Bottom-Up and Top-Down Attention Impairment Induced by Long-Term Exposure to Noise in the Absence of Threshold Shifts.

Abstract

ObjectiveWe aimed to assess the effect of noise exposure on bottom-up and top-down attention functions in industrial workers based on behavioral and brain responses recorded by the multichannel electroencephalogram (EEG).MethodIn this cross-sectional study, 563 shipyard noise-exposed workers with clinical normal hearing were recruited for cognitive testing. Personal cumulative noise exposure (CNE) was calculated with the long-term equivalent noise level and employment duration. The performance of cognitive tests was compared between the high CNE group (H-CNE, >92.2) and the low CNE group; additionally, brain responses were recorded with a 256-channel EEG from a subgroup of 20 noise-exposed (NG) workers, who were selected from the cohort with a pure tone threshold <25 dB HL from 0.25 to 16 kHz and 20 healthy controls matched for age, sex, and education. P300 and mismatch negativity (MMN) evoked by auditory stimuli were obtained to evaluate the top-down and bottom-up attention functions. The sources of P300 and MMN were investigated using GeoSource.ResultsThe total score of the cognitive test (24.55 ± 3.71 vs. 25.32 ± 2.62, p < 0.01) and the subscale of attention score (5.43 ± 1.02 vs. 5.62 ± 0.67, p < 0.001) were significantly lower in the H-CNE group than in the L-CNE group. The attention score has the fastest decline of all the cognitive domain dimensions (slope = −0.03 in individuals under 40 years old, p < 0.001; slope = −0.06 in individuals older than 40 years old, p < 0.001). When NG was compared with controls, the P300 amplitude was significantly decreased in NG at Cz (3.9 ± 2.1 vs. 6.7 ± 2.3 μV, p < 0.001). In addition, the latency of P300 (390.7 ± 12.1 vs. 369.4 ± 7.5 ms, p < 0.001) and MMN (172.8 ± 15.5 vs. 157.8 ± 10.5 ms, p < 0.01) was significantly prolonged in NG compared with controls. The source for MMN for controls was in the left BA11, whereas the noise exposure group's source was lateralized to the BA20.ConclusionLong-term exposure to noise deteriorated the bottom-up and top-down attention functions even in the absence of threshold shifts, as evidenced by behavioral and brain responses.