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双耳不平衡听力损失儿童的皮质可塑性与双重听觉模式。

Cortical plasticity with bimodal hearing in children with asymmetric hearing loss.

机构信息

Neurosciences & Mental Health, The Hospital for Sick Children, Toronto, ON, Canada; Institute of Medical Sciences, The University of Toronto, Toronto, ON, Canada; Collaborative Program in Neuroscience, The University of Toronto, Toronto, ON, Canada.

Institute of Medical Sciences, The University of Toronto, Toronto, ON, Canada; Department of Otolaryngology - Head & Neck Surgery, The Hospital for Sick Children, Toronto, ON, Canada; Department of Otolaryngology - Head & Neck Surgery, The University of Toronto, Toronto, ON, Canada.

出版信息

Hear Res. 2019 Feb;372:88-98. doi: 10.1016/j.heares.2018.02.003. Epub 2018 Feb 17.

Abstract

This longitudinal study aimed to identify auditory plasticity promoted by a cochlear implant in children with asymmetric hearing loss. Participants included 10 children who experienced (mean ± SD) 3.1 ± 3.6 years of asymmetric hearing (difference of 47.2 ± 47.6 dB) before receiving an implant at age 8.7 ± 5.1 years. Multi-channel electroencephalography was measured at initial implant use (5.8 ± 3.2 days) and after 10.2 ± 4.1 months in each child. Monaurally presented stimuli consisted of 36 ms trains of 9 acoustic clicks/biphasic electric pulses at a rate of 250 Hz, repeated at 1 Hz. The time-restricted artifact and coherent source suppression (TRACS) beamformer was used to locate sources underlying peak amplitudes of cortical responses. Results indicated consistent activity from the non-implanted ear but significant implant-driven changes to the auditory cortices. Initially, the newly implanted ear evoked activity which strongly lateralized to the ipsilateral auditory cortex and contributed to a significant aural preference for implant stimulation in children with limited acoustic experience pre-implantation. Cochlear implant use reversed these abnormalities, but the resolution was limited in children with longer periods of asymmetric hearing. These findings suggest that early implantation of children with asymmetric hearing rapidly restores hemispheric representations of bilateral auditory input in the auditory cortex. Most recorded changes were isolated to pathways stimulated by the cochlear implant, potentially reflecting an abnormal independence of the bilateral pathways with possible consequences for binaural integration in these bimodal listeners.

摘要

本纵向研究旨在确定人工耳蜗植入对单侧听力损失儿童的听觉可塑性的影响。参与者包括 10 名儿童,他们在 8.7 岁时(平均年龄为 5.1 岁)接受植入前经历了(平均值±标准差)3.1±3.6 年的单侧听力损失(差异为 47.2±47.6dB)。在每个孩子中,在初始植入使用(5.8±3.2 天)和 10.2±4.1 个月后,均进行多通道脑电图测量。单耳呈现的刺激由 36ms 的 9 个声学点击/双相电脉冲组成,以 250Hz 的速率重复,1Hz 重复。时间受限伪迹和相干源抑制(TRACS)波束形成器用于定位皮质反应峰值幅度下的源。结果表明,非植入耳的活动一致,但听觉皮质的植入驱动变化显著。最初,新植入的耳朵会引发活动,这些活动强烈偏向同侧听觉皮质,并导致在植入前具有有限声学经验的儿童中对植入刺激产生显著的听觉偏好。人工耳蜗的使用逆转了这些异常,但在单侧听力损失时间较长的儿童中,分辨率有限。这些发现表明,单侧听力损失儿童的早期植入可以迅速恢复听觉皮质中双侧听觉输入的半球代表。大多数记录到的变化仅限于人工耳蜗刺激的通路,这可能反映了双侧通路的异常独立性,可能对这些双模式听众的双耳整合产生影响。

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