感音神经性聋患者听觉皮层BOLD-fMRI研究

BOLD-fMRI Study of Auditory Cortex in Patients with Sensorineural Hearing Loss

目的利用血氧水平依赖的功能磁共振成像(blood oxygenation level dependent functional magnetic resonance imaging,BOLD-fMRI)技术观察感音神经性聋患者纯音刺激时大脑听觉皮层激活情况,探讨感音神经性聋的中枢客观检查方法。方法对22例单侧中重度感音神经性聋患者(耳聋组)和15例健康志愿者(对照组)行听觉刺激BOLD-fMRI检查,比较两组纯音刺激时听觉皮层激活的体积和信号强度。结果对照组纯音刺激单耳时,对侧听觉皮层激活体积和信号强度明显大于同侧(P<0.01),表现为对侧半球传导优势;耳聋组刺激健侧时健侧听觉皮层激活体积和信号强度大于患侧,但差异无统计学意义(P>0.05)。结论感音神经性聋患者纯音刺激健耳时对侧听觉半球传导优势消失,其听觉皮层可能发生了结构重塑。

Objective BOLD--fMRI was used to observe the activated auditory cortex evoked by pure tone stimuli in patients with sensorineural hearing loss and this paper is to discuss the objective measure for patient with sensorineural hearing loss. Methods BOLD--fMRI examinations were taken in 22 patients with unilateral moderate to severe sensorneural hearing loss and 15 control subjects. The volumes and intensities of the two hemispheres of the activated auditory cortex were analyzed quantitatively. Results Significant activation was found in the temporal lobe in control subjects, and significant differences in the volume and intensity were noted between the contralateral and ipsilateral activated auditory cortexes in them （P〈0.01）, exhibiting clearly contralateral predominance. When the normal ear of patients with sensorineural hearing loss received signals, there was no significant difference be- tween contralateral and ipsilateral activated auditory cortexes （P〉0.05）. Conclusion When the normal ear of pa- tients with sensorneural hearing loss was stimulated by pure tone, the contralateral hemisphere predominance disap- peared. This result seems to show the plasticity of auditory cortex of patients with unilateral hearing loss.