Oto-Rhino-Laryngosurgery Clinic, Institute of Physiology and Pathology of Hearing, M Mochnackiego 10, 02-042, Warsaw, Poland.
World Hearing Centre, Mokra 17, 05-830, Nadarzyn, Poland.
Eur Arch Otorhinolaryngol. 2023 Oct;280(10):4361-4369. doi: 10.1007/s00405-023-07924-y. Epub 2023 Apr 1.
If before cochlear implantation it was possible to assay biomarkers of neuroplasticity, we might be able to identify those children with congenital deafness who, later on, were at risk of poor speech and language rehabilitation outcomes.
A group of 40 children aged up to 2 years with DFNB1-related congenital deafness was observed in this prospective cohort study over three follow-up intervals (0, 8, and 18 months) after cochlear implant (CI) activation. Children were assessed for auditory development using the LittlEARS Questionnaire (LEAQ) score, and at the same time, measurements were made of matrix metalloproteinase-9 (MMP-9) plasma levels.
There were significant negative correlations between plasma levels of MMP-9 at 8-month follow-up and LEAQ score at cochlear implantation (p = 0.04) and LEAQ score at 18-month follow-up (p = 0.02) and between MMP-9 plasma levels at 18-month follow-up and LEAQ score at cochlear implantation (p = 0.04). As already reported, we confirmed a significant negative correlation between MMP-9 plasma level at cochlear implantation and LEAQ score at 18-month follow-up (p = 0.005). Based on this latter correlation, two clusters of good and poor CI performers could be isolated.
The study shows that children born deaf who have an MMP-9 plasma level of less than 150 ng/ml at cochlear implantation have a good chance of attaining a high LEAQ score after 18 months of speech and language rehabilitation. This indicates that MMP-9 plasma level at cochlear implantation is a good prognostic marker for CI outcome.
如果在人工耳蜗植入前能够检测到神经可塑性的生物标志物,我们或许就有可能识别出那些先天性耳聋的儿童,他们在以后的语言康复结果中存在风险。
本前瞻性队列研究观察了 40 名年龄在 2 岁以下、携带 DFNB1 基因突变的先天性耳聋儿童,他们在人工耳蜗植入(CI)激活后进行了三个随访间隔(0、8 和 18 个月)。使用 LittlEARS 问卷(LEAQ)评分评估儿童的听觉发育,同时测量基质金属蛋白酶-9(MMP-9)的血浆水平。
在 8 个月的随访中,MMP-9 的血浆水平与 CI 时的 LEAQ 评分(p=0.04)和 18 个月的 LEAQ 评分(p=0.02)呈显著负相关;在 18 个月的随访中,MMP-9 的血浆水平与 CI 时的 LEAQ 评分(p=0.04)呈显著负相关。正如我们之前报道的那样,我们证实了 CI 时的 MMP-9 血浆水平与 18 个月的 LEAQ 评分呈显著负相关(p=0.005)。基于这一相关性,我们可以将两组 CI 表现良好和较差的儿童区分开来。
该研究表明,在人工耳蜗植入时 MMP-9 血浆水平低于 150ng/ml 的先天性耳聋儿童在接受 18 个月的言语和语言康复后,有很大机会获得较高的 LEAQ 评分。这表明,CI 结果的 MMP-9 血浆水平是一个很好的预后标志物。