Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, 171 77, Stockholm, Sweden; Department of Otoneurology, Karolinska University Hospital, 141 86, Stockholm, Sweden.
Department of Linguistics, Stockholm University, 106 91, Stockholm, Sweden.
Int J Pediatr Otorhinolaryngol. 2021 Jan;140:110519. doi: 10.1016/j.ijporl.2020.110519. Epub 2020 Nov 24.
The primary aim was to examine how event-related potentials (ERPs) and mismatch negativity (MMN) change and develop over time among children with hearing loss (HL) using hearing aids (HAs) or cochlear implants (CIs). Children with normal hearing (NH) were tested as a reference group.
This three-year follow-up study included 13 children with sensorineural HL (SNHL); 7 children using bilateral HAs and 6 children using CIs; and 10 children with NH as a reference group. ERPs were recorded at baseline and after three years. At time for the original study the children were approximately 5-8 years old and at the follow-up study 8-11 years old. ERP recordings and data processing were identical in both sessions. A standard stimulus alternated with five different deviants (gap, intensity, pitch, location and duration), presented in a pseudorandom sequence, thus following the multi-feature paradigm, Optimum-1. MMN was calculated from the average ERP of each deviant minus the standard stimuli. Repeated measures ANOVA was used for the statistical analyses and the results were based on samples within a specific time interval; 80-224 ms.
There was a statistically significant difference in the obligatory responses between the NH and HA groups at baseline, but this difference disappeared after three years in our follow-up study. The children with HA also showed a significant difference in mean ERP at baseline compared to follow-up, and significant differences between the deviants at follow-up but not at baseline. This suggests an improvement over time among the children with HAs. On the other hand, the children with CIs did not differ from the NH children at baseline, but after three years their mean ERP was significantly lower compared to both the children with HA and NH, indicating a reduced development of the central auditory system in this age span among the children with CIs. Regarding MMN, there was an interaction between the duration deviant and time for the children with HA, also indicating a possible improvement over time among the HA children.
This three-year follow-up study shows neurophysiological differences between children with HL and children with NH. The results suggest a delay in the central auditory processing among the HA children compared to children with NH, but a possible catch-up, over time, and this potential may be worth to be utilized. Regarding the CI children, similar improvement in this age span is missing, meaning there are differences between the subgroups of children with HL, i.e. the children with HAs vs. CIs. The results highlight the importance of distinguishing between subgroups of children with HL in further research.
本研究旨在探讨使用助听器（HA）或人工耳蜗（CI）的听力损失（HL）儿童的事件相关电位（ERP）和失匹配负波（MMN）如何随时间变化和发展。正常听力（NH）儿童作为参考组进行了测试。
这是一项为期三年的随访研究，包括 13 名患有感音神经性 HL（SNHL）的儿童；7 名使用双侧 HA 的儿童和 6 名使用 CI 的儿童；以及 10 名 NH 儿童作为参考组。在基线和三年后记录 ERP。在原始研究时，儿童年龄约为 5-8 岁，在随访研究时为 8-11 岁。两次研究的 ERP 记录和数据处理均相同。标准刺激与五个不同的变异性（间隙、强度、音高、位置和持续时间）交替出现，以伪随机序列呈现，因此遵循多特征范式 Optimum-1。从每个变异性的平均 ERP 中减去标准刺激来计算 MMN。使用重复测量方差分析进行统计分析，结果基于特定时间间隔内的样本；80-224ms。
在基线时，NH 和 HA 组之间的强制性反应存在统计学上的显著差异，但在我们的随访研究中，三年后这种差异消失了。HA 组的儿童在基线时的 ERP 均值也与随访时存在显著差异，而且在随访时的变异性之间存在显著差异，但在基线时不存在。这表明 HA 组的儿童随着时间的推移有了改善。另一方面，CI 组的儿童在基线时与 NH 儿童没有差异，但三年后他们的 ERP 均值明显低于 HA 和 NH 组的儿童，表明在这个年龄段 CI 组的儿童的中枢听觉系统发育受到了限制。关于 MMN，HA 组的儿童在时长变异性上存在交互作用，这也表明 HA 组的儿童可能随着时间的推移而有所改善。
这项为期三年的随访研究显示了 HL 儿童和 NH 儿童之间的神经生理学差异。结果表明，与 NH 儿童相比，HA 儿童的中枢听觉处理存在延迟，但随着时间的推移可能会有所追赶，这种潜力值得利用。对于 CI 组的儿童，在这个年龄段内没有类似的改善，这意味着 HL 儿童的亚组之间存在差异，即 HA 组和 CI 组之间的差异。研究结果强调了在进一步研究中区分 HL 儿童亚组的重要性。
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