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Brainstem Auditory Evoked Potentials in Boys with Autism: Still Searching for the Hidden Truth.

Ververi A, Vargiami E, Papadopoulou V, Tryfonas D, Zafeiriou D - Iran J Child Neurol (2015)

Bottom Line: The mean values of all absolute and/or interpeak latencies were longer in patients when compared to controls, albeit the differences were not significant for any of the parameters.In addition, abnormalities (either shortening or prolongation) of absolute latencies I and V, as well as interpeak latency I-V, were significantly more common among patients.The latter individuals may benefit from targeted intervention to utilize brainstem plasticity.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

ABSTRACT

Objective: Brainstem auditory evoked potentials (BAEPs) have long been utilized in the investigation of auditory modulation and, more specifically, auditory brainstem functions in individuals with autism. Although most investigators have reported significant abnormalities, no single BAEPs pattern has yet been identified. The present study further delineates the BAEPs deficits among subjects with autism.

Materials & methods: BAEPs were recorded in 43 male patients, aged 35-104 months, who underwent standard evaluations after receiving a diagnosis of autism. The control group consisted of 43 age-matched typically developing boys. The study took place in a tertiary neurodevelopmental center over a period of two years.

Results: The mean values of all absolute and/or interpeak latencies were longer in patients when compared to controls, albeit the differences were not significant for any of the parameters. Prolonged or shortened absolute/interpeak latencies (control group mean ± 2.5SD) were unilaterally or bilaterally identified in 33% of patients, compared to 9% of controls. The most frequent findings included prolongation of absolute latencies I, V and III, followed by shortening of interpeak latency I-V. In addition, abnormalities (either shortening or prolongation) of absolute latencies I and V, as well as interpeak latency I-V, were significantly more common among patients. Taken together, BAEPs in 23% of patients were indicative of a clinically abnormal response in 32% of patients.

Conclusion: As can be easily concluded, BAEPs abnormalities characterize only a subset of subjects with autism, who may be important to identify clinically. The latter individuals may benefit from targeted intervention to utilize brainstem plasticity.

No MeSH data available.


Related in: MedlinePlus

Comparison between patients with autism (red bars) and controls
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Figure 1: Comparison between patients with autism (red bars) and controls

Mentions: Six parameters were bilaterally obtained from each participants resulting in recordings for 86 ears in each group (patient and control). Mean values of all absolute and/or interpeak latencies were longer in the patient when compared to the control, pooled recordings on both sides (Figure 1). The difference was not significant for any of the parameters (p > 0.22) (Mann-Whitney U tests). The mean (left and right) values for each individual were also prolonged in the control group (Table I), although the difference was again not significant (p > 0.30), (MannWhitney U tests). Moreover, a weak/moderate negative correlation between age and all absolute latencies was identified in the patient (rs ranging from -0.27 to -0.43, n = 43, p < 0.05) (Spearman’s correlations), but not in the control, bilateral recordings (rs < 0.19, n = 43, p>0.05) (Spearman’s correlations). On the contrary, no significant correlation was identified between BAEPs parameters and patient percentile of head circumference (rs < 0.19, n = 43, p > 0.05) (Spearman’s correlations). Prolonged or shortened absolute/interpeak latencies (control group mean ± 2.5SD) were unilaterally or bilaterally identified in 14 of 43 patients (33%) but only in 4 of 43 controls (9%). Table II details the various types of abnormalities in 86 unilateral recordings of each group. The most frequent disorders among patient recordings included the prolongation of waves I (13%) and V (9%), followed by the prolongation of wave III (8%). Among patient recordings with pathological IPLs, the most common deficit was shortening of IPL I-V (6%), which was, interestingly, two times more common than prolongation of the same wave. The prevalence of abnormalities (either shortening or prolongation) of latencies I (p = 0.005) and V (p = 0.028) as well as IPL I-V (p = 0.034) was significantly higher in the patient when compared to the control recordings (Chi-square tests). Although the rest of abnormalities also occurred more frequently among patient recordings, the prevalence differences between the two groups were not significant (p > 0.132) (Chi-square tests) (Table II). As far as an EEG is concerned, it was abnormal in 6/43 children with autism (generalized paroxysmal activity in four and diffuse slowing of basic rhythm in two), whereas MRI was undertaken in 32 patients and was abnormal in six. Four individuals manifested congenital dysplasia and the remaining two had myelin delay. Among subjects with autism, the presence of MRI findings was significantly correlated with longer absolute latency III and IPL I-III on the right side (p = 0.033 and 0.007, respectively) (Mann-Whitney U tests), whereas the identification of EEG abnormalities was correlated with longer IPL I-V on the right side (p = 0.041) (Mann-Whitney U tests). There was no significant correlation between CARS scores and the outcome of the various BAEPs parameters (rs < 0.19, n = 43, p > 0.05) (Spearman’s correlations). Taken together, BAEPs of 10/43 children with autism (23%) and 2/43 controls (4.7%) exhibited pathological values indicative of a clinically abnormal response. As far as the patient group is concerned, the deficit was apparently conductive in eight cases and sensorineural in the remaining two (Table III). The prevalence of abnormal BAEPs was significantly higher in the patient group (p = 0.026) (Chi-square test). Abnormal BAEPs in patients were not correlated with age (p = 0.93) (MannWhitney U test), CARS score (p = 0.83) (Mann-Whitney U test), EEG findings (p = 0.57) (Fisher’s exact test), or MRI abnormalities (p = 0.31) (Fisher’s exact test). Finally, there was no significant difference between left and right side absolute and/or interpeak latencies in either the patient or the control group (p > 0.05) (paired t-tests).


Brainstem Auditory Evoked Potentials in Boys with Autism: Still Searching for the Hidden Truth.

Ververi A, Vargiami E, Papadopoulou V, Tryfonas D, Zafeiriou D - Iran J Child Neurol (2015)

Comparison between patients with autism (red bars) and controls
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4515337&req=5

Figure 1: Comparison between patients with autism (red bars) and controls
Mentions: Six parameters were bilaterally obtained from each participants resulting in recordings for 86 ears in each group (patient and control). Mean values of all absolute and/or interpeak latencies were longer in the patient when compared to the control, pooled recordings on both sides (Figure 1). The difference was not significant for any of the parameters (p > 0.22) (Mann-Whitney U tests). The mean (left and right) values for each individual were also prolonged in the control group (Table I), although the difference was again not significant (p > 0.30), (MannWhitney U tests). Moreover, a weak/moderate negative correlation between age and all absolute latencies was identified in the patient (rs ranging from -0.27 to -0.43, n = 43, p < 0.05) (Spearman’s correlations), but not in the control, bilateral recordings (rs < 0.19, n = 43, p>0.05) (Spearman’s correlations). On the contrary, no significant correlation was identified between BAEPs parameters and patient percentile of head circumference (rs < 0.19, n = 43, p > 0.05) (Spearman’s correlations). Prolonged or shortened absolute/interpeak latencies (control group mean ± 2.5SD) were unilaterally or bilaterally identified in 14 of 43 patients (33%) but only in 4 of 43 controls (9%). Table II details the various types of abnormalities in 86 unilateral recordings of each group. The most frequent disorders among patient recordings included the prolongation of waves I (13%) and V (9%), followed by the prolongation of wave III (8%). Among patient recordings with pathological IPLs, the most common deficit was shortening of IPL I-V (6%), which was, interestingly, two times more common than prolongation of the same wave. The prevalence of abnormalities (either shortening or prolongation) of latencies I (p = 0.005) and V (p = 0.028) as well as IPL I-V (p = 0.034) was significantly higher in the patient when compared to the control recordings (Chi-square tests). Although the rest of abnormalities also occurred more frequently among patient recordings, the prevalence differences between the two groups were not significant (p > 0.132) (Chi-square tests) (Table II). As far as an EEG is concerned, it was abnormal in 6/43 children with autism (generalized paroxysmal activity in four and diffuse slowing of basic rhythm in two), whereas MRI was undertaken in 32 patients and was abnormal in six. Four individuals manifested congenital dysplasia and the remaining two had myelin delay. Among subjects with autism, the presence of MRI findings was significantly correlated with longer absolute latency III and IPL I-III on the right side (p = 0.033 and 0.007, respectively) (Mann-Whitney U tests), whereas the identification of EEG abnormalities was correlated with longer IPL I-V on the right side (p = 0.041) (Mann-Whitney U tests). There was no significant correlation between CARS scores and the outcome of the various BAEPs parameters (rs < 0.19, n = 43, p > 0.05) (Spearman’s correlations). Taken together, BAEPs of 10/43 children with autism (23%) and 2/43 controls (4.7%) exhibited pathological values indicative of a clinically abnormal response. As far as the patient group is concerned, the deficit was apparently conductive in eight cases and sensorineural in the remaining two (Table III). The prevalence of abnormal BAEPs was significantly higher in the patient group (p = 0.026) (Chi-square test). Abnormal BAEPs in patients were not correlated with age (p = 0.93) (MannWhitney U test), CARS score (p = 0.83) (Mann-Whitney U test), EEG findings (p = 0.57) (Fisher’s exact test), or MRI abnormalities (p = 0.31) (Fisher’s exact test). Finally, there was no significant difference between left and right side absolute and/or interpeak latencies in either the patient or the control group (p > 0.05) (paired t-tests).

Bottom Line: The mean values of all absolute and/or interpeak latencies were longer in patients when compared to controls, albeit the differences were not significant for any of the parameters.In addition, abnormalities (either shortening or prolongation) of absolute latencies I and V, as well as interpeak latency I-V, were significantly more common among patients.The latter individuals may benefit from targeted intervention to utilize brainstem plasticity.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

ABSTRACT

Objective: Brainstem auditory evoked potentials (BAEPs) have long been utilized in the investigation of auditory modulation and, more specifically, auditory brainstem functions in individuals with autism. Although most investigators have reported significant abnormalities, no single BAEPs pattern has yet been identified. The present study further delineates the BAEPs deficits among subjects with autism.

Materials & methods: BAEPs were recorded in 43 male patients, aged 35-104 months, who underwent standard evaluations after receiving a diagnosis of autism. The control group consisted of 43 age-matched typically developing boys. The study took place in a tertiary neurodevelopmental center over a period of two years.

Results: The mean values of all absolute and/or interpeak latencies were longer in patients when compared to controls, albeit the differences were not significant for any of the parameters. Prolonged or shortened absolute/interpeak latencies (control group mean ± 2.5SD) were unilaterally or bilaterally identified in 33% of patients, compared to 9% of controls. The most frequent findings included prolongation of absolute latencies I, V and III, followed by shortening of interpeak latency I-V. In addition, abnormalities (either shortening or prolongation) of absolute latencies I and V, as well as interpeak latency I-V, were significantly more common among patients. Taken together, BAEPs in 23% of patients were indicative of a clinically abnormal response in 32% of patients.

Conclusion: As can be easily concluded, BAEPs abnormalities characterize only a subset of subjects with autism, who may be important to identify clinically. The latter individuals may benefit from targeted intervention to utilize brainstem plasticity.

No MeSH data available.


Related in: MedlinePlus