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

Abstract

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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Potencial Evocado Auditivo de Tronco Encefálico: padrão de respostas de lactentes termos e prematuros

“…10,11 Auditory system neurological maturity is a twophase process. The first phase is intrauterine, and is over by the sixth month of gestation; at this point the peripheral auditory pathways are mature.…”

Neural conduction impairment in the auditory brainstem and the prevalence in term babies in neonatal intensive care unit

“…Excluded were also those who exposed to potentially ototoxic drugs such as aminoglycosides (mainly amikacin), and diuretics (furosemide), Genetic and metabolic disorders associated with hearing loss. Any babies who had a BAER threshold P40 dB normal hearing level (nHL) had been excluded from study entry to avoid any significant effect of peripheral hearing problems on the measurements of MLS BAER wave components so as to analyse MLS BAER variables more reliably and accurately, the same as our previous MLS BAER studies (Jiang, 2012;Jiang and Chen, 2014;Jiang et al, 2003Jiang et al, , 2005Jiang et al, , 2010Wilkinson et al, 2007). All our babies passed the neonatal hearing screening.…”

“…More recently, the MLS technique has been introduced to study the BAER in babies with perinatal problems. These studies have proven that the MLS technique enhances detection of some neuropathology in the neonatal brain, typically hypoxia-ischemia (Jiang, 2012;Jiang and Chen, 2014;Jiang et al, 2003Jiang et al, , 2005Jiang et al, , 2010Wilkinson et al, 2007).…”