RESUMEN
Chronic lung disease (CLD) in children represents a heterogeneous group of many clinico-pathological entities with risk of adverse impact of chronic or intermittent hypoxia. So far, few researchers have investigated the cognitive function in these children, and the role of auditory P300 in the assessment of their cognitive function has not been investigated yet. This study was designed to assess the cognitive functions among schoolchildren with different chronic pulmonary diseases using both auditory P300 and Stanford-Binet test. This cross-sectional study included 40 school-aged children who were suffering from chronic chest troubles other than asthma and 30 healthy children of similar age, gender and socioeconomic state as a control group. All subjects were evaluated through clinical examination, radiological evaluation and spirometry. Audiological evaluation included (basic otological examination, pure-tone, speech audiometry and immittancemetry). Cognitive function was assessed by auditory P300 and psychological evaluation using Stanford-Binet test (4th edition). Children with chronic lung diseases had significantly lower anthropometric measures compared to healthy controls. They had statistically significant lower IQ scores and delayed P300 latencies denoting lower cognitive abilities. Cognitive dysfunction correlated to severity of disease. P300 latencies were prolonged among hypoxic patients. Cognitive deficits in children with different chronic lung diseases were best detected using both Stanford-Binet test and auditory P300. P300 is an easy objective tool. P300 is affected early with hypoxia and could alarm subtle cognitive dysfunction.
Asunto(s)
Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/etiología , Enfermedades Pulmonares/psicología , Adolescente , Estudios de Casos y Controles , Niño , Enfermedad Crónica , Estudios Transversales , Potenciales Evocados Auditivos , Femenino , Humanos , Masculino , PsicometríaRESUMEN
OBJECTIVES: Children with epilepsy are at a considerable risk of cognitive impairment and school failure. Previous studies have typically documented abnormal responses in children with epilepsy at cortical level using speech stimuli. Recent studies reported that abnormal neural encoding of a speech syllable could be detected at the level of the brainstem using speech-evoked auditory brainstem response (ABR). The aim of this study is to investigate speech-evoked (ABR) results in children with epilepsy. METHODS: The study group consisted of 38 recently diagnosed epileptic children; none of them has received antiepileptic therapy. They were 22 males and 16 females with age 9.1 ± 3.1 years. The control group consisted of 38 healthy normal hearing children with matched age and gender distribution. All subjects underwent full history taking, basic audiologic evaluation including pure-tone, speech audiometry and immittance testing. Click ABR response was recorded monaurally from both ears at 90 dB nHL then speech ABR was recorded monaurally from each ear at 80 dB SPL. RESULTS: Though the study group disclosed normal click ABR compared to age matched normative values, speech-evoked ABR revealed a delayed waves V and A latencies in both ears. These findings reflect abnormal neural encoding of speech at the level of brainstem. The younger the age of epileptic child the more prolonged wave A latency and increased V/A inter-latency values. CONCLUSIONS: Speech-evoked ABR results denote abnormal timing in the brainstem; such brainstem abnormality could be detected by speech evoked ABR rather than conventional click evoked ABR.
Asunto(s)
Audiometría del Habla , Epilepsia/fisiopatología , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Adolescente , Factores de Edad , Audiometría de Tonos Puros , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , MasculinoRESUMEN
OBJECTIVES: Many studies confirmed the disappearance of otoacoustic emissions in some of the patients with auditory neuropathy spectrum disorder, yet the data about the incidence rate of such disappearance is scanty or even absent. This study aims to test the persistence of transient evoked otoacoustic emissions in patients with auditory neuropathy spectrum disorder over few years. METHODS: The study group consisted of 77 subjects (31 females and 46 males). Their ages ranged from 4 to 9 years (5.5 ± 1.5). All the subjects were previously diagnosed to have auditory neuropathy spectrum disorder affecting both ears. Transient evoked otoacoustic emissions test results of the recent follow up sessions were compared with their initial diagnostic evaluation sessions done 3-6 years ago (3.7 ± 0.8), in order to test the persistence of the emissions and the reduction of emissions level. RESULTS: The transient evoked otoacoustic emissions level was reduced in the follow up visit compared to the initial study group. The transient evoked otoacoustic emissions level showed insignificant reduction (less than 3dB) in 77.3% of the ears in the study group, and significant reduction (i.e. 3dB or more) in 20.8%, and was absent in 1.9%. The transient evoked otoacoustic emissions level reduction in the different study subgroups was homogenous; gender (males versus females) laterality (right versus left ears) incubated to neonatal intensive care unit versus those non incubated all showed no significant differences in transient evoked otoacoustic emissions level reduction. Moreover, the duration of auditory neuropathy spectrum disorder was not correlated to the degree of transient evoked otoacoustic emissions reduction. Those fitted with hearing aids had more reduction in their transient evoked otoacoustic emissions level compared with those not fitted with hearing aids. CONCLUSIONS: (1) Transient evoked otoacoustic emissions was still detected in 98.1% of patients with auditoryneuropathy spectrum disorder few years after the diagnosis.(2) Those fitted with hearing aids showed the most pronounced reduction in transient evokedotoacoustic emissions level.