听神经病患者失匹配负波特征与言语识别率的关系

目的观察听神经病(auditory neuropathy,AN)患者失匹配负波(mismatch negativity,MMN)的基本特征及其与最大言语识别率(phonetic balanced maximum,PBmax)的关系。方法用IHS3099(Version3.82)型诱发电位仪对14例(19耳)AN患者和24例(24耳)听力正常者行MMN测试,用GSI-61双通道诊断型听力计和SONY Tc-Fx25盒式双声道立体声录音机及自行录制的单音节音素平衡词表磁带分别测试14例(19耳)AN患者和19例(19耳)听力正常者的PBmax,比较两组MMN潜伏期和振幅差异有无显著性意义,并分析MMN潜伏期和振幅与PBmax的相关性。结果与对照组相比,AN组MMN(强度差异和频率差异)潜伏期显著延长(P<0.01),AN组强度差异MMN振幅与对照组相比有显著性差异(P=0.019),两组频率差异MMN振幅无显著性差异(P=0.128);AN组频率差异和强度差异MMN潜伏期与PBmax呈部分负相关(r=-0.647,P<0.01;r=-0.708,P<0.01),对照组强度差异MMN潜伏期与PBmax也呈部分负相关(r=-0.643,P<0.05),但对照组频率差异MMN潜伏期与PBmax无相关性(r=-0.027,P=0.913)。结论MMN潜伏期相对稳定,振幅变异较大。AN组MMN潜伏期明显比对照组延长,在群体水平与PBmax呈部分负相关。MMN潜伏期在预估AN患者的言语识别能力方面有一定的意义。

The Characteristic of Mismatch Negativity and the Relationship Between Mismatch Negativity and Speech Perception in Patients with Auditory Neuropathy

Objective To observe the basic characteristic of mismatch negativity(MMN) and the relationship between MMN and phonetic balanced maximum(PBmax) in patients with auditory neuropathy(AN).Methods The MMN of 14 AN patients(19 ears) and 24 subjects(24 ears) with normal hearing were examined with SMART EP of IHS3099(Version3.82).The PBmax of 14 AN patients(19 ears) and 19 subjects(19 ears) with normal hearing were tested with GSI-61 clinical audiometer fed with stereo cassette Deck Tc-Fx25(SONY) and presented with 50s-phonetic balanced test list.The latency and amplitude of MMN and PBmax of both groups were analyzed.Results The peak latency of MMN(frequency difference and intensity difference) in the AN group was significantly longer than that in the control group(P<0.01).In comparison with the control group,the amplitude of MMN evoked by intensity difference was significantly changed in the AN group(P=0.019),but the amplitude of MMN evoked by frequency difference was unchanged in the AN group(P=0.128).The MMN latency(frequency difference and intensity difference) was negatively correlated with PBmax in the AN group(r=-0.647,P<0.01;r=-0.708,P<0.01).The latency of MMN evoked by intensity difference was also negatively correlated with PBmax in the control group(r=-0.643,P<0.05),but the latency of MMN evoked by frequency difference had no correlation with the PBmax in the control group(r=-0.027,P=0.913).Conclusion The latency of MMN is relatively stable,but the amplitude of MMN is variable.The latency of MMN is significantly longer than that in the control group and is negatively correlated with PBmax at group level in the AN group.It suggests that MMN latency testing may offer a means of predicting speech perception.