An Intracochlear Approach to Improving the Clinical DP-Gram

改善临床 DP-Gram 的耳蜗内方法

• 批准号: 10174748
• 负责人: GLEN K. MARTIN
• 金额: --
• 依托单位: VA LOMA LINDA HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-10-01 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10174748
• 关键词: Abnormal Cell; Affect; Apical; Basal Cell; Basilar Membrane; Behavior; Biological Assay; Clinic; Clinical; Cochlea; Development; Ear; Exhibits; External auditory canal; Floor; Foundations; Frequencies; Future; Generations; Gerbils; Growth; Hearing Tests; Human; Impairment; Investigation; Knowledge; Lead; Measurement; Measures; Mechanics; Methods; Modeling; Nature; Noise; Outer Hair Cells; Output; Patient Recruitments; Patients; Pattern; Performance; Phase; Play; Population; Procedures; Research; Residual state; Role; Sensorineural Hearing Loss; Signal Transduction; Site; Source; Specificity; Tail; Techniques; Testing; Veterans; base; cell injury; experimental study; hearing impairment; improved; interest; notch protein; otoacoustic emission; patient population; pressure; programs; public health relevance; research clinical testing; response; tool; vector; Abnormal Cell; Affect; Apical; Basal Cell; Basilar Membrane; Behavior; Biological Assay; Clinic; Clinical; Cochlea; Development; Ear; Exhibits; External auditory canal; Floor; Foundations; Frequencies; Future; Generations; Gerbils; Growth; Hearing Tests; Human; Impairment; Investigation; Knowledge; Lead; Measurement; Measures; Mechanics; Methods; Modeling; Nature; Noise; Outer Hair Cells; Output; Patient Recruitments; Patients; Pattern; Performance; Phase; Play; Population; Procedures; Research; Residual state; Role; Sensorineural Hearing Loss; Signal Transduction; Site; Source; Specificity; Tail; Techniques; Testing; Veterans; base; cell injury; experimental study; hearing impairment; improved; interest; notch protein; otoacoustic emission; patient population; pressure; programs; public health relevance; research clinical testing; response; tool; vector

 DESCRIPTION (provided by applicant): PROJECT SUMMARY/ABSTRACT Distortion product otoacoustic emissions (DPOAEs) hold great promise as a means of providing a noninvasive window into the status of the cochlea that can both advance our scientific knowledge about cochlear function, and contribute a rapid test of hearing impairment to the clinical armamentarium. However, when measured at recommended primary-tone levels of about f1=65 and f2=55 dB SPL in patients with sensorineural hearing loss such as Veterans, poor signal-to-noise ratios (SNRs) often make clinical interpretations difficult. DPOAEs elicited by higher primary levels have better SNRs, but are both less sensitive and less frequency specific due to the associated basal spread of both excitation and DPOAE components. If these shortcomings could be overcome, the applicability of DPOAEs in the clinic would be greatly enhanced. The primary significance of the proposed program of research is to further our knowledge of ear-canal DPOAEs vs intracochlear DPs (iDPs) to improve DP-grams measured at moderate to high primary-tone levels for clinical purposes by: 1) understanding the basis of the apparent increase in frequency specificity of the ¿-oct IT procedure by simultaneous measures of both the DPOAE and direct observations of the effects of the IT on f2 and iDP near the basilar membrane (BM) in a gerbil model; 2) comparing these intracochlear measures to those obtained with a noninvasive iDP technique where an f3 tone is paired with the iDP to produce a DPOAE´ used to infer the behavior of the iDP. This comparison will establish the validity of the noninvasive ear-canal method for examining the behavior of iDPs, and determine the differences between DPOAEs and iDPs; and 3) simultaneously measuring the response/growth or input/output functions for both the ear-canal DPOAE´ and the iDP using direct intracochlear pressure measures near the BM. With this approach, transfer functions for the DPOAE´ can be developed that predict the behavior of the iDP inside the cochlea. The planned studies will also compare the performance of the standard DP-gram procedure to two new procedures, the ¿-oct IT DP- gram and the iDP-gram in a population of Veterans with noise-induced audiometric notches in the 4- to 6-kHz range. On the whole, the premise of the proposed experiments is that by determining the differences between conventional ear-canal DPOAEs and iDPs generated within the cochlea, a means towards improving the frequency specificity of clinical DP-gram tests obtained with moderate- to high-level primary tones will be provided. Accomplishing a more frequency-specific DP-gram will allow clinicians to reliably establish the pattern of outer hair cell damage using high-level primary tones to achieve adequate SNRs in Veterans with sensorineural hearing loss.

 描述（由申请人提供）： 项目摘要/摘要失真产品耳声排放（DPOAES）具有巨大的希望，是提供无创的窗口，以使耳蜗的状态提供无创的窗口，这些窗口既可以提高我们对耳蜗功能的科学知识，又可以迅速测试听力障碍对临床武术的检验。但是，当有感觉性听力损失（例如退伍军人）的患者（例如，信噪比差（SNR））以建议的初级色调水平约为F1 = 65 = 65 = 55 dB SPL时，通常会使临床解释变得困难。由较高初级级别引起的DPOAE具有更好的SNR，但由于兴奋和DPOAE成分的基本扩散，敏感性较低，频率较低。如果可以克服这些缺点，那么DPOAE在诊所中的适用性将大大提高。拟议的研究计划的主要意义是进一步了解早期 - 纳入DPOAE vs acochliel DPS（IDP）（IDPS），以改善以中等至高级音调的DP-gram为基础，以：1）通过：1）了解临床的基础：1）了解临床的基础，并直接通过dpoe的频率特异性，并直接在IT效果上进行IT效果，并直接对IT的效果进行i IT的效果。沙鼠模型中的基底膜（BM）； 2）将这些相位内测量结果与使用非侵入性IDP技术获得的测量值进行比较，其中F3音调与IDP配对以产生用于推断IDP行为的DPOAE。这种比较将确定非侵入性耳纳方法检查IDP的行为的有效性，并确定DPOAES和IDPS之间的差异； 3）只需使用直接的BM附近的直接的耳内压力测量值来测量耳朵 - 核DPOAE’和IDP的响应/生长或输入/输出功能。通过这种方法，可以开发出DPOAE的传递函数，以预测耳蜗内IDP的行为。计划的研究还将将标准DP-Gram程序的性能与两个新程序，即DP-GRAM和IDP-GRAM的两个新程序进行比较，在4至6-KHz范围内具有噪声诱导的听力计数的退伍军人中。总体而言，提出的实验的前提是，通过确定耳蜗内产生的常规早期 - 纳入DPOAE和IDP之间的差异，将提供提高使用中度至高级初级音调获得的临床DP-Cram测试频率特异性的方法。完成更频率的DP-Gram将允许临床医生使用高级主音调可靠地建立外部毛细胞损伤的模式，以在具有感觉性听力损失的退伍军人中获得足够的SNR。