Programa Associado de Pós-graduação em Fonoaudiologia, Universidade Federal do Rio Grande do Norte - UFRN - Natal (RN), Brasil, Universidade Federal da Paraíba - UFPB - João Pessoa (PB), Brasil, Universidade Estadual de Ciências da Saúde de Alagoas - UNCISAL, Maceió (AL), Brasil.
Unidade de Atenção à Saúde da Criança e Adolescente - UASCA, Hospital Universitário Onofre Lopes - EBSERH - Natal (RN), Brasil.
Codas. 2024 Sep 13;36(5):e20230303. doi: 10.1590/2317-1782/20242023303pt. eCollection 2024.
Neurosyphilis is an infection of the central nervous system caused by Treponema pallidum and may be symptomatic or asymptomatic in children with congenital syphilis. This study aims to describe the cortical activation pattern of a four-month-old infant with neurosyphilis using functional near-infrared spectroscopy (fNIRS). Born at term weighing 3,475 kg, she presented a Venereal Disease Research Laboratory (VDRL) test of 1:32 and changes in the cerebrospinal fluid test. She underwent treatment with crystalline penicillin for 10 days before discharge from the hospital. In the audiological evaluation, she presented normal tympanometry, otoacoustic emissions evoked by transient stimulus, brainstem auditory evoked potential with click stimulus at 80 and 30 dB nHL bilaterally. The Bayley III Scale was applied to assess language, cognition and motor development, showing delays in expressive language and broad motor skills. In the fNIRS acquisition, data were collected through 20 channels divided between the cerebral hemispheres. The /ba/ and /da/ stimuli were presented at 40 dB HL with the Psychopy software through a headphone. Data analysis used the MNE and MNE-NIRS toolboxes in the Spyder environment. The average by channel, ROI, and condition was exported for analysis. A similar theta coefficient was observed between the conditions and channels evaluated in both cerebral hemispheres, with a greater amplitude of oxyhemoglobin (HbO) being observed in the anterior position when compared to the posterior region of the temporal lobe. Therefore, this case report highlights the need to monitor the child development of babies with neurosyphilis.
神经梅毒是由苍白密螺旋体引起的中枢神经系统感染,在先天性梅毒的儿童中可能有症状或无症状。本研究旨在使用功能近红外光谱(fNIRS)描述一例患有神经梅毒的四个月大婴儿的皮质激活模式。该婴儿足月出生,体重 3.475 千克,VDRL 检测结果为 1:32,脑脊液检查结果发生变化。她接受了 10 天的青霉素结晶治疗,然后从医院出院。在听力评估中,她的鼓室图正常,瞬态刺激诱发的耳声发射,双侧脑干听觉诱发电位(click 刺激)在 80 和 30 dB nHL 时正常。采用贝利 III 量表评估语言、认知和运动发育,发现表达性语言和广泛运动技能发育迟缓。在 fNIRS 采集过程中,通过 20 个分布在大脑半球之间的通道收集数据。通过头戴式耳机,使用 Psychopy 软件以 40 dB HL 的强度呈现 /ba/ 和 /da/ 刺激。数据分析使用 Spyder 环境中的 MNE 和 MNE-NIRS 工具箱。导出了通道、ROI 和条件的平均值以供分析。在两个大脑半球的所有条件和通道评估中,观察到相似的θ系数,与颞叶后部相比,前区的氧合血红蛋白(HbO)振幅更大。因此,本病例报告强调了需要监测患有神经梅毒的婴儿的儿童发育。