中枢听觉测验联合脑电特征在阿尔茨海默病源性轻度认知障碍早期筛查中的应用

doi:10.3969/j.issn.1006-9771.2026.09.003

Abstract

Abstract:

Objective To investigate the application of central auditory testing combined with electroencephalographic features in the early screening of mild cognitive impairment due to Alzheimer's disease.

Methods A convenience sampling method was used to conduct a field survey in the Qixia District of Nanjing City, Jiangsu Province, from July to September, 2025. A total of 40 older adults diagnosed as mild cognitive impairment due to Alzheimer's disease and 23 cognitively normal older adults were recruited. Auditory N-back and dichotic listening paradigms were employed for assessment, while the scores of Montreal Cognitive Assessment Beijing Version (MoCA-BJ) and 32-channel electroencephalogram (EEG) data were simultaneously collected. Binary logistic regression analysis was applied to identify predictive indicators, receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated.

Results The total score of dichotic listening was positively correlated with overall cognitive function (r = 0.475, P < 0.01), while right-ear advantage showed negative correlations with overall cognition, visuospatial ability, abstract reasoning, and delayed recall (r < -0.276, P < 0.05). Task performance across all conditions of the N-back task was positively correlated with overall cognitive function (r > 0.249, P < 0.05). Regarding EEG features, δ and θ band power and power peaks were positively correlated with delayed recall (r > 0.258, P < 0.05), whereas (α+θ)/(α+β) and θ/(α+β) were positively correlated with naming ability and visuospatial executive function, respectively (r > 0.261, P < 0.05). The results of the binary logistic regression analysis showed that the total score of binaural dichotic listening, the accuracy of 1-back task, the average power of δ waves, and the ratio of θ/(α+β) were independent influencing factors for mild cognitive impairment due to Alzheimer's disease (P< 0.05). The ROC analysis indicated that the AUC for auditory task performance and EEG features were 0.845 and 0.735 respectively, and when combined, the AUC increased to 0.862.

Conclusion The screening model based on the integration of auditory task performance and EEG features can be used in the early identification of mild cognitive impairment due to Alzheimer's disease.

Key words: mild cognitive impairment due to Alzheimer's disease, central auditory test, electroencephalogram, older adults, early screening

CLC Number:

R749.1

Sun Fengyi, Yin Haiyan, Yin Tingting, Yang Bingqing, Gu Jianpeng, Wang Yan, Bai Yamei, Xu Guihua, Song Yulei. Application of central auditory testing combined with electroencephalogram characteristics in the early screening of mild cognitive impairment due to Alzheimer's disease[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(9): 1016-1024.

Figures/Tables 8

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References 35

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组别	n	性别(男/女)/n	年龄/岁	受教育年限/年	婚姻状态(未婚/已婚)/n	是否独居/n	有无家族史/n
HC组	23	4/19	70(63, 73)	11(9, 15)	1/22	2/21	4/19
AD源性MCI组	40	9/31	70(63, 76)	6.5(3, 9)	0/40	4/36	1/39
Z/χ²/t值		0.233	-0.279	-3.928	2.926	7.842	4.290
P值		0.630	0.780	< 0.001	0.492	0.117	0.059

变量	HC组(n = 23)	AD源性MCI组(n = 40)	Z值	P值
双耳分听任务表现
左耳正确评分	20(19, 20)	18.5(15, 19)	-3.950	< 0.001
右耳正确评分	20(19, 20)	19(18, 20)	-2.197	0.028
右耳优势	0(0, 0)	1(0, 1.50)	-3.268	0.001
双耳分听总分	40(38, 40)	38(32.5, 39)	-3.814	< 0.001
N-Back任务表现
0-back正确率	100(100, 100)	100(91.67, 100)	-2.497	0.013
1-back正确率	100(93.75, 100)	93.75(50, 100)	-3.417	< 0.001
2-back正确率	70(60, 80)	50(40, 70)	-2.986	0.003

脑电特征	HC组(n = 23)	AD源性MCI组(n = 40)	Z值	P值
δ波总功率	44.01(35.72, 49.07)	35.92(31.94, 43.90)	-2.184	0.029
δ波平均功率	39.24(30.95, 44.30)	31.16(27.17, 39.13)	-2.184	0.029
θ波总功率	30.95(26.05, 41.64)	25.23(22.14, 33.02)	-1.992	0.046
θ波平均功率	24.93(20.03, 35.62)	19.20(16.12, 27.00)	-1.992	0.046
功率峰值	42.45(33.15, 46.85)	33.77(28.45, 41.36)	-2.156	0.031
θ/β	9(7, 10)	7(5, 9)	-1.994	0.046
(α+θ)/(α+β)	5(4, 6)	4(3, 6)	-2.122	0.034
θ/(α+β)	5(3, 6)	3(2, 5)	-2.213	0.027

项目	视空间与执行能力	命名能力	注意力	语言能力	抽象能力	延迟回忆	定向能力	MoCA-BJ总分
左耳评分	0.409^b	0.232	0.369^b	0.241	0.322^a	0.313^a	0.178	0.491^b
右耳评分	0.251^a	0.230	0.298^a	0.257^a	0.191	0.071	0.116	0.276^a
右耳优势	-0.408^b	-0.100	-0.219	-0.122	-0.276^a	-0.372^b	-0.243	-0.456^b
双耳分听总分	0.379^b	0.288^a	0.365^b	0.270^a	0.308^a	0.286^a	0.155	0.475^b
0-back正确率	0.113	0.269^a	-0.057	0.218	0.155	0.213	-0.104	0.249^a
1-back正确率	0.248^a	0.293^a	0.256^a	0.308^a	0.211	0.275^a	0.132	0.384^b
2-back正确率	0.292^a	0.108	0.135	0.232	0.236	0.330^b	0.351^b	0.420^b

变量	视空间与执行能力	命名能力	注意力	语言能力	抽象能力	延迟回忆	定向能力	MoCA-BJ总分
δ波总功率	0.036	0.211	0.140	-0.143	0.177	0.265^a	0.149	0.195
δ波平均功率	0.036	0.211	0.140	-0.143	0.177	0.265^a	0.149	0.195
θ波总功率	0.094	0.155	0.195	-0.116	0.201	0.282^a	0.166	0.228
θ波平均功率	0.094	0.155	0.195	-0.116	0.201	0.282^a	0.166	0.228
功率峰值	0.024	0.222	0.118	-0.139	0.183	0.258^a	0.151	0.185
(α+θ)/(α+β)	0.118	0.261^a	-0.040	0.099	-0.088	0.020	0.056	0.113
θ/(α+β)	0.274^a	0.198	-0.044	0.001	-0.154	0.028	0.080	0.146

Application of central auditory testing combined with electroencephalogram characteristics in the early screening of mild cognitive impairment due to Alzheimer's disease

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变量	β	SE	Wald χ²	P值	OR值	95%CI
常量	-6.106	1.738	12.345	< 0.001
听觉任务表现
双耳分听总分	-0.250	0.109	5.268	0.022	0.778	0.629~0.964
1-back正确率	-0.105	0.049	4.681	0.031	0.900	0.818~0.990
脑电特征
δ波平均功率	-0.067	0.032	4.307	0.038	0.935	0.878~0.996
θ/(α+β)	-0.363	0.153	5.603	0.018	0.696	0.515~0.940

指标	AUC	95%CI	Youden指数	敏感性	特异性	截断值	P值
听觉任务表现模型	0.845	0.749~0.940	0.545	0.675	0.870	0.673	< 0.001
脑电特征模型	0.735	0.606~0.863	0.446	0.750	0.696	0.640	< 0.001
联合模型	0.862	0.761~0.963	0.658	0.875	0.783	0.589	0.002

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