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.

项目摘要 听力障碍是与不利有关的老年慢性健康状况 社会和情感福祉的变化。陡峭的倾斜，高频听力损失（HFHL）是最大的 具有过去噪音历史的中年和老年人的常见感官听力损失概况 接触。 HFHL受试者的普遍抱怨涉及在波动中的难以理解演讲 背景噪音。在噪声中识别语音的个体阈值差异很大，没有很好地预测 从听力图，不能通过扩增可靠地改善。该项目的基本动机是 确定生理和感知生物标志物，这些生物标志物更准确地预测噪声识别中的语音 与患有正常听力（NH）的年龄匹配的受试者相比，患有HFHL的受试者。我们的基础 假设是可以预测异常的HFHL受试者的噪声处理中的语音受损 阈值正常的低频信号的神经编码。在AIM 1中，我们采用了一系列 生理和心理物理测试以识别神经加工的阶段（从听觉神经到皮层） 和神经加工的模式（从听觉神经复合动作潜力到皮层编码 刺激良好的结构）最直接地映射到HFHL和NH受试者中的噪声结果中的语音。到 进一步探究低频信号的神经处理与噪声识别中的语音之间的联系， 我们将采用一种新的方法来增强通过沉浸式的闭环在噪声处理中的语音 Audiomotor软件培训接口。我们的初步数据表明，噪声识别中的语音可能是 有感觉性听力损失受试者的受试者有显着改善，这些受试者被随机分配给闭环 与分配给安慰剂听觉训练界面的主题相比，听众训练的训练。但是，是 尚不知道哪些生理和感知性语音处理的预测因素也经过修改以支持 语音识别阈值的变化。 AIM 2将通过随机的双盲来解决这一点 安慰剂控制的研究设计将比较语音处理的神经和生理预测指标 在训练之前，训练并在训练后进行后续测试。通过识别 神经加工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 在干预过程中，语音处理的动态转变，这些研究可能确定最多 噪声处理中语音的强大神经预测指标以及未来疗法的可能目标。