Sensory integration of auditory and visual cues in diverse contexts given age, vestibular hypofunction and hearing loss

考虑到年龄、前庭功能减退和听力损失，不同环境下听觉和视觉线索的感觉统合

• 批准号: 10224165
• 负责人: Anat Vilnai Lubetzky
• 金额: $ 14.36万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224165
• 关键词: 3-Dimensional; Activities of Daily Living; Address; Adult; Age; Auditory; Behavioral; Brain; Chronic; Clinical; Community Participation; Complex; Cues; Development; Disease; Dizziness; Environment; Equilibrium; Fall prevention; Functional disorder; Future; Goals; Head; Hearing; Image; Individual; Intervention; Investigation; Lead; Life; Link; Loudness; Measures; Methods; Mission; Musculoskeletal Equilibrium; Names; National Institute on Deafness and Other Communication Disorders; Noise; Patients; Performance; Peripheral; Pilot Projects; Population; Positioning Attribute; Postural response; Posture; Prevention program; Protocols documentation; Public Health; Rehabilitation therapy; Research; Risk Factors; Role; Sensory; Short Interspersed Nucleotide Elements; Side; Source; Stimulus; Structure; Subway; Sum; Technology; Testing; Training; Translating; Translations; United States; Validity and Reliability; Vestibular loss; Vision; Visual; Weight; Work; balance testing; base; deafness; design; environmental change; fall risk; falls; head mounted display; hearing impairment; improved; innovation; medical attention; modifiable risk; multisensory; portability; response; sensory input; sensory integration; somatosensory; sound; systematic review; theories; virtual reality; virtual reality environment; visual stimulus; visual-vestibular; young adult

ABSTRACT More than 1/3 of adults in the United States seek medical attention for vestibular disorders and hearing loss; disorders that can triple one’s fall risk and have a profound effect on one’s participation in activities of daily living. Hearing loss has been shown to reduce balance performance and could be one modifiable risk factor for falls. Patients with vestibular hypofunction tend to avoid busy, hectic, visually complex, and loud environments because these environments provoke dizziness and imbalance. While the visual impact on balance is well known, less is known about the importance of sounds for balance. In search for a possible mechanism to explain a relationship between what we hear and balance control, some studies suggested that sounds may serve as an auditory anchor, providing spatial cues for balance, similar to vision. However, the majority of these studies tested healthy adults’ response to sounds with blocked visuals. It is also possible that a relationship between hearing loss and balance problems is navigated via an undetected vestibular deficit. By understanding the role of auditory input in balance control, we can be better equipped to help this large portion of the population who seek medical attention for vestibular disorders and hearing loss. Therefore, there is a critical need for a systematic investigation of balance performance in response to simultaneous visual and auditory perturbations, similar to real-life situations. To answer this need, our team used recent advances in virtual reality technology and developed a Head Mounted Display (HMD) protocol of immersive environments, combining specific manipulations of visuals and sounds, including generated sounds (i.e., white noise) and real-world recorded sounds (e.g., a train approaching a station). This research will answer the following questions: (1) Are sounds used for balance and if yes, via what mechanism? (2) Do individuals with single-sided hearing loss have a balance problem even without any vestibular issues? (3) Are those with vestibular loss destabilized by sounds? To address these questions, the following specific aims will be investigated in individuals with unilateral peripheral vestibular hypofunction (n=45), individuals with single-sided deafness (n=45), and age-matched controls (n=45): Aim 1: Establish the role of generated and natural sounds in postural control in different visual environments; Aim 2: Determine the extent to which a static white noise can improve balance within a dynamic visual environment. We expect to clarify the role of sounds in the control of balance. This contribution will be significant because the mechanism underlying possible link between hearing loss and falls needs to be better understood. Our work will inform the development of improved balance assessments, specifically whether balance tests need to include postural responses to sounds. Hearing status may need to be considered as a potential indicator of increased fall risk. Our work will also inform the development of new rehabilitation combining sounds and visuals in different contexts. HMDs and headphones affordability and portability will allow future translation to a clinical setting.

抽象的 超过 1/3 的美国成年人因前庭疾病和听力问题就医 失落；可能使跌倒风险增加三倍并对日常活动产生深远影响的疾病 听力损失已被证明会降低平衡能力，并且可能是一种可改变的风险因素。 前庭功能低下的患者倾向于避免忙碌、忙碌、视觉复杂和喧闹的环境。 因为这些环境会引起头晕和不平衡，而对视觉平衡的影响却很大。 众所周知，人们对声音对于平衡的重要性知之甚少。 我们听到的声音和平衡控制之间存在关系，一些研究表明声音可以作为 听觉锚点，提供平衡的空间线索，类似于视觉。 测试健康成年人对声音和视觉障碍的反应之间也可能存在关系。 通过了解前庭缺陷的作用来解决听力损失和平衡问题。 平衡控制中的听觉输入，我们可以更好地帮助这大部分人群 因前庭疾病和听力损失而寻求医疗帮助，因此迫切需要一种治疗方法。 系统研究响应同时视觉和听觉扰动的平衡表现， 与现实生活中的情况类似。 为了满足这一需求，我们的团队利用虚拟现实技术的最新进展，开发了一个 Head 沉浸式环境的安装式显示 (HMD) 协议，结合了视觉效果的特定操作和 声音，包括生成的声音（即白噪声）和现实世界记录的声音（例如，火车驶近 这项研究将回答以下问题：（1）声音是否用于平衡，如果是，通过什么来实现平衡？ (2) 单侧听力损失的人即使没有任何平衡也会有平衡问题吗？ (3) 前庭功能丧失的人会因声音而不稳定吗？ 将在单侧外周前庭功能减退的个体中研究以下特定目标 (n=45)、单侧耳聋个体 (n=45) 和年龄匹配对照 (n=45)：目标 1：建立 生成的声音和自然声音在不同视觉环境中的姿势控制中的作用；目标 2：确定 我们期望静态白噪声可以在多大程度上改善动态视觉环境中的平衡。 阐明声音在平衡控制中的作用这一贡献将是重大的，因为该机制。 需要更好地了解听力损失和跌倒之间潜在的联系。 开发改进的平衡评估，特别是平衡测试是否需要包括姿势 对声音的反应可能需要被视为跌倒风险增加的潜在指标。 我们的工作还将为结合不同领域的声音和视觉效果的新康复治疗的发展提供信息。 头戴式显示器和耳机的经济性和便携性将允许未来转化为临床环境。