Physiological Assessment of Auditory Processing Disorders in TBI

TBI 中听觉处理障碍的生理评估

• 批准号: 10427221
• 负责人: Melissa Papesh
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10427221
• 关键词: Adult; Affect; Age; Assessment tool; Attention; Auditory; Auditory Evoked Potentials; Auditory Perceptual Disorders; Auditory Physiology; Auditory Threshold; Auditory area; Auditory system; Behavioral; Binaural; Blast Injuries; Central Auditory Processing Disorder; Characteristics; Chronic; Clinical Management; Cognition; Cognition Disorders; Cognitive; Conflict (Psychology); Craniocerebral Trauma; Diagnosis; Dichotic Listening Tests; Dimensions; Discrimination; Disease; Electrophysiology (science); Emotional; Environment; Exposure to; Freedom; Frequencies; Goals; Hearing; Impaired cognition; Impairment; Injury; Instruction; Intervention; Knowledge; Measures; Nervous system structure; Outcome; Outcomes Research; Participant; Patient Care; Patients; Pattern Recognition; Performance; Physiological; Population; Predisposition; Psychometrics; Rehabilitation therapy; Reporting; Research; Research Proposals; Risk; Running; Shapes; Signal Transduction; Speech; Symptoms; Telephone; Traumatic Brain Injury; Veterans; Work; attentional control; auditory discrimination; auditory processing; base; behavior measurement; behavior test; blast exposure; clinical care; clinical diagnosis; cognitive control; cognitive process; comorbidity; help-seeking behavior; improved; indexing; information processing; mild traumatic brain injury; normal hearing; operation; programs; relating to nervous system; response; social; sound; stem; tool

Mild traumatic brain injury (TBI) stemming from exposure to high-intensity blasts is one of the most prevalent injuries sustained by Veterans of Operation Enduring Freedom and Operation Iraqi Freedom. Recent research indicates that many of these Veterans can suffer from chronic difficulties processing auditory information in spite of normal hearing thresholds. Some of the most commonly reported problems include difficulty with speech in noisy or distracting environments, problems with long running speech and recalling lists of instructions, and difficulties on the telephone. Currently, little is known regarding how blast exposure affects the physiology of the auditory system to produce such deficits, nor the potential contributions of comorbid cognitive disorders to auditory processing concerns. In the current study, we aim to use electrophysiology in combination with behavioral testing to better understand how blast- exposure and TBI shape the neural encoding and discrimination of sound, and to probe the influence of cognitive factors on auditory processing. The long term goal of our research program is to develop electrophysiological tools which accurately and reliably reflect auditory function and can be used to improve clinical diagnosis and rehabilitation efforts of adult patients with acquired auditory processing disorder. Our overall objective for this CDA-2 research plan, which is the next step toward attainment of our long-term goal, is to systematically evaluate the utility of cortical and cognitive auditory evoked potentials (AEP) measures to reveal chronic physiological changes in auditory processing in Veterans with previous blast-exposure/TBI, and examine the relationship between these objective physiological measures and behavioral measures of hearing ability. Specifically, we will 1) determine how blast exposure and TBI affect neural discrimination of sound across domains including frequency, timing, intensity, and binaural integration at the level of the auditory cortex, 2) the impact of blast exposure/TBI on cognitive modulation of auditory encoding using cognitive AEPs, and 3) Assess the relationship between cortical and cognitive AEP measures and psychometrically based behavioral measures of auditory processing. We hypothesize that blast-exposed Veterans will demonstrate deficits in both cortical encoding of sound characteristics as evidenced by higher thresholds for detecting changes in sound and reduced amplitudes to changes in sound characteristics in blast- exposed/TBI Veterans compared to age- and hearing-matched control participants. We further predict that blast-exposed/TBI Veterans will show decreased cognitive control of sound encoding compared to control participants, and that cortical and cognitive AEP indices will be well correlated with behavioral measures of hearing ability. The outcomes of this research proposal include a better understanding of the bottom-up vs top-down contributions to auditory processing disorders in Veterans with previous blast-exposure and TBI and will serve as a starting point for developing physiological tools to evaluate auditory concerns in this population. These outcomes are expected to have a positive impact because they increase our knowledge of the impact of blast exposure and TBI on auditory function and will provide a significant step forward towards improved clinical care for these patients. This work will be significant because it is expected to have broad translational implications on the diagnosis and management of adult patients suffering from acquired auditory processing disorders.

因暴露于高强度爆炸而引起的轻度创伤性脑损伤 (TBI) 是其中之一 持久自由行动和行动退伍军人遭受的最常见伤害 伊拉克自由。最近的研究表明，许多退伍军人可能患有慢性病 尽管听力阈值正常，但仍难以处理听觉信息。一些 最常见的问题包括在嘈杂或分散注意力的情况下言语困难 环境、长时间讲话和回忆指令列表的问题，以及 电话困难。目前，人们对爆炸暴露如何影响 听觉系统的生理学造成了这种缺陷，也不是听觉系统的潜在贡献 共病认知障碍与听觉处理问题。在当前的研究中，我们的目标是 将电生理学与行为测试相结合，以更好地了解爆炸是如何发生的 暴露和 TBI 塑造了声音的神经编码和辨别，并探索 认知因素对听觉处理的影响。我们研究的长期目标 计划是开发准确可靠地反映听觉的电生理工具 功能，可用于改善成年患者的临床诊断和康复工作 患有获得性听觉处理障碍。我们的 CDA-2 研究计划的总体目标， 这是实现我们长期目标的下一步，是系统地评估 皮质和认知听觉诱发电位 (AEP) 测量的效用可揭示慢性 经历过爆炸暴露/TBI 的退伍军人听觉处理的生理变化，以及 检查这些客观的生理测量和行为之间的关系 听力能力的测量。具体来说，我们将 1) 确定爆炸暴露和 TBI 如何 影响跨领域声音的神经辨别，包括频率、时间、强度和 听觉皮层水平的双耳整合，2) 爆炸暴露/TBI 对听觉皮层的影响 使用认知 AEP 对听觉编码进行认知调节，以及 3) 评估关系 皮质和认知 AEP 测量与基于心理测量的行为测量之间的关系 听觉处理。我们假设，遭受爆炸袭击的退伍军人将表现出以下方面的缺陷： 较高的检测阈值证明了声音特征的皮层编码 声音的变化和振幅的降低导致爆炸中声音特性的变化 暴露/TBI 退伍军人与年龄和听力匹配的对照参与者进行比较。我们进一步 预测爆炸暴露/创伤性脑损伤退伍军人将表现出对声音的认知控制能力下降 与对照组参与者相比，皮质和认知 AEP 指数将 与听力能力的行为测量密切相关。本研究的成果 提案包括更好地理解自下而上与自上而下对听觉的贡献 患有先前爆炸暴露和创伤性脑损伤的退伍军人的处理障碍，将作为 开发生理学工具来评估该人群的听觉问题的起点。 这些结果预计将产生积极影响，因为它们增加了我们的知识 爆炸暴露和 TBI 对听觉功能的影响，将提供重要的一步 致力于改善这些患者的临床护理。这项工作将意义重大，因为 预计它将对诊断和管理产生广泛的转化影响 患有获得性听觉处理障碍的成年患者。

项目成果

Acquired Central Auditory Processing Disorder in Service Members and Veterans.

• DOI: 10.1044/2019_jslhr-19-00293
• 发表时间: 2020-03
• 期刊: Journal of speech, language, and hearing research : JSLHR
• 作者: Victoria Tepe;Melissa A Papesh;Shoshannah Russell;M. Samantha Lewis;Nina J. Pryor;Lisa Guillory

Functional Hearing Difficulties in Veterans: Retrospective Chart Review of Auditory Processing Assessments in the VA Health Care System.

退伍军人的功能性听力困难：退伍军人管理局医疗保健系统听觉处理评估的回顾性图表审查。

• DOI: 10.1044/2022_aja-22-00117
• 发表时间: 2023
• 期刊: American journal of audiology
• 影响因子: 1.8
• 作者: Papesh,MelissaA;Fowler,Lora;Pesa,StephanieR;Frederick,MelissaT
• 通讯作者: Frederick,MelissaT

Effects of Signal Type and Noise Background on Auditory Evoked Potential N1, P2, and P3 Measurements in Blast-Exposed Veterans.

• DOI: 10.1097/aud.0000000000000906
• 发表时间: 2021
• 期刊: Ear and hearing
• 影响因子: 3.7
• 作者: Papesh MA;Stefl AA;Gallun FJ;Billings CJ
• 通讯作者: Billings CJ