Resposta auditiva em regime permanente evocada por ruído modulado: uma proposta de protocolo para identificação de perdas auditivas
Ano de defesa: | 2016 |
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Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Tese |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal de Minas Gerais
Brasil ICB - INSTITUTO DE CIÊNCIAS BIOLOGICAS Programa de Pós-Graduação em Neurociências UFMG |
Programa de Pós-Graduação: |
Não Informado pela instituição
|
Departamento: |
Não Informado pela instituição
|
País: |
Não Informado pela instituição
|
Palavras-chave em Português: | |
Link de acesso: | http://hdl.handle.net/1843/34634 |
Resumo: | Aim: To propose a hearing loss identification protocol using steady-state auditory responses (ASSR) evoked by amplitude-modulated noise. Materials and Methods: The study consisted in two stages: the stage I of exploratory character and the stage II of investigation of the diagnostic accuracy of the stimuli. In stage I, twenty individuals (12 women) without any history of neurological or audiological diseases, aged from 18 to 59 years participated in stage I. The Audiostim system was used for stimuli generation and ASSR recording, in Fpz (ground electrode), Cz (active electrode) and (A1+A2)/2 (reference electrode) derivations. The tested stimuli were amplitude-modulated Wide-band noise (WBN), Low-band noise (LBN), High-band noise (HBN), Two-band noise (TBN) between 77 and 110 Hz, applied in intensity levels of 55, 45, and 25 dB sound pressure level (NPS). For detection, Magnitude-Squared Coherence (MSC) and Spectral F Test (SFT) were applied with a significance level of 5%. Detection times and rates were compared using the Friedman test and Tukey-Kramer as post hoc analysis. Besides, the true negatives (TN) were calculated in 16 different pass/fail protocols based on the stimulation parameters (stimuli types and intensity levels) and detection techniques (MSC or SFT). In stage II, thirty one individuals attended at Hearing Health Service of Hospital São Geraldo- HC / UFMG, aged between 16 and 70 years were included. Fifty two ears were considered, 32 with hearing loss of different degrees and 20 with normal hearing. The electrophysiological thresholds of WBN and TBN were estimated. The detection of responses was performed by MSC (α=0,05). The ROC curves were plotted considering the intensity range from 90 to 30 dB NPS for WBN and TBN. The areas under the curve were calculated and compared using the Mann-Whitiney test (α=0,05). The sensitivity and specificity of the WBN and TBN for each intensity (90 dB to 30 dB NPS) were obtained. Results: In stage I, the detection rates ranged from 100% to 55.6% in 55 dB NPS, 97.2% to 38.9% in 45 dB NPS and 66.7% to 8.3% in 25 dB NPS .The median detection times ranged from 68 to 157s for 55 dB NPS, 68-99s for 45 dB NPS, and 84-118s for 25 dB NPS. No statistical difference was found between MSC and STF considering the median detection times (p>0.05). TN above 90% were found for Protocols that employed WBN or HBN, at 55 dB NPS or that used WBN or HBN, at 45 dB NPS. For Protocols employing TBN, at 55 dB NPS or 45 dB NPS TN below 60% were found due to the low detection rates of stimuli that included low-band frequencies. In stage II, the ears with normal hearing had thresholds around 40 dB NPS in the evaluated bands. In mild losses the average thresholds ranged between 50 and 65 dB NPS. From moderate losses thresholds varied between 70 dB NPS and 80 dB NPS. The areas under the curve were 0.92 and 0.93 for the WBN of the TBN and did not differ statistically (p <0.05). Sensitivity was found above 95% for intensities below 50 dB NPS for the WBN and the TBN and in these intensities, specificity did not exceed 65%. In the intensities above 60 dB NPS sensitivity varied between 65% and 20% and specificity between 95% and 100% for both stimuli. The intensities of 50 and 60 dB NPS, the WBN had a sensitivity of 77% and specificity of 100% and 90% respectively. The TBN had a sensitivity of 97% at 50 dB NPS and 93% at 60 dB NPS and specificity of 80% at 50 dB NPS and 90% at 60 dB NPS. Conclusions: The application of RDB to 60 dB NPS showed sensitivity rates of 93% and specificity of 90%. These rates are consistent with those obtained by the OAE and the ABR (recommended tests to identify the stage of hearing screening programs). |
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Resposta auditiva em regime permanente evocada por ruído modulado: uma proposta de protocolo para identificação de perdas auditivasTriagemAudiçãoDetecçãoEletrofisiologiaNeurociênciasAudiçãoPerda auditivaEletrofisiologiaAim: To propose a hearing loss identification protocol using steady-state auditory responses (ASSR) evoked by amplitude-modulated noise. Materials and Methods: The study consisted in two stages: the stage I of exploratory character and the stage II of investigation of the diagnostic accuracy of the stimuli. In stage I, twenty individuals (12 women) without any history of neurological or audiological diseases, aged from 18 to 59 years participated in stage I. The Audiostim system was used for stimuli generation and ASSR recording, in Fpz (ground electrode), Cz (active electrode) and (A1+A2)/2 (reference electrode) derivations. The tested stimuli were amplitude-modulated Wide-band noise (WBN), Low-band noise (LBN), High-band noise (HBN), Two-band noise (TBN) between 77 and 110 Hz, applied in intensity levels of 55, 45, and 25 dB sound pressure level (NPS). For detection, Magnitude-Squared Coherence (MSC) and Spectral F Test (SFT) were applied with a significance level of 5%. Detection times and rates were compared using the Friedman test and Tukey-Kramer as post hoc analysis. Besides, the true negatives (TN) were calculated in 16 different pass/fail protocols based on the stimulation parameters (stimuli types and intensity levels) and detection techniques (MSC or SFT). In stage II, thirty one individuals attended at Hearing Health Service of Hospital São Geraldo- HC / UFMG, aged between 16 and 70 years were included. Fifty two ears were considered, 32 with hearing loss of different degrees and 20 with normal hearing. The electrophysiological thresholds of WBN and TBN were estimated. The detection of responses was performed by MSC (α=0,05). The ROC curves were plotted considering the intensity range from 90 to 30 dB NPS for WBN and TBN. The areas under the curve were calculated and compared using the Mann-Whitiney test (α=0,05). The sensitivity and specificity of the WBN and TBN for each intensity (90 dB to 30 dB NPS) were obtained. Results: In stage I, the detection rates ranged from 100% to 55.6% in 55 dB NPS, 97.2% to 38.9% in 45 dB NPS and 66.7% to 8.3% in 25 dB NPS .The median detection times ranged from 68 to 157s for 55 dB NPS, 68-99s for 45 dB NPS, and 84-118s for 25 dB NPS. No statistical difference was found between MSC and STF considering the median detection times (p>0.05). TN above 90% were found for Protocols that employed WBN or HBN, at 55 dB NPS or that used WBN or HBN, at 45 dB NPS. For Protocols employing TBN, at 55 dB NPS or 45 dB NPS TN below 60% were found due to the low detection rates of stimuli that included low-band frequencies. In stage II, the ears with normal hearing had thresholds around 40 dB NPS in the evaluated bands. In mild losses the average thresholds ranged between 50 and 65 dB NPS. From moderate losses thresholds varied between 70 dB NPS and 80 dB NPS. The areas under the curve were 0.92 and 0.93 for the WBN of the TBN and did not differ statistically (p <0.05). Sensitivity was found above 95% for intensities below 50 dB NPS for the WBN and the TBN and in these intensities, specificity did not exceed 65%. In the intensities above 60 dB NPS sensitivity varied between 65% and 20% and specificity between 95% and 100% for both stimuli. The intensities of 50 and 60 dB NPS, the WBN had a sensitivity of 77% and specificity of 100% and 90% respectively. The TBN had a sensitivity of 97% at 50 dB NPS and 93% at 60 dB NPS and specificity of 80% at 50 dB NPS and 90% at 60 dB NPS. Conclusions: The application of RDB to 60 dB NPS showed sensitivity rates of 93% and specificity of 90%. These rates are consistent with those obtained by the OAE and the ABR (recommended tests to identify the stage of hearing screening programs).Objetivo: O objetivo deste trabalho foi propor um protocolo de identificação de perdas auditivas utilizando Respostas auditivas de estado estável (RAEE) evocadas por ruídos modulados em amplitude (AM). Materiais e Métodos: O estudo foi conduzido em duas etapas: a etapa I de caráter exploratório e a etapa II de investigação da acurácia diagnóstica dos estímulos. Na Etapa I, vinte indivíduos da comunidade universitária da UFMG, com idade entre 18 e 59 anos foram avaliados. Foram consideradas 36 orelhas com audição dentro dos padrões de normalidade. Registrou-se a RAEE em Cz (eletrodo ativo) com referência (A1+A2)/2 e terra em Fpz. Os estímulos AM apresentados foram o ruído de banda larga (RBL- 1 a 8000Hz) e o ruído dividido em duas bandas moduladas em amplitude, apresentadas simultaneamente (RDB – 1 a 1000Hz e 2000 a 8000Hz) e separadamente (RBG – 1 a 1000 Hz e RBA – 2 a 8000Hz). As intensidades aplicadas foram 55, 45 e 25 dB NPS e a detecção das respostas foi realizada por meio da Magnitude Quadrática da Coerência (MSC) e do Teste F espectral (TFE) com α=0,05. As medianas dos tempos e as taxas de detecção foram comparadas utilizando o teste de Friedman com análise post hoc de Tukey-Kramer (α=0,05). Em seguida os verdadeiros negativos (VN) foram estimados para 16 protocolos de identificação (passa/falha) simulados a partir da combinação de parâmetros de estimulação. Na etapa II, foram avaliados 31 indivíduos atendidos no serviço de Saúde Auditiva do Hospital São Geraldo- HC/UFMG, com idade entre 16 e 70 anos. Foram consideradas 52 orelhas, 32 com perdas auditivas de diferentes graus e 20 com audição dentro dos padrões de normalidade. Foi realizada a estimativa dos limiares eletrofisiológicos do RBL e do RDB. A detecção das respostas foi realizada por meio da Magnitude Quadrática da Coerência (MSC), com α=0,05. As curvas ROC do RBL e RDB foram traçadas considerando a variação da intensidade de 90 a 30 dB NPS. As áreas abaixo da curva foram calculadas e comparadas através do teste U de Mann-whitney (α = 0,05). A sensibilidade e a especificidade do RBL e RDB para cada intensidade de estimulação (90 a 30 dB NPS) foram obtidas. Resultados: Na etapa I, as taxas de detecção variaram de 100% a 55.6% em 55 dB NPS, 97.2% a 38.9% em 45 dB NPS e 66.7% a 8.3% em 25 dB NPS. As medianas dos tempos de detecção variaram entre 68 e 157s para 55 dB NPS, 68-99s para 45 dB NPS, e 84-118s para 25 dB NPS. Não foi observada diferença estatística entre as taxas de detecção da MSC e do TFE (p>0.05). Os verdadeiros negativos (VN) acima de 90% foram encontrados para RBL ou RBA, em 55 dB NPS, assim como, para RBL ou RBA, em 45 dB NPS. Os protocolos que empregavam o RDB a 55 ou a 45 dB NPS apresentaram VN abaixo de 60%, devido às taxas de detecção reduzidas da banda grave. Na etapa II, as orelhas com audição dentro dos padrões de normalidade apresentaram limiares em torno de 40 dB NPS. Nas perdas leves a média dos limiares variou entre 50 e 65 dB NPS. A partir das perdas moderadas os limiares variaram entre 70 dB NPS e 80 dB NPS. As áreas abaixo da curva foram 0,92 para o RBL e 0,93 para o RDB e não diferiram estatisticamente (p<0,05). Constatou-se sensibilidade acima de 95% para as intensidades abaixo de 50 dB NPS para o RBL e o RDB. Nestas intensidades a especificidade não ultrapassou 65%. Nas intensidades acima de 60 dB NPS a sensibilidade variou entre 65% e 20% e a especificidade entre 95% e 100% para ambos os estímulos. Nas intensidades de 50 e 60 dB NPS, o RBL apresentou sensibilidade de 77% e especificidade de 100% e 90% respectivamente. O RDB apresentou sensibilidade de 97% em 50 dB NPS e 93% em 60 dB NPS e especificidade de 80% em 50 dB NPS e 90% em 60 dB NPS. Conclusões: Os resultados sugerem a aplicação do RDB à 60 dB NPS na identificação de perdas auditiva, pois este protocolo apresentou índices de sensibilidade de 93% e especificidade de 90%. Estes índices são compatíveis com os obtidos pela EOAE e pelo PEATE (exames recomendados para etapa de identificação).CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoFAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas GeraisCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorFINEP - Financiadora de Estudos e Projetos, Financiadora de Estudos e ProjetosUniversidade Federal de Minas GeraisBrasilICB - INSTITUTO DE CIÊNCIAS BIOLOGICASPrograma de Pós-Graduação em NeurociênciasUFMGCarlos Julio Tierra Criollohttp://lattes.cnpq.br/5743404268947726Otávio Gomes LinsMárcio Flávio Dutra MoraesPatrícia Cotta ManciniSilvana Maria do Monte Coelho FrotaLeonardo Bonato FelixThamara Suzi dos Santos2021-01-06T00:19:17Z2021-01-06T00:19:17Z2016-05-25info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisapplication/pdfhttp://hdl.handle.net/1843/34634porhttp://creativecommons.org/licenses/by-nc-nd/3.0/pt/info:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMG2021-01-06T00:19:17Zoai:repositorio.ufmg.br:1843/34634Repositório InstitucionalPUBhttps://repositorio.ufmg.br/oairepositorio@ufmg.bropendoar:2021-01-06T00:19:17Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.none.fl_str_mv |
Resposta auditiva em regime permanente evocada por ruído modulado: uma proposta de protocolo para identificação de perdas auditivas |
title |
Resposta auditiva em regime permanente evocada por ruído modulado: uma proposta de protocolo para identificação de perdas auditivas |
spellingShingle |
Resposta auditiva em regime permanente evocada por ruído modulado: uma proposta de protocolo para identificação de perdas auditivas Thamara Suzi dos Santos Triagem Audição Detecção Eletrofisiologia Neurociências Audição Perda auditiva Eletrofisiologia |
title_short |
Resposta auditiva em regime permanente evocada por ruído modulado: uma proposta de protocolo para identificação de perdas auditivas |
title_full |
Resposta auditiva em regime permanente evocada por ruído modulado: uma proposta de protocolo para identificação de perdas auditivas |
title_fullStr |
Resposta auditiva em regime permanente evocada por ruído modulado: uma proposta de protocolo para identificação de perdas auditivas |
title_full_unstemmed |
Resposta auditiva em regime permanente evocada por ruído modulado: uma proposta de protocolo para identificação de perdas auditivas |
title_sort |
Resposta auditiva em regime permanente evocada por ruído modulado: uma proposta de protocolo para identificação de perdas auditivas |
author |
Thamara Suzi dos Santos |
author_facet |
Thamara Suzi dos Santos |
author_role |
author |
dc.contributor.none.fl_str_mv |
Carlos Julio Tierra Criollo http://lattes.cnpq.br/5743404268947726 Otávio Gomes Lins Márcio Flávio Dutra Moraes Patrícia Cotta Mancini Silvana Maria do Monte Coelho Frota Leonardo Bonato Felix |
dc.contributor.author.fl_str_mv |
Thamara Suzi dos Santos |
dc.subject.por.fl_str_mv |
Triagem Audição Detecção Eletrofisiologia Neurociências Audição Perda auditiva Eletrofisiologia |
topic |
Triagem Audição Detecção Eletrofisiologia Neurociências Audição Perda auditiva Eletrofisiologia |
description |
Aim: To propose a hearing loss identification protocol using steady-state auditory responses (ASSR) evoked by amplitude-modulated noise. Materials and Methods: The study consisted in two stages: the stage I of exploratory character and the stage II of investigation of the diagnostic accuracy of the stimuli. In stage I, twenty individuals (12 women) without any history of neurological or audiological diseases, aged from 18 to 59 years participated in stage I. The Audiostim system was used for stimuli generation and ASSR recording, in Fpz (ground electrode), Cz (active electrode) and (A1+A2)/2 (reference electrode) derivations. The tested stimuli were amplitude-modulated Wide-band noise (WBN), Low-band noise (LBN), High-band noise (HBN), Two-band noise (TBN) between 77 and 110 Hz, applied in intensity levels of 55, 45, and 25 dB sound pressure level (NPS). For detection, Magnitude-Squared Coherence (MSC) and Spectral F Test (SFT) were applied with a significance level of 5%. Detection times and rates were compared using the Friedman test and Tukey-Kramer as post hoc analysis. Besides, the true negatives (TN) were calculated in 16 different pass/fail protocols based on the stimulation parameters (stimuli types and intensity levels) and detection techniques (MSC or SFT). In stage II, thirty one individuals attended at Hearing Health Service of Hospital São Geraldo- HC / UFMG, aged between 16 and 70 years were included. Fifty two ears were considered, 32 with hearing loss of different degrees and 20 with normal hearing. The electrophysiological thresholds of WBN and TBN were estimated. The detection of responses was performed by MSC (α=0,05). The ROC curves were plotted considering the intensity range from 90 to 30 dB NPS for WBN and TBN. The areas under the curve were calculated and compared using the Mann-Whitiney test (α=0,05). The sensitivity and specificity of the WBN and TBN for each intensity (90 dB to 30 dB NPS) were obtained. Results: In stage I, the detection rates ranged from 100% to 55.6% in 55 dB NPS, 97.2% to 38.9% in 45 dB NPS and 66.7% to 8.3% in 25 dB NPS .The median detection times ranged from 68 to 157s for 55 dB NPS, 68-99s for 45 dB NPS, and 84-118s for 25 dB NPS. No statistical difference was found between MSC and STF considering the median detection times (p>0.05). TN above 90% were found for Protocols that employed WBN or HBN, at 55 dB NPS or that used WBN or HBN, at 45 dB NPS. For Protocols employing TBN, at 55 dB NPS or 45 dB NPS TN below 60% were found due to the low detection rates of stimuli that included low-band frequencies. In stage II, the ears with normal hearing had thresholds around 40 dB NPS in the evaluated bands. In mild losses the average thresholds ranged between 50 and 65 dB NPS. From moderate losses thresholds varied between 70 dB NPS and 80 dB NPS. The areas under the curve were 0.92 and 0.93 for the WBN of the TBN and did not differ statistically (p <0.05). Sensitivity was found above 95% for intensities below 50 dB NPS for the WBN and the TBN and in these intensities, specificity did not exceed 65%. In the intensities above 60 dB NPS sensitivity varied between 65% and 20% and specificity between 95% and 100% for both stimuli. The intensities of 50 and 60 dB NPS, the WBN had a sensitivity of 77% and specificity of 100% and 90% respectively. The TBN had a sensitivity of 97% at 50 dB NPS and 93% at 60 dB NPS and specificity of 80% at 50 dB NPS and 90% at 60 dB NPS. Conclusions: The application of RDB to 60 dB NPS showed sensitivity rates of 93% and specificity of 90%. These rates are consistent with those obtained by the OAE and the ABR (recommended tests to identify the stage of hearing screening programs). |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-05-25 2021-01-06T00:19:17Z 2021-01-06T00:19:17Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/34634 |
url |
http://hdl.handle.net/1843/34634 |
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por |
language |
por |
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http://creativecommons.org/licenses/by-nc-nd/3.0/pt/ info:eu-repo/semantics/openAccess |
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http://creativecommons.org/licenses/by-nc-nd/3.0/pt/ |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de Minas Gerais Brasil ICB - INSTITUTO DE CIÊNCIAS BIOLOGICAS Programa de Pós-Graduação em Neurociências UFMG |
publisher.none.fl_str_mv |
Universidade Federal de Minas Gerais Brasil ICB - INSTITUTO DE CIÊNCIAS BIOLOGICAS Programa de Pós-Graduação em Neurociências UFMG |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UFMG instname:Universidade Federal de Minas Gerais (UFMG) instacron:UFMG |
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Universidade Federal de Minas Gerais (UFMG) |
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UFMG |
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UFMG |
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Repositório Institucional da UFMG |
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Repositório Institucional da UFMG |
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Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG) |
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repositorio@ufmg.br |
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1816830010570309632 |