Research on the brainstem auditory evoked potential in 788 children with autism spectrum disorders in South China

doi:10.11852/zgetbjzz2020-1812

Abstract

Abstract: Objective To investigate the characteristics of brainstem auditory evoked potential (BAEP) in children with autism spectrum disorder (ASD) and normal hearing threshold in South China. Methods The BAEP records of ASD children in Guangzhou Women and Children's Medical Center between 2013 and 2018 were retrospectively reviewed. Healthy controls matched by age and gender were also recruited. The thresholds,wave absolute latencies (AL),wave inter peak intervals (IPL),Ⅰ-Ⅲ/Ⅲ-Ⅴ inter peak interval ratio and Ⅴ/Ⅰ amplitude ratio of BAEP between both groups were analyzed and compared. And the BAEP data of the children would be excluded from both groups if the hearing threshold of his/her ear exceeded 30 dB nHL. Results A total of 788 ASD children and 150 healthy controls were included. BAEP data of 1 530 ears in ASD group and 300 ears in control group were included in final analysis. All participants in the two groups could differentiate into well-defined waveforms of BAEP at 90 dB nHL sound stimulation. 1) The absolute latencies of wave Ⅰ,wave Ⅲ,wave V and inter peak intervals of Ⅰ-Ⅲ of ASD children were significantly longer than those of children in control group (Z=-2.006,-3.986,-2.552,-2.405,P<0.05).2) The abnormal ratio of Ⅰ-Ⅲ/Ⅲ-Ⅴ inter peak interval of ASD group (3.14%) was significantly higher than that of the control group(P<0.001). Conclusions There are distinct changes in BAEP in ASD children,especially the abnormal prolongation of brainstem conduction time,suggesting that ASD children may have brainstem dysfunction,which may lead to the damage of related information transmission.

Key words: autism spectrum disorder, brainstem auditory evoked potential, children

摘要： 目的研究华南地区患孤独症谱系障碍(ASD)且听力阈值正常儿童的脑干听觉诱发电位的特征。方法回顾性分析2013—2018年在广州市妇女儿童医疗中心确诊为ASD儿童的脑干听觉诱发电位结果。将其与年龄及性别分布相匹配(P>0.05)的健康儿童诱发电位的听阈值、波潜伏期、波间期、Ⅰ-Ⅲ/Ⅲ-Ⅴ波间期比值及Ⅴ/Ⅰ波幅比值的异常率进行比较分析。如受试者一侧耳的听阈超过30 dBnHL,则该侧耳BAEP数据将被排除在两组之外。结果总共纳入符合入组标准的788例患儿及150例健康对照组儿童。ASD组共有1 530耳以及对照组300耳的BAEP资料纳入最终分析。两组入选受试者在90 dB声刺激下均能分化出良好波形。1)ASD儿童的Ⅰ波潜伏期、Ⅲ波、V波潜伏期以及Ⅰ-Ⅲ波间期均较同龄儿童延长,且差异具有统计学意义(Z=-2.006、-3.986、-2.552、-2.405,P＜0.05);2)ASD儿童Ⅰ-Ⅲ/Ⅲ-Ⅴ波间期比值异常率(3.14%)明显高于对照组,且差异具有统计学意义(P＜0.001)。结论 ASD儿童脑干听觉诱发电位存在特异性改变,尤其脑干传导时间的异常延长,提示ASD患儿存在脑干功能的障碍,可能导致相关信息传递的损害。

关键词: 孤独症谱系障碍, 脑干听觉诱发电位, 儿童

CLC Number:

R749.94

NING Shu-yao, CHEN Wen-xiong, YANG Si-yuan, LI Jia-ling, LIANG Hua-bing, HU You-xiu. Research on the brainstem auditory evoked potential in 788 children with autism spectrum disorders in South China[J]. Chinese Journal of Child Health Care, 2021, 29(7): 775-778.

宁书尧, 陈文雄, 杨思渊, 李嘉铃, 梁华冰, 胡优秀. 华南地区788例孤独症谱系障碍儿童脑干听觉诱发电位的研究[J]. 中国儿童保健杂志, 2021, 29(7): 775-778.

References

[1] American psychiatric association.Diagnostic and statistical manual of mental disorders (DSM)[J]. Codas. 2013,25(2):191-192.
[2] 刘贤,林穗方,陈文雄,等. 中国孤独症谱系障碍患病率Meta分析[J]. 中国儿童保健杂志,2018,26(4):280-285.
[3] Matta SM,Hill-Yardin EL,Crack PJ. The influence of neuroinflammation in autism spectrum disorder[J]. Brain Behav Immun,2019,79:75-90.
[4] 潘映辐. 临床诱发电位学[M].2版.北京:人民卫生出版社。2000:354,356.
[5] World Health Organization. Newborn and infant hearing screening-Current issues and guiding principles for action outcome of a WHO informal consultation[R]. Geneva,Switzerland:WHO,2010.
[6] Wolff JJ,Gu H,Gerig G,et al. Differences in white matter fiber tract development present from 6 to 24 month in infants with autism[J]. Am J Psychiatry,2012,169(6):589-600
[7] Roth DA,Muchnik C,Shabtai E,et al. Evidence for atypical auditory brainstem responses in young children with suspected autism spectrum disorders[J]. Dev Med Child Neurol,2012,54(1):23
[8] Talge NM,Tudor BM,Kileny PR. Click-evoked auditory brainstem responses and autism spectrum disorder:A meta-analytic review[J]. Autism Res,2018,11(6):916-927.
[9] Miron O,Daphne,Ari-Even Roth,et al. Auditory brainstem response in infants and children with autism spectrum disorder:A meta-analysis[J]. Autism Res,2018,11(2):355-363.
[10] Santos M,Marques C,Pinto AN,et al. Autism spectrum disorders and the amplitude of auditory brainstem response wave Ⅰ[J]. Autism Res,2017,10(7):1300-1305.
[11] 吴学文,刘明宇,王凤君,等. 6岁以内孤独症儿童听性脑干反应特征分析[J].听力学及言语疾病杂志,2015,23(5):466-469
[12] American Clinical Neurophysiology Society:Guideline 9A:Guidelines on evoked potentials[J]. Clin Neurophysiol,2006,23:125-137
[13] 屠仁军,谢维. 孤独症的神经生物学研究进展[J]. 中华精神科杂志,2017,50(1):77-80.
[14] Cellot G,Cherubini E. GABA ergic signaling as therapeutic target for autism spectrum disorders[J]. Front Pediatr,2014,2:70.
[15] Yang X,Si T,Gong Q,et al. Brain gray matter alterations and associated demographic profiles in adults with autism spectrum disorder:a meta-analysis of voxel-based morphometry studies[J]. Aust N Z J Psychiatry,2016,50(8):741-753.
[16] Amaral DG,Schumann CM,Nordahl CW. Neuroanatomy of autism[J]. Trends Neurosci,2008,31(3):137-145
[17] Richard EF,Manuel FC,S Hossein F,et al. Neuropathological mechanisms of seizures in autism spectrum disorder[J].Front Neurosci,2016,10(10):192
[18] Toma C,Torrico B,Hervas A,et al. Exome sequencing in multiplex autism families suggests a major role for heterozygous truncating mutations[J]. Mol Psychiatry,2014,19(7):784-790.
[19] Talkowski ME,Maussion G,Crapper L,et al. Disruption of a large intergenic noncoding RNA in subjects with neuro-developmental disabilities[J]. Am J Hum Genet. 2012,91(6):1128-1134.
[20] Gai X,Xie HM,Perin JC,et al. Rare structural variation of synapse and neurotransmission genes in autism[J]. Mol Psychiatry,2012,17(4):402-411.
[21] 陈文雄. 孤独症70年:从Kanner 到DSM-Ⅴ[J]. 临床儿科杂志,2013,31(11):1001-1004.
[22] 邹小兵,邓红珠. 美国精神疾病诊断分类手册第5版“孤独症谱系障碍诊断标准”解读[J]. 中国实用儿科杂志,2013,(8):561-563.
[23] 苏雪云,郭家俊.上海市自闭谱系障碍儿童早期干预现状调查[J].幼儿教育(教育科学),2011,30(6):47-50.
[24] 中华医学会儿科学分会发育行为学组,中国医师协会儿科分会儿童保健专业委员会,儿童孤独症诊断与防治技术和标准研究项目专家组.孤独症谱系障碍患儿常见共患问题的识别与处理原则[J].中华儿科杂志,2018,56(3):174-178.
[25] Miron O,Ari-Even Roth D,Lidia V,et al. Prolonged auditory brainstem responses in infants with autism.[J].Autism research :official journal of the International Society for Autism Res,2016,9(6):689-695.
[26] Roth D A E,Muchnik C,Shabtai E,et al. Evidence for atypical auditory brainstem responses in young children with suspected autism spectrum disorders[J]. Dev Med Child Neurol,2012,54(1):23-29.