老年性聋患者复杂听觉场景事件相关电位的特征研究

Characteristics of Event-related Potentials in Complex Auditory Scenes in Age-related Hearing Loss

目的研究老年性聋患者复杂听觉环境下事件相关电位(event related potential,ERP)的特征及其与认知能力及言语辨别能力的相关性,了解其言语辨别能力下降相关的中枢处理过程。方法采集25名老年性聋患者和25名听力正常年轻人的“鸡尾酒会”场景下ERP数据,比较相关成分振幅、峰值潜伏期及脑区激活差异。同时对老年性聋患者进行认知能力评估,并对其中14名老年人进行言语辨别能力测试,分析其与ERP相关性。结果老年性聋患者与年轻人相比关联性负变(contingent negative variation,CNV)振幅降低(F=5.174,P=0.027),同时N1、P1成分潜伏期延长(N1:F=6.067,P=0.021;P1:F=13.985,P=0.001),N1振幅升高(F=4.301,P=0.049)。单声源情况下老年性聋组枕叶激活减弱(t=-4.396,P<0.001),多声源情况下减弱进一步扩大到颞叶皮质(t=-5.569,P<0.001)。老年性聋组中,随年龄增长,CNV振幅下降(r=-0.460,P=0.021),P1潜伏期延长(r=0.419,P=0.037),TCT与CNV振幅呈正相关(r=0.601,P=0.023),认知量表总分与N1振幅呈负相关(r=-0.643,P=0.002)。结论老年性聋患者注意力资源分配与预期准备能力较年轻人显著下降,在单声源情况下出现选择性注意和工作记忆能力下降,多声源情况下进一步表现出显著的听觉皮层激活不足。注意力资源分配能力与总体认知水平相关,并随年龄增加而衰退,参与了老年性聋患者言语辨别能力下降的过程。

Objective To study the characteristics of event-related potentials(ERPs)in complex auditory environment in ARHL patients and their correlation with cognitive and speech discrimination abilities,and to understand the central processing during decreased speech discrimination in ARHL.Method ERP data in the"cocktail party"scene were collected in 25 subjects with ARHL and 25 young people with normal hearing.ERP amplitudes,peak latency and brain area activation of attention-related components were compared between the two groups.Cognitive ability of the ARHL subjects was evaluated(as well as speech discrimination in 14 subjects),and their correlations with ERP results were analyzed.Result Compared with the young subjects,the amplitude of the contingent negative variation(CNV)in the ARHL subjects were lower(F=5.174,P=0.027),with longer N1 and P1 latencies(F=6.067,P=0.021;F=13.985,P=0.001,respectively)and higher N1 amplitude(F=4.301,P=0.049).The ARHL group showed weakened occipital lobe ac‐tivation in single sound source condition(t=-4.396,P<0.001),which further extended to the temporal cortex in multiple sound sources condition(t=-5.569,P<0.001).In the ARHL group,CNV amplitude decrease and P1 latency prolongation increased with age(r=-0.460,P=0.021;r=0.419,P=0.037,respectively).TCT was positively correlated with the amplitude of CNV(r=0.601,P=0.023),while the total cognitive scale score was negatively correlated with N1 amplitude(r=-0.643,P=0.002).Conclusion The allocation of attention resources and anticipatory preparation ability in ARHL subjects were significantly lower than in young subjects.Selective attention and working memory ability showed a decrease in single sound source conditions,and further deficit in auditory cortical activation was demonstrated in the presence of background acoustic disturbances.The ability to allocate attention resources is related to overall cognitive level that declines with age,and participates in the process of speech discrimination decline in ARHL.