Electrically Evoked Auditory Event-Related Responses in Patients with Auditory Brainstem Implants: Morphological Characteristics, Test-Retest Reliability, Effects of Stimulation Level, and Association with Auditory Detection.
Electrically Evoked Auditory Event-Related Responses in Patients with Auditory Brainstem Implants: Morphological Characteristics, Test-Retest Reliability, Effects of Stimulation Level, and Association with Auditory Detection.
复制标题
听觉脑干植入物患者的电气诱发听觉事件相关反应：形态学特征，测试 - 重测可靠性，刺激水平的影响以及与听觉检测的关联。
DOI：
10.1097/aud.0000000000000342
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Buchman CA
中科院分区：
文献类型：
--
作者：
He S;McFayden TC;Teagle HF;Ewend M;Henderson L;Buchman CA
本研究旨在1)研究脑皮层电诱发听觉事件相关电位（eERP）的形态特征，并探讨eERP的形态与听觉刺激和非听觉刺激之间的潜在关联；2)评估发病eerp的重测信度；3)观察刺激水平对脑电痉挛发作的影响；4)探索利用起搏电位（eERP）估计听觉脑干植入物（ABIs）患者单个刺激电极可检测到的最低刺激水平的可行性。研究参与者包括5名儿童（S1-S5）和2名成人（S6-S7），单侧耳蜗核24M抗体。在测试时，儿童ABI受者的年龄从2.6岁到10.2岁（平均5.2岁）不等。S6和S7分别为21.2岁和24.6岁。S6和S7被诊断为II型神经纤维瘤病（NF2），并在手术切除肿瘤后植入ABI。所有儿童受试者在被诊断为耳蜗神经缺损后均接受ABIs。使用临床程序对单个电极测量可检测到的最低刺激水平（行为T水平）和估计的最大舒适水平（C水平）。对于电生理测量，刺激是一个100毫秒的双相脉冲序列，以单极耦合刺激模式传递到单个电极，刺激水平从亚阈值到C水平不等。所有受试者均获得eERP发作的电生理记录。对于评估起始eERP的重测信度的研究，在两次测试中使用相同的一组参数来测量反应。两次测试之间的时间间隔从两个月到六个月不等。能引起eERP发作的最低刺激水平被定义为目标T水平。本研究记录了所有受试者的发作性脑电图。观察到发病eERPs的形态学特征在受试者之间和受试者内部的变化。根据受试者的反馈，在诱发非听觉感觉的电极和没有任何非听觉刺激迹象的电极上，记录了具有复杂波形的eerp。ABIs患者的发作性eerp表现出良好的重测信度。刺激水平增加导致eERP振幅增加，但对ABIs患者的反应潜伏期的影响不一致。客观T水平与行为T水平相关。非NF2和NF2合并ABIs患者均可记录到eerp。两组ABI患者的eERPs在形态学特征上表现出受试者之间和受试者内部的差异。然而，在本研究中，在同一受试者中测量的发作性脑电图电位在整个学习过程中趋于稳定。eERP的发作可以潜在地用于估计ABIs患者的行为T水平。有必要对更多的成人ABI受者进行进一步的研究，以调查eERP的发作是否可以用于识别非听觉刺激的电极。
This study aimed to 1) characterize morphological characteristics of the electrically-evoked cortical auditory event-related potentials (eERP) and explore the potential association between onset eERP morphology and auditory vs non-auditory stimulation; 2) assess test-retest reliability of onset eERPs; 3) investigate effects of stimulation level on onset eERPs; and 4) explore the feasibility of using the onset eERP to estimate the lowest stimulation level that can be detected for individual stimulating electrodes in patients with auditory brainstem implants (ABIs). Study participants included five children (S1-S5) and two adults (S6-S7) with unilateral Cochlear Nucleus 24M ABIs. Pediatric ABI recipients ranged in age from 2.6 to 10.2 years (mean: 5.2 years) at the time of testing. S6 and S7 were 21.2 and 24.6 years of age at the time of testing, respectively. S6 and S7 were diagnosed with neurofibromatosis II (NF2) and implanted with an ABI after a surgical removal of the tumors. All pediatric subjects received ABIs after being diagnosed with cochlear nerve deficiency. The lowest stimulation level that could be detected (behavioral T level) and the estimated maximum comfortable level (C level) was measured for individual electrodes using clinical procedures. For electrophysiological measures, the stimulus was a 100-ms biphasic pulse train that was delivered to individual electrodes in a monopolar-coupled stimulation mode at stimulation levels ranging from sub-threshold to C levels. Electrophysiological recordings of the onset eERP were obtained in all subjects. For studies evaluating the test-retest reliability of the onset eERP, responses were measured using the same set of parameters in two test sessions. The time interval between test sessions ranged from two to six months. The lowest stimulation level that could evoke the onset eERP was defined as the objective T level. Onset eERPs were recorded in all subjects tested in this study. Inter- and intra-subject variations in morphological characteristics of onset eERPs were observed. Onset eERPs with complex waveforms were recorded for electrodes that evoked non-auditory sensations, based on feedback from subjects, as well as for electrodes without any indications of non-auditory stimulations. Onset eERPs in patients with ABIs demonstrated good test-retest reliability. Increasing stimulation levels resulted in increased eERP amplitudes but showed inconsistent effects on response latencies in patients with ABIs. Objective and behavioral T levels were correlated. eERPs could be recorded in both non-NF2 and NF2 patients with ABIs. eERPs in both ABI patient groups show inter- and intra-subject variations in morphological characteristics. However, onset eERPs measured within the same subject in this study tended to be stable across study sessions. The onset eERP can potentially be used to estimate behavioral T levels in patients with ABIs. Further studies with more adult ABI recipients are warranted to investigate whether the onset eERP can be used to identify electrodes with non-auditory stimulations.