成人人工耳蜗植入与认知功能：系统综述与荟萃分析
Cochlear Implantation and Cognitive Function in Adults: A Systematic Review and Meta-analysis.
文献信息
| PMID | 42886997 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Christi A Joyce |
| 作者单位 | Faculty of Medicine, Dalhousie University, Halifax, NS, Canada. |
| 期刊 | Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology |
| SCI 分区 | Q2 |
| IF | 1.9 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 评估成人植入者在人工耳蜗植入后第一年内认知功能的变化。
数据库检索： MEDLINE、Embase、Cochrane CENTRAL、Web of Science、PsycINFO和CINAHL。
方法： 进行了全面的文献检索，以识别评估成人人工耳蜗植入者认知的研究。纳入的研究为英文出版物，报告了语后聋成人在人工耳蜗植入前及植入后至少6个月的客观认知测试评分。干预性研究、队列研究、病例对照研究和病例数超过5例的病例系列符合条件。两名评价者独立筛选研究并提取数据。使用纽卡斯尔-渥太华量表评估研究质量和偏倚风险。采用DerSimonian-Laird法进行受试者内随机效应荟萃分析。对超过3项研究报告的认知测试，计算人工耳蜗植入前后认知测试评分的合并均数差。计算合并标准化均数差，纳入所有研究中报告的所有认知测试。
结果： 共识别出20项符合条件的研究，包括798名人工耳蜗植入者。在术后中位12个月（范围6至48个月）应用了15种不同的认知测试或测试组合。简易精神状态检查（MMSE）是最常应用的测试（6项研究），其次是MoCA（4项研究）。均数差的荟萃分析显示，人工耳蜗植入对MMSE评分无显著影响（合并均数差0.63 [95% CI：-1.02-2.28]），对MoCA评分有小的但显著的影响（合并均数差1.38 [95% CI：0.33-2.42]）。考虑所有认知测试，人工耳蜗植入后认知测试评分有小的但显著的改善（合并标准化均数差0.32 [95% CI：0.19-0.44]）。
结论： 成人人工耳蜗植入与至少部分测试中认知测试评分的小幅但显著改善相关。需要进一步研究以评估这些发现是否转化为痴呆风险的降低。
英文摘要
OBJECTIVE: To assess for changes in cognitive function in the first year following cochlear implantation in adult implant recipients.
DATABASE REVIEWED: MEDLINE, Embase, Cochrane CENTRAL, Web of Science, PsycINFO, and CINAHL.
METHODS: A comprehensive literature search was conducted to identify studies that assessed cognition in adult cochlear implant recipients. Included studies were English-language publications reporting objective cognitive testing scores both before and a minimum of 6 months after cochlear implantation in adults with postlingual hearing loss. Interventional studies, cohorts, case-controls, and case series with more than 5 patients were eligible. Two reviewers independently screened studies and extracted data. Study quality and risk of bias were evaluated using Newcastle-Ottawa Scale. Within-subjects random-effects meta-analyses were performed using the DerSimonian-Laird method. Pooled mean differences in cognitive test scores pre- versus postcochlear implantation were calculated for cognitive tests reported by more than 3 studies. Pooled standardized mean differences were calculated, including all reported cognitive tests across all studies.
RESULTS: Twenty eligible studies were identified, including a total of 798 cochlear implant recipients. Fifteen separate cognitive tests or testing batteries were applied at a median of 12 months postoperatively (range, 6 to 48 mo). The Mini-Mental Status Exam (MMSE) was the most frequently applied test (6 studies), followed by the MoCA (4 studies). Meta-analysis of mean differences showed no significant effect of cochlear implantation on MMSE score (pooled mean difference, 0.63 [95% CI: -1.02-2.28]), and a small but significant effect of cochlear implantation on MoCA score (pooled mean difference, 1.38 [95% CI: 0.33-2.42]). Considering all cognitive tests, there was a small but significant improvement in cognitive testing scores following cochlear implantation (pooled standardized mean difference 0.32 [95% CI: 0.19-0.44]).
CONCLUSIONS: Cochlear implantation in adults is associated with small but significant improvements in cognitive testing scores on at least some tests. Further research is needed to assess whether these findings translate to a reduction in dementia risk.