有无脑白质异常的重度-极重度感音神经性聋患儿的神经心理和学习能力发育分析

Analysis of Intelligence Tests in Children with Severe-to-profound Sensorineural Hearing Loss with or without White Matter Abnormalities

目的分析有、无脑白质异常的重度-极重度感音神经性聋患儿的智力测试结果,为脑白质异常聋儿的人工耳蜗植入提供参考。方法将2019年1月~2021年12月筛查的重度-极重度感音神经性聋患儿根据头颅MRI检查分为脑白质异常组(66例)和非脑白质异常组(129例),采用Gesell神经心理发育量表、Griffith精神发育量表及希-内学习能力测验量表对两组聋儿进行神经心理和学习能力测评,比较两组结果。结果本组重度-极重度感音神经性聋患儿中,头颅MRI提示脑白质异常者占33.85%(66/195),位于侧脑室后角旁、额叶、顶叶者居多,83.33%(55/66)的患者具有两个以上脑区脑白质异常。脑白质异常组和非脑白质异常组神经心理发育比较,神经心理发育商总平均分、语言单项比较,差异无统计学意义(P>0.05);而大运动、精细动作、适应能力和社交行为四个单项分别比较,差异有统计学意义(P<0.05);两组的学习能力比较,差异无统计学意义(P>0.05)。结论本组头颅MRI脑白质异常组与非脑白质异常组聋儿的神经心理发育、学习能力发育无显著差异。

Objective To analyze the intelligence test results of children with severe to profound sensorineural hearing loss with or without white matter abnormalities,and to provide reference for cochlear implantation in deaf children with white matter abnormalities.Methods The children with severe to profound sensorineural hearing loss screened from January 2019 to December 2021 were divided into white matter abnormal group(66 cases)and white matter normal group(129 cases)according to head MRI examination.Gesell neuropsychological development scale,Griffith mental development scale and Hiskey-Nebraska test of learning aptitude(H-NTLA)were used to evaluate the neuropsychological development quotient and learning ability quotient of the two groups.The neuropsychological development quotient and learning ability quotient of the two groups were compared and analyzed.Results Among the children with severe to profound sensorineural hearing loss,33.85%(66/195 cases)revealed white matter abnormalities on brain MRI,most of them were located in the posterior horn of the lateral ventricle,frontal lobe and parietal lobe,and 83.33%(55/66 cases)of the patients had white matter abnormalities in more than two brain regions.There was no significant difference in neuropsychological development,total average score of neuropsychological development quotient and single item of language between the white matter abnormal group and the white matter non-abnormal group,but there were significant differences in gross motor,fine motor,adaptive ability and social behavior(P<0.05).While there was no significant difference in learning ability between the two groups.Conclusion There was no significant difference in neuropsychological development and learning ability between the deaf children with abnormal white matter and those without abnormal white matter on brain MRI.