Characteristics of brainstem auditory evoked potentials of students studying folk dance

BACKGROUND： Previous experiments have demonstrated that brainstem auditory evoked potential is affected by exercise, exercise duration, and frequency. OBJECTIVE： Comparing the brainstem auditory evoked potential of students studying folk dance to students studying other subjects. DESIGN： Observational contrast study. SETTING： Physical Education College, Shandong Normal University PARTICIPANTS： Fifty-five female students were enrolled at Shandong Normal University between September and December in 2005, including 21 students that studied folk dance and 34 students that studied other subjects. The age of the folk dance students averaged （19 ± 1） years and dance training length was （6.0 ± 1.5） years. The students that studied other subjects had never taken part in dance training or other physical training, and their age averaged （22 ± 1） years, body height averaged （162 ± 5） cm, body mass averaged （51 ± 6） kg. All subjects had no prior ear disease or history of other neurological disorders. All students provided informed consent for the experimental project. METHODS： The neural electricity tester, NDI-200 （Shanghai Poseidon Medical Electronic Instrument Factory） was used to examine and record Brainstem Auditory Evoked Potential values of the subjects during silence, as well as to transversally analyze the Brainstem Auditory Evoked Potential values. The electrode positions were cleaned and degreased with soapy water, followed by ethanol. The selected bipolar electrodes were situated on the head： recording electrodes were placed at the Baihui acupoint, and the reference electrode was placed at the mastoid of the measured ear, with grounding electrodes in the center of the forehead. Brainstem Auditory Evoked Potential values were elicited by monaural stimulation of a ＂click＂ though an earphone; the other ear was sheltered by the white noise. The click intensity was 102 db, the stimulation frequency was 30 Hz, the bandpass filters were 1 000-3 000 Hz, the sensitivity was 5 ta V, and a total of 2 000 sweeps were averaged. Waveform identification and analysis： various components of the Brainstem Auditory Evoked Potential values were identified, and the peak latencies and peak-peak values were analyzed. MAIN OUTCOME MEASURES： Latency of Ⅰ , Ⅱ, Ⅲ, Ⅳ, Ⅴ and Peak-Peak Value of Ⅰ, Ⅲ, Ⅴwere measured. RESULTS： Fifty-five subjects were enrolled in the final analysis, without any loss. Compared to the students who studied other subjects ① Ⅰ -Ⅴ peak latencies （PL）： Ⅳ PL of the right ear of the folk dance students was obviously longer （P 〈 0.05）; ② Ⅰ, Ⅲ, V peak-peak values：Ⅰ peak-peak values of the right ear were obviously higher （P 〈 0.05）. CONCUSION： ① PL of the right ear of the folk dance students was obviously longer, which indicates that dancing results in a stronger sensibility to auditory stimuli. ②. Peak-peak values were obviously higher, which indicates that long-term exercise enhances the music senses and synchrony of auditory nerve impulses.

Enhanced auditory evoked potentials in musicians:A review of recent findings

Auditory evoked potentials serve as an objective mode for assessment to check the functioning of the auditory system and neuroplasticity.Literature has reported enhanced electrophysiological responses in musicians, which shows neuroplasticity in musicians. Various databases including Pub Med, Google, Google Scholar and Medline were searched for references related to auditory evoked potentials in musicians from 1994 till date. Different auditory evoked potentials in musicians have been summarized in the present article. The findings of various studies may support as evidences for music-induced neuroplasticity which can be used for the treatment of various clinical disorders. The search results showed enhanced auditory evoked potentials in musicians compared to non-musicians from brainstem to cortical levels. Also, the present review showed enhanced attentive and pre-attentive skills in musicians compared to non-musicians.

Electroencephalogram and brainstem auditory evoked potential in 539 patients with central coordination disorder

BACKGROUND： Electroencephalogram （EEG） and brainstem auditory evoked potential （BAEP） are objective non-invasive means of measuring brain electrophysiology. OBJECTIVE： To analyze the value of EEG and BAEP in early diagnosis, treatment and prognostic evaluation of central coordination disorder. DESIGN, TIME AND SETTING： This case analysis study was performed at the Rehabilitation Center of Hunan Children＇s Hospital from January 2002 to January 2006. PARTICIPANTS： A total of 593 patients with severe central coordination disorder, comprising 455 boys and 138 girls, aged 1-6 months were enrolled for this study. METHODS： EEG was monitored using electroencephalography. BAEP was recorded using a Keypoint electromyogram device. Intelligence was tested by professionals using the Gesell scale. MAIN OUTCOME MEASURES： （1） The rate of abnormal EEG and BAEP, （2） correlation of abnormalities of EEG and BAEP with associated injuries, （3） correlation of abnormalities of EEG and BAEP with high risk factors. RESULTS： The rate of abnormal EEG was 68.6% （407/593 patients）, and was increased in patients who also had mental retardation （P 〈 0.05）. The rate of abnormal BAEP was 21.4% （127/593 patients）. These 127 patients included 67 patients （52.8%） with peripheral auditory damage and 60 patients （47.2%） with central and mixed auditory damage. The rate of abnormal BAEP was significantly increased in patients who also had mental retardation （P 〈 0.01 ）. Logistic regression analysis showed that asphyxia （P 〈 0.05）, jaundice, preterm delivery, low birth weight and the umbilical cord around the neck were closely correlated with abnormal EEG in patients with central coordination disorder, lntracranial hemorrhage, jaundice （P 〈 0.05）, low birth weight and intrauterine infection （P 〈 0.05） were closely correlated with abnormal BAEP in patients with central coordination disorder. CONCLUSION： Central coordination disorder is often associated with abnormal EEG and BAEP. The rate of EEG or BAEP abnormality is positively associated with the size of the brain injury. Asphyxia is a high risk factor for abnormal EEG in central coordination disorder. Jaundice and intrauterine infection are high risk factors for abnormal BAEP in central coordination disorder.

Characteristics of brainstem auditory evoked potential of neonates with mild or moderate hyperbilirubinemia

BACKGROUND： Brainstem auditory evoked potential （BAEP） has been widely used to evaluate the functional integrity and development of injured auditory system and brain, especially to objectively evaluate the function of auditory system and brain stem of very young babies, such as neonates and sick babies. OBJECTIVE： To observe the changes of BAEP of neonates with hyperbilirubinemia, and to investigate the relationship of bilirubin concentration and BAEP. DESIGN： An observation experiment. SETTING： Department of Pediatrics, the 309 Clinical Division, General Hospital of Chinese PLA. PARTICIPANTS： Fifty-eight neonates with mild or moderate hyperbilirubinemia exhibiting jaundice within 24 hours after born, who received the treatment in the Department of Pediatrics, the 309 Clinical Division, General Hospital of Chinese PLA between January 2004 and May 2007, were recruited in this study. The involved neonates, 31 boys and 27 girls, had gestational age of 37 to 46 weeks. They had no history of birth asphyxia, and were scored 8 to 10 points when born. Written informed consents of examination and treatment were obtained from the guardians of the neonates. This study was approved by the Hospital Ethics Committee. According to serum total bilirubin value, the neonates were assigned into 3 groups： low-concentration bilirubin group （n =16）, moderate-concentration bilirubin group （n =27） and high-concentration bilirubin group （n =15）. According to mean daily bilirubin increase, the subjects were sub-assigned into bilirubin rapid increase group （n =39） and bilirubin slow increase group （n = 19）. METHODS： After admission, all the neonates received drug treatment. Meanwhile, their 116 ears were examined with a myoelectricity evoked potential equipment （KEYPOINT） in latency, wave duration, amplitude and wave shape differentiation of each wave of BAEP. BAEP abnormal type was observed and abnormal rate of BAEP was calculated. MAIN OUTCOME MEASURES： ①Abnormal rate and abnormal type of BAEP. ② Latency of waves Ⅰ , Ⅲ and Ⅴ, and wave duration of waves Ⅰ to Ⅲ,Ⅲ to Ⅴ, and Ⅰ to Ⅴ. RESULTS： Fifty-eight neonates with mild or moderate hyperbilirubinemia were involved in the final analysis. ①Abnormal type and abnormal rate of BAEP of neonates with hyperbilirubinemia： Among the 116 ears, unilateral or bilateral waves Ⅰ, Ⅲ,Ⅴ still existed. The latency of waves Ⅰ, Ⅲ and Ⅴ was ＋2.5 s longer than the normal level in 8, 4 and 15 ears, respectively. The wave duration of waves Ⅰ to Ⅲ and waves Ⅲ to Ⅴ was ＋2.5 s longer than the normal level in 6 and 14 ears, respectively. The wave duration of waves Ⅲ to Ⅴ was longer than that of ipsilateral waves Ⅰ to Ⅲ in 24 ears. The latency difference of wave Ⅴ between two ears was larger than 0.4 ms in 31 neonates with hyperbilirubinemia; The amplitude of wave Ⅴ to that of ipsilateral wave 1 was lower than 0.5 in 29 neonates. Totally 52 ears were abnormal, and the abnormal rate was 44.8%. One to two months later, 98% abnormal neonates with hyperbilirubinemia recovered. The abnormal rate in the low-, moderate-, and high-concentration bilirubin groups was 37.5%, 44.4% and 53.3%, respectively. ② Comparison of latency and wave duration of each wave of BAEP： Latency of waves Ⅰ, Ⅲ and Ⅴ, and wave duration of waves Ⅰ to III and Ⅲ to Ⅴ were gradually prolonged in low-, moderate-, and high-concentration bilirubin groups, but significant difference did not exist between two groups （P 〉 0.05）. ③ There were no significant differences in latency of waves Ⅰ, Ⅲand Ⅴ, and wave duration of waves Ⅰ to Ⅲ, Ⅲto Ⅴ and Ⅰ to Ⅴ between bilirubin rapid increase group and bilirubin slow increase group （P 〉 0.05）. CONCLUSION： Auditory acuity and brainstem of neonates with mild or moderate hyperbilirubinemia are damaged to some extent. High-concentration bilirubin causes BAEP abnormality easily. Bilirubin increase and its concentration change are not consistent with nervous lesion degree.

RELATIONS OF INTRACRANIAL PRESSURE, CREATINE KINASE AND BRAINSTEM AUDITORY EVOKED POTENTIAL IN PATIENTS WITH TRAUMATIC BRAIN EDEMA

We studied the relations of intracranial pressure (ICP),creatine kinase (CK) and bralnstem auditory evoked potential (BAEP) in 44 patients with traumatic brain edema who were admitted to our hospital from June 1990 to February 1991. There were 30 males and 14 females, with age range from 9 to 67 years. The results showed that the abnormal BAEP could reflect the severity of cerebral edema in acute head injury and was related to ICP and serum CK levels. When ICP>30 mmHg (4kPa), the abnormality of BAEP was more obvious than that of the control group (P<0.05); the serum CK levels were also elevated markedly. In patients with ICP over and below 4kPa, the rate of abnormal BAEP was 38.46% and 77.78% respectively (P<0.05). The serum CK level in the normal group or in the group with moderate abnormality of BAEP was significantly different from that in the group with severe abnormality or lack of BAEP (274.8± 98.24 U/L vs 705.3± 364.27 U/L; P<0.001). After treatment, the ICP returned to normal, and the BAEP norm

Normalization of auditory evoked potential and visual evoked potential in patients with idiot savant

Objective To investigate the variations of auditory evoked potentials (AEP) and visual evoked potentials (VEP) of patients with idiot savant (IS) syndrome. Methods Both AEP and VEP were recorded from 7 patients with IS syndrome, 21 mentally retarded (MR) children without the syndrome and 21 normally age matched controls, using a Dantec concerto SEEG 16 BEAM instrument. Results Both AEP and VEP of MR group showed significantly longer latencies (P1 and P2 latencies of AEP, P<0.01; N1 and N2 latencies of VEP, P< 0.01/0.05), lower P2 amplitudes (P<0.01) and higher P3 amplitudes (P<0.01), as compared with normal controls. But none of above mentioned changes was found with IS group. Almost all MR patients (90.1%) presented P4 component in both AEP and VEP, which was also in sharp contrast with its incidence in other 2 groups (IS: 14.3%; normal controls: 9.5%). Conclusion Patients with idiot savant syndrome presented normalized AEP and VEP.

Brainstem auditory evoked potential combined with high resolution cranial base CT can optimize the diagnosis of auditory nerve injury

Purpose:Auditory nerve injury is one of the most common nerve injury complications of skull base fractures.However,there is currently a lack of auxiliary examination methods for its direct diagnosis.The purpose of this study was to find a more efficient and accurate means of diagnosis for auditory nerve injury.Methods:Through retrospectively analyzing the results of brainstem auditory evoked potential(BAEP)and high-resolution CT(HRCT)in 37 patients with hearing impairment following trauma from January 1,2018 to July 31,2020,the role of the two inspection methods in the diagnosis of auditory nerve injury was studied.Inclusion criteria were patient had a clear history of trauma and unilateral hearing impairment after trauma;while exclusion criteria were:(1)severe patient with a Glasgow coma scale score<5 because these patients were classified as severe head injury and admitted to the intensive care unit,(2)patient in the subacute stage admitted 72 h after trauma,and(3)patient with prior hearing impairment before trauma.According to Goodman's classification of hearing impairment,the patients were divided into low/medium/severe injury groups.In addition,patients were divided into HRCT-positive and negative groups for further investigation with their BAEP results.The positive rates of BEAP for each group were observed,and the results were analyzed by Chi-square test(p<0.05,regarded as statistical difference).Results:A total of 37 patients were included,including 21 males and 16 females.All of them were hospitalized patients with GCS score of 6-15 at the time of admission.The BAEP positive rate in the medium and severe injury group was 100%,which was significantly higher than that in the low injury group(27.27%)(p<0.01).The rate of BEAP positivity was significantly higher in the HRCT-positive group(20/30,66.7%)than in the HRCT-negative group(1/7,14.3%)(p<0.05).Twenty patients(54.05%)were both positive for BEAP and HRCT test,and considered to have auditory nerve damage.Six patients(16.22%)were both negative for BEAP and HRCT test,and 10 patients(27.03%)were BAEP-negative but HRCT-positive:all the 16 patients were considered as non-neurological injury.The rest 1 case(2.70%)was BAEP-positive but HRCT-negative,which we speculate may have auditory nerve concussion.Conclusion:By way of BAEP combining with skull base HRCT,we may improve the accuracy of the diagnosis of auditory nerve injury.Such a diagnostic strategy may be beneficial to guiding treatment plans and evaluating prognosis.

Can bispectral index or auditory evoked potential index predict implicit memory during propofol-induced sedation?

Background Some patients still suffer from implicit memory of intraoperative events under adequate depth of anaesthesia. The elimination of implicit memory should be a necessary aim of clinical general anaesthesia. However, implicit memory cannot be tested during anaesthesia yet. We propose bispectral index （BIS） and auditory evoked potential index （AEPI）, as predictors of implicit memory during anaesthesia. Methods Thirty-six patients were equally divided into 3 groups according to the Observer＇s Assessment of Alertness/Sedation Score： A, level 3; B, level 2 ;and C, level 1. Every patient was given the first auditory stimulus before sedation. Then every patient received the second auditory stimulus after the target level of sedation had been reached. BIS and AEPI were monitored before and after the second auditory stimulus presentation. Four hours later, the inclusion test and exclusion test were performed on the ward using process dissociation procedure and the scores of implicit memory estimated. Results In groups A and B but not C, implicit memory estimates were statistically greater than zero （P〈0.05）. The implicit memory scores in group A did not differ significantly from those in group B （P〉0.05）. Implicit memory scores correlated with BIS and AEPI （P〈0.01）. The area under ROC curve is BIS〉 AEPI. The 95% cutoff points of BIS and AEPI for predicting implicit memory are 47 and 28, respectively. Conclusions Implicit memory does not disappear until the depth of sedation increases to level 1 of OAA/S score. Implicit memory scores correlate well with BIS and AEPI during sedation. BIS is a better index for predicting implicit memory than AEPI during propofol induced sedation.

婴儿分泌性中耳炎的听力学结果分析

目的 探讨226、1 000 Hz鼓室声导抗测试和气-骨导听性脑干反应(ABR)以及畸变产物耳声发射(DPOAE)在诊断低月龄婴儿分泌性中耳炎(OME)中的作用。方法 回顾性分析年龄为1~6个月的119例(192耳)中耳积液患儿(异常组)和66例(132耳)正常婴儿(正常组)的226、1 000 Hz鼓室声导抗测试和气-骨导ABR,以及DPOAE检测结果。结果 (1)OME婴儿,1 000 Hz鼓室声导抗异常图形(As型、B型、C型)有189耳(98.44%),226 Hz鼓室声导抗异常图形(As型、B型、C型)有135耳(70.31%);(2)OME婴儿ABR波Ⅰ潜伏期延长179耳(93.23%),ABR波Ⅴ反应阈中度异常69耳(35.94%)、轻度异常97耳(50.52%)、阈值正常26耳(13.54%),骨导ABR阈值正常164耳(85.42%),阈值轻度异常28耳(14.58%),气-骨导ABR阈值差值变大162耳(84.37%);(3)OME婴儿DPOAE未引出151耳(78.65%)。结论 1 000 Hz声导抗异常、气-骨导ABR阈值差变大、ABR波I潜伏期延长和气导ABR阈值异常对低月龄婴儿中耳积液的诊断有重要参考价值,226 Hz声导抗对部分低月龄婴儿中耳积液的诊断不能提供准确信息。

Binaural masking level difference for pure tone signals

The binaural masking level difference(BMLD)is a psychoacoustic method to determine binaural interaction and central auditory processes.The BMLD is the difference in hearing thresholds in homophasic and antiphasic conditions.The duration,phase and frequency of the stimuli can affect the BMLD.The main aim of the study is to evaluate the BMLD for stimuli of different durations and frequencies which could also be used in future electrophysiological studies.To this end we developed a GUI to present different frequency signals of variable duration and determine the BMLD.Three different durations and five different frequencies are explored.The results of the study confirm that the hearing threshold for the antiphasic condition is lower than the hearing threshold for the homophasic condition and that differences are significant for signals of 18ms and 48ms duration.Future objective binaural processing studies will be based on 18ms and 48ms stimuli with the same frequencies as used in the current study.

Combined monitoring of evoked potentials during microsurgery for lesions adjacent to the brainstem and intracranial aneurysms

Background Neurophysiologic monitoring during surgery is to prevent permanent neurological injury resulting from surgical manipulation. To improve the accuracy and sensitivity of intraoperative neuromonitoring, combined monitoring of transcranial electrical stimulation motor evoked potentials （TES-MEPs）, somatosensory evoked potentials （SSEPs） and brainstem auditory evoked potentials （BAEPs） was attempted in microsurgery for lesions adjacent to the brainstem and intracranial aneurysms. Methods Monitoring of combined TES-MEPs with SSEPs was attempted in 68 consecutive patients with lesions adjacent to the brainstem as well as intracranial aneurysms. Among them, 31 patients （31 operations, 28 of posterior cranial fossa tumors, 3 of posterior circulation aneurysms） were also subjected to monitoring of BAEPs. The correlation of monitoring results and clinical outcome was studied prospectively. Results Combined monitoring of evoked potentials （EPs） was done in 64 （94.1%） of the 68 patients. MEPs monitoring was impossible for 4 patients （5.9%）. No complication was observed during the combined monitoring in all the patients. In 45 （66.2%） of the 68 patients, EPs were stable, and they were neurologically intact. Motor dysfunction was detected by MEPs in 8 patients, SSEPs in 5, and BAEPs in 4, respectively. Conclusions A close relationship exists between postoperative motor function and the results of TES-MEPs monitoring TES-MEPs are superior to SSEPs and BAEPs in detecting motor dysfunction, but combined EPs serve as a safe, effective and invasive method for intraoperative monitoring of the function of the motor nervous system. Monitoring of combined EPs during microsurgery for lesions adjacent to the brainstem and intracranial aneurysms may detect potentially hazardous maneuvers and improve the safety of subsequent procedures.

THE GENETIC-INDUCED HEARING lOSS CAN BLOCK THE EFFECT OF NOISE TRAUMA IN WAlTZING GUINEA PIG

The waltzing guinea pig may be a good model to investigate if genetic factor can change the sensitivity in noise-induced hearing loss. A total of 34 waltzig guinea pigs were studied and we found that there is no any significant increased sensitivity to noise trauma if the age-induced hearing loss was considered in waltz-ing guinea pig.

P50 auditory sensory gating in first onset schizophrenics and normal healthy adults

The aim of this research was to investigate the variations of P50 auditory sensory gating(P50)in normal healthy adults and the first onset schizophrenics.By using the American Nicolet Bravo electromyography/evoked potential(EMG/EP)system,P50 was measured with conditioning-testing paradigm(paired-click stimuli S1 and S2 were used)in 58 first onset schizophrenics and 108 healthy adults,and the Positive and Negative Syndrome Scale(PANSS)was applied.The following three conclusions have been reached.(1)In normal control(NC)group,measured from central,anterior and posterior zone(Cz,Fz and Pz respectively),there were no statistical differences(P>0.05)between S1 and S2 evoked P50 peak latencies(S1-P50 and S2-P50);the ampli-tudes of S2-P50[(2.2P1.4),(2.3P1.5)and(2.1P1.4)μV respectively]reduced significantly as compared with S1-P50[(5.6P3.3),(5.6P3.9)and(4.9P2.8)μV respectively](P<0.01);the S2/S1 ration,S1-S2 difference,and 100(1-S2/S1)had no statistical differences(P>0.05).(2)Compared with NC,the schizophrenic group significantly showed lower S1-P50 amplitudes(P<0.01,except at Pz in whichZ=2.030,P=0.042),higher S2-P50 amplitudes,higher S2/S1 ratio,lower S1-S2 difference,and more decreased 100(1-S2/S1)(P<0.01)at Cz,Fz and Pz.(3)No significant correlations were found among S2/S1 ratio,S1-S2,100(1-S2/S1)of sen-sory gating and PANSS(P>0.05)in schizophrenic group.The first onset schizophrenics had sensory gating deficits,which could be quantified by P50.

Study of cochlear hydrops analysis masking procedure in patients with Meniere＇s disease and otologically normal adults

Background The cochlear hydrops analysis masking procedure （CHAMP） is a new diagnostic technique for Meniere＇s disease （MD）. But its value has not been well proven. This study aimed to evaluate the diagnostic value of CHAMP for MD. Methods CHAMP test was taken in three populations using the Auditory Evoked Potential system delivered by Bio-logic Systems Corporation： （1） otologically normal subjects; （2） patients clinically diagnosed with definite MD; （3） patients clinically diagnosed with probable and possible MD. Results According to the comparison between the normal and definite MD group, if the abnormal criterion of CHAMP was defined as latency delay less than 0.3 ms, then the corresponding sensitivity was only 52%. However, if the abnormal criterion was defined as latency delay between 0.6 and 3.8 ms, then a sensitivity of 93% and a specificity of 100% can be achieved. The complex amplitude ratio showed a significant overlap between normal and definite MD group. If the abnormal criterion was defined as a complex amplitude ratio less than 0.95, the corresponding specificity was only 50%. However, if the abnormal cdtedon was defined as less than 0.80, the corresponding sensitivity was 60%, and the specificity was 97%. If the abnormal criterion of CHAMP was defined as latency delay less than 0.6 ms or the complex amplitude ratio less than 0.80, CHAMP result can be obtained in all subjects with good sensitivity and specificity. Conclusions CHAMP can differentiate patients with Meniere＇s disease from otologically normal subjects with high sensitivity and specificity. The recommended cdterion of abnormal CHAMP was a latency delay less than 0.6 ms or a complex amplitude ratio less than 0.80.

Neonatal ventral hippocampal lesion as a valid model of schizophrenia： evidence from sensory gating study

Background The neonatal ventral hippocampal lesion （NVHL） rat model has been proposed as an experimental model for schizophrenia. NVHL rats display impaired central nervous system （CNS） inhibition, which may lead to a phenomenon similar to P50 sensory gating deficits observed in schizophrenic patients. In this study, we investigated whether sensory gating deficits occurred in the NVHL rat as a model for schizophrenia. Methods We created the NVHL rat model using ibotenate. The P20 and N40 were measured to assess sensory response and gating in NVHL and sham rats. Epidural electrodes recorded evoked potentials （EPs）, from which latencies, amplitudes, difference scores （$1-$2）, and gating ratios （$2/$1） were assessed. Results Compared with sham controls, prolonged S1 N40 latency and decreased S2 N40 amplitude were detected in the NVHL group. In neither difference scores nor gating ratios, a significant difference was found between NVHL group and sham controls. Conclusions NVHL rats may be a valid animal model for schizophrenia. This strategy will be useful in future neurobiological studies investigating the etiology of schizophrenia.

Prevalence and Parental Awareness of Hearing Loss in Children with Down Syndrome

Background： To establish the prevalence of hearing deficit in children with Down syndrome （DS） in Hong Kong as measured by brainstem auditory evoked potentials （BAEP）. The secondary objective is to examine the agreement between BAEP and clinical questioning in detecting hearing deficit in DS. Methods： Consecutive DS patients attending the Down＇s Clinic in a regional pediatric referral center were recruited into this cross-sectional study. BAEP data performed within 12 months were retrieved. The care-taker was interviewed with a structured questionnaire to detect any symptom of hearing impairment. BAEP findings and clinical questionings were compared in an agreement analysis using quadratic weighted kappa statistics. Results： Filly DS patients （35 male, 15 female, mean age 11.70 years ± 5.74 standard deviation） were recruited. Eighteen patients （36.0%） were identified having hearing deficit by BAEP. Among patients with hearing impairment, 13 patients （72.2%） had a conductive deficit, and most have mild to moderate hearing loss. Five patients （27.8%） had sensorineural deficit and most have moderate to severe degree. Eight （44.4%） had bilateral hearing deficit. Care-takers of 13 patients （26.0%） reported symptoms of hearing impairment, with 9 （69.2%） having mild symptoms, 3 （23.1%） had moderate symptoms and 1 （7.7%） had severe symptoms. The weighted kappa was 0.045 （95.0% confidence interval - 0.138-0.229）, indicating very poor strength of agreement between BAEP and clinical questioning. For patients with conductive hearing impairment, only 1 patients （7.7%） recalled history ofotitis media. Conclusions： The estimated point prevalence of hearing impairment in Chinese DS children in Hong Kong is 36%. Our finding of poor strength of agreement between objective testing and symptom questioning reflects significant underestimation of hearing impairment by history taking alone. In view of the high prevalence and low parental awareness, continuous surveillance of hearing is mandatory for DS patients throughout childhood and adolescence.

A zebrafish model for hearing loss and regeneration induced by blast wave

Zebrafish have the potential to regrow injured organs and tissues,but their use as a model for hearing regeneration following blast injury has never been reported.In this study,zebrafish were exposed to a blast wave produced by an underwater blast wave generator.The first peak sound pressures produced by this generator were up to 224dB and 160kPa,measured at 25cm away from the machine.Zebrafish hearing sensitivity was examined by analyzing auditory evoked potentials from 1 to 35 days post blast wave exposure.Cell death and cell proliferation in inner ear organs,including the saccule,lagena,and utricle,were investigated using a terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling assay,and cell proliferation assay using 5-ethynyl-20-deoxyuridine,respectively.Significant differences in auditory evoked potential thresholds were observed between exposed and control groups,demonstrating both blast wave-induced hearing loss and recovery of hearing sensitivity.An apoptosis assay revealed significantly increased numbers of terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labelingpositive cells in the inner ear sensory epithelia of exposed groups compared with the control group.However,numbers of 5-ethynyl-20-deoxyuridine-positive cells in the inner ear of exposed groups recovered to a normal level within 10 post blast wave exposure.Furthermore,blast wave exposure caused brain injury with increased cell apoptosis and decreased neurogenesis.Compared with drug or noise-induced zebrafish models,our blast wave-induced model elicited more serious hearing loss phenotypes,which required more time to return to a normal level.Overall,this zebrafish model can provide a reliable animal model for both hearing loss and regeneration research.The study was approved by the Shanghai 6th Hospital Animal Care and Use Committee,China(approval No.2017-0196)on February 28,2017.

Effect of Acupuncturing Houxi（S13）and Shenmen（HT7）in Trealing Cerebral Traumatio Dementia

Sixty-two cerebral traumatic patients were randomly divided into two groups: acupuncturegroup (32 cases) and physiotherapy group (30 cases) . The changes of mini-mental status examination(MMSE) scores and auditory evoked potential P300 were observed bofore and aiter treatment. Results: themarkedly effective rate and the total effective rate of the acupuncture group were 46. 9% and 81 . 3% respec-tively, which were significantly higher than that of 10. 0% and 30. 0% of the physiottierapy group (P < 0.01 ) . It was found that after treatment the above-mentioned indexes in the acupuncture group changed signifi-cantly (P < 0 . 05 ￣0. 001 ) , while in the physiotherapy group they were not(P >0. 05) . The therapeutic ef-fect in acupunctrue group was better than that in physiotherapy group (P< 0 . 001 ) . The results confirmed thatthe cognitive function of cerebral traumatic dementia patients was enhanced effectively after acupuncturingHouxi (S13 ) and Shenmen (HT7) .

A follow-up study on features of sensory gating P50 in treatment-resistant depression patients

Background Depressive disorder is a well-known chronic, recurrent and disabling mental disease with high direct and indirect costs to society in both western and eastern cultures. Approximately 40% of depressed patients show only partial or no response to initial or even multiple antidepressant medications and are usually called treatment-resistant depression （TRD） patients. The present work was to measure the features of sensory gating （SG） P50 in TRD patients with the intent of understanding the characteristics of this disease. Methods In 50 TRD patients, 39 non-treatment-resistant depression （NTRD） patients and 51 healthy controls （HC）, auditory evoked potential P50 was measured using the conditioning/testing paradigm presented with auditory double clicks stimuli, and 36 TRD patients had repeated measurements after an 8-week venlafaxine treatment course. Results All the depressive disorder patients, including the TRD and NTRD groups, showed an increased testing stimulus wave （$2-P50） amplitude compared to controls （P 〈0.01 and P 〈0.05）, but there was no significant difference between the TRD and NTRD groups （P 〉0.05）. There were significant differences in the ratio of testing stimulus （S2） and conditioning stimulus （S1） （S2/S1） and in the value of 100 × （1-S2/S1） among the three groups. Compared to the baseline, TRD patients had no significant changes of features and different expression of P50 after acute treatment （P 〉0.05）. Meanwhile, a statistically significant positive correlation of S2/S1 with the scores of the 17-item Hamilton Rating Scale for Depression （HAMD-17） （P 〈0.01）, and a significantly negative correlation of S1-S2, 100 × （1-S2/S1） with the scores of HAMD-17 （P 〈0.01） were observed in the TRD patients＇ baseline measurement, but there was no correlation after venlafaxine treatment （P 〉0.05）. Conclusions Both the TRD and NTRD patients had obvious SG deficits, with a more severe deficit in TRD patients. Although, with a correlated relationship to the severity of depressive symptoms, SG P50 deficit might be suggested as a trait marker for TRD, and a combination of S2/S1 ratio, S1-S2 and 100 × （1-S2/S1）, was recommended for electrophysiological measurement in TRD patients.

Application of A-line autoregressive model with exogenous input index during the wake-up test in spinal surgery under propofol-remifentanil anaesthesia

Paraplegia is a rare but terrible complication following major spinal operation. Intraoperative monitoring should be used to detect the neurological compucauons early so that they can be surgically revised.1 The common procedures for spinal cord monitoring are intraoperative wake-up test and neurophysiological methods. The latter includes somatosensory evoked potentials （SSEP） and motor evoked potentials （MEP）. The wake-up test has been routinely used to monitor voluntary motor function of the lower limbs during corrective spinal surgery.