Haapala Sini, Niemitalo-Haapola Elina, Raappana Antti, Kujala Tiia, Suominen Kalervo, Kujala Teija, Jansson-Verkasalo Eira
1Logopedics, Department of Behavioural Sciences and Philosophy, University of Turku, Turku, Finland; 2Neurocognitive Unit, Oulu University Hospital, Oulu, Finland; 3Logopedics, Faculty of Humanities, and 4Department of Otorhinolaryngology-Head & Neck Surgery, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; 5Cicero Learning, and 6Cognitive Brain Research Unit, Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
Ear Hear. 2014 May-Jun;35(3):e75-83. doi: 10.1097/AUD.0000000000000002.
To investigate at the age of 2 years the effects of childhood recurrent acute otitis media (RAOM) on central auditory processing by using cortical event-related potentials elicited by syllable stimuli.
During a 1-year period, 22- to 26-month-old children fulfilling the criteria for tympanostomy tube insertion in Oulu University Hospital, Oulu, Finland, were recruited to the RAOM group (N = 20). The control group (N = 19) was matched by age, sex, and mother's educational level. In both groups, children were typically developing and had no family history of language disorder or developmental language problems. Finnish syllables /ke:/ and /pi:/ as standards and their variants with changes in frequency, intensity, vowel, consonant, and vowel duration as deviants were used to record P1, N2, and mismatch negativity (MMN) responses in the multifeature paradigm. The clinically healthy ears at the time of registration were a prerequisite for the participation.
Children with RAOM and their controls showed the age-typical P1 and N2 responses with no differences in the amplitudes or latencies between the groups, which suggests unaffected basic encoding of sound features and sound representation formation. However, the groups showed different auditory discrimination profiles. In children with RAOM, frequency and vowel MMN amplitudes were increased. Furthermore, the MMN latency for the frequency change was shorter and the frequency MMN amplitude lateralized to the left hemisphere in the RAOM group instead of an adult-like right-hemispheric lateralization observed in the controls. The children with RAOM had a more anterior MMN amplitude scalp distribution for the intensity change than control children. In addition, the MMN amplitude elicited by consonant change was evenly distributed unlike in controls, who had a left-side preponderant lateralization. Taken together, these results suggest an elevated responsiveness for frequency, vowel, and intensity changes, and an immature pattern of discriminating small speech sound contrasts in children with RAOM.
The results suggest that childhood RAOM does not affect the central auditory pathway integrity or sound encoding. However, RAOM may lead to aberrant preattentive discrimination of sound features even when the peripheral auditory input is normal. These results are clinically significant because even transient problems with auditory processing may delay language development.
通过使用音节刺激诱发的皮层事件相关电位，研究2岁时儿童复发性急性中耳炎（RAOM）对中枢听觉处理的影响。
在1年的时间里，招募了芬兰奥卢大学医院符合鼓膜置管标准的22至26个月大的儿童进入RAOM组（N = 20）。对照组（N = 19）按年龄、性别和母亲教育水平进行匹配。两组儿童发育均正常，且无语言障碍家族史或发育性语言问题。使用芬兰语音节/ke:/和/pi:/作为标准刺激，以及频率、强度、元音、辅音和元音时长发生变化的变体作为偏差刺激，在多特征范式中记录P1、N2和失配负波（MMN）反应。登记时临床健康的耳朵是参与研究的前提条件。
RAOM患儿及其对照组表现出与年龄相符的P1和N2反应，两组之间的波幅或潜伏期无差异，这表明声音特征的基本编码和声音表征形成未受影响。然而，两组表现出不同的听觉辨别特征。在RAOM患儿中，频率和元音MMN波幅增加。此外，RAOM组中频率变化的MMN潜伏期较短，且频率MMN波幅向左半球侧化，而对照组中观察到的是类似成人的右半球侧化。RAOM患儿强度变化的MMN波幅头皮分布比对照儿童更靠前。此外，辅音变化诱发的MMN波幅在RAOM患儿中均匀分布，而对照组则以左侧优势侧化。综上所述，这些结果表明RAOM患儿对频率、元音和强度变化的反应性升高，且辨别小语音对比的模式不成熟。
结果表明儿童RAOM不影响中枢听觉通路的完整性或声音编码。然而，即使外周听觉输入正常，RAOM也可能导致对声音特征的异常前注意辨别。这些结果具有临床意义，因为即使是听觉处理的短暂问题也可能延迟语言发育。
