Lammers Marc J W, van Eijl Ruben H M, van Zanten Gijsbert A, Versnel Huib, Grolman Wilko
Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Room G.02.531, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
J Assoc Res Otolaryngol. 2015 Oct;16(5):669-78. doi: 10.1007/s10162-015-0532-x. Epub 2015 Jul 11.
Neurophysiological studies in animals and humans suggest that severe hearing loss during early development impairs the maturation of the auditory brainstem. To date, studies in humans have mainly focused on the neural activation of the auditory brainstem in children treated with a cochlear implant (CI), but little is known about the pattern of activation in adult CI users with early onset of deafness (prelingual, before the age of 2 years). In this study, we compare auditory brainstem activation in prelingually deaf and late-implanted adult CI users to that in postlingually deaf CI users. Electrically evoked auditory brainstem responses (eABRs) were recorded by monopolar stimulation, separately using a middle and an apical electrode of the CI. Comparison of the eABR latencies revealed that wave V was significantly delayed in the prelingually deaf CI users on both electrode locations. Accordingly, when the apical electrode was stimulated, the III-V interwave interval was significantly longer in the prelingually deaf group. These findings suggest a slower neural conduction in the auditory brainstem, probably caused by impairment of maturation during the long duration of severe hearing loss in infancy. Shorter wave V latencies, reflecting a more mature brainstem, appeared to be a predictor for better speech perception.
对动物和人类的神经生理学研究表明,早期发育过程中的严重听力损失会损害听觉脑干的成熟。迄今为止,针对人类的研究主要集中在接受人工耳蜗植入(CI)治疗的儿童的听觉脑干神经激活情况,但对于耳聋早发(语前聋,2岁之前)的成年人工耳蜗使用者的激活模式知之甚少。在本研究中,我们比较了语前聋和植入较晚的成年人工耳蜗使用者与语后聋人工耳蜗使用者的听觉脑干激活情况。通过单极刺激分别使用人工耳蜗的中间电极和顶端电极记录电诱发听觉脑干反应(eABR)。eABR潜伏期的比较显示,在两个电极位置上,语前聋人工耳蜗使用者的V波均显著延迟。因此,当刺激顶端电极时,语前聋组的III-V波间期明显更长。这些发现表明听觉脑干中的神经传导较慢,这可能是由于婴儿期长期严重听力损失期间成熟过程受损所致。反映脑干更成熟的较短V波潜伏期似乎是更好的言语感知的一个预测指标。