老年人中枢听觉系统的弥散张量成像研究  

Diffusion tensor imaging of the central auditory system in the elderly

作　　者：彭璐[1] 余水莲[2] 景艳[1] 陈睿春[1] 梁建平[1] 

机构地区：[1]广西壮族自治区人民医院耳鼻咽喉-头颈外科,南宁530021 [2]广西壮族自治区人民医院磁共振室

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第8期637-640,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：广西壮族自治区卫生厅自筹经费科研课题(No:Z2014628)

摘　　要：目的:结合听性脑干反应(ABR)及弥散张量成像技术对老年性聋患者中枢听觉系统进行分析,探讨老年性聋中枢听觉系统的微观结构改变。方法:选择老年性聋患者25例(老年性聋组)、老年听力正常者8例(老年听力正常组)及听力正常健康青年人15例(对照组),应用ABR检测高声强刺激后双耳Ⅰ、Ⅲ、Ⅴ波潜伏期及Ⅰ-Ⅴ波间期,比较三组之间ABR的各波潜伏期及Ⅰ-Ⅴ波间期的差异。用弥散张量成像技术检测三组左右侧下丘及颞横回的各向异性分数(FA)值,比较下丘及颞横回左右侧FA值的差异及三组之间下丘及颞横回FA值的差异。结果:老年性聋组、老年听力正常组及对照组组内比较显示,左侧颞横回FA值与右侧有明显差异(P<0.05),左右两侧ABR各波潜伏期、波间期及下丘FA值差异无统计学意义(P>0.05)。三组组间比较显示,老年听力正常组和老年性聋组ABRⅠ、Ⅲ、Ⅴ波潜伏期较对照组明显延迟(P<0.05),老年性聋组较老年听力正常组Ⅴ波潜伏期延长(P<0.05),三组的Ⅰ-Ⅴ波间期未见明显差异(P>0.05)。老年听力正常组和老年性聋组下丘FA值明显低于对照组(P<0.05),而老年性聋组与老年听力正常组下丘FA值差异无统计学意义(P>0.05)。老年性聋组颞横回FA值<老年听力正常组FA值<对照组FA值(P<0.05)。结论:随着年龄的增长,中枢听觉系统神经纤维存在微观结构破坏;其中听觉皮层纤维结构破坏在老年性聋中表现更明显。Objective：To evaluate the changes in the central auditory system of presbycusis by applying auditury brainstem response（ABR）and diffusion tensor imaging（DTI）.Method：A total of twenty-five elderly subjects with expressed presbycusis,eight elderly subjects with normal hearing and fifteen healthy volunteers as young controls were enrolled in the study.Each participant was examined using ABR and DTI.ABR measures were obtained from all the subjects.The fractional anisotropy（FA）was measured at two brain regions of the auditory pathway-the inferior colliculus（IC）and Heschl＇s gyrus.Result：Higher FA values were recorded at the left side of the Heschl＇s gyrus in all three groups（P〈0.05）.There were no significant differences between the left and right side of the ABR results and FA values of inferior colliculus in the three groups（P〈0.05）.Aging increased ABR peak latencies,yet did not change theⅠ-Ⅴinterpeak latency interval.Comparing with the elderly subjects with normal hearing group,the waveⅤlatencies of the presbycusis group were prolonged（P〈0.05）.Comparing with the healthy control group,the FA values of the IC were reduced in both of the elderly subjects with normal hearing group and the presbycusis group（P〈0.05）.No statistically differences were observed between the presbycusis group and the elderly subjects with normal hearing group in the FA values of the IC（P〈0.05）.Significant differences between all groups were found in the FA values of the Heschl＇s gyrus,with higher values in the elderly subjects with normal hearing group than in the presbycusis group and even higher values in the healthy control group than in the elderly subjects with normal hearing group（P〈0.05）.Conclusion：The results indicated that the age-related microstructural changes exist in the central part of the auditory system,which are more obvious in the patients with presbycusis.

关 键 词：老年性聋 听性脑干反应 弥散张量成像 听觉皮层 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]