正常成人言语诱发听性脑干反应的临床研究
发布时间：2018-08-30 11:18
【摘要】： 目的 1、探讨正常成人言语诱发听性脑干反应(speech evoked auditory brainstem response, speech-ABR)的电生理特性及其与诱发言语声学特性的关系,并比较和分析与短声诱发听性脑干反应(click evoked auditory brainstem response, click-ABR)的差异。 2、比较正常成人左、右耳记录的speech-ABR在时域及频域上的差异,探讨脑干编码双耳来源的言语信息的差异及其可能原因。 3、探讨言语强度对正常成人speech-ABR电生理特性的影响及其在脑干神经元编码言语信息中的意义。 4、探讨speech-ABR产生和编码的神经机制及其在研究言语感知机制中的应用价值,建立正常成人speech-ABR的记录规范和分析方法,获取speech-ABR参数的正常参考值,从而为言语感知机制的基础及临床研究提供客观方法,为后续言语相关疾病的基础及临床研究、专业应用软件的开发奠定基础。 方法 记录80dB SPL强度下正常成人右耳(31例)短声及合成言语声da诱发的听性脑干反应,计算da和speech-ABR的时域及频域参数,分析两者的关系,同时比较speech-ABR与click-ABR的差异。click-ABR及speech-ABR各目标波的潜伏期及出现率进行描述性统计分析；speech-ABR各主波潜伏期之间进行双变量相关分析,符合正态分布者求Pearson相关系数,不符合正态分布者求Spearman相关系数；配对χ2检验(McNmar Test)两种刺激诱发的Ⅲ及Ⅰ波出现率的差异有无统计学意义,配对t检验click-ABR与speech-ABR的Ⅴ波、Ⅲ波及Ⅰ波潜伏期差异是否具有统计学意义。采用80dB SPL的合成言语声da为刺激对正常成人(31例)进行双耳同侧记录的speech-ABR测试,分析反应的潜伏期、幅值及波形评分；并对反应20～50 ms部分进行快速傅立叶变换,计算基频及第一共振峰的幅值。采用配对t检验比较speech-ABR各主波的潜伏期、幅值、波形评分、F0幅值及F1幅值的双耳差异是否具有统计学意义。采用不同强度(80dB、60dB、40dB、和20dB SPL)的合成言语声da为刺激对正常成人(32例)进行speech-ABR测试,分析speech-ABR的潜伏期、幅值及潜伏期的相关性。各强度speech-ABR的主波潜伏期、幅值及潜伏期差值进行描述性统计分析；采用one-way ANOVA检验各强度的主波潜伏期及波幅的差异是否具有统计学意义,方差齐性检验提示方差不齐时,用Brown-Forsythe法分析；有统计学差异者进一步多重比较,方差齐者用LSD法,方差不齐者用Dunnett's T3法；各强度主波的潜伏期之间进行双变量相关分析,符合正态分布者求Pearson相关系数,不符合正态分布者求Spearman相关系数。研究结果采用SPSS13.0统计软件进行统计处理,假设检验水准a=0.05。 结果 正常成人speech-ABR由一系列主波组成,可分为起始部分(包括Ⅴ波和A波)、过渡部分(C波)、频率跟随部分(D-E-F波)和终止部分(O波),各主波的潜伏期均在相应刺激事件发生后的12 ms内。A波潜伏期分别与V、C、D、E及F波潜伏期有显著相关性(P0.05),其中与Ⅴ波潜伏期的相关性最强(r=0.824,P=0.000)；D、E及F波潜伏期相互间显著相关(P0.01)。与click-ABR相比,speech-ABR的Ⅴ波和Ⅲ波潜伏期显著延迟(P0.01),Ⅲ波出现率显著降低(P=0.003),而Ⅰ波潜伏期的延迟和出现率的降低无统计学意义(P0.05)。speech-ABR主波潜伏期的双耳差异无统计学意义；幅值除A波及O波外双耳差异亦无统计学意义；反应的波形评分右耳大于左耳,差异有显著性(P0.05)。无论记录耳为何侧,基频的幅值均大于第一共振峰的幅值,差异有显著性；无论是基频的幅值还是第一共振峰的幅值,双耳差异均无统计学意义(P0.05)。随着言语强度的降低,各主波的潜伏期逐渐延长,潜伏期差异有统计学意义(P0.05),而幅值差异无统计学意义(P＞0.05)。在强度降低20 dB SPL级差时,主波中潜伏期的平均延长值表现为V、A, C、O波接近,而D、E、F波接近。不同强度下, V-A-C波潜伏期之间、D-E波潜伏期、E-F波潜伏期的相关性均有统计学意义,且相关系数大于0.40,其中V-A波潜伏期的相关系数大于0.80。强度降低时,潜伏期间的相关性有统计学意义的主波逐渐增多。 结论 1、speech-ABR由一系列主波组成,可分为起始部分(包括V波和A波)、过渡部分(C波)、频率跟随部分(D-E-F波)和终止部分(O波),其成分主要来源于脑干。 2、speech-ABR主要成分关联密切,类似于听性脑干诱发电位中短声诱发的Ⅰ-Ⅴ波、SN10及低频声诱发的FFR的结合,较好地反应了刺激言语的声学信息。 3、双耳记录的speech-ABR的潜伏期、幅值以及F0、F1的幅值均无显著差异,可能因为speech-ABR在脑干的来源和分布无明显偏向性,与大脑半球言语功能的不对称性无明显对应性。 4、右耳记录的反应波形评分高于左耳记录,可能与左半球的语言优势有关,但听觉传导通路、脑干的what-where通路及大脑半球言语功能的不对称性之间并非简单的对应关系。 5、刺激言语强度对speech-ABR的影响符合听觉诱发电位的一般生理特性,随着强度的降低,各主波的潜伏期逐渐延长,差异有统计学意义；而幅值差异无统计学意义。 6、不同刺激强度下speech-ABR反应起始部分与频率跟随部分的潜伏期及其显著相关性的不同变化特点支持两者的来源具有不同的神经机制。 7、speech-ABR是研究人类听觉诱发电位的一种新手段,提供了良好的言语感知机制基础及临床研究的客观方法。本实验较好地对正常成人的speech-ABR进行了记录及分析,建立了speech-ABR的记录规范及分析方法,测试了正常参考值,初步探讨了speech-ABR的神经机制及应用价值,为speech-ABR在言语感知机制基础及临床研究中的应用奠定了一定的基础。
[Abstract]:objective
1. To investigate the electrophysiological characteristics of speech evoked auditory brainstem response (speech-ABR) and its relationship with evoked speech acoustic characteristics in normal adults, and to compare and analyze the differences between click evoked auditory brainstem response (click-ABR).
2. To compare the differences of speech-ABR recorded in left and right ears of normal adults in time domain and frequency domain, and to explore the differences of speech information encoded by brain stem from binaural sources and their possible causes.
3. To investigate the effect of speech intensity on the electrophysiological characteristics of speech-ABR in normal adults and its significance in encoding speech information by brain stem neurons.
4. To explore the neural mechanism of speech-ABR production and coding and its application value in the study of speech perception mechanism, to establish normal adult speech-ABR recording standards and analysis methods, and to obtain normal reference values of speech-ABR parameters, so as to provide objective methods for the basic and clinical research of speech perception mechanism, and to provide follow-up speech-related diseases. Foundation and clinical research, and lay the foundation for the development of professional application software.
Method
The auditory brainstem responses induced by short and synthetic speech sounds were recorded at 80 dB SPL intensity in 31 normal adults. The time domain and frequency domain parameters of Da and speech-ABR were calculated, and the relationship between them was analyzed. The Pearson correlation coefficients were obtained for those with normal distribution and Spearman correlation coefficients for those without normal distribution. There was no significant difference in the occurrence rates of the third and first waves induced by two stimuli in paired_2 test (McNmar test), and there was no significant difference between click-ABR and speech-ABR by paired t test. Speech-ABR test was performed in 31 normal adults with 80 dB SPL synthetic speech DA as stimulus. The latency, amplitude and waveform score of the response were analyzed. Fast Fourier transform (FFT) was used to calculate the fundamental frequency and the order of the response from 20 to 50 ms. Paired t test was used to compare the latency, amplitude, waveform score, F0 amplitude and F1 amplitude of the main waves of speech-ABR. Speech-ABR test was performed in 32 normal adults with different intensity (80 dB, 60 dB, 40 dB, and 20 dB SPL) of synthetic speech da. The correlation between the latency, amplitude and latency of the main wave of each intensity speech-ABR was analyzed by descriptive statistics; the difference of the latency and amplitude of the main wave of each intensity was tested by one-way ANOVA to see whether the difference of the latency and amplitude of the main wave of each intensity was statistically significant. When the homogeneity test of variance suggested that the variance was not uniform, the Brown-Forsythe method was used. The results showed that the Pearson correlation coefficients were obtained for those with normal distribution and Spearman correlation coefficients for those without normal distribution. Statistical processing, hypothesis test level a=0.05.
Result
The normal adult speech-ABR consists of a series of main waves, which can be divided into the initial part (including V wave and A wave), the transitional part (C wave), the frequency following part (D-E-F wave) and the terminal part (O wave). The latency of each main wave is within 12 ms after the corresponding stimulus event. The latency of A wave is significantly correlated with the latency of V, C, D, E and F wave respectively (P 0.05). Compared with click-ABR, the latency of wave V and wave III of speech-ABR was significantly delayed (P 0.01), and the occurrence rate of wave III was significantly decreased (P = 0.003), while the latency and occurrence rate of wave I had no statistical significance (P 0.05). There was no significant difference between the two ears in the latency of the main wave of h-ABR; there was no significant difference in amplitude between the two ears except A wave and O wave; the wave score of the right ear was higher than that of the left ear, and the difference was significant (P 0.05). There was no significant difference between the two ears (P 0.05). With the decrease of speech intensity, the latency of each main wave was gradually prolonged, and the latency was statistically significant (P 0.05), but the amplitude was not statistically significant (P > 0.05). When the intensity was reduced by 20 dB SPL, the average latency of the main wave was prolonged. The correlation coefficients between V-A-C wave latency, D-E wave latency and E-F wave latency were statistically significant, and the correlation coefficients were greater than 0.40. The correlation coefficients of V-A wave latency were greater than 0.80.
conclusion
1. Speech-ABR consists of a series of main waves, which can be divided into the initial part (including V-wave and A-wave), the transitional part (C-wave), the frequency-following part (D-E-F wave) and the terminal part (O wave). The main components of speech-ABR come from the brain stem.
2. The main components of speech-ABR are closely related, similar to the combination of short-tone-evoked I-V waves, SN10 and low-frequency-evoked FFR in auditory brainstem evoked potentials, which better reflect the acoustic information of speech stimulation.
3. The latency, amplitude and F0, F1 amplitudes of speech-ABR recorded by binaural recording were not significantly different, possibly because the source and distribution of speech-ABR in the brain stem were not biased, and there was no obvious correspondence with the asymmetry of speech function in the cerebral hemisphere.
4. The response waveform score recorded in the right ear is higher than that recorded in the left ear, which may be related to the linguistic superiority of the left hemisphere, but there is not a simple correspondence between the auditory conduction pathway, what-where pathway in the brainstem and the asymmetry of speech function in the cerebral hemisphere.
5. The effect of speech intensity on speech-ABR conforms to the general physiological characteristics of auditory evoked potentials. With the decrease of speech intensity, the latency of each main wave gradually prolongs, and the difference is statistically significant.
6. The latency and significant correlation between the initial part of speech-ABR response and the frequency-following part of speech-ABR response under different stimulus intensities support that the two sources have different neural mechanisms.
7. Speech-ABR is a new method to study human auditory evoked potentials, which provides a good foundation for speech perception mechanism and an objective method for clinical research. The neural mechanism and application value of peech-ABR lay a foundation for the application of speech-ABR in the basic mechanism of speech perception and clinical research.
【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】：R764
[Abstract]:objective
1. To investigate the electrophysiological characteristics of speech evoked auditory brainstem response (speech-ABR) and its relationship with evoked speech acoustic characteristics in normal adults, and to compare and analyze the differences between click evoked auditory brainstem response (click-ABR).
2. To compare the differences of speech-ABR recorded in left and right ears of normal adults in time domain and frequency domain, and to explore the differences of speech information encoded by brain stem from binaural sources and their possible causes.
3. To investigate the effect of speech intensity on the electrophysiological characteristics of speech-ABR in normal adults and its significance in encoding speech information by brain stem neurons.
4. To explore the neural mechanism of speech-ABR production and coding and its application value in the study of speech perception mechanism, to establish normal adult speech-ABR recording standards and analysis methods, and to obtain normal reference values of speech-ABR parameters, so as to provide objective methods for the basic and clinical research of speech perception mechanism, and to provide follow-up speech-related diseases. Foundation and clinical research, and lay the foundation for the development of professional application software.
Method
The auditory brainstem responses induced by short and synthetic speech sounds were recorded at 80 dB SPL intensity in 31 normal adults. The time domain and frequency domain parameters of Da and speech-ABR were calculated, and the relationship between them was analyzed. The Pearson correlation coefficients were obtained for those with normal distribution and Spearman correlation coefficients for those without normal distribution. There was no significant difference in the occurrence rates of the third and first waves induced by two stimuli in paired_2 test (McNmar test), and there was no significant difference between click-ABR and speech-ABR by paired t test. Speech-ABR test was performed in 31 normal adults with 80 dB SPL synthetic speech DA as stimulus. The latency, amplitude and waveform score of the response were analyzed. Fast Fourier transform (FFT) was used to calculate the fundamental frequency and the order of the response from 20 to 50 ms. Paired t test was used to compare the latency, amplitude, waveform score, F0 amplitude and F1 amplitude of the main waves of speech-ABR. Speech-ABR test was performed in 32 normal adults with different intensity (80 dB, 60 dB, 40 dB, and 20 dB SPL) of synthetic speech da. The correlation between the latency, amplitude and latency of the main wave of each intensity speech-ABR was analyzed by descriptive statistics; the difference of the latency and amplitude of the main wave of each intensity was tested by one-way ANOVA to see whether the difference of the latency and amplitude of the main wave of each intensity was statistically significant. When the homogeneity test of variance suggested that the variance was not uniform, the Brown-Forsythe method was used. The results showed that the Pearson correlation coefficients were obtained for those with normal distribution and Spearman correlation coefficients for those without normal distribution. Statistical processing, hypothesis test level a=0.05.
Result
The normal adult speech-ABR consists of a series of main waves, which can be divided into the initial part (including V wave and A wave), the transitional part (C wave), the frequency following part (D-E-F wave) and the terminal part (O wave). The latency of each main wave is within 12 ms after the corresponding stimulus event. The latency of A wave is significantly correlated with the latency of V, C, D, E and F wave respectively (P 0.05). Compared with click-ABR, the latency of wave V and wave III of speech-ABR was significantly delayed (P 0.01), and the occurrence rate of wave III was significantly decreased (P = 0.003), while the latency and occurrence rate of wave I had no statistical significance (P 0.05). There was no significant difference between the two ears in the latency of the main wave of h-ABR; there was no significant difference in amplitude between the two ears except A wave and O wave; the wave score of the right ear was higher than that of the left ear, and the difference was significant (P 0.05). There was no significant difference between the two ears (P 0.05). With the decrease of speech intensity, the latency of each main wave was gradually prolonged, and the latency was statistically significant (P 0.05), but the amplitude was not statistically significant (P > 0.05). When the intensity was reduced by 20 dB SPL, the average latency of the main wave was prolonged. The correlation coefficients between V-A-C wave latency, D-E wave latency and E-F wave latency were statistically significant, and the correlation coefficients were greater than 0.40. The correlation coefficients of V-A wave latency were greater than 0.80.
conclusion
1. Speech-ABR consists of a series of main waves, which can be divided into the initial part (including V-wave and A-wave), the transitional part (C-wave), the frequency-following part (D-E-F wave) and the terminal part (O wave). The main components of speech-ABR come from the brain stem.
2. The main components of speech-ABR are closely related, similar to the combination of short-tone-evoked I-V waves, SN10 and low-frequency-evoked FFR in auditory brainstem evoked potentials, which better reflect the acoustic information of speech stimulation.
3. The latency, amplitude and F0, F1 amplitudes of speech-ABR recorded by binaural recording were not significantly different, possibly because the source and distribution of speech-ABR in the brain stem were not biased, and there was no obvious correspondence with the asymmetry of speech function in the cerebral hemisphere.
4. The response waveform score recorded in the right ear is higher than that recorded in the left ear, which may be related to the linguistic superiority of the left hemisphere, but there is not a simple correspondence between the auditory conduction pathway, what-where pathway in the brainstem and the asymmetry of speech function in the cerebral hemisphere.
5. The effect of speech intensity on speech-ABR conforms to the general physiological characteristics of auditory evoked potentials. With the decrease of speech intensity, the latency of each main wave gradually prolongs, and the difference is statistically significant.
6. The latency and significant correlation between the initial part of speech-ABR response and the frequency-following part of speech-ABR response under different stimulus intensities support that the two sources have different neural mechanisms.
7. Speech-ABR is a new method to study human auditory evoked potentials, which provides a good foundation for speech perception mechanism and an objective method for clinical research. The neural mechanism and application value of peech-ABR lay a foundation for the application of speech-ABR in the basic mechanism of speech perception and clinical research.
【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】：R764
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