老年性聋患者言语处理的功能磁共振研究

发布时间：2018-06-24 01:49

本文选题：老年性聋 + 言语　；参考：《福建医科大学》2013年硕士论文

【摘要】：目的利用血氧水平依赖的功能磁共振成像技术(blood oxygenatin level dependent-functional magneticresonance imaging，BOLD-fMRI)，分析正常听力青年人、正常听力老年人和老年性聋患者行听觉性言语刺激时大脑脑区的激活情况，研究衰老、耳聋对大脑听觉中枢功能重组的影响，以及半球优势的变化。方法18例健康青年志愿者（青年组）、10例正常听力老年人（老年组）及10例老年性聋患者（老年聋组），分别行听觉任务的BOLD-fMRI检查。采用组块设计方法，给予频率为1kHz，声强为90dB±3dB（经过环境噪音检测仪Smart Sensor AR844测量并校准后）单音节言语刺激声，左右耳分别随机给声，每种刺激重复2次。所有数据均经统计参数图(statistical parametric mapping5，SPM5)软件离线后处理，获得解剖功能图、分析感兴趣激活脑区的体积、信号强度，并计算偏侧化指数。结果三组受试者行听觉性言语刺激时明显激活的脑区基本一致，以颞上回、颞中回的激活最明显,以听皮层为感兴趣脑区（region of interest，ROI）。激活体积：两老年组与青年人相比，左耳刺激时，左侧ROI激活体积增加（P〈0.05），右侧ROI激活体积明显减少（P〈0.05）；右耳刺激时，两侧ROI激活体积均减少（P〈0.05）。老年聋组与老年组比较，无论是左耳还是右耳刺激，双侧ROI激活体积均有所减少，但差异无统计学意义。激活强度：左耳刺激时，不同组间双侧ROI的激活强度均无明显差异；右耳刺激时，老年组较老年聋组与青年组均增强（P〈0.05），，老年性聋组较青年组稍减弱，差异无统计学意义。青年组单耳刺激时，刺激耳对侧ROI的激活体积与强度较刺激耳同侧均明显增加，表现为对侧半球优势，偏侧化指数分别为-0.58（左耳刺激）、0.37（右耳刺激）。老年组与老年聋组单耳刺激时对侧半球传导优势较青年组明显减弱，偏侧化指数分别为-0.24、0.28（老年组），-0.18、0.25（老年聋组）。青年组左、右耳分别行听觉任务时，双侧ROI激活总体积之比分别为1:2.06，表现为右耳优势（左脑优势）；老年组、老年聋组总体积之比分别为1:1.51、1:1.61，表现为右耳优势减弱（左耳优势增强）。结论听觉性言语任务激活脑区以颞上回、颞中回激活最明显。随着年龄的增长，这些脑区激活的幅度减弱，出现对侧半球传导优势及右耳优势减弱的趋势。因而衰老与耳聋后皮层发生了功能重组，这可能就是言语识别下降的原因之一。
[Abstract]:Objective to analyze the activation of brain region in normal hearing young people, normal hearing elderly and patients with presbycusis by using (blood oxygenatin level dependent-functional magneticresonance imaginging-BOLD-fMRI, which is a functional magnetic resonance imaging technique dependent on blood oxygen level, and to study aging. The effect of deafness on the recombination of brain and auditory center and the change of hemispheric dominance. Methods 18 healthy young volunteers (young group) with normal hearing and old people (aged group) and 10 patients with presbycusis (aged group) were examined with BOLD-fMRI. The method of block design was used to give monosyllabic speech stimuli with a frequency of 1 kHz and a sound intensity of 90 dB 卤3 dB (measured and calibrated by Smart Sensor AR844). All the data were processed off-line by statistical parameter map (statistical parametric mapping5 (SPM5) software. Anatomic function map was obtained. The volume, signal intensity and lateralization index of the activated brain region were analyzed. Results the activation of auditory speech stimulation in the three groups was basically the same. The activation of superior temporal gyrus and middle temporal gyrus was the most obvious, and the auditory cortex was the area of interest. Activation volume: the activation volume of ROI in left ear increased significantly (P < 0.05) and decreased significantly in right ear (P < 0.05), and in right ear stimulation, the activation volume of ROI decreased in both sides (P < 0.05). The activation volume of bilateral ROI was decreased in both left and right ears, but there was no significant difference between the deaf group and the elderly group. Activation intensity: there was no significant difference in the activation intensity of bilateral ROI between different groups during left ear stimulation, while in the right ear stimulation, the activation intensity of ROI in the geriatric group was significantly higher than that in the old deaf group and the young group (P < 0.05), and the difference was not statistically significant in the presbycusis group compared with the young group (P < 0.05). The activation volume and intensity of the contralateral ROI in the young group were significantly higher than those in the ipsilateral side of the stimulated ears. The contralateral hemispheric dominance was observed, and the hemiplegia index was -0.58 (left ear stimulation) 0.37 (right ear stimulation). The contralateral hemispheric conduction advantage of the elderly group and the elderly group was significantly decreased compared with that of the young group, and the hemispheric index was -0.24 卤0.28 (aged group) and 0.180.25 (aged group), respectively. The ratio of the total volume of bilateral ROI activation was 1: 2.06 when the left and right ears were assigned to auditory tasks respectively in the young group, showing the advantage of the right ear (left brain dominance), while in the elderly group, the ratio of activation of ROI was 1: 2.06, respectively. The ratio of total volume of deafness group was 1: 1.51 and 1: 1.61respectively, showing that the right ear dominance was weakened (left ear dominance was enhanced). Conclusion auditory speech task activates the superior temporal gyrus and the middle temporal gyrus. With the increase of age, the activation amplitude of these brain regions decreased, and the contralateral hemispheric conduction dominance and the right ear dominance decreased. Therefore, the functional recombination of the aging and deafness cortex may be one of the reasons for the decline in speech recognition.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R764.436

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