Acute and long-term effects of adrenocorticotropin and dexamethasone on the auditory brainstem response in multiple sclerosis patients

Abstract

Auditory brain-stem responses (ABRs) were compared in two groups of multiple sclerosis (MS) patients receiving standard treatment with adrenocorticotropin (ACTH) and with dexamethasone (DEX). ABRs were recorded prior to treatment, on the 1st and 8th day of therapy, and 21 days after the hormonal treatment had been discontinued. ABRs in MS patients were within the normal range of variability. Latencies of ABR components increased with increasing rate of presentation, and with decreasing intensity of the click stimuli. Changes in ABRs displayed a consistent pattern in patients treated with ACTH, but showed less coherence after DEX. In ACTH treated patients' latencies of the late ABR waves V and Vn were prolonged after clicks of high intensity, and reduced following clicks of low intensity resulting in a decreased slope of the latency-intensity function of these ABR waves. This pattern became most prominent in the recordings after the treatment had been discontinued, and could reflect an improved transmission across both afferent excitatory and recurrent inhibitory synapses in the auditory pathways. The findings indicate that--besides a common anti-inflammatory action--therapies with ACTH and DEX differ with regard to their influence on central nervous functioning.