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目的:针对先天性聋患儿群体在人工耳蜗植入(CI)后听觉功能恢复效果存在较大差异的问题,从诱发脑电源活动角度探讨影响患儿CI术后听觉功能恢复效果的内在机制。方法:首先征集先天性聋患儿23例以及正常对照儿童10例,于术前(0个月)及术后3、6、9和12个月定期采集视觉诱发的事件相关电位(ERP)数据,在CI术后12个月依据听觉功能恢复评估情况,将患儿划分为恢复“良好”与“较差”组。然后采用标准低分辨率层析成像(sLORETA)源定位分析技术,呈现出2组患儿相关大脑皮层的ERP演化情况,同时与正常对照组相比较。结果:先天性聋患儿耳聋期间存在大脑皮层跨模态功能重组;在CI术后患儿大脑皮层跨模态功能重组逐渐退化,相关脑区活动随之趋于正常,在术后第12个月听觉功能恢复“良好”与“较差”组患者在颞叶和顶叶周边联合皮层活动差异有统计学意义(P<0.05)。结论:先天性聋患儿大脑皮层跨模态重组的正常化逆转与CI术后患儿听觉功能的恢复情况相关,特别是患儿颞叶和顶叶周边视听联合皮层的异常活动的正常化在一定程度上影响了听觉功能的恢复效果,对指导患者CI术后听力恢复训练和康复评估具有重要意义。
OBJECTIVE: To investigate the significant difference in auditory function recovery after cochlear implants (CI) in children with congenital deafness, and to explore the underlying mechanisms that influence the recovery of auditory function after CI in children with induced brain activity. Methods: Twenty-three children with congenital deafness and 10 children with normal controls were enrolled. Visually-induced event-related potential (ERP) data were collected preoperatively (0 months) and 3, 6, 9 and 12 months after surgery , The patients were divided into the recovery “good” and “poor” groups according to the assessment of hearing function recovery 12 months after CI. Then, using standard low-resolution tomography (sLORETA) source localization analysis technique, the evolution of ERP in cerebral cortex associated with the two groups was visualized and compared with the normal control group. Results: There was a cross-modal functional reorganization of cortex during deafness in children with congenital deafness. After cerebral cortex cross-modal functional reorganization, children with deafness gradually degenerated and their related brain regions tended to be normal. After 12th Month auditory function recovery “good” and “poor” group of patients in the temporal and parietal lobe joint cortex activity difference was statistically significant (P <0.05). Conclusion: The normalized reversal of cross-modal reorganization of cerebral cortex in children with congenital deafness is related to the recovery of auditory function in children with CI. Especially the normalization of abnormal activity of the audiovisual cortex in the temporal lobe and parietal lobe in children To a certain extent, affects the recovery of auditory function, which is of great significance to guide the training of hearing recovery and evaluation of rehabilitation after CI.