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内侧橄榄耳蜗传出神经对多发性硬化症患者噪声环境中言语辨别能力的影响。

Effect of Medial Olivocochlear Efferents on Speech Discrimination in Noise in Multiple Sclerosis.

作者信息

Küçüköner Asuman, Küçüköner Ömer, Özgür Abdulkadir, Terzi Murat

机构信息

Vocational School of Health Services, Ondokuz Mayis University, Samsun, Turkey.

Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey.

出版信息

Noise Health. 2024;26(123):507-513. doi: 10.4103/nah.nah_71_23. Epub 2024 Dec 30.

Abstract

BACKGROUND

Patients with multiple sclerosis (MS) experience difficulties in understanding speech in noise despite having normal hearing.

AIM

This study aimed to determine the relationship between speech discrimination in noise (SDN) and medial olivocochlear reflex levels and to compare MS patients with a control group.

MATERIAL AND METHODS

Sixty participants with normal hearing, comprising 30 MS patients and 30 healthy controls, were included. For both groups, distortion product otoacoustic emissions (DPOAEs) were recorded at frequencies of 1000, 1400, 2000, 2800, 4000, 5600 and 8000 in the presence and absence of contralateral white sound at 65 dB SPL. Speech discrimination tests in the presence and absence of noise, Symbol Digit Modalities Test (SDMT) and Montreal Cognitive Assessment (MoCA) scale were applied to all participants to evaluate their cognitive skills.

RESULTS

In age- and sex-matched groups, the DPOAE signal-to-noise ratio value was 6.50 ± 1.30 in the right ear at a frequency of 8000 Hz in the control group and 2.40 ± 1.75 in the MS group (P < 0.05). In the comparison of suppression between ears, lower suppression was found at 1400 and 2000 Hz in the left ear and 1000 Hz in the right ear in the MS group (P < 0.05). In the control group, a moderately significant positive correlation existed between right ear SDN scores and left ear suppression values (P < 0.05). The cognitive functions of the MS group were lower in MoCA and SDMT (P < 0.05). Patients who scored less than 21 points in MoCA also had low suppression results (P < 0.05).

CONCLUSION

Comprehensive evaluations are necessary to uncover the presence of auditory perception disorders, such as noise sensitivity or speech disorders in noise, amongst MS patients.

摘要

背景

尽管听力正常,但多发性硬化症(MS)患者在嘈杂环境中理解言语存在困难。

目的

本研究旨在确定噪声中言语辨别(SDN)与内侧橄榄耳蜗反射水平之间的关系,并将MS患者与对照组进行比较。

材料与方法

纳入60名听力正常的参与者,包括30名MS患者和30名健康对照者。对两组在65 dB SPL的对侧白噪声存在和不存在的情况下,分别在1000、1400、2000、2800、4000、5600和8000 Hz频率记录畸变产物耳声发射(DPOAE)。对所有参与者进行有噪声和无噪声情况下的言语辨别测试、符号数字模态测试(SDMT)和蒙特利尔认知评估(MoCA)量表,以评估他们的认知技能。

结果

在年龄和性别匹配的组中,对照组右耳在8000 Hz频率下的DPOAE信噪比为6.50±1.30,MS组为2.40±1.75(P<0.05)。在双耳抑制比较中,MS组左耳在1400和2000 Hz以及右耳在1000 Hz处的抑制较低(P<0.05)。在对照组中,右耳SDN分数与左耳抑制值之间存在中度显著正相关(P<0.05)。MS组的MoCA和SDMT认知功能较低(P<0.05)。MoCA得分低于21分的患者抑制结果也较低(P<0.05)。

结论

有必要进行全面评估,以发现MS患者中是否存在听觉感知障碍,如噪声敏感性或噪声中的言语障碍。

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