| Objective:Mismatch negativity(MMN)is a component of event-related potential(ERP),which is an EEG response evoked by a series of repetitive,identical "standard stimuli" with any discernible difference in the "deviant stimuli"."The difference negative wave with an onset latency of 100-250 ms,obtained by subtracting the wave evoked by the standard stimulus from the wave evoked by the deviant stimulus,is called MMN,which is an electrophysiological measure of the automatic processing of sensory information in the brain.Obstructive sleep apnea hypopnea syndrome(OSAHS)is a condition in which the upper airway collapses during sleep,causing apnea and hypoventilation,usually accompanied by snoring,disrupted sleep architecture,frequent decreases in oxygen saturation,daytime sleepiness,and inattention.There are few clinical reports on the application of MMN in OSAHS disease.This study investigates the function of the auditory center in adult patients with different degrees of OSAHS by observing the characteristics of auditory MMN latency and wave amplitude,and comparing it with MMN in healthy controls,so as to provide a theoretical basis for exploring whether there is specificity of the auditory center in patients with different degrees of OSAHS and further promote the understanding of This will provide a theoretical basis for exploring whether there is specificity in the auditory centers of patients with different degrees of OSAHS,further promote research on the auditory centers of adult patients with OSAHS,and provide a reference for the prevention of long-term complications in adult patients with OSAHS in the future.Methods:Thirty-five adult patients with mild,38 adult patients with moderate,and 40 adult patients with severe OSAHS were used as the experimental group,and 40 adult patients with normal physical examination were used as the healthy control group.153 adult patients with different degrees of OSAHS and normal physical examination were subjected to MMN,polysomnography(PSG),pure tone audiometry(PTA),acoustic immittance(AI),and auditory brainstem response(ABR).PTA,Acoustic immittance(AI),and Auditory brainstem response(ABR)were performed.Information was collected from adult patients with different degrees of OSAHS as well as normal adults by PSG examination,and then screened by inclusion criteria to divide them into mild OSAHS group,moderate OSAHS group,severe OSAHS group,and control group.Subjects with abnormal hearing were excluded by PTA examination.Subjects with middle ear abnormalities and auditory neuroma lesions were excluded by AI and ABR examinations.The MMN of the subjects in the mild OSAHS,moderate OSAHS,severe OSAHS and control groups was tested using the classic oddball model with a standard stimulus of 1000 Hz and a deviated stimulus of 2000 Hz,and the characteristics of the MMN latency and amplitude of each group were observed.We also compared the differences in MMN latency,amplitude,gender and age between adult patients with different degrees of OSAHS and normal subjects and between two pairs of adult patients with mild,moderate,and severe OSAHS.Results:(1)MMN waveforms were elicited normally in 153 subjects(306 ears).The mean latency and mean wave amplitude of MMN in the adult group with mild OSAHS were 158.71±16.25 ms and 2.81±1.37 μV,respectively;the mean latency and mean wave amplitude of MMN in the normal adult group were 143.07±29.92 ms and 2.70±1.40 μV,respectively.(2)The mean latency and mean wave amplitude of MMN in the adult group with moderate OSAHS were 169.85±28.90ms and 3.39±2.44μV,respectively;the mean latency and mean wave amplitude of MMN in the normal adult group were 143.07±29.92ms and 2.70±1.40μV,respectively.(3)The mean latency and mean wave amplitude of MMN in the adult group with severe OSAHS were 175.83±24.79ms and 2.54±1.29μV,respectively;the mean latency and mean wave amplitude of MMN in the normal adult group were 143.07±29.92ms and 2.70±1.40μV,respectively.(4)There was a statistically significant difference in latency between the adult group with moderate and severe OSAHS and the normal control group(p-values were(0.015,0.001);there was no statistically significant difference in latency between the adult group with mild OSAHS and the normal control group(p-value was 0.111);there was no statistically significant difference in age and gender between the three experimental groups;no statistically significant difference in wave amplitude between the three experimental groups and the normal control group(p-values were 0.879,0.798,0.316,respectively).(5)Two-by-two comparison of age,gender,latency,and wave amplitude between the three groups of patients with different degrees of OSAHS was performed,and the data were processed using SPSS 20.0 statistical software,and ANOVA was performed between the groups.The results showed no statistical difference between the three groups of patients with different degrees of OSAHS in terms of age,gender,latency,and wave amplitude.Conclusion:(1)MMN latency was not statistically different in adult patients with mild OSAHS compared to controls,while MMN latency was prolonged in adult patients with moderate and severe OSAHS compared to controls.The prolonged MMN latency implies a decrease in the speed of processing auditory information through the central auditory pathway,and we consider that prolonged hypoxemia in OSAHS patients has an impact on cortical auditory function.This provides a theoretical basis for exploring the relationship between the complications of different degrees of OSAHS and their auditory centers,further promoting research on the auditory aspects of OSAHS,and also providing a reference for the future prevention of auditory center problems in patients with moderate or severe OSAHS,i.e.,the clinical application of MMN.(2)The MMN wave amplitude in adult patients with different degrees of OSAHS was not statistically different from the control group.There are many factors affecting the wave amplitude,which may also be related to the small sample size and inter-individual differences in MMN wave amplitude in this study,so we need to conduct a large sample and multi-center study in the future to further understand the changes in wave amplitude and promote the study of the auditory center in patients with different degrees of OSAHS.(3)There were no statistically significant differences between the ages and gender of the adult patients with different degrees of OSAHS and the controls,considering the possibility that the majority of the subjects in this study were aged 35-45 years or related to the small sample size of this study.(4)There was no statistical difference between the age,gender,latency,and wave amplitude of the three groups of adult patients with different degrees of OSAHS,which may be due to the insufficient sample size in this study or the fact that all patients with different degrees of OSAHS produced changes in the auditory center,it is also possible that there is no difference in gender between groups,but overall comparison still shows that the incidence of OSAHS is more frequent in men than in women,and we need to conduct a large sample and multicenter study in the future to observe the characteristics of age,latency,and wave amplitude among adult patients with different degrees of OSAHS. |
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