脑干听觉诱发电位及体感诱发电位在重型颅脑损伤患者预后评估中的作用

目的 分析探讨脑干听觉诱发电位(BAEP)及体感诱发电位(SEP)与重型颅脑损伤病人预后的关系.方法 对33 例重型颅脑损伤患者早期行BAEP 及SEP 测定并进行动态监测,同时行头颅CT 检查并记录GCS 评分.结果 BAEP 及SEP 预测预后的敏感性、特异性、准确性均较高.BAEP、SEP 异常程度低,则预后较好;异常程度高,则预后不良.结论 BAEP、SEP 可以比较准确地评估重型颅脑损伤患者的预后.     

体温过高对豚鼠耳蜗电图-脑干听觉诱发电位综合波的影响

目的：探讨体温过高对耳蜗电图-脑干听觉诱发电位综合波(ECochG-BAEP SW)的影响。方法：计算机平均叠加技术记录豚鼠脑干听觉诱发电位(BAEP)、耳蜗电图(ECochG)和：ECochG—BAEP SW，体表物理升温法逐步升高豚鼠体温，观察3组电位波形、波峰潜伏期(PL)、波峰间潜伏期(IPL)和波幅的变化。结果：随体温升高(36℃至42℃)，ECochG-BA：EPSW波形始终兼具BAEP和ECochG的特点，有十分突出的1波，其波幅为BA：EP的I波波幅的数倍，且明显大于ECochG的N1波波幅；与BAEP和ECochG一致，ECochG-BAEPSW的PL和IPL随体温升高而逐渐缩短；与BAEP的Ⅰ，Ⅱ，Ⅲ波和ECochG的N1，N2，N3波波幅相似，ECochG-BAEP SW的1，2波波幅也在体温过高至40℃后开始出现显著降低。结论：体温过高对豚鼠ECochG-BAEPSW的影响与BAEP和ECochG相似，且其波形始终兼具两者特点。     

Influence of stimulation parameters on auditory stimulus processing in schizophrenia and major depression: an auditory evoked potential study

The influence of stimulation frequency and stimulus intensity on the auditory evoked potential components N1 and P2 was investigated in schizophrenic and major depressive patients. The findings in the patients were compared with those in normal controls. At a high stimulation frequency the amplitude of N1 was enhanced in both schizophrenic and major depressive patients; the latency of N1 increased only in the schizophrenic patients. These changes may be related to impairments of auditory input control and processing in these diseases. In the schizophrenic patients, P2 latency was prolonged under treatment with high-potency neuroleptic drugs.     

Intraoperative Erb's Point-Vertex recording increases brainstem auditory evoked potential wave V amplitude

ObjectiveRecording derivations for intraoperative brainstem auditory evoked potential (BAEP) monitoring consist of a preauricular electrode referenced to Cz′. These derivations are prone to unfavorable signal amplitude. This study analyses whether an alternative noncephalic electrode positioned over ipsilateral Erb’s point, thereby generating a new Erb’s point-vertex recording derivation, improves BAEP recordings.MethodsElectrodes were placed preauricularly (A1/A2) and at left and right Erb’s point (EP1/EP2). They were referenced to Cz′. Click sound stimulation (80–95 dB above hearing level) was applied. At intraoperative baseline conditions, latencies and amplitudes of waves I–V of all derivations were analyzed.ResultsData of 30 patients (54 ± 15 years/17 females) with normal hearing or mild symmetrical presbycusis undergoing infratentorial surgeries (15 microvascular decompressions) were analyzed. Using EP1-Cz′/EP2-Cz′ derivations compared to A1-Cz′/A2-Cz′, amplitudes for wave IV (left +65%, p < 0.001; right +43%, p = 0.002) and wave V (left +54%, p < 0.001; right +48%, p < 0.001) were significantly increased. Only in the left (EP1) derivation, there was a tendency towards less reproducibility of wave I, resulting in a decrease of amplitude (−35%, p = 0.005).ConclusionsAdding an Erb’s point electrode derivation resulted in larger amplitudes of waves IV to V. whereas conventional preauricular or mastoid derivation is preferential for wave I assessment.SignificanceIncreased wave amplitudes facilitate detection of pathologically reduced wave forms (wave V in particular) which represents a significant advancement.     

酒精所致精神障碍患者的脑干听觉诱发电位

目的分析酒精所致精神障碍患者的脑干听觉诱发电位（ＢＡＥＰ）表现。方法对３０例长期嗜酒所致精神障碍患者进行ＢＡＥＰ检测，并与正常人进行对照。结果病例组ＢＡＥＰ各波峰潜伏期（ＰＬ）、峰间期（ＩＰＬ）延长，波形分化差，与正常对照组有显著性差异。结论ＢＡＥＰ异常与临床表现及影像学，实验室结果基本一致，提示诱发电位可作为慢性酒精中毒的诊断方法之一     

Depression and anxiety as a single disorder: evidence from brain stem auditory evoked potentials

Anxiety and depression are often interlinked as demonstrated by clinical, epidemiological, psychopharmacological and even genetic studies. However, robust biochemical and electrophysiological evidence for linkage or separation of mood and anxiety disorders is scarce. Brain stem auditory evoked potentials (BASEP) can easily and non-invasivly be measured in psychiatric patients and reflect neurophysiological processes in the brain stem. The aim of the present study was to evaluate BASEP in drug-free patients suffering from panic disorder or major depression and to compare these to healthy controls. Patients (n = 26; panic = 16, depression = 10) were diagnosed according to Diagnostic and Statistical Manual (DSM)-III-R criteria assessed by the Hamilton Anxiety and Hamilton Depression Scales, and all underwent 3 weeks of medications washout. All subjects (n = 36) completed the study. N3 latency was decreased in the patient group (P < 0.05), N3-5 interval was lengthened (P < 0.05), the N3 latency correlated with anxiety scores and depression scores correlated with the N3 and N5 latency periods. In conclusion, our small sample demonstrated shared electrophysiological variables in panic disorder and depression, further supporting the concept of spectrum disorder.     

Middle latency auditory evoked potentials (MLAEPs) in (MS)

Middle latency auditory evoked potentials (MLAEPs) were studied in 30 definite multiple sclerosis (MS) patients in addition to brain-stem auditory evoked potentials (BAEPs). BAEP abnormalities were detected in 18 (60%) patients. MLAEPs were abnormal in 22 (73%) of them. In 15 patients BAEPs and MLAEPs were both abnormal. MLAEPs were found abnormal in 7 of the 12 patients with normal BAEPs. In 18 patients with abnormal BAEPs only 3 had normal MLAEPs. MLAEPs abnormalities are consistent with a rostral auditory pathway involvement. Therefore, they can be used in combination with BAEPs to examine the whole auditory system to improve the sensitivity.     

Visual and auditory evoked potentials in the early diagnosis and follow-up of neurosarcoidosis

Visual and brainstem auditory evoked potentials (VEPs, BAEPs) were recorded in 23 patients with neurosarcoidosis. Eight patients (35%) had abnormal BAEPs, and 10 (43%) had abnormal VEPs. Four of the 8 patients with abnormal BAEPs had facial paresis, one had impaired memory and only 3 had symptoms and signs compatible with brainstem lesion. Seven of the patients with abnormal VEPs had no visual symptoms. These findings suggest that BAEP and VEP can reveal subclinical nervous system involvement in sarcoidosis and can also help in the early diagnosis of neurosarcoidosis. Successive recordings of 5 patients showed that BAEP and VEP were useful in the follow-up of these patients.     

响度依赖性听觉诱发电位在情感障碍疾病中的应用进展

中枢5-羟色胺功能活性与情感障碍疾病密切相关,而响度依赖性听觉诱发电位可反映中枢5-羟色胺功能的活性,为情感障碍疾病的诊断和疗效预测提供新的方法和依据.现将响度依赖性听觉诱发电位及其在抑郁症及双相情感障碍中的应用进行综述.     

Brainstem auditory evoked potentials in tuberous sclerosis

Brainstem auditory evoked potentials were recorded in 4 subjects and pattern reversal evoked potentials in 1 subject, all with tuberous sclerosis. Alterations were found (absence or delay of components and prolonged interpeak intervals) which may suggest impaired nervous conduction also at brainstem level in patients with tuberous sclerosis.

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Sommario Sono stati registrati i potenziali evocati auditivi troncoencefalici in 4 soggetti con sclerosi tuberosa, in uno di essi sono stati registrati anche i potenziali evocati visivi da pattern reversal. Sono state ritrovate alterazioni delle risposte (assenza o ritardo di alcune componenti ed intervalli interpicco prolungati) che possono suggerire l'esistenza di una conduzione nervosa alterata anche a livello del tronco dell'encefalo nei pazienti con sclerosi tuberosa.

     

Brain stem auditory evoked response development in the kitten

The development of brain stem auditory evoked responses (BAERs), recorded from a surface electrode as short-latency, volume-conducted potentials, was studied in a series of kittens over a postnatal period ranging from birth to 60 days. Repeated, longitudinal observations on particular kittens were supplemented with observations on additional kittens during the first and second postnatal week to determine age of onset of the BAERs. The position of the animal and sound source within the recording chamber were held constant across recording sessions, as was click intensity except during recordings in which intensity effects were specifically studied. Click rates of 1, 10, 50 and 100/sec were routinely presented. Reference electrodes at the tongue, pinna and neck showed volume-conducted responses to the click stimuli and resulted in considerable distortion of the activity recorded by the vertex electrod; the forepaw, in contrast, showed no activity and a vertex-forepaw electrode configuration provided good resolution of the BAERs across development.A number of new observations were made. BAERs were first observed at 4 days of age, approximately the same age at which depth evoked potentials are first recorded in brain stem auditory nuclei. Initially the BAERs were diffuse, high threshold and fatigued rapidly, characteristics shared with depth evoked potentials in the early postnatal period. Over the first two weeks, the potentials showed marked decrease in threshold, increased resistance to fast click rates, and better definition of wave forms. All BAER components showed exponential decreases in latency. Because all of the brain stem evoked potentials could be recorded concurrently and longitudinally in the same subject a number of developmental comparisons were possible among the BAER components. Wave 1, related to the acoustic nerve in the adult cat, showed a developmental time course and adult latency similar to that reported for N₁. Wave 2, related to the cochlear nucleus in the adult, showed a marked bimodality over the first month; wave 2a was a large amplitude clearly separated wave which gradually fused as an inconspicuous conspicuous leading shoulder on wave 2b. Wave 2b developed with a time course and adult latency similar to that reported for the ventral cochlear nucleus. Wave 3, related to the region of the superior olivary complex in the adult, showed a clear but transient bimodality during the third week of development. Wave 5, related to the inferior colliculus in the adult, appeared later than waves 1–4 and showed a significantly slower rate of development than waves 1–4. These data indicate that differential developmental changes occur within the brain stem auditory pathway and that the BAERs provide a dynamic probe of concurrent maturational interactions.     

急性颅脑损伤病人脑干听觉诱发电位动态变化与预后的关系

目的探讨急性颅脑损伤病人脑干听觉诱发电位(BAEP)动态变化与预后的关系。方法动态检测73例急性颅脑损伤病人双侧BAEP,根据BAEP分级标准:Ⅰ级20例,Ⅱ级19例,Ⅲ级17例,Ⅳ级17例。观察BAEP分级变化与GOS的关系。结果颅脑损伤后1周不同BAEP分级预后良好率分别为Ⅰ级90%,Ⅱ级84.2%,Ⅲ级58.8%,Ⅳ级11.8%。BAEP改变与GOS变化存在线性相关关系(χ2回归=25.523,P0.01;χ2偏离=3.675,P0.05);BAEP好转者预后良好率(72.4%)较恶化者(23.1%)显著升高(χ2=8.922,P=0.003)。结论急性颅脑损伤病人BAEP变化与预后存在明显相关性。动态观察BAEP变化可能是评估急性颅脑损伤病人预后的一种有效方法。     

Electroencephalogram and brainstem auditory evoked potential in 539 patients with central coordination disorder

BACKGROUND： Electroencephalogram （EEG） and brainstem auditory evoked potential （BAEP） are objective non-invasive means of measuring brain electrophysiology. OBJECTIVE： To analyze the value of EEG and BAEP in early diagnosis, treatment and prognostic evaluation of central coordination disorder. DESIGN, TIME AND SETTING： This case analysis study was performed at the Rehabilitation Center of Hunan Children＇s Hospital from January 2002 to January 2006. PARTICIPANTS： A total of 593 patients with severe central coordination disorder, comprising 455 boys and 138 girls, aged 1-6 months were enrolled for this study. METHODS： EEG was monitored using electroencephalography. BAEP was recorded using a Keypoint electromyogram device. Intelligence was tested by professionals using the Gesell scale. MAIN OUTCOME MEASURES： （1） The rate of abnormal EEG and BAEP, （2） correlation of abnormalities of EEG and BAEP with associated injuries, （3） correlation of abnormalities of EEG and BAEP with high risk factors. RESULTS： The rate of abnormal EEG was 68.6% （407/593 patients）, and was increased in patients who also had mental retardation （P 〈 0.05）. The rate of abnormal BAEP was 21.4% （127/593 patients）. These 127 patients included 67 patients （52.8%） with peripheral auditory damage and 60 patients （47.2%） with central and mixed auditory damage. The rate of abnormal BAEP was significantly increased in patients who also had mental retardation （P 〈 0.01 ）. Logistic regression analysis showed that asphyxia （P 〈 0.05）, jaundice, preterm delivery, low birth weight and the umbilical cord around the neck were closely correlated with abnormal EEG in patients with central coordination disorder, lntracranial hemorrhage, jaundice （P 〈 0.05）, low birth weight and intrauterine infection （P 〈 0.05） were closely correlated with abnormal BAEP in patients with central coordination disorder. CONCLUSION： Central coordination disorder is often associated with abnormal EEG an     

Early auditory evoked potentials (EAEP) in vertebral basilar insufficiency

Summary Stimulation with a short tone pip elicits an acoustic nerve compound action potential (I) and different waves (II–VII) in the initial 10 ms. Seven waves have been studied in 40 control subjects and five waves in 12 patients with vertebral-basilar insufficiency. Abnormalities of the different waves were observed at levels such as cochlea and/or acoustic nerve, medulla, caudal pons, rostral pons, and midbrain. The recording of early auditory evoked potentials (EAEP) is a noninvasive method of confirming impairment of the auditory pathway caused by a reduced vascular supply of vertebral and basilar arteries.     

Recognizability of brain stem auditory evoked potential components

In examining neurological patients suspected of having a brain stem lesion with brain stem auditory evoked potentials (BAEPs), a technique giving high amplitudes and/or maximal recognizability of most of the components was preferred.
An increase of interstimulus intervals and stimulus strength and a widening of the band-passes of the amplifier were found to increase the amplitudes and the recognizability in BAEPs from normal subjects and patients. A random monaural 75 dBHL stimulation with 230 msec intervals and frequency cut-offs of the amplifier of 50–5,000 c/sec was chosen as the standard procedure.
In normal subjects aged 10–69 years, a decrease in amplitudes was found with increasing age. Men older than 50 years had longer latencies than younger men. Women had shorter latencies and higher amplitudes than men. Waves I, III and V were recognized in all normal subjects; the recognizability of waves II, IV and VI was 94% or more in subjects younger than 50 years, 85–93% in the oldest subjects.     

脑干听觉诱发电位在听阈正常的语言发育迟缓患儿中的意义

目的 探讨脑干听觉诱发电位（BAEP）在听阈正常而语言发育迟缓患儿中的变化规律及应用价值.方法 分析100例听阈正常而语言发育迟缓患儿BAEP的变化规律;按年龄分组比较两个年龄段之间各波的延长时间.结果 （1）BAEP正常10例,异常90例,BAEP表现为Ⅰ、Ⅴ波潜伏期（PL）延长,Ⅲ~Ⅴ、Ⅰ~Ⅴ波峰间期（IPL）延长;（2）随着年龄增长,Ⅴ波PL与Ⅲ~Ⅴ波IPL延长时间越长.结论 Ⅰ波、Ⅴ波延长对早期诊断听阈正常而语言发育迟缓患儿具有一定的意义,说明即使听阈正常也可能存在听觉传导通路异常,且随着年龄增加,脑干上段受损越严重.     

Brainstem auditory evoked potentials in postconcussion syndrome

Brainstem auditory evoked potentials (BAEPs) were recorded from 55 patients with postconcussion syndrome (PCS) to elicit evidence of an organic and subclinical brainstem disorder. Fifteen patients (27.3%) showed abnormal responses unilaterally or bilaterally, especially for one or more interpeak latencies prolonged beyond the upper 99% confidence limits. Other 9 patients had borderline responses. The BAEP alterations were not correlated either with dizziness at the time of recording, or with vestibular troubles in the routine caloric test. Though BAEP abnormalities may be present a long time after injury, we found an improvement of responses in the majority of 14 re-tested patients. These data show that BAEP can give an objective demonstration of a reversible brainstem disorder in patients with PCS.

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Sommario I potenziali evocati acustici del tronco cerebrale (BAEP) sono stati registrati in 55 pazienti affetti da sindrome soggettiva postcraniotraumatica (PCS), per evidenziare un possibile danno organico subclinico del tronco cerebrale. Quindici pazienti (27.3%) hanno mostrato risposte alterate unilateralmente o bilateralmente, soprattutto a causa della presenza di una o più latenze interpicchi oltre i limiti fiduciali superiori del 99%. Altri 9 pazienti hanno mostrato risposte borderline. Non sono state ritrovate correlazioni tra il reperto di BAEP alterati e la presenza di vertigini all'atto dell'esame, né con il comportamento dell'esame vestibolare. Benché le alterazioni del BAEP si possano osservare anche a distanza di molti mesi dal trauma, la maggioranza dei pazienti con BA EP alterati, ad un secondo esame ha mostrato un miglioramento della risposta. Tali dati dimostrano che i BAEP sono in grado, in alcuni pazienti affetti da PCS, di evidenziare un danno organico del tronco cerebrale, passibile di regressione.

     

Brain function in patients with cerebral fat embolism evaluated using somatosensory and brain-stem auditory evoked potentials

Summary In two victims of traffic accidents with broken bones and fat embolism, serial recordings of somatosensory evoked potentials (SEPs) and brain-stem auditory evoked potentials (BAEPs) were examined to assess brain function. Initial SEPs and BAEPs revealed normal subcortical components, while the late cortical components of SEPs were abolished, findings indicative of diffuse dysfunction of grey rather than of white matter. As the neurological functions became normal, the late components appeared. It is concluded that while absent late components of SEPs do reflect cortical dysfunction, they are not necessarily associated with a poor prognosis. Repetitive recordings of SEPs appear to be a useful tool for assessing the neurological condition and the prognosis of patients with cerebral fat embolism.     

Influence of magnetic resonance imaging on somatosensory and brain-stem auditory evoked potentials in man

Summary There is still a need to prove that even static magnetic fields up to 1.5 T used in magnetic resonance imaging (MRI) are biologically safe and harmless for humans. Recordings of median and ulnar nerves and brain-stem auditory evoked potentials in 20 patients were completed prior to and after MRI investigation of the central nervous system. Neither the somatosensory nor the auditory evoked potentials exhibited any significant change of latencies, interpeak latencies or amplitudes. Since these electrophysiological parameters are highly dependent on the quality of nerve conduction and integrity of information processing in various nuclei, it may be assumed that MRI causes no lasting changes in either respect.