聴性脳幹反応(ABR)における両耳相互作用--ABR・AP同時記録による検討-1-振幅の変化を指標として (京都大学医学部耳鼻咽喉科学教室6年間の歩み(1977-1982年)--檜学教授還暦によせて)

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Auditory brainstem responses (ABR) were first recorded in humans by Jewett et al. (1971), having been shown to reflect activities in both peripheral and central auditory systems. Data from single unit studies, lesion studies and clinical studies obtained by many authors suggest that waves I and II reflect synchronous activities in the eighth nerve and cochlear nuclei ipsilateral to the ear stimulated, respectively.These data also suggest that waves III, IV, V and VI are dependent on the integrity of activities of the higher brainstem auditory nuclei, i. e., superior olivary complex, nuclei of the lateral lemniscus, and inferior colliculus, etc. Identification of the sources of these later waves (III-VI) is, however, less precise than that of early waves (I and II) because of neuro-anatomical and neurophysiological complexities of the upper brainstem auditory nuclei to access. Fortunately, binaurally innervated neurons are present in the higher brainstem auditory nuclei, and binaural interaction is known to occur at most levels of these higher brainstem auditory nuclei.This fact can present valuable information if studied from the standpoint of binaural interaction where the phenomenon seems to take place in ABR. This paper deals with binaural interaction in ABR to reveal the level of wave where binaural interaction takes place. Binaural interaction in ABR is defined in this paper as any deviation in latency and amplitude of the components of ABR from those of properly masked ABR.Auditory brainstem responses and electrocochleogram were recorded in response to monaural click stimuli with or without a continuous white noise to the contralateral ear in 24 subjects who were all normal hearing adults. The results were as follows.1) Neither latency or amplitude of ABR-wave I and EcochG-AP (N1) evoked by clicks at 90dBHL with masking noise at 50dB were altered or degraded by a continuous white noise at 70dB or at silent presented to the contralateral ear (p<0.05). This data implied that a transcranial masking phenomenon did not attribute to the degration of ABR-wave I and EcochG-AP (N1) up to the noise level of 70dB.2) Contrary to the stability of ABR-wave I and EcochG-AP (N1) depicted as above, the amplitudes of ABR-waves II and VI decreased as the intensity of a continuous noise to contralateral ear increased (P<0.05).3) Latency of ABR-wave IV showed a statistically significant prolongation with the increase of the intensity of the noise (P<0.05).4) Both latency and amplitude of ABR-wave V were the most stable to the noise loaded to the contralateral ear.5) The method of binaural interaction in ABR defined in this paper is concluded to be clinically useful in the detection of brainstem pathologic conditions where a clear distinction between ABR-wave V and the other waves is difficult.
耳鼻咽喉科臨床学会の論文

聴性脳幹反応(ABR)における両耳相互作用--ABR・AP同時記録による検討-1-振幅の変化を指標として (京都大学医学部耳鼻咽喉科学教室6年間の歩み(1977-1982年)--檜学教授還暦によせて)

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