Rappaport J M, Gulliver J M, Phillips D P, Van Dorpe R A, Maxner C E, Bhan V
Department of Otolaryngology, Dalhousie University, Halifax, Nova Scotia.
J Otolaryngol. 1994 Oct;23(5):307-24.
Disturbances of hearing in multiple sclerosis patients have been variably reported, likely because standard audiologic testing emphasizes assessment of peripheral, rather than central, auditory function. This study investigated a group of patients with multiple sclerosis (MS), prospectively selected on the basis of magnetic resonance imaging (MRI) scans. Five of these patients had demyelinating lesions that included the rostral auditory fibre tracts, while another seven patients had lesions restricted to brainstem auditory sites. A further four had no lesions in the distribution of their auditory pathways. A comprehensive battery of audiometric tests, including standard audiometry and retrocochlear testing, was performed. In addition, their findings on electrophysiologic testing, including auditory brainstem responses (ABR) and middle latency responses (MLR), were studied. Finally, their performances in gap detection and speech recognition in continuous and interrupted background noise were examined to assess their auditory temporal resolution. The MS patients were found to be selectively impaired under the interrupted masker of this speech-in-noise paradigm, confirming a temporal processing defect. Furthermore, these patients' performances suggested a predominant role of forebrain pathways in mediating auditory temporal resolution.
多发性硬化症患者听力障碍的报道各不相同，这可能是因为标准听力测试侧重于评估外周而非中枢听觉功能。本研究调查了一组根据磁共振成像（MRI）扫描前瞻性选择的多发性硬化症（MS）患者。其中5名患者有脱髓鞘病变，包括听觉纤维束的头端，另外7名患者的病变局限于脑干听觉部位。另有4名患者听觉通路分布无病变。进行了一系列全面的听力测试，包括标准听力测定和蜗后测试。此外，还研究了他们在电生理测试中的结果，包括听觉脑干反应（ABR）和中潜伏期反应（MLR）。最后，检查了他们在连续和间断背景噪声中的间隙检测和语音识别表现，以评估他们的听觉时间分辨率。发现MS患者在此噪声中语音范式下的间断掩蔽条件下存在选择性损伤，证实了时间处理缺陷。此外，这些患者的表现表明前脑通路在介导听觉时间分辨率方面起主要作用。
