ABSTRACT Objective To analyze age-related changes in the central auditory pathway in healthy elderly individuals. Methods A prospective, quantitative cross-sectional study. The caseload comprised 18 adults (mean age, 22.78 years) and 18 elderly individuals (mean age, 66.72 years) of both sexes, who met inclusion criteria. Subjects were submitted to basic audiological evaluation and related electrophysiologic tests: brainstem auditory evoked potential with click stimulus and frequency-following response. Results Elderly individuals had higher wave and interpeak latencies (waves I, III and V and interpeaks I-V and III-V) of brainstem auditory evoked potential. Latencies of frequency following response waves A, E, F and O were also higher in elderly individuals. Frequency following response amplitudes were better in A than in D, F and O waves in these subjects. Likewise, interpeak intervals (V-A and V-O) were larger in elderly relative to adult individuals. Lower slope values were observed in elderly individuals. Conclusion Brainstem auditory evoked potential and frequency-following response allowed appropriate assessment of age-related changes in the auditory pathway. Slower neural response to auditory stimuli suggests reduced synchrony between neural structures.

RESUMO Objetivos: gerar valores de referência para diferentes testes comportamentais de processamento auditivo central (PAC) em adultos normo-ouvintes, com estratificação de faixa etária, assim como, comparar os resultados segundo a variável presença ou ausência de transtorno do PAC(TPAC). Métodos: a casuística foi composta por 94 adultos normo-ouvintes, com pelo menos 11 anos de escolaridade, os quais foram distribuídos em dois grupos, conforme o desempenho nos testes de Identificação de Sentenças Dicóticas(DSI), Masking Level Difference(MLD), Randon Gap Detection Test(RGDT), Fala Comprimida Adaptado(FCA) e Testes de Padrão de Duração e Frequência(TPD/TPF). Os 64 sujeitos que apresentaram normalidade em todos os testes formaram o G1 e os 30 sujeitos com alteração em pelo menos um deles originaram o G2. Foi realizada uma descrição com valores de média, desvio padrão (DP), mínima, máxima e intervalo de confiança. Posteriormente, foi utilizado o teste não paramétrico de comparação entre variáveis U de Mann-Whitney. Em todas as análises foi considerado nível de significância de 5% (p≤0,05). Resultados: o somatório de dois desvios padrões ao desempenho médio do G1, originou valores de referência para os diferentes testes abordados. Quando comparados os grupos G1 e G2, o G1 apresentou melhores resultados, sendo esta significante nos testes DSI(orelha esquerda), MLD,RGDT,TPD e TPF para a faixa etária entre 18 e 29 anos e, DSI(orelha esquerda), RGDT e FCA(orelha direita) na faixa etária de 30 a 58 anos. Conclusão: foi possível gerar valores de referência para diferentes testes comportamentais de PAC, em adultos normo-ouvintes, assim como, constatar um melhor desempenho para o grupo com ausência de TPAC.

ABSTRACT Purpose: to generate reference values for different behavioral central auditory processing (CAP) tests in normally hearing adults, with age stratification, as well as to compare the results, according to the presence or absence of CAP disorder (CAPD). Methods: the study sample consisted of 94 adults with normal auditory thresholds, with at least 11 years of schooling, who were divided into two groups, according to the performance in the Dichotic Sentences Identification Test (DSI), Masking Level Difference (MLD), Random Gap Detection Test (RGDT), Adapted Time-Compressed Speech (ATCS) and Duration and Frequency Pattern Tests (DPT/FPT).The 64 subjects who presented normality in all the tests formed the G1 group and the 30 subjects who presented alteration in at least one of them, originated the G2 group. To accomplish the analysis it was used the Mann-Whitney U Test. In all analyzes, the significance level was 5% (p≤0.05). Results: the sum of the two standard deviations for the mean performance of G1 yielded reference values for the different tests addressed. When G1 and G2 groups were compared, G1 presented better results, this being significant in the DSI (left ear), MLD, RGDT, DPT and FPT tests, for the group aged between 18 and 29 years and, DSI (right ear), RGDT and ATCS (right ear), for the group from 30 to 58 years. Conclusion: it was possible to generate reference values for different behavioral tests of CAP in normally hearing adults, as well as to verify a better performance for the group with no CAPD.

Abstract Introduction Frequency-following response with speech stimulus (FFR-speech) is a subcortical potential that satisfactorily evaluates the processing of verbal information. However, there still are differences in the literature regarding its analysis and stimulation protocol. Objective To compare two stimulation protocols for the capture of FFR-speech, to identify the percentage of occurrence of the waves among them and to compare it with the specialized literature, as well as to describe the interpeaks of its waves. Method Considering the eligibility criteria, the sample consisted of 30 normal-hearing adults, with no complaints of speech comprehension. All of themwere submitted to a basic audiological evaluation, to brainstem auditory evoked potential with click stimulus, and to FFR-speech. In the latter, 2 types of stimulation were performed, 3 series of 1,000 sweeps, and 2 series of 3,000 sweeps, for subsequent analysis of the resulting wave, in which we tried to mark the peak V followed by valleys A, C, D, E, F, and O. Results Differences in latency and interpeaks were not found between the protocols. In general, a higher occurrence of waves in the stimulation of 2 series of 3,000 sweeps was observed, but only the A valley presented a significant difference. When the values of the waves were compared with the literature, the V and A waves showed fewer occurrences in the present study. Conclusion The protocol of 2 series of 3,000 sweeps was better for FFR-speech in the studied equipment, considering the higher occurrence of waves, even though it is inferior to the specialized literature. Furthermore, it was possible to describe interpeak values and to observe no difference between the studied protocols

RESUMO Objetivo: gerar valores de referência para diferentes testes de processamento auditivo central, investigando a influência da audição periférica e considerando escolaridade e cognição, na população idosa. Métodos: pesquisa de caráter prospectivo, quantitativo e transversal. A casuística foi composta por 23 idosos, com idades entre 60 a 81, sendo 8 homens e 14 mulheres. Em relação as características audiológicas, foram incluídos idosos com limiares auditivos normais ou perda auditiva neurossensorial de grau leve e moderado, classificados pela média quadritonal, proposta pela Organização Mundial da Saúde. Todos realizaram avaliação audiológica básica, Teste de Dominância Manual de Edinburgh, Mini Exame do Estado Mental, e sete testes comportamentais de processamento auditivo central. Para a analise estatística, foi utilizado o teste não paramétrico U de Mann-Whitney. Resultados: o Teste de Fala Comprimida Adaptado foi influenciado pela perda auditiva periférica, em ambas as orelhas (p valor 0,000), não tendo sido encontradas diferenças significantes nos outros dados analisados. Conclusão: foram gerados valores de referência para os diferentes testes comportamentais. A perda auditiva influenciou os resultados do Teste Fala Comprimida Adaptado, de modo a sugerir que ele não seja aplicado em idosos com alteração periférica. Em relação a escolaridade e cognição, houve similaridade entre os idosos com limiares auditivos normais e perda auditiva.

ABSTRACT Objective: to generate reference values for different central auditory processing tests, investigating the influence of peripheral hearing and considering education and cognition, in the elderly. Methods: a prospective, quantitative and cross-sectional study. The casuistry consisted of 23 elderly, aged between 60 and 81 years old, being 8 men and 14 women. Regarding the audiological characteristics, the elderly were included with normal auditory thresholds or mild and moderate sensorineural hearing loss, classified by the quadritonal average, proposed by the World Health Organization. All elderly underwent Basic Audiological Evaluation, Edinburgh Handedness Inventory, Mini Mental State Examination, and seven central auditory behavioral tests. Statistical analysis was performed using the nonparametric Mann-Whitney U test. Results: the Adapted Time-Compressed Speech Test was influenced by the peripheral hearing loss, in both ears (p-value = 0,000), and no significant differences were found in the other data analyzed. Conclusion: reference values were generated for the different behavioral tests. Hearing loss influenced the results of the Adapted Time-Compressed Speech Test, suggesting that it should not be applied in the elderly with peripheral alteration. Regarding education and cognition, there was a similarity among the elderly with normal hearing thresholds and those presented with hearing loss.

Abstract Introduction The use of the speech-evoked auditory brainstem response (ABR) shows how the brainstem operates up to the subcortex in a more complexmanner than when the click-evoked ABR is used. Objective To study the applicability of the speech-evoked ABR in adults with hearing loss. Methods The sample was composed of a study group of 11 subjects, with ages ranging between 18 and 59 years, and auditory thresholds within normal standards, with loss of up to 65 dB at high frequencies or up to moderately severe symmetric sensorineural hearing loss. The sample underwent a basic audiological assessment, as well as speech-evoked ABR and click-evoked ABR, in which waves I, III and V, and V, A, C, D, E, F were respectively marked. The electrophysiological assessments were performed using the SmartEP device (Intelligent Hearing Systems, Miami, FL, US). Results For the speech-evoked ABR, the reference values were used in the identification and analysis of the study group. Those values found for the study group were: V = 8.56; A = 10.97; C = 21.33; D = 29.51; E = 37.93; F = 46.96; and O = 55.97. In the comparison between groups, the study group presented an increase in latency only in wave C. Conclusion The speech-evoked ABR can be performed in subjects with up to moderately severe hearing loss, and the test proved to be appropriate, because, unlike the click-evoked ABR, the former does not suffer influence of peripheral hearing loss.

Abstract Introduction The auditory system consists of sensory structures and central connections. The evaluation of the auditory pathway at a central level can be performed through behavioral and electrophysiological tests, because they are complementary to each other and provide important information about comprehension. Objective To correlate the findings of speech brainstem-evoked response audiometry with the behavioral tests Random Gap Detection Test and Masking Level Difference in adults with hearing loss. Methods All patients were submitted to a basic audiological evaluation, to the aforementioned behavioral tests, and to an electrophysiological assessment, by means of click-evoked and speech-evoked brainstem response audiometry. Results There were no statistically significant values among the electrophysiological test and the behavioral tests. However, there was a significant correlation between the V and A waves, as well as the D and F waves, of the speech-evoked brainstem response audiometry peaks. Such correlations are positive, indicating that the increase of a variable implies an increase in another and vice versa. Conclusion It was possible to correlate the findings of the speech-evoked brainstem response audiometry with those of the behavioral tests Random Gap Detection and Masking Level Difference. However, there was no statistically significant correlation between them. This shows that the electrophysiological evaluation does not depend uniquely on the behavioral skills of temporal resolution and selective attention.

RESUMO Objetivo: detectar a sensibilidade, para avaliar a habilidade de resolução temporal, comparando os testes Randon Gap Detection Test (RGDT) e Gaps- In-Noise (GIN) além de sugerir valores de referência nestes testes para idosos. Métodos: participaram 38 idosos, 24 mulheres e 14 homens, com idades entre 60 e 82 anos, com audição normal ou perda auditiva neurossensorial até moderada; com simetria entre as orelhas; timpanograma tipo A, reflexos acústicos presentes, com queixa de processamento auditivo. Todos Foram submetidos a avaliação básica para caracterizar a audição periférica, RGDT e GIN. Resultados: a sensibilidade encontrada para o teste RGDT na identificação da habilidade de resolução temporal foi de 88,64% e no GIN de 67,65%. Os valores médios para o limiar de detecção de gap no teste GIN encontraram-se em torno de 8ms e para o teste RGDT em 23,13ms. Conclusão: o teste RGDT demonstrou maior sensibilidade para detecção da alteração da habilidade de resolução temporal. Os valores dos limiares de resolução temporal, sugeridos como valores de referência para idosos, são de 8ms para o GIN e 23,13 ms para o RGDT.

ABSTRACT Purpose: detecting the sensitivity to evaluate the temporal resolution ability, by comparing Randon Gap Detection Test (RGDT) and Gaps- In-Noise (GIN) tests, in addition to suggesting reference values in these tests for elderly people. Methods: 38 elderly people, 24 women and 14 men, aged between 60 and 82 years, with normal hearing or sensorineural to moderate hearing loss; with symmetry between the ears; Type A tympanogram, acoustic reflex, with auditory processing complaints. All patients underwent basic evaluations to characterize the peripheral hearing - RGDT and GIN. Results: the sensitivity found for RGDT regarding the identification of the temporal resolution ability was 88.64% and 67.65% in GIN. The mean values for the gap detection thresholds in GIN test were around 8ms and for the RGDT test in 23,13ms. Conclusion: RGDT test presented greater sensitivity for detecting the change in temporal resolution ability. The values of temporal resolution thresholds suggested as reference values for the elderly people, are 8ms for GIN and 23.13 ms for RGDT.