Prevalence of attention deficit hyperactivity disorder (ADHD) in children presenting with self-inserted nasal and aural foreign bodies

Introduction

Attention deficit hyperactivity disorder (ADHD) is one of the commonest behaviour disorders in children, characterized by hyperactivity, inattention and impulsiveness. Tendency towards risk-taking behaviour and accident proneness is well recognized in these children. Accordingly, it could be hypothesized that children with ADHD are at increased risk for self-inserting foreign bodies, but a Medline search did not reveal any studies that investigated this possibility.

Objectives

To study the prevalence of ADHD among children seen with self-inserted foreign bodies.

Method

Children attending ENT service in a tertiary care children's hospital with self-inserted foreign bodies were assessed for the presence of ADHD. Two rating scales, Strengths and Difficulties Questionnaire (SDQ)-Parent Version, and Conners Parent Rating Scale (CPRS) were used to identify the cardinal features of ADHD.

Results

A total of 34 children, age 3-10 years, participated in the study. Majority (51.6%) were female. Nearly 25% had one or more previous incidents of foreign body insertion and 20% had previous accidental injuries that needed hospitalization. A prevalence of 14.3% for ADHD was identified, which is almost 3 times more than that reported in a previous study among children attending medical and surgical outpatient clinics (5.1%). High rates for abnormal hyperactivity scores were reported by parents, 37.4% with SDQ and 20% with CPRS. Although 64.7% of the sample was under 5 years, almost all children who were identified with ADHD belonged to 5-10 year age group, thus effectively excluding younger aged children who may have age related apparent hyperactivity.

Conclusions

Awareness of possible association between self-insertion of foreign bodies and ADHD is needed and an assessment for hyperactivity/ADHD is justified in such children, especially in those over the age of 5 years.     

Cognitive potential of children with attention deficit and hyperactivity disorder

The literature has described comorbidities among the symptoms of children with Attention Deficit and Hyperactivity Disorder (ADHD) and the auditory processing changes, and these symptoms have been overlooked in the assessment, and consequently, on the rehabilitation of these individuals.ObjectiveTo compare the findings of the long latency auditory evoked potentials in children with and without ADHD.MethodThis is a historical cohort cross-sectional case-control study, in which we enrolled 30 children with and without ADHD, aged 8-12 years. We performed the long-latency auditory evoked potential test in two scanning procedures through passive and active tasks differing in frequency and duration (MMNf and MMNd) (P300f and P300D).ResultsWhen comparing the performance of children with and without ADHD in the electrophysiological test assessment of hearing, we found significant differences concerning the P2 amplitude in the LE - which was higher for the ADHD group; and concerning the N2 amplitude and latency - which were abnormal in the ADHD group.ConclusionThis study provided a greater understanding of the central auditory pathways of children with and without ADHD when evaluated from electrophysiological tests.     

The age dependent relationship between facial fractures and skull fractures

OBJECTIVE: To provide clinical evidence to support the age dependent relationship between facial fractures and skull fractures. DESIGN: Retrospective chart review of all children and adults admitted with combined facial fractures and skull fractures and skull fractures alone between January 1991 and November 1997. SETTING: The Albany Medical Center Hospital, a tertiary level-one trauma center. PATIENTS: Two hundred and one children, ages 1 month to 17 years, with skull fractures (frontal, parietal, or temporal), and 41 children with concurrent facial fractures were included in this study. One hundred and thirty-nine adults, ages 18-90 years, with skull fractures, and 70 adults with concurrent facial fractures were also studied. OUTCOME MEASURES: The gender, age, skull fracture, facial fracture, Glasgow coma score (GCS), mechanism of injury, and outcome of all patients admitted with frontal, parietal, or temporal fractures with or without facial fractures. RESULTS: There are a significantly greater (P < 0.001) number of facial fractures associated with skull fractures among adults as compared to children. Moreover, there is an exponential rise in facial fractures associated with skull fractures between infancy and adolescence. The GCS of children with combined facial and skull fractures is significantly lower than in those with skull fractures only (P < 0.001). CONCLUSION: The spectrum of craniofacial injuries is related to the specific developmental stage of the craniofacial skeleton. This is demonstrated by the variable pattern of combined facial and skull fractures observed clinically in children and adults.     

Hearing evaluation in chronic renal failure children

Chronic renal failure (CRF) causes a lot of systemic side-effects, among them: neurological and otological complications. In present study hearing evaluation was made in young patients, using distortion product otoacoustic emissions (DPOAEs) and auditory brainstem responses (ABR). THE AIM OF STUDY: (1) objective assessment of hearing organ activity in CRF children, (2) localization of hearing organ part involved in CRF, (3) establishing best parameters of ipsilateral stimulation in DPOAEs for clinical use. MATERIALS AND METHODS: Hearing acuity was assessed in 22 CRF children ranging in age from 9 to 17 years and 18 healthy children ranging in age from 10 to 18 years. At first pure tone audiometry and tympanometry were evaluate. Only patients with normal middle ear condition and hearing threshold better than 30 dB HL were put forward further investigations. Objective assessment of hearing condition included: (1) DPOAEs using DP-gram format. Two simultaneous pure-tone signals (primaries) were presented to the ear at two different frequencies (f1 and f2, where f2 > f1) and the 2f1-f2 were analyzed. Five pairs of non equal level and L2 were used L1 and L2: panel A1: L1 = 65 and L2 = 60 dB SPL, panel A2: L1 = 63 and L2 = 55 dB SPL, panel A3: L1 = 59 and L2 = 45 dB SPL, panel A4: L1 = 55 and L2 = 35 dB SPL, panel A5: L1 = 51 and L2 = 25 dB SPL; (2) ABR investigation using click stimulus, at 90 dB nHL level. Wave I, III, V latencies and intervals I-III, III-V, I-V were evaluated. Our results reviled significantly lower mean DPOAEs amplitudes in CRF children when compare to healthy children, at all frequencies measured. No differences in ABR evaluation were observed. Most optimal DPOAEs parameters in clinical use seem to be panel A1, A2 and A3 of level L1 and L2.     

Pneumococcal serum antibody concentrations during the first three years of life: a study of otitis-prone and non-otitis-prone children

One hundred and thirteen children were followed prospectively from birth until the age of 3, serum being obtained from cord blood, and at the ages of 3, 6, 12, 18, 24, 30 and 36 months. Thirteen children developed recurrent acute otitis media (rAOM), 29 remained very healthy and the remaining children formed an intermediate group. Cord serum concentrations were determined of total IgG class, of IgG1 and IgG2 subclasses, as well as of specific IgG antibodies against the pneumococcal capsular types, 3, 6A and 19F. The specific pneumococcal IgG as well as IgA and IgM antibodies were also followed in the sequential serum samples up to the age of 3 in the rAOM and healthy children. Despite total IgG class and IgG1 and IgG2 subclass concentrations being of the same magnitude in cord serum of rAOM (median: 11.15, 7.48 and 2.16 g/l for IgG, IgG1 and IgG2, respectively) as in that of healthy children (median: 10.21, 8.16 and 2.16 g/l, respectively), both in cord serum and in most serum samples drawn during the first year of life, specific IgG antibodies against types 6A and 19F, but not against type 3, were significantly lower in the rAOM group than in the healthy children. In the intermediate group, cord serum concentrations of specific IgG antibodies to type 6A were of the same magnitude as in the healthy children. The only significant difference in specific IgM and IgA antibody concentrations against types 3, 6A and 19F between the two groups was noted for type 6A antibodies at 36 months of age where rAOM children exhibited lower values. The results indicate an association between pre-existing low specific IgG antibody levels against AOM-associated pneumococcal types and the development of rAOM.     

p75NTR and sortilin increase after facial nerve injury

OBJECTIVES: After axotomy, Schwann cells (SCs), required for successful nerve regeneration, undergo a number of cellular changes including dedifferentiation, proliferation, expression of molecules that support axon growth, and apoptosis. This study investigated the role of p75, sortilin, and proneurotrophins in SC survival after facial nerve (FN) axotomy. STUDY DESIGN: Preliminary animal study. METHODS: With use of FN SCs, expression of p75 and its coreceptor sortilin were quantified by immunofluorescence on days 12, 22, and 52 after axotomy in vivo and by Western blot in vitro. Contralateral FNs served as a control. SC apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). To verify a causative role for p75 in FN SC death, cultured FN SCs were treated with pro-nerve growth factor (NGF), and apoptosis was determined by TUNEL. RESULTS: Expression of p75 and sortilin increased in FN SCs distal (P < .05) to the axotomy compared with the contralateral controls for all time points. SC apoptosis also significantly increased in the distal segment compared with the contralateral and proximal portions (P < .05). ProNGF, a p75 ligand, increased apoptosis and p75 expression in primary FN SC cultures. CONCLUSION: FN axotomy increases p75 and sortilin expression in SCs, which correlates with increased apoptosis. These findings suggest roles for p75 and sortilin in SC loss after FN injury. Sortilin is a novel target in promoting FN healing after injury.     

Effect of adenotonsillectomy on attention deficit-hyperactivity disorder in children with adenotonsillar hypertrophy: A prospective cohort study

BackgroundThis study was conducted to explore the effect of adenotonsillectomy on the improvement of attention deficit hyperactivity disorder (ADHD) symptoms in children with adenotonsillar hypertrophy.MethodsThis prospective cohort study was conducted on 59 children aged 6–12 years with adenotonsillar hypertrophy and ADHD who were candidates for adenotonsillectomy at Besat Hospital, Hamadan University of Medical Sciences, in 2014. The status of ADHD was evaluated at baseline and one and three months after surgery using Conners' Rating Scales.ResultsOf 59 children with ADHD (35 boys and 24 girls), 41 improved one month after surgery and 51 after three months. Only 8 children had no improvement. The Conners' score decreased significantly from 71.37 at baseline to 61.31 (P = 0.001) and 49.14 (P = 0.001) one and three months after surgery, respectively. The score of attention deficit and hyperactivity decreased from 1.76 and 2.10 at baseline to 1.52 and 1.83 after one month (P = 0.001) and to 1.24 and 1.52 after three months (P = 0.001), respectively. The results were statistically significant for both boys and girls.ConclusionThis study indicated that adenotonsillectomy can significantly improve ADHD in children with adenotonsillar hypertrophy and help them return to normal life.     

儿童头颅侧位片测量参数对腺样体肥大诊断价值的研究

目的 获取儿童头颅侧位片指标参数值,以期发现用于儿童腺样体肥大辅助诊断的相关指标。方法 选取2020年7月至2021年7月期间到山东大学齐鲁医院耳鼻喉科就诊并确诊腺样体肥大的3～10岁患儿(A/N≥0.71)480例(男女各240例)。采用MIMICS 21.0软件对480例患儿侧位片的9项观测指标进行观测和分析,数据通过SPSS 22.0进行各项统计分析。结果 其中NS/TS(X₂)、PNS-UPW(X₅)、SPP-SPPW(X₆)、∠U1-LI(X₇)、∠UI-NA(X₈)、∠LI-NB(X₉)6项指标与A/N(X₁)指标存在强线相关性关系。结论 头颅侧位片相关指标对于儿童腺样体肥大诊疗具有较高的价值,其中NS/TS(X₂)、PNS-UPW(X₅)、SPP-SPPW(X₆)、∠U1-LI(X₇)、∠UI-NA(X₈)和∠L...     

Efficacy of isotonic nasal wash (seawater) in the treatment and prevention of rhinitis in children

OBJECTIVE: To evaluate the potential of nasal isotonic saline application to prevent reappearance of cold and flu in children during the winter. DESIGN: Prospective, multicenter, parallel-group, open, and randomized comparison. SETTING: Eight pediatric outpatient clinics. PATIENTS: A total of 401 children (aged 6-10 years) with uncomplicated cold or flu. INTERVENTIONS: We randomly assigned patients to 2 treatment groups, one with just standard medication, the other with nasal wash with a modified seawater solution (Physiomer) plus standard medication, and observed them for 12 weeks. MAIN OUTCOME MEASURES: The primary efficacy end points were nasal symptoms resolution during acute illness (visits 1 and 2). We also looked for reappearance of cold or flu, consumption of medication, complications, days off school, and reported days of illness during the following weeks when preventive potential was evaluated (visits 3 and 4). RESULTS: At visit 2, patients in the saline group achieved primary end points (measured on a 4-point numeric scale on which 1 indicated no symptoms and 4, severe symptoms) in the parameters nasal secretion and obstruction (mean scores vs nonsaline group, 1.79 vs 2.10 and 1.25 vs 1.58, respectively) (P < .05 for both). During the prevention phase (at visit 3, 8 weeks after study entry) patients in the saline group showed significantly lower scores in sore throat, cough, nasal obstruction, and secretion (P < .05 for all). By visit 3, significantly fewer children in the saline group were using antipyretics (9% vs 33%), nasal decongestants (5% vs 47%), mucolytics (10% vs 37%), and systemic antiinfectives (6% vs 21%) (P < .05 for all). During the same period children in the saline group also reported significantly fewer illness days (31% vs 75%), school absences (17% vs 35%), and complications (8% vs 32%) (P < .05 for all). Similar results were found at the final visit. CONCLUSION: Children in the saline group showed faster resolution of some nasal symptoms during acute illness and less frequent reappearance of rhinitis subsequently.     

Attention deficit hyperactivity disorder symptoms in children with vocal fold nodules

ObjectivesThe aim of this case–control study was to investigate the symptoms of attention-deficit/hyperactivity disorder (ADHD) in children with vocal fold nodules (VNs).MethodsStudy group (SG) included children between 4 and 12 years. As a control group (CG), children between 4 and 12 years without VNs were included in the study. Parents of the participants completed the Conners’ Parent Rating Scale-Revised: Short Form (CPRS-RS) which was used to analyze the symptoms of ADHD.ResultsForty-five children (30 boys and 15 girls) with VNs and 45 controls (30 boys and 15 girls) were enrolled in the study. Multivariate analysis of variance revealed that the CPRS-RS Hyperactivity and Oppositional Subscales were significantly higher in the SG than the CG (p < .05), after controlling the effects of age and gender.ConclusionsOur findings suggest associations between VNs and hyperactivity and oppositional behaviors in children. Clinicians should be aware of ADHD symptoms in children with VNs.     

Auditory brainstem response,middle latency response,and late cortical evoked potentials in children with learning disabilities

Auditory evoked potentials (AEPs) and behavioral tests were used to evaluate auditory processing in 10 children aged 7 to 11 years who were diagnosed as learning disabled (LD). AEPs included auditory brainstem responses (ABRs), middle latency responses (MLRs), and late cortical responses (P1, N1, P2, P3). Late cortical responses were recorded using an active listening oddball procedure. Auditory processing disorders were suspected in the LD children after a psychologist found phonologic processing and auditory memory problems. A control group of 10 age- and gender-matched children with no hearing or reported learning difficulties was also tested. Teacher ratings of classroom listening and SCAN Competing Words and Staggered Spondaic Word scores were poorer in the LD children. There were minor ABR latency differences between the two groups. Wave Na of the MLR was later and Nb was smaller in the LD group. The main differences in cortical responses were that P1 was earlier and P3 was later and smaller in the LD group.     

The contribution of processing impairments to SLI: Insights from attention-deficit/hyperactivity disorder

Slowed speed of processing and impaired rapid temporal processing (RTP) have been proposed to underlie specific language impairment (SLI), but it is not clear that these dysfunctions are unique to SLI. We considered the contribution of attention-deficit/hyperactivity disorder (ADHD), which frequently co-occurs with language impairments, to performances on processing tasks. School-aged children who had SLI without concurrent ADHD (n = 14), ADHD without concurrent SLI (n = 14), and typical development (TD, n = 28) performed two nonverbal speeded tasks and one auditory RTP task. RTP impairments were found in many children with SLI and ADHD, and some children with TD. Children with ADHD demonstrated slower processing speed than children with SLI or TD. Overall, findings questioned the uniqueness of these processing dysfunctions to language impairments and the validity of the behavioural paradigms traditionally used to estimate processing dysfunctions. Accounts of SLI should be further scrutinized by considering the influence of other disorders.Learning outcomes: Readers will (1) become familiar with areas of overlap between SLI and ADHD, (2) understand some of the confounds associated with behavioural measures of processing speed in children, and (3) recognize the value in testing models of language disorders by including participants with other types of disorders.     

腺样体肥大所致鼻气道阻塞对儿童颅面发育的影响

目的探讨腺样体肥大所致鼻呼吸阻塞对儿童颅面发育的影响。方法对30例腺样体肥大儿童（腺样体肥大组）和27例正常儿童（正常儿童组）分别进行声反射鼻测量和X线头颅测量。结果腺样体肥大组鼻咽腔容积为（15.49±6.59）cm3,较正常儿童组（20.78±4.91）cm减小,差异有统计学意义（P〈0.01）;腺样体肥大组鼻气道阻力为（5.58±3.28）cmH2O/Lmin,较正常儿童组（2.28±1.30）cmH2O/Lmin增大,差异有统计学意义（P〈0.01）。X线头颅测量显示腺样体肥大组儿童面部形态呈明显的垂直向生长,下颌后缩,下颌角变大,其中前下面高为（68.32±6.66）mm,较正常儿童组（62.09±6.30）mm增大,差异有统计学意义（P〈0.01）;面高比例为0.7±0.08,较正常儿童组0.77±0.11减小,差异有统计学意义（P〈0.05）。结论腺样体肥大可致鼻阻力增大和鼻咽腔容积减小;鼻气道阻塞可明显影响儿童颅面发育。     

Mucocele after transnasal endoscopic repair of traumatic anterior skull base fistula in children

Objectives

To report the long-term sinonasal complications after endoscopic repair of anterior skull base fractures in children. This study describes mucocele formation in 6 patients treated endoscopically for posttraumatic CSF fistulae. We aim to address possible etiologic factors, specific treatments and follow-up modalities.

Patients and methods

12 children, mean age 5.8 years (3-10), treated endoscopically at our institution between 2004 and 2010 for an anterior cranial base fracture complicated by a CSF fistula. An iatrogenic mucocele was observed in 6 cases. A retrospective review of the files of these 6 patients was carried out demonstrating demographic characteristics, presenting signs/symptoms, site of skull base defect, repair technique, timing and onset of the mucoceles, their presentation and management. A systematic CT-scan and/or MRI was carried out at 3 months, 1 year and then annually.

Results

3 patients presented after cranial trauma with persistent CSF nasal leak, and 4 with meningitis. Posttraumatic defects reached the posterior wall of the frontal sinus and the junction of ethmoid and frontal bone in 3 cases, and the cribriform plate in 3 cases. Endoscopic closure was performed in all cases, with the middle turbinate as an overlay patch. No recurrence of a CSF leak was observed. After a mean period of 16 months, a single iatrogenic mucocele was observed in 4 patients (radiological detection only), and multiple mucoceles in 2 patients. Surgical treatment was advocated in cases of proptosis, quick expansion of the mucocele leading to sinus bony wall remodelling or erosion (2 cases), and meningitis related to an erosion of the cribriform plate by the mucocele. Three mucoceles were successfully treated endoscopically, and 1 required an external approach.

Conclusion

Mucocele incidence after endoscopic repair of skull base fractures in children is not insignificant (50% in our 12 patients series). Paediatric anatomical features, cranial trauma, and the transethmoidal approach may play a role in mucocele pathogenesis. Long-term clinical and radiological follow-up is therefore recommended. These mucoceles may be managed endoscopically with good outcomes.     

女性胆结石患者垂体—性腺轴激素变化的研究

本文采用放射免疫法测定了62例女性胆囊结石和15例女性肝胆管结石患者血清 FSH、LH和血浆 E_2、P、T 的含量.并与42例正常妇女对照分析。实验结果表明育龄女性胆囊结石患者 E_2含量明显升高(P<0.01),T 含量显著减少(P<0.05),绝经后胆囊结石患者 T 含量明显减少(P<0.01),P 含量显著升高(P<0.01),育龄女性和绝经后胆囊结石患者 E_2/T 比值与对照组相比均有显著性差异(P<0.01),育龄女性肝胆管结石患者卵泡期 E_2、T 及 E_2/T 比值有显著性差异。提示女性胆结石患者存在明显的垂体一性腺轴激素合成或代谢的异常。     

Primary pediatric endonasal dacryocystorhinostomy—A review of 58 procedures

Objectives

The objectives of this study are to report the outcomes of pediatric patients with lacrimal system obstruction who underwent primary endoscopic dacryocystorhinostomy (EDCR).

Study design

The authors conducted a retrospective noncomparative case series.

Methods

The operative and postoperative data have been collected in 58 children aged between 3 months and 13 years (mean 4.1 years). The total of 58 primary EDCRs has been performed by two surgeons using a standardized surgical technique. The EDCRs were performed 52 times on one eye, 6 times on both eyes (3 times simultaneously, 3 times at the separate sitting with an interval of 4-6 months). The follow-up evaluations include taking history, clinical examinations including a fluorescein disappearance test.

Results

The follow-up interval ranged from 12 to 36 months (mean 17 months, median 15 months). The success rate was 51/58 (87.9%) in all 58 EDCRs. The success rate was 47/51 (92.2%) in the group of postsaccal obstructions, 3/5 (60.0%) in the group of postsaccal and suprasaccal obstrutions and 1/2 (50.0%) in presaccal obstructions. The procedures were successful in all eight children aged under 1 year old (100%) and in 14 of 15 children between 1 and 2 years old (93.3%). The silicone intubation was used in 54 EDCRs.

Conclusions

The endoscopic DCR is a safe and effective procedure for most children with the success rate comparable to that achieved in the external DCR and in adults. The success rate of the postsaccal obstructions is significantly higher than in presaccal or combined pre- and postsaccal obstructions.     

Topographic mapping of the auditory evoked potentials. I. Auditory cortex response and middle latency response]

Color imaging of the human auditory cortex response and middle latency response of 21 otologically normal young adults was studied. All the waveforms, latencies, amplitudes and the location of FNa, FPa, FN1, FP2 were analysed. Considerable variations about the foci location in normal adults were found in this study.     

Improved behavior and sleep after adenotonsillectomy in children with sleep-disordered breathing

OBJECTIVE: To determine changes in behavior and sleep in children before and after adenotonsillectomy for sleep-disordered breathing (SDB) using the validated Pediatric Sleep Questionnaire (PSQ) and Conners' Parent Rating Scale-Revised Short Form (CPRS-RS). DESIGN: Prospective, nonrandomized study. SETTING: Ambulatory surgery center affiliated with an academic medical center. PATIENTS: A total of 117 consecutive children (61 boys and 56 girls) (mean [SD] age, 6.5 [3.1] years) who were clinically diagnosed as having SDB and who had undergone adenotonsillectomy. Complete follow-up data were available in 71 of 117 patients (61%). INTERVENTIONS: Parents completed the PSQ and CPRS-RS before surgery and 6 months after surgery. MAIN OUTCOME MEASURES: Changes in age- and sex-adjusted T scores for all 4 CPRS-RS behavior categories (oppositional behavior, cognitive problems or inattention, hyperactivity, and Conners' attention-deficit/hyperactivity disorder [ADHD] index) were determined for each subject before and after surgery. Changes in PSQ scores from a select 22-item sleep-related breathing disorder subscale were also determined. RESULTS: Preoperatively, the mean (SD) T scores on the CPRS-RS for oppositional behavior, cognitive problems or inattention, hyperactivity, and ADHD index were 59.4 (13.7), 59.5 (13.6), 62.0 (14.4), and 59.9 (13.4), respectively. A T score of 60.0 in any category placed a child in the at-risk group. Postoperatively, T scores for each category were 51.0 (9.6), 51.2 (8.8), 52.4 (10.52), and 50.6 (7.8), respectively. All changes were statistically significant (P<.001) and clinically significant by approximating a change of 1 SD from the baseline score. For the PSQ, the preoperative and postoperative mean (SD) scores were 0.6 (0.1) and 0.1 (0.1), respectively, on a scale of 0 to 1, with scores higher than 0.33 suggesting obstructive sleep apnea. Correlations between sleep and behavior scores were statistically significant before surgery (P=.004 for ADHD index and cognitive problems, P=.008 for oppositional behavior) and after surgery (P=.049 for cognitive problems, P=.03 for oppositional behavior). Higher baseline T scores for the CPRS-RS were associated with larger changes in T scores for the CPRS-RS in all 4 domains (oppositional behavior, cognitive problems or inattention, hyperactivity, and ADHD index). CONCLUSIONS: Children diagnosed as having SDB experience improvement in both sleep and behavior after adenotonsillectomy. The PSQ and CPRS-RS may be useful adjuncts for screening and following children who undergo adenotonsillectomy for SDB.     

Auditory brainstem responses as a clinical evaluation tool in children after perinatal encephalopathy

Auditory brainstem responses (ABR) reveals the neurophysiological status of the neural axis. In this study we compared the ABR of healthy children, under 1-year-old, with children who suffered from perinatal encephalopathy (PE). OBJECTIVE: The purpose of this study was to characterize the ABR differences between children with PE and healthy children in order to identify groups with specific neurophysiological profiles, associated with their neurological condition. METHODS: Thirty-six children with perinatal encephalopathy (PE) and 36 healthy children, ages 1-12 months, were studied. The variables considered were: latencies of waves I, II, N1, III, V, and N2; interpeak latency interval (IPL) of waves I-III, III-V, and I-V; as well as amplitudes of waves I, III, and V. The results were analyzed using ANOVA, as well as Ji(2), and Ward's cluster analysis. RESULTS: The absolute latencies of the ABR showed an inverse correlation with the children's age. Latencies of waves I, II, N1, V, and N2, IPL III-V, and amplitude of waves III and V show significant differences (p<0.05) between healthy and PE children. Children with PE showed greater absolute latencies and larger wave amplitudes than the control group. Ward's cluster analysis, used to define the groups with similar functional characteristics, revealed three groups: fast, intermediate, and slow-responders, depending on their wave latencies and IPL wave amplitudes. These groups were gender- (p<0.03), age- (p<0.0001), and neurological damage- (p<0.01) related. CONCLUSIONS: Our data clearly show that the ABR obtained from PE children differ from ABR obtained from healthy children. PE infants showed larger wave latencies, intervals amplitudes than the control group. Three functional profiles resulted from the groups established using the Ward's method, and these indicate their neurological functional condition.     

Classification of passive auditory event-related potentials using discriminant analysis and self-organizing feature maps

Discriminant analysis (DA) and self-organizing feature maps (SOFM) were used to classify passively evoked auditory event-related potentials (ERP) P(1), N(1), P(2) and N(2). Responses from 16 children with severe behavioral auditory perception deficits, 16 children with marked behavioral auditory perception deficits, and 14 controls were examined. Eighteen ERP amplitude parameters were selected for examination of statistical differences between the groups. Different DA methods and SOFM configurations were trained to the values. SOFM had better classification results than DA methods. Subsequently, measures on another 37 subjects that were unknown for the trained SOFM were used to test the reliability of the system. With 10-dimensional vectors, reliable classifications were obtained that matched behavioral auditory perception deficits in 96%, implying central auditory processing disorder (CAPD). The results also support the assumption that CAPD includes a 'non-peripheral' auditory processing deficit.