Effects of hypothermia on brainstem auditory evoked potentials in humans

Ten adult patients who underwent open heart surgery under induced hypothermia had brainstem auditory evoked potentials (BAEPs) recorded at 1 degree- to 2 degrees C-steps as body temperature was lowered from 36 degrees C to 20 degrees C to determine temperature-dependent changes. Hypothermia produced increased latencies of BAEP waves I, III, and V; the prolongation was more severe for the later components with the result that interpeak latencies I-III, III-V, and I-V were also prolonged. The temperature-latency relationship was nonlinear and best expressed by exponential curve. The latencies of waves I, III, V and the interpeak latency I-V increased roughly 7% for each 1 degree C drop; they doubled at a temperature around 26 degrees C. The amplitude of the BAEP components had a quasiparabolic relationship to temperature; the amplitude rose with hypothermia to 28 degrees or 27 degrees C, but decreased linearly with further cooling. All BAEP components were present at temperatures above 23 degrees C and absent below 20 degrees C. With rewarming, the changes reversed and BAEPs returned to initial prehypothermia status.     

Click spatial position influences middle latency auditory evoked potentials (MAEPs) in humans

Middle latency auditory evoked potentials (MAEPs) were elicited by monaural and binaural clicks. The Na component (latency 15.8 msec) was larger in amplitude and shorter in latency at electrodes contralateral to the stimulated ear in monaural conditions, but showed no evidence of binaural occlusion. The Pa (28.4 msec) and Nb (42.0 msec) components did not change in amplitude or distribution as a function of the ear of stimulus delivery, but were smaller following binaural stimulation than would have been predicted from separately recorded monaural responses. These results indicate that functionally distinct generator systems are responsible for different components of the MAEP. The generators of the Na are more effectively activated by contralateral inputs. In contrast, the generators of the Pa and Nb receive equally effective and convergent inputs from the two ears.     

Auditory and somatosensory evoked potentials (AEPs and SEPs) and ballistic movements in parkinson disease

In five patients with initial idiopathic Parkinson disease AEPs (early and late components of auditory evoked potentials), SEPs (somatosensory evoked potentials) and arm ballistic movements (abduction of the humerus) were studied. Experimental sessions were conducted before starting treatment (L-Dopa plus Carbidopa) and at two and six month intervals. Before treatment evoked potential abnormalities were found in four out of five patients; EMG patterns underlying ballistic arm abduction movements were altered in all patients; corresponding prolonged duration of initial movements and low mean velocities were found. After treatment AEP and SEP showed a reduction of previously observed abnormalities and both EMG patterns and kinematic variables consistently improved. It is suggested that the electrophysiological investigations employed in this preliminary study may be a useful tool in clinical and pharmacological researches on Parkinson disease.

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Sommario Sono stati studiati in 5 pazienti affetti da sindrome di Parkinson idiopatica iniziale gli AEPs (componenti precoci e tardive), i SEPs ed i movimenti balistici (abduzione dell'omero). Lo studio è stato condotto prima dell'inizio della terapia (L-Dopa+Carbidopa), e due e sei mesi dopo l'inizio della terapia. Anomalie dei potenziali evocati sono state riscontrate prima dell'inizio della terapia in 4 pazienti. I dati elettromiografici relativi ai movimenti balistici di abduzione del braccio erano alterati in tutti i pazienti ed erano caratterizzati da un ritardo nell'inizio del movimento e da una diminuizione della velocità media.Dopo la terapia si è rivelata una riduzione delle anomalie precedentemente riscontrate per gli AEPs ed i SEPs ed anche i patterns EMG e le variabili kinematiche sono apparse notevolmente migliorati. Dall'analisi di questi risulati sembra emergere la possibilità che queste metodiche neurofisiologiche possano essere utilizzate quale mezzo per controllare la progressione della sindrome e l'efficacia di eventuali trials farmacologici.

     

Effects of Hypericum extract (LI160) on the change of auditory evoked potentials by cortisol administration

Target symptoms treated with Hypericum extract, i.e. somatisation, fatigue and depression could be related to an increased activity of glucocorticoids in the brain. One potential mechanism is the increased permeability of the blood-brain barrier for glucocorticoids. Hypericum extract LI160 reduces intracerebral glucocorticoid concentration possibly by its action to induce the expression of the transport protein P-glycoprotein (P-gp). To test this hypothesis directly, we performed a randomised double-blind crossover study to examine the effect of intravenously administered cortisol on auditory evoked potentials (AEPs) and salivary cortisol concentration. Nineteen healthy subjects were treated for 2 weeks with 300 mg LI160 twice a day or placebo. On the 14th day, AEPs were recorded every 30 min, at times -60, -30 and 0 min before the start of the infusion and at +30, +60 and +90 min after starting the infusion. The rate of infusion was 20 mg cortisol/h. No changes in the AEP, especially the N1-P2 component, could be observed under cortisol infusion and consequently no modification with the treatment of Hypericum extract. The salivary concentration of cortisol under cortisol infusion was slightly but significantly decreased in the Hypericum condition compared to placebo. The results of the present study are therefore inconclusive with respect to the influence of LI160 treatment on the expected cortisol-induced AEP changes, but support the concept of an action of Hypericum on P-gp function by the observed changes in salivary cortisol.     

Brainstem auditory evoked potentials and middle latency auditory evoked potentials in young children

Measurements of brainstem auditory evoked potentials (BAEP) and middle latency auditory evoked potentials (MLAEP) are readily available neurophysiologic assessments. The generators for BAEP are believed to involve the structures of cochlear nerve, cochlear nucleus, superior olive complex, dorsal and rostral pons, and lateral lemniscus. The generators for MLAEP are assumed to be located in the subcortical area and auditory cortex. BAEP are commonly used in evaluating children with autistic and hearing disorders. However, measurement of MLAEP is rarely performed in young children. To explore the feasibility of this procedure in young children, we retrospectively reviewed our neurophysiology databank and charts for a 3-year period to identify subjects who had both BAEP and MLAEP performed. Subjects with known or identifiable central nervous system abnormalities from the history, neurologic examination and neuroimaging studies were excluded. This cohort of 93 children up to 3 years of age was divided into 10 groups based on the age at testing (upper limits of: 1 week; 1, 2, 4, 6, 8, 10 and 12 months; 2 years; and 3 years of age). Evolution of peak latency, interpeak latency and amplitude of waveforms in BAEP and MLAEP were demonstrated. We concluded that measurement of BAEP and MLAEP is feasible in children, as early as the first few months of life. The combination of both MLAEP and BAEP may increase the diagnostic sensitivity of neurophysiologic assessment of the integrity or functional status of both the peripheral (acoustic nerve) and the central (brainstem, subcortical and cortical) auditory conduction systems in young children with developmental speech and language disorders.     

The adaptation of cochlear and brainstem auditory evoked potentials in humans.

The adaptation of the responses from the cochlear nerve and the auditory brainstem nuclei was studied using a burst of four clicks as the stimulus. Nine experimental conditions were obtained from three stimulus levels (60, 70 and 80 dB SL) and from three intervals between click in the burst (15, 24 and 32.5 msec). Six subjects were each tested three times for each of the experimental conditions and the techniques used and results obtained are summarized. Various models of the adaptation of the brainstem responses are proposed which predict different results. The results for the adaptation of the N1 response are basically in agreement with previous work, and the more central brainstem responses showed less adaptation than the peripheral responses. These findings may be explained by postulating different adaptation mechanisms for the peripheral and central responses. The 60dB stimulus level condition gave rise to more adaptation than the 80dB level, and this is in agreement with studies of low and high threshold reception systems reported elsewhere.     

Middle latency auditory evoked potentials (MLAEPs) in (MS)

Middle latency auditory evoked potentials (MLAEPs) were studied in 30 definite multiple sclerosis (MS) patients in addition to brain-stem auditory evoked potentials (BAEPs). BAEP abnormalities were detected in 18 (60%) patients. MLAEPs were abnormal in 22 (73%) of them. In 15 patients BAEPs and MLAEPs were both abnormal. MLAEPs were found abnormal in 7 of the 12 patients with normal BAEPs. In 18 patients with abnormal BAEPs only 3 had normal MLAEPs. MLAEPs abnormalities are consistent with a rostral auditory pathway involvement. Therefore, they can be used in combination with BAEPs to examine the whole auditory system to improve the sensitivity.     

Changes of middle latency auditory evoked potentials during natural sleep in humans

During natural nocturnal sleep, Na and Pa middle latency auditory evoked potentials (MLAEPs) underwent significant variations which were related to sleep stages. The deepening of sleep from stage II to stage IV was paralleled by a latency shift and an amplitude decrease of Na and Pa, while MLAEPs were similar in wakefulness and REM sleep. Moreover, Na and Pa components tended to shift over the hemisphere contralateral to the stimulated ear during sleep. These findings demonstrate that the responsiveness of the auditory cortex to acoustic stimuli is modulated during sleep. Vigilance should be monitored during MLAEP recordings in patients.     

Early auditory evoked potentials (EAEP) in vertebral basilar insufficiency

Stimulation with a short tone pip elicits an acoustic nerve compound action potential (I) and different waves (II--VII) in the inital 10 ms. Seven waves have been studied in 40 control subjects and five waves in 12 patients with vertebral-basilar insufficiency. Abnormalities of the different waves were observed at levels such as cochlea and/or acoustic nerve, medulla, caudal pons, rostral pons, and midbrain. The recording of early auditory evoked potentials (EAEP) is a noninvasive method of confirming impairment of the auditory pathway caused by a reduced vascular supply of vertebral and basilar arteries.     

Effects of laserneedle stimulation in the external auditory meatus on brainstem and very early auditory evoked potentials in humans

OBJECTIVES: For the first time, brainstem auditory evoked potentials (BAEP) and very early auditory evoked potentials (EAEP) were investigated in 23 volunteers (mean age: 26.5 +/- 3.6 years) under resting conditions and during continuous and frequency modulated (2 Hz) laser stimulation in the external auditory meatus. METHODS: Using a new ear adapter, the outer region of the auditory canal was stimulated with laser light (685 nm, 4 x 30-40 mW, duration: 10 minutes). RESULTS: The EAEPs were significantly changed during continuous (p=0.019), as well as frequency modulated (p=0.014) laser stimulation compared with control measurements. DISCUSSION: Physiologic alterations of inner ear mechanism such as extra-cerebral changes in conductance or stimulation-dependent depolarization processes in extra-cerebral regions of the auditory system could be possible explanations for the significant difference in measurement parameters.     

Early auditory evoked potentials (EAEP) in vertebral basilar insufficiency

Summary Stimulation with a short tone pip elicits an acoustic nerve compound action potential (I) and different waves (II–VII) in the initial 10 ms. Seven waves have been studied in 40 control subjects and five waves in 12 patients with vertebral-basilar insufficiency. Abnormalities of the different waves were observed at levels such as cochlea and/or acoustic nerve, medulla, caudal pons, rostral pons, and midbrain. The recording of early auditory evoked potentials (EAEP) is a noninvasive method of confirming impairment of the auditory pathway caused by a reduced vascular supply of vertebral and basilar arteries.     

Brain-stem auditory evoked potentials in squirrel monkey (Saimiri sciureus)

To more fully characterize brain-stem auditory evoked potentials (BAEPs) in non-human primates, BAEPs were recorded from chronically implanted epidural electrodes in 10 squirrel monkeys (Saimiri sciureus). The effects of stimulus intensity, repetition rate, and anesthesia (ketamine 20 mg/kg i.m.) on peak latencies and inter-peak intervals were evaluated. Monkey wave forms consisted of approximately 7 peaks (I-VII), each exhibiting similar latencies across sessions, with later peaks exhibiting greater variability. In some subjects, additional peaks (IIa, IIIa) and slow potentials were recorded. The slow potentials provided a substratum for peaks IV through VII. As with human, monkey peaks exhibited systematic changes in latency with changes in stimulus intensity or repetition rate. These shifts included significant decreases in latency with increasing intensity for peaks I-IV and increases in latency with increases in repetition rate for peaks III, V, and VI. Inter-peak intervals were similar to those observed in human. Furthermore, ketamine anesthesia significantly delayed the latencies of most peaks (except I, V, and VII). Some differences between monkey and human BAEPs were evident in the relative amplitude of specific peaks. For example, peak V is typically most prominent in human, while this was true for peak III in monkey. The similarities between unanesthetized monkey and human inter-peak intervals suggest that the times required for impulses to reach particular brain-stem areas are conserved across primate species that vary in brain size. This supports the hypothesis that comparably numbered BAEP peaks in monkey and human index homologous processes. The data also suggest that the differences between animal and human BAEPs commonly reported may result from the use of anesthetics. In summary, unanesthetized monkey BAEPs resemble human BAEPs in morphology, number of peaks, polarity, latency variability, inter-peak intervals, slow potentials superimposed on the high-frequency peaks, and variations in morphology, amplitude, and resolution of peaks as a function of recording site. Thus, unanesthetized monkey BAEPs may be an excellent model for investigating the neural substrates of human BAEP or for determining species differences in acoustic processing among primates.     

Trigeminal evoked potentials in humans

Techniques were described for recording trigeminal evoked potentials in humans in response to maxillary gum stimulation. Variations in the responses as a function of stimulating and recording electrode position and stimulus intensity were presented. A standard methodology was proposed in order to obtain the characteristic response repeatedly. The characteristic triphasic wave form consisted, primarily, of an N20, P34, N51 sequence of deflections. Average latencies of components were derived from recordings following stimulation of the asymptomatic side of the face in a patient population. Indirect tests supported the view that muscle potentials did not significantly contribute to the characteristic response. It was concluded that the techniques were suitable for electrophysiological testing of fifth nerve function in routine clinical applications.     

A preliminary report of evoked potential marker study of pattern shift visual evoked potentials (PS-VEP) and auditory evoked potentials (AEP) on schizophrenic twins

This paper reports the result of electroneurophysiological study of the pattern shift visual evoked potentials (PS-VEP) and auditory evoked potentials (AEP) on six pairs of schizophrenic twins. The result indicated that there were significant differences in the inter-pair variance between MZ and DZ in latency P2, amplitude P2-N2 and P2 of using PS-VEP. AEP was also used for this group cases, and the result showed the presence of statistical differences in the inter-pair variance of latency N2, amplitude N1-P2 and P2. The authors speculated upon that the above six electrophysiological markers may be related to genetic factors, which had been proved by the blood group, character, clinical symptoms and treatment response of those patients.     

Influence of extreme head rotations on brainstem auditory evoked potentials (BAEP)

The influence of extreme head rotations on BAEP was studied in 47 patients who had vertebral artery angiogram. Patients with and without unilateral hypoplasia of the vertebral artery (VA) lumen were identified and all patients were further divided into two groups: with and without hypertension. The subjects underwent a BAEP examination in three head positions: neutral position, extreme right and extreme left rotation. In the subgroup of patients with hypertension and unilateral VA hypoplasia, and following the rotation away from the non-hypoplastic vessel a statistically significant decrease in the PV wave amplitude and prolonged PV wave latency was found. Head maneuvers in subjects with normal blood pressure or in hypertensive patients with symmetrical VA did not cause significant changes in BAEP. These results document the effect of head rotation in subjects with potentially impaired collateral flow. An increase in the PV wave latency and decrease in its amplitude may reflect subtle changes in the brainstem perfusion in hypertensive patients. These changes maybe due to a reduced capacity to compensate for dynamic obstruction of VA following the head rotations.     

Middle latency auditory evoked potentials (MAEPs) in chronic schizophrenics.

Middle latency auditory evoked potentials were recorded in medicated chronic schizophrenics and controls at stimulation rates of 10/s, 2/s, and 1/s. Increasing the stimulation rate did not change Pa amplitude but decreased Pb amplitude. There was no difference between the two groups.     

Brainstem auditory evoked potentials in meningomyelocele

The brainstem auditory evoked potentials (BAEP) of twenty-seven Myelomeningocele (MMC) patients were analyzed and compared with the results of a normal population. The longest wave V or V-I interpeak latencies were seen in patients with shunted hydrocephalus and cranial nerve defects. The shortest wave V and V-I interpeak latencies were found in patients without hydrocephalus. However, these latencies of MMC patients were significantly longer than the latencies of a normal population. Wave I latencies of all MMC subgroups were not significantly different from the results of the normal probands. It is assumed that V-I interpeak latency prolongation in MMC patients, which is related to the severity of the clinical signs of the Arnold Chiari malformation, is mostly due to an elongation of the brainstem.     

Sensation seeking and auditory evoked potentials

The relationship between auditory evoked potentials (AEP) and the German version of Zuckerman's Sensation Seeking Scale was examined. The slope of the amplitude/stimulus intensity function (N1/P2 component) and the N1 latency were particularly studied, as these variables have been found to be potential predictors of the response to lithium prophylaxis. Thirty-three healthy subjects participated in two testing series on the first day and in a third run 3 weeks later. Binaural clicks at four intensity levels (58, 68, 78, 88 dB HL, ISI 2.1 sec) were presented in randomized order by headphone. Eighty responses were averaged at each intensity level. The pattern of correlation between the German version of the Sensation Seeking Scale and a personality inventory (FPI) supports the validity of the Sensation Seeking Scale. Only a tendency toward steeper slopes of the amplitude/stimulus intensity function (ASF) in high sensation seekers was observed in the first run. However, there was a significant interaction of sensation seeking and the test run. Only high sensation seekers showed an influence of retesting on the slope of the ASF, leading to a decrease of the slope in the second, compared with the first run. This might correspond to the psychological pattern of sensation seeking, which is characterized by a permanent need for new and exciting situations and, at the same time, by a rapid loss of interest in these situations. With regard to the N1 latency, a significant interaction of sensation seeking and lead was found. Low sensation seekers showed longer N1 latencies over the right than over the left hemisphere, a finding that accords with some psychophysiological theories on the relation between asymmetric hemispherical activation and certain psychological constructs. Our results support the view that sensation seeking is a personality feature that is closely related to certain physiological variables.     

Frontal auditory evoked potentials and augmenting-reducing

Auditory evoked potentials (AEPs) to tones (750 Hz--200 msec) ranging from 50 to 80 dB SPL were studied at Cz and Fz leads in 29 normal adults (15 males) ranging in age from 20 to 22. Peak-to-trough amplitudes were measured for the P1-N1 and the N1-P2 wave forms as well as baseline (500 msec prestimulus)-to-peak amplitudes for each component, i.e., P1, N1 and P2. Amplitudes were examined as a function of intensity and electrode location. Cz-Fz amplitude differences increased with increasing stimulus intensity, the differentiating peak being the N1 component. An overall reducing phenomenon was found at Fz in the 70-80 dB range whereas an augmenting effect was observed at Cz for these intensities. The augmenting/reducing groups defined by analysis of individual amplitude-intensity patterns were different whether we considered Fz or Cz results: Fz reducers were more numerous than Cz reducers. These results on prominent reducing at the frontal level were examined in relation to the data concerning the modulatory function of the frontal cortex on auditory EPs. Implications were drawn for the role of the frontal cortex in cortical augmenting-reducing.     

Expressed emotion and auditory evoked potentials

The expressed emotion (EE) of key relatives has been shown to predict the course of illness in psychiatric patients. In this study, we examined whether there might be physiological correlates to the EE index in nonbiological key relatives of patients with affective psychoses. High-EE and low-EE relatives were compared concerning their slopes of the amplitude/stimulus intensity function (auditory evoked N1/P2-component). We found that the slopes were clearly steeper in the case of low-EE relatives. In comparing the slopes of all key relatives with those of an age-matched control group without psychiatrically ill partners, we could find no differences. Therefore, the slope differences between high-EE and low-EE relatives do not seem to reflect differences in the illness of partners. We speculated whether a steep slope as well as low EE could be associated with an action-oriented, impulsive communication style, which would prevent the development of an affectively tense communication pattern.