Effects of Signal Type and Noise Background on Auditory Evoked Potential N1, P2, and P3 Measurements in Blast-Exposed Veterans.
Effects of Signal Type and Noise Background on Auditory Evoked Potential N1, P2, and P3 Measurements in Blast-Exposed Veterans.
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DOI：
10.1097/aud.0000000000000906
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Billings CJ
中科院分区：
文献类型：
--
作者：
Papesh MA;Stefl AA;Gallun FJ;Billings CJ
暴露于高强度冲击波的退伍军人经常报告持续存在听觉困难，例如噪声中语音 (SIN) 理解问题，即使听力灵敏度保持正常。然而，事实证明这些主观报告很难得到客观证实。在这里，我们试图确定在听觉诱发电位（AEP）范式中使用复杂的刺激和具有挑战性的信号对比，而不是传统使用简单的刺激和简单的信号对比，是否可以提高这些措施的能力：（1）区分有听觉投诉的爆炸暴露退伍军人和神经系统正常的对照参与者，以及（2）预测 SIN 感知的行为测量。共有 33 名成年人（年龄 19-56 岁）参与了这项研究，其中包括 17 名在过去 10 年内暴露于高强度冲击波的退伍军人，以及 16 名神经系统正常的对照参与者，这些参与者的年龄和听力状况与退伍军人参与者相匹配。所有参与者均完成以下测试措施：（1）调查感知听力能力的问卷； (2) SIN 理解的行为测量，包括 BKB-SIN、以 0 和 +5 dB 信噪比 (SNR) 呈现的 AzBio，以及以 +5 dB SNR 呈现的单词级辅音-元音-辅音测试； (3) 电生理学任务，涉及响应简单音调（500 Hz 标准，1000 Hz 异常）和复杂语音音节（/ba/ 标准，/da/ 异常）的奇怪范式，这些音节以安静和四人语音的方式呈现，信噪比为 +5 dB。与对照组参与者相比，遭受爆炸影响的退伍军人报告了明显更大的听觉困难。在 SIN 感知测试中，各组的行为表现普遍较差，但并不显着。无论背景条件如何，受到爆炸影响的参与者对音调信号的 P3 反应潜伏期明显长于对照组参与者，尽管各组对语音信号的反应相似。对于皮质 AEP，组成员身份与刺激类型或背景之间没有发现显着的相互作用。根据背景杂音中的信号测量的 P3 幅度占主观听觉报告方差的 30.9%。行为 SIN 性能最好通过 N1 和 P2 对安静信号的响应组合来预测，这分别占 0 dB SNR 和 BKB-SIN 下 AzBio 方差的 69.6% 和 57.4%。尽管与对照组相比，遭受爆炸影响的参与者报告了更多的听觉困难，但在皮质和认知 AEP 测量中使用复杂刺激和具有挑战性的信号对比，未能揭示比对简单刺激和简单信号对比的反应更大的群体差异。尽管如此，只有 P3 对背景胡言乱语中呈现的信号的反应才能预测主观听觉投诉。相比之下，皮质 N1 和 P2 反应可以预测行为 SIN 表现，但不能预测主观听觉抱怨，并且使用具有挑战性的背景胡言乱语通常不会改善表现预测。这些结果表明，具有挑战性的刺激方案更有可能利用感知到的听觉缺陷，但可能无益于预测 SIN 理解的临床测量表现。最后，应谨慎解释这些结果，因为暴露于爆炸的参与者在 SIN 感知测试中的表现并没有明显较差。
Veterans who have been exposed to high-intensity blast waves frequently report persistent auditory difficulties such as problems with speech-in-noise (SIN) understanding, even when hearing sensitivity remains normal. However, these subjective reports have proven challenging to corroborate objectively. Here, we sought to determine whether use of complex stimuli and challenging signal contrasts in auditory evoked potential (AEP) paradigms rather than traditional use of simple stimuli and easy signal contrasts improved the ability of these measures to (1) distinguish between blast-exposed Veterans with auditory complaints and neurologically normal control participants, and (2) predict behavioral measures of SIN perception. A total of 33 adults (aged 19–56 years) took part in this study, including 17 Veterans exposed to high-intensity blast waves within the past 10 years and 16 neurologically normal control participants matched for age and hearing status with the Veteran participants. All participants completed the following test measures: (1) a questionnaire probing perceived hearing abilities; (2) behavioral measures of SIN understanding including the BKB-SIN, the AzBio presented in 0 and +5 dB signal to noise ratios (SNRs), and a word-level consonant-vowel-consonant test presented at +5 dB SNR; and (3) electrophysiological tasks involving oddball paradigms in response to simple tones (500 Hz standard, 1000 Hz deviant) and complex speech syllables (/ba/ standard, /da/ deviant) presented in quiet and in four-talker speech babble at a SNR of +5 dB. Blast-exposed Veterans reported significantly greater auditory difficulties compared to control participants. Behavioral performance on tests of SIN perception was generally, but not significantly, poorer among the groups. Latencies of P3 responses to tone signals were significantly longer among blast-exposed participants compared to control participants regardless of background condition, though responses to speech signals were similar across groups. For cortical AEPs, no significant interactions were found between group membership and either stimulus type or background. P3 amplitudes measured in response to signals in background babble accounted for 30.9% of the variance in subjective auditory reports. Behavioral SIN performance was best predicted by a combination of N1 and P2 responses to signals in quiet which accounted for 69.6% and 57.4% of the variance on the AzBio at 0 dB SNR and the BKB-SIN, respectively. Although blast-exposed participants reported far more auditory difficulties compared to controls, use of complex stimuli and challenging signal contrasts in cortical and cognitive AEP measures failed to reveal larger group differences than responses to simple stimuli and easy signal contrasts. Despite this, only P3 responses to signals presented in background babble were predictive of subjective auditory complaints. In contrast, cortical N1 and P2 responses were predictive of behavioral SIN performance but not subjective auditory complaints, and use of challenging background babble generally did not improve performance predictions. These results suggest that challenging stimulus protocols are more likely to tap into perceived auditory deficits, but may not be beneficial for predicting performance on clinical measures of SIN understanding. Finally, these results should be interpreted with caution since blast-exposed participants did not perform significantly poorer on tests of SIN perception.