自闭症谱系障碍儿童的听觉脑干反应

Heba Abou El Wafa, S. Ghobashy, H. Kozou, A. Zakaria
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摘要

自闭症谱系障碍(ASD)的评估和管理是复杂的,因此需要不断努力为ASD的筛查、诊断和治疗制定循证指南。本研究旨在研究自闭症儿童听觉脑干反应(ABR)作为一种潜在的生物标志物,在婴儿期早期检测自闭症,并研究其与重复行为的关系。研究对象包括60名在Elhadara大学医院和mamura精神病院儿童和青少年门诊就诊的儿童,根据DSM-5诊断为ASD。那些有听力或视力障碍、癫痫综合征、精神病或其他情感障碍的人被排除在研究之外。总共有53名(88.3%)男孩和7名(11.7%)女孩参与了这项研究。平均±SD年龄为6.41±1.99岁。儿童自闭症评定量表(第二版)、重复行为量表(修订版)和听力学研究由一名听力学顾问进行,重点是ABR。结果对结果进行统计分析,研究发现,ASD组的右耳和左耳的波III和波V的绝对潜伏期,以及右耳和左耳的波I - III和波I - V的峰间潜伏期均明显偏离正常值,左侧波I的潜伏期与重复行为量表修订总分呈显著正相关。这表明波I的持续时间越长,对应于重复和限制行为的严重程度。结论在对疑似ASD患者进行初步评估时,可按80 dB的ABR(而不是筛查听力障碍时通常按30 dB的ABR),并检查所有参数,以评估听觉加工,而不仅仅是排除听力问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Auditory brainstem responses in children with autistic spectrum disorder
Background The assessment and management of autism spectrum disorder (ASD) is complex and therefore requires continuous efforts for developing evidence-based guidelines for the screening, diagnosis, and treatment of ASD. This research aims to study auditory brainstem response (ABR) in autistic children as a potential biomarker that could detect autism early during infancy as well as to study its relation to repetitive behavior. Patients and methods It included 60 children diagnosed with ASD according to DSM-5 among those attending the Child and Adolescent Outpatient Clinic at Elhadara University Hospital and Mamoura Psychiatric Hospital. Those with hearing or visual impairment, epileptic syndromes, psychotic illness, or other affective disorder were excluded from the study. In all, 53 (88.3%) boys and seven (11.7%) girls participated in this study. Their mean±SD age was 6.41±1.99 years. Childhood Autism Rating Scale, 2nd ed., Repetitive Behavior Scale–Revised, and audiological studies were performed with emphasis on ABR by a consultant of audiology. Results Statistical analysis was done on the results and the study showed that absolute latency of waves III and V on the right ear and those of waves I and III on the left ear and interpeak latencies I–III and I–V of both the right and left ears were significantly away from norms in the ASD group and latency of wave I from the left side shows a significant positive correlation with total Repetitive Behavior Scale–Revised score. This denotes that a longer duration of wave I corresponds to severity of repetitive and restricted behaviors. Conclusion During initial assessment of a suspected ASD case, click ABR at an intensity of 80 dB (not the usual one at an intensity of 30 dB for screening of hearing impairment) to be requested and examination of the full parameters for assessment of auditory processing and not only for excluding a hearing problem.
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