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婴儿早期的开/关磁听觉诱发电位:脑不成熟的一种可能标志

On and Off magnetic auditory evoked responses in early infancy: a possible marker of brain immaturity.

作者信息

Wakai R T, Lutter W J, Chen M, Maier M M

机构信息

Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA.

出版信息

Clin Neurophysiol. 2007 Jul;118(7):1480-7. doi: 10.1016/j.clinph.2007.04.003. Epub 2007 May 14.

Abstract

OBJECTIVE

To follow the development of the auditory evoked on- and off-responses in early infancy.

METHODS

The subjects were healthy infants, studied at conceptional age (CA) 39-66 weeks. Serial auditory evoked responses (AERs) were recorded in 17 subjects in response to tones of frequency 1.5 kHz and duration 1.0 s in order to follow the development of the AERs. Two small substudies were performed to examine off-responses evoked by tones of varying duration. The first used 0.2, 0.3, 0.4, and 0.5s tones; the second used 0.5, 1.0, and 2.0 s tones.

RESULTS

For the 1.0 s tones, the on- and off-responses consisted of three components: P250, P400, and N750 m. The on- and off-responses had similar amplitude, in contrast to adult AERs in which the on-responses are typically much larger. Prior to about CA 47 weeks, the on-responses were actually smaller on average than the off-responses, and in infants born prior to CA 38 weeks the AERs were dominated by the off-response. Off-responses were seen for tones as brief as 0.2 s; however, the P400m component was often absent in the off-responses for tone durations < or = 0.5 s. An interaction was observed in which the N750 m-On component was strongly suppressed when it overlapped the P250 m-Off.

CONCLUSIONS

Off-responses are much more prominent in infant than in adult AERs, especially in pre-term infants and at early CAs. On- and off-responses also exhibit more complex behavior in infants than in adult; the individual components can interact and behave independently.

SIGNIFICANCE

Measurement of auditory off-responses can improve the assessment of infant neurodevelopment, potentially providing a marker of brain immaturity.

摘要

目的

追踪婴儿早期听觉诱发的起始反应和终止反应的发展情况。

方法

研究对象为健康婴儿,其孕龄(CA)为39 - 66周。对17名受试者记录一系列听觉诱发反应(AERs),以回应频率为1.5kHz、持续时间为1.0秒的纯音,从而追踪AERs的发展。进行了两项小型子研究,以检查不同持续时间纯音诱发的终止反应。第一项研究使用了持续时间为0.2、0.3、0.4和0.5秒的纯音;第二项研究使用了持续时间为0.5、1.0和2.0秒的纯音。

结果

对于持续时间为1.0秒的纯音,起始反应和终止反应由三个成分组成:P250、P400和N750m。起始反应和终止反应的振幅相似,这与成人AERs不同,成人AERs中起始反应通常要大得多。在大约孕龄47周之前,平均而言起始反应实际上比终止反应小,并且在孕龄38周之前出生的婴儿中,AERs以终止反应为主。对于持续时间短至0.2秒的纯音也能观察到终止反应;然而,对于持续时间≤0.5秒的纯音,终止反应中P400m成分常常缺失。观察到一种相互作用,即当N750m - 起始成分与P250m - 终止成分重叠时,N750m - 起始成分会受到强烈抑制。

结论

终止反应在婴儿AERs中比在成人AERs中更为显著,尤其是在早产儿和孕龄较早时。起始反应和终止反应在婴儿中也表现出比成人更复杂的行为;各个成分可以相互作用并独立表现。

意义

测量听觉终止反应可以改善对婴儿神经发育的评估,有可能提供脑不成熟的一个标志物。

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