CAEP基本概念及其临床应用.pptVIP

案例 4 助听后皮层电位测试时年龄 Visit 1 8 months old Visit 2 9 months old 第二次来访前提高助听器的增益 第九周进行助听器验配 不够明显的皮层电位反应，随着 提高助听器增益，获得更多皮层 电位的反应 NAL: Dillon, Van Dun, Carter, Gardner-Berry Electrode location电极放置位置 Inverting Non-inverting + - Ground NAL: Dillon, Van Dun, Carter, Gardner-Berry Filtering滤波 NAL: Dillon, Van Dun, Carter, Gardner-Berry Reducing measurement variability (random electrical signals) 减少测试变异因素（随机电噪声）? Speeding up measurements提高测试速度? Increasing validity of interpretation提高判断效度 NAL: Dillon, Van Dun, Carter, Gardner-Berry 解决方法：Residual Noise Calculation 残余噪声计算技术，即时显示残余噪声水平 Grand Average n = 16 infants + MM OO OR UU AH EE SH SS ms 0.00 200.00 400.00 600.00 - NAL: Dillon, Van Dun, Carter, Gardner-Berry P Adults /tae/ /gae/ /mae/ 500 Hz 2 kHz Time (ms) Infants P1 P2 P N1 NAL: Dillon, Van Dun, Carter, Gardner-Berry Fig. 1 Examples of P1 waveforms for a normally developing central auditory pathway (top), an unstimulated central auditory system, (second from top), a partially stimulated central auditory system loss (third from top), a re-organized auditory cortex (bottom). Anu Sharma,a,* Amy A. Nash,a and Michael Dormanb，Cortical development, plasticity and re-organization in children with cochlear implants J Commun Disord. 2009 Jul–Aug; 42(4): 272–279. 多相波形（一种重组的听觉皮层） 波形延迟（部分被刺激的中枢听觉系统损失） 分化负波（未被刺激的中枢听觉系统） 正常发育（正常发育的中枢听觉通路） NAL: Dillon, Van Dun, Carter, Gardner-Berry Presentation of average response in series Proportion with responses present - adults反应呈现百分比-成人 NAL: Dillon, Van Dun, Carter, Gardner-Berry CLINICAL APPLICATIONS临床应用 Estimating hearing thresholds in non-responsive adults听力阈值评估 Elderly infirm – stroke, dementia Workers’ compensation Good agreement between CAEP and audiometric thresholds in awake adults Tsui, Wong Wong 2002 Cortical thresholds minus Behavioral thresholds 68% +5 dB 84% +10 dB 91% +15 dB NAL: Dillon, Van Dun, Carter, Gardner-Berry NAL: Dillon, Van Dun, Carter, Gardner-Berry Davis (1965) Cortical evoked potential versus behavioural thr