Neuro-otology Department, National Hospital for Neurology and Neurosurgery, London, UK.
Stroke. 2012 May;43(5):1285-9. doi: 10.1161/STROKEAHA.111.644039. Epub 2012 Mar 1.
Auditory functional limitations experienced by patients after stroke of the central auditory pathways remain underinvestigated. Purpose- To measure patient-reported hearing difficulties in everyday life in nonaphasic patients with stroke of the auditory brain versus normal control subjects. To examine how hearing difficulties correlate with auditory tests and site of lesion in individual cases.
We recruited 21 individuals with auditory brain stroke (excluding those with aphasia) diagnosed on the basis of a brain MRI conducted 1 to 2 weeks after the stroke and assessed in the chronic stage of stroke. Twenty-three controls matched for age and hearing were also recruited. All subjects completed the Amsterdam Inventory for Auditory Disability (consisting of subscales of sound detection, recognition, localization, speech in quiet, speech in noise) and underwent baseline audiometry and central auditory processing tests (dichotic digits, frequency and duration patterns, gaps in noise).
Sound recognition and localization subscores of the inventory were significantly worse in case subjects versus control subjects, with severe and significant functional limitation (z score >3) reported by 9 out of 21 case subjects. None of the inventory subscales correlated with audiometric thresholds, but localization and recognition subscales showed a moderate to strong correlation with dichotic digits (left ear) and pattern tests.
A substantial proportion of patients may experience and report severe auditory functional limitations not limited to speech sounds after stroke of the auditory brain. A hearing questionnaire may help identify patients who require more extensive assessment to inform rehabilitation plans.
中枢听觉通路卒中后患者的听觉功能障碍仍未得到充分研究。目的-测量非失语性卒中后听觉脑患者在日常生活中报告的听力困难,并与正常对照组进行比较。检查听力困难在个体病例中与听觉测试和病变部位的关系。
我们招募了 21 名经脑 MRI 诊断为听觉脑卒中和(排除失语症)的患者,这些患者在卒中后 1 至 2 周内进行了诊断,并在卒中的慢性阶段进行了评估。还招募了 23 名年龄和听力匹配的对照组。所有受试者均完成了阿姆斯特丹听力障碍量表(由声音检测、识别、定位、安静言语、噪声言语的子量表组成),并进行了基线听力测试和中枢听觉处理测试(双耳分听数字、频率和时长模式、噪声中间隙)。
病例组的声音识别和定位量表得分明显低于对照组,21 例病例中有 9 例报告有严重和显著的功能障碍(z 评分>3)。量表的任何子量表均与听力阈值无关,但定位和识别子量表与双耳分听数字(左耳)和模式测试呈中度至强相关。
相当一部分患者可能会经历并报告听觉功能严重受限,不仅限于言语声音,这是听觉脑卒后的一种表现。听力问卷可能有助于识别需要更广泛评估的患者,以制定康复计划。