Rapid acquisition of the frequency-specific auditory brainstem response through parallel stimulus presentation

通过并行刺激呈现快速获取特定频率的听觉脑干反应

• 批准号: 10468716
• 负责人: Ross K Maddox
• 金额: $ 38.5万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10468716
• 关键词: Acoustic Nerve; Acoustics; Address; Adult; Affect; Age; Anesthesia procedures; Area; Audiology; Auditory Brainstem Responses; Auditory Threshold; Auditory system; Behavior Therapy; Behavioral; Brain; Child; Childhood; Clinic; Clinical; Cochlea; Cognitive; Data; Development; Diagnosis; Diagnostic; Ear; Electrodes; Ensure; Evoked Potentials; Exposure to; Financial cost; Frequencies; Future; General Anesthesia; Goals; Gold; Habilitation; Head; Health Services Accessibility; Hearing; Hearing Aids; Hearing Tests; ImProv; Infant; Intervention; Laboratories; Language Development; Lead; Length; Linguistics; Masks; Mathematics; Measurement; Measures; Methods; Modeling; Morphology; Napping; Noise; Normal Range; Patients; Pattern; Periodicity; Persons; Pharmaceutical Preparations; Public Health; Randomized; Risk; Running; Series; Signal Transduction; Sleep; Specificity; Speech Development; Speed; Stimulus; Techniques; Testing; Time; Translations; United States; Visit; Work; accurate diagnosis; base; behavior test; cost; design; developmental disease; diagnostic tool; experimental study; hearing impairment; hearing range; improved; innovation; insight; interest; normal hearing; notch protein; recruit; relating to nervous system; response; sedative; sound; standard measure; temporal measurement

Project Summary/Abstract The goal of this proposal is to develop a new kind of frequency-specific auditory brainstem response (ABR) exam—the parallel ABR (pABR)—which is designed to provide faster, more informative diagnoses. Measuring the ABR involves presenting brief sounds over a range of frequencies and intensities and recording the brain's response through electrodes placed on the head. Approximately 150,000 infants are referred for a diagnostic ABR exam each year in the United States. The results of this exam inform important clinical decisions that affect the child's long-term speech and language development. To ensure good recording quality in pediatric use, the test is performed while the patient sleeps. There are many measurements to make in a single exam, and if the patient wakes up early then the test is cut short, leading to incomplete diagnoses or the need to return for a second visit, which may result in attrition and delayed access to sound. In some patients it may be necessary to use sedatives or general anesthesia to ensure good measurements, but recent studies have found that early exposure to such drugs may damage the developing brain and cause cognitive problems later in childhood. Our preliminary data show that the pABR provides rapid measurement that could address traditional techniques' major shortcoming. In this project we will run experiments that test key aspects of the pABR which are essential to understand before its translation to the clinic. These experiments will be run in adult subjects for three reasons. First, it is a new technique whose feasibility needs to be demonstrated before testing in infants. Second, we will be able to determine the accuracy of the pABR by comparing its results to the behavioral tests of hearing loss that are possible in adults. Third, ABRs mature at a young age, making adults a reasonable model. In Aim 1 we will test the hypothesis that specific combinations of stimulus parameters (how fast they are presented and their intensity) will provide optimal signal-to-noise ratios and measurement times. In Aim 2 we will test the hypothesis that the pABR will accurately predict hearing thresholds and be faster in clinical use than traditional ABR. We will recruit people with hearing ranging from normal to severe loss. We will test pABR accuracy by comparing its threshold predictions to behavioral audiograms. We will test speed by comparing acquisition time of pABR to that of standard diagnostic ABR. In Aim 3 will test the hypothesis that the pABR provides cochlear place specific responses, particularly at high stimulus levels where these are hard to obtain due to spread of excitation. We will employ established methods using high-pass masking noise to determine this. Traditional ABR is an important and necessary diagnostic tool for pediatric audiology, but it carries significant time and financial cost. The aims of this project will answer basic questions about the pABR in adult subjects with normal hearing and with hearing loss. These studies will pave the way for the pABR's future translation, which would positively impact thousands of infants and children each year.

项目概要/摘要 该提案的目标是开发一种新型的频率特异性听觉脑干反应（ABR） 检查——并行 ABR (pABR)——旨在提供更快、信息更丰富的诊断。测量 ABR 涉及呈现一系列频率和强度的简短声音并记录大脑的声音 通过放置在头上的电极做出反应。大约 150,000 名婴儿被转诊接受诊断 美国每年都有ABR考试。该检查的结果为影响的重要临床决策提供了信息 孩子的长期言语和语言发展。为了确保儿科使用中良好的记录质量， 测试在患者睡觉时进行。在一次检查中需要进行许多测量，如果 患者早起，然后测试被缩短，导致诊断不完整或需要返回进行检查 第二次访问，这可能会导致人员流失和延迟获取声音。对于某些患者来说，可能需要 使用镇静剂或全身麻醉来确保良好的测量结果，但最近的研究发现早期 接触此类药物可能会损害正在发育的大脑，并导致儿童后期出现认知问题。我们的 初步数据表明，PABR 提供的快速测量可以解决传统技术的问题 主要缺点。在这个项目中，我们将进行实验来测试 pABR 的关键方面，这些方面至关重要 在翻译到临床之前先了解一下。这些实验将在成人受试者中进行，原因有三个。 首先，这是一项新技术，在婴儿身上进行测试之前需要证明其可行性。其次，我们将 能够通过将 pABR 的结果与听力损失的行为测试进行比较来确定 pABR 的准确性 这在成年人中是可能的。第三，ABR在很小的时候就成熟了，使成年人成为一个合理的模型。在目标 1 中，我们 将测试以下假设：刺激参数的特定组合（它们呈现的速度及其 强度）将提供最佳的信噪比和测量时间。在目标 2 中，我们将检验假设 pABR 将准确预测听力阈值，并且在临床使用中比传统 ABR 更快。我们 将招募听力从正常到严重丧失的人员。我们将通过比较 pABR 的准确性来测试 pABR 的准确性 行为听力图的阈值预测。我们将通过比较 pABR 的采集时间来测试速度 标准诊断 ABR。在目标 3 中，将测试 pABR 提供耳蜗位置特异性的假设 反应，特别是在高刺激水平下，由于兴奋的扩散而很难获得这些反应。我们将 采用使用高通掩蔽噪声的既定方法来确定这一点。传统的ABR是一个重要的 和儿科听力学必要的诊断工具，但它需要大量的时间和财务成本。目标 该项目将回答有关听力正常和有听力的成人受试者的 pABR 的基本问题 损失。这些研究将为 pABR 的未来翻译铺平道路，这将对数千人产生积极影响 每年的婴儿和儿童。