言语诱发听觉脑干反应的稳定性评价

发布时间：2018-04-30 00:14

本文选题：听觉诱发电位 + 言语诱发听觉脑干反应　；参考：《南方医科大学》2010年硕士论文

【摘要】：背景和目的短声和纯音等简单声音诱发的短潜伏期听觉诱发电位,如听性脑干诱发反应,因其具有波形稳定、重复性高、不易受觉醒状态和麻醉影响等优点,已广泛应用于临床,为听力学、神经耳科学疾病的定位诊断提供了简便安全的技术手段。通过对短潜伏期听觉诱发电位的研究,人们对于短声、纯音等简单声音的听觉处理机制已有一定认识,但对听觉处理言语等复合声音的认识尚十分有限。因此,听觉系统处理言语的神经基础及机制一直是国内外广大学者致力研究的热点。脑干神经元放电模式与言语声学特征具有高度相关性,提示脑干是言语处理的重要部位,记录这些电位变化可发现听觉言语处理的机制,从而使听性脑干诱发反应记录技术成为了言语感知基础及临床研究的重要工具。目前言语诱发脑干反应(Speech-ABR)的研究以美国西北大学Kraus教授主持的研究小组报告最多,该小组以学习障碍(learning problem,LP)儿童为研究对象,采用合成单音节/da/诱发出由起始部分(正性V波和负性A波)和频率跟随部分(负性C波、D波、E波和F波)组成的Speech-ABR。他们发现Speech-ABR中各波形成与刺激声有高度的相关性,并且LP儿童因听觉系统异常导致的语言障碍能为Speech-ABR所反映出来。Speech-ABR是对言语障碍人群进行筛选、诊断及疗效观察的良好工具,可较早地觉察听觉信息处理能力低下的情况,并进行针对治疗,具有重要的预防价值。目前对Speech-ABR的研究仍处于起步阶段,研究主要集中于反应中各主波与刺激间关系的研究,有关反应稳定性的报道极少。然而,反应主波的潜伏期和波幅是听觉诱发电位常用的临床指标,测量结果是否稳定具有重要的临床意义。目前国内尚缺少Speech-ABR测试稳定性的系统研究,因此本文主要工作是对中国正常青年人Speech-ABR测试的稳定性进行初步研究。方法本文采用两次横断面研究,以南方医科大学在读学生为受试者,测量和评价言语诱发脑干反应主波的稳定性。研究对象共40人,其中男性20例,女性20例,年龄19-26岁,均为右利手,无听觉系统、神经系统疾病及精神障碍病史,短声诱发听觉脑干反应(Click-ABR)正常。受试者随机分为两组,每组各20人。两组受试者的测试时间间隔2个月。以声音/da/作为刺激,对每个受试者分别测试其右耳常规Click-ABR和Speech-ABR,其中Click-ABR记录一组(播放1024个刺激),Speech-ABR记录三组(每组播放1024个刺激),且要求每组记录参加平均的反应个数不少于1000个。测试时每组实验间隔1分钟。分析每个受试者的3组反应、3组反应的平均波形以及每组测试者所有反应平均后的总体波形。平均波形通过Matlab读取每个测试者的3组反应后作平均处理得到；总体波形通过Matlab读取每组20名测试者的60个反应后作平均处理得到。根据前期工作中制定的主波判定准则判定Speech-ABR中的各主波,并通过Matlab-软件编程以读取各主波的潜伏期及幅值数值,并分别统计两组受试者中各主波被成功引出的次数。结果 Speech-ABR的FFR部分与刺激/da/的准周期性波表现出高度的相关性,认为Speech-ABR中D-E-F组成的周期波为/da/中的准周期性波所诱发,且包含了基频及共振峰等信息,反映了Speech-ABR对/da/的锁相特性。而V、A、C及O波为言语刺激中的瞬态性事件所诱发。单次记录的Speech-ABR波形虽含有较多的噪声状杂波,波形较不稳定,但经平均后杂波大大减少。单次记录反应和单个受试者总体平均反应都包含了V-O波中的多个或全部主波,且两组受试者总体平均波形中各主波的潜伏期和幅值相差很小,无统计学差异(p0.1),表明Speech-ABR记录是相对稳定的,分析时应以总体平均反应为重点。所有主波中,以V、A、C和F波的引出率最高(40%-60%),D、E和O波的引出率较低(20%-30%),且瞬态性波(V、A、C和O波)的引出率比周期性波(D、E和F波)的引出率高。结论 Speech-ABR中的D、E和F波与/da/中的d、e和f波有锁相关系,表明Speech-ABR很好地反映了刺激言语/da/的声学信息。单次Speech-ABR、单个受试者三次Speech-ABR的平均反应和每组受试者的Speech-ABR总体平均反应,都表现出很高的相似性,表明Speech-ABR记录具有较高的稳定性。组1和组2总体平均波形中主波的潜伏期和幅值无统计学差异,表明在一定时间范围内Speech-ABR测试具有很好的重复性。V、A、C和F波在一次实验中的引出率较高,表明它们比其它主波更稳定,可作为主要分析对象。综上,Speech-ABR的测试结果具有较好的稳定性和重复性,其V、A、C和F波可作为临床观测的重要指标,是言语感知机制的基础及临床研究的良好工具。
[Abstract]:Background and purpose
Short latency auditory evoked potential induced by short sound and pure sound, such as auditory brainstem evoked response, has been widely used in clinic because of its advantages of stable waveform, high repetition, not easy to be affected by awakening state and anesthetic effect. It provides a simple and safe technical means for location diagnosis of Audiology and neurotic diseases. In the study of short latency auditory evoked potential, people have a certain understanding of the hearing processing mechanism of simple sound such as short sound and pure tone, but the understanding of complex sound such as speech processing is still limited. Therefore, the auditory system is a hot spot for the scholars at home and abroad to deal with the neural basis and mechanism of speech.
Brain stem neurons are highly correlated with speech acoustic characteristics, suggesting that brainstem is an important part of speech processing. Recording these potential changes can discover the mechanism of auditory speech processing, thus making auditory brainstem evoked response recording technology an important tool for speech perception basis and clinical research. The study of dry reaction (Speech-ABR) is the most reported by the research group chaired by Professor Kraus of the Northwestern University. The group uses the learning problem (LP) children as the research object and uses synthetic monosyllabic /da/ to induce the initiation part (positive V wave and negative A wave) and frequency following part (negative C wave, D wave, E wave and F wave). Ech-ABR. they found a high correlation between the formation of each wave in the Speech-ABR and the sound of the stimulus, and the language disorder caused by the abnormal auditory system in LP children can be reflected by the Speech-ABR, and.Speech-ABR is a good tool for screening, diagnosis and therapeutic observation of speech disorders. At present, the study of Speech-ABR is still in its infancy. The study mainly focuses on the relationship between the main waves and the stimuli in the reaction, and there are few reports about the stability of the reaction. However, the latency and amplitude of the reaction main wave are the common clinical indicators of the auditory evoked potential. The stability of the test results is of important clinical significance. There is still a lack of systematic research on the stability of Speech-ABR test at home. Therefore, the main work of this paper is to make a preliminary study on the stability of Speech-ABR test of normal young people in China.
Method
In this study, two cross-sectional studies were conducted to measure and evaluate the stability of the main wave of speech induced brainstem response in the students of Southern Medical University. There were 40 subjects, including 20 men, 20 women, 19-26 years old, all right hand, no hearing system, the history of mental disorders and mental disorders, and short sound evoked auditory brain. The subjects were randomly divided into two groups, each group was randomly divided into two groups, each group was 20. The test time interval between the two groups was 2 months. The sound /da/ was used as a stimulus. The subjects were tested for the normal Click-ABR and Speech-ABR in the right ear, of which a group of Click-ABR (1024 stimuli) and three groups of Speech-ABR (1024 for each group) were recorded. The average number of responses of each group was not less than 1000. The test interval of each group was 1 minutes. The 3 groups of each response, the average waveform of the 3 groups of reactions, and the overall wave form after the average reaction of each test group were analyzed. The average waveform was read by the average of the 3 groups of each tester by Matlab. The overall waveform is obtained by reading the 60 reactions of 20 testers in each group by Matlab. The main waves in the Speech-ABR are determined according to the principal wave criterion formulated in the previous work, and the latency and amplitude values of the main waves are read by the Matlab- software, and the main waves of the two groups are counted respectively. The number of times that is elicited by success.
Result
The FFR part of Speech-ABR shows a high correlation with the quasi periodic waves that stimulate /da/. It is believed that the periodic wave of D-E-F in Speech-ABR is induced by the quasi periodic wave in /da/, and contains the information of the fundamental and resonance peaks, reflecting the phase locking characteristics of /da/, and V, A, C and O waves are transient events in speech stimuli. The single recorded Speech-ABR waveform contains more noise like clutter, the waveform is more unstable, but the average after clutter is reduced greatly. The single recording reaction and the overall average response of the individual subjects include the multiple or all main waves in the V-O wave, and the latent and amplitude phases of the main waves in the two groups of subjects' overall mean waveforms. The difference is very small, there is no statistical difference (P0.1), indicating that the Speech-ABR record is relatively stable, and the analysis should focus on the overall average reaction. In all main waves, the extraction rate of V, A, C and F waves is the highest (40%-60%), D, E and O waves are lower (20%-30%), and the extraction rate of transient waves is higher than that of periodic waves.
conclusion
The D, E and F waves in Speech-ABR have a phase-locked relationship with D, e and F waves in /da/, indicating that Speech-ABR is a good reflection of the acoustic information of stimulus speech /da/. It has high stability. There is no statistical difference between the latency and amplitude of the main wave in group 1 and group 2. It shows that the Speech-ABR test in a certain time range has a good repeatability.V, A, C and F waves are higher in one experiment, indicating that they are more stable than other main waves, which can be used as the main analysis object. To sum up, Spee The test results of ch-ABR have good stability and repeatability, and their V, A, C and F Bob are important indicators of clinical observation. It is a good tool for the basic and clinical research of speech perception mechanism.

【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R338

【共引文献】