窄带CE-Chirp声诱发的听性稳态反应对正常青年人阈值测试的研究

目的 了解正常青年人的听性稳态反应阈值及与纯音测听检查的相关性.方法 30例听力正常受试者(60耳),年龄24～30岁；听性稳态反应调制频率为90 Hz,分别记录500 Hz、1 000 Hz、2 000Hz和4000 Hz4个频率听性稳态反应原始阈值、测试中是清醒或是睡眠状态、检测完成总时间等.结果 听性稳态反应原始阈值高于纯音听阈值.听性稳态反应原始阈值,无论睡眠组22例(44耳)或是清醒组7例(14耳),耳别间和性别间在各个频率上均无显著性差异.调制频率为90 Hz,睡眠组听性稳态反应阈值与纯音测听阈值相关性更好,且1 000 Hz、2000 Hz,呈高、中度相关.睡眠组,以50 dBSPL刺激声作为听性稳态反应分析强度,各频率中,500 Hz引出率最低(率=84.1％),有显著性差异(x2=10.37；P=0.016).结论 调制频率为90 Hz的听性稳态反应对睡眠状态正常青年人听阈检查更准确,尤以1 000Hz、2000 Hz两频率更有参考价值.     

Age-Related Changes in the Relationship Between Auditory Brainstem Responses and Envelope-Following Responses

Hearing thresholds and wave amplitudes measured using auditory brainstem responses (ABRs) to brief sounds are the predominantly used clinical measures to objectively assess auditory function. However, frequency-following responses (FFRs) to tonal carriers and to the modulation envelope (envelope-following responses or EFRs) to longer and spectro-temporally modulated stimuli are rapidly gaining prominence as a measure of complex sound processing in the brainstem and midbrain. In spite of numerous studies reporting changes in hearing thresholds, ABR wave amplitudes, and the FFRs and EFRs under neurodegenerative conditions, including aging, the relationships between these metrics are not clearly understood. In this study, the relationships between ABR thresholds, ABR wave amplitudes, and EFRs are explored in a rodent model of aging. ABRs to broadband click stimuli and EFRs to sinusoidally amplitude-modulated noise carriers were measured in young (3–6 months) and aged (22–25 months) Fischer-344 rats. ABR thresholds and amplitudes of the different waves as well as phase-locking amplitudes of EFRs were calculated. Age-related differences were observed in all these measures, primarily as increases in ABR thresholds and decreases in ABR wave amplitudes and EFR phase-locking capacity. There were no observed correlations between the ABR thresholds and the ABR wave amplitudes. Significant correlations between the EFR amplitudes and ABR wave amplitudes were observed across a range of modulation frequencies in the young. However, no such significant correlations were found in the aged. The aged click ABR amplitudes were found to be lower than would be predicted using a linear regression model of the young, suggesting altered gain mechanisms in the relationship between ABRs and FFRs with age. These results suggest that ABR thresholds, ABR wave amplitudes, and EFRs measure complementary aspects of overlapping neurophysiological processes and the relationships between these measurements changes asymmetrically with age. Hence, measuring all three metrics provides a more complete assessment of auditory function, especially under pathological conditions like aging.     

Age-Related Changes in Processing Simultaneous Amplitude Modulated Sounds Assessed Using Envelope Following Responses

Listening conditions in the real world involve segregating the stimuli of interest from competing auditory stimuli that differ in their sound level and spectral content. It is in these conditions of complex spectro-temporal processing that listeners with age-related hearing loss experience the most difficulties. Envelope following responses (EFRs) provide objective neurophysiological measures of auditory processing. EFRs were obtained to two simultaneous sinusoidally amplitude modulated (sAM) tones from young and aged Fischer-344 rats. One was held at a fixed suprathreshold sound level (sAM1_FL) while the second varied in sound level (sAM2_VL) and carrier frequency. EFR amplitudes to sAM1_FL in the young decreased with signal-to-noise ratio (SNR), and this reduction was more pronounced when the sAM2_VL carrier frequency was spectrally separated from sAM1_FL. Aged animals showed similar trends, while having decreased overall response amplitudes compared to the young. These results were replicated using an established computational model of the auditory nerve. The trends observed in the EFRs were shown to be due to the contributions of the low-frequency tails of high-frequency neurons, rather than neurons tuned to the sAM1_FL carrier frequency. Modeling changes in threshold and neural loss reproduced some of the changes seen with age, but accuracy improved when combined with an additional decrease representing synaptic loss of auditory nerve neurons. Sound segregation in this case derives primarily from peripheral processing, regardless of age. Contributions by more central neural mechanisms are likely to occur only at low SNRs.     

Utility of auditory steady-state and brainstem responses in age-related hearing loss in rats

Conclusions: The results support the idea that auditory steady-state response (ASSR) is a more accurate test for studying age-related hearing loss (ARHL) in Sprague-Dawley rats. Differences in the rat middle ear may explain the variations of the click properties, with a displacement of the energy toward the 8 and 10 kHz frequencies compared with humans. Objectives: The purpose of this study was to evaluate ARHL in older and younger Sprague-Dawley rats using auditory clicks and tone burst with auditory brainstem response (ABR), in addition to ASSR. Methods: This was a prospective cohort study with 50 animals divided into 5 groups based on their age in months. A total of 100 registers were elicited from each one of the 3 auditory measurements systems in an electrically shielded, double-walled, sound-treated cabin. Nine frequencies, from 0.5 to 16 kHz were analyzed with the auditory steady-state response and compared with the results elicited by the clicks and tone-burst ABR. Results: Comparisons between the different frequencies showed lower thresholds in those frequencies below 2 kHz, independently of their age in months. The ARHL was detected by each one of the three auditory measurement systems, but with lower thresholds with the ASSR test. Finally, auditory clicks showed better correlations with 8 and 10 kHz elicited by ASSR, which was different to what was expected, based on human studies.     

应用多频稳态诱发电位鉴别诊断职业性噪声聋的临床研究

目的探讨应用多频稳态诱发电位（multiple auditory steady-state evoked responses，ASSR）鉴别诊断职业性噪声聋的方法与意义。方法33例客观聋组、47例夸大聋组和30例正常听力组人员均行0．5、1、2、4kHz频率处的ASSR和纯音测试（pure tone threshold audiometry，PTA），对结果进行统计学分析。结果①客观聋组、正常听力组的ASSR反应阈与PTA听阈相关系数为0．67～0．89，夸大聋组为0．28～0．47。②在Bayes准则下分别应用ASSR反应阈、PTA听阈进行判断分析的总体符合率分别为78．18％、82．73％，判别夸大聋的准确率为65．96％、74．47％。③客观聋组的ASSR反应阈与VIA听阈存在线性依存关系，可建立回归方程。结论在职业性噪声聋诊断中，可利用ASSR为鉴别夸大聋和评估真实听阈提供证据。     

多频稳态诱发电位在职业性噪声聋诊断的应用

目的探讨多频稳态诱发电位（multiple auditory steady-state evoked responses,ASSR）鉴别诊断职业性噪声聋的可行性及临床应用价值。方法33例客观聋组、47例夸大聋组和30例正常听力组人员均行0.5kHz、1kHz、2kHz、4kHz共四个频率处的ASSR和纯音测试（pure tone threshold audiometry,PTA）,进行相关性分析和一元回归分析。结果各频率的ASSR-PTA差值在正常听力组依次为（7.63±5.62）dBHL、（11.58±2.80）dBHL、（10.54±3.24）dBHL、（9.20±3.32）dBHL,在客观聋组依次为（-0.63±8.22）dBHL、（8.99±8.75）dBHL、（12.50±8.50）dBHL、（10.03±10.13）dBHL,在夸大聋组依次为（-18.02±18.15）dBHL、（-11.05±16.63）dBHL、（-6.06±19.17）dBHL、（-5.81±20.17）dBHL。各频率ASSR反应阈与PTA听阈的相关系数在正常听力组依次为0.668、0.839、0.791、0.716,在客观聋组依次为0.817、0.826、0.892、0.768,而在夸大聋组依次为0,280、0.352、0.396、0.468。以客观聋组的ASSR反应阈为自变量、PTA听阈为因变量,进行一元回归分析。经回顾性考核和前瞻性考核,证实应用ASSR评估真实听力效果较好。结论应用ASSR鉴别诊断职业性噪声聋是可行的,有临床应用价值。     

大前庭水管综合征婴幼儿患者ASSR和ABR听力学特点

目的利用听觉稳态诱发反应(auditory steady state response, ASSR)与听性脑干反应(auditory brainstem response, ABR)对大前庭水管综合征(large vestibular aqueduct syndrome, LVAS) 患者进行听力测试,探讨其ASSR和ABR的听力学特点。方法对63例（121耳）确诊为LVAS和同期来我院就诊的20例非LVAS感音神经性聋患儿进行ASSR和ABR测试,分别记录结果,分析并观察其特点。结果LVAS组:ASSR 在0.5～4?kHz阈值呈上升趋势,直至4?kHz反应阈消失,近成直线关系,随低频听阈值的升高,斜率值减小;给出最大刺激频率中,1?kHz反应阈最后消失;当ASSR听阈介于50～80?dBHL时,若ABR以dBnHL为单位,其对应的反应阈数值小于ASSR听阈数值;当ASSR听阈＞100?dBHL时,ABR 109.6?dBnHL已不能引出V波;84耳ABR最大声刺激未引出V波, 其对应ASSR仍可全部或部分频率引出反应阈。非LVAS组:0.5～4?KHz阈值曲线多为平坦型, 2～4?kHz均值与ABR V波反应阈相近。结论大前庭水管综合征患者ASSR 0.5～4?kHz各频率反应阈值呈升高趋势直至消失,其数值与ABR反应阈数值大小具有阶段性改变,其改变区间在80～100?dBHL。     

Auditory gamma oscillations predict global symptomatic outcome in the early stages of psychosis: A longitudinal investigation

Objectives

The gamma-band auditory steady-state response (ASSR) is thought to reflect the function of parvalbumin-positive γ-aminobutyric acid (GABA)-ergic interneurons and may be a candidate biomarker in early psychosis. Although previous cross-sectional studies have shown that gamma-band ASSR is reduced in early psychosis, whether reduced gamma-band ASSR could be a predictor of the long-term prognosis remains unknown.

窄带CE-Chirp声诱发的ASSR在婴儿听力筛查及诊断中的应用

目的探讨窄带CE-Chirp声诱发的听性稳态反应(ASSR)在婴儿听力筛查及诊断中应用的可行性。方法对10例(20耳)耳声发射听力筛查双耳未通过的婴儿(观察组)行ASSR筛查,年龄2～12个月,平均6个月。对照组为10例(20耳)听力正常且耳声发射听力筛查通过的婴儿,年龄为1～11个月,平均6个月。观察组婴儿自然睡眠或测试前口服10%的水合氯醛溶液后进入睡眠,对照组婴儿在自然睡眠下进行测试。应用丹麦国际听力(Inter-acoustics)的EclipseASSR1.02系统,刺激声为窄带(NB)CE-Chirp声,刺激重复率为90次/秒。耳机型号为ER-3A插入式气导耳机。刺激声强度≤80dBnHL时,4个频率双耳同时给声(0.5、1、2、4kHz);刺激声强度>80dBnHL时,单频率双耳给声。初始给声强度为30dBnHL,4个频率都引出反应,判定为ASSR筛查通过;若某个频率未引出,则以20dB一档提高刺激声强度直至引出反应后,再采用降10升5的方法,分别找到每个频率的反应阈。结果观察组10例(20耳)中有2耳(10%)ASSR检查通过,ASSR检查未通过的18耳分别得出500、1000、2000、4000Hz的听阈所用时间为2.4～36.1分钟,平均24.5分钟;对照组10例(20耳)ASSR检查均通过,所用时间为45秒～5.5分钟,平均3.2分钟。结论 NBCE-Chirp ASSR具有快速、特异性高的特点,可用于婴儿听力筛查和频率特异性听力评估。     

极重度听损大前庭水管综合征婴幼儿患者ABR和ASSR结果分析

目的通过对极重度听力损失的大前庭水管综合征婴幼儿进行听性脑干反应（ABR）和多频稳态反应（ASSR）测试,探讨其ABR检查过程中出现的声诱发短潜伏期负向波（acoustically evoked short latency negative response,ASNR）及其ASSR特点。方法回顾性研究22例（42耳）极重度听力损失的大前庭水管综合征（LVAS）婴幼儿,另选择28例（56耳）极重度听力损失的非LVAS的感音神经性耳聋婴幼儿作为对照组,研究其ABR及ASSR相关性。结果①LVAS婴幼儿组ABR测试中,36耳（85．7％）记录到AsNR,在109．6 dB nHL刺激强度引出的ASNR平均潜伏期在3．04±0．22msT对照组中婴幼儿无一例记录到ASNR。②LVAS婴幼儿组ASSRNI]试在250、500和1000Hz引出率明显高于对照组,两组间差异有统计学意义（P〈0．01）。结论相比于普通的极重度感音神经性耳聋患儿,极重度听损LVAS患儿进行听力学检查时,ABR容易出现ASNR负向波,ASSR测试结果显示较高的中低频的电位反应引出率,此结果可用于临床辅助诊断大前庭水管综合征。