Subclinical Auditory Neural Deficits in Patients With Type 1 Diabetes Mellitus.
Subclinical Auditory Neural Deficits in Patients With Type 1 Diabetes Mellitus.
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DOI：
10.1097/aud.0000000000000781
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Plack CJ
中科院分区：
文献类型：
--
作者：
AlJasser A;Uus K;Prendergast G;Plack CJ
补充数字内容可在文本中找到。糖尿病（DM）与多种感觉并发症有关。很少有人关注糖尿病的听觉神经性并发症。本研究的目的是确定1型糖尿病（T1DM）是否影响声音快速时间波动的神经编码，以及任何缺陷如何影响行为表现。参与者是30名年轻的听力正常的T1DM患者，以及30名年龄、性别和听力匹配的健康对照。测量包括使用点击诱发的听觉脑干反应对听神经和脑干功能的电生理测量，以及使用持续频率跟随反应（FFR）对脑干神经时间编码的电生理测量；时间编码行为测试（耳间相差辨别和频差阈值）；噪声环境下的语音感知测试；以及使用言语、空间和听力质量量表对听力障碍进行自我报告。T1DM患者与对照组在听觉脑干反应方面无显著差异。然而，T1DM组对颞叶包膜和颞叶精细结构的ffr均显著降低。T1DM组的耳间相位差和频差阈值也明显高于对照组，语音噪声表现更差，总体语音、空间和质量得分也低于对照组。这些发现表明，在听力学阈值未升高的情况下，T1DM与脑干神经时间编码退化有关，并且FFR可能在使用标准临床试验识别任何异常之前提供T1DM神经损伤的早期指标。然而，神经缺陷与行为缺陷之间的关系尚不明确。
Supplemental Digital Content is available in the text. Diabetes mellitus (DM) is associated with a variety of sensory complications. Very little attention has been given to auditory neuropathic complications in DM. The aim of this study was to determine whether type 1 DM (T1DM) affects neural coding of the rapid temporal fluctuations of sounds, and how any deficits may impact on behavioral performance. Participants were 30 young normal-hearing T1DM patients, and 30 age-, sex-, and audiogram-matched healthy controls. Measurements included electrophysiological measures of auditory nerve and brainstem function using the click-evoked auditory brainstem response, and of brainstem neural temporal coding using the sustained frequency-following response (FFR); behavioral tests of temporal coding (interaural phase difference discrimination and the frequency difference limen); tests of speech perception in noise; and self-report measures of auditory disability using the Speech, Spatial and Qualities of Hearing Scale. There were no significant differences between T1DM patients and controls in the auditory brainstem response. However, the T1DM group showed significantly reduced FFRs to both temporal envelope and temporal fine structure. The T1DM group also showed significantly higher interaural phase difference and frequency difference limen thresholds, worse speech-in-noise performance, as well as lower overall Speech, Spatial and Qualities scores than the control group. These findings suggest that T1DM is associated with degraded neural temporal coding in the brainstem in the absence of an elevation in audiometric threshold, and that the FFR may provide an early indicator of neural damage in T1DM, before any abnormalities can be identified using standard clinical tests. However, the relation between the neural deficits and the behavioral deficits is uncertain.