老年性聋患者不同刺激模式下失匹配负波特征分析

The Characteristic of Mismatch Negativity in Presbycusis Patients with Different Stimulus Modes

目的观察老年性聋(presbycusis)患者频率差异及持续时间差异失匹配负波(mismatch negativity,MMN)的特征。方法应用美国智听公司SmartEP诱发电位系统,采用被动的Oddball模式对30例老年性聋患者(老年性聋组)、26名老年听力正常者(老年听力正常组)和30名正常青年人(对照组)进行频率差异MMN和持续时间差异MMN检测。结果老年性聋组频率差异MMN潜伏期(202.53±33.75ms)与老年听力正常组(182.48±36.44ms)及对照组(174.23±41.19ms)相比明显延长(P<0.05),而波幅(4.89±1.52μV)与老年听力正常组(5.02±1.63μV)及对照组(5.54±1.58μV)相比差异无统计学意义(P>0.05),老年听力正常组频率差异MMN的潜伏期、波幅与对照组比较差异无统计学意义(P>0.05);老年性聋组持续时间差异MMN潜伏期(243.65±19.40ms)与老年听力正常组(216.47±30.89ms)及对照组(184.68±43.16ms)比较差异均有显著统计学意义(P<0.05),波幅(4.39±1.03μV)与对照组(5.32±1.97μV)比较差异有显著统计学意义(P<0.05),与老年听力正常组(4.73±1.78μV)比较差异无统计学意义(P>0.05);另外,老年性聋组频率差异MMN的潜伏期较持续时间差异MMN潜伏期短(P<0.05),频率差异MMN波幅与持续时间差异MMN波幅差异无统计学意义(P>0.05),老年听力正常组频率差异MMN的潜伏期较持续时间差异MMN潜伏期短(P<0.05),波幅差异无统计学意义(P>0.05),对照组频率差异MMN与持续时间差异MMN潜伏期及波幅差异均无显著统计学意义。结论老年性聋组频率差异及持续时间差异MMN的潜伏期较老年听力正常组及对照组延长,其波幅较对照组小,提示老年性聋患者听皮层可能发生了可塑性变化;老年性聋组持续时间差异MMN与频率差异MMN相比潜伏期长,提示持续时间差异MMN较频率差异MMN更敏感,能够更早的反映其皮层及皮层下的变化。

Objective To study the characteristic of frequency mismatch negativity（MMN） and duration MMN in presbycusis patients. Methods Thirty presbycusis patients ,26 normal hearing elderly subjects and 34 normal adults were tened with frequency MMN and duration MMN with smartEP of IHS455（version54468） by positive Oddball stimulus paradigm. Results The latency of frequency MMN （242. 53±33. 75 ms）in presbycusis patient group was significantly longer than those of in normal hearing older group（184.68± 43.16 ms）and normal adult group （ 174.23±41.19 ms） （P^4.45）, however, the amplitude（4.89 ± 1.12 uV） was wot different from of in normal hearing elder group（5.42 ± 1.63 uV） and normal aduit group（5.04 ± 1. 58 uV） （P〉0.05）. There were no differences of the MMN latency and amplitude between normal hearing elder group and normal aduct group. Similarly,the latehcy of duration MMN（243.65± 19.44 ms） in presbycois patient group was significantly longer those of in normal hearing elder group（216.47±30.89 ms） and normal adult group（184. 68±43. 16 ms） （P〈0. 05）;and the amplitnde（4. 39±1. 03 uV） was smaller than that of in normal adult group（5.32± 1.97 uV） ,but not smaller than that of in normal hearing elder group（4.73 ± 1.78uV）. In presbycusis patient group, the latency of frequency MMN was significant shorter than that of duration MMN, but the amplitudes were not different, in normal hearing elder group, some results were observal as in presbycusis patient group. In normal adult group, the latency and amplitudes of frequency MMN and duration MMN were not different. Conclusion The latency of frequency MMN and duration MMN in preshycusis patients was longer than those of in control groups, and the amplitude was smaller, which may lead to auditory cortex＇s plasticity change. The latency of duration MMN was longer than that of frequency MMN. Suggested thai the duration MMN was more sensitive than frequency MMN,this may earlier reflect auditory cortex and subcortical change.