Thai-Van Hung, Micheyl Christophe, Norena Arnaud, Collet Lionel
Service d'Explorations Fonctionnelles ORL et Audiophonologiques, Hôpital Edouard Herriot, Lyon, France.
Brain. 2002 Mar;125(Pt 3):524-37. doi: 10.1093/brain/awf044.
Earlier data in the literature have shown local improvements in frequency discrimination performance near the cut-off frequency of steeply sloping, high-frequency hearing loss in subjects with cochlear damage. The general objective of the present study was to characterize further the relationships between this effect and various audiometric variables: namely, the slope, extent and shape of the hearing loss. In particular, we were interested in determining whether the effect was present in subjects with more moderately sloping hearing loss and/or other patterns of loss. Frequency difference limens (DLFs) were measured in 20 subjects (eight female, 12 male, median age 55.5 years) with high-frequency hearing loss. At least 12 frequencies were tested at intervals of 1/8 octave over a range of 1.5 octaves around the cut-off frequency for hearing loss (Fc). The Fc corresponded to the audiogram edge frequency and was defined as the highest test frequency, at the beginning of the slope, with a hearing threshold of no more than 5 dB HL above that of the best hearing frequency. The level of the test tones was randomized over a range of 6 dB around a nominal level, following an equal-loudness contour curve measured at 1/2-octave intervals. Results showed that DLFs were significantly smaller in a frequency band 1/4 octave wide centred on Fc than in the other bands. Furthermore, the average DLF measured in this band proved to be negatively correlated with the slope of hearing loss. No such significant relationship was found with the other audiometric indices considered, namely, the extent and maximum amount of hearing loss and the log-transformed cut-off frequency. The 20 subjects were divided into three groups according to the slope of their hearing loss relative to Fc (steep, >25 dB/1/2 octave; medium, between 12 and 25 dB/1/2 octave; and shallow, <12 dB/1/2 octave). A local improvement in DLF around Fc was observed in the steep- and medium-slope groups and was confirmed statistically in the steep-slope group. Similar measurements in subjects with low-frequency or notched hearing loss allowed us to establish the presence of similar local improvements in DLFs around audiogram edges. These results, which suggest the slope of the hearing loss to be the most important factor for the occurrence of local DLF improvements, are consistent with both an interpretation in terms of peripheral mechanisms and one in terms of central mechanisms, i.e. injury-induced neural reorganization.
文献中早期的数据表明,在患有耳蜗损伤的受试者中,靠近陡峭斜坡状高频听力损失截止频率处,频率辨别能力会出现局部改善。本研究的总体目标是进一步描述这种效应与各种听力测定变量之间的关系,即听力损失的斜率、范围和形状。特别是,我们感兴趣的是确定这种效应是否存在于听力损失斜率较为平缓的受试者和/或其他听力损失模式的受试者中。对20名患有高频听力损失的受试者(8名女性,12名男性,年龄中位数55.5岁)进行了频率辨别阈(DLF)测量。在听力损失截止频率(Fc)周围1.5倍频程范围内,以1/8倍频程为间隔,至少测试了12个频率。Fc对应于听力图的边缘频率,定义为在斜率起始处,听力阈值不超过最佳听力频率5 dB HL以上的最高测试频率。测试音的强度在围绕标称强度6 dB的范围内随机变化,遵循以1/2倍频程间隔测量的等响度轮廓曲线。结果表明,以Fc为中心的1/4倍频程宽频带内的DLF明显小于其他频带。此外,在该频带中测得的平均DLF与听力损失的斜率呈负相关。在所考虑的其他听力测定指标,即听力损失的范围和最大程度以及对数转换后的截止频率方面,未发现这种显著关系。根据听力损失相对于Fc的斜率(陡峭,>25 dB/1/2倍频程;中等,12至25 dB/1/2倍频程;浅,<12 dB/1/2倍频程),将20名受试者分为三组。在陡峭斜率组和中等斜率组中观察到Fc周围DLF的局部改善,并且在陡峭斜率组中得到了统计学证实。对低频或有切迹听力损失的受试者进行的类似测量,使我们能够确定在听力图边缘周围的DLF中存在类似的局部改善。这些结果表明听力损失的斜率是局部DLF改善发生的最重要因素,这与基于外周机制和基于中枢机制(即损伤诱导的神经重组)的解释均一致。