Otolaryngology Department, Clinical Hospital of the University of Chile, Santiago, Chile.
Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile.
PLoS One. 2020 May 19;15(5):e0233224. doi: 10.1371/journal.pone.0233224. eCollection 2020.
Epidemiological evidence shows an association between hearing loss and dementia in elderly people. However, the mechanisms that connect hearing impairments and cognitive decline are still unknown. Here we propose that a suprathreshold auditory-nerve impairment is associated with cognitive decline and brain atrophy.
audiological, neuropsychological, and brain structural 3-Tesla MRI data were obtained from elders with different levels of hearing loss recruited in the ANDES cohort. The amplitude of waves I (auditory nerve) and V (midbrain) from auditory brainstem responses were measured at 80 dB nHL. We also calculated the ratio between wave V and I as a proxy of suprathreshold brainstem function.
we included a total of 101 subjects (age: 73.5 ± 5.2 years (mean ± SD), mean education: 9.5 ± 4.2 years, and mean audiogram thresholds (0.5-4 kHz): 25.5 ± 12.0 dB HL). We obtained reliable suprathreshold waves V in all subjects (n = 101), while replicable waves I were obtained in 92 subjects (91.1%). Partial Spearman correlations (corrected by age, gender, education and hearing thresholds) showed that reduced suprathreshold wave I responses were associated with thinner temporal and parietal cortices, and with slower processing speed as evidenced by the Trail-Making Test-A and digit symbol performance. Non-significant correlations were obtained between wave I amplitudes and other cognitive domains.
These results evidence that reduced suprathreshold auditory nerve responses in presbycusis are associated with slower processing speed and brain structural changes in temporal and parietal regions.
流行病学证据表明,老年人的听力损失与痴呆之间存在关联。然而,将听力损伤与认知能力下降联系起来的机制尚不清楚。在这里,我们提出阈上听觉神经损伤与认知能力下降和脑萎缩有关。
我们从 ANDES 队列中招募了不同听力损失程度的老年人,获得了听力、神经心理学和大脑结构 3T MRI 数据。在 80dBnHL 处测量了听觉脑干反应中 I 波(听神经)和 V 波(中脑)的振幅。我们还计算了 V 波与 I 波的比值,作为阈上脑干功能的替代指标。
我们共纳入 101 名受试者(年龄:73.5±5.2 岁(均值±标准差),平均受教育年限:9.5±4.2 年,平均听力图阈值(0.5-4kHz):25.5±12.0dBHL)。我们在所有受试者(n=101)中均获得了可靠的阈上 V 波,但在 92 名受试者(91.1%)中复制了可重复的 I 波。部分 Spearman 相关分析(校正年龄、性别、教育和听力阈值)表明,阈上 I 波反应减弱与颞叶和顶叶皮质变薄以及 Trail-Making Test-A 和数字符号表现较慢的处理速度有关。I 波幅度与其他认知领域之间未得到显著相关性。
这些结果表明,老年性聋中阈上听神经反应减弱与颞叶和顶叶区域较慢的处理速度和脑结构变化有关。