先天性感音神经性听力损失儿童人工耳蜗植入前静息状态连接与植入后听觉/语言预后的关系

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-09-22 DOI:10.1016/j.ijporl.2025.112574

Yan Huang , Rong Yan , Shuai Yan , Yuqi Xia , Caifeng Xia , Wenwen Su , Yuyang Wang , Tianyu Xin , Zhe Chen , Zhikai Zhang , Yuhe Liu

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引用次数: 0

摘要

目的探讨静息状态功能连通性（rs-FC）模式是否可以预测重度至重度先天性感音神经性听力损失（CSHL）儿童人工耳蜗植入（CI）后的听觉和语言康复结果，从而为个性化预后和治疗策略提供依据。方法对20例双侧CSHL患儿在听觉皮层发育敏感期行静息态磁共振成像（rs-fMRI）检查。采用幼儿有意义听觉整合量表/有意义听觉整合量表（IT-MAIS/MAIS）在术后12个月内的5个时间点评估患儿的听觉和语言能力。采用多元线性回归分析评估ci前rs-FC与行为结果之间的关系。基于rs-FC显著特征建立了预测模型。结果植入后每个随访点的IT-MAIS/MAIS评分均有显著改善（p < 0.0001）。术前rs-FC涉及前额皮质、枕顶区和皮质下结构，与基线和纵向听觉表现密切相关。特定脑区（包括眶额皮质、角回和Heschl’s回）之间的FCs与术后不同阶段的改善相关。基于rs- fc的预测模型对ci后结果具有较高的解释力（R2值高达0.82）。结论静息状态脑连接模式预ci可作为预测CSHL患儿听觉和语言康复预后的可靠神经影像学生物标志物。这些发现为早期预测提供了神经功能基础，并支持术前脑成像指导下个性化康复方案的发展。

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Pre-implant resting-state connectivity links to post-cochlear implantation auditory/language outcomes in children with congenital sensorineural hearing loss

Objective

To investigate whether preoperative resting-state functional connectivity (rs-FC) patterns can predict auditory and language rehabilitation outcomes following cochlear implantation (CI) in children with severe-to-profound congenital sensorineural hearing loss (CSHL), thereby informing individualized prognostic and therapeutic strategies.

Methods

Twenty pediatric patients with bilateral CSHL underwent resting-state functional magnetic resonance imaging (rs-fMRI) prior to CI during the sensitive period of auditory cortex development. The Infant-Toddler Meaningful Auditory Integration Scale/Meaningful Auditory Integration Scale (IT-MAIS/MAIS) was used to assess the postoperative auditory and language abilities at five time points over 12 months. Multiple linear regression analyses were performed to evaluate the relationship between pre-CI rs-FC and behavioral outcomes. A predictive model was developed based on significant rs-FC features.

Results

Significant improvements in the IT-MAIS/MAIS scores were observed at each follow-up point post-implantation (p < 0.0001). Preoperative rs-FC, involving the prefrontal cortex, occipitoparietal regions, and subcortical structures, strongly correlated with baseline and longitudinal auditory performance. FCs between specific brain regions, including the orbital frontal cortex, angular gyrus, and Heschl's gyrus, were associated with different phases of postoperative improvement. The rs-FC-based predictive model demonstrated high explanatory power for post-CI outcomes (R² values up to 0.82).

Conclusion

Resting-state brain connectivity patterns pre-CI can serve as reliable neuroimaging biomarkers for predicting auditory and language rehabilitation outcomes in young children with CSHL. These findings provide a neurofunctional basis for early prognostication and support the development of personalized rehabilitation protocols guided by preoperative brain imaging.

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.