A sensitive period for the development of the central auditory system in children with cochlear implants: Implications for age of implantation.
A sensitive period for the development of the central auditory system in children with cochlear implants: Implications for age of implantation.
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DOI：
10.1097/00003446-200212000-00004
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发表时间：
2002-12-01
期刊：
影响因子：
3.7
通讯作者：
Spahr, Anthony J.
中科院分区：
文献类型：
--
作者：
Sharma, Anu;Dorman, Michael F.;Spahr, Anthony J.
目的：探讨不同年龄段人工耳蜗术对人中枢听觉系统发育的影响。设计：我们对中枢听觉通路成熟度的测量是P1皮层听觉诱发电位的潜伏期。由于P1潜伏期随着年龄的变化而变化，因此它们可以用来推断先天聋儿童的听觉通路的成熟状态，这些儿童在安装人工耳蜗后重新获得听力。我们研究了104名年龄从1.3岁到17.5岁的先天性耳聋儿童和3名先天性耳聋成人的P1反应潜伏期的发展。自变量为人工耳蜗术前耳聋持续时间。以皮层听觉诱发电位的潜伏期为因变量。结果：植入儿童的P1潜伏期与年龄匹配的听力正常同龄人的比较显示，植入前听觉剥夺时间最长的植入儿童-7岁或更长-对言语的皮质反应潜伏期异常。植入的儿童在电刺激开始后6个月内，听觉剥夺时间最短-大约3.5年或更少-有与年龄相适应的潜伏期反应。结论：我们的数据表明，在没有正常刺激的情况下，有一个大约3.5年的敏感期，在此期间，人类中央听觉系统保持最大限度的可塑性。在大约7岁之前，一些儿童，但不是所有儿童，都保持着可塑性。7岁以后，可塑性大大降低。这些数据可能与何时为先天失聪儿童植入人工耳蜗术的最佳时机有关。
Objective: The aim of the present experiment was to assess the consequences of cochlear implantation at different ages on the development of the human central auditory system. Design: Our measure of the maturity of central auditory pathways was the latency of the P1 cortical auditory evoked potential. Because P1 latencies vary as a function of chronological age, they can be used to infer the maturational status of auditory pathways in congenitally deafened children who regain hearing after being fit with a cochlear implant. We examined the development of P1 response latencies in 104 congenitally deaf children who had been fit with cochlear implants at ages ranging from 1.3 yr to 17.5 yr and three congenitally deaf adults. The independent variable was the duration of deafness before cochlear implantation. The dependent variable was the latency of the P1 cortical auditory evoked potential. Results: A comparison of P1 latencies in implanted children with those of age-matched normal-hearing peers revealed that implanted children with the longest period of auditory deprivation before implantation-7 or more yr-had abnormal cortical response latencies to speech. Implanted children with the shortest period of auditory deprivation-approximately 3.5 yr or less-evidenced age-appropriate latency responses within 6 mo after the onset of electrical stimulation. Conclusions: Our data suggest that in the absence of normal stimulation there is a sensitive period of about 3.5 yr during which the human central auditory system remains maximally plastic. Plasticity remains in some, but not all children until approximately age 7. After age 7, plasticity is greatly reduced. These data may be relevant to the issue of when best to place a cochlear implant in a congenitally deaf child.