Automated Objective Audiometry using Long Latency Steady State Responses

本项目的目的是开发一种自动听阈评估系统，该系统使用CORCALIC 在稳态条件下对听觉长潜伏期诱发反应(LLR)进行了客观分析。测试 当今主导临床实践的方法，如听性脑干反应(ABR)和 听觉稳态反应(ASSR)，仅允许对听力敏感度和 不能提供听觉通路的全面视图，而皮质可以达到 回应。以前，成熟度和觉醒水平问题，以及临床缺乏舒适感 听力学专家在解释LLR结果时，限制了其在临床上的广泛应用。 研究人员在他们之前的工作和最近的一些出版物中证明了 一种客观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赫兹的调制速率。这项工作将 Date已经在成人、儿童和婴儿中证明了成功，并计划将重点放在这一点上 适用于这一最年轻的群体，因为他们不能通过传统的听力测试和 因为它们给大脑皮层反应带来了最大的挑战。这一阶段的具体目标 第二个项目如下：1)优化ASSLLR采集系统，以改进数据和 光谱分析分辨率以及将响应分析和检测算法合并到 目前由智能听力系统制造和销售的系统平台，2)精细化 用于响应检测和降噪的算法和分析工具；3)评估 听力正常的受试者(n=20)以及听力正常的儿童和成人的数据采集系统 已知的感觉神经性和传导性听力损失(n=50)与行为阈值的比较，4) 新生儿和婴幼儿数据采集与分析系统的评价(n=80) 与ABR相比，特别关注参与者状态。工作还将涉及测试的开发 以具体目标3和4的结果为基础的议定书和参考数据集以及示范 这种反应也可以用超过阈值的语音刺激来获得。成功者 这项工作的完成将产生一种临床工具，将为客观评估 包括大脑皮层的听觉系统。

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.