Neural Pathophysiology and Suprathreshold Processing in Older Adults with Elevated Thresholds

阈值升高的老年人的神经病理生理学和阈上处理

• 批准号: 10222647
• 负责人: Daniel B. Polley
• 金额: $ 54万
• 依托单位: MASSACHUSETTS EYE AND EAR INFIRMARY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-02 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10222647
• 关键词: Acoustic Nerve; Acoustics; Action Potentials; Address; Adult; Age; Audiology; Auditory; Auditory Threshold; Auditory area; Behavioral; Binaural; Biological Markers; Chronic; Clinic; Code; Communication; Computer software; Cues; Data; Diagnosis; Discrimination; Double-Blind Method; Elderly; Electrocochleographies; Environment; Exhibits; Frequencies; Functional disorder; Future; Goals; Health; Hearing; Hearing Tests; High-Frequency Hearing Loss; Immersion; Impairment; Individual; Intervention Studies; Link; Longitudinal Studies; Maps; Measurement; Measures; Memory; Motivation; Motor; Music; Noise; Outcome; Pathology; Patients; Peripheral; Persons; Physiological; Placebos; Prevalence; Psychological Transfer; Psychophysics; Randomized; Recording of previous events; Reflex action; Research Design; Sensorineural Hearing Loss; Series; Signal Transduction; Social Well-Being; Speech; Speech Intelligibility; Stimulus; Structure; Tablets; Testing; Training; Video Games; Well in self; Workplace; auditory discrimination; auditory feedback; base; cochlear synaptopathy; cohort; experimental study; follow-up; hearing impairment; improved; instrument; middle age; middle ear; normal hearing; novel strategies; otoacoustic emission; placebo controlled study; pressure; recruit; relating to nervous system; response; social; sound; speech in noise; speech processing; speech recognition; stimulus processing; true biomarker; visual feedback

Project Summary Hearing impairment is a common chronic health condition of older age that has been linked to adverse changes in social and emotional well-being. Steeply sloping, high-frequency hearing loss (HFHL) is the most common sensorineural hearing loss profile for middle-aged and older adults with a past history of noise exposure. A common complaint of subjects with HFHL relates to a difficulty understanding speech in fluctuant background noise. Individual thresholds for recognizing speech in noise vary widely, are not well predicted from the audiogram, and are not reliably improved by amplification. The underlying motivation for this project is to identify physiological and perceptual biomarkers that more accurately predict speech in noise recognition in subject with HFHL, as compared to age-matched subjects with normal hearing (NH). Our underlying hypothesis is that impaired speech in noise processing for subjects with HFHL can be predicted from abnormal neural coding of low-frequency signals, where thresholds are normal. In Aim 1, we employ a series of physiological and psychophysical tests to identify the stage of neural processing (from auditory nerve to cortex) and mode of neural processing (from the auditory nerve compound action potential to subcortical encoding of stimulus fine structure) that most directly map onto speech in noise outcomes in HFHL and NH subjects. To further probe the linkage between neural processing of low-frequency signals and speech in noise recognition, we will employ a new approach to enhance speech in noise processing through an immersive, closed-loop audiomotor software training interface. Our preliminary data suggest that speech in noise recognition can be significantly improved in subjects with sensorineural hearing loss that were randomly assigned to closed-loop audiomotor training, as compared to subjects assigned to a placebo auditory training interface. However, it is not known which physiological and perceptual predictors of speech processing are also modified to support a change in speech recognition thresholds. Aim 2 will address this point through a randomized, double-blind placebo-controlled study design that will compare the neural and physiological predictors of speech processing before training, after training and at a follow-up test after training has been discontinued. By identifying the biomarkers of neural processing that not only predict speech outcomes in a baseline condition, but also track dynamic shifts in speech processing over the course of an intervention, these studies may identify the most robust neural predictors of speech in noise processing as well as possible targets for future therapies.

项目概要 听力障碍是老年人常见的慢性健康状况，与不利的健康状况有关 社会和情感健康的变化。陡坡高频听力损失 (HFHL) 是最严重的 有噪音病史的中老年人常见的感音神经性听力损失情况 接触。 HFHL 受试者的一个常见主诉是难以理解波动的言语 背景噪音。识别噪声中语音的各个阈值差异很大，无法很好地预测 从听力图来看，并且不能通过放大来可靠地改善。该项目的根本动机是 识别生理和感知生物标记，以更准确地预测噪声识别中的语音 HFHL 受试者与年龄匹配的听力正常受试者 (NH) 进行比较。我们的底层 假设 HFHL 受试者的噪声处理中的言语受损可以通过异常预测 低频信号的神经编码，阈值正常。在目标 1 中，我们采用了一系列 生理和心理物理测试，以确定神经处理的阶段（从听觉神经到皮质） 和神经处理模式（从听神经复合动作电位到皮层下编码） 刺激精细结构）最直接地映射到 HFHL 和 NH 受试者噪声结果中的语音。到 进一步探讨噪声识别中低频信号的神经处理与语音之间的联系， 我们将采用一种新方法，通过沉浸式闭环来增强噪声处理中的语音 音频电机软件培训界面。我们的初步数据表明，噪声识别中的语音可以 被随机分配到闭环组的感音神经性听力损失受试者的显着改善 音频运动训练，与分配给安慰剂听觉训练界面的受试者相比。然而，它是 不知道语音处理的哪些生理和感知预测因子也被修改以支持 语音识别阈值的变化。目标 2 将通过随机、双盲的方法解决这一点 安慰剂对照研究设计，将比较语音处理的神经和生理预测因子 训练前、训练后以及训练停止后的后续测试中。通过识别 神经处理的生物标志物不仅可以预测基线条件下的语音结果，还可以跟踪 干预过程中语音处理的动态变化，这些研究可能会确定最 噪声处理中语音的稳健神经预测因子以及未来治疗的可能目标。