Effect of Acupuncture on the Auditory Evoked Brain Stem Potential in Parkinson's Disease

Under the auditory evoked brain stem potential (ABP) examination, the latent period of V wave and the intermittent periods of III-V peak and I-V peak were significantly shortened in Parkinson's disease patients of the treatment group (N=29) after acupuncture treatment. The difference of cumulative scores in Webster's scale was also decreased in correlation analysis. The increase of dopamine in the brain and the excitability of the dopamine neurons may contribute to the therapeutic effects, in TCM terms, of subduing the pathogenic wind and tranquilizing the mind.……

Effect of Qiangli Dingxuan Tablet on Cerebral Hemodynamics and Brainstem Auditory Evoked Potentials in Vertigo Patients with Posterior Circulation Ischemia

OBJECTIVE: To observe the effect of Qiangli Dingxuan Tablet on cerebral hemodynamics and brainstem auditory evoked potentials in vertigo patients with posterior circulation ischemia. METHODS: A total of 120 vertigo patients with posterior circulation ischemia were randomly divided into observation group and control group. 60 patients in the control group were treated with conventional western medicine. 60 patients in the observation group were treated with Qiangli Dingxuan Tablet on the basis of the control group. After 2 weeks of treatment, the improvement of vertigo(dizziness handicap inventory(DHI), dizziness handicap inventory(DHI)), the hemodynamic index(Basilar artery blood flow velocity(BA), left vertebroarterial artery(LVA), and the average blood flow velocity of right vertebroarterial artery(RVA)) and the changes in brain stem auditory evoked potential(BAEP) of two groups were observed. And statistical analysis was conducted for the clinical efficacy and adverse reactions during treatment of two groups. RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(P < 0.05). The DHI and DARS scores of the two groups were significantly lower than those before treatment(P < 0.05), and the degree of reduction was more obvious in the observation group(P < 0.05). The levels of BA, LVA and RVA in the two groups were significantly higher than those before treatment(P < 0.05), and the levels of BA, LVA and RVA in the observation group were significantly higher than those in the control group(P < 0.05). The indexes of BAEP latency I, II, III and indexes of BAEP peak latency I-III, III-V, IV were obviously lower than those before treatment(P < 0.05). Besides, the decrease of BAEP index in the observation group was significantly lower than that in the control group(P < 0.05). No adverse reactions occurred during the treatment of the two groups. CONCLUSION: Qiangli Dingxuan Tablet is able to significantly improve the cerebral hemodynamics and brainstem auditory evoked potentials of patients with PCIV, and quickly relieve vertigo. It is safe and reliable and worthy of clinical application.

Collagen/heparan sulfate porous scaffolds loaded with neural stem cells improve neurological function in a rat model of traumatic brain injury

One reason for the poor therapeutic effects of stem cell transplantation in traumatic brain injury is that exogenous neural stem cells cannot effectively migrate to the local injury site,resulting in poor adhesion and proliferation of neural stem cells at the injured area.To enhance the targeted delivery of exogenous stem cells to the injury site,cell therapy combined with neural tissue engineering technology is expected to become a new strategy for treating traumatic brain injury.Collagen/heparan sulfate porous scaffolds,prepared using a freeze-drying method,have stable physical and chemical properties.These scaffolds also have good cell biocompatibility because of their high porosity,which is suitable for the proliferation and migration of neural stem cells.In the present study,collagen/heparan sulfate porous scaffolds loaded with neural stem cells were used to treat a rat model of traumatic brain injury,which was established using the controlled cortical impact method.At 2 months after the implantation of collagen/heparan sulfate porous scaffolds loaded with neural stem cells,there was significantly improved regeneration of neurons,nerve fibers,synapses,and myelin sheaths in the injured brain tissue.Furthermore,brain edema and cell apoptosis were significantly reduced,and rat motor and cognitive functions were markedly recovered.These findings suggest that the novel collagen/heparan sulfate porous scaffold loaded with neural stem cells can improve neurological function in a rat model of traumatic brain injury.This study was approved by the Institutional Ethics Committee of Characteristic Medical Center of Chinese People’s Armed Police Force,China(approval No.2017-0007.2)on February 10,2019.

Formal Auditory Training with Individuals after Traumatic Brain Injury

Purpose: Establishing the effects of a formal auditory training program on individuals, after a traumatic brain injury by means of behavioral and electrophysiological tests. Study Design: Longitudinal study. Setting: Study conducted at the electrophysiology clinic of the Federal University of S&#227;o Paulo. Patients: Nine individuals with normal hearing, 20 to 37 years old, who were exposed to severe traumatic brain injury (score of 3 - 8 on the Glasgow Coma Scale upon hospital admission), 6 - 24 months earlier (11 months on average) and had imaging tests showing diffuse axonal injury with or without associated focal lesion. Intervention(s): subjected to a formal auditory training program in an acoustic booth involving eight 45-minute sessions aiming at training the auditory temporal order judgment (frequency and duration of sounds), auditory closure, and figure-ground separation skills for verbal and nonverbal sounds in monotic and dichotic listening tasks. The sessions and activities, in each session, were organized in increasing order of complexity to challenge the auditory system. In order to establish the efficacy of the auditory training, all participants were subjected to behavioral and electrophysiological assessments of the auditory processing, before and after the formal auditory training. Results: On the electrophysiological assessment, the absolute latencies of waves III and V, and of interpeak interval I-V decreased after the auditory training. However, the P300 did not exhibit a significant difference in either the latency or the amplitude parameters. Regarding the behavioral assessment of the auditory processing, it was verified that adequacy of the auditory figure-ground skills for verbal sounds, and the temporal order judging skills. Conclusions: individuals with diffuse axonal injury following a severe traumatic brain injury exhibited an improvement of central auditory processing after formal auditory training, as manifested on electrophysiological and behavioral assessments.

AN EXPERIMENTAL STUDY OF ELECTROACUPUNCTURE ON AUDITORY IMPAIRMENT CAUSED BY KANAMYCIN IN GUINEA PIGS

Frequency following response(FFR)and auditory brain stem evoked potential response(ABR)were used to determine the auditory acuity in evaluating the effect of electro-acupuncture treatment of kanamycin-induced auditory impairment in guinea pigs.Thesuccinate dehydrogenase(SDH)activity and morphological changes of the inner earreceptors were examined under the light and scanning electron microscope in cochlearspread preparations.The results showed that 1)electro-acupuncture was effective but nosignificant differences were found among the stimulating wave forms;2)Tinggong(SI19),Yifeng(SJ 17),Shenshu(UB 23),Sanyinjiao(Sp 6),Zhubin(K 9)and Waiguan(SJ 5)are all effective acupoints,especially the combination of Tinggong(SI 19),Sanyinjiao(Sp6)and Zhubin(K 9)acupoints;3)improvement in the cochlear function and excitabilityof the cortical and lower auditory center and increase of the mitochondrial SDH activityand energy supply in hair cells might contribute to the mechanism of the treatment.

RELATIONS OF INTRACRANIAL PRESSURE, CREATINE KINASE AND BRAINSTEM AUDITORY EVOKED POTENTIAL IN PATIENTS WITH TRAUMATIC BRAIN EDEMA

We studied the relations of intracranial pressure (ICP),creatine kinase (CK) and bralnstem auditory evoked potential (BAEP) in 44 patients with traumatic brain edema who were admitted to our hospital from June 1990 to February 1991. There were 30 males and 14 females, with age range from 9 to 67 years. The results showed that the abnormal BAEP could reflect the severity of cerebral edema in acute head injury and was related to ICP and serum CK levels. When ICP>30 mmHg (4kPa), the abnormality of BAEP was more obvious than that of the control group (P<0.05); the serum CK levels were also elevated markedly. In patients with ICP over and below 4kPa, the rate of abnormal BAEP was 38.46% and 77.78% respectively (P<0.05). The serum CK level in the normal group or in the group with moderate abnormality of BAEP was significantly different from that in the group with severe abnormality or lack of BAEP (274.8± 98.24 U/L vs 705.3± 364.27 U/L; P<0.001). After treatment, the ICP returned to normal, and the BAEP norm

397例听神经瘤听力特征分析

目的 分析听神经瘤患者听力学特征,为筛查听神经瘤提供参考依据。方法 回顾性分析2019年8月—2022年4月诊治的397例单侧听神经瘤患者临床资料,所有患者均行纯音测听、声导抗测试、言语识别率(SDS)、畸变产物耳声发射(DPOAE)、听性脑干诱发电位(ABR)和颅脑增强MRI。结果 以典型症状就诊者312例,非典型症状就诊者85例。以突发性聋就诊者25例;患耳听力正常者54例,包含大型甚至特大型肿瘤,99例全聋者亦包含内听道和中型肿瘤。5例全聋者言语识别能力未完全消失。DPOAE一致型245例,耳蜗型72例,蜗后型79例。ABR阳性率98.0%(389/397),8例ABR波形正常者中3例为双侧非对称听力损失。结论 非典型症状就诊者占比21.4%,以突发性聋就诊、听力正常或ABR正常者不能排除听神经瘤;DPOAE和ABR可作为筛查听神经瘤的重要检查方法。

先天性外中耳畸形患者听性脑干反应与颞骨发育的相关性研究

目的探讨先天性外中耳畸形患者临床早期听性脑干反应(ABR)与远期颞骨发育情况之间的相关性。方法回顾性分析先天性外中耳畸形患者临床资料,包括婴幼儿期ABR、青少年或儿童期颞骨CT及患者基本情况等。比较颞骨发育不同患者间ABR阈值差异。结果Jahrsdoerfer评分及乳突气化程度与ABR气导阈值及气骨导差值负相关,先天性外耳道骨性闭锁患者Jahrsdoerfer评分高组ABR气导阈值(P=0.011)、ABR气骨导差值低于Jahrsdoerfer评分低组(P=0.033)。所有先天性外中耳畸形患者乳突气化型组ABR气导阈值(P=0.005)及气骨导差值(P<0.001)低于非气化型组。先天性外耳道狭窄伴胆脂瘤组ABR气导阈值(P=0.002)及ABR气骨导差(P<0.001)高于不伴胆脂瘤组。结论对先天性外中耳畸形患者而言,婴幼儿时期进行ABR检查不仅可以反映患者听力情况,也具有预测颞骨发育情况的意义。

AEEG结合脑干听觉诱发电位表现与昏迷患者预后的相关性分析

目的探讨动态脑电图(AEEG)结合脑干听觉诱发电位(BAEP)表现与昏迷患者预后的相关性。方法回顾性研究2023-01—2024-01周口市中医院神经内科收治的60例昏迷患者的临床资料,60例患者均行AEEG、BAEP检查,连续随访3个月,采用格拉斯哥预后量表(GOS)评估预后情况,分为预后良好组(GOS评分3~5分)32例,预后不良组(GOS评分1~2分)28例,分析AEEG、BAEP检查对患者预后的评估价值,采用Spearman相关性分析法探讨AEEG、BAEP与GOS评分的相关性。结果联合检查的准确性较AEEG、BAEP单独检查高,敏感性较BAEP单独检查高(P<0.05);联合检查的敏感性与AEEG单独检查比较差异无统计学意义(P>0.05),特异性与AEEG、BAEP单独检查比较差异无统计学意义(P>0.05);Spearman相关性分析显示,AEEG、BAEP分级与3个月后的GOS评分均呈负相关(r=-0.720、-0.650,P<0.05)。结论AEEG联合BAEP检查对昏迷患者预后具有较高的预测效能,且AEEG、BAEP分级与昏迷患者的预后均呈负相关。

早期帕金森病患者前庭诱发肌源性电位检查对脑干功能损伤的筛查价值

目的探讨早期帕金森病(PD)患者前庭诱发肌源性电位(VEMPs)检查对脑干功能损伤的筛查价值。方法我院就诊的106例早期PD患者(PD组)和同期100例健康体检者(对照组),均行VEMPs检测,比较两组VEMPs参数,并分析其诊断效能,根据帕金森病评分量表将患者分为预后良好组和预后不良组,比较不同预后患者VEMPs参数,并分析其预后评估效能。结果与对照组比较,PD组p13、n23、n10及p15水平更高(P<0.05)。ROC曲线显示,p13诊断早期PD的AUC和截点值分别为0.806、15.56 ms,n23诊断早期PD的AUC和截点值分别为0.773、24.54 ms,n10诊断早期PD的AUC和截点值分别为0.817、12.39 ms,p15诊断早期PD的AUC和截点值分别为0.620、15.47 ms,四者联合诊断早期PD的AUC为0.945,高于单项诊断(P<0.05)。与预后不良组比较,预后良好组p13、n23、n10及p15水平更低(P<0.05)。ROC曲线显示,p13评估早期PD预后的AUC和截点值分别为0.824、19.36 ms,n23评估早期PD预后的AUC和截点值分别为0.803、27.36 ms,n10评估早期PD预后的AUC和截点值分别为0.775、13.28 ms,p15评估早期PD预后的AUC和截点值分别为0.789、17.19 ms,四者联合评估早期PD预后的AUC为0.975,高于单项评估(P<0.05)。结论VEMPs检查能够较好反映早期PD患者脑干功能损伤情况,具有一定的筛查价值,且能用于预后评估。

振幅整合脑电图在足月新生儿病理性黄疸脑损伤诊断中的应用价值分析

目的:探讨振幅整合脑电图在足月新生儿病理性黄疸(PJON)脑损伤诊断中的应用价值。方法:选取2021年1月—2023年6月泗洪县第一人民医院收治的79例足月PJON患儿作为研究对象,患儿均接受振幅整合脑电图与脑干听觉诱发电位检查,以实验室检查及影像学检查结果为“金标准”,比较振幅整合脑电图检查、脑干听觉诱发电位检查诊断足月PJON脑损伤的效能。结果:实验室检查及影像学检查结果显示,79例足月PJON患儿中,确诊脑损伤10例。振幅整合脑电图诊断足月PJON脑损伤的灵敏度、特异度、准确率高于脑干听觉诱发电位,差异有统计学意义(P<0.05)。结论:振幅整合脑电图检查诊断足月PJON脑损伤的灵敏度、特异度与准确率较高,能为临床诊治提供依据。

婴儿分泌性中耳炎的听力学结果分析

目的 探讨226、1 000 Hz鼓室声导抗测试和气-骨导听性脑干反应(ABR)以及畸变产物耳声发射(DPOAE)在诊断低月龄婴儿分泌性中耳炎(OME)中的作用。方法 回顾性分析年龄为1~6个月的119例(192耳)中耳积液患儿(异常组)和66例(132耳)正常婴儿(正常组)的226、1 000 Hz鼓室声导抗测试和气-骨导ABR,以及DPOAE检测结果。结果 (1)OME婴儿,1 000 Hz鼓室声导抗异常图形(As型、B型、C型)有189耳(98.44%),226 Hz鼓室声导抗异常图形(As型、B型、C型)有135耳(70.31%);(2)OME婴儿ABR波Ⅰ潜伏期延长179耳(93.23%),ABR波Ⅴ反应阈中度异常69耳(35.94%)、轻度异常97耳(50.52%)、阈值正常26耳(13.54%),骨导ABR阈值正常164耳(85.42%),阈值轻度异常28耳(14.58%),气-骨导ABR阈值差值变大162耳(84.37%);(3)OME婴儿DPOAE未引出151耳(78.65%)。结论 1 000 Hz声导抗异常、气-骨导ABR阈值差变大、ABR波I潜伏期延长和气导ABR阈值异常对低月龄婴儿中耳积液的诊断有重要参考价值,226 Hz声导抗对部分低月龄婴儿中耳积液的诊断不能提供准确信息。

柴胡疏肝散对原发性抑郁症患者BAEP、VEP的影响

目的:观察柴胡疏肝散对原发性抑郁症患者脑干听觉诱发电位(BAEP)和视觉诱发电位(VEP)的影响。方法:将100例原发性抑郁症患者随机分为中药组、西药组,分别给予中药柴胡疏肝散和盐酸帕罗西汀治疗,采用脑诱发电位仪,记录治疗前后BAEP和VEP。结果:两组经治疗后,BAEP的I、V波治疗前后无明显改变(P>0.05),Ⅲ波潜伏期较治疗前明显缩短(P<0.05),VEP各波潜伏期均显著缩短(P<0.05);治疗后两组BAEP、VEP相比无统计学差异(P>0.05)。结论:柴胡疏肝散可缩短原发性抑郁症患者BAEP和VEP的潜伏期,减轻患者临床症状,具有应用价值。

诱发电位预测重症脑卒中患者不良预后时机研究

目的探讨短潜伏期体感诱发电位（SLSEP）和脑干听觉诱发电位（BAEP）预测急性重症脑卒中患者预后的最佳时机。方法以Glasgow昏迷量表（GCS）评分≤12分并经头部CT和（或）MRI检查证实的幕上大面积梗死或大容积出血患者作为观察对象,分别于发病后第1~3和4~7天行GCS评分、SLSEP和BAEP检查;并于发病后6个月采用改良Rankin量表（m RS）评估预后,分析发病后不同时间窗预测指标（GCS评分、SLSEP和BAEP）与预后评估指标（m RS评分）之间的关联性和预测准确性。结果（1）关联性分析：发病第1~3天,GCS评分、SLSEP和BAEP与m RS评分之间无关联性（均P〉0.05）;发病第4~7天,SLSEP和BAEP与m RS之间存在关联性（均P〈0.01,C〉0.400）。（2）预后预测准确性分析：发病第4~7天,SLSEP和BAEPⅤ波预测灵敏度为85.71%~97.62%、BAEP特异度为80.00%~90.00%,各项预测指标阳性预测值达89.13%~96.88%、SLSEP阴性预测值为83.33%~85.71%,其中SLSEP和BAEP预测准确度均达临床预期,尤以SLSEP最佳（88.46%~90.38%）。结论急性重症脑卒中患者发病第4~7天SLSEP和BAEP预测不良预后的准确性较高。

针刺“内听宫”穴对突发性耳聋患者听觉脑干诱发电位的影响

目的:探讨针刺“内听宫”穴治疗突发性耳聋的机理。方法:使用诱发电位仪测定正常组、突聋组的ABR,观察针刺“内听宫”穴前后ABR的变化。结果:针刺正常耳“内听宫”穴,针刺前后ABR的Ⅰ波、Ⅴ波潜伏期以及Ⅰ-Ⅴ波间期无显著性变化(P>0.05);而针刺突聋耳“内听宫”穴后,其ABR波形分化明显清晰,Ⅰ波、Ⅲ波、Ⅴ波均出现,且重复性好,Ⅰ波、Ⅴ波潜伏期缩短(P<0.05)。结论:针刺“内听宫”穴能提高突聋耳耳蜗听神经以及外侧丘系桥脑的兴奋性和传导性,但对正常耳无影响。该穴位可用于治疗突发性耳聋。

脑干听觉诱发电位在儿科临床应用的价值

本文对1240例患儿BAEP资料进行了分析,正常518例,异常722例。其中新生儿、乳幼儿486例;轻～重度异常占74.5％,双侧极重度异常占25.5％。BAEP异常最高的疾患为听力障碍、听力障碍危险因素、语言障碍、脑干肿瘤、智力障碍和脑性瘫痪。本文尚对该类疾患BAEP异常的类型和程度进行了分析。结果显示:BAEP是新生儿、婴幼儿听力障碍和脑干听中枢功能异常早期筛查的有效方法。对早期干预,促进听力、语言和智能的恢复具有重要价值。

诱发电位监测技术在脑干及其附近肿瘤手术中的应用

目的探讨诱发电位技术在脑干及其附近肿瘤手术中的应用价值。方法选择静脉麻醉下脑干及其附近病变手术病人18例,术中监测脑干听觉诱发电位(BAEP)7例,体感诱发电位(SEP)18例,运动诱发电位(MEP)5例。当术中波形发生明显异常时,即通知术者调整或停止操作。结果本组术中诱发电位监测均顺利完成。BAEPⅤ波变化6例,其中波形逐渐恢复5例,术后均未出现新的神经功能障碍;未恢复1例,术后轻度意识障碍,3d后清醒。SEP波形变化4例,其中手术结束时恢复至基线水平3例,术后未发现异常;未恢复1例,术后病人昏迷。MEP出现变化1例,调整刺激后恢复。结论在脑干及其附近病变手术中应用多种诱发电位技术,可及时、有效地监测并保护脑干功能。

先天性听力损失的确诊和随访及病因分析

目的 了解先天性听力损失在母婴同室 (well babynursery ,WBN)与新生儿重症监护室 (newbornintensivecareunit ,NICU)中的发病率以及可能导致听力损失的高危因素 ,探讨较为科学而可行的早期诊断、跟踪随访及早期干预模式。方法 采用瞬态诱发耳声发射 (transientevokedotoacousticemission,TEOAE)进行新生儿听力普遍筛查 (2阶段筛查 ) ;对复筛未“通过”者 ,于生后 3个月采用听性脑干反应 (auditorybrainstemresponse,ABR)和 4 0Hz听觉相关电位 (40Hzauditoryeventrelatedpotentials,4 0Hz AERP)技术予以诊断。ABR异常婴幼儿及听力损失高危儿于生后 6个月～ 3岁前进行跟踪随访和定期的听力学评估 ,对诊断为永久性听力损失的婴幼儿于生后 6个月提出早期干预方案。结果 新生儿及婴幼儿先天性听力损失患儿占同期接受新生儿普遍听力筛查总数的 5 73‰ (91/ 15885 ) ;WBN中听力损失患儿占同期WBN中接受新生儿普遍听力筛查总数的 3 6 7‰ (5 1/ 13887) ,NICU中听力损失患儿占同期NICU中接受新生儿普遍听力筛查总数的 2 0 0 2‰ (40 / 1998)。结论 对于NICU新生儿 ,无论其是否“通过”新生儿听力普遍筛查 ,都有必要在生后 3个月左右接受ABR检查 ;3个月后的随访人群包括ABR异常婴幼儿和听力损失高危儿 ;追?

听性脑干反应严重异常和耳声发射正常的小儿听力障碍的临床特征分析

目的 探讨包含小儿听神经病在内的听性脑干反应 (auditorybrainstemresponse ,ABR)严重异常 ,畸变产物耳声发射 (distortionproductotoacousticemission ,DPOAE)正常为特征的听功能障碍症侯群的病因学特征、病损部位与临床听力学特点。方法 选取 2 0 0 2～ 2 0 0 4年听力专科中ABR严重异常、DPOAE正常 ,排除中耳传导功能异常的患儿 98例 (16 8耳 )入选为研究组。根据神经康复科医师的评估 ,作出是否伴有精神运动发育迟缓及其相关病因的诊断 ,统计伴有精神运动发育迟缓的研究组中听力损失高危因素的类型与比例 ;选择ABR严重异常、DPOAE异常、排除中耳病变的患儿4 6例 (82耳 )作为蜗性病变对照组 ,比较研究组与蜗性病变患儿ABR的异同点 ;选择健康同龄小儿4 0例 (72耳 )作为正常对照组 ,观察研究组与正常听力小儿ABR和DPOAE的异同点。结果 ①研究组 98例患儿中 ,83 6 7%患儿伴有精神运动发育迟缓的临床症状 ,其相关的致病因素中 ,以新生儿高胆红素血症所占的比例最高 ;② 10 3dB强度刺激声 (听力级 )刺激时 ,无波分化的为 5 3耳、仅能记录到波Ⅴ的 7耳 ,90dB强度刺激声仅能记录到Ⅴ波的 9耳 ,80dB仅能记录到Ⅴ波的 4耳 ,共 73耳(43 4 5 % ) ,病损部位主要在听神经远端 ;10

脑干听觉诱发电位和体感诱发电位对昏迷患者预后的判断

目的脑干听觉诱发电位(BAEP)和体感诱发电位(SEP)与昏迷患者预后密切相关,探讨BAEP和SEP判断昏迷患者脑功能状态的可行性和准确性。方法采用丹麦Dantec公司生产Neuromatic2000型肌电图诱发电位仪。检查ICU病房中36例昏迷患者的BAEP和SEP。BAEP分析III-V波,SEP分析P15、N20、P25波。检查结果分为正常和异常。预后分为好转和死亡。结果36例患者,BAEP正常12例,异常24例。SEP正常13例,异常23例。好转13例,死亡23例。当SEP异常时,死亡率明显高于SEP正常时。而同时伴有BAEP异常时,死亡率更高。14例患者SEP检查P15、N20、P25波均消失,12例死亡,病死率为86%。5例患者BAEP检查III-V波和SEP检查P15、N20、P25波均消失,全部死亡,病死率为100%。结论BAEP和SEP的正常与否与昏迷患者的预后有密切关系(P=0.011)。SEP异常是判定的主要根据。BAEP和SEP相结合,则可以提高判断的准确性。对昏迷患者进行动态的BAEP和SEP观察可提高判断的准确性。