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ORIGINAL ARTICLE  UPDATE ON TRANSLATIONAL RESEARCH AND DIAGNOSTIC-THERAPEUTIC PATHWAYS IN AUDIOLOGY 

Otorhinolaryngology 2021 September;71(3):125-33

DOI: 10.23736/S2724-6302.21.02375-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Metabolic and functional correlates of age-related hearing loss: advanced MRI findings and rehabilitation perspectives of the central auditory pathways

Ettore CASSANDRO 1, 2, Renzo MANARA 3, Sara PONTICORVO 1, Davide BROTTO 3, Arianna CAPPIELLO 2, Sofia CUOCO 1, 2, Maria T. PELLECCHIA 1, 2, Claudia CASSANDRO 1, 2, Elena CANTONE 4, Alfonso SCARPA 2, Josef PFEUFFER 5, Francesco DI SALLE 1, 2, Fabrizio ESPOSITO 6

1 Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Salerno, Italy; 2 San Giovanni di Dio e Ruggi D’Aragona University Hospital, Scuola Medica Salernitana, Salerno, Italy; 3 Department of Neurosciences, University of Padua, Padua, Italy; 4 ENT Section, Department of Neuroscience, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy; 5 Siemens Healthcare GmbH, MR Application Development, Erlangen, Germany; 6 Department of Advanced Medical and Surgical Sciences, Luigi Vanvitelli University of Campania, Naples, Italy



BACKGROUND: Presbycusis is the hearing loss (HL) determined by aging mechanisms affecting the inner ear. Auditory cortical hypoperfusion has been shown in the early phases of presbycusis, suggesting a regionally selective metabolic vulnerability secondary to peripheral loss of function. In this study, HL patients were stratified according to the audiogram profiles to possibly enable a finer regional characterization of cortical perfusion changes within the primary auditory cortex.
METHODS: Sixty-two HL patients (age range: 47-78 years, PTA>50dB) and thirty-two normal hearing (NH) subjects (age-range 48-78 years) were enrolled in a 3 Tesla MRI study. Two clusters of HL patients were identified, and labeled as low-loss-high-slope (LLHS) and high-loss-low-slope (HLLS), according to the audiogram centro-types from an independent data set of fifty-five HL patients (age range: 45-80 years, PTA>50dB). Pseudo-continuous arterial spin labeling (ASL) and T1-weighted MRI were performed to derive cerebral blood flow (CBF) maps and to assess group-level perfusion changes within the primary auditory cortex.
RESULTS: The comparison of CBF maps of all HL patients vs. NH controls confirmed a statistically significant CBF reduction in a compact region encompassing the right transverse temporal gyrus. The separate comparisons of LLHS and HLLS patients vs. NH subjects resulted in different localizations of the hypoperfusion region along the transverse temporal gyrus.
CONCLUSIONS: Presbycusis is associated with perfusion reductions in the right primary auditory cortex with a different spatial pattern according to the audiogram profile. The observed heterogeneity of central auditory perfusion patterns may underlie different pathogenetic aspects and clinical forms of presbycusis.


KEY WORDS: Hearing loss; Presbycusis; Cerebrovascular circulation; Magnetic resonance imaging

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