Effects of Non-Blast mTBI on Binaural Processing and Speech Understanding in Noise

Non-Blast mTBI 对噪声中双耳处理和语音理解的影响

• 批准号: 10537947
• 负责人: Tess Koerner
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-11-01 至 2027-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10537947
• 关键词: Affect; Athletic Injuries; Attention; Auditory; Behavioral; Binaural; Brain Injuries; Central Nervous System; Clinical; Clinical Protocols; Clinical Treatment; Clinical assessments; Code; Cognitive; Complex; Cues; Detection; Development; Diagnosis; Electrophysiology (science); Environment; Freedom; Future; Goals; Hearing; Hearing problem; High Prevalence; Impairment; Individual; Knowledge; Lead; Measures; Methods; Modeling; Noise; Outcome; Outcomes Research; Participant; Patient Self-Report; Patients; Pattern; Performance; Peripheral; Population; Process; Protocols documentation; Recording of previous events; Rehabilitation therapy; Reporting; Research; Research Proposals; Sensory; Sensory Aids; Signal Transduction; Speech; Speech Perception; Stimulus; Stream; Structure; Testing; Training Programs; Veterans; Work; attentional modulation; auditory processing; behavior measurement; behavior prediction; blast exposure; clinical development; clinical diagnosis; cognitive process; comparison control; design; evidence base; experience; falls; improved; mild traumatic brain injury; neural; neuromechanism; neurophysiology; normal hearing; operation; patient population; predictive modeling; programs; response; sound; source localization; speech in noise; stem; tool; treatment strategy; vehicular accident

Mild traumatic brain injury (mTBI) resulting from blast exposure or non-blast incidents such as falls, sports inju- ries, or motor vehicle accidents is prevalent in Operation Enduring Freedom and Operation Iraqi Freedom Vet- erans. In addition, mTBIs represent the leading causes of brain injury in the general US population. Individuals with a history of these brain injuries often report substantial difficulties understanding speech in noise despite having normal peripheral hearing sensitivity. Research using behavioral central auditory processing measures have established that Veterans and non-Veterans with a history of mTBI have binaural processing deficits that likely impact speech understanding in complex listening environments. However, the behavioral measures used in previous studies are unable to effectively tease apart how mTBI effects sensory or cognitive mecha- nisms underlying impaired binaural processing abilities and how these deficits relate to speech understanding in complex listening environments. This lack of knowledge severely limits our understanding of the neurophysi- ological consequences of mTBI and impedes the development of effective, individualized clinical diagnosis and treatment strategies for this patient population. The long-term goal of our research program is to develop tar- geted auditory assessment and rehabilitation tools for individuals with brain injury who have substantial audi- tory difficulties. Our specific objectives for this CDA-2 proposal are to identify the effects of mTBI on sensory and cognitive processing mechanisms and to identify bottom-up and top-down neural coding deficits that are predictive of speech understanding in complex listening environments in this clinical population. Specifically, we aim to identify patterns of bottom-up sensory and top-down cognitive neural coding deficits from electro- physiological measures designed to assess the neural encoding of binaural temporal cues and electrophysio- logical measures designed to assess the cognitive modulation of cortical responses to binaural speech stimuli. This proposal also aims to determine relationships between electrophysiological responses and behavioral measures of speech understanding in complex listening environments. We hypothesize that some Veteran and non-Veteran participants with mTBI will demonstrate degraded neural responses in electrophysiological measures designed to assess the bottom-up neural encoding of binaural auditory cues and those that are de- signed to assess the top-down cognitive modulation of cortical responses to speech. We further hypothesize that a combination of these electrophysiological measures will best predict performance on behavioral measures that assess speech understanding in complex listening environments and self-reported auditory diffi- culties. The expected outcomes of this research proposal include a better understanding of effects of mTBI on top-down sensory and bottom-up cognitive auditory processes that impact the perception of speech in noise. These results will have a significant positive impact by identifying neural mechanisms that should be prioritized in future studies that aim to further delineate the mechanistic and functional effects of mTBI. Together, this work will provide strong evidence for processing mechanisms that should be targeted in future research on the development of clinical auditory assessment and rehabilitation methods for civilians and Veterans with mTBI.

由爆炸暴露或非爆炸事件（如福尔斯跌倒、运动损伤）引起的轻度创伤性脑损伤（mTBI）， 在持久自由行动和伊拉克自由兽医行动中， erans。此外，mTBI是美国普通人群脑损伤的主要原因。个人 有这些脑损伤史的人经常报告在噪音中理解语言有很大的困难， 具有正常的周边听觉灵敏度。使用行为中枢听觉处理测量的研究 已经确定有mTBI病史的退伍军人和非退伍军人具有双耳处理缺陷， 可能会影响复杂听力环境中的语音理解。然而，行为测量 无法有效地梳理mTBI如何影响感官或认知机制- 双耳处理能力受损的潜在原因以及这些缺陷与言语理解的关系 在复杂的聆听环境中。这种知识的缺乏严重限制了我们对神经物理学的理解。 mTBI的临床后果，并阻碍有效的，个性化的临床诊断和 针对这一患者群体的治疗策略。我们研究计划的长期目标是开发焦油- 获得了听觉评估和康复工具，用于脑损伤患者， 保守党的困难。我们的CDA-2提案的具体目标是确定mTBI对感觉的影响。 和认知处理机制，并确定自下而上和自上而下的神经编码缺陷， 预测该临床人群在复杂听力环境中的语音理解。具体地说， 我们的目标是从电刺激中识别自下而上的感觉和自上而下的认知神经编码缺陷的模式， 生理措施，旨在评估双耳时间线索和电生理的神经编码， 旨在评估大脑皮层对双耳语音刺激的认知调节的逻辑测量。 该建议还旨在确定电生理反应和行为之间的关系， 在复杂的听力环境中的语音理解的措施。我们假设一些老兵和 患有mTBI的非退伍军人参与者将在电生理检查中表现出神经反应退化， 旨在评估双耳听觉线索的自下而上的神经编码的措施，以及那些去- 来评估大脑皮层对语言反应的自上而下的认知调节。我们进一步假设 这些电生理测量的组合将最好地预测行为表现， 在复杂的听力环境中评估言语理解的措施和自我报告的听觉差异， 邪教该研究提案的预期成果包括更好地了解mTBI对 自上而下的感觉和自下而上的认知听觉过程，影响噪音中的语音感知。 这些结果将通过确定应该优先考虑的神经机制产生重大的积极影响 在未来的研究中，旨在进一步阐明mTBI的机制和功能作用。在一起，这 这项工作将提供强有力的证据，处理机制，应针对未来的研究， 为患有mTBI的平民和退伍军人开发临床听觉评估和康复方法。