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Differenzierung cochleärer Synaptopathien in verschiedene Hörstörungen

Differentiating cochlear synaptopathies into different hearing disorders

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Zusammenfassung

Demografischer Wandel und verändertes Freizeitverhalten lassen in den nächsten 20–30 Jahren eine rapide Zunahme von Hörstörungen erwarten. Damit steigt das Risiko, an altersbedingtem Sprachdiskriminationsverlust, Tinnitus, Hyperakusis oder, wie neueste Studien postulieren, an Demenz zu erkranken. Es verdichten sich Hinweise darauf, dass bei Mensch und Tier der Verlust spezifischer Hörfasern an verschiedenen Hörstörungen beteiligt ist. Dieser Hörfaserverlust kann durch cochleäre Synaptopathie oder Deafferenzierung verursacht werden und führt nicht zwangsläufig zu klinisch messbaren Hörschwellenabweichungen. Tierexperimentell wurde belegt, dass eine verminderte Hörnervaktivität nach akustischem Trauma oder durch Alter zentral über eine disproportional erhöhte und schnellere akustisch evozierte Stammhirnantwort kompensiert werden kann. Die Analyse der überschwelligen Amplituden von auditorisch evozierten Hirnstammpotenzialen und deren Latenz in Kombination mit nichtinvasiven bildgebenden Techniken wie die Magnetresonanztomographie können helfen die zentrale Kompensationsfähigkeit von Probanden zu identifizieren und definierten Hördefiziten zuzuordnen.

Abstract

Due to demographic change and altered recreational behavior, a rapid increase in hearing deficits is expected in the next 20–30 years. Consequently, the risk of age-related loss of speech discrimination, tinnitus, hyperacusis, or—as recently shown—dementia, will also increase. There are increasing indications that the loss of specific hearing fibers in humans and animals is involved in various hearing disorders. This fiber loss can be caused by cochlear synaptopathy or deafferentation and does not necessarily lead to clinically measurable threshold changes. Animal experiments have shown that reduced auditory nerve activity due to acoustic trauma or aging can be centrally compensated by disproportionately elevated and faster auditory brainstem responses (ABR). The analysis of the suprathreshold amplitudes of auditory evoked brain stem potentials and their latency in combination with non-invasive imaging techniques such as magnetic resonance imaging can help to identify the central compensatory ability of subjects and to assign defined hearing deficits.

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Abbreviations

ABR:

Akustisch evozierte Hirnstammpotenziale

ASSR:

Evozierte Potenziale nach Exposition von amplitudenmodulierten Tönen

BA:

Brodmann-Region

BOLD:

„Blood oxygenation level dependent“

dB:

Dezibel

fMRT:

Funktionelle Magnetresonanztomographie

ms:

Millisekunden

r-fcMRT:

„Resting state functional connectivity MRT“

SPL:

Schalldruckpegel

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Funding

Förderung

Die Arbeiten wurden über die Deutsche Forschungsgemeinschaft DFG-Kni-316-4-1, FOR 2060 project FE 438/5-1, KN316/12-1 and RU713/5‑1, KN316-13-1, SPP16-08 DFG und Hahn Stiftung (Index AG), Action on Hearing Loss (RNID Grant 54) unterstützt

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Authors and Affiliations

  1. Universitätsklinik für Hals-Nasen-Ohren-Heilkunde, Plastische Operationen, Sektion Molekulare Hörphysiologie, Hörforschungszentrum Tübingen (THRC), Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Deutschland

    M. Knipper, B. Hofmeier, W. Singer, S. Wolpert & L. Rüttiger

  2. MR-Forschung, Abteilung für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum Tübingen, Tübingen, Deutschland

    U. Klose

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  1. M. Knipper
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  3. W. Singer
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  4. S. Wolpert
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Correspondence to M. Knipper.

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Interessenkonflikt

M. Knipper, B. Hofmeier, W. Singer, S. Wolpert, U. Klose und L. Rüttiger geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Knipper, M., Hofmeier, B., Singer, W. et al. Differenzierung cochleärer Synaptopathien in verschiedene Hörstörungen. HNO 67, 406–416 (2019). https://doi.org/10.1007/s00106-019-0660-4

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