颅脑损伤后持续植物状态下听性脑干反应的研究

目的 评估颅脑外伤后持续植物状态（persistent vegetative state，PVS）患者的脑干功能。方法 对25例（50耳）PVS患者行听性脑干反应（auditory brainstem response，ABR）检测，对结果进行单因素方差分析（one—wayanova）。结果 PVS患者的ABR异常率为66％，其改变复杂多样，主要表现为Ⅰ～Ⅴ各波的异常或分化不良，甚至波形缺如；波Ⅰ、Ⅲ、Ⅴ潜伏期（peak latency，PL）延长，Ⅰ—Ⅴ波间期（interpeak latency，IPL）延长，双侧波Ⅴ潜伏期的耳间差（inter—aural latency difference，ILD）增大；Ⅲ—Ⅴ与Ⅰ—Ⅲ波间期之比大于1。结论 PVS患者的ABR结果呈多样性改变，反映了植物状态下存在不同程度的脑干损害，为其诊疗及预后判断提供了参考资料。     

80例听阈正常的婴儿BAEP结果分析

目的分析80例V波反应听阈正常的婴儿脑干听觉诱发电位（BAEP）的结果,探讨婴儿正常值与成人的差异以及性别、左右耳对BAEP结果的影响。方法婴儿共80例（160耳）,年龄3~12个月,平均4.3个月;成人共65例（130耳）,年龄18~67岁,平均35.6岁,均行BAEP检查。分析在80 d B声强刺激下I、Ⅲ、V波潜伏期（PL）,I一Ⅲ、Ⅲ一V、I—V波峰间期（IPL）。结果Ⅲ、V波潜伏期及I一Ⅲ、Ⅲ~V、I—V波峰间期婴儿组较成人组明显延长,差异有统计学意义（P〈0.05）;I波潜伏期两组间无明显差异（P〉0.05）。婴儿组内性别间、左右耳间无明显差异（P〉0.05）。结论与成人比较,婴儿III、V波潜伏期及I一Ⅲ、Ⅲ一V、I—V波峰间期相对延长。性别、左右侧耳对BAEP结果亦无显著性影响。提示婴儿听觉传导通路发育不完全,以髓鞘发育差距尤为明显。     

青年急性耳鸣高刺激率ABR的检测及临床意义

目的研究高刺激率听觉脑干反应（Auditory brainstem response,ABR）检测对青年急性耳鸣的临床意义。方法选取青年急性耳鸣58耳与正常青年44耳,分别进行高、低刺激率ABR检测,比较波Ⅰ、Ⅲ、Ⅴ的潜伏期（peaklatency,PL）和Ⅰ～Ⅲ、Ⅲ～Ⅴ和Ⅰ～Ⅴ峰间潜伏期（interpeak latency,IPL）及两种刺激速率PL差值（ΔPL）、IPL差值（ΔIPL）。结果采用51.1次/s与11.1次/s的波PL及IPL的差值作为分析参数：耳鸣组波ⅠPL差值较正常组缩短,有统计学意义（P〈0.05）;Ⅰ～ⅤIPL差值较正常组延长,差异具有显著性（P〈0.01）。正常组与耳鸣组高、低刺激率ABRⅠ～ⅤIPL差值〉0.272ms的耳数分别为1耳和28耳。结论高刺激率ABR较常规ABR对青年急性耳鸣的检测更为敏感,可作为耳鸣患者的一种临床检查方法。     

先天性心脏病患儿短声诱发听性脑干反应的探讨

探讨先天性心脏病(先心病)对患儿脑干发育的影响。方法探讨先心病患儿听性脑干反应 (ABR)，并以正常儿为对照组。结果年龄<12月，青紫型先心病(CCHD)患儿Ⅰ波潜伏期(LP)正常，Ⅰ～V 波峰间潜伏期(IPL)较正常儿显著延长，非青紫型先心病(NCCHD)患儿Ⅰ波LP、Ⅰ～V波IPL均显著延长；4 ～6岁者NCCHD和CCHD无反复缺氧发作者LP和Ⅰ～V波IPL与正常儿无差异，CCHD反复缺氧发作者Ⅰ ～V波IPL较正常儿显著延长，异常率2.3％。结论先心病不延迟婴儿期脑干发育，缺氧发作可损害脑干功 能，对缺氧发作者应尽早进行干预。     

儿童OSAHS不同刺激重复率听性脑干反应的临床研究

目的 探讨儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep Apnea-hypopnea syndrome,OSAHS)的脑干听觉诱发电位反应(Brain Auditory Evoked Potention,BAEP)的特征。方法 对经多导睡眠检测确诊的儿童OSAHS患者87例,经声阻抗检查呈A型曲线,4～7岁,分别以11.1、33.1?Hz的不同刺激重复率进行BAEP测试,比较不同病变程度对两种刺激重复率听觉阈值、潜伏期及波间期差的影响。结果 与对照组比较,OSAHS轻度组：两种刺激重复率的 BAEPⅠ、Ⅲ、Ⅴ波的潜伏期及波间期差均在正常范围,Ⅴ波听阈为25dBnHL;中度组：刺激重复率33.1Hz,Ⅰ、Ⅲ、Ⅴ波的潜伏期及波间期差无异常,Ⅴ波听阈25dBnHL;刺激重复率11.1Hz,Ⅰ、Ⅲ、Ⅴ波的潜伏期延长,差异具有统计学意义（P＜0.05）,Ⅰ～Ⅲ、Ⅰ～Ⅴ波间期延长,Ⅲ～Ⅴ间期在正常范围,Ⅴ波听阈28dBnHL;重度组：刺激重复率33.1Hz,Ⅰ、Ⅲ、Ⅴ波的潜伏期及各波间期差均延长,Ⅴ波听阈35dBnHL;刺激重复率11.1Hz,Ⅰ、Ⅲ、Ⅴ波的潜伏期及波间期差均延长,Ⅴ波听阈40dBnHL。重度OSAHS患者两种刺激重复率各波潜伏期、波间期差听阈改变均具有统计学意义。结论 低频短声刺激能较早反映OSAHS患儿脑干功能的改变;重度OSAHS患儿的BAEP测试结果异常,提示OSAHS对听阈及听觉脑干传导功能都存在影响。     

听觉脑干诱发电位波形变化在听神经瘤诊断中的意义

目的探讨听神经瘤病人听觉脑干诱发电位(ABR)波形改变的意义。方法对手术证实为听神经瘤的23例病人ABR的潜伏期、波形进行回顾性分析。结果在23例病人中,11例潜伏期延长,Ⅰ~Ⅴ波间期耳间差(IPL)大于0.4 ms;2例潜伏期延长,但Ⅰ~Ⅴ波间期耳间差小于0.4 ms;2例V波缺失;8例无波形反应。全部患侧波形均异常、重复性差,2例出现对侧波形异常。结论ABR波形变化在听神经瘤诊断中有重大意义;波形异常、重复性差可作为判断ABR异常的辅助指标。     

90岁以上老年性聋患者的听性脑干反应

目的分析90岁以上老年性聋患者听性脑干反应(ABR)的特征。方法对14例90岁以上老年性聋患者(平均年龄91.1.4±1.3岁,26耳)进行交替短声ABR测试。听力正常人9例(平均年龄22.7±1.2岁,18耳)作为对照组。观测Ⅰ、Ⅲ、Ⅴ波的峰潜伏期(PeakLatency,PL)和Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期(Inter-PeakLatency,IPL),并分别与对照组总体均数进行比较。结果总体的I波引出率和III波引出率均为76.9%(20/26),V波引出率为84.6%(22/26)。高龄老年性聋组各波PL较对照组延长。Ⅰ-Ⅲ波IPL、Ⅲ-Ⅴ波IPL、Ⅰ-Ⅴ波IPL无组间统计学差异。结论 90岁以上高龄老年性聋患者ABR波形分化较差。     

脑干听觉诱发电位用以检测腭裂患儿听力的评价

目的:评价腭裂患儿脑干听觉诱发电位(BAEP)的异常情况及听力障碍程度、性质.方法:应用脑干听觉诱发电位检测32例腭裂患儿的听觉阈值,各波潜伏期及阈值异常率,潜伏期延长的异常率.结果:腭裂患儿听觉阈值及各波潜伏期较正常儿显著提高和延长(P＜0.01),阈值异常率为68.75%,腭裂患儿普遍存在程度不同的听力障碍,半数以上为中、重度听力障碍.潜伏期延长的异常率为65.6%.患侧耳数Ⅰ、Ⅲ、Ⅴ波延长分别为30耳、18耳、32耳.腭裂患儿Ⅰ～Ⅴ波峰间期较正常儿童明显延长,表明存在一定程度的中枢传导通路功能障碍.不同类型及不同年龄腭裂患儿之间BAEP反应阈及异常率比较差异无显著性(P＞0.05).结论:68.75%腭裂患儿存在听力障碍且大部分是传导性听力丧失,BAEP作为筛选适于低龄儿童听力的工具,具有重要的临床意义.     

儿童孤独症患者脑干听觉诱发电位改变的初步观察

目的：通过观察儿童孤独症患者患者脑干听觉诱发电位的改变,探讨听觉诱发电位检测在听觉障碍儿童孤独症诊断中的临床意义。方法：按DSM－IV诊断标准确诊的15例孤独症患儿的14例正常对照组,同期接受听觉诱发反应检测,比较两组间波Ⅰ-Ⅴ各波峰潜伏期,波峰潜伏期差和波幅的差异。结果：孤独症患儿左侧波Ⅴ、右侧波Ⅱ峰间潜伏期和右侧Ⅰ－Ⅲ、Ⅰ－Ⅴ峰间潜伏期差较对照组显著延长（P＜0．05－0．005）,孤独症组右侧波Ⅲ振幅较对照组增高（P＜0．05）,其他各指标两组间无显著性差异,结论：孤独症患儿脑干听觉诱发电位的突出改变是潜伏期有延长的趋势,对就诊于耳鼻咽喉科的听阈正常而有听觉障碍,言语交往能力着,脑干听觉诱发电位检查潜伏期延长的儿童,应警惕孤独症或其他神经精神发育障碍。     

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。     

Comparative ABR profile in high risk infants

Auditory brainstem responses (ABR) were studied in 52 children upto the age of 3 months, suffering from neonatal jaundice, prematurity, pyogenic meningitis and septicemia. Absolute latency of wave I and interpeak latency I–V were found to be significantly delayed in cases of jaundice and absolute latency of wave V and interpeak latency I–V were prolonged in cases with prematurity. In cases following pyogenic meningitis absolute latency of wave V and interpeak latency of I–III, I–V were significantly delayed compared to septicemia where absolute latency I,V and interpeak latency I–V were significantly delayed (P<0.05). Maximum auditory insult was seen in cases with neonatal jaundice where 30.77% each had severe SN deafness and 30.77% had moderate degree of deafness compared to prematurity, meningitis and septicemia where 14.28, 7.69 and 25% were found to have severe SN deafness and 7.14, 38.46 and 25% had moderate deafness. Overall incidence of deafness of any kind in these factors was 44.23%.     

Brainstem auditory evoked potentials correlate with morphological changes in Gunn rat pups.

The relationship of brainstem structure and function in bilirubin encephalopathy is incompletely understood. The present experiments compare quantitative measures of brainstem structures with brainstem auditory evoked potentials (BAEPs) in infant jaundiced (jj) and nonjaundiced (Nj) Gunn rats. Ten jj's from 4 litters were injected with sulfadimethoxine at 11-12 days of age to raise their brain bilirubin concentration. Littermate controls were jj's given saline, and Nj's given sulfadimethoxine or saline. At 15-17 days of age BAEPs were recorded, and rats were prepared for histological examination, as was reported in the previous paper (Conlee and Shapiro, 1991). Significant differences between groups were seen for BAEP wave I latency (P = 0.002). I-II interwave interval (P = 0.001), and amplitudes of waves I, II, III, and IV (each P less than 0.0005) due to increased latencies and decreased amplitudes in the jj-sulfa group. Animals with the most severe BAEP abnormalities had the most severe histological abnormalities. Cochlear nucleus volume had a positive linear correlation with the amplitude of BAEP waves I, II, and IV, and an inverse correlation with wave I latency and I-II interwave interval (P less than or equal to 0.001). The highest correlations were BAEP I-II interwave interval and amplitude of waves I and II with cochlear nucleus volume (r = -0.78, 0.71 and 0.70, respectively, P less than 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)     

Relationship between head size and latency of the auditory brainstem response

This investigation examines the relationship between the head size of 22 normally hearing individuals and the latency of their respective auditory brainstem responses (ABR). The absolute latency of wave V and the I-V interpeak interval were examined in 12 female and 10 male subjects with varying head sizes. Strong positive correlations were obtained between head size and the latency of both wave V and the I-V interpeak interval. The evidence suggests that this relationship is based upon subject differences in brain size which is reflected in head size. Head size appears to be an important source of intersubject variability which should be considered in order to increase the clinical usefulness of the ABR.     

Investigation of auditory brainstem function in diabetic patients

We performed brainstem auditory evoked potential (BAEP) examinations in 15 patients with long-standing type 1 diabetes mellitus. We applied cardiovascular reflex tests for assessment of autonomic neuropathy. The aim of our investigation was to compare the BAEP results of this patient group with those of controls and to look for the possible correlation between alteration of the auditory brainstem function and cardiovascular autonomic neuropathy. Analysis of the latencies (waves I, II, III, and V) and the interpeak latencies (I-III and I-V) of BAEP revealed a significant difference between those of diabetics and those of healthy controls. The amplitudes of waves I, III, and V were definitely lower in comparison with amplitudes of healthy controls. We observed a positive correlation between the overall autonomic score and the latencies (waves III and V) and interpeak latencies (I-III, I-V). These data support the hypothesis that long-standing diabetes mellitus and diabetic neuropathy might be revealed as a cause of certain dysfunctions of the central auditory pathways.     

Auditory brainstem response in pediatric migraine: during the attack and asymptomatic period

OBJECTIVE: The aim of this study was to evaluate the hearing parameters of children with migraine during ictal and interictal period. METHOD: 16 pediatric patients with migraine and normal otolaryngologic examination were evaluated. Hearing parameters were assessed with auditory brainstem response (ABR) testing between and during the migraine attacks. Binaural absolute latencies of waves I, III and V, interpeak latencies I-III, III-V and I-V of ABR in response to 80 dB nHL clicks were calculated. Initial findings were compared with those of 20 healthy volunteers. RESULTS: Peak latencies of wave V and interpeak latencies of I-V were prolonged during the attack in migraineurs on the left. The side of latency elongation was not affected by the side of headache. When these parameters were separately compared for gender, they were prolonged in boys during the attack in migraineurs; however in girls, while there was statistically significant difference at interpeak latencies of I-V, no significant difference was noted at peak latencies of wave V. CONCLUSIONS: ABR waves did not exceed clinical norms in migraine patients in headache-free period. But, important effects on sensorineural hearing parameters were detected during the attack. Our results indicated a transient impairment of the auditory brainstem function during the headache in pediatric migraine patients.     

Axonal injury in auditory nerve observed in reversible latency changes of brainstem auditory evoked potentials (BAEP) during cerebellopontine angle manipulations in rats

Intraoperative monitoring of brainstem auditory evoked potentials (BAEP) has been widely utilized to reduce the incidence of postoperative hearing disturbance due to cerebellopontine angle manipulations. The prolongation of wave V of BAEP is usually used as a criterion to warn the surgeons to modify their surgical maneuvers. However, it is not known whether all neuropathological changes are avoided if BAEP latency intraoperatively returns to the baseline level or some neuropathological changes 'silently' occur even if BAEP normalizes. The aim of this study was to experimentally clarify this point that would be important for the long-term prognosis of patients' hearing. The cerebellopontine angle portion of the auditory nerve was quantitatively compressed in the rats and reversible prolongation of BAEP latency was reproduced just as it occurs during surgery in humans. Twenty-four hours after the compression, the auditory nerve was removed for beta-APP immunostaining to investigate the degree of axonal injury. The results of the present study disclosed that axonal injury occurred even in the cases where the intraoperative normalization of prolonged wave IV (equivalent to wave V in humans) latency had been obtained. Therefore, the interpretation of BAEP changes based only on the prolongation of the latency of BAEP was not enough to prevent the auditory nerve from developing morphological changes. Changes in the amplitude of wave V of BAEP appears to be more sensitive than its latency change as an intraoperative indicator for axonal injury in the auditory nerve.     

经鼻持续正压通气对OSAHS患者ABR的影响

目的　研究经鼻持续正压通气(continuouspositiveairwaypressurethroughthenares,nCPAP)治疗前后阻塞性睡眠呼吸暂停低通气综合征(obstructivesleepapnea/hypopneasyndrom ,OSAHS)患者听性脑干反应(ABR)各波潜伏期及波间期的变化,探讨OSAHS患者脑干电生理变化的解剖学及病理生理学基础。方法　对4 5例( 90耳)OSAHS患者及16例( 32耳)正常对照者行ABR测试及多导睡眠监测(polysomnography ,PSG) ,对其中34例( 6 8耳)OSAHS患者行nCPAP治疗前后ABR测试对比。结果　OSAHS患者的波Ⅲ、Ⅴ潜伏期及Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期比正常对照组明显延长(P <0 .0 5 )。nCPAP治疗后波Ⅲ潜伏期较治疗前缩短,Ⅰ-Ⅲ波间期较治疗前缩短,Ⅲ-Ⅴ波间期较治疗前延长;nCPAP治疗后OSAHS患者呼吸紊乱指数及减血氧次数较治疗前明显下降(P <0 .0 5 )。结论　OS AHS患者的脑干听觉传导通路受损,与其高碳酸-低氧血症有密切关系。nCPAP治疗可以改善脑干听觉传导功能。     

Auditory brainstem responses from children three months to three years of age: normal patterns of response. II

Auditory brainstem responses (ABR) were measured in 535 children from 3 months to 3 years of age. The latencies reported in this paper should be unaffected by peripheral hearing loss because each child had bilateral wave V responses at 20 dB HLn. Wave V latencies decreased as age increased, at least to 18 months of age, while little or no change was noted in wave I latencies over the same age range. Thus, interpeak latency differences followed the same developmental time course as wave V. The shapes of wave V latency-level functions were comparable across age groups. These results suggest that changes in wave V latency with age are due to central (neural) factors and that age-appropriate norms should be used in evaluations of ABR latencies in children. Interaural differences in absolute wave V latencies and interpeak latency differences were similar to those observed in infants and adults, indicating that response symmetry is independent of age. Statistical analyses suggested that the distributions of absolute and relative latency measurements are normal, making it possible to describe norms in terms of means and standard deviations. A simple model is described that accounts accurately for changes in mean wave V latencies as function of age from preterm through the first three years of life.