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Auditory processing following infantile spasms: An event-related potential study
Tangunu Fosi1,2,3, Klaus Werner1,3, Stewart G Boyd2,3
1Young Epilepsy, Surrey, United Kingdom.
Insights
Infantile spasms (IS) impair auditory processing and language development in infants, even after remission. Early intervention may mitigate, but not reverse, these long-term effects on brain connectivity.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Auditory Neuroscience
Background:
- Infantile spasms (IS), a severe epilepsy syndrome, can impact neurodevelopment.
- Auditory processing is crucial for language acquisition in infants.
- The long-term effects of IS on auditory processing remain poorly understood.
Purpose of the Study:
- To investigate acoustic auditory processing in infants with recent infantile spasms (IS).
- To assess the impact of IS on event-related potentials (ERPs) and cognitive development.
- To explore the relationship between IS duration and auditory processing deficits.
Main Methods:
- Compared event-related potentials (ERPs) and Bayley Scales of Infant Development (BSID-II) in 22 infants with recent IS (uWS) and 22 healthy controls.
- Auditory stimuli included repeated pure tones and environmental broadband sounds.
- Assessments were conducted one month after IS remission.
Main Results:
- Patients with IS exhibited reduced N100 suppression and prolonged latencies to pure tones.
- Novelty P300 amplitude was significantly reduced in IS patients.
- Delayed P300 peak latency to broadband sounds correlated with IS duration, and BSID-II scores were lower in patients.
Conclusions:
- Infantile spasms lead to significant deficits in complex acoustic information processing.
- These auditory processing impairments may negatively affect language development.
- Altered cortical connectivity in auditory processing areas is the likely mechanism, with treatment potentially limiting severity.
Objectives:
To investigate acoustic auditory processing in patients with recent infantile spasms (IS).
Methods:
Patients (n = 22; 12 female; median age 8 months; range 5-11 months) had normal preceding development, brain magnetic resonance imaging (MRI), and neurometabolic testing (West syndrome of unknown cause, uWS). Controls were healthy babies (n = 22; 11 female; median age 6 months; range 3-12 months). Event-related potentials (ERPs) and psychometry (Bayley Scales of Infant Development, Second Edition, BSID-II) took place at a month following IS remission.
Results:
Following a repeated pure tone, uWS patients showed less suppression of the N100 at the mid-temporal electrodes (p = 0.006), and a prolonged response latency (p = 0.019). Their novelty P300 amplitude over the mid-temporal electrodes was halved (p = 0.001). The peak of the novelty P300 to environmental broadband sounds emerged later over the left temporal lobe in patients (p = 0.015), the lag correlating with duration of spasms (r = 0.547, p = 0.015). BSID-II scores were lower in patients (p < 0.001), with no correlation to ERP.
Significance:
Complex acoustic information is processed poorly following IS. This would impair language. Treatment did not reverse this phenomenon, but may have limited its severity. The data are most consistent with altered connectivity of the cortical acoustic processing areas induced by IS.