噪声暴露致噪声下听性脑干反应潜伏期改变的听力学分析

Analysis of audiological characteristics of noise exposure on changes in the latency of ABR in noise

彭逹;毛杭泽;王翩;郑书坤;赵乌兰;邱伟

1:浙江中医药大学

2:浙江清华长三角研究院

3:State University of New York at Plattsburgh 101 Broad Street

摘要
目的 探讨噪声下听性脑干反应(auditory brainstem response, ABR)(噪声下ABR)波V随噪声变化而产生的噪声强度-潜伏期函数曲线斜率(简称迁移率)改变相关的听力学特征,为噪声性耳蜗突触病变的研究提供参考。方法 招募114例年龄18~44周岁工人为研究对象,其中噪声暴露组56例,对照组58例。进行常频和扩展高频纯音听阈测试、畸变产物耳声发射(distortion product otoacoustic emissions, DPOAE)、噪声下言语测听、言语声诱发听性脑干反应(speech-evoked ARR,s-ABR)和噪声下ABR测试,比较两组差异。结果 噪声暴露组扩展高频听阈值均显著高于对照组(P<0.05),噪声下言语测听信噪比损失显著高于对照组(P<0.05),噪声下ABR波V迁移率显著低于对照组(P<0.01)。在4、5、6、7、8、9kHz,噪声暴露组DPOAE幅值显著小于对照组(P<0.05),其余频率差异无统计学意义(P>0.05)。结论 职业噪声暴露会导致噪声下ABR的波V潜伏期迁移率降低,噪声下ABR可能可作为对耳蜗突触病有效的检测手段,联合各项测试有助于提早发现并及时干预。
关键词
耳蜗突触病;噪声下听性脑干反应;时间编码
基金项目(Foundation):
美国国立失聪和其他沟通障碍研究院项目(NIDCD/NIH、1R01DC015990);; 浙江中医药大学校级科研基金(2021ZZ05);浙江中医药大学横向课题(20181015);; 西万拓听力奖学金项目(782299A00501)
作者
彭逹;毛杭泽;王翩;郑书坤;赵乌兰;邱伟
参考文献

[1] ZHAO F,STEPHENS D.A critical review of King-Kopetzky syndrome:hearing difficulties,but normal hearing?[J].Audiological Medicine,2007,5(2):119-124.

[2] KUJAWA S G,LIBERMAN M C.Adding insult to injury:cochlear nerve degeneration after “temporary” noise-induced hearing loss[J].Journal of Neuroscience,2009,29(45):14077-14085.

[3] FURMAN A C,KUJAWA S G,LIBERMAN M C.Noise-induced cochlear neuropathy is selective for fibers with low spontaneous rates[J].Journal of Neurophysiology,2013,110(3):577-586.

[4] BRAMHALL N F,KONRAD-MARTIN D,MCMILLAN G P,et al.Auditory brainstem response altered in humans with noise exposure despite normal outer hair cell function[J].Ear and Hearing,2017,38(1):e1-e12.

[5] PRENDERGAST G,COUTH S,MILLMAN R E,et al.Effects of age and noise exposure on proxy measures of cochlear synaptopathy[J].Trends in Hearing,2019,23:2331216519877301.

[6] MEHRAEI G,HICKOX A E,BHARADWAJ H M,et al.Auditory brainstem response latency in noise as a marker of cochlear synaptopathy[J].Journal of Neuroscience,2016,36(13):3755-3764.

[7] PINSONNAULT-SKVARENINA A,SOUCY W,NOЁL J,et al.Supra-threshold deficits in normal hearing military recruits exposed to impulse noise[J].The Journal of the Acoustical Society of America,2022,152(4):2419-2433.

[8] SURESH C H,KRISHNAN A.Search for electrophysiological indices of hidden hearing loss in humans:click auditory brainstem response across sound levels and in background noise[J].Ear and Hearing,2021,42(1):53-67.

[9] SUTHAKAR K,LIBERMAN M C.Noise masking in cochlear synaptopathy:Auditory brainstem response vs.auditory nerve response in mouse[J].Journal of Neurophysiology,2022,127(6):1574-1585.

[10] DHRRUVAKUMAR S,SHAMBHU T,KONADATH S.Assessment of hidden hearing loss in individuals exposed to occupational noise using cochlear,neural,temporal functions and quality of life measures[J].Indian Journal of Otolaryngology and Head & Neck Surgery,2021:1-8.DOI:10.1007/s12070-021-02373-7

[11] MONSON B B,CARAVELLO J.The maximum audible low-pass cutoff frequency for speech[J].The Journal of the Acoustical Society of America,2019,146(6):EL496-EL501.

[12] 毛杭泽,赵乌兰,蔡国庆,等.正常听力青年人言语诱发ABR与扩展高频测听的性别与年龄差异[J].听力学及言语疾病杂志,2023,31(5):423-428.

[13] RODR??GUEZ VALIENTE A,TRINIDAD A,GARC??A BERROCAL J R,et al.Extended high-frequency (9-20 kHz) audiometry reference thresholds in 645 healthy subjects[J].International Journal of Audiology,2014,53(8):531-545.

[14] DING Y,LIU Y,LI D,et al.Correlation between pure tone audiometry at all frequencies and distortion product otoacoustic emission of patients with hidden hearing loss[J].Biotechnology and Genetic Engineering Reviews,2023:1-12.DOI:10.1080/02648725.2023.2209408

[15] 张雪颢,赵乌兰,王枫,等.不同听力检测方法对早期发现噪声性隐性听力损失的意义[J].听力学及言语疾病杂志,2020,28(3):273-276.

[16] STIEPAN S,SIEGEL J,LEE J,et al.The association between physiological noise levels and speech understanding in noise[J].Ear and Hearing,2020,41(2):461-464.

[17] SREEDHAR A,SUMESH J,RAVIKUMAR M,et al.Speech ABR findings in auto rickshaw drivers exposed to occupational noise[J].Indian Journal of Otolaryngology and Head & Neck Surgery,2022,74(Suppl 3):3987-3992.

[18] BHARADWAJ H M,MASUD S,MEHRAEI G,et al.Individual differences reveal correlates of hidden hearing deficits[J].Journal of Neuroscience,2015,35(5):2161-2172.