title: Auditory efferent function is affected in multiple sclerosis.
abstract: OBJECTIVE
  This study evaluated efferent medial olivocochlear (MOC) function in patients with multiple sclerosis (MS). Various afferent auditory abnormalities have been described in MS, but there is a paucity of data on efferent function. The brain stem is a site of predilection for MS plaques and the efferent MOC pathway may be affected at this level.
  
  
  METHODS
  The study included 30 patients who had normal hearing. According to MRI findings, they were divided into two groups: those with an identifiable brain stem lesion (n = 10) and those with MS lesions in other parts of the central nervous system but without demonstrable MS plaques in the brain stem (n = 20). MOC function was evaluated by the olivocochlear suppression test, using transient evoked otoacoustic emissions. All subjects underwent standard auditory tests, including pure-tone audiometry and recording of auditory brain stem evoked responses. Twenty-two healthy subjects with normal hearing, matched for age and gender, served as a reference group for the auditory data.
  
  
  RESULTS
  The results showed that 66.6% of all patients had reduced MOC function, particularly those (90%) with identified lesions of the brain stem on MRI. Furthermore, abnormal MOC function was found in 55% patients without evidence of a brain stem lesion on MRI.
  
  
  CONCLUSIONS
  This study provides the evidence for a deficit of efferent auditory function in the majority of patients with MS. Taking into consideration the possible roles of the MOC system in processing of auditory information, abnormal MOC suppression in patients with MS may explain a variety of auditory presentations that are currently largely overlooked. This study also highlights the diagnostic value of the MOC suppression test as a site-of-lesion diagnostic test in MS and in identifying subtle brain stem lesions undetected by MRI, suggesting that subtle brain stem lesions may exist and that the MOC suppression test is sufficiently sensitive to detect them. Accordingly, the MOC suppression test may provide a tool for an early diagnosis of MS.
authors.affiliation: Department of Neuro-Otology, The National Hospital for Neurology and Neurosurgery, United Kingdom.
authors.forename: Albert
authors.initials: A
authors.lastname: Coelho
authors.forename: Borka
authors.initials: B
authors.lastname: Ceranić
authors.forename: Deepak
authors.initials: D
authors.lastname: Prasher
authors.forename: David H
authors.initials: DH
authors.lastname: Miller
authors.forename: Linda M
authors.initials: LM
authors.lastname: Luxon
mesh_terms: D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D001306:Auditory Pathways / Q000473:pathology / Q000503:physiopathology*; D001933:Brain Stem / Q000473:pathology / Q000503:physiopathology; D017626:Cochlear Nucleus / Q000473:pathology / Q000503:physiopathology*; D004292:Dominance, Cerebral / Q000502:physiology; D004525:Efferent Pathways / Q000473:pathology / Q000503:physiopathology; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000503:physiopathology*; D009433:Neural Inhibition / Q000502:physiology; D009847:Olivary Nucleus / Q000473:pathology / Q000503:physiopathology*; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology*; D012016:Reference Values