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听力正常且耳鸣症状轻微的成年人的听觉门控与扩展高频阈值

Auditory Gating and Extended High-Frequency Thresholds in Normal-Hearing Adults With Minimal Tinnitus.

作者信息

Campbell Julia, LaBrec Alison, Bean Connor, Nielsen Mashhood, So Won

机构信息

Department of Communication Sciences and Disorders, The University of Texas at Austin.

Central Sensory Processes Laboratory, The University of Texas at Austin.

出版信息

Am J Audiol. 2019 Apr 22;28(1S):209-224. doi: 10.1044/2019_AJA-TTR17-18-0036.

Abstract

Purpose The goal of this study was to assess whether peripheral auditory sensitivity in frequency regions above 8 kHz is related to central inhibitory function, as measured through a sensory gating paradigm, in normal-hearing adults with tinnitus (TINN) and without tinnitus (NTINN). The contribution of gating processes and peripheral sensitivity in extended high frequencies to tinnitus severity was evaluated via a hierarchical multiple regression method. Method Cortical auditory evoked potentials (CAEPs) were recorded in response to pairs of tones in normal-hearing adults without tinnitus, NTINN ( n = 45), and adults with tinnitus, TINN ( n = 21). CAEP peak component amplitude, latency, and gating indices were compared and correlated with extended high-frequency (EHF) pure-tone averages (PTAs) across groups and with tinnitus severity. An exploratory analysis was performed to investigate gating variability within the TINN group. Based on Tinnitus Handicap Inventory (Newman, Jacobson, & Spitzer, 1996) median scores, the TINN group was categorized into low- and high-median subgroups, and gating indices were compared between these subgroups. A hierarchical multiple regression analysis was performed to determine the amount of variance accounted for in the TINN group. Results Decreased gating via the CAEP Pa component and increased gating via the N1 component correlated with increased tinnitus severity, even in individuals who would traditionally be classified as having no tinnitus handicap. In the TINN group, lower EHF PTA thresholds correlated with tinnitus severity and decreased Pa gating. Individuals with a greater severity of tinnitus demonstrated atypical gating function reflected in both Pa and N1 components. Gating function and EHF PTA accounted for significant variance regarding tinnitus severity. Conclusions A trade-off between lower and higher level gating function was observed in adults with normal hearing and tinnitus, indicative of higher order compensatory mechanisms. Better cochlear sensitivity in extended high frequencies was related to decreased lower level gating processes and increased tinnitus THI scores, suggestive of an interaction between decreased gating and heightened auditory awareness. We are currently exploring whether gating processes in this population are compensatory, and the role of gating in auditory awareness.

摘要

目的 本研究的目的是评估在伴有耳鸣(TINN)和不伴有耳鸣(NTINN)的听力正常成年人中,8kHz以上频率区域的外周听觉敏感性是否与通过感觉门控范式测量的中枢抑制功能相关。通过分层多元回归方法评估门控过程和扩展高频区域的外周敏感性对耳鸣严重程度的影响。方法 对不伴有耳鸣的听力正常成年人(NTINN,n = 45)和伴有耳鸣的成年人(TINN,n = 21)记录皮质听觉诱发电位(CAEP),以响应成对的纯音。比较CAEP峰成分振幅、潜伏期和门控指数,并与各组的扩展高频(EHF)纯音平均听阈(PTA)以及耳鸣严重程度进行相关性分析。对TINN组内的门控变异性进行探索性分析。根据耳鸣 handicap 量表(Newman、Jacobson和Spitzer,1996)的中位数得分,将TINN组分为低中位数和高中位数亚组,并比较这些亚组之间的门控指数。进行分层多元回归分析以确定TINN组中可解释的方差量。结果 通过CAEP的Pa成分降低门控以及通过N1成分增加门控与耳鸣严重程度增加相关,即使在传统上被归类为无耳鸣障碍的个体中也是如此。在TINN组中,较低的EHF PTA阈值与耳鸣严重程度和Pa门控降低相关。耳鸣严重程度较高的个体在Pa和N1成分中均表现出门控功能异常。门控功能和EHF PTA在耳鸣严重程度方面解释了显著的方差。结论 在听力正常且伴有耳鸣的成年人中观察到较低和较高水平门控功能之间的权衡,这表明存在更高阶的代偿机制。扩展高频区域更好的耳蜗敏感性与较低水平门控过程的降低和耳鸣THI得分的增加相关,提示门控降低与听觉意识增强之间存在相互作用。我们目前正在探索该人群中的门控过程是否具有代偿性,以及门控在听觉意识中的作用。

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