一岁前或之后植入人工耳蜗：儿童接受者的认知灵活性、计划和问题解决能力
Cochlear implantation before age one or after: cognitive flexibility, planning, and problem-solving in pediatric recipients.
文献信息
| PMID | 42760367 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Maria Nicastri |
| 作者单位 | Department of Sense Organs, Sapienza University of Rome, Rome, Italy. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 本研究探讨了人工耳蜗植入年龄与学龄期人工耳蜗（CI）儿童执行功能结局之间的关联，包括认知灵活性（CF）和计划与问题解决（PPS）。同时考察了与这些结局相关的人口学、认知和听力学因素。
方法： 将61名8-10岁植入CI的儿童分为婴儿期CI组（生命第一年内植入；n=30）和幼儿期CI组（13至24个月之间植入；n=31）。使用改良卡片分类测验评估CF，使用伦敦塔测验评估PPS。进行了组间比较、相关分析和分层回归分析。
结果： 婴儿期CI组的CF和PPS表现显著优于幼儿期CI组（p<0.01）。CF与母亲教育程度、非言语智力、接受性词汇和CI阈值相关，而PPS与接受性词汇和CI听力阈值相关。回归分析揭示了不同的预测因素模式。植入年龄最初可预测CF，但在控制接受性词汇、CI阈值、非言语智力和母亲教育程度后不再显著；接受性词汇是CF的唯一独立预测因素。相比之下，植入年龄和CI阈值独立预测PPS（p<0.05）。
结论： 较早植入人工耳蜗与更好的执行功能结局相关，尽管不同领域似乎受不同因素影响。CF可能与语言发展关系更密切，而PPS可能与植入时机和听觉可及性关系更强。
英文摘要
PURPOSE: This study investigated the association between age at cochlear implantation and executive function outcomes, including cognitive flexibility (CF) and planning and problem-solving (PPS), in school-age children with cochlear implants (CIs). Demographic, cognitive, and audiological factors associated with these outcomes were also examined.
METHODS: Sixty-one children with CIs aged 8-10 years were divided into Infancy CI (implanted within the first year of life; n = 30) and Toddlerhood CI groups (implanted between 13 and 24 months; n = 31). CF was assessed using the Modified Card Sorting Test and PPS using the Tower of London Test. Group comparisons, correlations, and hierarchical regression analyses were performed.
RESULTS: The Infancy CI group showed significantly better CF and PPS performance than the Toddlerhood CI group (p < 0.01). CF was associated with maternal education, nonverbal intelligence, receptive vocabulary, and CI thresholds, whereas PPS was associated with receptive vocabulary and CI hearing thresholds. Regression analyses revealed different predictor patterns. Age at implantation predicted CF initially but was no longer significant after controlling for receptive vocabulary, CI thresholds, nonverbal intelligence, and maternal education; receptive vocabulary was the only independent predictor of CF. In contrast, age at implantation and CI thresholds independently predicted PPS (p < 0.05).
CONCLUSION: Earlier cochlear implantation is associated with better executive function outcomes, although different domains appear to be influenced by distinct factors. CF may be more closely related to language development, whereas PPS may be more strongly associated with implantation timing and auditory access.