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首页> 美国卫生研究院文献>Frontiers in Human Neuroscience >Brain Plasticity Can Predict the Cochlear Implant Outcome in Adult-Onset Deafness
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Brain Plasticity Can Predict the Cochlear Implant Outcome in Adult-Onset Deafness

机译：脑可塑性可以预测成人发作性耳聋的人工耳蜗结果

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Sensory plasticity, which is associated with deafness, has not been as thoroughly investigated in the adult brain as it has in the developing brain. In this study, we examined the brain reorganization induced by auditory deprivation in people with adult-onset deafness and its clinical relevance by measuring glucose metabolism before cochlear implant (CI) surgery. F-18 fluorodeoxyglucose positron emission tomography (18F-FDG-PET) scans were performed in 37 postlingually deafened patients during the preoperative workup period, and in 39 normal-hearing (NH) controls. Behavioral CI outcomes were measured at 1 year after implantation using a phoneme identification test with auditory cueing only. In the deaf individuals, areas involved in the auditory pathway such as the inferior colliculus and bilateral superior temporal gyri were hypometabolic compared to the NH controls. The hypometabolism observed in the deaf auditory cortices gradually returned to levels similar to the controls as the duration of deafness increased. However, contrary to our previous findings in congenitally deaf children, this metabolic recovery failed to have a significant prognostic value for the recovery of the speech perception ability in adult CI patients. In a broad occipital area centered on the primary visual cortices, glucose metabolism was higher in the deaf patients than the controls, suggesting that the area had become visually hyperactive for sensory compensation immediately after the onset of deafness. In addition, a negative correlation between the metabolic activity and behavioral speech perception outcomes was observed in the visual association areas. In the medial frontal cortices, cortical metabolism in most patients decreased, but patients who had preserved metabolic activities showed better speech performance. These results suggest that the auditory cortex in people with adult-onset deafness is relatively resistant to cross-modal plasticity, and instead, individual traits in late-stage visual processing and cognitive control seem to be more reliable prognostic markers for adult-onset deafness.
机译：与耳聋相关的感觉可塑性尚未像在发育中的大脑中那样在成年大脑中得到充分研究。在这项研究中，我们通过测量人工耳蜗（CI）手术前的葡萄糖代谢，检查了成年耳聋患者的听觉剥夺所致的大脑重组及其临床意义。在术前检查期间对37例耳聋后的患者和39例正常听力（NH）的对照者进行了F-18氟脱氧葡萄糖正电子发射断层扫描（ 18 F-FDG-PET）扫描。在植入后1年，仅通过听觉提示进行音素识别测试，测量行为CI结果。在聋人中，与NH对照相比，听觉通路涉及的区域（如下丘和双侧颞上回）代谢不足。随着耳聋持续时间的增加，在聋人听觉皮层中观察到的低代谢逐渐恢复到与对照组相似的水平。但是，与我们先前在先天性聋儿童中的发现相反，这种代谢恢复对于成人CI患者的语音感知能力恢复没有明显的预后价值。在以初级视觉皮层为中心的宽枕叶区域，失聪患者的葡萄糖代谢高于对照组，这表明在失聪发作后，该区域在视觉上已变得过度活跃，可以进行感觉补偿。另外，在视觉关联区域中观察到了代谢活动与行为言语感知结果之间的负相关。在内侧额叶皮质中，大多数患者的皮质代谢下降，但保留了代谢活动的患者表现出更好的言语表现。这些结果表明，成年聋的人的听觉皮层对交叉模态可塑性有相对的抵抗力，相反，后期视觉处理和认知控制中的个体特征似乎是成年聋的更可靠的预后指标。

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