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Biomedical subjects

S Michelini

Publications and source records attributed to S Michelini.

At least 37 records · Page 2Linked to original sources

Electrocochleography and brainstem potentials in the diagnosis of the deaf child.

The deaf child must receive sound amplification before he reaches the age of two years. At this age the hearing threshold is best measured objectively by electrocochleography (ECochG) and auditory brainstem response (ABR) audiometry. When used correctly, both methods allow an exact threshold estimation which is informative enough for adequate hearing aid prescription. Both methods have advantages and disadvantages when used in children. The advantages of ECochG are: (a) a more exact threshold estimation and (b) strictly monaural evaluation. The advantages of ABR are: (a) ease of performance; it is not invasive and does not require general anaesthesia and (b) allows for exploration of higher levels in the auditory pathway up to the midbrain. We believe that ECochG and ABR are compatible and complementary in the diagnosis of childhood deafness. ABR could be used in first instance, while ECochG could be reserved for doubtful cases and for those who cannot be adequately sedated. Extra-audiological factors such as the availability of anaesthetists and varying hospital facilities, play a further role in determining the choice of electric response technique.

Audiometry↗

Phonometric study of the second heart sound in normal man.

The fast Fourier transform (FFT) was employed to analyze the frequency spectra of the second heart sound in 19 healthy subjects. The data obtained show that the second heart sound is mainly composed of low-frequency vibrations, and that the frequency vs. amplitude spectra for the various filters do not exceed 150 Hz. The different spectra obtained can represent a useful reference to compare with pathological acoustical findings.

Adult↗

Evaluation of the monaurally evoked brainstem response in the diagnosis of sensorineural hearing loss.

The auditory brainstem responses (ABRs) obtained in 47 subjects with asymmetric hearing loss (12 with surgically confirmed cerebello-pontine angle tumours, 35 without otoneurologic and/or neuroradiologic evidence of tumour) were evaluated by means of an index named delta V. The calculation of this index was based upon the patient's wave V absolute latency obtained at a fixed intensity of 90 dB HL and the value of latency predictable by means of the normative data. The index clearly separates retrocochlear from cochlear sites of lesion. Moreover delta V values obtained in defined cochlear lesions show a linear relation with the patient's pure tone hearing loss at 2 and 4 kHz; this behaviour is probably due to a reduction of the auditory dynamic range in the recruiting ears. delta V appears to have clinical usefulness because of two main points: first it is based upon an evaluation of the monaurally evoked ABR; second, it improves the diagnostic specificity of the responses. The rate of false positive results can be further reduced by combining delta V and IT5 values.

Audiometry, Evoked Response↗

Logarithmic display of auditory evoked potentials.

Auditory evoked potentials (AEP) can be simultaneously recorded on-line as a succession of 11 waves, through a single input channel of a mini-computer. Since the response waves differ widely in frequency, a computing routine has been developed to display the whole response pattern in a single picture. Based upon a non-linear samples reduction of the digitized response, this routine allows a logarithmic transformation of the time axis. The method improves the identification of the AEP components and provides an objective estimate of the central auditory pathway for both neurophysiological and neuroclinical studies.

Computers↗

Habituation and rate effect in the auditory cortical potentials evoked by trains of stimuli.

The effects of the stimulus repetition rate over the habituated auditory cortical evoked responses were studied. The stimulation pattern consisted of trains of pure tone bursts with interstimulus interval (ISI) of 1 s, and intertrain interval (ITI) of 5 s, delivered with constant time and intensity parameters during 93 min. The analysis of the responses was based upon across averaging of the trains, each single response being evaluated in the latency and amplitude parameters. Two time-dependent factors affected the responses in a distinct way: the habituation throughout the whole stimulation and the rate effect within the train. The linear regressions of the time/amplitude functions of the responses were calculated in relation to the duration of ISI and ITI. By introducing a correction factor depending on the repetition rate it was possible to evaluate the relationships between habituation and repetition rate. Changes in the repetition rate do not have any effect on the habituation process. The two phenomena are completely distinct, and they probably have neurophysiologic substances corresponding to different levels in the central nervous system (CNS).

Acoustic Stimulation↗

The auditory brainstem response to binaural delayed stimuli in man.

The brainstem responses (BER) evoked by binaural clicks (0.1 ms) with interaural time differences (delta t) from 0 to 3.5 ms were studied in 6 normal subjects. The responses analysis was carried out via computer in two different ways: (a) Comparison between binaural BER and templates obtained with the addition of two monaural BERs. (b) Extraction from the binaural BER of the second delayed pattern. The results suggest that an algebraic addition of the responses from the two stimulated sides is the main mechanism of the binaural BER generation. In comparison with the templates, the binaural response shows some differences which are evident at delta t = 0--1.5 ms and are limited in the region of VI and VII waves. Such differences are caused essentially to an amplitude decrease of the second pattern--that is response to the delayed stimulus--mainly at delta t 1.5 ms. However these results do not allow us to say if the phenomenon recorded at the surface is due to central adaptation or to specific mechanism of binaural interaction.

Acoustic Stimulation↗

Callosal transfer of impulses originating from superficial and deep nerves of the cat forelimb.

1. Experiments were performed in 18 chloralose-anaesthetized, curarized cats in order to study the callosal transfer of somatic information originated in exteroceptive and proprioceptive receptors. Several cutaneous and deep nerves of the forelimb were prepared and stimulated with graded intensities, so as to activate selectively afferent fibres pertaining to the different groups of Lloyd's classification. Simultaneous records were taken (and averaged on-line by means of a multichannel analyzer) from the distal end of a cut dorsal rootlet (C7-C8), from the cerebral cortex (SI, SII or area 3a, according to the experiment) and from the somesthetic callosal region (SCR). 2. The low-threshold afferent fibres (Group II) of cutaneous origin were found to have a wide projection to the SCR, with the maximal density in its middle portion. Some of the fastest corticocallosal impulses are relayed monosynaptically at cortical level. Plots of the amplitude of cortical and callosal responses as a function of stimulus strength showed that both central responses have the same threshold and exhibit a parallel, sharply-rising amplitude increase, thus suggesting that the cortico-callosal re-transmission system for afferent impulses of cutaneous origin is very powerful in nature. Impulses elicited in afferent fibres of higher threshold (Group III) do not enhance the cortical and callosal positive waves provoked by Group II afferent volleys. 3. Afferent fibres of deep origin were also found to send a wide projection to the SCR, although less substantial than that of cutaneous fibres. Stimulation of the deep radial nerve elicited mass responses in the whole SCR, provided the strength of stimuli was high enough to engage the Group II fibres. Only in the central portion of the SCR were small potentials recorded in response to pure Group I volleys of DRN. Experiments performed with selective stimulation of pure muscular branches of forelimb deep nerves as well as of articular and mixed (muscular and articular) branches gave evidence making it possible to ascertain the origin of deep afferent fibres projecting to the SCR. Stimulation of the forelimb muscular branches with strength provoking full activation of Group I afferent and additional engagement of those of Group II, did not provoke mass responses in the whole extent of the SCR. In order to obtain callosal potentials upon stimulation of pure muscular nerves, it was necessary to increase the stimulus strength at or above the threshold for Group III fibres. On the contrary, the same callosal foci unresponsive to Group I and II muscular afferent volleys exhibited clear-cut responses to stimulation of the lowest-threshold Group I and/or Group II afferents of articular and mixed nerves. From the results it might be inferred that only proprioceptive information originating from articular receptors and from extrafusal muscular afferents has access to the callosal interhemispheric transfer.

Animals↗