Purpose: To perform a descriptive analysis of the performance of patients referred to a public educational institution to take part in the assessment of auditory processing and to correlate the assessment findings to the variables of age and hearing complaints, also to correlate results to behavioral and electrophysiological assessments. Methods: The study included 159 individuals that were referred to the public health system to take part in an assessment of auditory processing. All participants underwent pure-tone audiometry, acoustic immittance measures, behavioral tests of auditory processing, and electrophysiological hearing assessment. Results: The main complaint was learning disability and the tests that presented higher prevalence of abnormal results were temporal processing and dichotic listening tests. In all electrophysiological tests the number of normal results was higher than the altered ones. The proportion of normal and abnormal individuals in behavioral and electrophysiological tests did not differ in relation to gender. There was weak correlation between auditory closure and right ear middle latency responses; between left ear middle latency responses and total middle latency responses; among temporal ordering and electrode effect and P300; between temporal processing and right ear middle latency responses; between dichotic listening and P300 and also between binaural interaction and right and left ears acoustic reflexes. Conclusion: The most frequent complaint among participants of this study was learning disability. Temporal processing and dichotic listening skills showed higher prevalence of alteration in the assessment. Most participants were referred to assessment of auditory processing by the speech-language pathologist. Correlation between behavioral and electrophysiological assessments was weak.Keywords: Speech, language and hearing sciences; Hearing; Auditory perception; Auditory perceptual disorders; Evoked potentials, Auditory; Hearing tests RESUMO Objetivo: Realizar uma análise descritiva do desempenho de pacientes encaminhados a um hospital de uma instituição de ensino público, para avaliação do processamento auditivo, e correlacionar os achados desta avaliação à idade, queixas, resultados e às avaliações auditivas comportamental e eletrofisiológica. Métodos: O estudo incluiu 159 indivíduos encaminhados pelo sistema público de saúde para avaliação do processamento auditivo. Todos os participantes realizaram audiometria tonal liminar, medidas de imitância acústica, testes comportamentais do processamento auditivo e avaliação eletrofisiológica da audição. Resultados: A principal queixa referida foi a de dificuldade de aprendizagem e os testes que avaliam processamento temporal e escuta dicótica foram os que apresentaram maior prevalência de alteração. Em todos os testes eletrofisiológicos, o número de resultados normais foi superior aos alterados. A proporção de indivíduos normais e alterados, nos testes comportamentais e eletrofisiológicos, não diferiu em relação ao gênero. ...
Human t-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy (HAM) is a progressive neurological disease whose diagnosis is defined by clinical manifestations and seropositivity for HTLV-1 infection. Cognitive impairment (CI) is considered to occur after spinal impairment. A 51-year-old HTLV-1-infected man classified as an asymptomatic carrier presented difficulties in listening comprehension and executive memory. He was assessed for central auditory processing (CAP), cognition (event-related auditory evoked potential [P300]), and otoneurological functions (galvanic vestibular-evoked myogenic potential [gVEMP]). Altered responses were found in CAP, P300, and gVEMP, but the neurological examination and cognitive screening were normal. After a 2-year follow-up, we disclosed a positive Babinski sign, a mild CI, worsened P300, and gVEMP latencies, and the patient reported progressive lumbar pain and difficulty running. He was, then, reclassified as HAM. The first examination, in 2016, had already shown abnormal results in P300 and gVEMP despite the HTLV-1-asymptomatic carrier status. Therefore, tests that provide subclinical measures of neurological disease progression can be useful tools for an early diagnosis and intervention in HTLV-1 patients. Electrophysiological results had worsened as well as the clinical status and the cognitive function and the progression from asymptomatic status to an HTLV-1-associated neurological disease occurred within 2 years. Thus, HTLV-1-infected individuals with complaints of CI, hearing, or otoneurological manifestations should be submitted to neuropsychological and electrophysiological tests, allowing them to be properly cared in case of HAM progression.
Background: The HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is the most common neurological manifestation associated with Human T-cell Lymphotropic Virus type-1 (HTLV-1) infection. Although cognitive impairment has been highlighted in the spectrum of HTLV-1 neurological manifestations, it may go unnoticed in those who do not spontaneously report it. We aimed at evaluating the applicability of a self-perceived memory score (SMS) and the cognitive event-related potential (P300) for the early detection of cognitive impairment in HTLV-1-infected people.Methods: The SMS was measured by a 0-10 visual analog scale combined with a sad-happy faces rating scale. The higher the number, the better was the SMS. The P300 was obtained through an oddball paradigm with a mental counting task. The participants were 15(21,4%) individuals with HAM/TSP, 20(28,6%) HTLV-1-asymptomatic carriers, and 35(50%) seronegative controls.Results: SMS (p<0.001) and P300 latency (p<0.001) got progressively worse from asymptomatic to HAM/TSP. A SMS <7.2 points and a P300 latency >369.0 milliseconds were considered as altered result and indicated cognitive impairment. The HAM/TSP group showed the highest prevalence of altered P300 (80%) and SMS (87%). Interestingly, the asymptomatic group also presented signi cant higher prevalence of altered SMS (60%) and P300 (35%) when compared to controls (<10%). The frequency of cognitive impairment was 16 times higher in the asymptomatic group and 69 times higher in the HAM/TSP group when compared to controls. Conclusion:The use of SMS in the medical consultation was a useful and easy-to-apply method to screen HTLV-1 infected subjects for everyday memory complaints. BackgroundThe rst descriptions of the neurological disease associated with HTLV-1 infections were based on the motor function assessed by mobility and strength disability [1, 2]. The HTLV-1 associated myelopathy / tropical spastic paraparesis (HAM/TSP) is a chronic, slow-progressing neurological in ammatory disease that affects approximately 4% of the infected individuals [3, 4]. However, the prevalence of neurological disorders that do not meet the criteria for de nite HAM/TSP, such as urinary disorders, sexual dysfunction and skin lesions, can occur in around 30% of those individuals classi ed as HTLV-1-asymptomatic carriers [4][5][6]. In fact, non-medullary symptoms have been neglected in the HTLV-1 infection [7].Recent evidences have showed that HTLV-1 is related to a complex of neurological manifestations that are not limited to the clinical spectrum of HAM/TSP, affecting all the segments of the central nervous system to a greater or lesser extent [3,[8][9][10][11][12][13][14][15][16][17][18]. In this context, cognitive impairment has been reported as one of the manifestations of the HTLV-1 infection [11,13,[19][20][21][22][23][24]. On the other hand, HAM/TSP remains as the most important neurological disease associated with 26]. Therefore, cognitive impairment can be underdiagnosed and may go unnoticed in those indivi...
dBNA (88%); uso de filtro passa-alta de 10 Hz (50%) e passa-baixa de 200 Hz (75%); montagem dos eletrodos em C3/C4 (ativos) A1/A2 (referências), e Fpz (neutro) (88%); amplitude Na-Pa, como principal parâ-metro de comparação e normalidade; e uso do teste ANOVA (63%) para análise estatística. Nos estudos revisados, a média da latência da onda Pa e da amplitude Na-Pa em crianças e adolescentes normo-ouvintes foi de 32 milissegundos e 1,57 microvolts, respectivamente. Conclusão:Não há consenso quanto aos parâmetros de registro do PEAML em crianças e adolescentes brasileiros. Ainda assim, a média de latência de Pa e amplitude Na-Pa encontrada em crianças e adolescentes brasileiros normo-ouvintes, avaliados nos oito artigos desta revisão, concorda com os parâmetros de normalidade já estabelecidos internacionalmente.
Background: The HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is the most common neurological manifestation associated with Human T-cell Lymphotropic Virus type-1 (HTLV-1) infection. Although cognitive impairment has been highlighted in the spectrum of HTLV-1 neurological manifestations, it may go unnoticed in those who do not spontaneously report it. We aimed at evaluating the applicability of a self-perceived memory score (SMS) and the cognitive event-related potential (P300) for the early detection of cognitive impairment in HTLV-1-infected people. Methods: The SMS was measured by a 0-10 visual analog scale combined with a sad-happy faces rating scale. The higher the number, the better was the SMS. The P300 was obtained through an oddball paradigm with a mental counting task. The participants were 15(21,4%) individuals with HAM/TSP, 20(28,6%) HTLV-1-asymptomatic carriers, and 35(50%) seronegative controls. Results: SMS (p<0.001) and P300 latency (p<0.001) got progressively worse from asymptomatic to HAM/TSP. A SMS <7.2 points and a P300 latency >369.0 milliseconds were considered as altered result and indicated cognitive impairment. The HAM/TSP group showed the highest prevalence of altered P300 (80%) and SMS (87%). Interestingly, the asymptomatic group also presented significant higher prevalence of altered SMS (60%) and P300 (35%) when compared to controls (<10%). The frequency of cognitive impairment was 16 times higher in the asymptomatic group and 69 times higher in the HAM/TSP group when compared to controls. Conclusion: The use of SMS in the medical consultation was a useful and easy-to-apply method to screen HTLV-1 infected subjects for everyday memory complaints.
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