学龄儿童与青年人言语诱发听性脑干反应的比较

目的 比较学龄儿童与青年人言语诱发听性脑干反应( speech-ABR)的基本特征,探讨学龄期儿童脑干言语处理能力的发育情况.方法 对纯音听阈、声导抗、耳声发射和短声听性脑干反应(click-ABR)测试结果均正常的20名青年人(21～ 26岁)和18名学龄儿童(6～11岁)行speech-ABR测试.刺激声为/da/音,采用插入式耳机,右耳给声.结果 学龄儿童与青年人speech-ABR波形均由瞬态反应(V、A、C、O波)及周期性反应(D、E、F波)等几部分构成.学龄儿童的O波潜伏期(47.80 ±0.38)ms短于青年人(48.10±0.40) ms,差异具有统计学意义(t=2.330,P=0.026);学龄儿童F波波幅(-0.21±0.15)μV大于青年人(-0.12±0.08)μV,差异具有统计学意义(t=2.146,P =0.043);二者其余各波的潜伏期及波幅差异均无统计学意义(P值均＞0.05).结论 学龄儿童与青年人speech-ABR的基本特征相近,其脑干言语处理能力不亚于青年人.     

生殖激素对正常青年人言语听性脑干反应特性的影响

目的 分析正常青年人生殖激素浓度与言语诱发听性脑干反应(speech-ABR)幅值及潜伏期的相关性,探讨生殖激素对青年人言语听性脑干反应特性的影响.方法 选择纯音听阈、声导抗、短声诱发听性脑干反应(click-ABR)测试均正常的青年35例为研究对象,其中女性17例(27.29±1.83岁),男性18例(28.17±2.50岁),分别行speech-ABR测试,刺激声为/da/音,采用插入式耳机,右耳给声,记录并分析各波潜伏期及波幅,同时检测血清中雌二醇、总睾酮的浓度,分析雌二醇、总睾酮的浓度与speech-ABR各波幅值及潜伏期的相关性.结果 ①女性speech-ABR各波(V、A、D、E、F、O波)潜伏期均比男性短(P<0.05),V/A复合波斜度大于男性,除O波外,女青年speech-ABR其余各波幅值均显著大于男性(P<0.05).②女青年雌二醇水平(118.77±102.66 pg/ml)显著高于男青年(52.91±14.77 pg/ml)(P<0.05),而总睾酮浓度(457.65±140.82 pg/ml)显著低于男青年(3 677.37±1 155.80 pg/ml)(P<0.05).③speech-ABR各波潜伏期与雌二醇浓度呈负相关(P<0.05),相关系数在0.2~0.4之间,与总睾酮浓度呈正相关关系(P<0.05),相关系数在0.4~0.7之间.④speech-ABR各波幅值随雌二醇浓度增加而增大,正向波V波与雌二醇浓度呈正相关,而负向波A、D、E、F及O波呈负相关,相关系数在0.2~0.7之间;speech-ABR各波幅值随总睾酮浓度增加而降低,起始复合波V波、A波及V/A斜率与睾酮的相关系数在0.4~0.6之间,为中度相关(P<0.05);而周期性成分与睾酮浓度的相关性不强,其中D波幅值与总睾酮浓度的相关性无统计学意义(P>0.05),而E波和F波的相关性也只是弱相关(P<0.05);此外,结束波O波幅值与睾酮水平无关(r=0.133, P>0.05).结论 生殖激素水平与speech-ABR的幅值及潜伏期存在一定相关性,可能是导致正常青年人言语诱发听性脑干反应特性性别差异的原因之一.     

言语诱发听性脑干反应的主波特性

目的探讨正常成人言语诱发听性脑干反应(speech evoked auditory brainstem response,speech-ABR)主波的电生理特性。方法记录64例正常成人右耳的speech-ABR,分析主波的极性、潜伏期及幅值及其与性别、年龄的相关性。结果 speech-ABR的主波主要为正极性;除E波极性与性别显著相关外,其他主波极性的性别和年龄差异无统计学意义。V波和A波潜伏期女性较男性显著缩短,V波幅值女性较男性显著增大;而两者潜伏期和幅值的年龄差异无统计学意义。在C、D、E、F和O波中,两种极性的潜伏期差异(除E波和O波外)以及幅值差异无统计学意义;而其潜伏期和幅值的性别和年龄差异亦无统计学意义。结论 speech-ABR各主波的潜伏期和幅值受极性、性别和年龄差异的影响较小,具有较高的稳定性,是言语感知机制基础及临床研究的良好指标。     

学龄前期自闭症谱系障碍儿童与健听儿童言语诱发听性脑干反应的比较研究

目的　比较学龄前期自闭症谱系障碍（autism spectrum disorders,ASD）患儿与健听儿童言语诱发听性脑干反应（speech evoked auditory brainstem responses,speech-ABR）的基本特征,探讨ASD患儿脑干言语处理能力。方法　对声导抗、耳声发射、短声听性脑干反应测试结果正常的10例ASD患儿（3～6岁）和9名健听儿童（3～6岁）行speech-ABR测试,采用强度为80 dB SPL的/da/作为刺激声。结果　两组speech-ABR曲线均由瞬态成分（V、A、C、O）和周期性成分（D、E、F）组成,两组潜伏期及波幅差异均 无统计学意义（P＞0.05）。结论　学龄前ASD患儿与健听儿童speech-ABR具有相似的基本特征,两者脑干言语处理能力相近。     

双耳同侧记录的言语诱发听性脑干反应的对比研究

目的:比较左、右耳记录的言语诱发听性脑干反应(speech-ABR)在时域及频域上的差异,探讨脑干编码不同耳别来源的言语信息的差异及其可能原因。方法:以合成言语/da/为刺激声对健康成人进行双耳同侧记录的speech-ABR测试,分析反应的潜伏期、幅值及波形评分。对反应20～50ms部分进行快速傅立叶变换,计算基频及第一共振峰的幅值。结果:不同耳别记录的speech-ABR主波的潜伏期差异无统计学意义;右耳记录的A波幅值显著大于左耳记录,O波幅值则显著小于左耳记录,其他主波幅值的耳别差异均无统计学意义。右耳记录的波形评分大于左耳记录,两者差异有统计学意义。无论记录耳别,基频的幅值均大于第一共振峰的幅值,差异有统计学意义;无论是基频的幅值还是第一共振峰的幅值,耳别差异均无统计学意义。结论:speech-ABR在脑干的来源和分布无明显偏向性,与大脑半球言语功能的不对称性无明显对应性。听觉传导通路、功能性what-where通路以及大脑两侧半球不是简单的对应关系。     

健康青年人言语诱发听性脑干反应的成分及特性

目的 探讨正常青年人言语诱发听性脑干反应(speech evoked auditory brainstemresponse,speech-ABR)的电生理特性及其与诱发言语声学特性的关系,并比较和分析与短声诱发听性脑干反应(click evoked auditory brainstem response,click-ABR)的差异.方法 记录31名31耳正常听力青年短声及合成言语/da/诱发的听性脑干反应.计算/da/和speech-ABR的时域及频域参数,并分析两者的关系.结果 正常青年人speech-ABR由一系列主波组成,可分为起始部分(包括V,A波)、过渡部分(C波)、频率跟随部分(D-E-F波)和终止部分(O波).A波分别与V、C、D、E及F波潜伏期有相关性(P＜0.05),其中与V波潜伏期的相关性最强(r=0.847,P＜O.01);D、E及F波潜伏期相互间相关(P＜0.01);C波只与OR部分的V波和A波有相关性(P＜0.05);O波潜伏期呈相对独立性,与其他主波无相关(P＞0.05).与click-ABR相比,speech-ABR的V波和Ⅲ波潜伏期延迟(P＜0.01),Ⅲ波出现率降低(P＜0.01),而Ⅰ波潜伏期的延迟和出现率的降低无统计学意义(P＞0.05).结论 speech-ABR是研究人类听觉诱发电位的一种新手段,其成分主要来源于脑干.speech-ABR主要成分关联密切,类似于听性脑干诱发电位中短声诱发的Ⅰ～Ⅴ波、SNIO及低频声诱发的FFR的结合,较好地反应了刺激言语的声学信息,是研究听觉言语处理机制的良好工具.     

学龄前儿童言语诱发听性脑干反应的性别差异

目的 探讨学龄前儿童的言语诱发听性脑干反应(speech-ABR)的性别差异及其与语言、音乐能力的关系。方法 研究对象为135例3～6岁学龄前儿童，均通过了新生儿听力筛查且无听觉系统疾病；其中，男65例，女70例，在清醒状态下进行speech-ABR测试，并由儿童的父母填写幼儿多元智力量表。结果 相较于男生，女生speech-ABR的波V、波A潜伏期均显著缩短(P<0.05),波A波幅显著增大(P<0.05)。排除年龄干扰进一步分析发现，女生的波V、波A波幅与语言智力得分显著正相关(分别为r=0.421,P<0.001;r=0.267,P<0.05),男生波V的潜伏期、女生波V波幅与音乐智力得分显著相关(分别为r=-0.296,P<0.05;r=0.295,P<0.05)。结论 学龄前儿童言语诱发听性脑干反应存在显著的性别差异；脑干听觉功能与学龄前儿童的语言和音乐能力的发展密切相关，且性别是其中不可忽略的重要因素。     

刺激声时程对有无噪声暴露史听力正常青年人言语声诱发听性脑干反应的影响北大核心CSCD

目的分析不同时程言语声诱发听性脑干反应(speech evoked auditory brainstem responses,s-ABR)在有无噪声暴露史听力正常青年人中应用的差异,探讨其用于隐性听力损失诊断的临床应用价值。方法选取18~40周岁听阈正常、有噪声暴露史的男性工人15例(接噪组,平均年龄31.53±6.56岁)以及听阈正常、无噪声暴露史的男青年25例(对照组,年龄23.20±4.60岁)进行40 ms/da/音和170 ms/da/音的s-ABR测试,比较两组两种时程刺激声s-ABR潜伏期、波间期和幅值。结果接噪组170 ms/da/音s-ABR的O波潜伏期明显较对照组延长(P<0.05),其余V、A、D、E、F波潜伏期及各波振幅、波间期两组间差异均无统计学意义(均为P>0.05);两组40 ms/da/音s-ABR各波潜伏期、波间期及振幅差异均无统计学意义(P>0.05);对照组170 ms/da/音s-ABR各波潜伏期明显较40 ms/da/音s-ABR延长,各波波间期明显较40 ms/da/音s-ABR增宽(均P<0.05);接噪组170 ms/da/音s-ABR V、A、F、O波潜伏期显著延长(P<0.05),而两种时程刺激声s-ABR各波间期差异无统计学意义(P>0.05)。结论不同时程言语声诱发s-ABR测试可以用于不同的听觉处理机制分析;40 ms时程/da/音的s-ABR各波潜伏期可能对于隐性听力损失的诊断更有价值。     

言语诱发听性脑干反应的潜伏期特性分析

目的探讨不同刺激强度下健康成人言语诱发听性脑干反应（speech evoked auditory brainstem response,speech-ABR）的潜伏期特性及其在脑干神经元编码言语信息中的意义。方法记录32例健康成人32耳在4种刺激强度（20、40、60、80dBSPL）、11.1次/s速率下的speech-ABR,分析不同强度条件下speech-ABR的潜伏期和相关性。结果 speech-ABR由一系列主波组成,分为起始部分（包括V和A波）、过渡部分（C波）、频率跟随部分（D-E-F波）和终止部分（O波）。随着强度的降低,各主波潜伏期逐渐延长,差异有统计学意义（P〈0.05）。强度降低20dBSPL级差时,潜伏期的平均延长值表现为V、A、C、O波接近,D、E、F波接近。不同强度下,V-A-C波潜伏期之间、D-E波潜伏期、E-F波潜伏期的相关性均有统计学意义,且相关系数大于0.40,其中V-A波潜伏期的相关系数大于0.80;强度降低时,潜伏期间的相关性有统计学意义的主波逐渐增多。结论健康成人speech-ABR各主波的潜伏期随着刺激强度降低而显著延长;起始反应和频率跟随反应的潜伏期及其显著相关性具有不同的变化特点。言语强度降低时,speech-ABR主波潜伏期的显著延长以及主波潜伏期间相关性的改变可能与言语的不易被识别有关。     

正常青年人失匹配负波检查

目的探讨失匹配负波(mismatch negativity,MMN)检查在正常青年人中的特点,并分析阅读状态和集中注意力时MMN检查的结果有无差异。方法对12例青年女性(年龄29-31y,平均30.08y)和18例青年男性(年龄27-34y,平均30.22y)行MMN检查,所有受试者均行听性脑干反应(ABR)阈值检查,确定ABR阈值,MMN检查在受试者在阅读状态和集中注意力状态时分别检测,采用oddball刺激方式,给予短纯音刺激,偏差刺激声为2000Hz,概率为20%,标准刺激为1000 Hz,概率为80%,刺激频率为1.1次/s,刺激声强度为ABR阈上50dB nHL;观察MMN潜伏期及波幅的特点。结果所有受试者ABR阈值均≤25 dB nHL。每例受试者均可引出MMN波形,女性在阅读状态下MMN潜伏期为159.57±20.64 ms,波幅为3.82±1.38 uV,在集中注意力状态下MMN潜伏期为155.96±17.51 ms,波幅为4.28±1.89 uV,经配对t检验潜伏期和波幅在两种状态下无显著差异;男性在阅读状态下MMN潜伏期为150.48±19.57 ms,波幅为3.75±1.27 uV,在集中注意力状态下MMN潜伏期为144.81±15.42 ms,波幅为3.99±1.34 uV,经配对t检验潜伏期和波幅在两种状态下无显著差异;经独立样本t检验,男女在上述两种状态下MMN波幅和潜伏期均无显著差异。结论正常青年男女均能引出MMN波形,男女之间MMN检查的波幅和潜伏期无差异,阅读状态和集中注意力状态对MMN检查的波幅和潜伏期无影响。     

Brainstem auditory evoked potentials with speech stimulus in neonates

IntroductionBrainstem auditory evoked potentials in response to complex sounds, such as speech sounds, investigate the neural representation of these sounds at subcortical levels, and faithfully reflect the stimulus characteristics. However, there are few studies that utilize this type of stimulus; for it to be used in clinical practice it is necessary to establish standards of normality through studies performed in different populations.ObjectiveTo analyze the latencies and amplitudes of the waves obtained from the tracings of brainstem auditory evoked potentials using speech stimuli in Brazilian neonates with normal hearing and without auditory risk factors.Methods21 neonates with a mean age of 9 days without risk of hearing loss and with normal results at the neonatal hearing screening were evaluated according to the Joint Committee on Infant Hearing protocols. Auditory evoked potentials were performed with speech stimuli (/da/ syllable) at the intensity of 80 dBNA and the latency and amplitude of the waves obtained were analyzed.ResultsIn the transient portion, we observed a 100% response rate for all analyzable waves (Wave I, Wave III, Wave V and Wave A), and these waves exhibited a latency <10 ms. In the sustained portion, Wave B was identified in 53.12% of subjects; Wave C in 75%; Wave D in 90.62%; Wave E in 96.87%; Wave F in 87.5% and Wave O was identified in 87.5% of subjects. The observed latency of these waves ranged from 11.51 ms to 52.16 ms. Greater similarity was observed for the response latencies, as well as greater amplitude variation in the studied group.ConclusionsAlthough the wave morphology obtained for brainstem evoked potentials with speech stimulation in neonates is quite similar to that of adults, a longer latency and greater variation in amplitude were observed in the waves analyzed.     

Effect of high-frequency hearing loss on compound action potentials recorded from the intracranial portion of the human eighth nerve.

Compound action potentials (CAP) were recorded from the exposed intracranial portion of the eighth nerve to stimulation with click sounds in patients with sensorineural high-frequency hearing loss who underwent microvascular decompression (MVD) operations to treat trigeminal neuralgia (TN). In patients with normal hearing the CAP recorded in that way is characterized by a negative peak, preceded by a small positivity and followed by a positivity and sometimes a second negative peak. In patients with high-frequency hearing loss the CAP also usually had an initial sharp negative peak in response to clicks of high intensity (105 to 110 dB Pe SPL), similar to findings in patients with normal hearing, but in patients with high-frequency hearing loss the initial negative peak was often followed by a slow negative deflection. The latency of the initial negative peak in the CAP in patients with high-frequency hearing loss was longer than the latency of this peak in patients with normal hearing, but the difference in latencies of this peak to condensation and rarefaction clicks was small. When the stimulus intensity was lowered the amplitude of the initial peak decreased, and the CAP became dominated by a broad negative peak with a latency of 6 to 8 ms. In 11 of 15 patients with severe high-frequency hearing loss, a series of quasi-periodic waves was superimposed on the CAP. The frequency of these waves varied between 500 and 1200 Hz, and the waves could be detected between 6 and 16 ms after presentation of the click stimulus. These waves were usually present in the response to stimuli in the intensity range from 75 to 110 dB Pe SPL. Only 4 of 17 patients with normal hearing had similar waves.     

Speech-evoked brainstem response in normal adolescent and children speakers of Brazilian Portuguese

This study aimed to analyze the coding responses of speech sounds (syllable/da/) in children and adolescent speakers of Brazilian Portuguese with typical development and normal hearing, aged between 8 and 16 years, in order to establish normative data of speech ABR response. This normative data can be used as a reference for speech ABR responses and also to enable the diagnosis in individuals with different pathologies. The analyze for absolute latency of speech sounds, more specifically the syllable/da/, for speech-ABR in children and adolescent speakers of Brazilian Portuguese with typical development were: right ear - wave V (6,43–6,57), wave A (7,35–7,57), wave C (18,19–18,46), wave D (21,99–22,42), wave E (30,73–31,05), wave F (39,19–39,55) and wave O (47,75–48,24) and left ear - wave V (6,44–6,57), wave A (7,36–7,59), wave C (18,26–18,55), wave D (22,22 -22,50), wave E (30,58–30,97), wave F (39,05–39,35) and wave O (47,78–48,13). For the amplitude values (μv), the responses were within the following ranges: right ear - wave V (0,10–0,14), wave A (0,19–0,25), wave C (0,08–0,13), wave D (0,11–0,17), wave E (0,17–0,42), wave F (0,14–0,33) and wave O (0,11–0,31) and left ear - wave V (0,09–0,13), wave A (0,08–0,23), wave C (0,08–0,14), wave D (0,10–0,15), wave E (0,20–0,26), wave F (0,16–0,22) and wave O (0,12–0,20). For the values of complex VA (slope: μv/ms and area μv x ms) the follow values obtained were: right ear – slope (0,32–0,42) and area (0,29–0,38) and left ear – slope (0,30–0,39) and area (0,27–0,35).     

正常成年人言语声刺激诱发的听性脑干反应

目的　探讨听力正常成人言语声诱发听性脑干反应（auditory brainstem response to speech sounds,s-ABR）各波的电生理特性。方法　以40 ms时程复合语音/da/为刺激声,诱发40名母语为汉语的健听成人（男性20名,女性20名）的s-ABR,分析s-ABR各波的引出率,潜伏期与受试者年龄、性别的关系。结果　S-ABR引出的7个反应波形中,女性受试者V、A波潜伏期较男性短（V波t =-3.601,P =0.001;A波t =-2.829,P =0.007）,其余各波潜伏期受性别影响小;各波潜伏期受年龄影响较小;各波振幅受性别及年龄影响较小;均无统计学差异（P＞0.05）。结论　S-ABR各波稳定性较好,是研究听觉言语处理机制的良好工具。     

听力损失老年人佩戴助听器前后皮层听觉诱发电位与言语感知的研究

目的 探讨皮层听觉诱发电位(cortical auditory evoked potential,CAEP)用于中度与重度听力损失老年人助听前后言语识别能力评估的可靠性和有效性.方法 26例中度与重度听力损失老年人均验配同一型号测试用助听器,于佩戴助听器前后在声场中分别测试/m/、/g/、/t/三个刺激声在65 dB ...     

Stimulus duration and waves of auditory brainstem response

This study was conducted to investigate the effects of stimulus duration on auditory brainstem response (ABR) waveform. Stimuli were 3-kHz tone bursts with 1 ms rise/fall times and durations of 5, 10, 20 and 30 ms. They were delivered at interstimuli intervals ranging from 80 to 140 ms. Latency and amplitude increases were observed in waves V and VI as the stimulus duration increased, whereas wave III showed no increase in latency, but decreased in amplitude. Animal experiments showed that the slowly rising curve of the response with increasing stimulus duration results in an increase in the peak latency and in the amplitude of the slow component of the ABR. Thus the change in ABR waveform observed when the duration of the stimulus was increased is not explained by a recovery process of the nervous system, but is possibly mediated by the slow component of the ABR.     

Binaural interaction of bone-conducted auditory brainstem responses in children with congenital atresia of the external auditory canal

Bilateral bone-conducted auditory brainstem responses (BC-ABRs) were recorded in children with atresia of the external auditory canal bilaterally (AECB) in order to compare the response characteristics to normal hearing adults. The binaural interaction component (BIC) of the ABR occurs when the sum of the monaural-evoked ABR amplitudes are different in amplitude when compared to the binaural-evoked ABR amplitude. Previous electrophysiological work from our lab has shown that children with AECB lateralize bone-conducted (BC) sound. Furthermore, we have found in normal-hearing adults that BICs exist using BC clicks. In adults, BC-BIC occurred in the latency region corresponding to waves IV-VI, whereas for children with AECB corresponding peak latencies occurred earlier. Same as normal-hearing adults, BC-ABR IV-V complex peak amplitudes for sum of the BC-monaural right and BC-monaural left ears were different from binaural response amplitude. Individual peak latencies were similar in children with AECB when compared to normal-hearing adults except for shorter latencies for BIC. These results indicate that: (1) BC-BI is present in children with AECB as well as normal-hearing adults; (2) the gross response properties of BIC are similar in children with AECB and normal-hearing adults; (3) fitting of a bilateral BC hearing aid might be a feasible method to optimize binaural hearing and sound lateralization.