Article(id=1149769462250914768, tenantId=1146029695717560320, journalId=1146123166801305609, issueId=1149769458706723113, articleNumber=null, orderNo=null, doi=10.12404/j.issn.1671-1815.2405448, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1721318400000, receivedDateStr=2024-07-19, revisedDate=1740672000000, revisedDateStr=2025-02-28, acceptedDate=null, acceptedDateStr=null, onlineDate=1752056001484, onlineDateStr=2025-07-09, pubDate=1747497600000, pubDateStr=2025-05-18, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1752056001484, onlineIssueDateStr=2025-07-09, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1752056001484, creator=13701087609, updateTime=1752056001484, updator=13701087609, issue=Issue{id=1149769458706723113, tenantId=1146029695717560320, journalId=1146123166801305609, year='2025', volume='25', issue='14', pageStart='5705', pageEnd='6154', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1752056000638, creator=13701087609, updateTime=1768456798957, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1218559392753041779, tenantId=1146029695717560320, journalId=1146123166801305609, issueId=1149769458706723113, language=EN, specialIssueTitle=, coverIllustrator=, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1218559392753041780, tenantId=1146029695717560320, journalId=1146123166801305609, issueId=1149769458706723113, language=CN, specialIssueTitle=, coverIllustrator=, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=5788, endPage=5794, ext={EN=ArticleExt(id=1149769462448047060, articleId=1149769462250914768, tenantId=1146029695717560320, journalId=1146123166801305609, language=EN, title=A New Method to Eliminate Stimulus Artifacts in Auditory Brainstem Responses, columnId=1156262732384031076, journalTitle=Science Technology and Engineering, columnName=Papers·Medicine, runingTitle=null, highlight=null, articleAbstract=

ABR(auditory brainstem response) is an objective method for detecting hearing loss, which is widely used in clinical practice, and its waveform characteristics are influenced by stimulus parameters. There are stimulus artifacts in ABR measured using unipolar stimulus, and alternating polarity is currently the only way to eliminate stimulus artifacts. However, considering the physiological differences in the effects of stimuli with different polarities on the auditory system, alternating polarity stimuli may lead to latency jitter in the induced ABR. Therefore, a new method was proposed to eliminate stimulus artifacts-the method of division and sum polarity, which first used positive and negative stimuli separately and then superimposed the two responses induced. The subjects with normal hearing were recruited, and their data that the click ABRs under four polarity ways (positive polarity, negative polarity, alternating polarity, division and sum polarity), as well as the tone-burst ABRs at five frequencies under two polarity ways (alternating polarity and division and sum polarity) were compared, with a focus on their waveform differentiation and latency differences. The results show that the difference in click ABRs under different polarity ways is insignificant, indicating that it is not sensitive to stimulus polarity. The waveform of low-frequency tone-burst ABRs is better under division and sum polarity than under alternating polarity, indicating that the low-frequency tone-burst ABR is more sensitive to stimulus polarity, and the sensitivity decreases with the increase of stimulus frequency. Based on the analysis of the above results, it is recommended to use unipolar stimulus for the click ABR, and the division and sum polarity method for the tone-burst ABR. The feasibility of the division and sum polarity method is validated in this study, which provides a new approach for eliminating stimulus artifacts when measuring evoked potentials.

, correspAuthors=Pan-ke WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Yan-bing JIANG, Pan-ke WANG, Lin LIN), CN=ArticleExt(id=1149769487777448171, articleId=1149769462250914768, tenantId=1146029695717560320, journalId=1146123166801305609, language=CN, title=消除脑干听觉诱发电位中刺激伪迹的新方法, columnId=1156262732526637414, journalTitle=科学技术与工程, columnName=论文·医药、卫生, runingTitle=null, highlight=null, articleAbstract=

脑干听觉诱发电位(auditory brainstem response, ABR)检测是一种客观检测听力损失的方法,目前在临床上广泛应用,其波形特性会受刺激声参数的影响。采用单极性的刺激声测量的ABR中会存在刺激伪迹,而交替极性是目前消除刺激伪迹的唯一办法。然而,考虑到不同极性的刺激对听觉系统作用的生理差异,交替极性的刺激可能导致诱发的ABR出现潜伏期抖动现象。因此,提出了一种新的消除刺激伪迹的方法——分和极性法,即先分开使用正极性和负极性的刺激再叠加诱发得到的两种响应。实验招募了听力正常的受试者,比较了短声在单极性(正/负极性)、交替极性和分和极性4种极性处理方法下诱发的ABR,以及5种频率的短纯音在交替极性和分和极性两种方法下的ABR,重点关注了它们的波形分化和潜伏期差异。实验结果表明短声ABR在不同极性处理方法下的差异不明显,说明其对刺激极性不敏感;低频短纯音ABR在分和极性下的波形形态比交替极性下的更好,说明低频短纯音ABR对刺激极性较为敏感,且这种敏感程度随着刺激频率的升高而降低。基于对实验结果的分析,对于短声ABR,推荐使用单极性刺激;对于短纯音ABR,推荐使用分和极性法。本文研究检验了分和极性法的可行性,为测量诱发电位时消除刺激伪迹提供了一种新的方法。

, correspAuthors=王攀科, authorNote=null, correspAuthorsNote=
*王攀科(1984—),男,汉族,河南洛阳人,博士,讲师。研究方向:神经元信号实时分类系统、神经元电路实时解码系统的设计与实现。E-mail:
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姜言冰(1989—),女,汉族,山东潍坊人,博士,讲师。研究方向:生物医学信号检测与处理、听力损失检测。E-mail:

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姜言冰(1989—),女,汉族,山东潍坊人,博士,讲师。研究方向:生物医学信号检测与处理、听力损失检测。E-mail:

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姜言冰(1989—),女,汉族,山东潍坊人,博士,讲师。研究方向:生物医学信号检测与处理、听力损失检测。E-mail:

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Science Technology and Engineering, 2019, 19(10): 137-143., articleTitle=The design of filter for simulating hearing loss based on the least square method, refAbstract=null)], funds=[Fund(id=1172853015364125310, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149769462250914768, awardId=GDMUB2023004, language=CN, fundingSource=广东医科大学博士学位人员科研启动基金(GDMUB2023004), fundOrder=null, country=null), Fund(id=1172853015418651263, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149769462250914768, awardId=4SG21018G, language=CN, fundingSource=广东医科大学学科建设项目(4SG21018G), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1172853011417285190, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149769462250914768, xref=null, ext=[AuthorCompanyExt(id=1172853011425673799, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149769462250914768, companyId=1172853011417285190, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1. 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Statistical data on the latencies of wave Ⅰ, wave Ⅲ and wave Ⅴ of click ABRs

, figureFileSmall=null, figureFileBig=null, tableContent=
短声
ABR
正极性 负极性 交替极性 分和极性 F P
波 Ⅰ 1.50±0.12 1.56±0.14 1.50±0.14 1.52±0.13 0.698 0.503
波 Ⅲ 3.56±0.14 3.62±0.12 3.60±0.15 3.60±0.16 0.331 0.720
波 Ⅴ 5.44±0.21 5.50±0.20 5.44±0.23 5.48±0.24 0.260 0.772
), ArticleFig(id=1172853014827254393, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149769462250914768, language=CN, label=表1, caption=

短声ABR的波Ⅰ、波Ⅲ和波Ⅴ的潜伏期的统计数据

, figureFileSmall=null, figureFileBig=null, tableContent=
短声
ABR
正极性 负极性 交替极性 分和极性 F P
波 Ⅰ 1.50±0.12 1.56±0.14 1.50±0.14 1.52±0.13 0.698 0.503
波 Ⅲ 3.56±0.14 3.62±0.12 3.60±0.15 3.60±0.16 0.331 0.720
波 Ⅴ 5.44±0.21 5.50±0.20 5.44±0.23 5.48±0.24 0.260 0.772
), ArticleFig(id=1172853014974055034, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149769462250914768, language=EN, label=Table 2, caption=

Statistical data on the latencies of wave Ⅰ, wave Ⅲ and wave Ⅴ of low-frequency tone-burst ABRs

, figureFileSmall=null, figureFileBig=null, tableContent=
低频短纯音ABR 500 Hz 1 000 Hz
交替极性 分和极性 交替极性 分和极性
波 Ⅰ 2.12±0.17 1.88±0.15
P <0.001
波 Ⅲ 4.43±0.17 4.31±0.18 4.06±0.20 4.00±0.19
P 0.081 0.423
波 Ⅴ 5.88±0.25 5.88±0.22 5.81±0.20 5.81±0.21
P 1.000 1.000
), ArticleFig(id=1172853015074718331, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149769462250914768, language=CN, label=表2, caption=

低频短纯音ABR的波Ⅰ、波Ⅲ和波Ⅴ的潜伏期的统计数据

, figureFileSmall=null, figureFileBig=null, tableContent=
低频短纯音ABR 500 Hz 1 000 Hz
交替极性 分和极性 交替极性 分和极性
波 Ⅰ 2.12±0.17 1.88±0.15
P <0.001
波 Ⅲ 4.43±0.17 4.31±0.18 4.06±0.20 4.00±0.19
P 0.081 0.423
波 Ⅴ 5.88±0.25 5.88±0.22 5.81±0.20 5.81±0.21
P 1.000 1.000
), ArticleFig(id=1172853015137632892, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149769462250914768, language=EN, label=Table 3, caption=

Statistical data on the latencies of wave Ⅰ, wave Ⅲ and wave Ⅴ of high-frequency tone-burst ABRs

, figureFileSmall=null, figureFileBig=null, tableContent=
高频短纯音ABR 2 000 Hz 4 000 Hz 8 000 Hz
交替极性 分和极性 交替极性 分和极性 交替极性 分和极性
波 Ⅰ 1.81±0.16 1.75±0.17 1.56±0.16 1.56±0.15 1.50±0.18 1.50±0.19
P 0.345 1.000 1.000
波 Ⅲ 3.81±0.17 3.81±0.17 3.68±0.22 3.68±0.23 3.62±0.21 3.62±0.24
P 1.000 1.000 1.000
波 Ⅴ 5.56±0.23 5.50±0.24 5.50±0.27 5.44±0.25 5.50±0.29 5.50±0.29
P 0.505 0.547 1.000
), ArticleFig(id=1172853015196353149, tenantId=1146029695717560320, journalId=1146123166801305609, articleId=1149769462250914768, language=CN, label=表3, caption=

高频短纯音ABR的波Ⅰ、波Ⅲ和波Ⅴ的潜伏期的统计数据

, figureFileSmall=null, figureFileBig=null, tableContent=
高频短纯音ABR 2 000 Hz 4 000 Hz 8 000 Hz
交替极性 分和极性 交替极性 分和极性 交替极性 分和极性
波 Ⅰ 1.81±0.16 1.75±0.17 1.56±0.16 1.56±0.15 1.50±0.18 1.50±0.19
P 0.345 1.000 1.000
波 Ⅲ 3.81±0.17 3.81±0.17 3.68±0.22 3.68±0.23 3.62±0.21 3.62±0.24
P 1.000 1.000 1.000
波 Ⅴ 5.56±0.23 5.50±0.24 5.50±0.27 5.44±0.25 5.50±0.29 5.50±0.29
P 0.505 0.547 1.000
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消除脑干听觉诱发电位中刺激伪迹的新方法
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姜言冰 1, 2 , 王攀科 1, 2, * , 林林 1, 2
科学技术与工程 | 论文·医药、卫生 2025,25(14): 5788-5794
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科学技术与工程 | 论文·医药、卫生 2025, 25(14): 5788-5794
消除脑干听觉诱发电位中刺激伪迹的新方法
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姜言冰1, 2 , 王攀科1, 2, * , 林林1, 2
作者信息
  • 1. 广东医科大学生物医学工程学院, 东莞 523808
  • 2. 东莞市医学电子与医学影像设备重点实验室, 东莞 523808
  • 姜言冰(1989—),女,汉族,山东潍坊人,博士,讲师。研究方向:生物医学信号检测与处理、听力损失检测。E-mail:

通讯作者:

*王攀科(1984—),男,汉族,河南洛阳人,博士,讲师。研究方向:神经元信号实时分类系统、神经元电路实时解码系统的设计与实现。E-mail:
A New Method to Eliminate Stimulus Artifacts in Auditory Brainstem Responses
Yan-bing JIANG1, 2 , Pan-ke WANG1, 2, * , Lin LIN1, 2
Affiliations
  • 1. School of Biomedical Engineering, Guangdong Medical University, Dongguan 523808, China
  • 2. Key Laboratory of Medical Electronics and Medical Imaging Equipment, Dongguan 523808, China
出版时间: 2025-05-18 doi: 10.12404/j.issn.1671-1815.2405448
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脑干听觉诱发电位(auditory brainstem response, ABR)检测是一种客观检测听力损失的方法,目前在临床上广泛应用,其波形特性会受刺激声参数的影响。采用单极性的刺激声测量的ABR中会存在刺激伪迹,而交替极性是目前消除刺激伪迹的唯一办法。然而,考虑到不同极性的刺激对听觉系统作用的生理差异,交替极性的刺激可能导致诱发的ABR出现潜伏期抖动现象。因此,提出了一种新的消除刺激伪迹的方法——分和极性法,即先分开使用正极性和负极性的刺激再叠加诱发得到的两种响应。实验招募了听力正常的受试者,比较了短声在单极性(正/负极性)、交替极性和分和极性4种极性处理方法下诱发的ABR,以及5种频率的短纯音在交替极性和分和极性两种方法下的ABR,重点关注了它们的波形分化和潜伏期差异。实验结果表明短声ABR在不同极性处理方法下的差异不明显,说明其对刺激极性不敏感;低频短纯音ABR在分和极性下的波形形态比交替极性下的更好,说明低频短纯音ABR对刺激极性较为敏感,且这种敏感程度随着刺激频率的升高而降低。基于对实验结果的分析,对于短声ABR,推荐使用单极性刺激;对于短纯音ABR,推荐使用分和极性法。本文研究检验了分和极性法的可行性,为测量诱发电位时消除刺激伪迹提供了一种新的方法。

脑干听觉诱发电位  /  刺激伪迹  /  交替极性  /  分和极性  /  短声  /  短纯音

ABR(auditory brainstem response) is an objective method for detecting hearing loss, which is widely used in clinical practice, and its waveform characteristics are influenced by stimulus parameters. There are stimulus artifacts in ABR measured using unipolar stimulus, and alternating polarity is currently the only way to eliminate stimulus artifacts. However, considering the physiological differences in the effects of stimuli with different polarities on the auditory system, alternating polarity stimuli may lead to latency jitter in the induced ABR. Therefore, a new method was proposed to eliminate stimulus artifacts-the method of division and sum polarity, which first used positive and negative stimuli separately and then superimposed the two responses induced. The subjects with normal hearing were recruited, and their data that the click ABRs under four polarity ways (positive polarity, negative polarity, alternating polarity, division and sum polarity), as well as the tone-burst ABRs at five frequencies under two polarity ways (alternating polarity and division and sum polarity) were compared, with a focus on their waveform differentiation and latency differences. The results show that the difference in click ABRs under different polarity ways is insignificant, indicating that it is not sensitive to stimulus polarity. The waveform of low-frequency tone-burst ABRs is better under division and sum polarity than under alternating polarity, indicating that the low-frequency tone-burst ABR is more sensitive to stimulus polarity, and the sensitivity decreases with the increase of stimulus frequency. Based on the analysis of the above results, it is recommended to use unipolar stimulus for the click ABR, and the division and sum polarity method for the tone-burst ABR. The feasibility of the division and sum polarity method is validated in this study, which provides a new approach for eliminating stimulus artifacts when measuring evoked potentials.

auditory brainstem response  /  stimulus artifacts  /  alternating polarity  /  division and sum polarity  /  click  /  tone-burst
姜言冰, 王攀科, 林林. 消除脑干听觉诱发电位中刺激伪迹的新方法. 科学技术与工程, 2025 , 25 (14) : 5788 -5794 . DOI: 10.12404/j.issn.1671-1815.2405448
Yan-bing JIANG, Pan-ke WANG, Lin LIN. A New Method to Eliminate Stimulus Artifacts in Auditory Brainstem Responses[J]. Science Technology and Engineering, 2025 , 25 (14) : 5788 -5794 . DOI: 10.12404/j.issn.1671-1815.2405448
脑干听觉诱发电位(auditory brainstem response, ABR)是当人耳受到声刺激后,在头皮表面记录到的由听觉系统产生的电位变化,通常出现在声刺激之后的10 ms内,可以反映耳蜗至脑干听觉神经通路的健康状况[1]。目前,ABR检测在临床上被广泛应用,因其不受主观情绪的影响,可以客观地检测听力损失。ABR是一种声刺激诱发的脑电信号,它的波形特性会受刺激声参数的影响,如刺激类型、刺激极性等[2]。常用的刺激类型有短声和短纯音等,而刺激极性/相位是指声信号时域中初始部分的相位,正向过零则为正极性(也叫密波),负向过零则为负极性(也叫疏波)[3]
声刺激在发出时,其极性会影响耳机膜片的初始振动方向,比如密波短声使耳机膜片朝向人耳鼓膜方向振动,而疏波短声则相反[4]。声刺激到达鼓膜后,正极性刺激会给鼓膜一种向外的作用力,使耳蜗基底膜向上运动到前庭阶,此时毛细胞纤毛弯曲,实现毛细胞去极化;而负极性刺激则会作用在鼓膜上一种向内的力,使耳蜗基底膜向下运动到鼓室阶,毛细胞纤毛反向弯曲,实现毛细胞超极化[5-6]。至于声刺激极性对后续听觉通路的影响,目前尚没有文献给出全面的理论解释,但可以肯定的是刺激极性对ABR信号是有影响的。
关于刺激极性对ABR信号的影响,曾有不少学者开展过相关研究,但结论一致存在争议。首先,关于不同极性的短声诱发的ABR信号之间的差异,有研究认为疏波短声诱发的ABR比密波和交替极性的短声ABR的潜伏期更短;另有研究则认为疏波和密波的短声ABR的潜伏期无明显差异[7]。此外,关于不同极性的短纯音对ABR信号的影响,因涉及短纯音不同频率不同时程的多样化,相关研究则更为复杂,不少研究认为低频刺激诱发的ABR信号受刺激极性的影响较为明显[8-9]
对于短声刺激,考虑到其时程较短(一般采用100 μs),无论采用正极性或负极性的短声,其伪迹都不会干扰到ABR信号的有效成分。然而,对于短纯音刺激,为了兼顾刺激声的瞬态特性和频率特异性,采用的短纯音的时程可能较长,此时短纯音的刺激伪迹会淹没ABR信号[10]。对此,临床上目前唯一的解决办法是采用交替极性的刺激。但考虑到正、负极性的刺激自耳机中发出经听觉通路到最终诱发出ABR信号的作用机理存在的差异性,交替极性的刺激可能会对ABR信号的特性产生不利影响。因此,现尝试一种新的方法,即将正、负极性的刺激分开播放再将得到的目标信号求平均。然后,通过实验比较短声在正极性、负极性、交替极性和新方法下的波形特性,以及短纯音在交替极性和新方法下的波形特性,以检验新方法的有效性。
为了检验刺激声极性对ABR信号的影响,除了常规的单极性(正/负极性)和交替极性外,本研究提出了一种新的极性处理方式,将其命名为分和极性法,以短声为例,如图1(d)所示。该方法先重复播放正极性的刺激声n次,然后将记录的脑电信号经过常规的预处理后,分段叠加平均得到ABR信号,再重复播放负极性的刺激声n次,同样经过分段叠加平均等处理后得到ABR信号,最后将正极性刺激诱发的ABR信号和负极性刺激诱发的ABR信号相加取平均,得到最终的ABR信号。图1(a)~图1(c)分别展示了采用正极性、负极性和交替极性处理短声刺激获取ABR信号的过程示意图。
本次实验测试了两种常用的刺激声,即短声和短纯音。其中,短声采用脉宽为100 μs,频率范围为200~10 000 Hz的矩形波;短纯音采用了包络为“2-1-2”、频率由低到高分别为500、1 000、2 000、4 000、8 000 Hz的5种刺激。图2图3分别是短声和5种频率的短纯音的时域波形和幅度谱,由图3的幅度谱可以看出这几种刺激声的能量分布情况。本次实验测试了短声在单极性(正/负极性)、交替极性和分和极性4种方法下的ABR信号,即图1所示,其中n取1 500次。考虑到5种短纯音刺激的时长(见图2短纯音的时域波形),采用单极性刺激时刺激伪迹会淹没ABR信号,故本次实验只测试了交替极性和分和极性两种极性处理方法下短纯音诱发的ABR信号,其中n也取1 500次。
本次实验招募了7名听力正常的青年受试者。实验前,对每位受试者做了标准听力图测试,每位受试者都签署了实验知情同意书。为了避免环境中的电磁干扰,实验安排在电磁屏蔽室中进行。
本次实验播放刺激声的声强统一用70 dB nHL (normal hearing level),重复速率统一为25次/s。实验时先播放正极性短声,重复播放至少3 000次,将采集到的ABR信号作为一段实验记录,同样极性的刺激至少重复两遍以检验ABR响应的可重复性。然后以同样的方式分别播放负极性短声和交替极性短声,记录采集到的ABR信号。对于短纯音刺激,先播放正极性500 Hz短纯音,重复播放至少1 500次,同样至少重复两遍;然后播放负极性500 Hz短纯音,重复播放至少1 500次,同样至少重复两遍,采集到的正、负极性的短纯音ABR记录用于实现分和极性法;最后播放交替极性500 Hz短纯音,重复播放至少3 000次,同样至少重复两遍。随后,以同样的方式依次播放1 000、2 000、4 000、8 000 Hz的短纯音刺激,记录所得的ABR信号。
使用MATLAB处理实验数据。第一步滤波,采用了带宽为100~3 000 Hz的带通滤波器。第二步分段,以刺激声的位置为分段点。第三步叠加平均,对于单极性和交替极性的短声ABR,选3 000段进行叠加平均得到ABR信号,即得到图1(a)~图1(c);然后分别选1 500段长度的正极性和负极性短声ABR进行叠加平均,将得到的刺激伪迹相反的ABR信号相加取平均,可得分和极性法的ABR信号,即图1(d)。对于5种频率的短纯音ABR,其数据处理方法同短声ABR。
此外,还对获得的短声ABR和短纯音ABR的潜伏期做了统计分析。对于4种极性处理方法下的短声ABR的主要波峰的潜伏期做了方差分析;对两种极性处理方法下的5种频率的短纯音ABR的主要波峰的潜伏期做了配对t检验,其中显著性水平α=0.05。
根据图1中对短声刺激的4种极性处理方法,分别获得了正极性短声ABR、负极性短声ABR、交替极性短声ABR和分和极性短声ABR,以其中一名受试者的波形为例,如图4所示。值得注意的是,单极性短声诱发的ABR中都存在刺激伪迹,见图4中第1~2个图中所标0 ms附近的尖峰,而第3个图中没有尖峰,是因为交替极性和分和极性法都能将刺激伪迹抵消。由图4可见,短声ABR在4种极性处理方法下的波形分化程度差不多,波I~波V都较为明显。
4种短声ABR的波I、波Ⅲ和波V的潜伏期的统计数据(均值、标准差和方差分析)如表1所示。由表1可以看出,4种极性处理方法下的短声ABR的潜伏期没有显著差异(P>0.05,F-test),说明了刺激声的极性对短声ABR的潜伏期没有明显影响。
图5展示了一名受试者在500 Hz和1 000 Hz短纯音刺激下的ABR波形,极性处理分别采用了交替极性和分和极性法。由图5可以看出,500 Hz短纯音在交替极性下诱发的ABR信号波形形态较差,相比之下在分和极性下的ABR信号有分化较好的波Ⅲ和波V(两种方法下的波I都缺失);同样,1 000 Hz短纯音ABR在分和极性下的波形也比交替极性下有更好的波形形态。由此可见,刺激声的极性对低频短纯音ABR的波形分化有明显影响。
表2显示了低频短纯音ABR在交替极性和分和极性下的主要波峰的潜伏期的统计数据(均值、标准差和配对t检验)。由表2可见,1 000 Hz短纯音ABR在分和极性下的波I的潜伏期比交替极性下的短,且配对t检验结果P<0.001,这说明该差异具有统计学意义。但低频短纯音ABR的波V在两种极性处理方法下潜伏期没有显著差异,此时配对t检验结果P>0.05。
图6展示了一名受试者在2 000、4 000、8 000 Hz短纯音刺激下的ABR波形,极性处理分别采用了交替极性和分和极性法。由图6可以看出,相比于低频短纯音ABR,随着刺激频率的升高,短纯音ABR在两种极性处理方法下的波形形态都变得更好。其中,2 000 Hz短纯音ABR在分和极性下的波Ⅱ明显,但交替极性下的波Ⅱ难以分辨,分和极性下的波形形态明显优于后者。但随着刺激频率的进一步升高,4 000 Hz和8 000 Hz短纯音ABR的波形形态在两种极性处理方法下的差异已不明显。由此可见,当刺激声频率升高时,刺激声极性对短纯音ABR的波形分化的影响逐渐减小,当刺激声频率高到一定程度后,两种极性处理方法下的ABR波形差异基本可以忽略。
表3显示了高频短纯音ABR在交替极性和分和极性下的主要波峰的潜伏期的统计数据(均值、标准差和配对t检验)。由表3可见,短纯音ABR的波I、波Ⅲ和波V的潜伏期会随着刺激声频率升高而缩短,而潜伏期在两种极性处理方法之间的差异也逐渐变小。高频短纯音ABR在交替极性和分和极性下的潜伏期均值差基本都不会超过0.1 ms。
研究了短声ABR在正极性、负极性、交替极性和分和极性4种极性处理方法下的波形特性,研究结果表明4种极性处理方法下的短声ABR在波形分化程度和潜伏期上都没有显著差异。由于短声是一种宽频信号,在100~8 000 Hz的频率上均有能量分布,但频域能量主要集中在高频段(图3),而听觉系统的锁相特性是一个低频主导的现象,因而不难理解短声的极性对ABR信号的影响不明显。考虑到短声伪迹不会干扰ABR的波形识别,以及受试者可能存在的个体差异性,当采用短声诱发ABR时,建议使用单极性(疏波或密波)。
通过对比5种频率的短纯音ABR在交替极性和分和极性两种方法下的波形特性,研究结果表明低频短纯音ABR容易受刺激声极性的影响,分和极性下的波形形态优于交替极性下的,但随着刺激声频率的升高,这种优势越来越不明显,这意味着高频短纯音ABR对刺激声极性不敏感。高频短纯音的频域能量也是集中在高频段(图3),这与短声有相似之处,进一步验证了听觉系统的锁相现象是低频主导的。考虑到短纯音ABR受极性影响的程度与短纯音频率的相关性,当采用短纯音诱发ABR时,建议使用本文研究提出的分和极性法代替交替极性。
理论上讲,神经响应是受多种因素作用的,在神经响应的初始阶段,同种刺激的不同极性对耳蜗的作用差异是以到达耳蜗的时间差的形式表现出来的[11],但在耳蜗基底膜触发神经响应后不同极性的表现差异尚待进一步研究。由于耳蜗的蜗尖对低频成分敏感,蜗底对高频成分敏感,在刺激到达耳蜗触发神经响应前,低频刺激相比于高频刺激传播速度较慢,刺激位置蜗尖较远,所以需要花更多的时间才能触发耳蜗基底膜的神经兴奋,因此使用相反极性的低频刺激诱发的ABR在潜伏期上会有比较大的差值[12]。当将交替极性的刺激诱发的ABR数据平均再叠加时,就容易出现潜伏期抖动的问题,此时得到的ABR波形分化不清晰。相比之下,本文研究提出的分和极性法则是将两个在头皮表面采集到的稳定的ABR波形叠加求平均,一方面可以抵消刺激伪迹,另一方面增大了得到清晰ABR的可能。同样是为了改进ABR测量的质量,Martinez等[13]提出了一种随机刺激水平的方法(即刺激声播放时声强水平是随机的),在改善声舒适度的同时也有助于提高ABR成分的识别。
虽然听觉系统的锁相现象是由低频主导的,换言之,当使用低频刺激时诱发的ABR信号才会明显受极性影响,而使用短声这种能量集中在高频段的宽频刺激时,这种刺激极性的低频效应往往会被掩盖[14]。但是如果患者存在高频听力损失,此时诱发的ABR信号则取决于听觉系统对低频刺激的反应了。有研究表明,疏波和密波的短声ABR的潜伏期的差值会随着患者高频听力损失程度的增加而增大[15]。因此,对于高频听力损失的患者,不管采用哪种刺激类型诱发ABR,对刺激极性都会比正常人敏感。对于这些患者,分和极性法可能比交替极性法更适用。
鉴于正/负极性的刺激声对听觉系统作用的生理差异,本文研究提出了一种新方法来消除刺激伪迹,即分和极性法。利用听力正常的受试者的实验数据,比较了短声ABR在4种极性处理方式下的波形特性和5种频率的短纯音ABR在两种极性处理方式下的波形特性。实验结果表明短声ABR受极性影响不明显,但短纯音ABR对刺激极性较为敏感,且这种敏感程度随着刺激频率的升高而降低。本文研究证明了分和极性法相对传统的交替极性的优势,这为测量诱发电位时消除刺激伪迹提供了一种新的方案。在下一步的研究工作中,将计划招募听力受损的受试者,特别是高频听力损失患者,进一步检验分和极性法在不同刺激类型中的有效性。
  • 广东医科大学博士学位人员科研启动基金(GDMUB2023004)
  • 广东医科大学学科建设项目(4SG21018G)
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2025年第25卷第14期
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doi: 10.12404/j.issn.1671-1815.2405448
  • 接收时间:2024-07-19
  • 首发时间:2025-07-09
  • 出版时间:2025-05-18
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  • 收稿日期:2024-07-19
  • 修回日期:2025-02-28
基金
广东医科大学博士学位人员科研启动基金(GDMUB2023004)
广东医科大学学科建设项目(4SG21018G)
作者信息
    1. 广东医科大学生物医学工程学院, 东莞 523808
    2. 东莞市医学电子与医学影像设备重点实验室, 东莞 523808

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*王攀科(1984—),男,汉族,河南洛阳人,博士,讲师。研究方向:神经元信号实时分类系统、神经元电路实时解码系统的设计与实现。E-mail:
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
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