健康更年期后女性的脑干言语编码能力分析

The Analyses of Auditory Brainstem Pathway Encoding of Speech Sounds in Healthy Post-Menopause Women

付欣;刘锦峰;王宁宇;李金兰;温晓慧;李晓婷;王彦君;

1:首都医科大学附属北京朝阳医院耳鼻咽喉头颈外科首都医科大学耳鼻咽喉科学院耳鼻咽喉头颈科学教育部重点实验室(首都医科大学)

摘要
目的分析更年期后女性的言语诱发听性脑干反应(speech-ABR)特征,探讨更年期对女性脑干言语处理能力的影响。方法对纯音听阈、声导抗、短声听性脑干反应(click-ABR)测试结果均正常的20例更年期后女性(5060岁)及27例青年女性(2160岁)及27例青年女性(2128岁)行speech-ABR测试。刺激声为/da/音,采用插入式耳机,右耳给声。结果 1更年期后女性与青年女性speech-ABR波形均由瞬态反应(V、A和O波)、过渡部分C波以及周期性反应(D、E、F波)构成。2除C波不稳定外,更年期后女性speech-ABR瞬态成分V波(6.99±0.34ms)、A波(8.32±0.49ms)及O波(48.86±0.50ms)的潜伏期较青年女性(V波6.60±0.25ms、A波7.56±0.31ms、O波47.88±0.31ms)明显延长(均为P<0.05);除V波幅值无显著差异外,更年期后女性的A波(-0.16±0.06μV)和O波(-0.12±0.06μV)幅值(绝对值)也明显低于青年女性(A波-0.27±0.08μV、O波-0.18±0.07μV),差异均有统计学意义(均为P<0.05)。3更年期后女性周期成分D波(23.27±0.67ms)、E波(31.88±0.58ms)、F波(40.61±1.22ms)的潜伏期均较青年女性(D波22.40±0.44ms、E波31.00±0.43 ms、F波39.53±0.61ms)显著延长(均为P<0.05),除E波幅值差异无统计学意义(P>0.05)外,更年期女性D波(-0.12±0.04μV)和F波(-0.08±0.06μV)幅值(绝对值)明显低于青年女性(D波-0.17±0.08μV、F波-0.16±0.07μV)(均为P<0.05)。4青年女性的V/A斜率明显大于更年期女性(P<0.05)。结论更年期后女性听性脑干反应对言语信号编码的同步性及锁相能力均降低,提示生殖激素降低和年龄增加会降低女性脑干的言语处理能力。
关键词
言语;听性脑干反应;更年期后;生殖激素
基金项目(Foundation):
首都医科大学耳鼻咽喉头颈外科教育部重点实验室开放课题基金(2012EBYH02);; 国家自然科学基金(81271090/H1304);; 北京市科委计划项目(Z131100004013049);; 首都卫生发展科研专项(首发2011-2003-02)联合资助
作者
付欣;刘锦峰;王宁宇;李金兰;温晓慧;李晓婷;王彦君;
参考文献

1 Hederstierna C,HuItcrantz M,Rosenhall U.Estrogen and hearing from a clinical point of view;characteristics of auditory function in women with Turner syndrome[J].Hear Res,2009,252:3.

2 Tandon OP,Khaliq F,Goel N.Auditory evoked potential responses in menopausal women:a normative study[J].Indian J Physiol Pharmacol,2001,45:361.

3 Anderson S,White-Schwoch T,Parbery-Clark A,et al.Reversal of age-related neural timing delays with training[J].Proc Natl Acad Sci USA,2013,110:4357.

4 White-Schwoch T,Woodruff Carr K,Anderson S,et al.Older adults benefit from music training early in life:biological evidence for long-term training-driven plasticity[J].J Neurosci,2013,33:17667.

5 Al-Mana D1,Ceranic B,Djahanbakhch O,et al.Hormones and the auditory system:a review of physiology and pathophysiology[J].Neuroscience,2008,153:881.

6 Wallentin M.Putative sex differences in verbal abilities and language cortex:a critical review[J].Brain Lang,2009,108:175.

7 Chandrasekaran B,Kraus N.The scalp-recorded brainstem response to speech:neural origins and plasticity[J].Psychophysiology,2010,47:236.

8 Wible B,Nicol T,Kraus N.Atypical brainstem representation of onset and formant structure of speech sounds in children with language-based learning problems[J].Biol Psychol,2004,67:299.

9 刘锦峰,王宁宇,付欣,等.学龄儿童与青年人言语诱发听性脑干反应的比较[J].中华耳鼻咽喉头颈外科杂志,2012,47:646.

10 Johnson KL,Nicol T,Zecker SG,et al.Developmental plasticity in the human auditory brainstem[J].J Neurosci,2008,28:4000.

11 Skoe E,Kraus N.Auditory brainstem response to complex sounds a tutorial[J].Ear Hear,2010,31:302.

12 Johnson KL,Nicol TG,Kraus N.The brainstem response to speech:a biological marker of auditory processing[J].Ear Hear,2005,26:424.

13 Akhoun I,Gallégo S,Moulin A,et al.The temporal relationship between speech auditory brainstem responses and the acoustic pattern of the phoneme/ba/in normal-hearing adults[J].Clin Neurophysiol,2008,119:922.

14 Johnson KL,Nicol TG,Zecker SG,et al.Auditory brainstem correlates of perceptual timing deficits[J].J Cogn Neurosci,2007,19:376.

15 Vander Werff KR,Burns KS.Brain stem responses to speech in younger and older adults[J].Ear Hear,2011,32:168.

16 Canlon B,Frisina RD.Sex hormones and hearing:apioneering area of enquiry[J].Hear Res,2009,252:1.

17 刘锦峰,王宁宇,温晓慧,等.新生儿与成人瞬态诱发耳声发射性别差异的比较[J].听力学及言语疾病杂志,2012,20:429.

18 刘锦峰,李晓婷,王宁宇.脑干及外周听觉结构与功能的性别差异[J].听力学及言语疾病杂志,2014,22:100.

19 Krizman J,Skoe E,Kraus N.Sex differences in auditory subcortical function[J].Clinical Neurophysiology,2012,123:590.

20 Smith MJ,Adams LF,Schmidt PJ,et al.Effects of ovarian hormones on human cortical excitability[J].Ann Neurol,2002,51:599.

21 刘锦峰,张宏煜,王宁宇.雌、孕激素对女性听觉功能的影响[J].国际耳鼻咽喉头颈外科杂志,2011,35:195.

22 Smith MJ,Adams LF,Schmidt PJ,et al.Effects of ovarian hormones on human cortical excitability[J].Ann Neurol,2002,51:599.

23 Serra A,Maiolino L,Agnello C,et al.Auditory brain stem response throughout the menstrual cycle[J].Ann Otol Rhinol Laryngol,2003,112:549.

24 Parbery-Clark A,Anderson S,Hittner E,et al.Musical experience offsets age-related delays in neural timing[J].Neurobiol Aging,2012,33:1483.