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Master's Dissertation
DOI
Document
Author
Full name
Ana Cecília Grilli Fernandes Stefanelli
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Furtado, Erikson Felipe (President)
Rossi, Natalia Freitas
Linhares, Maria Beatriz Martins
Zanchetta, Sthella
Title in Portuguese
Avaliação audiológica e hiperacusia nos Transtornos do Espectro Autista
Keywords in Portuguese
Adolescência
Complexo olivococlear medial
Hiperacusia
Infância
Transtorno do espectro autista
Vias auditivas
Abstract in Portuguese
Embora hiper-reatividade auditiva (HRA) e/ou hiperacusia (HPA) sejam manifestações frequentes no Transtorno do Espectro Autista (TEA) são poucos os estudos que investigaram este sintoma com medidas fisiológicas ou exploraram os mecanismos auditivos neurais que podem estar associados a esta característica. O principal objetivo deste trabalho foi estudar a queixa subjetiva (o sintoma) e o desconforto observável (o sinal) da HPA no TEA e avaliar a relação com o efeito inibitório do complexo olivococlear medial (EICOCM). Foram recrutadas 13 crianças e adolescentes com TEA (idade média = 7,2 anos) de ambos os sexos, e 11 crianças e adolescentes com desenvolvimento típico (idade média = 7,2 anos) de ambos os sexos. Para avaliar a HPA, todos os sujeitos responderam a um questionário de caracterização desse sintoma. As medidas psicoacústicas e eletroacústicas permitiram a determinação da sensibilidade auditiva, do funcionamento coclear, do nível de desconforto auditivo e do campo dinâmico da audição. Para a avaliação da via eferente, o EICOCM foi investigado pelas emissões otoacústicas evocadas transientes com ruído contralateral. Os resultados mostraram que o grupo com TEA apresentou desconforto em intensidades mais baixas nas frequências de 1 kHz, 2 kHz e 4 kHz (1 kHz, t = 1,99, p = 0,059; 2 kHz, t = 2,16, p = 0,042; 4 kHz, t = 2,37, p = 0,028), e menor faixa dinâmica auditiva em comparação com o grupo controle, sendo que nas frequências de 0,5 kHz, 4 kHz e 8 kHz houve diferenças estatisticamente significantes (respectivamente: 0,5 kHz p = 0,03; 4 kHz p = 0,01 e 8 kHz p = 0,03). As emissões otoacústicas evocadas transientes evidenciaram amplitudes de resposta coclear semelhante entre os grupos, porém, o efeito inibitório não: o grupo com TEA apresentou valores menores em comparação ao grupo controle (F(4;76) = 3,49, p = 0,01). Houve correlação positiva entre o EICOCM e a medida do campo dinâmico da audição. Crianças e adolescentes com TEA apresentaram maior ocorrência de hiperacusia, o que pode indicar que esse sinal está relacionado a um déficit no EICOCM
Title in English
Audiological evaluation and hyperacusis in Autistic Spectrum Disorder
Keywords in English
Adolescence
Auditory pathways
Autism spectrum disorder
Childhood
Hyperacusis
Medial olivocochlear bundle
Abstract in English
Although auditory hyper-responsiveness (AHR) and/or hyperacusis is a frequent manifestation in Autism Spectrum Disorder (ASD), few studies have investigated this symptom with physiological measures or explored the neural auditory mechanisms that may be associated with this characteristic. The main objective was to study the complains (symptom) and the evident discomfort (sign) of hyperacusis in ASD and to evaluate its relationship with the inhibitory effect of the medial olivocochlear bundle (MOCB). Two groups, one of 13 children and adolescents with ASD (mean age = 7.2 years) of both sexes, and other with 11 children and adolescents typically developed (mean age = 7.2 years) of both sexes, were recruited. To assess hyperacusis, all subjects answered a questionnaire characterizing this symptom. The psychoacoustic and electroacoustic measurements allowed the determination of auditory sensitivity, cochlear functioning, level of auditory discomfort and auditory dynamic range. For the evaluation of the efferent pathway, the inhibitory effect of the MOCB was assessed by transient evoked otoacoustic emissions with contralateral noise. The results showed that the group with ASD presented discomfort at lower frequencies in the frequencies of 1, 2 and 4 kHz (1 kHz, t = 1.99, p = 0.059; 2 kHz, t = 2.16, p = 0.042; 4 kHz, t = 2.37, p = 0.028), and lower auditory dynamic range in comparison with the control group, while for the frequencies of 0, 5, 4 and 8 kHz, a statistically significant difference was found (respectively: 0.5 kHz p = 0.03; 4 kHz p = 0.01 and 8 kHz p = 0.03). Transient evoked otoacoustic emissions showed similar cochlear response amplitudes between groups, while the inhibitory effect did not: the group with ASD presented lower values in comparison to the control group (F(4;76) = 3.49, p = 0,01). There was a positive correlation between the inhibitory effect of the MOCB and the auditory dynamic range measurement. Children and adolescents with ASD had a higher occurrence of hyperacusis, which may point out that this sign is associated with a deficit in the inhibitory effect of MOCB
 
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Publishing Date
2019-08-28
 
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