【摘要】 目的 探讨经颅磁刺激（rTMS）对耳鸣疗效与患者听觉事件相关电位（ERPs）特性的相关性，寻找耳鸣疗效可能的预测指标。方法 前瞻性收集2023年12月～2024年10月间就诊于我科的44例主观性耳鸣患者及21例年龄、性别相匹配的健康对照，采集受试者基线ERPs，并对耳鸣患者进行2周的rTMS治疗，依据疗效将耳鸣患者分为有效组（24例）和无效组（20例）。分析各组ERPs中N100(N1)和P300(P3)的潜伏期及幅值差异，及与疗效之间的相关性。结果 与健康对照组相比，整体耳鸣患者的P3潜伏期显著延长（381.53±22.47ms vs. 364.36±25.23ms,P<0.05）；对rTMS有效患者的P3潜伏期（390.27±15.37ms）显著长于无效患者（369.50±25.45ms）或健康对照组（364.36±25.23ms），无效组与健康对照组无统计学差异；而N1潜伏期及幅值、P3幅值在各组间无统计学差异（P>0.05）。结论 耳鸣患者群体在反映认知处理速度的P3潜伏期指标上存在显著的异质性。耳鸣患者中，基线P3潜伏期显著延长的亚群，更有可能对rTMS治疗产生应答；而基线P3潜伏期接近正常的耳鸣患者，则不太可能从rTMS方案中获益。更多还原

【Abstract】 Objective To investigate the correlation between auditory event-related potentials(ERPs) and the therapeutic efficacy of repeated transcranial magnetic stimulation(rTMS) in tinnitus patients, aiming to identify potential objective indicators for treatment efficacy. Methods A prospective study was conducted on 44 tinnitus patients who underwent rTMS treatment and 21 age-and sex-matched healthy controls between December 2023 and October 2024. Based on treatment outcomes, tinnitus patients were divided into an effective group(n=24) and an ineffective group(n=20). The latency and amplitude of N100(N1) and P300(P3) components in ERPs were analyzed among the groups, and the correlation between subjective scales and objective indicators was evaluated. Results Compared to the healthy control group, tinnitus patients showed significantly prolonged P3 latency(381.53±22.47 ms vs. 364.36±25.23 ms, P<0.05). The P3 latency in effective group(390.27±15.37 ms) was significantly longer than that in ineffective group(369.50±25.45 ms) or healthy controls(364.36±25.23 ms), while no statistical difference was observed between ineffective group and healthy controls.No significant differences were observed in N1 latency, N1 amplitude, or P3 amplitude among the groups(P>0.05). Conclusions There is marked heterogeneity within the tinnitus patient population regarding the P3 latency, an indicator reflecting cognitive processing speed. Among tinnitus patients, the subgroup with significantly prolonged baseline P3 latency is more likely to respond to rTMS treatment; while patients with baseline P3 latency close to normal are less likely to benefit from the rTMS protocol.更多还原