正常成人言語誘發(fā)聽性腦干反應(yīng)的臨床研究
發(fā)布時間：2018-08-30 11:18
【摘要】： 目的 1、探討正常成人言語誘發(fā)聽性腦干反應(yīng)(speech evoked auditory brainstem response, speech-ABR)的電生理特性及其與誘發(fā)言語聲學(xué)特性的關(guān)系,并比較和分析與短聲誘發(fā)聽性腦干反應(yīng)(click evoked auditory brainstem response, click-ABR)的差異。 2、比較正常成人左、右耳記錄的speech-ABR在時域及頻域上的差異,探討腦干編碼雙耳來源的言語信息的差異及其可能原因。 3、探討言語強度對正常成人speech-ABR電生理特性的影響及其在腦干神經(jīng)元編碼言語信息中的意義。 4、探討speech-ABR產(chǎn)生和編碼的神經(jīng)機制及其在研究言語感知機制中的應(yīng)用價值,建立正常成人speech-ABR的記錄規(guī)范和分析方法,獲取speech-ABR參數(shù)的正常參考值,從而為言語感知機制的基礎(chǔ)及臨床研究提供客觀方法,為后續(xù)言語相關(guān)疾病的基礎(chǔ)及臨床研究、專業(yè)應(yīng)用軟件的開發(fā)奠定基礎(chǔ)。 方法 記錄80dB SPL強度下正常成人右耳(31例)短聲及合成言語聲da誘發(fā)的聽性腦干反應(yīng),計算da和speech-ABR的時域及頻域參數(shù),分析兩者的關(guān)系,同時比較speech-ABR與click-ABR的差異。click-ABR及speech-ABR各目標(biāo)波的潛伏期及出現(xiàn)率進行描述性統(tǒng)計分析；speech-ABR各主波潛伏期之間進行雙變量相關(guān)分析,符合正態(tài)分布者求Pearson相關(guān)系數(shù),不符合正態(tài)分布者求Spearman相關(guān)系數(shù)；配對χ2檢驗(McNmar Test)兩種刺激誘發(fā)的Ⅲ及Ⅰ波出現(xiàn)率的差異有無統(tǒng)計學(xué)意義,配對t檢驗click-ABR與speech-ABR的Ⅴ波、Ⅲ波及Ⅰ波潛伏期差異是否具有統(tǒng)計學(xué)意義。采用80dB SPL的合成言語聲da為刺激對正常成人(31例)進行雙耳同側(cè)記錄的speech-ABR測試,分析反應(yīng)的潛伏期、幅值及波形評分；并對反應(yīng)20～50 ms部分進行快速傅立葉變換,計算基頻及第一共振峰的幅值。采用配對t檢驗比較speech-ABR各主波的潛伏期、幅值、波形評分、F0幅值及F1幅值的雙耳差異是否具有統(tǒng)計學(xué)意義。采用不同強度(80dB、60dB、40dB、和20dB SPL)的合成言語聲da為刺激對正常成人(32例)進行speech-ABR測試,分析speech-ABR的潛伏期、幅值及潛伏期的相關(guān)性。各強度speech-ABR的主波潛伏期、幅值及潛伏期差值進行描述性統(tǒng)計分析；采用one-way ANOVA檢驗各強度的主波潛伏期及波幅的差異是否具有統(tǒng)計學(xué)意義,方差齊性檢驗提示方差不齊時,用Brown-Forsythe法分析；有統(tǒng)計學(xué)差異者進一步多重比較,方差齊者用LSD法,方差不齊者用Dunnett's T3法；各強度主波的潛伏期之間進行雙變量相關(guān)分析,符合正態(tài)分布者求Pearson相關(guān)系數(shù),不符合正態(tài)分布者求Spearman相關(guān)系數(shù)。研究結(jié)果采用SPSS13.0統(tǒng)計軟件進行統(tǒng)計處理,假設(shè)檢驗水準(zhǔn)a=0.05。 結(jié)果 正常成人speech-ABR由一系列主波組成,可分為起始部分(包括Ⅴ波和A波)、過渡部分(C波)、頻率跟隨部分(D-E-F波)和終止部分(O波),各主波的潛伏期均在相應(yīng)刺激事件發(fā)生后的12 ms內(nèi)。A波潛伏期分別與V、C、D、E及F波潛伏期有顯著相關(guān)性(P0.05),其中與Ⅴ波潛伏期的相關(guān)性最強(r=0.824,P=0.000)；D、E及F波潛伏期相互間顯著相關(guān)(P0.01)。與click-ABR相比,speech-ABR的Ⅴ波和Ⅲ波潛伏期顯著延遲(P0.01),Ⅲ波出現(xiàn)率顯著降低(P=0.003),而Ⅰ波潛伏期的延遲和出現(xiàn)率的降低無統(tǒng)計學(xué)意義(P0.05)。speech-ABR主波潛伏期的雙耳差異無統(tǒng)計學(xué)意義；幅值除A波及O波外雙耳差異亦無統(tǒng)計學(xué)意義；反應(yīng)的波形評分右耳大于左耳,差異有顯著性(P0.05)。無論記錄耳為何側(cè),基頻的幅值均大于第一共振峰的幅值,差異有顯著性；無論是基頻的幅值還是第一共振峰的幅值,雙耳差異均無統(tǒng)計學(xué)意義(P0.05)。隨著言語強度的降低,各主波的潛伏期逐漸延長,潛伏期差異有統(tǒng)計學(xué)意義(P0.05),而幅值差異無統(tǒng)計學(xué)意義(P＞0.05)。在強度降低20 dB SPL級差時,主波中潛伏期的平均延長值表現(xiàn)為V、A, C、O波接近,而D、E、F波接近。不同強度下, V-A-C波潛伏期之間、D-E波潛伏期、E-F波潛伏期的相關(guān)性均有統(tǒng)計學(xué)意義,且相關(guān)系數(shù)大于0.40,其中V-A波潛伏期的相關(guān)系數(shù)大于0.80。強度降低時,潛伏期間的相關(guān)性有統(tǒng)計學(xué)意義的主波逐漸增多。 結(jié)論 1、speech-ABR由一系列主波組成,可分為起始部分(包括V波和A波)、過渡部分(C波)、頻率跟隨部分(D-E-F波)和終止部分(O波),其成分主要來源于腦干。 2、speech-ABR主要成分關(guān)聯(lián)密切,類似于聽性腦干誘發(fā)電位中短聲誘發(fā)的Ⅰ-Ⅴ波、SN10及低頻聲誘發(fā)的FFR的結(jié)合,較好地反應(yīng)了刺激言語的聲學(xué)信息。 3、雙耳記錄的speech-ABR的潛伏期、幅值以及F0、F1的幅值均無顯著差異,可能因為speech-ABR在腦干的來源和分布無明顯偏向性,與大腦半球言語功能的不對稱性無明顯對應(yīng)性。 4、右耳記錄的反應(yīng)波形評分高于左耳記錄,可能與左半球的語言優(yōu)勢有關(guān),但聽覺傳導(dǎo)通路、腦干的what-where通路及大腦半球言語功能的不對稱性之間并非簡單的對應(yīng)關(guān)系。 5、刺激言語強度對speech-ABR的影響符合聽覺誘發(fā)電位的一般生理特性,隨著強度的降低,各主波的潛伏期逐漸延長,差異有統(tǒng)計學(xué)意義；而幅值差異無統(tǒng)計學(xué)意義。 6、不同刺激強度下speech-ABR反應(yīng)起始部分與頻率跟隨部分的潛伏期及其顯著相關(guān)性的不同變化特點支持兩者的來源具有不同的神經(jīng)機制。 7、speech-ABR是研究人類聽覺誘發(fā)電位的一種新手段,提供了良好的言語感知機制基礎(chǔ)及臨床研究的客觀方法。本實驗較好地對正常成人的speech-ABR進行了記錄及分析,建立了speech-ABR的記錄規(guī)范及分析方法,測試了正常參考值,初步探討了speech-ABR的神經(jīng)機制及應(yīng)用價值,為speech-ABR在言語感知機制基礎(chǔ)及臨床研究中的應(yīng)用奠定了一定的基礎(chǔ)。
[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.
【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】：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.
【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】：R764
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