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.

项目摘要/摘要 该提案的目的是开发一种新型的特定于频率的听觉脑干响应（ABR） 考试 - 平行的ABR（PABR） - 旨在提供更快，更有信息的诊断。测量 ABR涉及在各种频率和强度上呈现简短的声音，并记录大脑的声音 通过将电子放在头上的响应。诊断大约有15万个婴儿 每年在美国的ABR考试。这项考试的结果为影响的重要临床决策提供了影响 孩子的长期言语和语言发展。为了确保儿科使用良好的记录质量， 患者入睡时进行测试。一次考试中有许多测量值 病人提早醒来，然后缩短了测试，导致诊断不完整或需要返回 第二次访问，这可能导致损耗并延迟访问声音。在某些患者中，可能有必要 使用镇静剂或全身麻醉来确保良好的测量，但最近的研究发现 接触此类药物可能会损害发育中的大脑，并在童年后期引起认知问题。我们的 初步数据表明，PABR提供了可以解决传统技术的快速测量。 主要的缺点。在这个项目中，我们将进行测试PABR关键方面的实验，这是必不可少的 在转化为诊所之前要了解。这些实验将在成人受试者中进行，原因有三个。 首先，这是一种新技术，在婴儿进行测试之前，需要证明其可行性。第二，我们会的 能够通过将其结果与听力损失的行为测试进行比较来确定PABR的准确性 成人可能是可能的。第三，艾伯（Abr）年轻时就成熟，使成年人成为合理的模型。在目标1中我们 将检验以下假设，即刺激参数的特定组合（它们的出现速度和它们 强度）将提供最佳的信噪比和测量时间。在AIM 2中，我们将检验假设 与传统ABR相比，PABR可以准确预测听力阈值，并且在临床使用方面的使用速度更快。我们 会招募听力从正常到严重损失的人。我们将通过比较PABR的精度来测试PABR的精度 行为听力图的阈值预测。我们将通过将PABR的获取时间与 标准诊断ABR。在AIM 3中将检验PABR提供人工耳蜗特定的假设 反应，特别是在高刺激水平上，由于兴奋的蔓延很难获得。我们将 员工使用高通掩蔽噪声确定了方法来确定这一点。传统艾伯是一个重要的 以及儿科听力学的必要诊断工具，但它具有大量的时间和经济成本。目的 该项目将回答有关PABR的基本问题 损失。这些研究将为PABR的未来翻译铺平道路，这将对数千个产生积极影响 每年的婴儿和儿童。