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

• 批准号: 10238036
• 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
• 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/10238036
• 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; Gold; Habilitation; Head; Health Services Accessibility; Hearing; Hearing Aids; Hearing Tests; ImProv; Infant; Intervention; Laboratories; Language Development; Lead; Length; Linguistics; Masks; Mathematics; Measurement; Measures; Methods; Modeling; Morphology; Napping; Noise; Normal Range; Patients; Pattern; Periodicity; 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; base; behavior test; cost; design; developmental disease; experimental study; hearing impairment; hearing range; improved; innovation; insight; interest; normal hearing; notch protein; recruit; relating to nervous system; response; sedative; sound; standard measure; temporal measurement; tool

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.

项目总结/摘要 本研究的目的是开发一种新的频率特异性听性脑干反应（ABR） 并行ABR（pABR）-旨在提供更快，更丰富的诊断。测量 ABR包括在一定频率和强度范围内呈现简短的声音， 通过放置在头部的电极做出反应。约有15万名婴儿被转诊接受诊断， ABR考试每年在美国举行。这项检查的结果为重要的临床决策提供信息， 孩子的长期语言发展。为了确保儿科使用的良好记录质量， 测试是在病人睡觉时进行的。在一次检查中有许多测量，如果 病人醒来早，然后测试被缩短，导致不完整的诊断或需要返回一个 第二次访问，这可能会导致磨损和声音获取延迟。在某些患者中，可能需要 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， 接触这些药物可能会损害发育中的大脑，并在儿童期后期引起认知问题。我们 初步数据表明，pABR提供了快速的测量，可以解决传统技术的问题， 主要缺点。在这个项目中，我们将进行实验，测试pABR的关键方面，这是必不可少的 在将其应用于临床之前，这些实验将在成年受试者中进行，原因有三。 首先，这是一项新技术，在婴儿身上进行测试之前，需要证明其可行性。二是 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 在成年人身上是可能的。第三，ABR在很小的时候就成熟了，这使得成年人成为一个合理的模型。在目标1中， 将测试刺激参数的特定组合（它们呈现的速度以及它们的 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 pABR将准确地预测听阈，并且在临床应用中比传统ABR更快。我们 将招募听力正常到严重受损的人。我们将通过比较pABR的准确性来测试pABR的准确性。 行为听力图的阈值预测。我们将通过比较pABR的采集时间和 标准诊断性ABR。在目标3中，将检验pABR提供耳蜗位置特异性的假设。 反应，特别是在高刺激水平，这些是很难获得由于传播的兴奋。我们将 使用高通掩蔽噪声来确定这一点。传统ABR是一种重要的 和儿童听力学的必要诊断工具，但它需要大量的时间和经济成本。目标 将回答听力正常和听力正常的成年受试者的pABR的基本问题 损失这些研究将为pABR的未来翻译铺平道路，这将对数千人产生积极影响。 婴儿和儿童每年。