Interactive Effects of Aging and Blast Exposure on Central Auditory System

衰老和爆炸暴露对中枢听觉系统的交互影响

• 批准号: 10329963
• 负责人: Jonathan Henry Venezia
• 金额: --
• 依托单位: VA LOMA LINDA HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-01-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10329963
• 关键词: Address; Adult; Affect; Afghanistan; Age; Aging; Anatomy; Area; Attention; Audiology; Auditory; Auditory Perceptual Disorders; Auditory Threshold; Auditory area; Auditory system; Award; Behavioral; Blast Injuries; Brain; Central Auditory Diseases; Classification; Clinic; Clinical; Cognitive; Communication; Complex; Conflict (Psychology); Consultations; Development; Development Plans; Diagnosis; Diagnostic; Diffuse; Diffusion Magnetic Resonance Imaging; Disease; Educational workshop; Environment; Explosion; Exposure to; Functional Magnetic Resonance Imaging; Funding; Goals; Grant; Hearing; Hearing Tests; Hearing problem; Image; Imaging technology; Impairment; Individual; Injury; Iraq; Knowledge; Laboratories; Lead; Learning; Link; Measures; Memory; Mentors; Mentorship; Methods; Modality; Modernization; Morphology; Nervous system structure; Neuropsychology; Noise; Participant; Patients; Pattern; Performance; Peripheral; Physics; Physiological; Population; Post-Concussion Syndrome; Post-Traumatic Stress Disorders; Process; Psychophysics; Recording of previous events; Reporting; Research; Research Personnel; Sensorineural Hearing Loss; Source; Specificity; Speech; Techniques; Testing; Training; Training Activity; Traumatic Brain Injury; United States National Institutes of Health; Veterans; Visit; Work; Writing; age effect; age related; auditory processing; auditory rehabilitation; base; behavior measurement; behavior test; blast exposure; brain health; career; career development; cognitive ability; cognitive system; cognitive testing; comorbidity; design; diagnostic tool; education research; experience; gray matter; hearing impairment; imaging modality; improved; middle age; mild traumatic brain injury; neuroimaging; non-invasive imaging; normal aging; normal hearing; receptive field; rehabilitation science; rehabilitation strategy; relating to nervous system; research and development; speech in noise; speech processing; speech recognition; success; tool; white matter

Many blast-exposed Veterans report difficulty in complex listening situations (e.g., understanding speech in noise) despite normal or near-normal performance on standard audiological tests. This suggests a deficit in central auditory processing. Indeed, blast-exposed Veterans perform abnormally on central auditory tests, particularly those assessing temporal processing. A similar pattern is observed in middle age adults who often have good peripheral hearing but show deficits on tests of temporal processing and speech understanding in noise. Age-related auditory deficits have been linked to functional and anatomical changes in the central auditory system. The physiologic origin of auditory deficits in blast-exposure is currently unknown, although the similarity in behavioral profiles between aging and blast exposure suggests similar mechanisms may be affected. It is therefore possible that the auditory deficits experienced by blast-exposed Veterans will intensify as they enter middle age and beyond. This has not been investigated systematically. The present study will determine: (a) whether there is an interaction between aging and blast exposure on temporal processing and speech recognition (Specific Aim 1); (b) whether age- and/or blast-related differences in behavioral performance can be linked to neuroanatomical changes within or outside the auditory system (Specific Aim 2); and (c) whether aging, blast exposure, or their interaction lead to changes in functional representations of speech in the auditory cortex (Specific Aim 3). Groups of 50 blast-exposed and 50 unexposed Veterans will be tested. Young (18-39 years) and middle age (40-60 years) Veterans will be represented in equal numbers within each blast exposure group. Each participant will be assessed on a number of temporal processing and speech recognition tests known to reveal deficits in middle age listeners. Gray and white matter morphology will be assessed using T1- and diffusion-weighted magnetic resonance imaging (MRI). Finally, cortical activity will be measured during a competing speech task using functional MRI. We hypothesize that aging and blast exposure will produce interactive effects on performance in temporal processing and speech tests, and that performance will be linked to changes in the structural and functional integrity of the central auditory nervous system. We will test for alternatives, e.g., that auditory performance is linked to cognitive ability or brain health outside the auditory system. We expect our findings will: (a) lead to improvements in diagnosis and classification of central auditory deficits; and (b) motivate focused rehabilitation strategies. This study will build on the candidate’s previous research using psychophysical and neuroimaging techniques to examine speech processing in listeners with normal hearing and sensorineural hearing loss. A strong mentorship team will contribute to research and career development. Dr. Marjorie Leek is the primary mentor and will provide guidance on behavioral testing in clinical populations (particularly blast exposure) and general oversight of the career development plan. Co-mentor Dr. Barbara Holshouser will coordinate imaging activities and provide expert training in neuroimaging including advanced imaging modalities, post-processing, and MR physics. Co- mentor Dr. Bruce Lyeth will provide research education in experimental traumatic brain injury (TBI) research. Co-mentor Dr. Grace Lee will provide training in cognitive assessment. Drs. Joseph Helpern and Christopher Stecker will provide consultation in diffusion-weighted imaging and functional auditory imaging, respectively. Training activities will include: workshops on grant writing, imaging methods, and TBI; consultation with research groups and clinicians involved in neuropsychology, audiology and TBI; and visits to Dr. Lyeth’s laboratory. The candidate will apply for NIH R01 and VA RR&D Merit Award funding toward the end of the award period. The candidate’s short-term career goals are to gain experience with new clinical populations, learn new neuroimaging modalities, and establish a background in TBI research. The candidate’s long-term career goal is to become an independent VA investigator in auditory rehabilitation science.

许多暴露于爆炸的退伍军人报告在复杂的聆听情况下很难 噪声）尽管在标准听力学测试上表现正常或近正常表现。这暗示了防御 中央听觉处理。实际上，暴露于爆炸的退伍军人在中央听觉测试中表现出色， 特别是那些评估临时处理的人。在中年成年人中观察到类似的模式 有良好的外围听力，但在临时处理和语音理解的测试中进行了定义 噪音。与年龄有关的听觉定义与中央的功能和解剖变化有关 听觉系统。目前，爆炸暴露中听觉定义的生理起源目前尚不清楚，尽管 衰老和爆炸暴露之间的行为曲线相似性表明相似的机制可能是 做作的。因此，通过爆炸暴露的退伍军人所经历的听觉定义可能会加剧 当他们进入中年及以后。这尚未系统地研究。本研究将 确定：（a）在临时处理和 语音识别（特定目标1）； （b）行为的年龄和/或与爆炸有关的差异 性能可以与听觉系统内部或外部的神经解剖学变化链接（特定目的 2）; （c）衰老，爆炸或它们的相互作用是否导致功能表示的变化 听觉皮层中的语音（特定目标3）。 50个爆炸式和50名意外退伍军人的组将 进行测试。年轻（18-39岁）和中年（40-60岁）退伍军人将以同等数量代表 在每个爆炸暴露组中。每个参与者将对许多临时处理进行评估，并 言语识别测试已知会在中年听众中揭示防御措施。灰色和白质形态 将使用T1和扩散加权磁共振成像（MRI）评估。最后，皮质活动 将在使用功能性MRI的竞争性语音任务中测量。我们假设衰老和爆炸 暴露会对临时处理和语音测试中的性能产生互动影响，并且 性能将与中央听觉神经的结构和功能完整性的变化有关 系统。我们将测试替代方案，例如，听觉性能与认知能力或大脑健康有关 在听觉系统之外。我们希望我们的发现将：（a）导致诊断和 中央听觉的分类定义； （b）以动力为重点的康复策略。这项研究将建立 关于候选人的先前研究，使用心理物理和神经影像学技术来检查语音 在听力正常和感官听力损失的听众中处理。一个强大的攻向团队将 有助于研究和职业发展。 Marjorie Leek博士是主要导师，将提供 临床人群中的行为测试指南（尤其是爆炸暴露）和一般监督 职业发展计划。联合委员会博士芭芭拉·霍尔索瑟（Barbara Holsouser）将协调成像活动并提供 神经影像学专家培训，包括高级成像方式，后处理和MR物理学。共同 导师Bruce Lyeth博士将在实验性创伤性脑损伤（TBI）研究中提供研究教育。 Grace Lee博士将提供认知评估的培训。博士。约瑟夫·赫尔珀和克里斯托弗 Stecker将分别在扩散加权成像和功能听觉成像中提供咨询。 培训活动将包括：有关赠款写作，成像方法和TBI的研讨会；与 研究小组和临床医生参与神经心理学，听力学和TBI；并参观莱斯博士 实验室。候选人将在结束时申请NIH R01和VA RR＆D优异奖奖励资金 奖励期。候选人的短期职业目标是获得新的临床人群的经验， 学习新的神经影像学方式，并在TBI研究中建立背景。候选人的长期 职业目标是成为听觉康复科学领域的独立VA调查员。