Automated Objective Audiometry using Long Latency Steady State Responses

本计画的目的是发展一个使用皮质神经网路的自动化听阈估测系统。 在稳态条件下客观分析听觉长潜伏期诱发反应（LLR）。测试 目前主导临床实践的方法，如听觉脑干反应（ABR）和 听觉稳态反应（ASSR），只允许间接推断听力灵敏度， 不能提供听觉通路的全面视图，因为可以通过皮质 应答以前，成熟和唤醒水平的问题，以及缺乏舒适的临床 听力学家在解释LLR结果方面的局限性限制了其广泛的临床实施。 调查人员在他们以前的工作和最近的一些出版物中已经证明了 客观的分析方法可以成功地应用于LLR-定义为听觉 稳态长延迟响应（ASSLLR）-使用低于20 Hz的调制速率。的工作 date已在成人，儿童和婴儿中取得成功，计划重点是 应用于这个最年轻的群体，因为他们不能通过传统的听力测试， 因为它们对大脑皮层的反应提出了最大的挑战。本阶段的具体目标 二、项目内容如下：1）优化ASSLLR采集系统，提高数据质量， 光谱分析分辨率以及将响应分析和检测算法结合到 目前由智能听力系统公司制造和销售的系统平台，2）完善 用于响应检测和降噪的算法和分析工具，3）评估 用于正常听力受试者（n = 20）以及患有 已知的感觉神经性和传导性听力损失（n = 50）与行为阈值相比，4） 新生儿和幼儿数据采集和分析系统的评价（n = 80） 与ABR相比，特别注意参与者状态。工作还将涉及开发测试 基于具体目标3和4的成果和示范的协议和参考数据集 超阈值语言刺激也能产生反应。成功 这项工作的完成将产生一种临床工具，它将提供客观评价 包括皮层水平的听觉系统。

The aim of this project is to develop an automated hearing threshold estimation system using cortical auditory long-latency evoked responses (LLR) analyzed objectively in a steady-state condition. Test methods that dominate clinical practice today, such as auditory brainstem response (ABR) and auditory steady state response (ASSR), permit only indirect inferences about hearing sensitivity and cannot provide a comprehensive view of the auditory pathway, as can be achieved with cortical responses. Previously, maturation and level-of-arousal issues, as well as lack of comfort by clinical audiologists in the interpretation of LLR results have limited their widespread clinical implementation. The investigators have demonstrated in their previous work and in a number of recent publications that an objective analysis approach can be successfully applied to the LLR – defined as the Auditory Steady State Long Latency Responses (ASSLLR) -- using modulation rates below 20 Hz. The work to date has demonstrated success in adults, children and infants with a planned focus for this application on this youngest group, as they cannot be tested by conventional audiometry and because they present the greatest challenges for cortical responses. The specific aims of this Phase II project are, as follows: 1) Optimization of the ASSLLR acquisition system to improve data and spectral analysis resolution and incorporation of response analysis and detection algorithms onto the system platform currently manufactured and marketed by Intelligent Hearing Systems, 2) Refinement of algorithm and analysis tools for response detection and noise reduction, 3) Evaluation of the system for data acquisition in subjects with normal hearing (n=20) and in children and adults with known sensorineural and conductive hearing losses (n=50) compared to behavioral thresholds, 4) Evaluation of the system for data acquisition and analysis in newborns and young infants (n=80) compared to ABR with special attention to participant state. Work will also involve development of test protocols and reference datasets based on the outcomes of Specific Aims 3 & 4 and demonstration that responses can be acquired with supra-threshold speech stimuli as well. The successful completion of this work will result in a clinical tool that will provide methods for objective evaluation of the auditory system that includes the cortical level.