颞叶癫痫患者言语感知障碍的临床研究

目的:利用噪声环境下的言语听觉感知测试技术(hearing in noise test,HINT),研究颞叶癫痫(temporal lobe epilepsy,TLE)患者的言语感知能力并探讨其神经机制。方法:选择30 例TLE患者和30 例年龄、性别匹配的正常对照作为研究对象,外周听力均正常,进行噪声环境下的言语感知能力测试,获得TLE组与正常对照组的信噪比阈值并进行对比分析。结果:正常对照组的信噪比阈值明显低于TLE 组(P<0.001),表明TLE 患者在噪声环境下的言语感知能力出现显著下降。结论:TLE患者虽然具有正常听力,但是噪声环境下理解言语的能力明显降低,严重影响了言语交流的效果。本研究首次证实TLE患者在言语感知方面存在缺陷,这可能与TLE导致中枢性听觉处理机制出现障碍有关。

A clinical study on deficits of speech perception in noise in patients with temporal lobe epilepsy

Objective:To explore the behavioral performance of speech perception in noise in patients with temporal lobe epilepsy by means of hearing in noise test (HINT) and to discuss the possible underlying neural mechanisms. Method: Thirty patients with TLE and 30 age- and sex-matched healthy adult volunteers with normal peripheral hearing were recruited to participate in the present study. Each subject’s performance of speech perception in noise was evaluated using the HINT protocol. The threshold of signal- to- noise ratio (SNR) was obtained and then compared between the patients with TLE and healthy controls. Result:The SNR threshold of healthy controls was significantly lower than that of patients with TLE (P< 0.001), indicating that patients with TLE were impaired in their ability of perceiving speech in noise. Conclusion: Although patients with TLE had normal peripheral hearing, their ability of understanding speech in noisy environment was impaired, which may lead to declined ability of speech communication. These findings provide the first evidence that patients with TLE are associated with deficits of speech perception in noise, which may be related to their central auditory processing disorders as a consequence of TLE.