Analysis of brain activity for speech stimuli and child development of an infant with neurosyphilis: case report.
Isabelle Costa de Vasconcelos, Thalita da Silva Oliveira, Ana Beatriz Santos and 5 others
PMID 39292018WHAT IT FOUND
A four-month-old with treated neurosyphilis had normal peripheral hearing but delayed expressive language and fine motor skills.
Brain imaging showed speech detection without left-hemisphere lateralization. This single case cannot prove a treatment effect, but highlights the need for multidisciplinary monitoring beyond hearing tests.
Key findings
01The infant showed below-average performance in expressive language and fine motor skills, with borderline cognition and receptive language on the Bayley-III scale.
02Peripheral hearing and brainstem responses were normal, confirming that hearing loss was not the cause of the developmental delays observed.
03fNIRS detected auditory processing with anterior temporal activation in both hemispheres, but no left-hemisphere lateralization was observed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a single case report, so no general conclusions can be drawn about the population. It is impossible to determine if the developmental delays were caused by neurosyphilis, hyperbilirubinemia, or socioeconomic factors. Longitudinal follow-up was not possible due to the family's social vulnerability and travel difficulties. The fNIRS findings are preliminary and need replication in larger studies to determine if the lack of lateralization is specific to neurosyphilis.
Declared interests
Funding was provided by the Ministry of Health (TED 54/2017) and CAPES. No conflicts of interest were declared by the authors.
The easy way to misread this
Do not interpret the lack of left-hemisphere lateralization on fNIRS as a definitive diagnostic marker for neurosyphilis. This was a single case with multiple confounding factors, and the study explicitly states that further research is needed to determine if this pattern is specific to the condition.