RESUMEN
BACKGROUND: Previous studies reported that particular types of interferon medications might contribute to hearing loss in some patients. The package insert included in the original Food and Drug Administration application for intramuscular interferon beta-1a (Avonex) stated that some patients in the treatment group reported decreased hearing sensitivity. OBJECTIVE: The purpose of the present investigation was to assess if individuals with multiple sclerosis (MS) taking intramuscular interferon beta-1a have significantly poorer hearing thresholds than those not currently using any disease-modifying therapies. METHODS: This was a secondary analysis of data collected as part of two larger studies evaluating auditory function in patients with MS. The goal of this analysis was to determine if users of interferon beta-1a do not have significantly worse hearing thresholds than nonusers of disease-modifying therapies, after adjusting for potential confounders. A linear mixed model was fit to the audiometric thresholds of our subjects. This model included interferon beta-1a use, MS disease subtype, gender, test frequency, age, disease duration (number of years), and the Expanded Disability Status Scale score. RESULTS AND CONCLUSIONS: With all subjects included, there is insufficient evidence to say that intramuscular interferon-beta 1a is not ototoxic (in relation to nonuse of a disease-modifying therapy) at all frequencies tested except 3000 and 6000 Hz. After removing two influential subjects, the results indicated that there is statistical support for no ototoxic effect of intramuscular interferon beta-1a at test frequencies from 250 to 6000 Hz. There is insufficient evidence, however, to rule out an ototoxic effect at 8000 Hz. Future studies should further evaluate the effect of interferon on auditory function in patients with MS. Neuroscience nurses should monitor their patients' hearing throughout the course of treatment.
Asunto(s)
Audiometría de Tonos Puros/enfermería , Umbral Auditivo/efectos de los fármacos , Interferón beta/efectos adversos , Esclerosis Múltiple/tratamiento farmacológico , Esclerosis Múltiple/enfermería , Adulto , Femenino , Humanos , Interferón beta-1a , Interferón beta/administración & dosificación , Masculino , Persona de Mediana Edad , Valores de ReferenciaRESUMEN
This technical report describes an approach to the measurement of speech intelligibility for sentences presented in a sound field in the presence of 16-talker babble. More specifically, we detail our (1) selection and preparation of target speech materials, (2) selection and preparation of experimental babble, (3) analog instrumentation, (4) software routines for attenuator control, (5) calibration, (6) experimental subjects, and (7) experimental protocol. In the final section of this report we present speech-intelligibility data from 16 young adults (21-30 yr of age) with normal hearing sensitivity for pure-tone signals.
Asunto(s)
Audición/fisiología , Ruido , Pruebas de Discriminación del Habla/métodos , Percepción del Habla/fisiología , Adulto , Planificación Ambiental , Femenino , Humanos , Masculino , Enmascaramiento Perceptual , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
The purpose of the present investigation was to determine whether differences exist in audiometric hearing status between individuals with and without multiple sclerosis (MS) and between individuals with relapsing-remitting MS (RRMS) and individuals with secondary progressive MS (SPMS). Forty-seven subjects with MS (26 with RRMS and 21 with SPMS) and forty-nine control subjects without MS completed both a comprehensive case-history questionnaire and a conventional hearing evaluation. Statistical analyses, accounting for the potential confounding factors of age, sex, noise exposure, and use of ototoxic medications, revealed significant differences in hearing thresholds between subjects with and without MS at select audiometric test frequencies (p < 0.05). At these audiometric test frequencies, the subjects with MS had poorer hearing thresholds. Additional analyses revealed significant differences in hearing sensitivity at select audiometric frequencies between the subjects with RRMS and the subjects with SPMS, such that those with SPMS had poorer hearing thresholds. These findings have significant clinical implications for practitioners working with patients with MS.
Asunto(s)
Trastornos de la Audición/etiología , Audición , Esclerosis Múltiple Crónica Progresiva/fisiopatología , Esclerosis Múltiple Recurrente-Remitente/fisiopatología , Adulto , Audiometría de Tonos Puros , Umbral Auditivo , Femenino , Trastornos de la Audición/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Esclerosis Múltiple Crónica Progresiva/complicaciones , Esclerosis Múltiple Recurrente-Remitente/complicaciones , Oregon , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Almost half of the population with multiple sclerosis (MS) complains of difficulty hearing, despite having essentially normal pure-tone thresholds. The purpose of the present investigation was to evaluate the effects of frequency-modulation (FM) technology utilization on speech perception in noise for adults with and without MS. Sentence material was presented at a constant level of 65 dBA Leq from a loudspeaker located at 0 degrees azimuth. The microphone of the FM transmitter was placed 7.5 cm from this loudspeaker. Multitalker babble was presented from four loudspeakers positioned at 45 degrees, 135 degrees, 225 degrees, and 315 degrees azimuths. The starting presentation level for the babble was 55 dBA Leq, The level of the noise was increased systematically in 1 dB steps until the subject obtained 0% key words correct on the IEEE (Institute for Electrical and Electronic Engineers) sentences. Test results revealed significant differences between the unaided and aided conditions at several signal-to-noise ratios.
Asunto(s)
Audífonos/clasificación , Pérdida Auditiva/rehabilitación , Esclerosis Múltiple/fisiopatología , Ruido/efectos adversos , Percepción del Habla/fisiología , Estimulación Acústica , Adulto , Análisis de Varianza , Audiometría de Tonos Puros , Audiometría del Habla , Umbral Auditivo , Estudios de Casos y Controles , Femenino , Pérdida Auditiva/etiología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/complicaciones , Ondas de Radio/clasificaciónRESUMEN
The present investigation examined speech perception in noise of adults with and without multiple sclerosis (MS). Institute of Electrical and Electronic Engineers (IEEE) sentences were presented at a constant level of 65 dBA L(eq) (equivalent continuous noise level [4 dB exchange rate]) from a loudspeaker located at 0-degree horizontal azimuth and 1.2 m from the study participant. Uncorrelated multitalker babble was presented from four loudspeakers positioned at 45-, 135-, 225-, and 315-degree azimuths and 1.7 m from the study participant. The starting presentation level for the babble was 55 dBA L(eq). The level of the babble was increased systematically in 1 dB steps until the subject obtained 0% key words correct on the IEEE sentences. Results revealed a significant difference in speech perception between the two groups at nine signal-to-noise ratios. Some clinical implications of these results are discussed.