Spatiotemporal Dynamics of Language Processing in School-Age Children with Mild-to-Severe Hearing Loss

项目摘要/摘要 听力损失的儿童面临着严重的语言延迟的风险，这会导致学习上的困难 以及整个生命周期中的职业设置。然而，听力损失儿童的语言延迟并不是 普遍性；一些儿童明显落后于听力正常的儿童(CNH)，而另一些儿童表现 与CNH类似。最近在轻度到重度听力损失儿童(即重听儿童)中的工作 [CHH])佩戴助听器的人表明语言障碍的程度与听力剂量有关， 由助听器提供获得语音的程度和助听器使用量来定义。 然而，听觉通路(即听力损失和听力剂量)与语言之间的关系 功能仍不清楚。此外，听觉通路对语言相关神经振荡动力学的影响 是完全未知的。拟议的职业生涯早期R21项目将提供有关以下影响的关键新数据 学龄儿童语言功能和神经动力学多层次听觉通路的变异性。 我们有希望的初步工作表明，脑磁图(Meg)的无创成像可以 在整个左侧化语言中精确检测支持语言处理的神经模式 并可以量化儿童神经活动改变与听力剂量之间的关系 啊哈。在当前的研究中，我们将描述听觉通路、语言处理、 在CHH和人口统计学上匹配的CNH的大量队列中的神经发育。参赛者将接受 在一系列语言任务、结构核磁共振、神经心理学和听力测试过程中的基于任务的脑磁图 测试。在目标1中，我们将确定行为差异背后的时空振荡动力学。 在语言加工中观察到CHH和人口统计上匹配的CNH之间的差异。语言缺陷 CHH中的处理将伴随着任务相关神经活动的增加和功能连接的改变 在整个左倾语言网络中。CHH还将在#年招募与语言相关的同源区域 右半球，表明一种补偿机制，和网络水平的振荡像差将 预测任务绩效。在目标2中，我们将表征听觉剂量对语言处理的影响 表现和神经生理学。我们假设听力剂量越高的CHH表现越好。 在语言任务中的表现和更正常化的语言相关神经活动。此外，我们假设 助听器的使用和适合性的个人贡献将取决于听力损失的程度，例如 助听器的使用将对听力损失较轻的儿童产生更大的影响，而助听器的可听性将 这一因素在听力损失较严重的儿童中更为显著。这项研究将提供准确的、定量的 支持语言发展的关键方面的标记，并将确定个人和累加贡献 可塑性的听觉因素，如助听器的适合性和使用。这些数据将有助于描述 在慢性肝炎的语言障碍，并被用来优化治疗干预措施。

Project Summary/Abstract Children with hearing loss are at risk for significant language delays, which cascade into difficulties in educational and vocational settings throughout the lifespan. However, language delays in children with hearing loss are not universal; some children fall significantly behind children with normal hearing (CNH), while others perform similarly to CNH. Recent work in children with mild-to-severe hearing loss (i.e., children who are hard-of-hearing [CHH]) who wear hearing aids suggests that the degree of language impairment correlates with auditory dosage, defined by both the degree to which a hearing aid provides access to speech and the amount of hearing aid use. Nonetheless, the relationship between auditory access (i.e., hearing loss and auditory dosage) and language function is still unclear. Further, the impact of auditory access on language-related neural oscillatory dynamics is completely unknown. The proposed early-career R21 project will provide pivotal new data on the impact of variability in auditory access on multiple tiers of language function and neuronal dynamics in school-age children. Our promising preliminary work shows that noninvasive imaging with magnetoencephalography (MEG) can precisely detect the neural patterns supporting language processing throughout the left-lateralized language network in children and can quantify the relationship between altered neuronal activity and auditory dosage in CHH. In the current study, we will characterize the associations between auditory access, language processing, and neural development in a large cohort of CHH and demographically matched CNH. Participants will undergo task-based MEG during a battery of language tasks, structural MRI, and neuropsychological and audiometric testing. In Aim 1, we will identify the spatiotemporal oscillatory dynamics that underlie the behavioral differences in language processing observed between CHH and demographically matched CNH. Deficits in language processing in CHH will be coupled with increased task-related neural activity and altered functional connectivity throughout the left-lateralized language network. CHH will also recruit homologous language-related regions in the right hemisphere, indicative of a compensatory mechanism, and network-level oscillatory aberrations will predict task performance. In Aim 2, we will characterize the impact of auditory dosage on language processing performance and neurophysiology. We hypothesize that CHH with higher auditory dosage will exhibit better performance in language tasks and more normalized language-related neural activity. Further, we hypothesize that the individual contributions of hearing aid use and fit will depend on the degree of hearing loss, such that hearing aid use will have a greater effect on children with milder hearing loss, while hearing aid audibility will be the more significant factor in children with more severe hearing loss. This study will provide precise, quantitative markers supporting key facets of language development and will identify the individual and additive contributions of malleable auditory factors such as hearing aid fit and use. These data will help characterize the nature of language impairments in CHH and be used to optimize therapeutic interventions.