSS. They also showed dysfunction of the central sensory neuron as a difference in the amplitude of cortical response, which indicates subclinical damage to the CNS.

Evaluation of Brainstem Auditory Evoked Potential in Diabetics

BACKGROUND: Brainstem auditory evoked potentials (BAEP) have been used for electrophysiological assessment of central neuropathy in diabetes. However, the role of this test in documenting the abnormality, the site of abnormality and relation of these abnormalities with metabolic control of diabetes are not clear as yet. The present study was done to explore the presence of abnormalities, if any, in the test parameters and relation of these with diabetic status. METHODS: It was a cross sectional study with controls. Thirty patients of diabetes mellitus (group 1) and thirty healthy controls (group 2) were included in the study. All the patients were subjected to detail clinical history, clinical and neurological examination. Detail laboratory investigation including haemogram, fasting and postprandial plasma sugar (2 hours), HbA1c, urine R/E, 24 hour urine for proteins, ECG, RFT, LFT and lipid profile were done. BAEP was done in all the subjects RESULTS: Mean peak latency of waves I, III, V and interpeak latency of I-III, III-V, I-V were prolonged in group 1, but were not statistically significant. Abnormal BAEP response was found in 8 patients (27%) in group 1. There was no significant relation between abnormal BAEP response with age, sex, type of diabetes, duration of diabetes since detection, fasting plasma sugar level, postprandial plasma sugar level, glycosylated haemoglobin, presence of retinopathy, nephropathy and peripheral neuropathy. CONCLUSIONS: BAEP is a useful method for obtaining an early diagnosis of central and cranial nerve abnormalities in diabetic patients.DOI: http://dx.doi.org/10.3126/jucms.v1i2.8403 Journal of Universal College of Medical Sciences Vol.1(2) 2013: 8-12

Vestibular evoked myogenic potentials in patients with fibromyalgia syndrome

Objective:To assess vestibular evoked myogenic potentials in patients with fibromyalgia syndrome.Methods:Twenty-four patients with fibromyalgia syndrome (two men and 22 women) and 21 female controls were included in the study. All patients underwent vestibular evoked myogenic potential testing.Results:Statistical comparison of fibromyalgia patients with control subjects showed a significant difference with respect to n23 latencies and interpeak latencies (p < 0.05). There was no significant difference in p13 latencies, nor in p13 amplitudes, n23 amplitudes or interpeak amplitudes (p > 0.05).Conclusions:Although patients with fibromyalgia syndrome generally have subjective neurotological symptoms, clinical and laboratory assessments usually fail to detect any objective abnormality. However, it is possible to detect abnormalities on vestibular evoked myogenic potential testing in such patients, indicating dysfunction in the vestibulospinal pathway, possibly in the saccule. Elongation of the n23 latency and of the interpeak latency of waves p13–n23, during vestibular evoked myogenic potential testing, may be a useful, objective indicator demonstrating neurotological involvement in fibromyalgia syndrome patients. Future research investigating the mechanisms of this latency elongation may help increase understanding of the pathogenesis of fibromyalgia syndrome.

Auditory Brainstem Evoked Responses in Newborns With Down Syndrome

Auditory brainstem evoked responses (ABRs) were compared in 15 newborns with Down syndrome and 15 sex-, age-, and weight-matched control newborns. Participants had normal ABRs based upon values specific to 32- to 42-weeks postconceptional age. Although Wave III and Wave V component latencies and the Wave I–III interpeak latency (IPL) were shorter in ABRs of infants with Down syndrome, the Wave III–V IPL was not, pointing to anomalies in the lower rather than upper brainstem auditory pathways. Shorter Down syndrome ABR latencies have been reported at many ages. Extending these findings to newborns suggests that the underlying basis for this develops prenatally. ABR patterns in infants with Down syndrome were similar to reports for intrauterine growth restricted newborns.