CNS Infections Effect on the Inner Ear
Palavras-chave
Resumo
Descrição
Aims and objectives:
The present proposal aims to improve the outcome from central nervous system infections (CNS) by improving the understanding of when and why patients develop hearing loss and other neurological sequelae. The investigators will elucidate the temporal development and restitution of a sensorineural hearing loss and will clarify if any therapeutic window exists, where sequelae can be limited.
Also the investigators will investigate if communication between cochlea and cerebrospinal fluid is a window to the intracranial pressure.
Background:
CNS infections remain diseases with high mortality and morbidity. Among survivors from bacterial meningitis, 30 % suffer hearing loss or deafness arising from injury to the inner ear - the cochlea. From previous work it is known that brain inflammation, brain edema and subsequent pressure changes can be transduced to the inner ear due to communication between the cochlea and cerebrospinal fluid (CSF).
The viability of cochlear hair cells can evaluated by non-invasive measurement of otoacoustic (OAE) emissions which are low-intensity sounds from the cochlea (OAE).
Methods and materials:
The investigators will perform repeated measurements of OAE and Wide Band tympanometry (WBT) in all patients admitted with suspicion of a CNS infection. OAE and WBT will be compared to intracranial pressure (ICP) measured during lumbar puncture as well as clinical-, biochemical- and imaging data. An age-matched control group will be included. At discharge and at follow-up patients will receive a neurological, vestibulare examination, cognitive test and a regular hearing test.
Expected outcome and perspectives:
From repeated measures during a course of disease, the investigators will elucidate the development of a hearing loss and clarify if any therapeutic window exists, where sequelae can be limited. This is also an opportunity to assess OAE as a non-invasive measure of intracranial pressure which is believed to be among the clinical complications responsible for a poor outcome.
datas
| Última verificação: | 09/30/2018 |
| Enviado pela primeira vez: | 05/31/2018 |
| Inscrição estimada enviada: | 10/17/2018 |
| Postado pela primeira vez: | 10/22/2018 |
| Última atualização enviada: | 10/17/2018 |
| Última atualização postada: | 10/22/2018 |
| Data real de início do estudo: | 11/30/2017 |
| Data Estimada de Conclusão Primária: | 11/30/2020 |
| Data Estimada de Conclusão do Estudo: | 11/30/2020 |
Condição ou doença
Intervenção / tratamento
Diagnostic Test: Cohort with CNS infections
Diagnostic Test: OAE/WBT
Diagnostic Test: Biomarker
Diagnostic Test: Cohort with CNS infections
Diagnostic Test: Cohort with CNS infections
Fase
Grupos de Armas
| Braço | Intervenção / tratamento |
|---|---|
| Cohort with CNS infections Otoacoustic emissions (OAE), Wide Band Tympanometry (WBT), Vestibular function tests. Audiometry. MOCA, eGOS are cognitive tests.
Biomarker is a protein found in the inner ear examined in the cerebral fluid. | Diagnostic Test: Cohort with CNS infections Vhit, Caloric test |
| OAE/WBT control: Healthy individuals Otoacoustic emissions in normal position with head. Otoacoustic emission in different head positions. | |
| OAE/WBT control: Systemic infection Otoacoustic emission during admission | |
| OAE/WBT control: ICP changes Otoacoustic emission on patients without an CNS infection before and after elective lumbare puncture with measurement of intracranial pressure (ICP). | |
| Biomarker control Inner ear biomarkers in patients without CNS infection. Inner ear fluid examination from patients that underwent elective cochlea implantation. |
Critério de eleição
| Idades qualificadas para estudar | 18 Years Para 18 Years |
| Sexos elegíveis para estudo | All |
| Método de amostragem | Non-Probability Sample |
| Aceita Voluntários Saudáveis | sim |
| Critério | Inclusion Criteria: - Patients with a CNS infection admitted to the hospital. Exclusion Criteria: - Patients with known hearing loss |
Resultado
Medidas de Resultado Primário
1. Cochlear damage [Day1-90]
Medidas de Resultado Secundário
1. Vestibular function loss [Day 1-90]
2. Identifying biochemical markers in CSF during a CNS infection [Day 1-90]
3. Cognitive impairment [Day 90]
