Contexte: La réponse synchrone des fibres auditives, évaluée à partir de l'onde I des potentiels d'action évoqués auditifs (PEA), ou à partir du potentiel d'action composite (PAC) du nerf auditif, est l'élément clé du dépistage des neuropathies auditives. De récentes études ont toutefois montré que le seuil et l'amplitude de cette réponse pouvaient être absolument normaux malgré une perte importante de fibres du nerf auditif. Dans ce travail de thèse, nous proposons une nouvelle méthode d'exploration fonctionnelle, potentiellement applicable à l'homme, rendant mieux compte du nombre et de l'intégrité des fibres du nerf auditif. Cette méthode a été évaluée à l'aide d'un modèle pharmacologique de neuropathie physiologiquement pertinent.Matériel et méthodes: Chez des gerbilles, une perte sélective de fibres auditives a été induite par application d'une faible concentration d'ouabaïne dans la niche de la fenêtre ronde de la cochlée. Cette neuropathie a ensuite été caractérisée par des comptages de synapses (immunohistochimie/imagerie confocale 3D) et l'enregistrement de l'activité unitaire de fibres du nerf auditif. Les PAC et l'activité soutenue du nerf ont été enregistrés 6 jours après l'application d'ouabaïne, à l'aide d'une électrode de recueil disposée dans la niche de la fenêtre ronde. Résultats: L'application d'ouabaïne induit une perte spécifique des fibres à basse activité spontanée (AS<0,5 potentiel d'action/sec) comme observé au cours du vieillissement et après une surexposition sonore. La disparition de cette population de fibres est indétectable à l'aide du PAC car leur réponse unitaire est à la fois retardée et désynchronisée. Par contre, l'amplitude de la réponse soutenue du nerf se révèle être un bien meilleur indicateur de la perte des fibres à basse activité spontanée. Pour aller plus loin, nous avons mis au point une méthode qui permet d'observer l'activité synchrone et soutenue du nerf auditif dans une même réponse. Cette approche rend compte des trois mécanismes de fusion vésiculaire (libération rapide, lente et soutenue) de la première synapse auditive.Conclusion: L'analyse de la réponse soutenue du nerf auditif est une approche fiable pour déterminer le nombre et le phénotype fonctionnel des fibres qui composent le nerf auditif. Cette méthode, applicable à l'homme, devrait améliorer le dépistage des neuropathies, avec une meilleure différenciation des atteintes d'origine synaptique et/ou neuronale.Mots clés: Cochlée, nerf auditif, potentiel d'action composite, activité soutenue du nerf auditif, enregistrement unitaires, ouabaïne, neuropathie / Background: The synchronous activation of the auditory nerve fibers (ANFs), is commonly studied through the compound action potential (CAP), or the auditory brainstem responses (ABR), to probe deafness in experimental and clinical settings. Recent studies have shown that substantial ANF loss can coexist with normal hearing threshold, and even unchanged CAP amplitude, making the detection of auditory neuropathies difficult. In this study, we took advantage of the round window neural noise (RWNN) to probe ANF loss in a physiologically-relevant model of neuropathy.Material and methods: ANF loss was induced by the application of ouabain onto the round window niche. CAP and RWNN of the gerbil's cochlea were recorded through an electrode placed onto the round window niche, 6 days after the ouabain application. Afferent synapse counts and single-unit recordings were carried-out to determine the degree and the nature of ANF loss, respectively. Results: Application of a low ouabain-dose into the gerbil RW niche elicits a specific degeneration of low spontaneous rate (SR) fibers, as shown by single-unit recordings. Simultaneous recordings (CAP/single-unit) demonstrate that low-SR fibers have a weak contribution to the CAP amplitude because of their delayed and broad first spike latency distribution. However, the RWNN amplitude decreases with the degree of synaptic loss. The RWNN method is therefore more sensitive than CAP to detect low-SR fiber loss, most probably because it reflects the sustained discharge rate of ANFs. Based on these data, we proposed a far-field method (Peri-stimulus time response-PSTR) to assess the fast, slow, and sustain vesicular release at the first auditory synapse.Conclusion: The round window neural noise is a faithful proxy to probe the degree and the SR-based nature of fiber loss. This method could be translated into the clinic to probe hidden hearing loss and orient the practitioner toward synaptopathy and/or neuropathy.Key words: Cochlea, auditory nerve, compound action potential, round window neural noise, single fiber recording, ouabain-induced neuropathy

Made available in DSpace on 2015-05-14T13:00:16Z (GMT). No. of bitstreams: 1 parte1.pdf: 4104748 bytes, checksum: 578975146349baff07079d6c3f9756b6 (MD5) Previous issue date: 2008-08-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Snake venoms contain a complex arsenal of protein bio-active components, many of these being neurotoxins (NTXs). These snakes have high neurotoxic activity venom, corresponding to the Elapidae family, which includes coral snakes (Micrurus) whose venom contains circa 90-95% of low molecular mass protein components. Among these, several are postsynaptic neurotoxins or α- NTXs (MM = 6-9 kDa). The Micrurus ibiboboca (Merren, 1820) is a snake of the Elapidae family witch is quite common in the Northeast of Brazil. In spite of the great diversity of species of Micrurus, scarce works involving the nervous system with isolated and pure toxins of those serpents has been developed in level biochemical, pharmacological and electrophysiological. The aim of this study was to purify the toxin Mic6c7NTX of the Micrurus ibiboboca venom, characterize to biochemically and electrophysiologically the toxin Mic6c7NTX in the peripheral nervous system (PNS) of rats, evaluating alterations in the record of the Compound Action Potential (CAP) of the isolate nerve and the toxin activity on the voltage-dependent sodium channels (Nav) in the neurons of the dorsal root ganglion (DRG). The venom was extracted from the Micrurus ibiboboca collected in Paraiba State (Brazil). Initially, electrophysiological tests (current clamp method) using the single sucrose gap technique were accomplished with crude venom (100μg/mL). It was observed that in this concentration the crude venom caused reduction in the CAP amplitude (25%). This neurotoxity led into an intriguing question: what components of the venom would promote to reduction in the excitability of the nerve? Based upon this question, I decided to purify the venom throughout the Liquid Chromatography of the High Performance (HPLC) of the Cation Exchange Chromatography (CIEX) and the Reverse Phase Chromatography (RPC). The molecular mass (MM) of the raw toxin was determined by mass-spectrometry (MALDI-QTOF/ MS) and N-terminal sequence by means of Edman s Degradation. The search for similarity with other toxins was accomplished against proteomic data bank. The CIEX profile showed 19 fractions and the highest peak fraction was used for the second dimension. The toxin Mic6c7NTX obtained by RPC showed elution in 26.7%of the acetonitrile (ACN) and MM 7.047.56Da. The obtained partial N-terminal sequence showed 31 aminoacid residues. The search for similarity of structure and function showed great similarity (65%) with other short chain α-NTXs Australian elapids snakes. The electrophysiological studies (single sucrose gap technique) showed that the toxin Mic6c7NTX (1 μM) reduced the excitability of the isolate nerve similarly to the reduction observed in the crude venom about 21%. Other CAP parameters such as despolarization speed (DSCAP), repolarization time (τCAP) and peak of time (PTCAP) did not show alterations. This suggests that the toxin may be affecting the Nav channels. For the confirmation of that hypothesis experiments were accomplished with whole cell patch-clamp technique in DRG neurons. This results showed that the toxin Mic6c7NTX (1 WM) abolished completely the current of Nav channels sensitive the tetrodotoxin (TTX-S). Also the Nav channels TTX resistant (TTX-R) were investigated in the presence of the Mic6c7NTX toxin previously using TTX (100 nM). This results showed that the toxin Mic6c7NTX (100 nM) abolished completely the current of Nav channels TTX-R and IC50 = 30nM. However, reversion of this blocking was not observed. The present study biochemically and electrophysiologically characterized an α-NTX of the Micrurus ibiboboca elapid snake. Furthermore, it showed a potent toxin with affinity Nav channels TTX-S and TTX-R of the PNS. This is the first α-NTX isolated and identified of the venom from the Micrurus ibiboboca (Merrem, 1820) snake. / As serpentes da família Elapidae possuem uma peçonha com alta atividade neurotóxica e capacidade de letalidade. Fazem parte dessa família as serpentes corais americanas (gênero Micrurus) com suas peçonhas contendo cerca de 90-95% de componentes protéicos, sendo na sua maior parte neurotoxinas com baixa massa molecular (6-8 kDa), podendo ser destacadas as neurotoxinas com ação pós-sinápticas ou α-Neurotoxinas (α-NTX). A Micrurus ibiboboca (Merrem, 1820) é uma serpente da família Elapidae, comum na região Nordeste. Apesar da grande diversidade de espécies do gênero Micrurus sp., escassos trabalhos envolvendo atividade de toxinas isoladas e puras destas peçonhas e sistema nervoso têm sido desenvolvidos em nível bioquímico, farmacológico ou eletrofisiológico. O objetivo desse estudo foi purificar a toxina Mic6c7NTX da peçonha de M. ibiboboca, caracterizar bioquímicamente e investigar com ferramentas eletrofisiológicas a ação da toxina no Sistema Nervoso Periférico (SNP) de ratos avaliando alterações no Potencial de Ação Composto (PAC) do nervo isquiático isolado e a atividade da toxina nos canais para sódio dependentes de voltagem (Nav) em neurônios do gânglio da raiz dorsal (DRG). A peçonha da M. ibiboboca foi extraída de serpentes coletadas no Estado da Paraíba (Brasil). Inicialmente, ensaios eletrofisiológicos com o método de current clamp utilizando a técnica de single sucrose gap foram realizados com a peçonha bruta (100 Wg/mL). Os resultados mostraram que a peçonha bruta nessa concentração promoveu redução na amplitude do PAC (25%). Esse efeito da toxina na excitabilidade do nervo levantou o questionamento: Que componentes da peçonha estariam causando essa diminuição da excitabilidade? A peçonha foi purificada por meio de Cromatografia Líquida de Alta Performance (HPLC), de troca catiônica (CIEX) e fase reversa (RPC). Na sequência, os picos da CIEX foram submetidos à RPC e posteriormente analisados por espectrometria de massas (MALDI-TOF/MS) que detectou a massa molecular da toxina Mic6c7NTX de 7.047,56 Da. Em seguida, foi determinado o seu N-terminal por Degradação de Edman que apresentou 31 resíduos de aminoácidos e serviu de estudo para a bioinformática na busca por similaridade em banco de dados proteômicos com outras toxinas protéicas, demonstrando que a toxina Mic6c7NTX apresentou similaridade (65%) com α-NTXs de cadeia curta de serpentes elapídicas australianas. Posteriormente, foi investigado o efeito da toxina isolada no SNP. Os estudos eletrofisiológicos em single sucrose gap demonstraram que a toxina Mic6c7NTX (1 WM) reduziu a excitabilidade do nervo isolado de forma similar à observada pela peçonha bruta. Não foram observadas alterações significantes em outros parâmetros do PAC, como velocidade de despolarização (VDPAC), tempo de repolarização (τPAC) e tempo de pico (PTPAC), sugerindo que a toxina atuasse num sítio de ligação específico dos [Escreva uma citação do documento ou o 11 canais Nav no SNP. Para a confirmação dessa hipótese foram realizados experimentos de voltage clamp com a técnica de whole cell patch-clamp em cultura primária de neurônios DRG da medula espinhal de ratos. Os resultados mostraram que a toxina Mic6c7NTX (1 WM) aboliu completamente as correntes dos canais Nav sensíveis à tetrodotoxina (TTX-S). Também foi investigado o efeito da toxina sobre a população de canais Nav resistentes à TTX (TTX-R), utilizando previamente TTX (100 nM) para bloquear os canais Nav TTX-S. Os registros com a toxina Mic6c7NTX (100 nM) demonstraram um bloqueio total da corrente nos canais Nav TTX-R dos DRGs e uma IC50 da toxina em torno de 30 nM. Também foi observado que essa toxina se liga aos canais Nav de forma lenta e irreversível. O presente estudo caracterizou bioquímica e eletrofisiologicamente uma α-NTX da serpente elapídica Micrurus ibiboboca. Farmacologicamente, trata-se de uma potente toxina com afinidade aos canais Nav TTX-S e TTX-R do SNP. Essa é a primeira α-NTX isolada e caracterizada da peçonha da serpente Micrurus ibiboboca (Merrem, 1820).

This study determined whether the Hodgkin-Huxley model for unmyelinated nerve fibres could be more comprehensively modified to predict excitation behaviour at Ranvier nodes of a human sensory nerve fibre, as specifically applied to the prediction of temporal characteristics of the human auditory system. The model was developed in three phases. Firstly, the Hodgkin-Huxley model was modified to describe action potential dynamics at Ranvier nodes using recorded ionic membrane current data from single human myelinated peripheral nerve fibres. A nerve fibre cable model, based on a combination of two existing models, was subsequently developed using human sensory nerve fibre morphometric data. Lastly the morphological parameters of the nerve fibre model were changed to resemble a Type I peripheral auditory nerve fibre and coupled to a volume-conduction model of the cochlea. This study is the first to show that the Hodgkin-Huxley model equations can be modified successfully to predict excitation behaviour of a generalised human peripheral sensory nerve fibre without using the Goldman-Hodgkin-Katz equations. The model includes a more comprehensive establishment of temperature dependence of the physiological and electrical parameters compared to existing models. Two versions of the human Type I auditory nerve fibre model were developed, one simulating an undamaged (non-degenerate) fibre and another a damaged (degenerate) fibre. Comparison between predicted and measured results indicated similar transient and persistent sodium, as well as slow potassium ionic membrane currents to those found in generalised sensory nerve fibres. Results confirm that chronaxie, rheobase current, mean latency, threshold and relative refractive periods depend on the amount of degeneracy of fibres. The model could account for threshold differences observed between different asymmetric waveforms. The combination of persistent sodium and slow potassium ionic membrane currents could in part predict non-monotonic excitation behaviour observed experimentally. A simplified method was developed to calculate electrically evoked compound action potential responses following neural excitation. It provided a computationally effective way to obtain an estimate of profile widths from the output of models that calculate neural excitation profiles, and an indirect way to estimate stimulus attenuation by calculating the value of the parameter that produces the best fit to experimental data. Results also confirmed that electrode arrays located closer to the modiolus produce more focussed neural excitation spread than more laterally located arrays. / Thesis (PhD)--University of Pretoria, 2010. / Electrical, Electronic and Computer Engineering / unrestricted

Introduction: Auditory neuropathy spectrum disorder (ANSD) is a disorder characterized by impaired temporal coding of acoustic signals due to a deficiency in neural synchrony or neural transmission. Despite variations in speech perception outcomes within both patients and studies, current evidence demonstrates that children with ANSD, who use hearing aids (HAs) or cochlear implants (CIs), generally achieve speech perception performance comparable to peers with sensorineural hearing loss (SNHL). However, limited studies have reported factors that have prognostic value for auditory intervention outcomes. The objectives of this doctoral thesis, consisting of three consecutive associated projects on children with ANSD, were (1) to determine factors with predictive value for post-intervention (CIs and/or HAs) outcomes through a retrospective study, (2) to systematically summarize and critically appraise existing evidence of the prognostic value of early auditory electrophysiologic tests and MRI findings for CI outcomes through a systematic review (SR), and (3) to systematically overview, summarize, and critically appraise evidence of CI outcomes through an umbrella review of current SRs (overview of SRs). -- Methods: For the first project, the records of 38 children with ANSD between 5 and 18 years old, 63.20% males, who used CIs (71%) and/or HAs, identified at the Children's Hospital of Eastern Ontario (CHEO) were reviewed. For the second and third projects, the SRs were guided by the PRISMA 2020 statement, and electronic databases were searched without restrictions on language, publication status, or year of publication. In the second project, studies on children with ANSD (including those with cochlear nerve deficiency [CND]), cochleovestibular nerve (CVN) abnormalities, or SNHL reporting the relevance of preoperative and/or postoperative electric compound action potential (eCAP), electric auditory brainstem response (eABR), and/or MRI results to CI outcomes were included. The methodological quality and strength of evidence were assessed using the Crowe Critical Appraisal Tool (CCAT) and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool, respectively. In the third project, all SRs that reported CI outcomes in children with ANSD were included. The methodological quality of the selected SRs was evaluated using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) checklist, and the risk of bias in evidence was assessed using the Risk of Bias in Systematic Reviews (ROBIS) tool. -- Results: In the retrospective chart review (first project), ages at HL diagnosis and CI activation and the length of follow-up with CI/HA showed a significant relationship with open-set speech perception outcomes (i.e., the scores of Phonetically Balanced Kindergarten [PBK] test with word and phoneme speech materials and Hearing in Noise Test [HINT] in quiet and noise conditions). Using a Forward Linear Multiple Regression Model, the length of follow-up with CI/HA and bilateral amplification showed prognostic value for speech perception performance. In the second project, 25 papers were included in the review. While it was difficult to draw a firm conclusion about the eCAP findings, current evidence strongly supports the prognostic value of eABR and MRI for post-CI speech perception outcomes. According to the eight SRs selected for the third project, children with ANSD achieve CI outcomes comparable to their peers with SNHL. However, in children with postsynaptic ANSD (i.e., those with CND), cochlear nerve hypoplasia is associated with better speech recognition outcomes compared to cochlear nerve aplasia, especially in the absence of additional disabilities and/or medical comorbidities (ADs/MCs). -- Conclusion: Children with ANSD, especially those without cochlear nerve aplasia and ADs/MCs, achieve speech perception outcomes comparable to their peers with SNHL. In addition, age at HL diagnosis, age at CI activation, the length of follow-up with CI/HA, bilateral amplification, and eABR and MRI findings are associated with or have predictive value for intervention outcomes. The findings of the SRs should be interpreted with caution given the low quality of evidence and risk of bias in the studies selected for SRs.

<div>Electrical nerve stimulation (ENS) is an emerging therapy for many neurological disorders. Compared with conventional one-way stimulations, closed-loop ENS approaches increase the stimulation efficacy and minimize patient's discomfort by constantly adjusting the stimulation parameters according to the feedback biomarkers from patients. Wireless neurostimulation devices capable of both stimulation and telemetry of recorded physiological signals are welcome for closed-loop ENS systems to improve the quality and reduce the costs of treatments, and real-time digital signal processing (DSP) engines processing and extracting features from recorded signals can reduce the data transmission rate and the resulting power consumption of wireless devices. Electrically-evoked compound action potential (ECAP) is an objective measure of nerve activity and has been used as the feedback biomarker in closed-loop ENS systems including neural response telemetry (NRT) systems and a newly proposed autonomous nerve control (ANC) platform. It's desirable to design a DSP engine for real-time processing of ECAP in closed-loop ENS systems. </div><div><br></div><div>This thesis focuses on developing the DSP architecture for real-time processing of ECAP, including stimulus artifact rejection (SAR), denoising, and extraction of nerve fiber responses as biomedical features, and its VLSI implementation for optimal hardware costs. The first part presents the DSP architecture for real-time SAR and denoising of ECAP in NRT systems. A bidirectional-filtered coherent averaging (BFCA) method is proposed, which enables the configurable linear-phase filter to be realized hardware efficiently for distortion-free filtering of ECAPs and can be easily combined with the alternating-polarity (AP) stimulation method for SAR. Design techniques including folded-IIR filter and division-free averaging are incorporated to reduce the computation cost. The second part presents the fiber-response extraction engine (FREE), a dedicated DSP engine for nerve activation control in the ANC platform. FREE employs the DSP architecture of the BFCA method combined with the AP stimulation, and the architecture of computationally efficient peak detection and classification algorithms for fiber response extraction from ECAP. FREE is mapped onto a custom-made and battery-powered wearable wireless device incorporating a low-power FPGA, a Bluetooth transceiver, a stimulation and recording analog front-end and a power-management unit. In comparison with previous software-based signal processing, FREE not only reduces the data rate of wireless devices but also improves the precision of fiber response classification in noisy environments, which contributes to the construction of high-accuracy nerve activation profile in the ANC platform. An application-specific integrated circuit (ASIC) version of FREE is implemented in 180-nm CMOS technology, with total chip area and core power consumption of 19.98 mm² and 1.95 mW, respectively. </div><div><br></div>