本文選題：聽覺誘發(fā)電位 + 言語誘發(fā)聽覺腦干反應(yīng)　； 參考：《南方醫(yī)科大學(xué)》2010年碩士論文

【摘要】：背景和目的 短聲和純音等簡單聲音誘發(fā)的短潛伏期聽覺誘發(fā)電位,如聽性腦干誘發(fā)反應(yīng),因其具有波形穩(wěn)定、重復(fù)性高、不易受覺醒狀態(tài)和麻醉影響等優(yōu)點,已廣泛應(yīng)用于臨床,為聽力學(xué)、神經(jīng)耳科學(xué)疾病的定位診斷提供了簡便安全的技術(shù)手段。通過對短潛伏期聽覺誘發(fā)電位的研究,人們對于短聲、純音等簡單聲音的聽覺處理機制已有一定認識,但對聽覺處理言語等復(fù)合聲音的認識尚十分有限。因此,聽覺系統(tǒng)處理言語的神經(jīng)基礎(chǔ)及機制一直是國內(nèi)外廣大學(xué)者致力研究的熱點。 腦干神經(jīng)元放電模式與言語聲學(xué)特征具有高度相關(guān)性,提示腦干是言語處理的重要部位,記錄這些電位變化可發(fā)現(xiàn)聽覺言語處理的機制,從而使聽性腦干誘發(fā)反應(yīng)記錄技術(shù)成為了言語感知基礎(chǔ)及臨床研究的重要工具。目前言語誘發(fā)腦干反應(yīng)(Speech-ABR)的研究以美國西北大學(xué)Kraus教授主持的研究小組報告最多,該小組以學(xué)習(xí)障礙(learning problem,LP)兒童為研究對象,采用合成單音節(jié)/da/誘發(fā)出由起始部分(正性V波和負性A波)和頻率跟隨部分(負性C波、D波、E波和F波)組成的Speech-ABR。他們發(fā)現(xiàn)Speech-ABR中各波形成與刺激聲有高度的相關(guān)性,并且LP兒童因聽覺系統(tǒng)異常導(dǎo)致的語言障礙能為Speech-ABR所反映出來。Speech-ABR是對言語障礙人群進行篩選、診斷及療效觀察的良好工具,可較早地覺察聽覺信息處理能力低下的情況,并進行針對治療,具有重要的預(yù)防價值。目前對Speech-ABR的研究仍處于起步階段,研究主要集中于反應(yīng)中各主波與刺激間關(guān)系的研究,有關(guān)反應(yīng)穩(wěn)定性的報道極少。然而,反應(yīng)主波的潛伏期和波幅是聽覺誘發(fā)電位常用的臨床指標,測量結(jié)果是否穩(wěn)定具有重要的臨床意義。目前國內(nèi)尚缺少Speech-ABR測試穩(wěn)定性的系統(tǒng)研究,因此本文主要工作是對中國正常青年人Speech-ABR測試的穩(wěn)定性進行初步研究。 方法 本文采用兩次橫斷面研究,以南方醫(yī)科大學(xué)在讀學(xué)生為受試者,測量和評價言語誘發(fā)腦干反應(yīng)主波的穩(wěn)定性。研究對象共40人,其中男性20例,女性20例,年齡19-26歲,均為右利手,無聽覺系統(tǒng)、神經(jīng)系統(tǒng)疾病及精神障礙病史,短聲誘發(fā)聽覺腦干反應(yīng)(Click-ABR)正常。受試者隨機分為兩組,每組各20人。兩組受試者的測試時間間隔2個月。以聲音/da/作為刺激,對每個受試者分別測試其右耳常規(guī)Click-ABR和Speech-ABR,其中Click-ABR記錄一組(播放1024個刺激),Speech-ABR記錄三組(每組播放1024個刺激),且要求每組記錄參加平均的反應(yīng)個數(shù)不少于1000個。測試時每組實驗間隔1分鐘。分析每個受試者的3組反應(yīng)、3組反應(yīng)的平均波形以及每組測試者所有反應(yīng)平均后的總體波形。平均波形通過Matlab讀取每個測試者的3組反應(yīng)后作平均處理得到；總體波形通過Matlab讀取每組20名測試者的60個反應(yīng)后作平均處理得到。根據(jù)前期工作中制定的主波判定準則判定Speech-ABR中的各主波,并通過Matlab-軟件編程以讀取各主波的潛伏期及幅值數(shù)值,并分別統(tǒng)計兩組受試者中各主波被成功引出的次數(shù)。 結(jié)果 Speech-ABR的FFR部分與刺激/da/的準周期性波表現(xiàn)出高度的相關(guān)性,認為Speech-ABR中D-E-F組成的周期波為/da/中的準周期性波所誘發(fā),且包含了基頻及共振峰等信息,反映了Speech-ABR對/da/的鎖相特性。而V、A、C及O波為言語刺激中的瞬態(tài)性事件所誘發(fā)。單次記錄的Speech-ABR波形雖含有較多的噪聲狀雜波,波形較不穩(wěn)定,但經(jīng)平均后雜波大大減少。單次記錄反應(yīng)和單個受試者總體平均反應(yīng)都包含了V-O波中的多個或全部主波,且兩組受試者總體平均波形中各主波的潛伏期和幅值相差很小,無統(tǒng)計學(xué)差異(p0.1),表明Speech-ABR記錄是相對穩(wěn)定的,分析時應(yīng)以總體平均反應(yīng)為重點。所有主波中,以V、A、C和F波的引出率最高(40%-60%),D、E和O波的引出率較低(20%-30%),且瞬態(tài)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。 結(jié)論 Speech-ABR中的D、E和F波與/da/中的d、e和f波有鎖相關(guān)系,表明Speech-ABR很好地反映了刺激言語/da/的聲學(xué)信息。單次Speech-ABR、單個受試者三次Speech-ABR的平均反應(yīng)和每組受試者的Speech-ABR總體平均反應(yīng),都表現(xiàn)出很高的相似性,表明Speech-ABR記錄具有較高的穩(wěn)定性。組1和組2總體平均波形中主波的潛伏期和幅值無統(tǒng)計學(xué)差異,表明在一定時間范圍內(nèi)Speech-ABR測試具有很好的重復(fù)性。V、A、C和F波在一次實驗中的引出率較高,表明它們比其它主波更穩(wěn)定,可作為主要分析對象。綜上,Speech-ABR的測試結(jié)果具有較好的穩(wěn)定性和重復(fù)性,其V、A、C和F波可作為臨床觀測的重要指標,是言語感知機制的基礎(chǔ)及臨床研究的良好工具。
[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.

【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R338

【共引文獻】

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