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Electrophysiologic and behavioral auditory findings in multiple sclerosis
F E Musiek1, K M Gollegly, K S Kibbe
1Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire 03756.
The American Journal of Otology
|September 1, 1989
Summary
Multiple sclerosis (MS) can cause hearing loss even with normal peripheral hearing. Auditory brainstem response (ABR) and masking level difference (MLD) tests effectively detect central auditory dysfunction in MS patients.
Area of Science:
- Neuroscience
- Audiology
- Neurology
Background:
- Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
- Hearing difficulties are a reported symptom in MS patients, but the underlying auditory pathway involvement is not fully understood.
- Central auditory dysfunction can occur independently of peripheral hearing loss in MS.
Purpose of the Study:
- To evaluate the effectiveness of a comprehensive auditory test battery in detecting central auditory dysfunction in individuals with multiple sclerosis.
- To identify the most sensitive diagnostic tests for auditory pathway abnormalities in MS.
- To explore the utility of specific tests, like Auditory Brainstem Response (ABR) and Masking Level Difference (MLD), in assessing MS-related auditory changes.
Main Methods:
- A cohort of 33 subjects with definite multiple sclerosis underwent a battery of auditory tests, including pure tone audiometry, seven behavioral measures, and electrophysiologic tests.
- Key electrophysiologic measures included Auditory Brainstem Response (ABR).
- Behavioral tests included Masking Level Difference (MLD) and dichotic speech measures.
Main Results:
- Over 40% of MS subjects with normal peripheral hearing reported subjective hearing difficulties.
- Auditory Brainstem Response (ABR) emerged as the most sensitive single test for identifying central auditory dysfunction.
- Combining ABR and Masking Level Difference (MLD) tests proved nearly as effective as the full test battery in detecting auditory dysfunction.
- Dichotic speech tests revealed a consistent left-ear deficit, suggesting potential interhemispheric involvement in MS auditory processing.
Conclusions:
- Auditory dysfunction is prevalent in multiple sclerosis, often occurring even with normal peripheral hearing.
- Auditory Brainstem Response (ABR) and Masking Level Difference (MLD) tests are valuable tools for diagnosing central auditory pathway involvement in MS.
- The findings suggest potential interhemispheric communication deficits in MS, as indicated by dichotic speech test results.