CoDAS
https://codas.org.br/article/doi/10.1590/2317-1782/e20250108pt
CoDAS
Artigo Original

Potencial evocado auditivo cortical com diferentes estímulos de fala em crianças com citomegalovirose congênita assintomática

https://www.scielo.br/j/codas/a/Nq8kscZYbhGJtHnZFGYjp6S/?format=pdf&lang=pt

Luara Rezende Madeira; Pamela Papile Lunardelo; Adriana Ribeiro Tavares

Downloads: 0
Views: 5

Resumo

RESUMO: Objetivo: Caracterizar os potenciais evocados auditivos corticais (PEAC) com estímulos de fala em crianças com CMVc assintomático comparando-as a crianças não infectadas com desenvolvimento típico de audição, fala e linguagem.

Método: A amostra incluiu 23 crianças com infecção assintomática por citomegalovírus congênito e 16 crianças controle, pareadas por idade, sexo, perímetro cefálico e classificação socioeconômica.O Potencial Evocado Auditivo Cortical foi registrado com estímulos de fala /da/ e /ga/ a 70 dBNA, utilizando eletrodos posicionados no vértice (Cz), na região frontal (Fpz) e lóbulos (A1 e A2). A presença dos componentes foi analisada e comparada entre os grupos por meio de estatística descritiva e inferencial.

Resultados: A análise das ondas indicou que o grupo controle apresentou respostas neurais mais próximas daquelas observadas em vias auditivas maduras, com a presença dos componentes N1 e P2 em processo de formação, evidenciada pela morfologia mais nítida nas ondas.Em relação à latência, observaram-se valores significativamente maiores no grupo controle para a sílaba /ga/.O grupo CMVc exibiu amplitudes superiores para o componente N2, indicando maior esforço neural na discriminação do estímulo auditivo.

Conclusão: Crianças com citomegalovírus assintomático podem apresentar alterações no processamento auditivo central, com diferenças na detecção e discriminação e pistas acústicas em relação ao grupo controle. O Potencial Evocado Auditivo Cortical é uma ferramenta para avaliar essas alterações, sendo necessárias mais pesquisas para compreender os efeitos do CMVc no desenvolvimento auditivo central.

Palavras-chave

Infecção por Citomegalovírus Congênita, Potenciais Evocados, Processamento Auditivo, Desenvolvimento Infantil, Audiologia

Referências

1 Fowler KB, Boppana SB. Congenital cytomegalovirus (CMV) infection and hearing deficit. J Clin Virol. 2006;35(2):226-31. http://doi.org/10.1016/j.jcv.2005.09.016. PMid:16386462.

2 Jenks CM, Hoff SR, Mithal LB. Congenital cytomegalovirus infection: Epidemiology, timely diagnosis, and management. Neoreviews. 2021;22(9):e606-13. http://doi.org/10.1542/neo.22-9-e606. PMid:34470762.

3 Ross SA, Boppana SB. Congenital cytomegalovirus infection: outcome and diagnosis. Semin Pediatr Infect Dis. 2005;16(1):44-9. http://doi.org/10.1053/j.spid.2004.09.011. PMid:15685149.

4 Dollard SC, Grosse SD, Ross DS. New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev Med Virol. 2007;17(5):355-63. http://doi.org/10.1002/rmv.544. PMid:17542052.

5 Townsend CL, Forsgren M, Ahlfors K, Ivarsson SA, Tookey PA, Peckham CS. Long-term outcomes of congenital cytomegalovirus infection in Sweden and the United Kingdom. Clin Infect Dis. 2013;56(9):1232-9. http://doi.org/10.1093/cid/cit018. PMid:23334811.

6 Lopez AS, Lanzieri TM, Claussen AH, Vinson SS, Turcich MR, Iovino IR, et al, and the Congenital Cytomegalovirus Longitudinal Study Group. Intelligence and academic achievement with asymptomatic congenital cytomegalovirus infection. Pediatrics. 2017;140(5):e20171517. http://doi.org/10.1542/peds.2017-1517. PMid:29066580.

7 Korndewal MJ, Oudesluys-Murphy AM, Kroes ACM, Van Der Sande MAB, De Melker HE, Vossen ACTM. Long-term impairment attributable to congenital cytomegalovirus infection: A retrospective cohort study. Dev Med Child Neurol. 2017;59(12):1261-8. http://doi.org/10.1111/dmcn.13556. PMid:28990181.

8 Williamson WD, Percy AK, Yow MD, Gerson P, Catlin FI, Koppelman ML, et al. Asymptomatic congenital cytomegalovirus infection. Audiologic, neuroradiologic, and neurodevelopmental abnormalities during the first year. Am J Dis Child. 1990;144(12):1365-8. http://doi.org/10.1001/archpedi.1990.02150360091031. PMid:2173889.

9 Temple RO, Pass RF, Boll TJ. Neuropsychological functioning in patients with asymptomatic congenital cytomegalovirus infection. J Dev Behav Pediatr. 2000;21(6):417-22. http://doi.org/10.1097/00004703-200012000-00003. PMid:11132792.

10 Tsutsui Y, Kawasaki H, Kosugi I. Reactivation of latent cytomegalovirus infection in mouse brain cells detected after transfer to brain slice cultures. J Virol. 2002;76(14):7247-54. http://doi.org/10.1128/JVI.76.14.7247-7254.2002. PMid:12072524.

11 Baran JA, Musiek FE. Behavioral assessment of the central auditory nervous system. In: Musiek FE, Rintelmann WF, editores. Contemporary perspectives in hearing assessment. Boston: Allyan & Bacon; 1991. p. 375–413.

12 Ponton CW, Eggermont JJ, Kwong B, Don M. Maturation of human central auditory system activity: evidence from multi-channel evoked potentials. Clin Neurophysiol. 2000;111(2):220-36. http://doi.org/10.1016/S1388-2457(99)00236-9. PMid:10680557.

13 Tallal P, Miller S, Fitch RH. Neurobiological basis of speech: A case for the preeminence of temporal processing. Ann N Y Acad Sci. 1993;682(1):27-47. http://doi.org/10.1111/j.1749-6632.1993.tb22957.x. PMid:7686725.

14 Bailey PJ, Snowling MJ. Auditory processing and the development of language and literacy. Br Med Bull. 2002;63(1):135-46. http://doi.org/10.1093/bmb/63.1.135. PMid:12324389.

15 Molfese DL. Predicting dyslexia at 8 years of age using neonatal brain responses. Brain Lang. 2000;72(3):238-45. http://doi.org/10.1006/brln.2000.2287. PMid:10764519.

16 Choudhury N, Benasich AA. Maturation of auditory evoked potentials from 6 to 48 months: prediction to 3 and 4 year language and cognitive abilities. Clin Neurophysiol. 2011;122(2):320-38. http://doi.org/10.1016/j.clinph.2010.05.035. PMid:20685161.

17 Guttorm TK, Leppänen PHT, Hämäläinen JA, Eklund KM, Lyytinen HJ. Newborn event-related potentials predict poorer pre-reading skills in children at risk for dyslexia. J Learn Disabil. 2010;43(5):391-401. http://doi.org/10.1177/0022219409345005. PMid:19890075.

18 Maitre NL, Lambert WE, Aschner JL, Key AP. Cortical speech sound differentiation in the neonatal intensive care unit predicts cognitive and language development in the first 2 years of life. Dev Med Child Neurol. 2013;55(9):834-9. http://doi.org/10.1111/dmcn.12191. PMid:23799953.

19 Yoder PJ, Molfese D, Murray MM, Key APF. Normative topographic ERP analyses of speed of speech processing and grammar before and after grammatical treatment. Dev Neuropsychol. 2013;38(8):514-33. http://doi.org/10.1080/87565641.2011.637589. PMid:24219693.

20 Key AP, Yoder PJ, Stone WL. Consonant differentiation mediates the discrepancy between non-verbal and verbal abilities in children with ASD. J Intellect Disabil Res. 2016;60(5):478-90. http://doi.org/10.1111/jir.12286. PMid:27120990.

21 Sandbank M, Yoder P, Key AP. Word processing in children with autism spectrum disorders: evidence from event-related potentials. J Speech Lang Hear Res. 2017;60(12):3441-55. http://doi.org/10.1044/2017_JSLHR-S-17-0011. PMid:29222572.

22 Martin BA, Tremblay KL, Korczak P. Speech evoked potentials: from the laboratory to the clinic. Ear Hear. 2008;29(3):285-313. http://doi.org/10.1097/AUD.0b013e3181662c0e. PMid:18453883.

23 Jerger J. Clinical experience with impedance audiometry. Arch Otolaryngol. 1970;92(4):311-24. http://doi.org/10.1001/archotol.1970.04310040005002. PMid:5455571.

24 ABEP: Brazilian Association of Research Companies [Internet]. Brazilian economic classification criterion. São Paulo: ABEP; 2011 [citado em 2025 Jan 2]. Disponível em: https://abep.org/criterio-brasil/

25 Silva LS, Regaçone SF, Oliveira ACS, Oliveira LS, Fernandes FT, Frizzo ACF. Auditory cortical potential: using different types of speech stimuli in children. Audiol Commun Res. 2017;22:e1788. http://doi.org/10.1590/2317-6431-2016-1788.

26 Alvarenga KF, Amorim RB, Agostinho-Pesse RS, Costa OA, Nascimento LT, Bevilacqua MC. Speech perception and cortical auditory evoked potentials in cochlear implant users with auditory neuropathy spectrum disorders. Int J Pediatr Otorhinolaryngol. 2012;76(9):1332-8. http://doi.org/10.1016/j.ijporl.2012.06.001. PMid:22796193.

27 Ohlrich ES, Barnet AB. Auditory evoked responses during the first year of life. Electroencephalogr Clin Neurophysiol. 1972;32(2):161-9. http://doi.org/10.1016/0013-4694(72)90138-1. PMid:4109343.

28 Frizzo ACF. Long-latency auditory evoked potentials: concepts and clinical applications. 1st ed. São Paulo: Fernandes A; 2018. p. 139–50.

29 Hall JW. New handbook of auditory evoked responses. London: Pearson Education; 2006.

30 Hansen JC, Hillyard SA. Temporal dynamics of human auditory selective attention. Psychophysiology. 1988;25(3):316-29. http://doi.org/10.1111/j.1469-8986.1988.tb01249.x. PMid:3406331.

31 Prakash H, Abraham A, Rajashekar B, Yerraguntla K. The effect of intensity on the speech evoked auditory late latency response in normal hearing individuals. J Int Adv Otol. 2016;12(1):67-71. http://doi.org/10.5152/iao.2016.1776. PMid:27340986.

32 Sharma A, Martin K, Roland P, Bauer P, Sweeney MH, Gilley P, et al. P1 latency as a biomarker for central auditory development in children with hearing impairment. J Am Acad Audiol. 2005;16(8):564-73. http://doi.org/10.3766/jaaa.16.8.5. PMid:16295243.

33 Mattsson TS, Lind O, Follestad T, Grøndahl K, Wilson W, Nicholas J, et al. Electrophysiological characteristics in children with listening difficulties, with or without auditory processing disorder. Int J Audiol. 2019;58(11):704-16. http://doi.org/10.1080/14992027.2019.1621396. PMid:31154863.

34 Alain C, Woods DL, Covarrubias D. Activation of duration-sensitive auditory cortical fields in humans. Electroencephalogr Clin Neurophysiol. 1997;104(6):531-9. http://doi.org/10.1016/S0168-5597(97)00057-9. PMid:9402895.

35 Gilley PM, Sharma A, Dorman M, Martin K. Developmental changes in refractoriness of the cortical auditory evoked potential. Clin Neurophysiol. 2005;116(3):648-57. http://doi.org/10.1016/j.clinph.2004.09.009. PMid:15721079.

36 Michalewski HJ, Starr A, Nguyen TT, Kong YY, Zeng FG. Auditory temporal processes in normal-hearing individuals and in patients with auditory neuropathy. Clin Neurophysiol. 2005;116(3):669-80. http://doi.org/10.1016/j.clinph.2004.09.027. PMid:15721081.

37 Tremblay KL, Ross B, Inoue K, McClannahan K, Collet G. Is the auditory evoked P2 response a biomarker of learning? Front Syst Neurosci. 2014;8:28. http://doi.org/10.3389/fnsys.2014.00028. PMid:24600358.

38 Kraus N, McGee T, Carrell T, Sharma A, Micco A, Nicol T. Speech-evoked cortical potentials in children. J Am Acad Audiol. 1993;4(4):238-48. PMid:8369541.

39 Bernal J, Harmony T, Rodríguez M, Reyes A, Yáñez G, Fernández T, et al. Auditory event-related potentials in poor readers. Int J Psychophysiol. 2000;36(1):11-23. http://doi.org/10.1016/S0167-8760(99)00092-6. PMid:10700619.

40 Albrecht R, Suchodoletz W, Uwer R. The development of auditory evoked dipole source activity from childhood to adulthood. Clin Neurophysiol. 2000;111(12):2268-76. http://doi.org/10.1016/S1388-2457(00)00464-8. PMid:11090781.

41 Almeqbel A. Speech-evoked cortical auditory responses in children with normal hearing. S Afr J Commun Disord. 2013;60(1):38-43. http://doi.org/10.4102/sajcd.v60i1.9. PMid:25158372.

42 Leppänen PH, Lyytinen H. Auditory event-related potentials in the study of developmental language-related disorders. Audiol Neurootol. 1997;2(5):308-40. http://doi.org/10.1159/000259254. PMid:9390838.

43 Koravand A, Jutras B, Lassonde M. Abnormalities in cortical auditory responses in children with central auditory processing disorder. Neuroscience. 2017;346:135-48. http://doi.org/10.1016/j.neuroscience.2017.01.011. PMid:28108252.

44 Romero ACL, Frizzo ACF, Chagas EFB, Isaac ML. Cortical auditory evoked potential in babies and children listeners. Rev Bras Otorrinolaringol (Engl Ed). 2020;86(4):395-404. http://doi.org/10.1016/j.bjorl.2019.01.007. PMid:30926456.

45 Cone-Wesson B, Wunderlich J. Auditory evoked potentials from the cortex: audiology applications. Curr Opin Otolaryngol Head Neck Surg. 2003;11(5):372-7. http://doi.org/10.1097/00020840-200310000-00011. PMid:14502069.

46 Chen XL, Zhang LQ, Bai LL. Ultrasound features of congenital cytomegalovirus infection in the first trimester: a case report. World J Clin Cases. 2025;13(5):97629. http://doi.org/10.12998/wjcc.v13.i5.97629. PMid:39959771.

47 Fowler KB, McCollister FP, Dahle AJ, Boppana S, Britt WJ, Pass RF. Progressive and fluctuating sensorineural hearing loss in children with asymptomatic congenital cytomegalovirus infection. J Pediatr. 1997;130(4):624-30. http://doi.org/10.1016/S0022-3476(97)70248-8. PMid:9108862.

48 Kassis I, Bero D, Hafner H, Chistyakov A, Meir M. Brainstem auditory pathway maturation in term neonates with congenital cytomegalovirus infection: a cohort study. Eur J Pediatr. 2023;182(1):95-100. http://doi.org/10.1007/s00431-022-04644-z. PMid:36207473.
 


Submetido em:
31/03/2025

Aceito em:
04/08/2025

69e6a874a9539516cc062683 codas Articles

CoDAS

Share this page
Page Sections