Brain-stem auditory impairment during the neonatal period in term infants after asphyxia: dynamic changes in brain-stem auditory evoked response to clicks of different rates

Jiang, Ze D.; Yin, Rong; Shao, Xiao M.; Wilkinson, A

doi:10.1016/j.clinph.2004.02.017

Cited by 39 publications

(47 citation statements)

References 54 publications

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“…Jiang et al (9,10) confirmed this outcome in human term neonates. These functional data together are in line with the findings of brainstem lesions with neuronal necrosis at sites concerning the auditory pathway after an event of perinatal asphyxia (27).…”

Section: Gunn Et Al (26) Demonstrated Prolongation Of Latencies Andsupporting

confidence: 68%

“…Perinatal hypoxic-ischemic insults, which occur in 1-6 per 1,000 live full-term births, are one of the major risk factors for auditory impairment (5-7) and severe neurological sequelae in newborn infants (8). Experimental studies suggest that there are already direct negative effects on hearing parameters within several hours to days after a peri-or postnatal event of severe hypoxia-ischemia (9)(10)(11).…”

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confidence: 99%

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Functional impairment of the auditory pathway after perinatal asphyxia and the short-term effect of perinatal propofol anesthesia in lambs

et al. 2013

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Background: Sensorineural hearing loss (SNHL) is a common feature in the postasphyxial syndrome in newborns. Several anesthetic drugs have been proposed to attenuate secondary neuronal injury elicited by hypoxia-ischemia. We hypothesized that propofol anesthesia reduces auditory impairment after perinatal asphyxia in comparison with isoflurane. Methods: Twenty-three pregnant ewes were randomized to propofol or isoflurane anesthesia and sedation. The lambs underwent in utero umbilical cord occlusion (isoflurane n = 5; propofol n = 7) and were compared with sham-treated animals (isoflurane n = 5; propofol n = 6) at a gestational age of 133 d. For 8 h after delivery by cesarean section, repeated auditory brainstem responses (ABRs) were recorded to obtain hearing thresholds, peak amplitudes, latencies, and interpeak latencies. results: Significantly elevated mean thresholds, diminished amplitudes, and elevated latencies were observed in the asphyxia group relative to the control group through the observation period. Comparison of anesthetic treatment in the asphyxia group revealed a significantly lower elevation in threshold and less impairment in the ABR amplitudes and latencies during propofol anesthesia as compared with isoflurane anesthesia. conclusion: Our results support the hypothesis that anesthesia with propofol has a preventive effect on the functional changes to the auditory pathway in the event of perinatal asphyxia.

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Section: Gunn Et Al (26) Demonstrated Prolongation Of Latencies Andsupporting

confidence: 68%

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confidence: 99%

Functional impairment of the auditory pathway after perinatal asphyxia and the short-term effect of perinatal propofol anesthesia in lambs

et al. 2013

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“…To improve the detection of neuropathology that affects the auditory brainstem, we used the method of increasing the rate of clicks while recording conventional BAER (9,19,20). The results show that this method can improve the detection to a certain degree.…”

Section: Jiang Et Almentioning

confidence: 99%

Brainstem Auditory Function at Term in Preterm Babies With and Without Perinatal Complications

Jiang

Brosi

et al. 2005

Pediatr Res

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Functional integrity of the auditory brainstem was studied at term in babies born at 30 -36 wk of gestation using maximum length sequence brainstem auditory evoked response (MLS BAER). Compared with normal term babies, preterm babies who had perinatal complications showed a tendency of an increase in wave V latency and I-V and III-V intervals at all 91-910/s clicks, with statistical significance at higher rates. Wave V latency and I-V interval increased significantly at 455/s and 910/s. III-V interval increased at all click rates, which was more significant at higher rates. III-V/I-III interval ratio increased at most rates. Waves III and V amplitudes reduced significantly mainly at 455/s and 910/s. In preterm babies who had no perinatal complications, there were no major MLS BAER abnormalities except an increase in III-V interval at 91-910/s. By comparison, the preterm babies with perinatal complications had a significant increase in wave V latency, I-V and III-V intervals, and III-V/I-III interval ratio at 455/s and 910/s clicks. These results suggest that although there are no major abnormalities in brainstem auditory function in preterm babies without perinatal complications, the auditory brainstem, mainly the more central part, in preterm babies with perinatal complications is impaired, which becomes more apparent at very high stimulus rates. We conclude that preterm babies with perinatal complications are at high risk of central auditory impairment. The integrity of auditory system is the base for language and speech development and has a tremendous impact on cognitive development. Auditory impairment, if undetected, will impede speech, language, and cognitive development (1,2). Impairment of the central auditory system eliminates or modulates afferent activity in the peripheral auditory system and then changes the structure and function of the developing brain that is highly plastic, leading to neurodevelopmental deficits. Preterm babies in the neonatal intensive care unit often have various perinatal complications and/or major conditions that may directly or indirectly impair the central nervous system (CNS), including the central auditory system. Therefore, these babies may be at high risk of central auditory impairment, although this remains to be determined. Research suggests that central auditory impairment in children born with perinatal problems occurs more frequently than commonly recognized (3,4). However, detection of the impairment in infants is difficult.There are numerous reports on auditory impairment in preterm babies or children born preterm (5,6). These reports generally concentrated on peripheral auditory impairment and showed that peripheral impairment, including conductive and sensory or sensorineural, is a common abnormality present in preterm babies. On the other hand, there are very few reports on central auditory impairment.As an objective test to study functional integrity of the auditory brainstem, the BAER has been used to study functional development of the human auditory syste...

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“…The measurements of two replicated BAER recordings to each stimulus condition were averaged for analysis. All data were analyzed at Ն40 dB above the threshold of each infant (11,18). The click intensity above BAER threshold was 48.8 Ϯ 8.1 dB in the preterm infants and 48.6 Ϯ 5.4 dB in the term controls, which did not differ significantly.…”

Section: Subjectsmentioning

confidence: 99%

Relative Maturation of Peripheral and Central Regions of the Human Brainstem From Preterm to Term and the Influence of Preterm Birth

Jiang

Brosi

et al. 2009

Pediatr Res

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Relative maturation of peripheral and central regions of the neonatal brainstem was studied using brainstem auditory evoked responses in 174 healthy preterm infants (gestational age 30 -36 wk). From 30-to 42-wk postconceptional age (PCA), I-III and III-V intervals shortened with increasing age. It was difficult to detect any apparent differences in maturational rate between the two intervals. However, III-V/I-III interval ratio decreased with increasing age, indicating that from preterm to term III-V interval shortens more than I-III interval. During term period (37-to 42-wk PCA), I-III interval was similar to term controls, but III-V interval was significantly longer and III-V/I-III interval ratio was significantly greater than controls at 37-to 38-wk PCA and 39 -40 wk PCA and was the same as controls at 41-42 wk. Therefore, from 30-to 42-wk PCA maturation of central regions of the brainstem, reflected by III-V interval, is relatively faster than peripheral regions, reflected by I-III interval which seems to be already more mature than III-V interval before 30 wk. Maturation in central regions in preterm infants is relatively delayed at early term, but "catches-up" later, whereas peripheral regions already reach normal level of maturation at early term. Preterm birth slightly delays early maturation of central brainstem regions. . Previous studies have shown that the immature brainstem can be damaged by various unfavorable perinatal conditions, e.g., hypoxia-ischemia (2). Recent studies revealed that brain structure may be abnormal in preterm infants and preterm birth is associated with regional cerebral tissue reductions (3,4). It remains unclear whether the rate of maturation in the more peripheral and more central regions of the brainstem is equal or different during earlier life and what influence the preterm birth exerts on this maturation. The understanding will help improve the care and management of very young infants, particularly for those who may be at risk of developmental abnormalities.In addition to detecting auditory abnormalities, brainstem auditory evoked responses (BAERs) have been used to study functional status and maturation of the, specifically auditory, brainstem (5-7). The responses, generating from specific brainstem auditory relay nuclei, are extremely complex and are under multiple inhibiting and facilitating influences from the rest of the CNS. Maturation of the BAER is associated with myelination of axons, formation of central synaptic connections, and axonal diameter and has been found to correlate with maturation of the brainstem, as well as the auditory pathway (8 -10). During early life, the BAER undergoes tremendous maturational changes, characterized by a shortening of wave latencies and an increase in wave amplitudes of the response (11-14). Furthermore, a shortening of the intervals between BAER wave peaks (i.e., interpeak intervals) with increasing age has been well documented.In BAER wave form, wave I, III, and V, the three major and reliable waves, originate fro...

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Brain-stem auditory impairment during the neonatal period in term infants after asphyxia: dynamic changes in brain-stem auditory evoked response to clicks of different rates

Cited by 39 publications

References 54 publications

Functional impairment of the auditory pathway after perinatal asphyxia and the short-term effect of perinatal propofol anesthesia in lambs

Functional impairment of the auditory pathway after perinatal asphyxia and the short-term effect of perinatal propofol anesthesia in lambs

Brainstem Auditory Function at Term in Preterm Babies With and Without Perinatal Complications

Relative Maturation of Peripheral and Central Regions of the Human Brainstem From Preterm to Term and the Influence of Preterm Birth

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