Subcortical neural response to click and speech stimuli in infants and young children with congenital cytomegalovirus: a preliminary study.
Ketilly Samilly de Souza Silva, Josefa Viviane de Moura Ferreira, Lara Louíse Pinto Câmara and 2 others
In 20 infants (10 with asymptomatic congenital CMV, 10 controls), subcortical responses to click and speech sounds were essentially the same between groups.
This does not rule out later hearing loss — the authors stress ongoing monitoring is still needed.
Key findings
1Click ABR and FFR measures showed no significant between-group differences, with one exception: right-ear wave I latency was shorter in the CMV group (Cohen's d = 1.43), which the authors flag as needing caution because of the number of comparisons and the lack of multiple-testing correction.
2The study's initial hypothesis — that infants with congenital CMV would show atypical subcortical neural responses compared with controls — was not confirmed.
3The authors state that intact subcortical responses at this single time point do not allow prediction of future auditory or language outcomes, and they call for longitudinal monitoring given the risk of delayed hearing loss in this population.
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What it does not show
Only 10 infants per group, which the authors acknowledge limits the ability to detect subtle differences. Cross-sectional design: a single time point cannot capture the delayed and fluctuating hearing loss that characterises congenital CMV. Wide age range (20 days to 3 years 7 months), and the authors note that latencies change with maturation during the first two years. No multiple-testing correction was applied, and the authors flag the one significant ABR finding as needing caution for this reason. Click ABR was recorded only at 80 and 30 dB nHL, so frequency-specific hearing thresholds could not be estimated. No complementary procedures were used (frequency-specific ABR, Visual Reinforcement Audiometry, neurodevelopmental assessment such as Bayley III, or neuroimaging). Exclusion of infants with any other risk factors for hearing loss or prematurity may reduce generalisability to real-world clinical populations. The study is preliminary and ongoing; the authors state they plan to expand the sample and conduct longitudinal follow-up.
Declared interests
Funded by CNPq (processes 404964/2023-0 and 444546/2023-5) and UFRN/PIBIC. No industry funding, no conflicts of interest declared.
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