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婴儿对音调及语音样本的皮质听觉诱发电位(CAEPs)动态变化

Dynamics of infant cortical auditory evoked potentials (CAEPs) for tone and speech tokens.

作者信息

Cone Barbara, Whitaker Richard

机构信息

University of Arizona, Department of Speech, Language and Hearing Sciences, PO Box 210071, Tucson, AZ 85721, United States.

出版信息

Int J Pediatr Otorhinolaryngol. 2013 Jul;77(7):1162-73. doi: 10.1016/j.ijporl.2013.04.030. Epub 2013 May 27.

Abstract

OBJECTIVES

Cortical auditory evoked potentials (CAEPs) to tones and speech sounds were obtained in infants to: (1) further knowledge of auditory development above the level of the brainstem during the first year of life; (2) establish CAEP input-output functions for tonal and speech stimuli as a function of stimulus level and (3) elaborate the data-base that establishes CAEP in infants tested while awake using clinically relevant stimuli, thus providing methodology that would have translation to pediatric audiological assessment. Hypotheses concerning CAEP development were that the latency and amplitude input-output functions would reflect immaturity in encoding stimulus level. In a second experiment, infants were tested with the same stimuli used to evoke the CAEPs. Thresholds for these stimuli were determined using observer-based psychophysical techniques. The hypothesis was that the behavioral thresholds would be correlated with CAEP input-output functions because of shared cortical response areas known to be active in sound detection.

DESIGN

36 infants, between the ages of 4 and 12 months (mean=8 months, s.d.=1.8 months) and 9 young adults (mean age 21 years) with normal hearing were tested. First, CAEPs amplitude and latency input-output functions were obtained for 4 tone bursts and 7 speech tokens. The tone bursts stimuli were 50 ms tokens of pure tones at 0.5, 1.0, 2.0 and 4.0 kHz. The speech sound tokens, /a/, /i/, /o/, /u/, /m/, /s/, and /∫/, were created from natural speech samples and were also 50 ms in duration. CAEPs were obtained for tone burst and speech token stimuli at 10 dB level decrements in descending order from 70 dB SPL. All CAEP tests were completed while the infants were awake and engaged in quiet play. For the second experiment, observer-based psychophysical methods were used to establish perceptual threshold for the same speech sound and tone tokens.

RESULTS

Infant CAEP component latencies were prolonged by 100-150 ms in comparison to adults. CAEP latency-intensity input output functions were steeper in infants compared to adults. CAEP amplitude growth functions with respect to stimulus SPL are adult-like at this age, particularly for the earliest component, P1-N1. Infant perceptual thresholds were elevated with respect to those found in adults. Furthermore, perceptual thresholds were higher, on average, than levels at which CAEPs could be obtained. When CAEP amplitudes were plotted with respect to perceptual threshold (dB SL), the infant CAEP amplitude growth slopes were steeper than in adults.

CONCLUSIONS

Although CAEP latencies indicate immaturity in neural transmission at the level of the cortex, amplitude growth with respect to stimulus SPL is adult-like at this age, particularly for the earliest component, P1-N1. The latency and amplitude input-output functions may provide additional information as to how infants perceive stimulus level. The reasons for the discrepancy between electrophysiologic and perceptual threshold may be due to immaturity in perceptual temporal resolution abilities and the broad-band listening strategy employed by infants. The findings from the current study can be translated to the clinical setting. It is possible to use tonal or speech sound tokens to evoke CAEPs in an awake, passively alert infant, and thus determine whether these sounds activate the auditory cortex. This could be beneficial in the verification of hearing aid or cochlear implant benefit.

摘要

目的

获取婴儿对纯音和语音的皮层听觉诱发电位(CAEP),以:(1)进一步了解生命第一年中脑干水平以上的听觉发育情况;(2)建立音调及语音刺激的CAEP输入-输出函数,作为刺激强度的函数;(3)完善在清醒状态下使用临床相关刺激测试婴儿CAEP的数据库,从而提供可转化为儿科听力评估的方法。关于CAEP发育的假设是,潜伏期和波幅输入-输出函数将反映编码刺激强度方面的不成熟。在第二个实验中,用用于诱发CAEP的相同刺激对婴儿进行测试。使用基于观察者的心理物理学技术确定这些刺激的阈值。假设是行为阈值将与CAEP输入-输出函数相关,因为已知在声音检测中活跃的共享皮层反应区域。

设计

测试了36名年龄在4至12个月(平均=8个月,标准差=1.8个月)的婴儿和9名听力正常的年轻成年人(平均年龄21岁)。首先,获取4个纯音短音和7个语音样本的CAEP波幅和潜伏期输入-输出函数。纯音短音刺激是0.5、1.0、2.0和4.0kHz的50ms纯音样本。语音样本/a/、/i/、/o/、/u/、/m/、/s/和/∫/由自然语音样本生成,持续时间也为50ms。从70dB SPL开始,以10dB的强度递减顺序获取纯音短音和语音样本刺激的CAEP。所有CAEP测试均在婴儿清醒并安静玩耍时完成。对于第二个实验,使用基于观察者的心理物理学方法确定相同语音和纯音样本的感知阈值。

结果

与成年人相比,婴儿CAEP成分的潜伏期延长了100-150ms。与成年人相比,婴儿的CAEP潜伏期-强度输入-输出函数更陡峭。在这个年龄,CAEP波幅随刺激声压级的增长函数与成年人相似,特别是对于最早的成分P1-N1。婴儿的感知阈值相对于成年人有所升高。此外,平均而言,感知阈值高于可获得CAEP的水平。当绘制CAEP波幅相对于感知阈值(dB SL)的曲线时,婴儿CAEP波幅增长斜率比成年人更陡峭。

结论

尽管CAEP潜伏期表明皮层水平神经传导不成熟,但在这个年龄,CAEP波幅随刺激声压级的增长与成年人相似,特别是对于最早的成分P1-N1。潜伏期和波幅输入-输出函数可能提供有关婴儿如何感知刺激强度的额外信息。电生理阈值和感知阈值之间差异的原因可能是感知时间分辨能力不成熟以及婴儿采用的宽带听力策略。本研究的结果可转化应用于临床。可以使用纯音或语音样本在清醒、被动警觉的婴儿中诱发CAEP,从而确定这些声音是否激活听觉皮层。这对于验证助听器或人工耳蜗的效果可能有益。

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