中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2023, Vol. 18 ›› Issue (9): 1968-1975.doi: 10.4103/1673-5374.361530

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

年龄相关听力损失加速快速语言理解能力下降和皮质网络连接失调

  

  • 出版日期:2023-09-15 发布日期:2023-03-06
  • 基金资助:
    国家自然科学基金（82171138；82071062）；广东省自然科学基金（2021A1515012038）；中央高校基础研究基金（20ykpy91）和中山临床研究培养计划（SYS-Q-201903）

Age-related hearing loss accelerates the decline in fast speech comprehension and the decompensation of cortical network connections

He-Mei Huang1, 2, #, Gui-Sheng Chen1, 2, 3, #, Zhong-Yi Liu4, #, Qing-Lin Meng5, Jia-Hong Li1, 2, Han-Wen Dong1, 2, Yu-Chen Chen6, Fei Zhao7, Xiao-Wu Tang1, 2, Jin-Liang Gao8, Xi-Ming Chen8, Yue-Xin Cai1, 2, 3, *, Yi-Qing Zheng1, 2, 3, *#br#   

  1. 1Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China; 2Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, Guangdong Province, China; 3Department of Otolaryngology, Shenzhen-Shanwei Central Hospital, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shanwei, Guangdong Province, China; 4Department of Radiology, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, Guangdong Province, China; 5Acoustics Lab of School of Physics and Optoelectronics and State Key Laboratory of Subtropical Building Science, South China University of Technology, Guangzhou, Guangdong Province, China; 6Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China; 7Department of Speech and Language Therapy and Hearing Science, Cardiff Metropolitan University, Cardiff, UK; 8Department of Otolaryngology, Shenzhen Baoan Maternal and Child Health Hospital, Shenzhen, Guangdong Province, China
  • Online:2023-09-15 Published:2023-03-06
  • Contact: Yue-Xin Cai, MD, caiyx25@mail.sysu.edu.cn; Yi-Qing Zheng, zhengyiq@mail.sysu.edu.cn.
  • Supported by:
    This work was supported by the National Natural Science Foundation of China, Nos. 82171138 (to YQZ), 82071062 (to YXC), the Natural Science Foundation of Guangdong Province, No. 2021A1515012038 (to YXC), the Fundamental Research Funds for the Central Universities, No. 20ykpy91 (to YXC) and the Sun Yat-Sen Clinical Research Cultivating Program, No. SYS-Q-201903 (to YXC).

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摘要：

造成老年性听力损失的原因很复杂，包括周围听力、中枢处理和认知相关能力，然而，导致听觉处理能力及其相关中枢变化的衰老和听力损失的因素仍不清楚。研究评估了27名老年性听力损失受试者，21名听力正常的老年人，以及30名听力正常的年轻受试者。包括噪音条件下的时阈压缩阈值和语言识别阈值的上限阈值测试用以评估听觉处理能力的行为指标。此外，以脑电图的电生理记录确定自发静止状态下大脑中与老年性听力损失有关的异常。各组间时阈压缩阈值和语言识别阈值存在明显差异。在老年性听力损失受试者中，相对于能量掩蔽（语谱噪声，SSN），信息掩蔽（嘈杂语噪声）对处理困难的影响更大。对于静止状态的脑电图信号，与正常年轻人组相比，正常老年人组的额叶（Brodmann分区，BA11）激活增强，而老年性听力损失组的顶叶（BA7）和枕叶（BA19）的激活更大。功能连接分析表明，与正常年轻人组相比，正常老年人的网络之间的连接，包括默认模式网络（DMN）、感觉运动网络、齿状突起网络、枕叶网络和额叶网络都有所增强。以上结果表明，正常的衰老和老年性听力损失的发展都对高级听觉处理能力有负面影响，而且听力损失会加速语言理解能力的下降。经历正常老化的老年人存在大量的补偿性功能连接，而老年性听力损失患者通过涉及视觉区的异常激活表现出失调。

https://orcid.org/0000-0002-2434-9747 (Yue-Xin Cai); https://orcid.org/0000-0002-3641-1640 (Yi-Qing Zheng)

Abstract: Patients with age-related hearing loss face hearing difficulties in daily life. The causes of age-related hearing loss are complex and include changes in peripheral hearing, central processing, and cognitive-related abilities. Furthermore, the factors by which aging relates to hearing loss via changes in auditory processing ability are still unclear. In this cross-sectional study, we evaluated 27 older adults (over 60 years old) with age-related hearing loss, 21 older adults (over 60 years old) with normal hearing, and 30 younger subjects (18–30 years old) with normal hearing. We used the outcome of the upper-threshold test, including the time-compressed threshold and the speech recognition threshold in noisy conditions, as a behavioral indicator of auditory processing ability. We also used electroencephalography to identify presbycusis-related abnormalities in the brain while the participants were in a spontaneous resting state. The time-compressed threshold and speech recognition threshold data indicated significant differences among the groups. In patients with age-related hearing loss, information masking (babble noise) had a greater effect than energy masking (speech-shaped noise) on processing difficulties. In terms of resting-state electroencephalography signals, we observed enhanced frontal lobe (Brodmann’s area, BA11) activation in the older adults with normal hearing compared with the younger participants with normal hearing, and greater activation in the parietal (BA7) and occipital (BA19) lobes in the individuals with age-related hearing loss compared with the younger adults. Our functional connection analysis suggested that compared with younger people, the older adults with normal hearing exhibited enhanced connections among networks, including the default mode network, sensorimotor network, cingulo-opercular network, occipital network, and frontoparietal network. These results suggest that both normal aging and the development of age-related hearing loss have a negative effect on advanced auditory processing capabilities and that hearing loss accelerates the decline in speech comprehension, especially in speech competition situations. Older adults with normal hearing may have increased compensatory attentional resource recruitment represented by the top-down active listening mechanism, while those with age-related hearing loss exhibit decompensation of network connections involving multisensory integration.

Key words: age-related hearing loss, aging, electroencephalography, fast-speech comprehension, functional brain network, functional connectivity, resting-state, sLORETA, source analysis, speech reception threshold