听觉稳态诱发电位研究近展

听觉稳态诱发电位(SSEP)是由调制声信号引起的,反应相位与刺激信号的相位具有稳定关系的听觉诱发电位。它快速、无创、频率特异性好、与行为听阈相关性好、测试方法客观,结果判定客观。在调制频率>60Hz时,不受醒觉状态影响,是儿童特别是婴幼儿理想的听力损失定量诊断方法。多频SSEP在前者的基础上,双耳多个测试频率同时刺激,同时记录反应。不影响测试准确性,但大大提高了测试效率。     

皮层诱发电位用于婴幼儿听觉功能测试

随着新生儿听力筛查项目在世界范围内广泛实施,越来越需要信度较高的客观技术评估婴幼儿听力损失程度来指导助听器验配并评估验配效果。经新生儿听力筛查确诊的听力损失婴幼儿通常应在出生后6~8周接受包括佩戴助听器在内的听力干预。对这些低龄婴幼儿应用行为测听技术进行助听器的效果评估是非常困难的,听觉诱发电位测     

言语听觉脑干诱发电位的临床应用

1 盲语听觉脑干诱发电位的由来 脑干在言语感知中发挥着重要作用,人们对人类言语感知能力的认识,不能仅仅关注高位听皮层的价值,还要探讨低位中枢的作用. 在听觉系统中,由声信号转化而成的、快速变化着的神经冲动,在脑干水平进行编码.     

皮层听觉诱发电位在听力评估中的应用

目的 探讨短纯音刺激皮层听觉诱发电位(cortical auditory evoked potentials, CAEP)对听力评估的价值。方法 受试者为听力正常成人19例(36耳),感音神经性聋成人患者21例(21耳),以500、1 000、2 000和4 000 Hz短纯音作为刺激声,在醒觉状态下颅顶电极记录CAEP的N1-P2复合波,分析N1-P2阈值与纯音听阈的相关性,以及两者差值在不同人群中的差异。结果 所有受试者四个测试频率的N1-P2阈值与对应频率纯音听阈值的相关系数依次为0.971、0.967、0.958、0.955,呈显著的线性相关;听力正常组36耳500、1 000、2 000和4 000 Hz的N1-P2阈值上限(95%置信区间)依次为32、27、32、39 dB SPL,即正常人阈值上限为32.5 dB SPL;正常人N1-P2阈值与纯音听阈的差值依次为18.9±6.1、11.6±5.9、13.3±7.0、18.7±8.3 dB;感音神经性聋患者两者差值依次为10.3±6.0、6.8±8.9、6.5±9.5、12.9±11.4 dB,四个测试频率的差值在两组人群...     

婴幼儿听觉脑干诱发电位的正常值

目 的探讨0～2岁婴幼儿听觉脑干诱发电位的正常值。方法 采用听觉脑干诱发电位（BAEP）对37例无耳科疾患的听力正常婴幼儿进行检查，测量Ⅰ．Ⅲ．Ⅴ波峰潜伏期和Ⅰ～Ⅲ．Ⅲ～Ⅴ峰间间期。结果 2岁组的各波峰潜伏期较1月龄组明显缩短，呈非常显著性差异（P〈0．001）；而各年龄组的Ⅰ～Ⅲ峰间潜伏期无明显差异（P〉0．05），2岁组的Ⅲ～Ⅴ峰间间期较1月龄组缩短，有显著差异（P〈0．05）。结论 随着年龄的增长，听觉脑干诱发电位的各波峰潜伏期逐渐缩短，但整个听觉通路的发育可能并不是完全平行的。     

听觉稳态诱发电位正常阈值的研究

随着听觉稳态诱发电位（ASSR）在临床上越来越多的应用,临床工作者急需了解其对于临床听力学的价值。每一个临床听力学实验室应该建立本实验室的正常值数据库以指导临床应用。本试验的目的即通过测试听力正常的青年男女的ASSR,建立自己的正常值范围,分析ASSR0．5～4．0kHZ分布的相位以及噪声相位有无统计学规律。     

听觉诱发电位临床应用进展

听觉诱发电位是通过记录听觉神经通路对声刺激信号的神经反应活动评估人类听觉功能的生理方法。本文回顾了自上世纪以来国内外听觉诱发电位临床应用的发展历程,归纳了现阶段在客观听阈评估、术中听力监测、中枢听觉功能评估、听神经病等特殊疾病诊断等方面的应用现状,并提出了测试标准化方面存在的问题,以期为听力学从业者提供一个了解听觉诱发电位临床应用进展的窗口。     

利用普通微机处理听觉诱发电位数据

利用普通微机处理听觉诱发电位数据赵宁军，李克勇目前，电反应测听国内已逐渐普及，耳蜗电图（ＥＣｏｃｈＧ）和听性脑干反应（ＡＢＲ）已在临床上广泛使用，有时需对ＥＣｏｃｈＧ和ＡＢＲ进行数据处理。目前多数医院尚无力购买专门的数据处理仪系统，仅能购买功能较低的...     

听觉诱发电位(AEP)的神经生物学基础及临床应用(5)

清醒状态下的VP是个很可靠的反应，只要受试者听力良好而能合作，一般均可成功地记录出这种反应。然而这种反应与受试者状态关系密切，随觉醒水平不同而有规律地变化，这与脑电背景活动有关。当困倦时VP显著降低，而当高度注意或清醒时则VP明显升高。在电反应测听中需要受试者维持足够的清醒水平时，可让他们阅读书籍、欣赏图片或静静地玩玩具。     

小儿听诱发电位检查前口服水合氯醛镇静作用的观察

目的 探讨小儿行听诱发电位检查前口服水合氯醛及睡眠剥夺法配合水合氯醛的镇静效果及安全性.方法 观察对象为720例行听性脑干反应(ABR)或听性稳态反应(ASSR)检查的患儿,检查前对3岁以内患儿按照体重计算水合氯醛用量后给予口服,对3岁以上患儿则采用睡眠剥夺法配合水合氯醛口服镇静.均于检查前半小时顿服10%水合氯醛0.5～0.8 ml/kg,然后进入测听室诱导睡眠.待患儿安睡后进行ABR或ASSR检测.结果 707例患儿能在30分钟内入睡,镇静成功率达98.2%,有13例(1.8%)患儿出现呕吐及活动过度并发症.结论 水合氯醛能使患儿产生良好的镇静效果,保证了ABR或ASSR检查的顺利进行及精确地判断结果.     

Influence of Tonic Reflex Activities on the Slow Auditory Evoked Potential

Possible influences of tonic reflex activities on the slow auditory evoked potential were investigated. For this purpose, the slow auditory evoked potential was picked up in 18 volunteers with normal hearing in relaxed position and in postures corresponding to reflex-induced positions and in 15 patients with cerebral palsy (CP) in tonic reflex pat-terns. No influence on latency for N₁₂₀ and P₂₁₅ due to postures could be observed' Latency within CP patients was age-dependent.

The effect of the reflex-inhibiting pattern (RIP) – the pattern inhibiting tonic reflex activity in CP patients as far as possible – on potential amplitude was different in the two groups. The effect of RIP in CP patients was comparable to the relaxed position in volunteers. This difference points toward an influence of tonic reflex activity on the slow auditory evoked potential.     

P300 Auditory Evoked Potential Latency In Elderly

Auditory cortical disorders in the elderly can be assessed by the P300. The lack of contemporary reference values of P300 latency in healthy elderly motivated this study.Aim: To estimate the effect of age on P300 latency in a group of elderly.Methods: We studied 62 elderly patients with pure tone thresholds up to 40 dB HL at the frequencies of 1000 and 2000 Hz, divided into groups according to age (60-64, 65-69 and 70-74 years). Were assessed by the P300 latency in response to the rare stimulus of 2000 Hz and 1000 Hz frequencies, both in the intensity of 80 dB HL.Study design: clinical, cross-sectional observational individual compared prospective.Results: The latency in Group 60 was 337.26 ms (SD 11.31) in Group 65 was 351.86 ms (SD 29.05) and in Group 70 it was 370.19 ms (SD 23.40). The linear regression of the values of P300 latency showed an increase of 2.85 ms per year of age. The statistical analysis showed that the results were significant.Conclusion: The P300 latency increases with age at a rate of 2.85 ms per year between the ages of 60 and 74 years.Send correspondence to: Maria José Santos Cóser – Rua Duque de Caxias 1668/304 Centro 97015-190 Santa Maria RS Brasil.Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on January 20, 2008; and accepted on February 25, 2010. cod. 5686     

Obstructive Sleep Apnea and P300 Evoked Auditory Potential

The obstructive sleep apnea syndrome (OSAS) reduces attention span, memory and concentration capacities, all associated with cognition. The analysis of the auditory P300 parameters could help infer cognitive dysfunction.ObjectiveTo compare the data from polysomnography and the auditory P300 in adults, primary snorers with OSAS patients.Materials and MethodsProspective study with primary snorers (N=12) and in OSAS patients (N=54), submitted to polysomnography, defined by the apnea-hypopnea index (AHI). The polysomnography and P300 variables were compared by the t-Student test, the Exact Fisher's Test, logistic regression and analysis of correlation with a significance level of 5%.ResultsAIH had an inverse correlation with the oximetry in both groups. The P300 prevalence was lower in the OSAS group (Fisher's Exact Test, p=0.027). Patient age did not influence the P300 prevalence (regression analysis; p=0.232). The P300 amplitude was lower in the OSAS group (t-Student test; p=0.003) and the P300 latency was similar in both groups (t-Student test; p=0.89).ConclusionThe reduction in the P300 amplitude in patients with OSAS suggests cognitive dysfunction induced by a reduction in auditory memory.     

斑马鱼听觉诱发电位检测系统的建立和应用

目的 建立斑马鱼听觉诱发电位(auditory evoked potential,AEP)检测系统.方法 设计并制作斑马鱼听觉诱发电位检测水箱;应用该系统检测和记录35条体长为10~46 mm斑马鱼的AEP,将斑马鱼分为5组:体长12~15 mm,6条;体长17~20 mm,4条;体长22~26 mm,4条;体长32~37 mm,9条;体长42~46 mm,12条.对照组为金鱼,体长38~54 mm,8条.通过麻醉实验、鱼鳔实验、噪声暴露实验并以金鱼为对照验证斑马鱼AEP检测系统的可靠性.结果 实验证实斑马鱼AEP检测系统获得的响应为听觉电生理反应;所有体长斑马鱼的听力频率范围为100 Hz~12 kHz,在发育过程中无听觉频率扩展的现象;成鱼最佳听力范围为600 Hz~1 kHz,5组斑马鱼AEP阈值分别为141.7±1.32、124.8±1.31、121.8±1.49、117.8±1.09和124.4±1.87 dB w;斑马鱼AEP阈值随体长增加而变化,具有随着发育成熟AEP阈值降低,随着衰老阈值升高的特征.结论 本研究建立了稳定的斑马鱼听觉诱发电位检测系统,该系统可用于斑马鱼AEP的检测.     

皮层听觉诱发电位评估耳聋儿童助听器验配效果的意义

目的 探讨皮层听觉诱发电位(cortical auditory evoked potential,CAEP)在助听器验配效果评估中的应用价值,为临床耳聋儿童听觉言语康复效果评估提供参考.方法 26例语前聋患儿均双耳选配助听器,分别测试患儿助听条件下的CAEP及助听听阈;根据助听后三个刺激声/m/、/g/、/t/在55 dB SPL强度下是否全部引出波形将息儿分为A组和B组,全部引出波形的患儿为A组,其余患儿为B组,比较二组的助听听阈.结果 26例患儿CAEP波形引出率为96.15％(25/26),A组(11例)0.25、0.5、1、2、4 kHz助听听阈均值分别为32.73±7.54、27.27±5.18、35.00±5.48、35.91±7.35、35.45±4.72 dB HL;B组(15例),除1例未引出CAEP外,有9例在65 dB SPL强度下全部引出CAEP波形,其0.25～4 kHz各频率助听听阈均值分别为36.11±7.82、35.00±4.33、38.89±6.51、40.00±7.07、43.33±8.66 dB HL;有5例在75 dB SPL强度下全部引出CAEP波形,其0.25～4 kHz各频率助听听阈均值分别为44.00±12.94、39.00±7.41、49.00±6.52、44.00±6.52、54.00±11.94 dBHL,且A组患儿各刺激声对应频段助听听阈均低于B组,差异有统计学意义(P＜0.05).阈值强度下低频声/m/、中频声/g/、高频声/t/的P1波潜伏期均值分别为130.16±24.85、114.80±25.99、122.88±27.05 ms,幅值分别为6.58±4.53、6.41±3.97、5.58±3.56 μV,相应频段助听听阈分别为34.30±7.69、40.20±8.48、41.40±8.07 dBHL,P1波潜伏期与相应频段助听听阈均无显著相关(P＞0.05),P1波幅值与相应频段助听听阈呈显著负相关(P＜0.05).结论 CAEP测试可用于评估儿童助听器选配效果,55 dB SPL强度下能够引出CAEP波形可作为评估助听器选配效果良好的指标之一.     

Auditory discrimination: The relationship between psychophysical and electrophysiological measures

Abstract

Objectives: This study aimed to (1) investigate the relationship between the acoustic change complex (ACC) and perceptual measures of frequency and intensity discrimination, and gap detection; and (2) examine the effects of acoustic change on the amplitudes and latencies of the ACC. Design: Psychophysical thresholds for frequency and intensity discrimination and gap detection, as well as ACCs elicited by stimuli containing increments in frequency, or intensity or gaps, were recorded from the same group of subjects. The magnitude of the acoustic change was systematically varied for the ACC recording. Study sample: Twenty-six adults with normal hearing, ranging in age between 19 and 39 years. Results: Electrophysiological and psychophysical measures for frequency and intensity discrimination were significantly correlated. Electrophysiological thresholds were comparable to psychophysical thresholds for intensity discrimination but were higher than psychophysical thresholds for gap detection and frequency discrimination. Increasing the magnitude of acoustic change increased the ACC amplitude but did not show consistent effects across acoustic dimensions for ACC latency. Conclusions: The ACC can be used as an objective index of auditory discrimination in frequency and intensity. The ACC amplitude is a better indicator for auditory processing than the ACC latency.     

Brainstem Auditory Evoked Potentials Suggest a Role for the Ventral Cochlear Nucleus in Tinnitus

Numerous studies have demonstrated elevated spontaneous and sound-evoked brainstem activity in animal models of tinnitus, but data on brainstem function in people with this common clinical condition are sparse. Here, auditory nerve and brainstem function in response to sound was assessed via auditory brainstem responses (ABR) in humans with tinnitus and without. Tinnitus subjects showed reduced wave I amplitude (indicating reduced auditory nerve activity) but enhanced wave V (reflecting elevated input to the inferior colliculi) compared with non-tinnitus subjects matched in age, sex, and pure-tone threshold. The transformation from reduced peripheral activity to central hyperactivity in the tinnitus group was especially apparent in the V/I and III/I amplitude ratios. Compared with a third cohort of younger, non-tinnitus subjects, both tinnitus, and matched, non-tinnitus groups showed elevated thresholds above 4 kHz and reduced wave I amplitude, indicating that the differences between tinnitus and matched non-tinnitus subjects occurred against a backdrop of shared peripheral dysfunction that, while not tinnitus specific, cannot be discounted as a factor in tinnitus development. Animal lesion and human neuroanatomical data combine to indicate that waves III and V in humans reflect activity in a pathway originating in the ventral cochlear nucleus (VCN) and with spherical bushy cells (SBC) in particular. We conclude that the elevated III/I and V/I amplitude ratios in tinnitus subjects reflect disproportionately high activity in the SBC pathway for a given amount of peripheral input. The results imply a role for the VCN in tinnitus and suggest the SBC pathway as a target for tinnitus treatment.