儿童听觉神经病变谱系障碍患者人工耳蜗植入后的皮质听觉可塑性:一项前瞻性研究。

Cortical Auditory Plasticity Following Cochlear Implantation in Children With Auditory Neuropathy Spectrum Disorder: A Prospective Study.

机构信息

Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences.

Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Otol Neurotol. 2021 Oct 1;42(9):e1227-e1233. doi: 10.1097/MAO.0000000000003257.

Abstract

OBJECTIVES

The cortical auditory evoked potential (CAEP) can provide an insight into the maturation of the central auditory nervous system by recording the auditory cortex responses to speech stimuli. This study aimed to explore the central auditory system development in children with auditory neuropathy spectrum disorder (ANSD) using cochlear implants (CIs) and to find the correlation of CAEP biomarkers with speech perception.

METHODS

This study was performed on 23 children with prelingual deafness, diagnosed with ANSD, as well as 23 children with prelingual deafness, without ANSD as the control group. All children underwent unilateral CI before the age of 3 years. Children with ANSD were classified into two groups, based on their CAEP results prior to implantation: children with a clear CAEP response (ANSD-I) and children without an identifiable CAEP (ANSD-II). The P1 component of CAEPs and speech intelligibility rating (SIR) were recorded before the initial device activation (baseline) and at 6, 12, and 24 months postimplantation.

RESULTS

The P1 CAEP responses were present in all children in the control group, while they were recorded in only 52% of ANSD children before the CI surgery. The longitudinal analysis revealed a significant reduction in the P1 latency and a significant improvement in the P1 amplitude across different time points in all study groups. However, the P1 latency and P1 amplitude were significantly shorter and larger in the control group than the ANSD group, respectively. Also, children in the ANSD-I group exhibited a slightly shorter P1 latency, a larger P1 amplitude, and a higher SIR score than the ANSD-II group after 2 years of follow-up. The P1 CAEP latency was significantly correlated with the SIR score.

CONCLUSION

The CAEP can be used as an objective indicator of auditory cortical maturation and a predictor of speech perception performance in implanted children with ANSD.

摘要

目的

皮质听觉诱发电位(CAEP)通过记录听觉皮层对言语刺激的反应,可以深入了解中枢听觉神经系统的成熟过程。本研究旨在使用人工耳蜗(CI)探索听神经病谱系障碍(ANSD)儿童的中枢听觉系统发育,并寻找 CAEP 生物标志物与言语感知的相关性。

方法

本研究纳入了 23 名患有语前聋的 ANSD 儿童和 23 名无 ANSD 的语前聋儿童作为对照组。所有儿童均在 3 岁前接受单侧 CI。根据植入前 CAEP 结果,将 ANSD 儿童分为两组:有明确 CAEP 反应的儿童(ANSD-I)和无可识别 CAEP 的儿童(ANSD-II)。在初始设备激活(基线)前以及植入后 6、12 和 24 个月时记录 CAEP 的 P1 成分和言语可懂度评分(SIR)。

结果

对照组所有儿童均记录到 P1 CAEP 反应,而 CI 术前仅 52%的 ANSD 儿童记录到 P1 CAEP 反应。纵向分析显示,所有研究组的 P1 潜伏期均显著缩短,P1 振幅均显著提高。然而,与 ANSD 组相比,对照组的 P1 潜伏期更短,P1 振幅更大。此外,在 2 年的随访后,ANSD-I 组的 P1 潜伏期稍短,P1 振幅更大,SIR 评分更高。P1 CAEP 潜伏期与 SIR 评分显著相关。

结论

CAEP 可作为 ANSD 植入儿童听觉皮质成熟的客观指标和言语感知性能的预测指标。

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