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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

基本信息

批准号：
10683206
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
项目类别：
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/10683206
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 Habilitation Head Hearing Hearing Aids Hearing Tests Infant Intervention Laboratories Language Development Length Linguistics Mathematics Measurement Measures Methods Modeling Morphology Napping Noise Normal Range Patients Pattern Periodicals 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 behavior prediction behavior test cost design developmental disease diagnostic tool experimental study hearing impairment hearing range improved innovation insight interest neural normal hearing notch protein recruit response sedative sound standard measure temporal measurement

项目摘要

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/摘要该方案的目标是开发一种新的频率特定的听性脑干反应(Abr)。检查-并行ABR(PABR)-旨在提供更快、更有信息量的诊断。量测 ABR包括在一系列频率和强度上呈现简短的声音，并记录大脑的通过放置在头部的电极进行反应。大约有150,000名婴儿被转介进行诊断在美国，ABR考试每年举行一次。这项检查的结果为重要的临床决策提供了依据儿童言语和语言的长期发展。为了确保儿科使用的良好记录质量，测试是在患者睡觉时进行的。在一次检查中要进行许多测量，如果患者早早醒来，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，这可能会导致磨损和延迟获得声音。在某些患者中，可能有必要使用镇静剂或全身麻醉以确保良好的测量，但最近的研究发现，早期接触这类药物可能会损害发育中的大脑，并导致儿童后期的认知问题。我们的初步数据显示，pABR提供了快速测量，可以解决传统技术的主要缺点是。在这个项目中，我们将运行实验来测试pABR的关键方面，这些方面是必不可少的在将其移植到临床之前了解。这些实验将在成年受试者身上进行，原因有三。首先，这是一项新技术，在婴儿身上测试之前需要证明其可行性。第二，我们将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的准确性这在成年人身上是可能的。第三，ABR在很小的时候就成熟了，使成年人成为合理的榜样。在目标1中，我们将测试刺激参数的特定组合(它们呈现的速度有多快以及它们的强度)将提供最佳的信噪比和测量时间。在目标2中，我们将检验假设与传统的ABR相比，pABR将准确地预测听力阈值，并在临床上使用更快。我们将招募听力从正常到严重丧失的人。我们将通过比较pABR的准确性来测试其准确性行为听力图的阈值预测。我们将通过比较pABR的获取时间和标准诊断性ABR。在目标3中，将测试pABR提供特定于耳蜗处的假设反应，特别是在高刺激水平下，由于兴奋的传播很难获得这些反应。我们会使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备的诊断工具，但花费了大量的时间和经济成本。目标在听力正常和听力正常的成人受试者中回答有关pABR的基本问题损失。这些研究将为pABR未来的翻译铺平道路，这将对数千人产生积极影响每年都有婴儿和儿童死亡。