CARLA GENTILE MATAS
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
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- Caracterização eletrofisiológica da audição em indivíduos com Síndrome de Down(2016) KAZAN, Hellen Medeiros; SAMELLI, Alessandra Giannella; NEVES-LOBO, Ivone Ferreira; MAGLIARO, Fernanda Cristina Leite; LIMONGI, Suelly Cecília Olivan; MATAS, Carla GentileABSTRACT Introduction Few studies have performed Brainstem (BAEP) and P300 Auditory Evoked Potentials simultaneously to assess central auditory pathways in normal hearing individuals with Down syndrome (DS), mainly because of the difficulty in applying these procedures to this population. Previous studies have suggested that individuals with DS might present different patterns of response compared with those of individuals with typical development; nevertheless, the identification of these potentials would be crucial for the establishment of an accurate audiological diagnosis. Purpose To characterize BAEP and P300 in normal-hearing individuals with DS. Methods BAEP and P300 were analyzed in 17 individuals with DS and in 21 individuals with typical development aged 7 to 15 years. The results were quantitatively and qualitatively analyzed using descriptive measures and hypothesis tests. Results In the quantitative analysis, latency values were lower in the BAEP for the DS group, with statistically significant difference for wave V and interpeaks III-V and I-V; there were no significant differences in the P300 latency values. In the qualitative analysis, there were a larger number of individuals with early values for BAEP latencies and late latencies for P300 in the DS group; both comparisons showed statistically significant differences. Conclusion Children and adolescents with DS can present early responses to the components of BAEP, suggesting that their auditory pathway requires less time for the neural transmission of acoustic stimuli to the brainstem. Concerning P300, individuals with DS may present increased latencies, suggesting impairment in the central auditory pathway for the cortical processing of auditory information.
- Evaluation of peripheral auditory pathways and brainstem in obstructive sleep apnea(2018) MATSUMURA, Erika; MATAS, Carla Gentile; MAGLIARO, Fernanda Cristina Leite; PEDRENO, Raquel Meirelles; LORENZI-FILHO, Geraldo; SANCHES, Seisse Gabriela Gandolfi; CARVALLO, Renata Mota MamedeIntroduction: Obstructive sleep apnea causes changes in normal sleep architecture, fragmenting it chronically with intermittent hypoxia, leading to serious health consequences in the long term. It is believed that the occurrence of respiratory events during sleep, such as apnea and hypopnea, can impair the transmission of nerve impulses along the auditory pathway that are highly dependent on the supply of oxygen. However, this association is not well established in the literature. Objective: To compare the evaluation of peripheral auditory pathway and brainstem among individuals with and without obstructive sleep apnea. Methods: The sample consisted of 38 adult males, mean age of 35.8 (+/- 7.2), divided into four groups matched for age and Body Mass Index. The groups were classified based on polysomnography in: control (n = 10}. mild obstructive sleep apnea (n = 11) moderate obstructive sleep apnea (n=8) and severe obstructive sleep apnea (n = 9}. All study subjects denied a history of risk for hearing loss and underwent audiometry, tympanometry, acoustic reflex and Brainstem Auditory Evoked Response. Statistical analyses were performed using three-factor ANOVA, 2 factor ANOVA, chi-square test, and Fisher's exact test. The significance level for all tests was 5%. Results: There was no difference between the groups for hearing thresholds, tympanometry and evaluated Brainstem Auditory Evoked Response parameters. An association was observed between the presence of obstructive sleep apnea and changes in absolute latency of wave V (p = 0.03). There was an association between moderate obstructive sleep apnea and change of the latency of wave V (p = 0.01). Conclusion: The presence of obstructive sleep apnea is associated with changes in nerve conduction of acoustic stimuli in the auditory pathway in the brainstem. The increase in obstructive sleep apnea severity does not promote worsening of responses assessed by audiometry, tympanometry and Brainstem Auditory Evoked Response. (C) 2016 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- Evolução audiométrica em usuários de implante coclear multicanal(2013) HOSHINO, Ana Cristina Hiromi; CRUZ, Dorilan Rodriguez da; GOFFI-GOMEZ, Maria Valéria Schmidt; BEFI-LOPES, Débora Maria; MATAS, Carla Gentile; FORTUNATO-TAVARES, Talita M.; TSUJI, Robinson KojiPURPOSE: to evaluate how long after activation one can achieve the desired auditory thresholds in individuals multichannel cochlear implant users from different age groups. METHOD: a retrospective cross-sectional from a database, approved by CEP / FMUSP, under number 779/06. Individuals implanted between January 2005 and September 2008, whose files had preoperative audiometric data and 3, 6 and 12 months after CI were included. Seventy-two patients fulfilled the criteria, and they were divided in two groups according to age: group I (17 year old) and GII (18-66 year old). Analysis of variance (ANOVA) of one factor in order to verify the interaction between the mean threshold and time after CI were used. RESULTS: we observed that 15 of the GI have reached around 30dBNA thresholds at 3 months after implant. The same happened to 26 patients of GII. We found significant interaction between time (F (3.140) = 91.973, p = 0.00) and the average hearing thresholds. Post-hoc analysis in the GI group were statistically significant differences for comparisons between HA and 3 months after implantation (p = 0.00) and between 3 and 12 months (p = 0.28). For GII only for comparison between HA and 3 months (p = 0.00). CONCLUSION: a significant hearing change may be observed beginning from three months after IC, but this result is not found in all implanted subjects.
- Cortical maturation in children with cochlear implants: Correlation between electrophysio-logical and behavioral measurement(2017) SILVA, Liliane Aparecida Fagundes; COUTO, Maria Ines Vieira; MAGLIARO, Fernanda C. L.; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; CARVALHO, Ana Claudia Martinho de; MATAS, Carla GentileCentral auditory pathway maturation in children depends on auditory sensory stimulation. The objective of the present study was to monitor the cortical maturation of children with cochlear implants using electrophysiological and auditory skills measurements. The study was longitudinal and consisted of 30 subjects, 15 (8 girls and 7 boys) of whom had a cochlear implant, with a mean age at activation time of 36.4 months (minimum, 17 months; maximum, 66 months), and 15 of whom were normal-hearing children who were matched based on gender and chronological age. The auditory and speech skills of the children with cochlear implants were evaluated using GASP, IT-MAIS and MUSS measures. Both groups underwent electrophysiological evaluation using long-latency auditory evoked potentials. Each child was evaluated at three and nine months after cochlear implant activation, with the same time interval adopted for the hearing children. The results showed improvements in auditory and speech skills as measured by IT-MAIS and MUSS. Similarly, the long-latency auditory evoked potential evaluation revealed a decrease in P1 component latency; however, the latency remained significantly longer than that of the hearing children, even after nine months of cochlear implant use. It was observed that a shorter P1 latency corresponded to more evident development of auditory skills. Regarding auditory behavior, it was observed that children who could master the auditory skill of discrimination showed better results in other evaluations, both behavioral and electrophysiological, than those who had mastered only the speech-detection skill. Therefore, cochlear implant auditory stimulation facilitated auditory pathway maturation, which decreased the latency of the P1 component and advanced the development of auditory and speech skills. The analysis of the long-latency auditory evoked potentials revealed that the P1 component was an important biomarker of auditory development during the rehabilitation process.
- Auditory pathway maturational study in small for gestational age preterm infants(2014) ANGRISANI, Rosanna Giaffredo; DINIZ, Edna Maria Albuquerque; GUINSBURG, Ruth; FERRARO, Alexandre Archanjo; AZEVEDO, Marisa Frasson de; MATAS, Carla GentilePURPOSE: To follow up the maturation of the auditory pathway in preterm infants small for gestational age (SGA), through the study of absolute and interpeak latencies of auditory brainstem response (ABR) in the first six months of age. METHODS: This multicentric prospective cross-sectional and longitudinal study assessed 76 newborn infants, 35 SGA and 41 appropriate for gestational age (AGA), born between 33 and 36 weeks in the first evaluation. The ABR was carried out in three moments (neonatal period, three months and six months). Twenty-nine SGA and 33 AGA (62 infants), between 51 and 54 weeks (corrected age), returned for the second evaluation. In the third evaluation, 49 infants (23 SGA and 26 AGA), with age range from 63 to 65 weeks (corrected age), were assessed. The bilateral presence of Transient Evoked Otoacoustic Emissions and normal tympanogram were inclusion criteria. RESULTS: It was found interaural symmetry in both groups. The comparison between the two groups throughout the three periods studied showed no significant differences in the ABR parameters, except for the latencies of wave III in the period between three and six months. As for the maturation with tone burst 0.5 and 1 kHz, it was found that the groups did not differ. CONCLUSION: The findings suggest that, in the premature infants, the maturational process of the auditory pathway occurs in a similar rate for SGA and AGA. These results also suggest that prematurity is a more relevant factor for the maturation of the auditory pathway than birth weight.
- Impact of ERT and follow-up of 17 patients from the same family with a mild form of MPS II(2022) STEPHAN, Bruno de Oliveira; QUAIO, Caio Robledo; SPOLADOR, Gustavo Marquezani; PAULA, Ana Carolina de; CURIATI, Marco Antonio; MARTINS, Ana Maria; LEAL, Gabriela Nunes; TENORIO, Artur; FINZI, Simone; CHIMELO, Flavia Teixeira; MATAS, Carla Gentile; HONJO, Rachel Sayuri; BERTOLA, Debora Romeo; KIM, Chong AeBackground: Mucopolysaccharidosis type II, also known as Hunter syndrome, is a rare X-linked recessive disorder caused by deficiency of the lysosomal enzyme Iduronate-2-Sulfatase (IDS), leading to progressive accumulation of Glycosaminoglycans (GAGs) in several organs. Over the years, Enzyme Replacement Therapy (ERT) has provided significant benefits for patients, retarding the natural progression of the disease. Results: The authors evaluated 17 patients from the same family with a mild form of MPS type II; the proband had developed acute decompensated heart failure refractory to clinical measurements at 23 years and needed a rather urgent heart transplant; however, he died from surgical complications shortly after the procedure. Nevertheless, subsequent to his tragic death, 16 affected male relatives were detected after biochemical tests identifying the low or absent activity of the IDS enzyme and confirmed by molecular analysis of the IDS gene. Following diagnosis, different options of treatment were chosen: 6 patients started ERT with Elaprase (R) (Idursulfase) soon after, while the other 10 remained without ERT. Eventually, 4 patients in the latter group began ERT with Hunterase (R) (Idursulfase Beta). None presented adverse effects to either form of the enzyme. Among the 6 individuals without any ERT, two died of natural causes, after reaching 70 years. Despite the variable phenotype within the same family (mainly heart dysfunctions and carpal tunnel syndrome), all 14 remaining patients were alive with an independent lifestyle. Conclusion: Here, the authors report the variable progress of the disease with and without ERT in a large Brazilian family with a slowly progressive form of MPS II, harboring the same missense variant in the IDS gene.
- P300 in workers exposed to occupational noise(2012) MASSA, Camila Goncalves Polo; RABELO, Camila Maia; MOREIRA, Renata Rodrigues; MATAS, Carla Gentile; SCHOCHAT, Eliane; SAMELLI, Alessandra GiannellaThe harm upon the central auditory pathways of workers exposed to occupational noise has been scarcely studied. Objective: To assess the central auditory pathways by testing the long latency auditory evoked potentials (P300) of individuals exposed to occupational noise and controls. Method: This prospective study enrolled 25 individuals with normal hearing thresholds. The subjects were divided into two groups: individuals exposed to occupational noise (13 subjects; case group) and individuals not exposed to occupational noise (12 subjects; control group). The P300 test was used with verbal and non-verbal stimuli. Results: No statistically significant differences were found between ears for any of the stimuli or between groups. The groups had no statistically significant difference for verbal or non-verbal stimuli. Case group subjects had longer latencies than controls. In qualitative analysis, a greater number of altered P300 test results for verbal and non-verbal stimuli was seen in the case group, despite the absence of statistically significant differences between case and control subjects. Conclusion: Individuals exposed to high sound pressure levels had longer P300 latencies in verbal and non-verbal stimuli when compared to controls.
- Evaluation of Subtle Auditory Impairments with Multiple Audiological Assessments in Normal Hearing Workers Exposed to Occupational Noise(2023) SAMELLI, Alessandra Giannella; ROCHA, Clayton Henrique; KAMITA, Mariana Keiko; LOPES, Maria Elisa Pereira; ANDRADE, Camila Quintiliano; MATAS, Carla GentileRecent studies involving guinea pigs have shown that noise can damage the synapses between the inner hair cells and spiral ganglion neurons, even with normal hearing thresholds-which makes it important to investigate this kind of impairment in humans. The aim was to investigate, with multiple audiological assessments, the auditory function of normal hearing workers exposed to occupational noise. Altogether, 60 workers were assessed (30 in the noise-exposure group [NEG], who were exposed to occupational noise, and 30 in the control group [CG], who were not exposed to occupational noise); the workers were matched according to age. The following procedures were used: complete audiological assessment; speech recognition threshold in noise (SRTN); speech in noise (SN) in an acoustic field; gaps-in-noise (GIN); transient evoked otoacoustic emissions (TEOAE) and inhibitory effect of the efferent auditory pathway; auditory brainstem response (ABR); and long-latency auditory evoked potentials (LLAEP). No significant difference was found between the groups in SRTN. In SN, the NEG performed worse than the CG in signal-to-noise ratio (SNR) 0 (p-value 0.023). In GIN, the NEG had a significantly lower percentage of correct answers (p-value 0.042). In TEOAE, the NEG had smaller amplitude values bilaterally (RE p-value 0.048; LE p-value 0.045) and a smaller inhibitory effect of the efferent pathway (p-value 0.009). In ABR, the NEG had greater latencies of wave V (p-value 0.017) and interpeak intervals III-V and I-V in the LE (respective p-values: 0.005 and 0.04). In LLAEP, the NEG had a smaller P3 amplitude bilaterally (RE p-value 0.001; LE p-value 0.002). The NEG performed worse than the CG in most of the assessments, suggesting that the auditory function in individuals exposed to occupational noise is impaired, even with normal audiometric thresholds.
- Características da avaliação auditiva na síndrome de Williams: revisão sistemática(2018) SILVA, Liliane Aparecida Fagundes; KIM, Chong Ae; MATAS, Carla GentileABSTRACT Purpose Identify the characteristics of the clinical audiological evaluation of individuals with Williams syndrome by means of a systematic literature review. Research strategies The following research question was initially determined: “What are the characteristics of clinical auditory assessment in individuals with Williams syndrome?”. From this, a bibliographic search was conducted in four databases using the descriptors: Williams syndrome, Hearing loss, and Audiology. Selection criteria Only full articles with evidence levels 1 or 2, published in Brazilian Portuguese or English, were selected. Data analysis Results obtained in the auditory tests used in the clinical routine, namely: immittance test, pure-tone audiometry, otoacoustic emissions, and brainstem auditory evoked potential were analyzed. Results Two hundred nine studies were found, but only 12 met the inclusion criteria for the study. It was possible to observe prevalence of type A tympanometry curve, which may occur with absence of acoustic reflexes, mild to moderate sensorineural hearing loss, affecting mainly the high frequencies, absent or less amplified otoacoustic emissions, and brainstem auditory evoked potential without retrocochlear alteration. Conclusion Cochlear impairment is common in individuals with Williams syndrome and the main disorders found in the hearing assessment in this population are absence of otoacoustic emissions and acoustic reflexes, as well as presence of mild to moderate sensorineural hearing loss, mainly in the high-frequency range, observed by audiometry.
- Audiological characteristics in mucopolysaccharidosis: a systematic literature review(2019) CHIMELO, Flávia Teixeira; SILVA, Liliane Aparecida Fagundes; KIM, Chong Ae; MATAS, Carla GentileABSTRACT Purpose: to describe the audiological characteristics of patients with mucopolysaccharidosis. Methods: after formulating the research question, three databases were considered for the search (Science Direct, Virtual Health Library and Web of Science); the following descriptors were used: mucopolysaccharidoses, hearing loss, and audiology. Articles were included that were original and complete, presenting audiological evaluation data in patients with mucopolysaccharidosis. Each study was classified according to the degree of recommendation and the level of scientific evidence, based on the criteria established by the Oxford Center for Evidence-based Medicine, and the results obtained from the evaluations were analyzed. Results: of the 499 articles found, eight met the inclusion criteria. Pure tone audiometry and tympanometry were performed in all studies. The incidence of hearing loss in patients with MPS ranged from 54% to 100% of the cases, with conductive hearing loss corresponding to 30% and 58.33%, mixed hearing loss corresponding to 28.5% and 66.66% and sensorineural hearing loss corresponding to less than 14%. None of the studies described the responses of otoacoustic emissions and auditory evoked potentials. Conclusion: the prevalence of hearing loss among individuals with MPS is higher than 54% of the cases, of which conductive and mixed are predominant.