scholarly journals The condition of bioelectrical activity of the brain among the patients suffering diabetes mellitus type II with hearing impairment

Author(s):  
Tetiana A. Shidlovskaya ◽  
Kateryna V. Ovsyanik ◽  
Nadiya Ya. Navalkivska

Topicality: The sensorineural hearing loss (SNHL) is a polyetiological disease with a complex pathogenesis. Sensorineural hearing loss is also caused by metabolic disorders and system diseases, including diabetes mellitus (DM).Quite often at sensorineural hearing loss there are extraauralic manifestations of the central nervous system (CNS). On the other hand, with diabetes, there are also observed the affection of the nervous system both in the form of polyneuropathy and certain disorders of the CNS. Electroencephalography (EEG) is a reliable, universal, objective, non-invasive method of research the functional condition of the CNS. Aim: to investigate changes in the condition of bioelectrical activity of the brain according to electroencephalography among patients with diabetes mellitus type II with impaired auditory function. Materials and methods: 43 patients with diabetes mellitus type II were examined, who, according to subjective audiometry, revealed impairments of auditory function and 15 persons of the control group. The EEG research was performed using a computer electroencephalograph from the company “DX-System” (Ukraine) according to the generally accepted method. Results and discussion: The qualitative analysis of EEG results among patients with diabetes revealed abnormalities in the functional condition of the CNS in the form of diffuse changes in bioelectrical activity of the brain, disorganization and desynchronization of basic rhythms, signs of irritation of brain structures, amplified by functional loads. Among the examined patients using background EEG we observed the expressed irritative changes, decrease in bioelectrical activity of a brain, desynchronization and disorganization of rhythms. Among many of them there were periodic sharp peaks and potentials, a tendency to accelerating the basic rhythm, and against this background, the increase in the content of slow waves (theta), mainly in the front leads. Moreover, the most pronounced changes in bioelectrical activity took place in the temporal and frontal leads. Thus, in patients with diabetes mellitus type II with SNHL disorganization and desynchronization of the EEG picture was detected in 34 patients (79.1 % cases). The expressed irritative changes were registered in 39 persons (90.6 % cases), hypersynchronous bursts were detected in 15 patients (34.8%), sharp peaks and potentials were present in 21 person (48.8 %) Many patients had smoothed zonal differences – 25 persons (58.1%) and lack of reaction to eye opening – 15 patients (34.8%)The decrease of bioelectrical activity reached 86.0 % cases. The amplitude of the basic alpha rhythm of the EEG among the examined patients diabetes mellitus type II with SNHL is significantly (p<0.01) lower than the norm in the temporal, parietal and occipital leads, which was 31.8±2.5, 44.1±3.1 and 43.5±4.2 мkV, respectively. In a significant part of the examined patients (88.3 %) with hearing impairments on the background of diabetes mellitus type II, these manifestations were increasing by hyperventilation. Violations of bioelectrical activity of the brain in 97.6% of cases were symmetrical, which indicates diffuse cerebral changes in the functional condition of the CNS in this category of patients. Irritations of the cortical structures of the brain were registered in all examined patients with diabetes mellitus type II. In many of these patients (97.6%) cortical irritation was combined with the involvement of deep brain structures. Thus, dysfunction of the diencephalic structures of the brain occurred in 48,8% of cases, diencephalic-stem – in 39,5%, mediobasal – in 9.3% cases. Only one patient had irritation of only the cortical structures. So, among our examined patients with diabetes mellitus type II with impaired auditory function according to EEG there are pronounced violations of bioelectrical activity according to EEG, including changes in the cortical and deep - diencephalic and stem structures of the brain. Conclusions: 1. The researches made by EEG method in patients with diabetes mellitus type II and SNHL objectively confirm the violation of the functional condition of the CNS among such patients. 2. In patients with diabetes mellitus type II and SNHL there are changes in bioelectrical activity mainly in the form of decreasing of bioelectrical activity of the brain (86,0%), expressed irritative changes (90.6%), irritation of deep structures of the brain (97,6), disorganization and desynchronization of the EEG picture (79.1% cases). 3. In patients with SNHL on the background of diabetes mellitus type II there is significantly (p<0.01) lower decreasing of amplitude of the alpha rhythm in comparison with the control values in temporal, parietal and occipital leads to 31.8±2.5, 44.1±3.1 and 43.5±4.2 mkV, respectively.

Author(s):  
Tetiana A. Shidlovskaya ◽  
Nadiya Ya. Navalkivska

Topicality: Objective research methods of the auditory analyzer are of great importance in diagnosis sensorineural disorders of auditory function, treatment of such diseases and solving a number of expert questions. While diagnosis the damage of auditory system, especially the receptor part of the auditory analyzer the method of the caused OAE on the frequency distortion product (DPOAE) plays a significant role. Quite often at sensorineural hearing loss of different genesis is observed an affection of cochlea structures of the inner ear. Diabetes mellitus (DM) is one of the most acute medical and social problems. According to the latest data, there are 463 million adults with diabetes mellitus in the world; accounting for 9.3% of the world's total population, meaning that 1 among 11 people suffers from diabetes (IDF Diabetes Atlas 9th edition, 2019). Among patients with diabetes, according to various authors, there are disorders in the auditory analyzer. Purpose: to determine changes in the condition of the receptor part of auditory analyzer according to the OAE registration of the frequency of distortion products among patients with diabetes mellitus type II with impaired auditory function. Materials and methods: 17 patients with diabetes mellitus type II were examined, who, according to subjective audiometry, revealed impairments of auditory function of the I-II degree. The control group consisted of 15 healthy normal-hearing persons who did not report hearing impairment, had no elevated blood sugar levels. 32 persons were examined in total. The registration of the caused OAE at frequency of distortion product (DPOAE) was conducted on the analyzing system "Eclipse" "Interacoustics" (Denmark) at frequencies 1-6 kHz. Statistical processing of the obtained results was carried out according to the conventional methods of mathematical variation statistics using the STATISTICA software package. The average value of indicators was calculated - magnitude (M) and its error (+- m). The probability of changes and differences between the comparative values was estimated by the criterion for the reliability of the difference (t) according to the Student's table. Results and discussion: We have selected for the analysis patients with diabetes mellitus type II, who according to subjective audiometry revealed impaired auditory function. Patients also reported otologic complaints of hearing loss, periodic or persistent subjective ear noise. As a result of the OAE researches at frequency distortion products, the following data were obtained. A full adequate response of the otoacoustic emission across all frequency spectrums was reported in only 3 patients (9.4% of cases) on the one hand. The majority of the observed patients in whom the OAE was registered received a partially positive test (68.7%). In 7 patients (21.8%) the OAE response was not registered. The absence of OAE response or a partially positive registration in 90.6% of the observed patients indicated violation function of the cochlea in such patients. The DPOAE (response intensity) emission amplitude at all tested frequencies (1-6 kHz) in patients with diabetes mellitus type II was significantly (P<0.01) lower than the norm at all frequencies. Particularly pronounced such a decrease is in the area of 4 kHz, where the amplitude of the OAE response was 5.9±0.2 dB at a norm of 9.4±0.5 dB. Therefore, in patients with diabetes mellitus type II with hearing impairment, there are changes in the receptor part of the auditory analyzer, which is confirmed by the data of objective examination methods. The changes we have identified in the OAE indicators may express the affection of the receptor structures of the auditory analyzer among patients with diabetes mellitus type II with impaired auditory function. The information obtained on the OAE indicators provides the detection of early violations and the objective ascertainment of changes in the receptor part of the hearing analyzer in diabetes mellitus type II. Conclusions: 1. OAE data on the frequency of distortion products in patients with diabetes mellitus type II objectively confirm the presence of violations in the auditory receptor. 2. In patients with diabetes mellitus type II, the OAE amplitude at the frequency of distortion products is significantly lower than normal at all tested frequencies (1-6 kHz). Particularly pronounced such a decrease is in the area of 4 kHz, where the amplitude of the OAE response was 5.9±0.2 dB at a norm of 9.4±0.5 dB. 3. The conducted researches prove the expediency of examination by the method of registration of OAE of patients with diabetes mellitus type II, since it promotes the early detection of violation in the receptor structures of the auditory analyzer in such patients. 4. The use of the method of recording otoacoustic emissions in the examination of patients with type II diabetes is important for the objectification of early signs of sensorineural hearing impairment in this contingent.


2020 ◽  
Vol 1 ◽  
pp. 27-34 ◽  
Author(s):  
Aleksey Oparin ◽  
Anton Kudriavtsev ◽  
Anatoliy Oparin

Diabetes mellitus is one of the most serious problems of the clinical medicine. This is determined by the fact that it is followed by multisystemic affects, as well as complications on the side of other organs and systems, among which a special place is occupied by gastroesophageal reflux disease. As for the combination and mutual influence of diabetes mellitus and gastroesophageal reflux disease, this issue has not been studied yet, the data of modern literature are not complete and quite contradictory. The aim of the study: to investigate the state of the factors of aggression and protection of the oesophageal mucosa in patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease without associated pathology. Method. There were two groups of patients under observation. The first group included 45 patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease (26 men and 19 women). The second group included 38 patients with gastroesophageal reflux disease without associated pathology – 20 men and 18 women. By sex, age, body weight, Helicobacter pylori infection, smoking and alcohol consumption, both groups were comparable. The surveillance program included determining the compensation ratio of carbohydrate metabolism and the state of the factor. The antioxidant protection factor was assessed by the level of catalase activity in the blood serum, as well as by the diameter of the celiac trunk and the blood flow velocity in it. Statistical processing of the obtained data was carried out with the aid of the program WINDOWS STATISTIKA 6.0. For all types of analysis, differences were considered statistically significant with p<0.05. Results. During the study, we found that in patients with diabetes mellitus type II with concomitant gastroesophageal reflux disease, as well as in patients with gastroesophageal reflux disease without associated pathology, the level of pH-metry was reduced, but with varying measures of confidence. At the same time, we found that patients with GERD without associated pathology had a decrease in the blood flow velocity in the celiac trunk. Concurrently, we ascertained that the decrease in the blood flow velocity in patients of both groups reduced the diameter of the celiac trunk. Conclusions. In patients with diabetes mellitus type II, concomitant gastroesophageal reflux disease has a subtle clinical presentation that is affected by a significant decline in mucosal sealing protection factors. In patients with GERD without associated pathology, typical clinical manifestations, accompanied by inflammation, acid regurgitation and dyspepsia, are more vivid.


2011 ◽  
Vol 22 ◽  
pp. S29
Author(s):  
Triada Exiara ◽  
Apostolos Konstantis ◽  
Maria Kouroupi ◽  
Anastasia Georgoulidou ◽  
Dimitra Papadopoulou ◽  
...  

2018 ◽  
Vol 3 (2) ◽  
pp. 95-105
Author(s):  
V. Ionova ◽  
V. Lantsova ◽  
E. Tkach ◽  
R. Ziganshin ◽  
V. Shender ◽  
...  

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