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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2023.tde-30052023-125258
Document
Author
Full name
Jacqueline Aquino do Nascimento
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2023
Supervisor
Committee
Matas, Carla Gentile (President)
Angrisani, Rosanna Mariangela Giaffredo
Rabelo, Camila Maia
Samelli, Alessandra Giannella
Title in Portuguese
Estudo da função auditiva periférica e central em adultos com síndrome de Williams
Keywords in Portuguese
Adulto
Audição
Genética
Perda auditiva
Potenciais evocados auditivos
Síndrome de Williams
Abstract in Portuguese
Introdução: A síndrome de Williams (SW) é uma desordem genética, causada devido a uma microdeleção no cromossomo 7, afetando aproximadamente 28 genes. Estudos evidenciaram a presença de perdas auditivas condutivas que parecem estar relacionadas à ausência do gene elastina, fragilidade coclear e sinais subclínicos de alterações no sistema auditivo desta população, além da presença de perdas auditivas neurossensoriais que podem variar de grau leve a profundo. No entanto, poucos estudos avaliaram o sistema auditivo central em adultos com SW. Objetivo: Caracterizar o sistema auditivo periférico e central de adultos com SW. Método: Estudo observacional transversal com 30 indivíduos de ambos os sexos, com idades entre 18 e 37 anos, sendo 15 com SW (grupo estudo) e 15 sem a síndrome e sem queixas auditivas (grupo controle), pareados por sexo e faixa etária. Os sujeitos foram submetidos à audiometria tonal e vocal, imitanciometria, emissões otoacústicas por estímulo transiente (EOAT), potencial evocado auditivo de tronco encefálico (PEATE) e potencial evocado auditivo de longa latência (PEALL). Resultados: Observou-se perda auditiva neurossensorial precoce em 53,33% da amostra estudada, a maioria de grau leve, ocorrendo a partir de 3 kHz, associada à hiperacusia. As EOAT estiveram ausentes em 53,3% dos sujeitos avaliados e, dentre aqueles que obtiveram presença das EOAT, foi observado amplitude das respostas e relação sinal/ruído significativamente menor comparado ao grupo controle. Quanto aos PEATE, foi observado aumento das latências absolutas das ondas I e III. A análise dos PEALL demonstrou aumento da amplitude P1-N1, P2-N2 e diminuição da amplitude N2-P3, além de atraso na latência de todos os componentes, em comparação ao grupo controle. Conclusão: Indivíduos adultos com SW apresentaram perda auditiva neurossensorial precoce nas freqüências altas e fragilidade coclear evidenciada por sinais subclínicos de alterações auditivas. Apresentaram alterações retrococleares na porção distal ao nervo auditivo e núcleos cocleares, além de déficits no processamento da informação auditiva, maior resposta neuronal na identificação das características do estímulo e dificuldades atencionais ao executar a tarefa auditiva
Title in English
Study of peripheral and central auditory function in adults with Williams syndrome
Keywords in English
Adult
Evoked potentials auditory
Genetics
Hearing
Hearing loss
Williams syndrome
Abstract in English
Introduction: Williams syndrome (WS) is a genetic disorder caused by a microdeletion in chromosome 7, affecting approximately 28 genes. Studies have demonstrated conductive hearing losses in this population, seemingly related to absent elastin gene, cochlear fragility, and subclinical signs of changes in the auditory system, as well as Sensorineural hearing losses ranging from mild to profound. However, few studies have assessed the central auditory system in adults with WS. Objective: To characterize the peripheral and central auditory system of adults with WS. Method: Cross-sectional observational study in 30 individuals of both sexes, aged 18 to 37 years 15 with WS (study group) and 15 with neither WS nor hearing complaints (control group), matched for sex and age. Subjects were submitted to tone and speech audiometry, acoustic immittance, transient evoked otoacoustic emissions (TEOAE), brainstem auditory evoked potentials (BAEP), and long-latency auditory evoked potentials (LLAEP). Results: Early sensorineural hearing loss was found in 53.33% of the study sample; they were mostly mild, occurring from 3 kHz, and were associated with hyperacusis. TEOAE were absent in 53.3% of assessed subjects; among those in whom TEOAE were present, the response amplitude and signal-to-noise ratio were significantly smaller than in the control group. As for BAEP, greater absolute latencies were found in waves I and III. LLAEP analysis revealed greater P1-N1 and P2-N2 amplitudes, smaller N2-P3 amplitude, and delayed latency in all components, in comparison with the control group. Conclusion: Adults with WS had early sensorineural hearing loss at high frequencies and cochlear fragility, demonstrated with subclinical signs of hearing changes. They also had retrocochlear changes in the distal portion of the auditory nerve and cochlear nuclei, auditory information processing deficits, greater neuronal response when identifying stimulus characteristics, and attentional difficulties when carrying out hearing tasks
 
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Publishing Date
2023-06-01
 
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