RESUMO Objetivo analisar o efeito do mascaramento estável e modulado no Potencial Evocado Auditivo Cortical com estímulo de fala em adultos-jovens. Método participaram 14 indivíduos com idades entre 19 e 28 anos de ambos os sexos e sem perda auditiva. O exame de Potencial Evocado Auditivo Cortical foi realizado com estímulo de fala sintética /ba/ simultâneo ao ruído Speech Shaped Noise apresentado em três condições: ruído estável com intensidade de 30 dB NPSpe (ruído estável fraco), ruído estável com intensidade de 65 dB NPSpe (ruído estável forte) e ruído modulado em intensidade de 30 dB NPSpe e 65 dB NPSpe em 25Hz e com período de modulação de 40 ms. Resultados foram observadas maiores latências nos componentes corticais, exceto P2, na condição de ruído estável forte e medidas mais robustas de amplitude dos componentes corticais P1, N1 e P2 na condição de ruído modulado com diferença estatística significativa na comparação com a condição de ruído estável forte. Houve pior morfologia na condição de ruído estável forte, quando comparado aos demais registros. Os limiares eletrofisiológicos médios para as condições de ruído estável forte e ruído modulado foram 60 dB NPSpe e 49 dB NPSpe, respectivamente, mostrando 11,7 dB de diferença média. Conclusão podemos inferir que houve um menor efeito mascarante do ruído modulado, comparado à condição de ruído estável forte, nas medidas de amplitude dos componentes corticais e uma diferença média de 11,7 dB entre os limiares eletrofisiológicos (interpretado como a medida do Benefício do Mascaramento Modulado).

ABSTRACT Purpose To analyze the effect of masking on the Cortical Auditory Evoked Potential with speech stimulus in young adults. Methods Fourteen individuals aged between 19 and 28 years of both sexes with no hearing loss participated in the study. The Cortical Auditory Evoked Potential examination was performed with synthetic speech stimulus /ba/ simultaneous to Speech Shaped Noise presented under three conditions: steady noise with a 30 dB SPLep intensity (weak steady noise), steady noise with a 65 dB SPLep intensity o (strong steady noise) and modulated noise with 30 dB SPLep and 65 dB SPLep intensities at 25Hz and modulation period of 40 ms. Results Higher latencies were observed in the cortical components, except P2, in the condition of strong steady noise and more meaningful measures of amplitude of the cortical components P1, N1 and P2 in the condition of modulated noise with statistically significant difference in comparison to the strong steady noise condition. There was worse wave morphology in the condition of strong steady noise, when compared to the other records. The average electrophysiological thresholds for the conditions of strong steady noise and modulated noise were 60 dB SPLep and 49 dB SPLep, respectively, showing a 11.7 dB mean difference. Conclusion We could infer that there was a lower masking effect of modulated noise when compared to the strong steady noise condition, in the amplitude measurements of the cortical components and an average difference of 11.7 dB between the electrophysiological thresholds (interpreted as the measure of the Masking Release).

Abstract Objective: To analyze the effect of noise on electrophysiological measurements (P1-N1-P2 complex) of cortical auditory evoked potentials in normal hearing individuals of different ages. Methods: The inclusion criteria for the study were young individuals, adults and elderly, aged 18–75 years, with auditory thresholds up to 25 dB. Participants were separated according to their age group: G1 (18–25 years old), G2 (31–59 years old) and G3 (60–75 years old). Cortical auditory evoked potentials were elicited with synthetic speech stimulus /da/ presented in two conditions: without masking and with masking (Delta-t 64ms). The results were expressed and analyzed using statistical measures. Results: High latencies and reduced amplitudes were observed in the Delta-t 64 ms condition, in all age groups. There were significant differences between the groups, both in P1 latencies for the two conditions and in N1 latencies in the Delta-t 64 ms condition. P1 latencies in the condition without masking were lower in G1 and P1 and N1 latencies in the Delta-t 64 ms condition were higher in G3. The described results show the influence of noise on cortical responses in all age groups, with G3 being the most affected by the masking presentation. Conclusion: The latency and amplitude measurements vary according to the stimulus presentation condition and age group. The forward masking phenomenon occurred with greater precision in G3. Level of evidence: (2c).

Abstract Objective: To investigate ocular movements measures of vectoelectro-nystagmography and video-nystagmography in dyslexic children and compare with measures of typical children. Methods: A systematic review of observational studies comparing the ocular movements differences between dyslexic and typical children with no publication date or language restriction. The literature survey included the bibliographic databases MEDLINE, ScienceDirect, Scopus, Web of Science, SciELO, Lilacs and CENTRAL. Gray literature databases were also searched, including: OpenGrey.eu, DissOnline.de, The New York Academy of Medicine and WorldCat. The meta-analysis was performed using software RevMan 5.3 (Cochran Collaboration). Results: A total of 2375 articles were found of which 113 fell within the inclusion criteria. Among these, 52 were duplicates (found in more than one research source), and 45 articles were selected for reading in full. Thirteen (13) articles were included for analysis and discussion. Meta-analysis showed statistical differences between the two groups for the total number of saccades and duration of fixation. Conclusion: The study revealed that children with dyslexia have longer duration of fixation and fewer saccades during ocular movements on vectoelectro-nystagmography and videonystagmography when compared to children without dyslexia.

ABSTRACT Purpose: to compare cortical auditory evoked responses using two speech stimuli, /ma/ and /da/, in normally hearing young adults. Methods: a cross-sectional, observational and analytical study, with a sample composed of nineteen normally hearing young adults, recruited by convenience, ages between 18 and 25 years old, from both genders, participated in the study. Cortical auditory evoked potentials (CAEP) were monaurally recorded in two conditions: 1) with a pair of speech stimuli /ba/ and /da/, and 2), with a pair of speech stimuli /ba/ and /ma/. The order of the experiments was randomized in a proportion of 50% for each of the two stimuli, totaling 100 stimuli for each experiment. Speech sounds were presented at 70 dB SPL. Descriptive and analytical statistical tests were performed. Results: mean latency values of the complex P1, N1, P2, N2 and P3 were lower for the /ma/ when compared to those of /da/ (p <0,05). There was no difference in amplitude values between responses evoked using /ma/ and /da/. Conclusion: cortical auditory evoked potentials, elicited by the speech stimulus /ma/ had, on average, lower latency peaks of P1-N1-P2-N2 and P3, when compared to those of speech stimulus /da/.

Abstract Introduction The use of hydroxychloroquine and chloroquine is formally indicated in cases of chronic autoimmune diseases. However, the use of these medications has already been associated with possible transitory or definitive alterations in hearing function and/or vestibular function in humans, when administrated in the short and long terms. Objective To describe, through a literature analysis, the functional vestibular and/or hearing alterations, caused by the use of hydroxychloroquine and chloroquine in youths and adults. Data Synthesis In total, 2,481 studies were identified in the initial search: out of these 32 were selected for a full-text reading, and 9 were selected after the exclusion of those which did not meet the eligibility criteria. Of these, four articles pointed to the presence of vestibular and auditory-associated alterations, three indicated only auditory pathologies, and two, vestibular disorders. Regarding the auditory alterations, tinnitus was the most frequent symptom, and bilateral sensorineural hearing loss was described in most studies, varying in degree from mild to severe. As for the vestibular alterations, vertigo was the most reported symptom. Conclusion Knowledge of the auditory and vestibular effects after the use of these substances can help in the decision regarding the best treatment, enabling the consideration of other available therapies for patients at risk of suffering those alterations, reducing the risk of auditory and vestibular disorders.

RESUMO Objetivo: analisar os critérios mais utilizados pelos peritos na elaboração do laudo pericial grafotécnico. Métodos: o método utilizado foi descritivo, quantitativo, inferencial e transversal, com análise estatística dos resultados obtidos em formulário aplicado aos peritos. Foram realizados cálculos estatísticos a partir da linguagem R versão 4.0.1, com significância estatística fixada em 5%. Resultados: a análise da frequência absoluta indicou uma maior ocorrência de uso dos critérios ataques, remates e andamento gráfico, com frequência relativa acima de 70%. Uma avaliação detalhada por meio da análise univariada mostrou que esses critérios não possuem relevância para o acerto durante a conclusão do laudo pericial apontando que a morfologia é um critério relevante para inferir se uma avaliação está correta. Os dados mostram também que os critérios ataques, inclinação, dinamismo e evolução, ao serem observados no que tange a modelagem multivariada, não foram considerados significantes, indicando que a subjetividade precisa ser observada para acerto do avaliador. Conclusão: os critérios de análise grafotécnica mais informados em relação ao acerto dos avaliadores não apresentaram relevância estatística pelos peritos para elaboração do laudo pericial.

ABSTRACT Purpose: to analyze the criteria most used by experts in the handwriting analysis report. Methods: a descriptive, quantitative, inferential, and cross-sectional study, with statistical analysis of the results obtained with a form administered to the experts. The statistical calculations were made with R language, version 4.0.1, with statistical significance set at 5%. Results: the absolute frequency analysis indicated a greater occurrence of the use of initial and final pen strokes and handwriting progress, with a relative frequency above 70%. A detailed evaluation with univariate analysis showed that these criteria are not relevant to correct conclusions in the expert analysis report. It also pointed out that morphology is a relevant criterion to infer whether an evaluation is correct. The data showed that initial pen stroke, inclination, dynamism, and evolution, when observed in terms of multivariate modeling, were not significant, indicating that subjectivity is essential for the experts to make correct analyses. Conclusion: the most reported expert handwriting analysis criteria in relation to the experts’ correct analyses were not statistically relevant for the development of the analysis reports.

RESUMO Objetivo: investigar o reconhecimento auditivo da fala intermitente em função de diferentes taxas de modulação e em função da idade. Métodos: participaram do estudo vinte jovens, vinte adultos de meia idade, e dezesseis idosos, todos com limiares auditivos iguais ou menores que 25 dB NA até a frequência de 4000 Hz. Os participantes foram submetidos a testes de reconhecimento da fala intermitente apresentada em três condições de modulação: 4 Hz, 10 Hz e 64 Hz. Percentuais de acerto foram comparados entre grupos etários e taxas de modulação. Para a investigação do efeito da taxa de modulação foi realizada ANOVA e testes Post Hoc, enquanto para a investigação do efeito da idade, utilizou-se o modelo de regressão linear misto (p<0,001). Resultados: sobre o efeito da idade, os dados mostram diferença significante entre jovens e idosos, e entre adultos de meia idade e idosos. Sobre o efeito da taxa de modulação, os índices de acerto da taxa mais lenta (4Hz) foram significantemente menores nos três grupos etários. Conclusão: foi verificado um efeito da idade no reconhecimento da fala intermitente: idosos apresentaram maior dificuldade. Percebeu-se também um efeito de taxa de modulação nos três grupos etários: quanto maior a taxa, melhor o desempenho.

ABSTRACT Purpose: to investigate the auditory recognition of intermittent speech in relation to different modulation rates and ages. Methods: 20 young people, 20 middle-aged adults, and 16 older adults, all of them with auditory thresholds equal to or lower than 25 dB HL up to the frequency of 4000 Hz. The participants were submitted to intermittent speech recognition tests presented in three modulation conditions: 4 Hz, 10 Hz, and 64 Hz. The percentages of correct answers were compared between age groups and modulation rates. ANOVA and post hoc tests were conducted to investigate the modulation rate effect, and the mixed linear regression model (p < 0.001). Results: regarding the age effect, the data showed a significant difference between young people and older adults, and between middle-aged and older adults. As for the modulation rate effect, the indexes of correct answers were significantly lower at the slower rate (4 Hz) in the three age groups. Conclusion: an age effect was verified on intermittent speech recognition: older adults have greater difficulty. A modulation rate effect was also noticed in the three age groups: the higher the rate, the better the performance.

ABSTRACT Purpose: to analyze forward masking in normally hearing young people, by using frequency-following responses. Methods: the synthetic syllable /da/ was used for the recordings of ten individuals, in the following conditions: /da/ with no masking, and /da/ after 4, 16, 32, and 64 milliseconds of masking. F-test (ANOVA) was applied for repeated measures with the Greenhouse-Geisser correction to compare testing conditions. For significant differences, multiple comparisons (between pairs of conditions) and Bonferroni correction were used. Data normality was verified by applying the Shapiro-Wilk test, and statistical significance was used at 5%. Results: wave latencies of all masking conditions were compared with those of no masking. A latency delay was observed in the transient region of the response (PV and A) in all masking conditions, except for 64 milliseconds. Latency delay also occurred for waves PW, PX, and PY, which corresponded to the sustained region of the response. Conclusion: forward masking was observed, by using frequency-following responses with /da/ syllable in four intervals (4, 16, 32, and 64 ms) of preceding masking. Forward masking was more evident in the transient region of the response than in the sustained one. This study highlights the importance of electrophysiological testing in temporal processing assessment.

RESUMO Objetivo Investigar o efeito da idade no benefício da modulação do ruído mascarante (masking release) e no pós-mascaramento ( forward masking). Métodos Participaram da pesquisa jovens (média de idade de 18 anos e quatro meses) e idosos (média de idade de 64 anos e três meses) falantes nativos do Português Brasileiro e com audição normal. Mediante uso de sentenças da versão brasileira do Hearing in Noise Test, determinou-se, para ambos os grupos, limiares de reconhecimento em presença de ruído estável e em presença de ruído modulado em amplitude (10 Hz). Para a pesquisa do pós-macaramento, foram determinados limiares auditivos em intervalos de tempo de 4, 16, 64 e 128 milissegundos, após a interrupção do ruído. Para avaliar a normalidade dos resultados obtidos, foi aplicado o teste de Shapiro-Wilk. Nas variáveis em que a normalidade foi indicada, aplicou-se o teste t de Student para amostras independentes e nos casos em que a normalidade não foi encontrada, aplicou-se o teste de Mann-Whitney. Foi considerado o nível de significância de 5% Resultados Observou-se o benefício da modulação do mascaramento nos dois grupos. Porém, esse benefício foi menor para o grupo dos idosos (p-valor < 0,001). Na investigação do pós-mascaramento, houve diferença significativa entre os grupos, na média de limiares em 128 milissegundos, após a cessação do ruído (p-valor = 0,006). Conclusão O estudo mostra efeito da idade no benefício de modulação do ruído mascarante e no pós-mascaramento.

ABSTRACT Purpose The purpose of this study was to investigate the age-related effects of modulation masking release and forward masking. Methods Ten younger (mean age of 18.4) and ten older (mean age of 64.3) adults participated in the study. All participants were native speakers of Brazilian Portuguese with normal hearing. Sentences of the Brazilian version of the Hearing in Noise Test were used to obtain speech recognition thresholds in the presence of steady-state noise and amplitude-modulated noise (10 Hz). To investigate forward masking, auditory thresholds were determined at time intervals of 4, 16, 64, and 128 ms after noise interruption. The Shapiro-Wilk test was applied to evaluate the normality of the results. In the variables in which normality was indicated, the Student’s t-test was applied for the independent samples, and the Mann-Whitney test was applied in cases where normality was not found. A significance level of 5% was adopted for all statistical analyses. Results Modulation masking release was present in both groups; however, it was significantly smaller in the elderly group. As for forward masking investigation, higher thresholds were obtained after noise interruption, and improved as the time interval between noise and stimulus presentation increased. Forward masking was higher in the elderly group, whit higher thresholds for the time interval of 128 ms. Conclusion An age-related effect was identified on modulation masking release and forward masking.

RESUMO Introdução A capacidade em perceber os sons da fala possibilita ao ser humano comunicar-se de forma eficiente. Esse aspecto deve ser considerado na avaliação dos distúrbios da comunicação humana. O Hearing in Noise Test (HINT) foi adaptado para o português brasileiro e faz uso de sentenças para avaliar o reconhecimento de fala em silêncio e na presença de ruído competitivo. O teste pode ser uma ferramenta clínica importante, embora não se observe a utilização do HINT na prática clínica audiológica no Brasil. Um dos motivos dessa ausência pode estar relacionado com a falta de padronização em alguns aspectos do teste, incluindo o julgamento de respostas apresentadas durante sua aplicação. Objetivo Analisar os diferentes critérios de julgamento de respostas obtidas de indivíduos submetidos à pesquisa de limiares de reconhecimento das sentenças do HINT em português brasileiro. Método A pesquisa foi realizada com 30 adultos jovens (três grupos de 10 pessoas), entre 18 e 25 anos, de ambos os gêneros, com audição normal. Os indivíduos foram submetidos ao teste de reconhecimento de sentenças em presença de ruído competitivo com uso de sentenças do HINT, adaptado para o português brasileiro. Foram determinados limiares de reconhecimento de sentenças na presença de ruído, através da utilização de três critérios de julgamento publicados na literatura brasileira. Foi realizada uma análise de variação única para comparar as médias dos limiares entre os três grupos. A probabilidade máxima de erro para rejeitar a hipótese nula foi de 5%. Resultados As médias e os desvios padrão dos limiares de reconhecimento de sentenças, respectivamente, foram: 59,90 dB NPS ± 1,43; 59,60 dB NPS ± 0,53 e 59,95 dB NPS ± 0,6. Não houve diferença, estatisticamente significativa, entre as médias (F=0,398; p>0,05). Conclusão Independentemente do critério de julgamento utilizado, as respostas obtidas de indivíduos submetidos à pesquisa de limiares de reconhecimento de sentenças na presença de ruído, foram semelhantes.

ABSTRACT Introduction The ability to recognize the sounds of speech enables an efficient communication. This ability must always be considered when communication disorders are evaluated. In this study, sentences of the Hearing in Noise Test (HINT), originally developed in English and adapted to Brazilian Portuguese, were used to evaluate speech recognition in silence and in the presence of noise. Although this test can be an important clinical tool, it is noticed that it has not been used in audiological clinical practice in Brazil. One possible reason is the lack of standardization of some aspects of the test, including the methods adopted to analyze the patient’s answers. Purpose The aim of this study was to analyze different judgment criteria of individuals’ answers during sentence recognition thresholds measurement using the HINT in Brazilian Portuguese. Methods The study was conducted with 30 young adults (three groups of 10 people), between 18 and 25 years old, of both genders, with normal hearing. HINT sentences were adapted to Brazilian Portuguese and speech recognition thresholds were determined in the presence of noise by using three judgment criteria published in Brazilian literature. A single variation analysis was performed to compare the average threshold between the three groups. The maximum error probability to reject the null hypothesis was 5%. Results The mean and standard deviations of thresholds, respectively, were: 59.90 ± 1.43 dB SPL; 59.60 ± 0.53 dB SPL and 59.95 ± 0.6 dB SPL. There was no statistically significant difference between the means (F = 0.398; p> 0.05). Conclusion Regardless the judging criteria used, results obtained in all groups were equivalent.

OBJETIVO: Este estudo investigou o efeito das diferentes taxas de modulações do mascaramento na magnitude do masking release. MÉTODOS: Quinze indivíduos jovens, com audição normal, foram submetidos ao teste de reconhecimento de sentença na presença de ruído, utilizando as listas de sentenças do HINT-Brasil. Foram obtidos limiares de reconhecimento de fala em presença de ruído estável e ruído modulado, em diferentes taxas de modulação (4, 8, 16, 32 e 64 Hz). A magnitude do masking release foi obtida para cada modulação e foi realizada a análise comparativa dos resultados. RESULTADOS: Os achados demonstraram melhores limiares de reconhecimento de sentenças quando o ruído mascarante foi modulado em 4, 8, 16 e 32 Hz e piores limiares quando o ruído mascarante estava estável e em 64 Hz. No que diz respeito à análise da relação sinal/ruído, foram observados, no presente estudo, maiores valores para as tarefas que envolvem reconhecimento de sentenças com ruído estável, seguidos das tarefas que envolvem reconhecimento de sentenças com ruído modulado em 64 Hz, e menores valores para as tarefas que envolvem reconhecimento de sentenças com ruído modulado em 32, 16, 8 e 4 Hz, respectivamente. CONCLUSÃO: A magnitude do masking release para sentenças não se diferencia com taxas de modulação em amplitude entre 4 e 32 Hz. No entanto, quando a taxa de modulação é elevada a 64 Hz, a magnitude do masking release diminui.

PURPOSE: To investigate the effect of modulation rate on masking release for speech. METHODS:Fifteen normal hearing subjects participated in the study. They were tested on speech perception in noise using the sentences of the HINT-Brazil. Speech recognition thresholds were obtained in the presence of steady masking and amplitude modulated masking at rates of 4, 8, 16, 32 and 64 Hz. The magnitude of masking release was obtained for each modulation rate, and results were compared. RESULTS:Data showed significantly lower speech thresholds when the masking noise was amplitude modulated at rates of 4, 8, 16 and 32 Hz, when compared to thresholds obtained in steady noise or noise modulated at 64 Hz. Speech-to-masker ratios (SMR) were higher in steady masking noise, followed by modulated noise at 64 Hz, and lower for modulated rates of 32, 16, 8 and 4 Hz, respectively. CONCLUSION: The magnitude of masking release for speech does not seem to differ significantly among modulation rates of 4 to 32 Hz. However, for a modulation rate of 64 Hz the magnitude of masking release is significantly reduced.

OBJETIVO: relatar os resultados do teste de potencial evocado auditivo de longa latência (PEALL) e da avaliação de linguagem de um paciente com afasia. MÉTODOS: o estudo avaliou um individuo do gênero masculino que sofreu uma lesão cortical na área frontal esquerda há 20 meses participando de terapia fonoaudiológica por 4 meses submetido ao exame PEALL no pré e pós tratamento. RESULTADOS: a avaliação da linguagem revelou 64,94% de acertos do total de pontos, apresentando melhor atuação na atividade de compreensão/expressão da linguagem oral, porém com maior dificuldade em organização da linguagem escrita. Quanto à avaliação do N2, foi observado atraso em hemisfério cerebral direito (HD) e esquerdo (HE), a amplitude do N2 encontrou-se diminuída em ambos os hemisférios, a latência do P3 encontrou-se atrasada em HE. Para a amplitude do P3, observou-se valores aumentados em HE. A melhora observada nos componentes N2 e P3 no exame pós tratamento, possivelmente seja devido à influência da estimulação dos exercícios fonoaudiológicos. CONCLUSÃO: esses resultados sugerem a importância da fonoterapia em indivíduos portadores de afasia e do exame de PEALL no acompanhamento da evolução clínica.

PURPOSE: to report the test results for evoked potential auditory of long latency (PEALL) and the language evaluation of a patient with aphasia. METHODS: a man volunteer that suffered a cortical injury in the left frontal area for 20 months took part in a speech therapy for 4 months and was submitted to PEALL examination in the pre and post treatment. RESULTS: the evaluation of the language showed 64.94% of hits with regards to the total of points, showing better performance in the activity of understanding/expression as for the verbal language, however, with more difficulty in organizing the written language. As for the evaluation of N2, a delay was observed in the right cerebral hemisphere (HR) and left hemisphere (HL). The amplitude of N2 diminished in both hemispheres. The latency of P3 was delayed in HL. For the amplitude P3, one observed increased values in HL. The improvement observed in the components N2 and P3 in the examination after treatment, is possibly due to influence of stimulation of speech exercises. CONCLUSION: these results suggest the importance of speech therapy in individuals with aphasia and the examination of PEALL in the follow-up of clinical evolution.