Differences in postinjury auditory system pathophysiology after mild blast and nonblast acute acoustic trauma.
Differences in postinjury auditory system pathophysiology after mild blast and nonblast acute acoustic trauma.
复制标题
DOI：
10.1152/jn.00710.2016
复制
发表时间：
2017-08
影响因子：
2.5
通讯作者：
N. Race;Jesyin Lai;R. Shi;Edward L. Bartlett
中科院分区：
文献类型：
--
作者：
N. Race;Jesyin Lai;R. Shi;Edward L. Bartlett
听力困难是退伍军人中最常见的残疾。考虑到爆炸事件期间的爆炸暴露容易直接损坏外周 (PAS) 和中枢听觉系统 (CAS) 组件，因此爆炸暴露可能发挥了一定作用。临床病例报告和实验室调查均详细记录了喷砂后 PAS 病理生理学。相比之下，爆炸引起的 CAS 功能障碍尚未得到充分研究，但据推测会导致一系列常见的退伍军人行为抱怨，包括学习、记忆、沟通和情绪调节。这项研究比较了成年雄性 Sprague-Dawley 大鼠的急性爆炸和非爆炸声脉冲创伤的影响。采用了一系列听力测试，包括失真产物耳声发射 (DPOAE)、听觉脑干反应 (ABR)、中潜伏期反应 (MLR) 和包络跟随反应 (EFR)。一般来说，在爆炸暴露动物的整个听觉神经轴（从耳蜗到皮质）中观察到更严重和持续的损伤后中枢听觉处理（CAP）缺陷。 DPOAE 和 ABR 结果分别捕获了耳蜗和听觉神经/脑干缺陷。 EFR 表现出时间处理损伤，表明听觉脑干和下丘区域存在功能损伤。 MLR 捕获丘脑皮质传输和皮质激活损伤。综上所述，结果表明爆炸引起的 CAS 功能障碍可能与 PAS 起源的适应不良神经可塑性发挥互补的病理生理学作用。即使是轻微的爆炸也会产生持久的听力损伤，可以通过无创电生理学进行评估，从而使这些测量能够作为简单、有效的诊断。新的和值得注意的爆炸暴露通常会产生听力困难。尽管耳蜗损伤通常会发生，但对中枢听觉处理的下游影响尚不清楚。此外，还比较了暴露于爆炸压力波的个体与未经历压力波的爆炸噪声的个体之间的结果。研究发现，单次爆炸暴露在爆炸后至少 4 周内，在上行听觉路径的所有阶段都会产生变化，而单独爆炸噪声会产生很大程度的瞬时变化。
Hearing difficulties are the most commonly reported disabilities among veterans. Blast exposures during explosive events likely play a role, given their propensity to directly damage both peripheral (PAS) and central auditory system (CAS) components. Postblast PAS pathophysiology has been well documented in both clinical case reports and laboratory investigations. In contrast, blast-induced CAS dysfunction remains understudied but has been hypothesized to contribute to an array of common veteran behavioral complaints, including learning, memory, communication, and emotional regulation. This investigation compared the effects of acute blast and nonblast acoustic impulse trauma in adult male Sprague-Dawley rats. An array of audiometric tests were utilized, including distortion product otoacoustic emissions (DPOAE), auditory brain stem responses (ABR), middle latency responses (MLR), and envelope following responses (EFRs). Generally, more severe and persistent postinjury central auditory processing (CAP) deficits were observed in blast-exposed animals throughout the auditory neuraxis, spanning from the cochlea to the cortex. DPOAE and ABR results captured cochlear and auditory nerve/brain stem deficits, respectively. EFRs demonstrated temporal processing impairments suggestive of functional damage to regions in the auditory brain stem and the inferior colliculus. MLRs captured thalamocortical transmission and cortical activation impairments. Taken together, the results suggest blast-induced CAS dysfunction may play a complementary pathophysiological role to maladaptive neuroplasticity of PAS origin. Even mild blasts can produce lasting hearing impairments that can be assessed with noninvasive electrophysiology, allowing these measurements to serve as simple, effective diagnostics.NEW & NOTEWORTHY Blasts exposures often produce hearing difficulties. Although cochlear damage typically occurs, the downstream effects on central auditory processing are less clear. Moreover, outcomes were compared between individuals exposed to the blast pressure wave vs. those who experienced the blast noise without the pressure wave. It was found that a single blast exposure produced changes at all stages of the ascending auditory path at least 4 wk postblast, whereas blast noise alone produced largely transient changes.