Processamento temporal e resposta auditiva de média latência em idosos candidatos e usuários de prótese auditiva

• Autor(a) principal: Pinheiro, Maria Madalena Canina [UNIFESP]
• Data de Publicação: 2011
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://repositorio.unifesp.br/handle/11600/9978
• topic: Prótese auditiva; Idosos; Implantes cocleares; Aged; Cochlear implants

Introduction: Aging can cause alterations in temporal processing and cognitive functions. Electrophysiological evaluation has been widely recommended to complement the behavioral evaluation of auditory processing. Objective: Verify and compare the behavioral auditory responses of temporal processing and the auditory middle latency response with cognitive processing in elderly candidates for and users of hearing aids. Methods: Sixty elderly people participated in the study, 20 males and 40 females, ranging in age from 61 to 85 (avg. 71.7) who are attended at the Integrated Hearing Assistance, Research and Education Center (NIAPEA) of the Federal University at São Paulo, and who are all new users of hearing aids. The individuals were organized in two groups according to their degree of hearing loss, considering frequencies of 500- 4000 Hz on the audiogram, denominated Group I (GI) and Group II (GII). In GI, the individuals had a degree of hearing loss lower than 50 dB and in GII above 50 dB. The cognitive factors were evaluated by means of long-latency auditory evoked potential tests– P300, Mini mental state examination (MMSE) and the Alzheimer Disease Assessment Scale (ADAS-COG). The procedures selected to achieve the objectives were the Middle Latency Auditory Evoked Potentials (MLAEP) tests, which studied the latency of the Na and Pa waves in milliseconds, and the amplitude of Na-Pa (μv). When an auditory and or electrode effect was present, the exam was considered altered. The Duration Pattern Tests (TPD) and Gap in Noise (GIN) test were used to analyze the responses of correct identification, and the gap detection threshold. Results: Elderly people who use hearing aids display a lower gap detection threshold, greater recognition of gaps and of discrimination of the duration pattern, lower latency and decrease in MLAEP in relation to the time when they were candidates. When they displayed deficits in information processing in auditory cortex, they displayed losses in the temporal resolution ability, which became worse in the presence of cognitive alteration. Conclusion: The temporal ordering and temporal resolution abilities deteriorated independent of the degree of hearing loss, revealing the age effect. The responses to Middle Latency Auditory Evoked Potentials tests were not influenced by the degree of hearing loss and significant changes in reassessment occurred after acclimatization. Thus, the effect of acoustic stimulation by the use of a hearing aid improved the hearing ability of temporal ordering, temporal resolution and the processing of information from the Central Auditory Nervous System to the primary auditory cortex. The behavior of temporal ordering did not change in the elderly with cognitive alterations; however, individuals without cognitive alterations had lower deficits in the functional integrity of the primary hearing areas and improvement in the behavior of temporal resolution.