军事退伍军人的耳鸣和声音耐受性降低：与耳蜗去传入的关系。
Tinnitus and decreased sound tolerance in military Veterans: Relationship with cochlear deafferentation.
文献信息
| PMID | 42743862 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Haley A Szabo |
| 作者单位 | VA National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, OR 3710 SW US Veterans Hospital Road/P5 NCRAR, Portland, OR, 97239, United States. |
| 期刊 | Hearing research |
| SCI 分区 | Q1 |
| IF | 3.2 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 军事退伍军人患噪声诱导的耳蜗突触病（一种耳蜗去传入）的风险很高。去传入的预测感知后果包括耳鸣和听觉过敏。本研究的目的是确定与噪声暴露极少的年轻非退伍军人对照组相比，报告持续性耳鸣和/或声音耐受性降低（DST）且听力图正常的退伍军人是否在三个去传入的生理指标上表现出降低：（1）听性脑干反应[ABR]波I振幅，（2）包络跟随反应[EFR]幅度，以及（3）宽带中耳肌反射[MEMR]幅度。还使用畸变产物耳声发射[DPOAE]评估了外毛细胞（OHC）功能。
结果： 与165名对照组相比，在22名有耳鸣的退伍军人和19名有DST的退伍军人样本中，平均ABR波I振幅、EFR幅度和高频DPOAE均降低。平均而言，有DST的退伍军人的MEMR幅度也小于对照组。虽然许多有耳鸣的退伍军人的MEMR小于对照组，但少数人的MEMR较大。与对照组相比，退伍军人的ABR波V/I振幅比往往升高。
结论： ABR、EFR和DPOAE测量表明，在患有持续性耳鸣或DST的退伍军人中，存在耳蜗去传入和亚临床高频OHC功能障碍。在ABR和EFR测量降低的耳鸣退伍军人中，并未一致观察到MEMR幅度的降低，这表明MEMR可能不是耳蜗去传入的可靠指标。听性脑干中中枢增益的增加可能导致了耳鸣和DST的感知。
英文摘要
PURPOSE: Military Veterans are at high risk for noise-induced cochlear synaptopathy, a type of cochlear deafferentation. Predicted perceptual consequences of deafferentation include tinnitus and hyperacusis. The objective of this study was to determine if compared to young non-Veteran controls with minimal noise exposure, Veterans with normal audiograms who report constant tinnitus and/or decreased sound tolerance (DST) show reductions in three physiological indicators of deafferentation: (1) auditory brainstem response [ABR] wave I amplitude, (2) envelope following response [EFR] magnitude, and (3) wideband middle ear muscle reflex [MEMR] magnitude. Outer hair cell (OHC) function was also evaluated using distortion product otoacoustic emissions [DPOAEs].
RESULTS: Mean ABR wave I amplitudes, EFR magnitudes, and high frequency DPOAEs were reduced in a sample of 22 Veterans with tinnitus and 19 Veterans with DST relative to 165 controls. On average, MEMR magnitudes were also smaller for Veterans with DST than for controls. While many Veterans with tinnitus had smaller MEMRs than controls, a small number had large MEMRs. ABR wave V/I amplitude ratios tended to be elevated for Veterans compared to controls.
CONCLUSIONS: ABR, EFR, and DPOAE measurements were suggestive of both cochlear deafferentation and subclinical high frequency OHC dysfunction in Veterans with constant tinnitus or DST. Reductions in MEMR magnitude were not consistently observed in Veterans with tinnitus who had reduced ABR and EFR measurements, indicating that the MEMR may not be a reliable indicator of cochlear deafferentation. Increased central gain in the auditory brainstem may have contributed to the perception of tinnitus and DST.