Fosi Tangunu, Werner Klaus, Boyd Stewart G, De Haan Michelle, Scott Rod C, Neville Brian G
Young Epilepsy, Surrey, United Kingdom.
Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom.
Epilepsia. 2017 May;58(5):872-881. doi: 10.1111/epi.13725. Epub 2017 Apr 12.
To investigate acoustic auditory processing in patients with recent infantile spasms (IS).
Patients (n = 22; 12 female; median age 8 months; range 5-11 months) had normal preceding development, brain magnetic resonance imaging (MRI), and neurometabolic testing (West syndrome of unknown cause, uWS). Controls were healthy babies (n = 22; 11 female; median age 6 months; range 3-12 months). Event-related potentials (ERPs) and psychometry (Bayley Scales of Infant Development, Second Edition, BSID-II) took place at a month following IS remission.
Following a repeated pure tone, uWS patients showed less suppression of the N100 at the mid-temporal electrodes (p = 0.006), and a prolonged response latency (p = 0.019). Their novelty P300 amplitude over the mid-temporal electrodes was halved (p = 0.001). The peak of the novelty P300 to environmental broadband sounds emerged later over the left temporal lobe in patients (p = 0.015), the lag correlating with duration of spasms (r = 0.547, p = 0.015). BSID-II scores were lower in patients (p < 0.001), with no correlation to ERP.
Complex acoustic information is processed poorly following IS. This would impair language. Treatment did not reverse this phenomenon, but may have limited its severity. The data are most consistent with altered connectivity of the cortical acoustic processing areas induced by IS.
研究近期患有婴儿痉挛症(IS)的患者的听觉处理情况。
患者(n = 22;12名女性;中位年龄8个月;范围5 - 11个月)先前发育正常,脑磁共振成像(MRI)及神经代谢检测(病因不明的韦斯特综合征,uWS)均正常。对照组为健康婴儿(n = 22;11名女性;中位年龄6个月;范围3 - 12个月)。在IS缓解后一个月进行事件相关电位(ERP)和心理测量(贝利婴儿发展量表第二版,BSID - II)。
在重复纯音刺激后,uWS患者在颞中电极处N100的抑制作用减弱(p = 0.006),反应潜伏期延长(p = 0.019)。他们在颞中电极上的新奇P300波幅减半(p = 0.001)。患者中,新奇P300对环境宽带声音的峰值在左颞叶出现得更晚(p = 0.015),延迟与痉挛持续时间相关(r = 0.547,p = 0.015)。患者的BSID - II评分较低(p < 0.001),与ERP无相关性。
IS后复杂听觉信息处理较差。这会损害语言能力。治疗未能逆转这一现象,但可能限制了其严重程度。这些数据与IS引起的皮质听觉处理区域连接性改变最为一致。