Auditory Brainstem Response Audiometry in Congenitally Hypothyroid Children Under Early Replacement Therapy

Abstract

ABSTRACT. Using auditory brainstem response audiometry, we evaluated 34 congenital hypothyroidism children under thyroid hormone therapy and 24 age-and sexmatched controls between 5 and 12 yr of age. Two main auditory brainstem response abnormalities were encountered: first, prolonged wave I latencies, secondary to a peripheral impairment, were found in seven congenital hypothyroidism children (20%): three of these showed signs of serious otitis media, unilaterally in two and bilaterally in the other, at the time of the evaluation. Second, shortened I-V interpeak latencies were observed in 10 children (29%). No correlation was found between the interpeak latencies and the L-thyroxine serum values at the time of the test or just prior to treatment initiation. Also, there was no correlation with estimated bone age at treatment initiation or with the Griffiths global mental development quotients assessed at 5 yr of age. These preliminary results suggest a significant incidence of auditory brainstem response abnormalities in treated hypothyroid children. (Pediatr Res 20: 570-573,1986) Abbreviations ABR, auditory brainstem response CH, congenital hypothyroidism T4, L-thyroxine IPL, interpeak latencyThe mental prognosis of infants with CH is improved when treatment is initiated before 3 months of age (1, 2). Since the development of newborn hypothyroid screening, treatment usually is initiated before 2 months of age. Earlier data have suggested that even early treated children may manifest neuropsychological dysfunction which may handicap development (3, 4). Glorieux et al. (5), studying a group of 3-yr-old early treated CH children, observed a significant positive correlation between the individual Griffiths global quotients (Griffiths developmental test) (6) and either the serum T4 levels or bone age estimated just prior to treatment initiation. Furthermore, as early as 18 months of age, these children had lower scores in the hearing-speech Griffiths scale than a control group (7). In addition, there is a Received November 25, 1985; accepted February 11, 1986. well-known association between hearing loss and hypothyroidism (8-12). ABR audiometry has proven to be reliable for the assessment of the peripheral auditory function in very young children and for the follow-up of the central auditory pathway maturation (1 3-18). In the case of a child diagnosed as hypothyroid at 2 yr of age, Mendel and Robinson (19) reported that ABR audiometry results, together with speech and growth, were markedly improved after T4 replacement therapy had been initiated.In the present study, we used the ABR audiometry in CH children for two purposes: first, to look for an association between psychological and eventual electrophysiological abnormalities in CH children as an early indicator of infants at particular risk and, second, for the early detection of eventual hearing problems. Data obtained in the group of treated CH children between 5 and 12 yr old suggest a significant prevalence of ABR abnormalities. MATERIALS AND METHODSThe s...

ENDOCRINOLOGY AND ADOLESCENCE: Congenital hypothyroidism: a clinical update of long-term outcome in young adults

“…Hearing impairment has been associated with (53,54,55,56,57) and others reporting no such impairment (54,58). One study investigated 12 older patients, at the age of 20 years, and suggested that auditory processing abnormalities persisted in these patients (59).…”

Neurocognitive Aspects of Hypothyroidism

“…42,43 Evidence from 4-year longitudinal studies of language and auditory processing skills in young children with congenital hypothyroidism shows essentially no difference in the expressive language skills between 7-yearolds with and without hearing impairments, 17 although the cohorts with hearing impairments continued to exhibit receptive language and reading deficits on serial assessment. 17 In a cross-cultural prospective study of nonverbal short-term memory span and pictorial serial ARCH INTERN MED/ VOL 158, JULY 13,1998position memory in teenagers from Papua New Guinea (most of whom had an iodine deficiency and mothers who had received supplementary iodine during pregnancy), 44 measured levels of total maternal thyroxine were not significantly associated with simple short-term memory span when the cohorts were 14 to 15 years old. However, on testing 2 year later, levels of total maternal thyroxine were significantly associated with more complex reverse order memory span operations and moderately associated (r = 0.39) with serial position memory.…”

Mild iron deficiency anaemia during pregnancy and lactation in guinea pigs alters amplitudes and auditory nerve velocity, but not brainstem transmission times in the offspring's auditory brainstem response

“…These prolonged PI latencies are in accordance with the elevated ABR thresholds we previously measured, 36 since these physiological markers are associated with peripheral hearing loss. 72 In contrast, the lack of effect on BTT indicated that mild prenatal IDA had no effect on neural transmission time along the brainstem (central) portion of the auditory pathway. We also observed IDA effects on ABR amplitudes in that females from IDA siblings were hyper-responsive to various stimulus intensities.…”