Stability of Early Auditory Evoked Potential Components Over Extended Test-Retest Intervals in Young Adults.
Stability of Early Auditory Evoked Potential Components Over Extended Test-Retest Intervals in Young Adults.
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DOI：
10.1097/aud.0000000000000872
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Brewer CC
中科院分区：
文献类型：
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作者：
Bieber RE;Fernandez K;Zalewski C;Cheng H;Brewer CC
在动物模型中，即使在听力敏感度没有变化的情况下，噪声暴露也会导致突触损伤。临床上有一种尚未满足的需求，即对人类听觉系统的这种损伤敏感的测量方法，可以增强纯音听力图。听觉诱发电位(AEP)的早期成分(即10ms)可能是突触完整性的有用的非侵入性指标。波I是在耳蜗内毛细胞(IHC)和听神经之间的突触水平上的同步神经活动的测量，可能具有特殊的临床应用价值。这种幅度测量在历史上被归类为在人类中太不稳定，不能用于临床波形解释，尽管最近的几项可靠性研究对这一观点提出了质疑。本研究的重点是检查早期AEP波幅测量的跨节段稳定性。本研究测量了38例19~33岁(女性21例)青年的AEP早期成分(波I、波V、总和电位[SP])的波幅。这些幅度测量的稳定性在12名年轻人(8名女性)的子组中进行了检查，间隔时间从15小时到328天不等。合格标准包括正常纯音听力敏感度、正常鼓室导纳和完整的声反射。参与者在最多四个时间点进行了测试。每项评估包括纯音阈值、鼓室导纳、噪声中语音测试、失真产物耳声发射(DPOAE)和早期听觉诱发电位(AEP)。用耳道和乳突电极蒙太奇采集对短声和爆音刺激作出反应的AEP。在基线和随访期间，没有发现纯音听力的临床变化。组内相关系数(ICCs)显示个体内波I和V波峰谷波幅的可靠性良好到极好，可靠性最高(0.92，95%CI[0.81-0.96])，当从耳道测量响应短声刺激时，I波的波幅最大。从耳道测量V/I波、SP波幅比和动作电位(AP)的ICC值较低，其中SP/AP的可靠性最差。这项研究的结果表明，当在一定条件下记录时，I波幅度在人类中可以是一种稳定的测量。这些发现与以前的工作是一致的，并可能为利用I波幅度推断内耳完整性的临床方案的开发提供信息。
Synaptic damage from noise exposures can occur even in the absence of changes in hearing sensitivity in animal models. There is an unmet clinical need for measurements sensitive to such damage to the human auditory system that can augment the pure tone audiogram. Early components (i.e. <10 ms) of the auditory evoked potential (AEP) may be useful non-invasive indicators of synaptic integrity. Wave I is a measure of synchronous neural activity at the level of the synapse between cochlear inner hair cells (IHCs) and the auditory nerve and may be of particular clinical utility. This amplitude measure has historically been classified as too variable in humans to be used for clinical waveform interpretation, though several recent reliability studies have challenged this view. The focus of the present study is to examine across-session stability of early AEP amplitude measures. In this study, amplitudes of early components (wave I, wave V, summating potential [SP]) of the AEP were measured in a cohort of 38 young adults aged 19–33 years (21 female). Stability of these amplitude measures were examined in a subset of 12 young adults (8 female), at time intervals ranging from 15 hours to 328 days between tests. Eligibility criteria included normal pure tone hearing sensitivity, normal tympanometry, and intact acoustic reflexes. Participants were tested at up to four time points. Each evaluation included pure tone thresholds, tympanometry, speech-in-noise testing, distortion-product otoacoustic emissions (DPOAE), and early auditory evoked potentials (AEPs). AEPs were collected in response to click and toneburst stimuli, with both ear canal and mastoid electrode montages. No clinical changes in pure tone hearing were found between baseline and follow-up visits. Intra-class correlation coefficients (ICCs) indicated good to excellent reliability for wave I and wave V peak-to-trough amplitudes within individuals across time, with greatest reliability (0.92, 95% CI [0.81–0.96]) and largest amplitudes for wave I when measured from the ear canal in response to a click stimulus. Other measures such as amplitude ratios of waves V/I and the SP and action potential (AP) showed lower ICC values when measured from the ear canal, with SP/AP ratio demonstrating the lowest reliability. The results of this study suggest that, when recorded under certain conditions, wave I amplitude can be a stable measure in humans. These findings are consistent with previous work and may inform the development of clinical protocols that utilize wave I amplitude to infer inner ear integrity.