本文選題：老年性聾 + 言語��； 參考：《福建醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的利用血氧水平依賴的功能磁共振成像技術(shù)(blood oxygenatin level dependent-functional magneticresonance imaging，BOLD-fMRI)，分析正常聽力青年人、正常聽力老年人和老年性聾患者行聽覺性言語刺激時大腦腦區(qū)的激活情況，研究衰老、耳聾對大腦聽覺中樞功能重組的影響，以及半球優(yōu)勢的變化。 方法18例健康青年志愿者（青年組）、10例正常聽力老年人（老年組）及10例老年性聾患者（老年聾組），分別行聽覺任務(wù)的BOLD-fMRI檢查。采用組塊設(shè)計方法，給予頻率為1kHz，聲強(qiáng)為90dB±3dB（經(jīng)過環(huán)境噪音檢測儀Smart Sensor AR844測量并校準(zhǔn)后）單音節(jié)言語刺激聲，左右耳分別隨機(jī)給聲，每種刺激重復(fù)2次。所有數(shù)據(jù)均經(jīng)統(tǒng)計參數(shù)圖(statistical parametric mapping5，SPM5)軟件離線后處理，獲得解剖功能圖、分析感興趣激活腦區(qū)的體積、信號強(qiáng)度，并計算偏側(cè)化指數(shù)。 結(jié)果三組受試者行聽覺性言語刺激時明顯激活的腦區(qū)基本一致，以顳上回、顳中回的激活最明顯,以聽皮層為感興趣腦區(qū)（region of interest，ROI）。 激活體積：兩老年組與青年人相比，左耳刺激時，左側(cè)ROI激活體積增加（P〈0.05），右側(cè)ROI激活體積明顯減少（P〈0.05）；右耳刺激時，兩側(cè)ROI激活體積均減少（P〈0.05）。老年聾組與老年組比較，無論是左耳還是右耳刺激，雙側(cè)ROI激活體積均有所減少，但差異無統(tǒng)計學(xué)意義。 激活強(qiáng)度：左耳刺激時，不同組間雙側(cè)ROI的激活強(qiáng)度均無明顯差異；右耳刺激時，老年組較老年聾組與青年組均增強(qiáng)（P〈0.05），，老年性聾組較青年組稍減弱，差異無統(tǒng)計學(xué)意義。 青年組單耳刺激時，刺激耳對側(cè)ROI的激活體積與強(qiáng)度較刺激耳同側(cè)均明顯增加，表現(xiàn)為對側(cè)半球優(yōu)勢，偏側(cè)化指數(shù)分別為-0.58（左耳刺激）、0.37（右耳刺激）。老年組與老年聾組單耳刺激時對側(cè)半球傳導(dǎo)優(yōu)勢較青年組明顯減弱，偏側(cè)化指數(shù)分別為-0.24、0.28（老年組），-0.18、0.25（老年聾組）。 青年組左、右耳分別行聽覺任務(wù)時，雙側(cè)ROI激活總體積之比分別為1:2.06，表現(xiàn)為右耳優(yōu)勢（左腦優(yōu)勢）；老年組、老年聾組總體積之比分別為1:1.51、1:1.61，表現(xiàn)為右耳優(yōu)勢減弱（左耳優(yōu)勢增強(qiáng)）。 結(jié)論聽覺性言語任務(wù)激活腦區(qū)以顳上回、顳中回激活最明顯。隨著年齡的增長，這些腦區(qū)激活的幅度減弱，出現(xiàn)對側(cè)半球傳導(dǎo)優(yōu)勢及右耳優(yōu)勢減弱的趨勢。因而衰老與耳聾后皮層發(fā)生了功能重組，這可能就是言語識別下降的原因之一。
[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 鹵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 鹵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.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R764.436

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