前庭神经鞘瘤中改变的神经音高编码：来自频率跟随反应的证据
Altered Neural Pitch Encoding in Vestibular Schwannoma: Evidence From Frequency-Following Responses.
文献信息
| PMID | 42929489 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Laura Jacxsens |
| 作者单位 | Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem, Belgium. |
| 期刊 | Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale |
| SCI 分区 | Q1 |
| IF | 2.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
重要性： 前庭神经鞘瘤（VS）常引起听力功能障碍，然而标准临床评估可能无法完全捕捉神经处理缺陷。
目的： 确定单侧VS是否损害语音声音的神经编码，以频率跟随反应（FFR）测量，且超出听力损失本身。
设计： 探索性观察性病例对照研究，包含受试者内比较和匹配的受试者间比较。
场所： 三级转诊中心（比利时安特卫普大学医院）。
参与者： 纳入23名患有未经治疗的单侧VS且具有足够残余听力以进行FFR评估的成人（平均年龄53.7±9.8岁；13名男性）。既往接受过VS治疗、神经系统疾病、中耳病变或重度听力损失的患者被排除。VS耳按年龄、性别和听阈与既往感音神经性听力损失（SNHL）队列匹配。干预或暴露：磁共振成像证实的单侧VS。
主要结局指标： 评估语音音高神经编码的FFR指标，以音高强度为主要结局。分析其他探索性FFR指标和共振峰编码（F1）。还记录听性脑干反应（ABR）潜伏期和阈值。
结果： 在受试者内，VS患耳与对侧耳相比，在/a/和/o/刺激段均显示音高强度降低（均P=.023）。在与SNHL对照的匹配比较中，音高强度仍显著降低（/a/的P=.049，/o/的P=.043），而其他FFR指标无显著差异。ABR分析显示VS患耳波V潜伏期和I至V峰间潜伏期延长。
结论： VS与语音音高神经编码降低相关，最一致地反映为FFR音高强度降低，即使在考虑听力损失后也是如此。
相关性： 这些发现提示VS中时间音高编码的选择性易损性，并支持FFR作为辅助措施的临床潜力，当标准听力学测试不能完全捕捉患者报告的聆听困难时。
英文摘要
IMPORTANCE: Vestibular schwannomas (VSs) frequently cause hearing dysfunction, yet standard clinical assessments may not fully capture neural processing deficits.
OBJECTIVE: To determine whether unilateral VS impairs neural encoding of speech sounds, as measured by frequency-following responses (FFRs), beyond hearing loss alone.
DESIGN: Exploratory observational case-control study with both within-subject and matched between-subject comparisons.
SETTING: Tertiary referral center (Antwerp University Hospital, Belgium).
PARTICIPANTS: Twenty-three adults (mean age 53.7 ± 9.8 years; 13 men) with untreated unilateral VS and sufficient residual hearing for FFR assessment were included. Patients with prior VS treatment, neurological disease, middle ear pathology, or profound hearing loss were excluded. VS ears were matched to a previous sensorineural hearing loss (SNHL) cohort by age, sex, and hearing thresholds.Intervention or Exposures:Magnetic resonance imaging-confirmed unilateral VS.
MAIN OUTCOME MEASURES: FFR measures of neural encoding of voice pitch were evaluated, with pitch strength as the primary outcome. Additional exploratory FFR measures and formant encoding (F1) were analyzed. Auditory brainstem response (ABR) latencies and thresholds were also recorded.
RESULTS: Within subjects, VS-affected ears showed reduced pitch strength compared with contralateral ears for both the /a/ and /o/ stimulus sections (both P = .023). In the matched comparison with SNHL controls, pitch strength remained significantly reduced (P = .049 for /a/, P = .043 for /o/), whereas other FFR measures did not differ significantly. ABR analysis showed prolonged wave V latency and interpeak latency I to V in VS-affected ears.
CONCLUSIONS: VS is associated with reduced neural encoding of voice pitch, most consistently reflected by reduced FFR pitch strength even after accounting for hearing loss.
RELEVANCE: These findings suggest a selective vulnerability of temporal pitch coding in VS and support the clinical potential of the FFR as an adjunct measure when standard audiological tests do not fully capture patient-reported listening difficulties.