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Auditory brainstem responses (ABR) in multiple sclerosis
Abstract:
Thirty-two multiple sclerosis (MS) patients, 10 males and 22 females, aged between 21 and 55, underwent pure-tone audiometry and testing of auditory brainstem response (ABR). Thirteen were classified as 'definite', 12 as 'probable' and 7 as 'possible', according to the McAlpine criteria. Each ear of each patient was tested monoaurally. The most common alterations were seen in the parameters of the cross-correlation between the normal template and the template of the individual MS patient. The second most altered parameters were those concerning the V wave which was absent in most cases but, when present, rarely showed latency-amplitude values falling outside the 90% confidence limit ellipses. Test-retest replicability and stimulations with increasing numbers of stimuli per second were useful in detecting intra-individual variability of waveform characteristics. When considering all the tests performed, 88% of the 'definite', 71% of 'probable' and 64% of 'possible' MS patients' ears showed ABR abnormalities. We stress the importance of a separate evaluation of the two ears due to the frequent unilateral alterations, and of an accurate evaluation of the ABR characteristics. We conclude that brainstem audiometry is a more reliable test for detecting demyelinating processes than is usually described in the literature.
Insights
Auditory Brainstem Response (ABR) testing reveals frequent abnormalities in multiple sclerosis (MS) patients, highlighting its value in detecting demyelinating processes. Separate ear evaluation is crucial due to common unilateral alterations.
Area of Science:
- Neuroscience
- Audiology
- Neurology
Background:
- Multiple Sclerosis (MS) is a demyelinating disease affecting the central nervous system.
- Auditory pathway involvement is common in MS, but its detection can be challenging.
- Standard audiological tests may not fully capture subtle neurological changes.
Purpose of the Study:
- To evaluate the utility of Auditory Brainstem Response (ABR) testing in detecting demyelinating processes in MS patients.
- To assess the prevalence and characteristics of ABR abnormalities in different MS classifications.
- To emphasize the importance of accurate ABR analysis and separate ear evaluation.
Main Methods:
- Thirty-two MS patients (21-55 years) underwent pure-tone audiometry and monoaural ABR testing.
- McAlpine criteria were used for MS classification ('definite', 'probable', 'possible').
- Cross-correlation analysis and V wave parameters were assessed, along with test-retest reliability.
Main Results:
- ABR abnormalities were detected in 88% of 'definite', 71% of 'probable', and 64% of 'possible' MS patients' ears.
- Cross-correlation parameters and V wave characteristics showed the most frequent alterations.
- Unilateral ABR abnormalities were common, necessitating separate ear evaluation.
Conclusions:
- Auditory Brainstem Response (ABR) testing is a highly reliable method for detecting demyelinating processes in MS.
- ABR is more sensitive than typically reported, especially when analyzing cross-correlation and V wave parameters.
- Accurate, separate evaluation of each ear's ABR is essential for comprehensive MS assessment.