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Auditory brainstem response findings and peripheral auditory sensitivity in adrenoleukodystrophy.
[adrenomyeloneuropathy]
Measurements
of
the
auditory
brainstem
response
(
ABR
)
were
obtained
in
96
individuals
with
X-
linked
adrenoleukodystrophy
(
X-
ALD
)
.
The
patients
were
divided
into
five
diagnostic
groups
on
the
basis
of
neurologic
diagnosis
.
The
five
groups
were
cerebral
childhood
and
adolescent
,
pure
adrenomyeloneuropathy
(
pure
AMN
)
,
adrenomyeloneuropathy
cerebral
(
AMN
cerebral
)
,
Addison
's
only
and
symptomatic
female
heterozygotes
.
Results
indicated
the
presence
of
marked
ABR
abnormalities
for
all
groups
most
frequently
involving
Wave
V
,
followed
by
Wave
III
and
Wave
I
.
Abnormalities
of
all
interpeak
latency
intervals
(
i
.
e
.
,
I
-
III
,
III
-V
and
I
-V
)
were
observed
for
all
groups
.
ABR
abnormalities
were
most
frequently
seen
in
the
AMN
-
cerebral
and
pure
AMN
groups
but
were
also
common
in
the
symptomatic
female
heterozygote
group
.
The
ABRs
in
the
cerebral
childhood
and
adolescent
group
were
the
least
impaired
of
the
five
groups
examined
.
Age
was
found
to
be
a
significant
independent
predictor
of
bilateral
ABR
abnormalities
but
VLCFA
levels
,
MRI
Loes
score
,
and
duration
of
symptoms
were
not
found
to
be
independent
predictors
of
bilateral
ABR
abnormalities
after
adjusting
for
ALD
phenotype
.
Patients
with
AMN
were
significantly
more
likely
to
have
bilateral
ABR
abnormalities
than
the
cerebral
childhood
and
adolescent
group
after
adjusting
for
age
,
duration
of
symptoms
,
EDSS
score
,
VLCFA
levels
and
MRI
Loes
scores
.
The
prevalence
of
peripheral
hearing
loss
was
not
found
to
exceed
that
present
in
age
and
sex
matched
normal
control
groups
derived
from
the
NHANES
(
1999
-
2000
)
,
indicating
a
lack
of
association
between
peripheral
hearing
loss
and
X-
linked
adrenoleukodystrophy
.
It
was
concluded
that
:
(
1
)
auditory
sensitivity
in
X-
ALD
is
not
significantly
impaired
;
(
2
)
ABR
abnormalities
are
a
frequent
finding
and
may
be
caused
by
abnormalities
of
fiber
tracts
in
the
region
of
the
lateral
lemniscus
and
inferior
colliculus
;
and
,
(
3
)
the
abnormalities
progress
slowly
and
appear
to
be
associated
mainly
with
the
AMN
phenotype
.
Diseases
Validation
Diseases presenting
"significant independent predictor"
symptom
adrenomyeloneuropathy
congenital diaphragmatic hernia
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