孤独症谱系障碍儿童听觉特征分析
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摘要
目的探讨孤独症谱系障碍(autism spectrum disorder, ASD)儿童听觉脑干反应(auditory brainstem response, ABR)各波潜伏期和峰间期的特征及与ASD行为表型间的关联。方法收集哈尔滨市明确诊断的2～6岁ASD儿童90例,应用脑干电位诱发反应仪采集ABR数据,分析ASD儿童左右耳各波潜伏期、峰间期特征及与临床表型的关联。结果ASD儿童左、右耳Ⅰ,Ⅲ,Ⅴ波潜伏期分别为(1.51±0.20)(3.83±0.34)(5.63±0.23)ms;(1.54±0.16)(3.78±0.23)(5.63±0.22)ms,均超过正常均值(P值均<0.05);ASD儿童Ⅰ-Ⅲ(6.6%),Ⅲ-Ⅴ(1.1%),Ⅰ-Ⅴ(3.3%)峰间期较正常儿童延长;<3岁组与3～7岁组ASD儿童相比,左右耳Ⅰ-Ⅲ,Ⅰ-Ⅴ峰间期均明显延长(P值均<0.05)。关联性分析发现,ASD儿童左耳Ⅰ波潜伏期与孤独症诊断访谈量表修订版(ADI-R)社交功能缺陷存在正相关(r=0.45,P<0.05);左耳Ⅰ波潜伏期、Ⅲ-Ⅴ峰间期和右耳Ⅴ波潜伏期与非言语性沟通能力障碍呈正相关(r值分别为0.35,0.39,0.34,P值均<0.05);左、右耳Ⅰ-Ⅲ峰间期与重复刻板行为呈正相关(r值分别为0.39,0.35,P值均<0.05)。结论 ASD儿童存在异常的听觉行为特征,且异常程度与ASD儿童社会交往、沟通及重复刻板行为的严重程度存在明显关联。
Objective To explore the characteristics of Auditory Brainstem Response(ABR) in children with ASD, and analyze their relation with the core symptoms of ASD. Methods Ninty children aged 2-6 with ASD were recruited from Harbin in this study. The data of ABR was collected by using BAEP, and the association among children's absolute latency and interpeak latency of ABR, core symptoms of ASD children's behavior and clinical manifestation was analyzed. Results Compared with the normal average value, children with ASD had longer the absolute latency of wave Ⅰ,Ⅲ,Ⅴ in bilateral ears, which were(1.51±0.20)(3.83±0.34)(5.63±0.23)ms,(1.54±0.16)(3.78±0.23)(5.63±0.22)ms, respectively(P<0.05). Some children's interpeak latency of Ⅰ-Ⅲ, Ⅲ-Ⅴ, Ⅰ-Ⅴ were longer than normal values. Children younger than 3 years old showed prolonged peak intervals of Ⅰ-Ⅲ and Ⅰ-Ⅴ than children in 3-7 years old. The study has also showed that there was positive correlation between the absolute latency of waveⅠin left ear and the social function defect(r=0.45, P<0.05); there was positive correlation between the latency of wave Ⅴin right ear or the latency of waveⅠin left ear or the Ⅰ-Ⅲ peakinterval and non-verbal communication ability dysfunction(r=0.35, 0.39, 0.34, P<0.05); there was positive correlation between the Ⅰ-Ⅲ peak interval and the repeated stereotyped symptoms(r=0.39, 0.35, P<0.05). Conclusion Children with ASD have abnormal auditory behavior. The absolute latency and interpeak latency of ABR is correlated to some parts of core symptoms of ASD.
Objective To explore the characteristics of Auditory Brainstem Response(ABR) in children with ASD, and analyze their relation with the core symptoms of ASD. Methods Ninty children aged 2-6 with ASD were recruited from Harbin in this study. The data of ABR was collected by using BAEP, and the association among children's absolute latency and interpeak latency of ABR, core symptoms of ASD children's behavior and clinical manifestation was analyzed. Results Compared with the normal average value, children with ASD had longer the absolute latency of wave Ⅰ,Ⅲ,Ⅴ in bilateral ears, which were(1.51±0.20)(3.83±0.34)(5.63±0.23)ms,(1.54±0.16)(3.78±0.23)(5.63±0.22)ms, respectively(P<0.05). Some children's interpeak latency of Ⅰ-Ⅲ, Ⅲ-Ⅴ, Ⅰ-Ⅴ were longer than normal values. Children younger than 3 years old showed prolonged peak intervals of Ⅰ-Ⅲ and Ⅰ-Ⅴ than children in 3-7 years old. The study has also showed that there was positive correlation between the absolute latency of waveⅠin left ear and the social function defect(r=0.45, P<0.05); there was positive correlation between the latency of wave Ⅴin right ear or the latency of waveⅠin left ear or the Ⅰ-Ⅲ peakinterval and non-verbal communication ability dysfunction(r=0.35, 0.39, 0.34, P<0.05); there was positive correlation between the Ⅰ-Ⅲ peak interval and the repeated stereotyped symptoms(r=0.39, 0.35, P<0.05). Conclusion Children with ASD have abnormal auditory behavior. The absolute latency and interpeak latency of ABR is correlated to some parts of core symptoms of ASD.
引文
[1] American Psychiatric Association.Diagnostic and statistical manual of mental disorders[M].fifth edition.Washington DC:American Psychiatric Association,2013:50-51.
[2] BAIO J,WIGGINS L,GHRISTENSEN O L,et al.Prevalence of aatism spectrum disorder among children aged 8 years-Austim and development disabilities monitoring network Ⅱ sites United States 2014[J].MMWR Suweill Summ,2018,67(6):1-23.
[3] 武丽杰.我国孤独症谱系障碍流行病学现状及趋势[J].中国实用儿科杂志,2013,28(8):571-576.
[4] 刘贤,林穗方,陈文雄,等.中国儿童孤独症谱系障碍患病率Meta分析[J].中国儿童保健杂志,2018,26(4):402-406.
[5] ROGERS S J,HEPBURN S,WEHNER E.Parent reports of sensory symptoms in toddlers with autism and those with other developmental disorders[J].J Autism Dev Disord,2003,33(6):631-642.5.
[6] WIGGINS L D,ROBINS D L,BAKEMAN R,et al.Brief report:sensory abnormalities as distinguishing symptoms of autism spectrum disorders in young children[J].J Autism Dev Disord,2009,39(7):1087-1091.
[7] SZYMANSKI C A,BRICE P J,LAM K H,et al.Deaf children with autism spectrum disorders[J].J Autism Dev Disord,2012,42(10):2027-2037.
[8] STIEGLER L N,DAVIS R.Understanding Sound Sensitivity in Individuals with Autism Spectrum Disorders[J].Focus Autism Other Dev Disab,2010,25(2):67-75.
[9] TAN Y H,XI C Y,JIANG S P,et al.Auditory abnormalities in children with autism[J].Open J Psych,2012,2(1):33-37.
[10] 王子才,钱冬梅,盛晓尉,等.用ABC量表分析儿童孤独症[J].临床儿科杂志,2002,20(2):80-81.
[11] 卢建平,杨志伟,舒明耀,等.儿童孤独症量表评定的信度、效度分析[J].中国现代医学杂志,2004,14(13):119-121.
[12] LORD C,RUTTER M,COUTEVR A.Autism diagnostic Interview Revised:a revised version oof a dignostic interview of for caregivers of individuals with possible pervasive development disorders[J].J Autism Dev Disord,1994,24:659-685.
[13] LORD C,RISI S,LAMBRECHT L,et al.The autism dig diognostic observation schedule-generic a standavd measure of social and communication deticits assoliated with the spectrum of autism[J].J Autism Dev Disord,2000,30(3):205-223.
[14] DABBOUS A O.Characteristics of auditory brainstem response latencies in children with autism spectrum disorders[J].Audiol Med,2012,10(3):122-131.
[15] 梁纯,洪琦,罗小杏,等.孤独症谱系障碍和发育性语言延迟儿童的听觉处理特征研究[J].中国儿童保健杂志,2013,21(6):578-580.
[16] VERVERI A,VARGIAMI E,PAPADOPOULOU V,et al.Brainstem auditory evoked potentials in boys with autism:Still Searching for the Hidden Truth[J].Iran J Child Neurol,2015,9(2):21-28.
[17] MIRON O,ROYH D A,GABIS L V,et al.Prolonged auditory brainstem responses in infants with autism[J].Autism Res,2016,9(6):689-695.
[18] 颜华,张惠佳,郭春光,等.孤独症儿童的脑干听觉诱发电位检测结果临床分析[J].中国儿童保健杂志,2013,21(4):419-421.
[19] 王建军,李乐加,刘芳.孤独症患者脑干听觉通路功能的评估与研究[J].癫痫与神经电生理学杂志,2012,21(5):288-290.
[20] 张楠,李玉茹.自闭症患儿听觉诱发反应检测分析[J].听力学及言语疾病杂志,2008,16(2):129-131.
[21] 李曰兵,许克铭.儿童脑干听觉诱发电位正常值及其在高危新生儿的应用[J].中华医学杂志,1990,70(11):642-645.
[22] MIRON O,BEAM A L,KOHANE I S.Auditory brainstem response in infants and children with autism spectrum disorder:a Meta-analysis of wave V[J].Autism Res,2017,11(2):355-363.
[23] TALGE N M,TUDOR B M,KILENYI P R.Click-evoked auditory brainstem responses and autism spectrum disorder:a meta-analytic review[J].Autism Res,2018,11(6):916-927.
[24] 程华,龚高浪,彭芸,等.孤独症儿童的脑自发活动低频振幅改变的功能磁共振成像研究[J].中国心理卫生杂志,2016,30(6):441-447.
[2] BAIO J,WIGGINS L,GHRISTENSEN O L,et al.Prevalence of aatism spectrum disorder among children aged 8 years-Austim and development disabilities monitoring network Ⅱ sites United States 2014[J].MMWR Suweill Summ,2018,67(6):1-23.
[3] 武丽杰.我国孤独症谱系障碍流行病学现状及趋势[J].中国实用儿科杂志,2013,28(8):571-576.
[4] 刘贤,林穗方,陈文雄,等.中国儿童孤独症谱系障碍患病率Meta分析[J].中国儿童保健杂志,2018,26(4):402-406.
[5] ROGERS S J,HEPBURN S,WEHNER E.Parent reports of sensory symptoms in toddlers with autism and those with other developmental disorders[J].J Autism Dev Disord,2003,33(6):631-642.5.
[6] WIGGINS L D,ROBINS D L,BAKEMAN R,et al.Brief report:sensory abnormalities as distinguishing symptoms of autism spectrum disorders in young children[J].J Autism Dev Disord,2009,39(7):1087-1091.
[7] SZYMANSKI C A,BRICE P J,LAM K H,et al.Deaf children with autism spectrum disorders[J].J Autism Dev Disord,2012,42(10):2027-2037.
[8] STIEGLER L N,DAVIS R.Understanding Sound Sensitivity in Individuals with Autism Spectrum Disorders[J].Focus Autism Other Dev Disab,2010,25(2):67-75.
[9] TAN Y H,XI C Y,JIANG S P,et al.Auditory abnormalities in children with autism[J].Open J Psych,2012,2(1):33-37.
[10] 王子才,钱冬梅,盛晓尉,等.用ABC量表分析儿童孤独症[J].临床儿科杂志,2002,20(2):80-81.
[11] 卢建平,杨志伟,舒明耀,等.儿童孤独症量表评定的信度、效度分析[J].中国现代医学杂志,2004,14(13):119-121.
[12] LORD C,RUTTER M,COUTEVR A.Autism diagnostic Interview Revised:a revised version oof a dignostic interview of for caregivers of individuals with possible pervasive development disorders[J].J Autism Dev Disord,1994,24:659-685.
[13] LORD C,RISI S,LAMBRECHT L,et al.The autism dig diognostic observation schedule-generic a standavd measure of social and communication deticits assoliated with the spectrum of autism[J].J Autism Dev Disord,2000,30(3):205-223.
[14] DABBOUS A O.Characteristics of auditory brainstem response latencies in children with autism spectrum disorders[J].Audiol Med,2012,10(3):122-131.
[15] 梁纯,洪琦,罗小杏,等.孤独症谱系障碍和发育性语言延迟儿童的听觉处理特征研究[J].中国儿童保健杂志,2013,21(6):578-580.
[16] VERVERI A,VARGIAMI E,PAPADOPOULOU V,et al.Brainstem auditory evoked potentials in boys with autism:Still Searching for the Hidden Truth[J].Iran J Child Neurol,2015,9(2):21-28.
[17] MIRON O,ROYH D A,GABIS L V,et al.Prolonged auditory brainstem responses in infants with autism[J].Autism Res,2016,9(6):689-695.
[18] 颜华,张惠佳,郭春光,等.孤独症儿童的脑干听觉诱发电位检测结果临床分析[J].中国儿童保健杂志,2013,21(4):419-421.
[19] 王建军,李乐加,刘芳.孤独症患者脑干听觉通路功能的评估与研究[J].癫痫与神经电生理学杂志,2012,21(5):288-290.
[20] 张楠,李玉茹.自闭症患儿听觉诱发反应检测分析[J].听力学及言语疾病杂志,2008,16(2):129-131.
[21] 李曰兵,许克铭.儿童脑干听觉诱发电位正常值及其在高危新生儿的应用[J].中华医学杂志,1990,70(11):642-645.
[22] MIRON O,BEAM A L,KOHANE I S.Auditory brainstem response in infants and children with autism spectrum disorder:a Meta-analysis of wave V[J].Autism Res,2017,11(2):355-363.
[23] TALGE N M,TUDOR B M,KILENYI P R.Click-evoked auditory brainstem responses and autism spectrum disorder:a meta-analytic review[J].Autism Res,2018,11(6):916-927.
[24] 程华,龚高浪,彭芸,等.孤独症儿童的脑自发活动低频振幅改变的功能磁共振成像研究[J].中国心理卫生杂志,2016,30(6):441-447.