Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
PLoS One. 2021 Jun 7;16(6):e0252717. doi: 10.1371/journal.pone.0252717. eCollection 2021.
The cortical auditory evoked potential (CAEP)-based P1 component acts as a biomarker for cochlear implantation (CI) outcomes in children with auditory neuropathy spectrum disorder (ANSD). To date, early intervention primarily before the age of two years and six months of CI usage is necessary and sufficient to achieve age-appropriate cortical maturation and good prognosis. However, varying degrees of neural dyssynchrony, resulting from the etiological heterogeneity of ANSD, may preclude uniform application of this hypothesis to ensure auditory cortical maturation. Thus, a focused evaluation of those carrying OTOF variants, which may be the salient molecular etiology of prelingual ANSD, would circumvent the issue of heterogeneity. Here, we sought to provide a much better understanding of the brain perspectives (i.e., P1 maturation) in OTOF-associated ANSD subjects and set the stage for an optimal strategy to enhance language development. We conducted a preliminary study comprising 10 subjects diagnosed with OTOF-related ANSD who underwent CI by a single surgeon and subsequently underwent measurements of the P1 component. We observed that DFNB9 subjects who received CI after 2 years of age exhibited "absent" or "anomalous" P1 components that correspond to delayed language development. However, timely implantation, as early as 12 months of age per se, might be insufficient to achieve age-appropriate cortical maturation of DFNB9 in cases with six to seven months of device use. This suggests the importance of sustained rehabilitation in DFNB9 than in other etiologies. Indeed, an additional follow-up study showed that a reduction in P1 latency was linked to an improvement in auditory performance. Collectively, our results suggest that central auditory maturation and successful outcome of CI in DFNB9 may have more demanding requirements, that is, earlier implantation and more sustained rehabilitation. We believe that the current study opens a new path toward genome-based neuroimaging in the field of hearing research.
皮质听觉诱发电位(CAEP)的 P1 成分是听神经病谱系障碍(ANSD)儿童人工耳蜗植入(CI)结果的生物标志物。迄今为止,早期干预主要是在 CI 使用前两年零六个月内进行,这对于实现年龄适当的皮质成熟和良好的预后是必要且充分的。然而,由于 ANSD 的病因异质性,导致不同程度的神经不同步,这可能会排除该假说在确保听觉皮质成熟方面的统一应用。因此,对携带 OTOF 变异体的患者进行有针对性的评估可能是避免异质性的关键。在这里,我们试图更好地了解 OTOF 相关 ANSD 患者的大脑观点(即 P1 成熟),并为增强语言发展制定最佳策略奠定基础。我们进行了一项初步研究,纳入了 10 名被诊断为 OTOF 相关 ANSD 的患者,这些患者由同一位外科医生进行 CI,并随后进行了 P1 成分测量。我们观察到,在 2 岁后接受 CI 的 DFNB9 患者表现出“缺失”或“异常”的 P1 成分,这与语言发育迟缓相对应。然而,尽早植入(例如,在 12 个月大时)本身可能不足以在使用设备六到七个月后使 DFNB9 达到适当的年龄的皮质成熟。这表明在 DFNB9 中持续康复比在其他病因中更为重要。事实上,一项额外的随访研究表明,P1 潜伏期的缩短与听觉表现的改善有关。总的来说,我们的研究结果表明,DFNB9 患者的中枢听觉成熟和 CI 的成功结果可能有更高的要求,即更早的植入和更持续的康复。我们相信,目前的研究为听力研究领域的基于基因组的神经影像学开辟了一条新的途径。
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