<p>The lateral superior olive (LSO) is a binaural nucleus that is critical for azimuthal sound localization. Bipolar principal cells of the LSO compute interaural level differences (ILDs) by comparing converging excitatory and inhibitory inputs driven by either ear. More specifically, this computation relies on integrating excitatory inputs from the ipsilateral cochlear nucleus with inhibitory, GABA/glycinergic inputs from the medial nucleus of the trapezoid body (MNTB), which are driven by sound originating at the contralateral ear. In order to reliably compute ILDs, the converging inputs must represent sounds of the same frequency. This specificity emerges during the first few weeks of postnatal life in rats as a result of functional and anatomical refinement. Interestingly, significant refinement of this auditory circuit occurs in the absence auditory experience. We focused on changes in the subcellular location of MNTB inputs and the expression of vesicular proteins before hearing onset.</p> <p>The subcellular distribution of inputs onto a neuron heavily influences synaptic integration and the mature distribution likely emerges during a period of circuit refinement. Little is known about how the inputs are distributed onto LSO principal cells and how the mature distribution is achieved. We studied the distribution of inhibitory inputs onto LSO neurons and found that significant re- distribution occurs before hearing onset. The mechanisms underlying the refinement of the inhibitory MNTB projection are not well understood but could be related to the transient co-transmission of the excitatory neurotransmitter glutamate. We studied the expression of vesicular proteins that may regulate the release of GABA/glycine and glutamate at the immature MNTB terminal. We found that MNTB terminals transiently express two Ca++ sensors, which may be associated with the different release properties for GABA/glycine and glutamate. Lastly, we asked one specific example of what controls the expression and sorting of vesicular proteins at the immature MNTB terminal.</p> / Doctor of Philosophy (PhD)

No description available.

Cette thèse porte sur la perception visuelle, auditive et audiovisuelle des voyelles nasales [ɑ̃] (« lent »),[ɔ̃] (« long ») et [ɛ̃] (« lin ») par des adultes devenus sourds, implantés cochléaires et implantés dutronc cérébral. L’étude sur la perception visuelle des voyelles, auprès de 22 adultes devenus sourds,redéfinit les sosies labiaux des voyelles nasales et propose une mise à jour de la classification desvisèmes. Trois études sur l’identification auditive des voyelles nasales auprès de 82, 15 et 10 adultesimplantés cochléaires mettent en évidence leur difficulté à reconnaitre les trois voyelles nasales, qu’ilsperçoivent comme des voyelles orales. Les analyses acoustiques et perceptives suggèrent que lesadultes implantés cochléaires s’appuient sur les informations fréquentielles des deux premiers picsspectraux mais négligent les informations d’intensité relative de ces pics. D’après l’étude menéeauprès de 13 adultes implantés du tronc cérébral, des informations acoustiques linguistiques sonttransmises par l’implant du tronc cérébral mais la fusion entre les informations auditives et visuellespourrait être optimisée pour l’identification des voyelles. Enfin, une enquête auprès de 179orthophonistes pointe le besoin d’une information sur la définition phonétique articulatoire actualiséedes voyelles [ɑ̃] et [ɛ̃]. / This thesis focuses on the visual, auditory and auditory-visual perception of french nasal vowels [ɑ̃](« lent »), [ɔ̃] (« long ») and [ɛ̃] (« lin ») by Cochlear Implant (CI) and Auditory Brainstem Implant(ABI) adults users. The study on visual perception of vowels, with 22 deafened adults, redefines thelip configuration of french nasal vowels and provides an update of the classification of vocalic visualphonemes. Three studies on auditory identification of nasal vowels with 82, 15 and 10 CI usershighlight their difficulty in recognizing the three nasal vowels, which they perceive as oral vowels.Acoustic and perceptual analyzes suggest that adults with CI rely on frequency informations of thefirst two spectral peaks but miss the informations of relative intensity of these peaks. The study with13 ABI users show that some linguistic acoustic cues are transmitted by the ABI but the fusion ofauditory and visual features could be optimized for the identification of vowels. Finally, a survey of179 Speech Language and Hearing Therapists show the need of an update on the phonetic articulationof french nasal vowels [ɑ̃] and [ɛ̃].

Le système nerveux central possède des réseaux de neurones capables de générer des commandes motrices rythmiques en l'absence d'informations sensorielles. Ces réseaux neuronaux sont communément appelés générateurs centraux de patron (CPG, central pattern generator) et sont impliqués dans plusieurs fonctions et comportements vitaux tels que la locomotion et la respiration. Dans certaines circonstances, ces réseaux neuronaux se doivent d'interagir afin de produire un comportement moteur adapté aux contraintes environnementales ainsi qu'aux exigences de l'organisme. C'est notamment le cas lors d'un effort physique où une augmentation du rythme respiratoire est rapidement observée pour subvenir aux besoins en oxygène de l'organisme. Dans ce contexte de neurosciences intégratives, mon travail doctoral a porté sur l'étude des mécanismes neurogènes responsables de l'interaction entre les CPG respiratoires du tronc cérébral et les CPG locomoteurs de la moelle épinière. Cette étude a été réalisée sur des préparations de tronc cérébral-moelle épinière isolée in vitro de rat nouveau-né (P0 à P2) au sein desquelles les centres respiratoires et locomoteurs sont conservés intacts. Par des approches électrophysiologique, pharmacologique, lésionnelle et neuroanatomique, les mécanismes de coordination entre ces sous-groupes neuronaux ont été étudiés. Dans ce contexte, un des principaux résultats de ce travail doctoral est la mise en évidence de l'existence d'une influence ascendante excitatrice issues des CPG locomoteurs spinaux sur les centres respiratoires, et plus particulièrement sur le groupe respiratoire parafacial, structure située dans le bulbe rachidien et impliquée dans la genèse de la commande respiratoire. Outre son implication dans la modulation du rythme respiratoire, cette influence ascendante module également l'activité des populations neuronales expiratoires des régions spinales thoraciques et lombaires. Ces données constituent la première mise en évidence de l'existence de neurones bi-fonctionnels au sein de la moelle-épinière chez le rat nouveau-né. / The central nervous system contains neural networks that can generate rhythmic motor drive in absence of sensory feedback. These neural networks are commonly called central pattern generators (CPG) and are involved in many vital functions and behaviors, such as locomotion or respiration. In certain circumstances, these neural networks must interact to produce motor behaviors adapted to environmental constraints and the basic needs of organism. This is the case during physical exercise when the respiratory frequency increases in order to satisfy the oxygen needs. In a context of integrative neurosciences, my doctoral work aimed at exploring the neurogenic mechanisms involved in the coordination between the medullary respiratory networks and the spinal locomotor CPG. To address this question, we used an isolated in vitro brain stem-spinal cord preparations from neonatal rats (0-2 days) in which the respiratory and the locomotor networks are kept intact. Using electrophysiological, pharmacological, lesional and neuroanatomical approaches, mechanisms involved in the coordination between locomotor and respiratory rhythms have been studied. The major finding of this doctoral work is the identification of an ascending excitatory influence from spinal locomotor CPG to the respiratory networks, acting particularly on the parafacial respiratory group, which is known to be engaged in the genesis of expiratory activity. In addition to the respiratory frequency modulation, this ascending influence also modulates the activity of spinal expiratory neurons located in lumbar and thoracic segments. These data provide the first evidence for the existence of bi-functional neurons in newborn rat spinal cord.

Acromegalia à uma doenÃa endÃcrina rara. Poucos estudos avaliaram sua associaÃÃo com deficiÃncia auditiva (DA) ou distÃrbios de conduÃÃo do impulso neural auditivo.Osresultados sÃo conflitantes. O objetivo à avaliar a transmissÃo auditiva central e perifÃrica em pacientes com acromegalia. AlÃm disso, avaliar a prevalÃncia e caracterÃsticas da DA em pacientes com acromegalia. Foi feito um estudo transversal com 36 pacientes com acromegalia de um ambulatÃrio especializado em Fortaleza-CearÃ. Foram excluÃdos pacientes com otoscopia anormal ou com histÃria familiar de deficiÃncia auditiva, uso de ototÃxicos ou exposiÃÃo a ruÃdo ocupacional. Inicialmente, o grupo foi avaliado por meio de audiometria tonal limiar. Considerou-se deficiÃncia auditiva (DA) quando a mÃdia dos tons puros foi > 25DbNA para baixas freqÃÃncias (250, 500, 1000 e 2000 Hz) ou altas freqÃÃncias (3000, 4000, 6000 e 8000 Hz).O grupo foi dividido em: acromegalia com DA (Acro DA) e sem DA (Acro NDA) e comparados quanto aos nÃveis hormonais e parÃmetros metabÃlicos. Posteriormente, este grupo de pacientes com acromegalia foi dividido em 2 subgrupos: com (n=16) e sem (n=20) diabetes ou intolerÃncia à glicose de jejum (DM/IGJ). Os resultados foram comparados entre os subgrupos e grupo controle (n=20) quantos aos parÃmetros dos potenciais evocados auditivos de tronco encefÃlico (PEATE). Para avaliar a normalidade da distribuiÃÃo foi utilizado o teste de Kolmogorov-Smirnov quando necessÃrio. Utilizou-se os testes qui-quadrado, t de Student e coeficiente de correlaÃÃo de Pearson. O nÃvel de significÃncia estatÃstica escolhido foi p<0.05 (statistical package for social sciences-SPSS 12.0). Dos 36 pacientes estudados, 14 (38,9%) mostraram DA sensorioneural (Acro DA), sendo em 9 casos bilateral e 5 unilateral. Nenhum apresentou DA mista ou condutiva. A prevalÃncia de DM/IGJ foi similar entre os grupos. As frequÃncias de 250, 3000, 4000, 6000 e 8000 Hz foram as mais afetadas e com padrÃo similar em ambos os lados.O grupo com acromegalia apresentou latÃncia da onda I em orelha direita aumentada em comparaÃÃo ao grupo controle (p=0,007), sem diferenÃa quanto aos intervalos interpicos em nenhum dos lados. Esse padrÃo foi o mesmo quando se comparou o subgrupo com DM/IGJ com o controle.TambÃm houve aumento da latÃncia da onda I na orelha direita em relaÃÃo à orelha esquerda no grupo com acromegalia. Em conclusÃo, mostrou-se uma elevada prevalÃncia de DA sensorioneural em pacientes com acromegalia.No entanto, nÃo se observou relaÃÃo dessa deficiÃncia com caracterÃsticas clÃnicas e metabÃlicas da doenÃa.Pacientes com acromegalia associada DM/IGJ mostraram um retardo no impulso neural no nervo auditivo unilateralmente à direita, evidenciando um efeito neuropÃtico nÃo homogÃneo dos distÃrbios do metabolismo dos carboidratos sobre o nervo auditivo. / Acromegaly is a rare endocrine disease. Few studies have evaluated its association with hearing loss (HL) or disturbance in conduction of the auditory neural impulse. The results are conflicting. The aim is to evaluate central and peripheral auditory transmission in acromegalic patients. Besides, to evaluate the prevalence and characteristics of HL in patients with acromegaly. A cross-sectional study was carried out on 36 patients with acromegaly in a specialized ambulatory in Fortaleza-CearÃ. Patients with abnormal otoscopy, family history of hearing loss, use of ototoxic drugs or occupational noise exposure were excluded. Initially, the group was evaluated by pure tone audiometry. HL was considered when pure tone average was > 25 DBHL for low frequencies (250, 500, 1000 e 2000 Hz) or high frequencies (3000, 4000, 6000 e 8000 Hz). The whole group was divided in: acromegaly with HL (Acro HL) and without HL (AcroNHL) and compared in regards to hormonal levels and metabolic parameters. Additionally that group of patients with acromegaly was divided into 2 subgroups: with (n=16) and without (n=20) diabetes mellitus/impaired glucose tolerance (DM/IGT). The results were compared among these subgroups and a control group (n=20) regarding the brainstem auditory evoked potentials (BAEP) parameters.Kolmogorov-Smirnov test was used to evaluate the normality of distribution when necessary. Qui-quadrado, Student t test and Pearson correlation coefficient were carried out. The level of statistical significance chosen was at p<0.05 (statistical package for social sciences-SPSS 12.0). Among 36 patients evaluated, 14 (38,9%) showed sensorioneural HL (Acro HL), being 9 bilateral and 5 unilateral cases. No one had mixed or conductive HL. The prevalence of diabetes/impaired glucose tolerance was similar between the groups. The frequencies 250, 3000, 4000, 6000 and 8000 Hz were the most affected and with a similar pattern in both ears. The group with acromegaly showed a prolonged peak I latency in the right ear in comparison to the control group (p=0,007), with no difference regarding the interpeak intervals in any sides. This pattern was the same when comparing the DM/IGT subgroup to controls. Also, we found a prolonged peak I latency in the right ear in relation to the left ear in the group with acromegaly.In conclusion, a high prevalence of sensorineural HL was shown in patients with acromegaly. Nevertheless, no correlation was observed between this dysfunction and clinical or metabolic characteristics of the disease. Patients with acromegaly associated with DM/IGT showed a delayed neural impulse in the auditory nerve unilaterally in the right side, evidencing a non-homogenous neuropathic effect of the carbohydrate metabolism disturbances on the auditory nerve.

Patients with Rett Syndrome (RTT) show severe breathing disorders in addition to other neuropathological features, contributing to the high incidence of sudden unexplained death and abnormal brain development. However, the molecular and cellular mechanisms underlying the breathing disorders are still unknown. Recent studies indicate that the dysfunction of brainstem norepinephrine (NE) systems are closely associated with breathing disorders in RTT patients as well as its mice model, the Mecp2-null (Mecp2─/Y) mice. This as well as the fact the major group of NE-ergic neurons in the locus coeruleus (LC) is CO2 chemosensitive suggests that the breathing disorders in RTT may be related these LC neurons. To test this hypothesis, we took a multidisciplinary approach and systematically studied these neurons using molecular biology, in-vitro brain slices, acutely dissociated neurons, immunocytochemistry, and whole-body plethysmograph. To facilitate the electrophysiological studies, we developed a new strain of transgenic mice with GFP expression selectively in the LC neurons of both WT and Mecp2─/Y mice. Breathing activity of the Mecp2─/Y mice showed selective disruptions in responses to mild hypercapnia. The defect was alleviated with the NE uptake blocker desipramine, suggesting the involvement of NE in central CO2 chemosensitivity. In the LC region, the expressions of tyrosine hydroxylase (TH) and dopamine beta-hydroxylase (DBH) at both protein and mRNA levels reduced by ~50% in Mecp2─/Y mice. No evidence was found for selective deficiency in TH- or DBH-containing neurons in Mecp2─/Y mice, and no major loss of NE-ergic LC cells were found, indicating that the NE defect is likely to result from deficient expression of biosynthetic enzymes rather than a loss of neurons in the LC. Several intrinsic membrane properties were abnormal in Mecp2─/Y LC neurons in comparison to wild type cells, including stronger inward rectification, shorter time constant, extended action potential duration, smaller amplitude of medium afterhyperpolarization (AHP) and over-expression of fast AHP. These abnormalities seem to be associated with the altered K+ and Na+ currents. Most importantly, Mecp2─/Y LC neurons displayed defective CO2 chemosensitivity in agreement of in vivo CO2 response, likely due to excessive expression of the homomeric Kir4.1 channel. Thus, it seems that the global effect of MeCP2 on the A6 NE system contributes to the impaired systemic CO2 response as well as the breathing irregularities in Mecp2─/Y mice. Such an alteration allowed CO2 to be detected only when hypercapnia became severe, leading to periodical hyper- and hypoventilation. These findings not only provide a novel etiology for the breathing disturbances of Mecp2─/Y mice but also show direct evidence for the first time on a molecular mechanism for the central CO2 chemosensitivity.

Cette thèse porte sur la perception visuelle, auditive et audiovisuelle des voyelles nasales [ɑ̃] (« lent »),[ɔ̃] (« long ») et [ɛ̃] (« lin ») par des adultes devenus sourds, implantés cochléaires et implantés dutronc cérébral. L’étude sur la perception visuelle des voyelles, auprès de 22 adultes devenus sourds,redéfinit les sosies labiaux des voyelles nasales et propose une mise à jour de la classification desvisèmes. Trois études sur l’identification auditive des voyelles nasales auprès de 82, 15 et 10 adultesimplantés cochléaires mettent en évidence leur difficulté à reconnaitre les trois voyelles nasales, qu’ilsperçoivent comme des voyelles orales. Les analyses acoustiques et perceptives suggèrent que lesadultes implantés cochléaires s’appuient sur les informations fréquentielles des deux premiers picsspectraux mais négligent les informations d’intensité relative de ces pics. D’après l’étude menéeauprès de 13 adultes implantés du tronc cérébral, des informations acoustiques linguistiques sonttransmises par l’implant du tronc cérébral mais la fusion entre les informations auditives et visuellespourrait être optimisée pour l’identification des voyelles. Enfin, une enquête auprès de 179orthophonistes pointe le besoin d’une information sur la définition phonétique articulatoire actualiséedes voyelles [ɑ̃] et [ɛ̃]. / This thesis focuses on the visual, auditory and auditory-visual perception of french nasal vowels [ɑ̃](« lent »), [ɔ̃] (« long ») and [ɛ̃] (« lin ») by Cochlear Implant (CI) and Auditory Brainstem Implant(ABI) adults users. The study on visual perception of vowels, with 22 deafened adults, redefines thelip configuration of french nasal vowels and provides an update of the classification of vocalic visualphonemes. Three studies on auditory identification of nasal vowels with 82, 15 and 10 CI usershighlight their difficulty in recognizing the three nasal vowels, which they perceive as oral vowels.Acoustic and perceptual analyzes suggest that adults with CI rely on frequency informations of thefirst two spectral peaks but miss the informations of relative intensity of these peaks. The study with13 ABI users show that some linguistic acoustic cues are transmitted by the ABI but the fusion ofauditory and visual features could be optimized for the identification of vowels. Finally, a survey of179 Speech Language and Hearing Therapists show the need of an update on the phonetic articulationof french nasal vowels [ɑ̃] and [ɛ̃].

The neural and sensory mechanisms underlying appropriate muscle recruitment in response to balance challenges remains elusive. We asked whether the decerebrate cat preparation might be employed for further investigation of postural mechanisms. First, we evaluated the muscular activation patterns and three-dimensional whole limb forces generated by a modified premammillary decerebrated cat. We hypothesized that directionally appropriate muscle activation does not require the cerebral cortices. Furthermore, we hypothesized that the muscle responses would generate functionally appropriate and constrained force responses similar to those reported in the intact animal. Data confirmed both of our hypotheses and suggested important roles for the brainstem and spinal cord in mediating directionally appropriate muscular activation. Second, we investigated how individual muscle activation is translated to functional ground reaction forces. We hypothesized that muscles are selectively activated based upon their potential counteractive endpoint force. Data demonstrated that the endpoint force generated by each muscle through stimulation was directed oppositely to the principal direction of each muscle's EMG tuning curve. Further, muscles that have variable tuning curves were found to have variable endpoint forces in the XY plane. We further hypothesized that the biomechanical constraints of individual muscle actions generate the constrained ground reaction forces created in response to support surface perturbations. We found that there was a lack of muscles with strong medial-lateral actions in the XY plane. This was further exaggerated at long stance conditions, which corresponds to the increased force constraint present in the intact animal under the same conditions. Third, we investigated how loss of cutaneous feedback from the footpads affects the muscle recruitment in response to support surface perturbations. We utilized our decerebrate cat model as it allows 1) isolation of the proprioceptive system (cutaneous and muscle receptor) and 2) observation of the cutaneous loss before significant compensation by the animal. We hypothesized that muscle spindles drive directionally sensitive muscle activation during postural disturbances. Therefore, we expected that loss of cutaneous feedback from the foot soles would not alter the directional properties of muscle activation. While background activity was significantly diminished, the directionally sensitive muscular activation remained intact. Due to fixation of the head, the decerebrate cat additionally does not have access to vestibular or visual inputs. Therefore, this result strongly implicates muscle receptors as the primary source of directional feedback. Finally to confirm that muscle receptors, specifically muscle spindles, are capable of generating feedback to drive the directionally tuning, we investigated the response properties of muscle spindles to horizontal support surface perturbations in the anesthetized cat. As previously stated, we hypothesized that muscle spindles provide the feedback necessary for properly directed muscular responses. We further hypothesized that muscle spindles can relay feedback about the perturbation parameters such as velocity and the initial stance condtion. Results confirmed that muscle spindle generate activation patterns remarkably similar to muscular activation patterns generated in the intact cat. This information, along the knowledge that cutaneous feedback does not substantially eliminate directional tuning, strongly suggests that muscle spindles contribute the critical directional feedback to drive muscular activation in response to support surface perturbations.

This work had as aim the evaluation of the central and peripheral hearing system of the subjects exposed to fuels. It was a prospective study, where attendants of three gas stations from Santa Maria were evaluated. After the adaptation to the inclusion criteria, the sample was composed of 24 subjects. A control group, of 24 was used in order to compare the results. The applied examinations were: Pure Tone Audiometry (PTA), Impedance Audiometry, research on acoustic reflexes, audiometry of high frequencies and the Auditory Brain Response (ABR). The average threshold of the study group was superior to the control group. The same occurred to the average thershold of the audiometry of high frequencies, in the range 9 to 14 kHz. In the frequencies from 16 to 20 kHz, the occurence of absent responses was higher in the study group in both ears. When compare in relation to the time of exposition, the average thresholds in high frequencies (9-14kHz) had significant statistical difference (p <0.05) in all the frequencies (9-14 kHz), when compared the control group to the study group. It was observed a greater absence of ipsilateral and contralateral acoustic reflexes in the right ear. In the left ear, there was no difference between the groups, concerning the occurrence of the ipsilateral reflex. The absence of contralateral reflex was bigger in the study group in all the teste frequencies. In the ABR, there was a change in the absolute latencies of Waves I and III and in all the interpeak latencies, in the right ear. In the left ear there was a change in the absolute latency of all the waves, and in all the interpeaks. The absolute latency of Wave III had greater occurrence of change, in both ears. The interaural difference of Wave V had a change in 19% of the subjects. The group exposed to fuels for at least three years demonstrated a change in the III-V interpeak of the right ear and in the absolute latency of Wave V in the left ear. In the group exposed for more than five years, the number of subjects with a change was statistical significant in: I-V interpeak of the right ear; absolute latency of Wave I and interpeak III-V of the left ear. It was verified that the subjects exposed to fuels had a statistically significant change in the average hearing thresholds in the frequencies 0.5 kHz (p=0.004), 2 kHz (p=0.001), 3 kHz (p=0.025), 9 kHz (p=0.007) and 10 kHz (p=0.026). In the ABR, it was observed a significant statistical difference in the interpeak III-V of the right ear (p=0.027) and the absolute latency of Wave V in the left ear (p=0.0257), in the group exposed for at least three years. In the group exposed for more than five years it was statistically significant the number of subjects with change in the I-V interpeak of the right ear (p=0.0173), in the absolute latency of Wave I and in the III-V interpeak of the left ear ( p=0.0173). / O presente trabalho teve como objetivo avaliar o sistema auditivo periférico e central de frentistas. Trata-se de um estudo prospectivo, onde foram avaliados frentistas de três postos de gasolina da cidade de Santa Maria. Após a adequação dos critérios de inclusão, a amostra totalizou 24 sujeitos. Um grupo controle, composto por 24 sujeitos, foi utilizado para comparação dos resultados. Os exames aplicados foram: audiometria tonal liminar (ATL), imitanciometria, audiometria de altas frequências e potenciais evocados auditivos de tronco encefálico (PEATE). A média de limiar na audiometria tonal liminar do grupo estudo foi superior a do grupo controle. O mesmo ocorreu com a média de limiar da audiometria de altas frequências, na faixa de 9 a 14kHz. Nas frequências de 16 a 20kHz, a ocorrência de respostas ausentes foi maior no grupo estudo em ambas as orelhas. Quando comparadas em relação ao tempo de exposição, as médias de limiares em altas frequências (9-14kHz) mostraram diferença estatisticamente (p<0,05) significante em todas as frequências (9-14kHz), quando comparados o grupo controle e o grupo estudo. Observou-se maior ausência de reflexos acústicos ipsi e contralateral no grupo estudo, na orelha direita. Na orelha esquerda, não houve diferença entre os grupos, quanto à ocorrência do reflexo ipsilateral. A ausência de reflexo contralateral foi maior no grupo estudo em todas as frequências testadas. No PEATE, houve alteração nas latências absolutas das ondas I e III e em todas as latências interpicos, na orelha direita. Na orelha esquerda houve alteração na latência absoluta de todas as ondas, e em todos os intervalos interpicos. A latência absoluta da onda III foi a que teve maior ocorrência de alteração, em ambas as orelhas. A diferença interaural da onda V mostrou alteração em 19% dos sujeitos. O grupo exposto a combustíveis há pelo menos três anos, apresentou alteração no intervalo interpico III-V da orelha direita e latência absoluta da onda V na orelha esquerda. No grupo exposto há mais de cinco anos, foram estatisticamente significantes o número de sujeitos com alteração: no intervalo interpico I-V da orelha direita; na latência absoluta da onda I e no intervalo interpico III-V da orelha esquerda. Verificou-se que frentistas apresentaram alteração estatisticamente significante nas médias de limiares auditivos nas frequências de 0,5 (p=0,004), 2 (p=0,001), 3 kHz (p=0,025),9kHz (p=0,007) e 10 kHz (p=0,026). No PEATE, observou-se diferença estatisticamente significante no intervalo interpico III-V da orelha direita (p=0,027) e na latência absoluta da onda V na orelha esquerda (p=0,0257), no grupo exposto por pelo menos três anos. No grupo exposto há mais de cinco anos foram estatisticamente significantes o número de sujeitos com alteração no intervalo interpico I-V da orelha direita (p=0,0173), na latência absoluta da onda I e no intervalo interpico III-V da orelha esquerda (p=0,0173).

Os potenciais evocados auditivos de tronco encefálico (PEATE) são um instrumento clínico muito útil na avaliação da maturação das vias auditivas em crianças nascidas pré-termo. Objetivos: Observar a maturação da via auditiva pela análise PEATE em crianças nascidas prétermo em três idades (4, 12 e 20 meses de idade). Casuística e Método: Coorte, individual, observacional, comparativo e contemporâneo. O fator em estudo foi crianças nascidas pré-termo e o desfecho à observação da maturação da via auditiva neste grupo, pela análise PEATE, em três avaliações (aos 4, 12 e 20 meses de idade), precedido de avaliação otorrinolaringológica e audiológica com objetivo de garantir que não apresentavam alteração auditiva. Resultados: Ingressaram 73 crianças pré-termo. Não foi encontrada diferença estatística (P>0,05) na comparação dos resultados entre os gêneros, bem como interaural. Houve diferença estatiticamente significante entre idade gestacional, as latências absolutas e intervalos interpicos nas três avaliações realizadas, ocorrendo uma diminuição das latências com o aumento da idade. Verificamos que a maturação da onda I foi mais rápida, e a maturação da onda V foi mais lenta. Podemos perceber que a maturação da via auditiva até o tronco encefálico segue o sentido caudorostral, sendo a da via periférica mais precoce, e a da rostral, mais tardia. Conclusão: Com base nos achados deste estudo, recomendamos que a aplicação do procedimento de avaliação audiológica através do PEATE em crianças nascidas pré-termo, pelo menos até os 20 meses de idade, seja realizado levando-se em conta a idade gestacional a fim de se obter análises fidedignas. / Brainstem Auditory Evoked Potential (BAEP) is a very useful clinical instrument in the evaluation of the auditory pathways maturation in preterm children. Objective: To observe the maturation of the auditory pathway with the use of the BAEP analysis in preterm children at three different ages (four, 12 and 20 months). Casuistry and Method: Group, individual, observational, comparative and contemporary. Preterm children and the outcome to observation of the auditory pathway maturation by the BAEP analysis in three evaluations (at 4, 12 and 20 months of age) were studied. The procedures were preceded by otolaryngological and auditory evaluation with the objective to guarantee the non presence of auditory alteration. Results: Seventy-three preterm children participated in the study. Statistically significant difference was not found (P> 0,05) in the comparison between genders and between ears. There was a statistically significant difference among gestational ages, absolute latencies and interpic intervals in the three evaluations conducted, occurring a reduction of latencies with age increase. We verified that maturation of wave I was faster and the maturation of wave V was slower. We could perceive that the maturation of the auditory pathway up to the brainstem follows the caudorostral direction, being the peripheral pathway more precocious and the rostral pathway more delayed. Conclusion: Based on the findings of this study, we recommend the application of the audiological evaluation procedure using BAEP in preterm children, at least until 20 months of age, by taking into account the gestational age in order to obtain reliable analyses.