Thesis (M.S.)--University of Michigan, 1985.

Thesis (M.S.)--University of Michigan, 1985.

Thesis (M. Sc.)--University of Hong Kong, 1998. / Includes bibliographical references (leaf 37-41).

Thesis (Doctoral)--Ludwig-Maximilians-Universität. / eContent provider-neutral record in process. Description based on print version record.

Made available in DSpace on 2015-07-22T20:50:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-01-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introdução: A necessidade da realização de diagnóstico audiológico nas primeiras semanas ou meses de vida aumentou com a consolidação dos programas de triagem auditiva neonatal. As emissões otoacústicas (EOA) e o potencial evocado auditivo de tronco encefálico (PEATE) com estímulo clique são amplamente utilizados. Para que a intervenção precoce tenha sucesso, informações precisas quanto ao tipo, grau e configuração da perda auditiva tornam-se necessárias. A realização do PEATE com o estímulo tone burst (TB) e da pesquisa da resposta auditiva de estado estável (RAEE) vêm se mostrando de grande valia, já que tais testes fornecem informações específicas por freqüência, permitindo uma avaliação audiológica mais detalhada. Objetivo: Analisar a aplicabilidade clínica do PEATE TB e da RAEE em 2 kHz, em lactentes nascidos a termo e pré-termo. Método: A casuística foi composta por 17 lactentes pré-termo e 19 lactentes a termo, de ambos os gêneros. O estudo foi realizado na UNIFESP e os lactentes, em sono natural, foram submetidos ao PEATE TB e à RAEE na freqüência de 2000 Hz, utilizando-se o equipamento Smart EP da Intelligent Hearing Systems. Resultados: A comparação entre as respostas da orelha direita e esquerda não apresentou diferenças estatisticamente significantes, permitindo considerar a amostra como um todo. A comparação das respostas dos lactentes pré-termo e a termo não apresentou diferenças estatisticamente significantes, com exceção do tempo de duração da RAEE. As latências médias da onda V no PEATE TB foram de 7,9 ms a 80 dBnNA, 8,9 ms a 60 dBnNA, 9,9 ms a 40 dBnNA e 10,8 ms a 30 dBnNA. A resposta eletrofisiológica mínima obtida com o PEATE TB foi de 32,4 dBnNA (52,4 dBNPS), em média. A RAEE mínima obtida foi de 13,8 dBNA (26,4 dBNPS), em média. A duração média do PEATE TB foi de 21,1 min e da RAEE de 22 min. Conclusões: O PEATE TB e a RAEE têm aplicabilidade clínica na freqüência de 2 kHz em lactentes, não havendo diferenças entre indivíduos a termo e pré-termo. / Introduction: Audiological diagnosis in the first weeks or months of life has increased with the consolidation of newborn hearing screening programs. Otoacoustic emissions (OAE) and auditory brainstem response (ABR) with click stimuli are widely used for this purpose. For a successful early intervention, accurate information about type, degree, and configuration of hearing loss are necessary. ABR with tone burst stimuli (TB ABR) and auditory steady-state response (ASSR) exams have been of great value, since these tests provide specific frequency information, resulting in a more detailed hearing evaluation. Objective: Analyze the clinical applicability of TB ABR and ASSR at 2 kHz, in full-term and premature infants. Method: The study was conducted at UNIFESP. Subjects were consisted of 17 premature infants and 19 full-term infants, male and female. In natural sleep, they have undergone TB ABR and ASSR exams (Smart EP - Intelligent Hearing Systems), at 2000 Hz. Results: Right and left ears responses showed no statistically significant differences, therefore they were considered as a whole. Wave V mean latencies in TB ABR were 7.9 ms to 80 dBnHL, 8.9 ms to 60 dBnHL, 9.9 ms to 40 dBnHL and 10.8 ms to 30 dBnHL. Electrophysiological minimum response obtained with TB ABR was 32.4 dBnHL (52.4 dBSPL), on average. ASSR minimum response was 13.8 dBHL (26.4 dBSPL), on average. TB ABR and ASSR exams lasted 21.1 min and 22 min, respectively. Premature and full-term infants responses showed no statistically significant differences, except for ASSR duration. Conclusions: Both TB ABR and ASSR have clinical applicability at 2 kHz in infants, with no differences between premature and full-term individuals. / TEDE / BV UNIFESP: Teses e dissertações

The mechanisms underlying the generation and spread of seizure activity have remained elusive despite a considerable research effort over the last two decades. Most of this work has concentrated on the characteristics of neuronal excitability and burst discharge at the single cell level. These studies have provided some understanding of the possible abnormalities of neurons within an epileptic focus, but little direct insight into the factors responsible for the striking synchronization of action potentials during interictal discharge or in the spread of synchronous activity across apparently normal brain tissue. Although synaptic activation probably plays a role in the generation of seizure activity, recent evidence indicates that seizure-like discharge can occur during chemical blockade of synaptic transmission (Jefferys and Haas 1982; Taylor and Dudek 1982). This rather surprising result emphasizes the importance of considering non-synaptic mechanisms for both the synchronization and spread of abnormal neuronal activity in the central nervous system. One important non-synaptic mechanism to consider is ephaptic interactions. This term refers to the direct electrical influence of extracellular field potentials on neuronal excitability. It is possible that ephaptic interactions, generated during seizure activity, simultaneously depolarize an entire population of neurons leading to both recruitment and synchronization of action potential discharge. This thesis investigates ephaptic interactions during evoked potentials in the hippocampal formation. The hippocampus is one of the most seizure-prone regions of the brain and its anatomical structure is ideal for the generation of field effects. Evoked potentials were used as "models" of synchronous neuronal discharge since they are more reproducible, easier to control, and better understood than seizure activity. This initial investigation of ephaptic interactions lays the foundation for further studies involving the complexities of epileptic activity. The first phase of this project examined the spatial characteristics of field potentials evoked in the hippocampus and the dentate gyrus. Current source density (CSD) analysis and voltage gradient determinations obtained from these fields were used to characterize the pattern of current flow within the neuropil and to predict the polarity and relative intensity of ephaptic influences on neuronal excitability. The detailed characteristics of extracellular voltage gradients varied between CAl and the dentate gyrus, and also between anti- and orthodromic responses. In general, voltage gradients during the positive components of a somatic population spike predicted ephaptic hyperpolarization of the neuronal population, whereas gradients observed during the negative component predicted depolarization. They were often an order of magnitude greater than the smallest gradient known to influence granule cell activity. An exception to this rule was the minimal gradient observed during the negative component of the dentate response. In the second phase of the study, extracellular voltage gradients were experimentally applied to the dentate gyrus to determine the sensitivity of granule cells to ephaptic interactions. The magnitude of the applied gradients were in the range observed during the evoked potentials studied in the first phase. These experiments demonstrated a remarkable sensitivity of granule cells to the applied fields. The fields could alter the population spike from near minimal to near maximal. Surprisingly, even antidromic potentials were influenced by the gradients. On the other hand, the EPSP phase of the population spike was not influenced. These findings established that extracellular currents can influence the excitability within a neuronal population without altering synaptic drive. The final phase of the project investigated the transmembrane potential (TMP) of pyramidal and granule cells during applied fields and evoked potentials. The TMP was calculated by subtracting the extracellular from the intracellular response. This potential ultimately determines the voltage dependent behavior of a neuron and gives a direct measure of any ephaptic interactions. In order to measure the intracellular influences of applied fields, the TMP was monitored while the impaled cell was exposed to extracellular voltage gradients spanning the same range as used in phase two of the project. The TMP shifted by as much as plus or minus 5 mV, depending on the amplitude and polarity of the gradient. This large shift in TMP accounts for the observed influence of the applied field potentials, and suggests that the voltage gradients associated with evoked potentials should also have a marked effect on the TMP. A depolarizing wave of the TMP occurred during the negative component of anti- and orthodromic CA1 responses. This depolarization was capable of initiating action potentials, and decreased the latency to discharge during orthodromic responses. During epileptiform discharge, a similar depolarizing wave was associated with each negative component of the burst. These depolarizations recruit and synchronize neuronal discharge by simultaneously increasing the excitability within an entire population of cells. These data support the hypothesis that ephaptic interactions in the hippocampal formation influence the pattern of cell discharge during evoked potentials. It is postulated that similar ephaptic interactions may contribute to recruitment and synchronization during seizure activity. / Medicine, Faculty of / Cellular and Physiological Sciences, Department of / Graduate

Ten experiments examined the interactions between vision and audition in stimulusdriven spatial attention orienting and inhibition of return (IOR). IOR is the demonstration that subjects are slower to respond to stimuli that are presented at a previously stimulated location. In each experiment, subjects made go/no-go responses to peripheral targets but not to central targets. On every trial, a target was preceded by a sensory event, called a "cue," either in the same modality (intramodal conditions) or in a different modality (crossmodal conditions). The cue did not predict the location of the target stimulus in any experiment. In some experiments, the cue and target modalities were fixed and different. Under these conditions, response times to a visual target were shorter when it appeared at the same location as an auditory cue than when it appeared on the opposite side of fixation, particularly at short (100 ms) cue-target stimulus onset asynchronies (Experiments 1A and IB). Similarly, response times to an auditory target were shorter when it appeared at the same location as a visual cue than when it appeared at a location on the opposite side of fixation (Experiments 2A and 2B). These crossmodal effects indicate that stimulus-driven spatial attention orienting might arise from a single supramodal brain mechanism. IOR was not observed in either crossmodal experiment indicating that it might arise from modality specific mechanisms. However, for many subjects, IOR did occur between auditory cues and visual targets (Experiments 3A and 3B) and between visual cues and auditory targets (Experiment 4A and 4B) when the target could appear in the same modality as the cue on half of the trials. Finally, the crossmodal effects of stimulus-driven spatial attention orienting on auditory and visual event-related brain potentials (ERPs) were examined in the final two experiments. Auditory cues modulated the ERPs to visual targets and visual cues modulated the ERPs to auditory targets, demonstrating that the mechanisms for spatial attention orienting cannot be completely modality specific. However, these crossmodal ERP effects were very different from each other indicating that the mechanisms for spatial attention orienting cannot be completely shared. / Arts, Faculty of / Psychology, Department of / Graduate

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18180号 / 医博第3900号 / 新制||医||1004(附属図書館) / 31038 / 京都大学大学院医学研究科医学専攻 / (主査)教授 髙橋 良輔, 教授 金子 武嗣, 教授 渡邉 大 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

A integridade da via auditiva e a investigação do respectivo limiar eletrofisiológico podem ser avaliadas por meio da observação, no domínio do tempo, dos potenciais evocados auditivos de tronco encefálico. Atualmente, nova técnica de análise dos potenciais evocados auditivos, no domínio das freqüências, tem sido utilizada para uma observação particular desses limiares. Assim, com a aplicação da transformada rápida de Fourier, é possível realizar a análise das freqüências comprometidas na audição, de maneira eficiente e rápida. O objetivo com este trabalho, então, foi desenvolver, caracterizar e realizar testes preliminares com um dispositivo único capaz de avaliar os potenciais evocados auditivos nos dois domínios, por meio de uma placa de som, que ainda não havia sido implementada para tal fim. Desse modo, foi produzido um aparelho capaz de registrar sinais biológicos da ordem de 0,5 ?V. Após a caracterização e o estudo simulado, foram conduzidos testes-piloto com doze seres humanos, ouvintes normais (n = 24 orelhas), divididos em dois grupos com o mesmo número de participantes. No grupo 1, os potenciais evocados auditivos de tronco encefálico adquiridos por meio de um instrumento padrão-ouro e de instrumento desenvolvido foram comparados entre si. Em seguida, os achados foram relacionados com o exame no domínio das freqüências formatado no novo aparelho. O grupo 2 foi submetido à avaliação dos potenciais miogênicos vestibulares, também com os dois instrumentos, e suas latências absolutas comparadas. Os resultados demonstraram não haver diferenças significativas entre os dois instrumentos para as amplitudes e latências do potencial evocado auditivo de tronco encefálico. Constatou-se, ainda, que as ondas presentes no domínio do tempo davam respostas equivalentes no domínio das freqüências. Por fim, também não foram encontradas diferenças significativas entre os dois aparelhos para as latências do potencial miogênico vestibular. / The integrity of the auditory pathway and the investigation of the respective electrophysiological threshold can be assessed by observation, in the time domain, of brainstem auditory evoked potentials. This assessment is usually evoked by clicks, which have a wide acoustic spectrum, and consequently serious limitations with respect to frequency specificity, in determining electrophysiological thresholds. New techniques for analyzing auditory evoked potentials in the frequency domain are currently being used for a closer observation of these thresholds. Thus, by applying the fast Fourier transform, one can analyzed the compromised auditory frequencies efficiently and rapidly. This method, on the other hand, does not investigate the integrity of specific auditory pathway structures, as the other method does. Although both types of assessment require similar biological amplifier architecture and are, to a certain extent, complementary, they are performed with two distinct devices. The first, which makes the observation in the time domain, is quite well known and several manufacturers have been producing it for a long time. The second, which inspects the potentials in the frequency domain, was introduced into the market only a few years ago. The aim of this study, therefore, was to develop, characterize and conduct preliminary tests with a single device capable of evaluating the auditory evoked potentials in both domains, by means of a sound card that had not been previously used for this purpose. Thus, a device was produced with biological amplifiers, filters, electrical protection apparatus and a logic control system capable of recording biological signals around 0.5 µV. After characterization and the simulated study, pilot tests were carried out with 12 normal- hearing subjects (n = 24 ears), allocated to two groups of 6 participants. In group 1, we observed the latencies and amplitudes of waves I, III and V of the brainstem auditory evoked potentials, using a gold standard instrument and a developed instrument and later compared them. The findings were then correlated to those of the frequency domain examination formatted on the new device. Group 2 was submitted to an assessment of components p13 and n23 of the vestibular myogenic potentials to observe the most delayed biological signals, also with both instruments, and their absolute latencies were compared. The results showed no significant differences between the two instruments for the amplitudes (p = 0.379; p = 0.301; p = 0.605, waves I, III and V, respectively) and latencies (p = 0.381; p = 0.140; p = 0.255) of the brainstem auditory evoked potentials. It was also found that the waves present in the time domain gave equivalent responses in the frequency domain. Finally, no significant differences were observed between the two devices for the absolute latencies of components p13 and n23 of the vestibular myogenic potentials, with p values of 0.102 and 0.078, respectively. Thus, it was concluded that the new instruments were efficient for the functions tested.

A integridade da via auditiva e a investigação do respectivo limiar eletrofisiológico podem ser avaliadas por meio da observação, no domínio do tempo, dos potenciais evocados auditivos de tronco encefálico. Atualmente, nova técnica de análise dos potenciais evocados auditivos, no domínio das freqüências, tem sido utilizada para uma observação particular desses limiares. Assim, com a aplicação da transformada rápida de Fourier, é possível realizar a análise das freqüências comprometidas na audição, de maneira eficiente e rápida. O objetivo com este trabalho, então, foi desenvolver, caracterizar e realizar testes preliminares com um dispositivo único capaz de avaliar os potenciais evocados auditivos nos dois domínios, por meio de uma placa de som, que ainda não havia sido implementada para tal fim. Desse modo, foi produzido um aparelho capaz de registrar sinais biológicos da ordem de 0,5 ?V. Após a caracterização e o estudo simulado, foram conduzidos testes-piloto com doze seres humanos, ouvintes normais (n = 24 orelhas), divididos em dois grupos com o mesmo número de participantes. No grupo 1, os potenciais evocados auditivos de tronco encefálico adquiridos por meio de um instrumento padrão-ouro e de instrumento desenvolvido foram comparados entre si. Em seguida, os achados foram relacionados com o exame no domínio das freqüências formatado no novo aparelho. O grupo 2 foi submetido à avaliação dos potenciais miogênicos vestibulares, também com os dois instrumentos, e suas latências absolutas comparadas. Os resultados demonstraram não haver diferenças significativas entre os dois instrumentos para as amplitudes e latências do potencial evocado auditivo de tronco encefálico. Constatou-se, ainda, que as ondas presentes no domínio do tempo davam respostas equivalentes no domínio das freqüências. Por fim, também não foram encontradas diferenças significativas entre os dois aparelhos para as latências do potencial miogênico vestibular. / The integrity of the auditory pathway and the investigation of the respective electrophysiological threshold can be assessed by observation, in the time domain, of brainstem auditory evoked potentials. This assessment is usually evoked by clicks, which have a wide acoustic spectrum, and consequently serious limitations with respect to frequency specificity, in determining electrophysiological thresholds. New techniques for analyzing auditory evoked potentials in the frequency domain are currently being used for a closer observation of these thresholds. Thus, by applying the fast Fourier transform, one can analyzed the compromised auditory frequencies efficiently and rapidly. This method, on the other hand, does not investigate the integrity of specific auditory pathway structures, as the other method does. Although both types of assessment require similar biological amplifier architecture and are, to a certain extent, complementary, they are performed with two distinct devices. The first, which makes the observation in the time domain, is quite well known and several manufacturers have been producing it for a long time. The second, which inspects the potentials in the frequency domain, was introduced into the market only a few years ago. The aim of this study, therefore, was to develop, characterize and conduct preliminary tests with a single device capable of evaluating the auditory evoked potentials in both domains, by means of a sound card that had not been previously used for this purpose. Thus, a device was produced with biological amplifiers, filters, electrical protection apparatus and a logic control system capable of recording biological signals around 0.5 µV. After characterization and the simulated study, pilot tests were carried out with 12 normal- hearing subjects (n = 24 ears), allocated to two groups of 6 participants. In group 1, we observed the latencies and amplitudes of waves I, III and V of the brainstem auditory evoked potentials, using a gold standard instrument and a developed instrument and later compared them. The findings were then correlated to those of the frequency domain examination formatted on the new device. Group 2 was submitted to an assessment of components p13 and n23 of the vestibular myogenic potentials to observe the most delayed biological signals, also with both instruments, and their absolute latencies were compared. The results showed no significant differences between the two instruments for the amplitudes (p = 0.379; p = 0.301; p = 0.605, waves I, III and V, respectively) and latencies (p = 0.381; p = 0.140; p = 0.255) of the brainstem auditory evoked potentials. It was also found that the waves present in the time domain gave equivalent responses in the frequency domain. Finally, no significant differences were observed between the two devices for the absolute latencies of components p13 and n23 of the vestibular myogenic potentials, with p values of 0.102 and 0.078, respectively. Thus, it was concluded that the new instruments were efficient for the functions tested.