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中枢听觉处理:对诊断为中风的儿童和青少年的行为及电生理评估

Central auditory processing: behavioral and electrophysiological assessment of children and adolescents diagnosed with stroke.

作者信息

Berticelli Amanda Zanatta, Bueno Claudine Devicari, Rocha Vanessa Onzi, Ranzan Josiane, Riesgo Rudimar Dos Santos, Sleifer Pricila

机构信息

Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.

Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.

出版信息

Braz J Otorhinolaryngol. 2021 Sep-Oct;87(5):512-520. doi: 10.1016/j.bjorl.2019.10.010. Epub 2019 Dec 9.

Abstract

INTRODUCTION

Central auditory processing refers to the efficiency and effectiveness with which the central nervous system uses auditory information: it may be altered in neurological disorders and brain injuries, such as strokes. However, despite evidence of probable alterations in the pediatric population, functional abilities and post-stroke limitations are still not well documented in the literature.

OBJECTIVE

To analyze the findings of the electrophysiological and behavioral evaluations of central auditory processing of children and adolescents diagnosed with stroke from a reference outpatient clinic, as well as to investigate possible associations with the variables: type and location of the stroke and age group.

METHODS

The present study is characterized as comparative cross-sectional. The sample, for convenience, included individuals aged 7-18 years divided into two groups: study group, composed of individuals with a diagnosis of stroke, and control group, composed of individuals with typical development. The evaluation consisted of the following procedures: anamnesis, basic audiological evaluation, behavioral evaluation of the auditory processing disorder (dichotic digit test, dichotic consonant-vowel, synthetic sentence identification/pediatric speech intelligibility, gaps in noise, pitch pattern sequence, masking level difference), and electrophysiological evaluation (P300 and mismatch negativity).

RESULTS

Nineteen children and adolescents were included in the study group. The control group was composed of 19 children and adolescents with typical development. In the comparison between the groups, a worse performance is observed for the study group in all the evaluated tests, behavioral and electrophysiological. In the behavioral evaluation of central auditory processing, there was a statistical difference for all tests, except for masking level difference and dichotic digit test, binaural separation step on the left. In the electrophysiological evaluation, there was a statistical difference in the latency of mismatch negativity and P300. No associations were found between the behavioral and electrophysiological findings and the location of the stroke and age group variables.

CONCLUSION

Children and adolescents diagnosed with stroke present a worse performance in the electrophysiological and behavioral evaluations of central auditory processing when compared to a control group.

摘要

引言

中枢听觉处理是指中枢神经系统利用听觉信息的效率和效果:在神经系统疾病和脑损伤(如中风)中可能会发生改变。然而,尽管有证据表明儿科人群可能存在改变,但文献中关于功能能力和中风后局限性的记录仍不完善。

目的

分析一家参考门诊诊所诊断为中风的儿童和青少年中枢听觉处理的电生理和行为评估结果,并调查与以下变量的可能关联:中风类型和部位以及年龄组。

方法

本研究为比较性横断面研究。为方便起见,样本包括7至18岁的个体,分为两组:研究组,由诊断为中风的个体组成;对照组,由发育正常的个体组成。评估包括以下程序:问诊、基本听力评估、听觉处理障碍的行为评估(双耳数字测试、双耳辅音-元音测试、合成句子识别/儿童言语可懂度、噪声间隙、音高模式序列、掩蔽级差)和电生理评估(P300和失配负波)。

结果

研究组纳入了19名儿童和青少年。对照组由19名发育正常的儿童和青少年组成。在两组比较中,研究组在所有评估的行为和电生理测试中表现更差。在中枢听觉处理的行为评估中,除掩蔽级差和双耳数字测试(左侧双耳分离步骤)外,所有测试均存在统计学差异。在电生理评估中,失配负波和P300的潜伏期存在统计学差异。行为和电生理结果与中风部位和年龄组变量之间未发现关联。

结论

与对照组相比,诊断为中风的儿童和青少年在中枢听觉处理的电生理和行为评估中表现更差。

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本文引用的文献

1
Mismatch Negativity in Children: Reference Values.儿童中的失配负波:参考值
Int Arch Otorhinolaryngol. 2019 Apr;23(2):142-146. doi: 10.1055/s-0038-1667313. Epub 2018 Oct 24.
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Auditory Evoked Potential Mismatch Negativity in Normal-Hearing Adults.正常听力成年人的听觉诱发电位失匹配负波
Int Arch Otorhinolaryngol. 2017 Jul;21(3):232-238. doi: 10.1055/s-0036-1586734. Epub 2016 Sep 2.
8
9
Central auditory processing outcome after stroke in children.儿童中风后的中枢听觉处理结果
Arq Neuropsiquiatr. 2014 Sep;72(9):680-6. doi: 10.1590/0004-282x20140107.
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