Central auditory deficits associated with HIV infection and treatment

与 HIV 感染和治疗相关的中枢听觉缺陷

• 批准号: 8924404
• 负责人: JAY C BUCKEY
• 金额: $ 64.35万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-02-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8924404
• 关键词: Adult; Anatomy; Appearance; Attention; Audiometry; Auditory; Auditory Brainstem Responses; Brain; Child; Childhood; Chronic; Clinic; Cohort Studies; Communicable Diseases; Complex; Conditioned Reflex; Data; Defect; Detection; Diagnosis; Early Diagnosis; Enrollment; Environment; Evoked Potentials; Exposure to; Functional disorder; Funding; Goals; HIV; HIV Infections; HIV Seropositivity; HIV-associated neurocognitive disorder; Hearing; Hearing Tests; Impaired cognition; Incidence; Individual; Inflammation; Interleukin-6; Knowledge; Language; Lead; Link; Measurement; Measures; Microglia; National Institute on Deafness and Other Communication Disorders; Nervous System Physiology; Neuraxis; Neurocognitive; Neurologic; Neurologic Dysfunctions; Neurologic Symptoms; Neuropsychological Tests; Noise; Pathway interactions; Patient Self-Report; Patients; Performance; Peripheral; Pharmaceutical Preparations; Plasma; Prevalence; Process; Protocols documentation; Questionnaires; Reporting; Research; Schedule; Speech; Speech Perception; Speech Reception Threshold Test; System; Tanzania; Test Result; Testing; Time; Toxin; Tympanometry; Withholding Treatment; antiretroviral therapy; auditory pathway; base; cognitive function; cognitive testing; cohort; experience; immune activation; improved; inflammatory marker; laptop; macrophage; middle ear; mortality; neurocognitive test; performance tests; prevent; public health relevance; sound; speech processing; standard measure; tool

 DESCRIPTION (provided by applicant): Results from our ongoing NIDCD-funded study in Tanzania in show that the main auditory problems in HIV+ adults and children are in the central nervous system. These deficits likely develop for the same reasons as HIV associated neurocognitive disorder (HAND) (i.e. due to effects on central nervous system pathways). These data also suggest that audiological tests of central auditory processing may be useful tools to study and track the effects of HIV infection and HIV treatment on the central nervous system. But, no data exist that correlate the results of audiological tests of central auditory processes and standard measures of cognitive function. Also, it is not known if these tests would be more sensitive or provide earlier detection of neurological complications than existing tests. Since these audiological tests are often well-standardized and easy to perform, they may offer improved ways to detect neurological dysfunction in HIV+ patients. The objective of the proposed study is to assess central auditory processing (e.g. gap detection thresholds, speech-in-noise thresholds, staggered spondaic word test results, and complex auditory brainstem response) in an established, well-studied, cohort of HIV+ and HIV- adults and children at the Infectious Disease Center in Dar es Salaam, Tanzania. The results from the auditory tests will be correlated with results from cognitive testing (T.O.V.A. and Cogstate batteries) as well as inflammatory marker levels (IL-6, sCD14), and followed over time. The combination of the audiological testing protocol with neurocognitive test results and inflammatory marker levels--all followed longitudinally--will provide a powerful combination to assess the appearance and progression of central neurological complications over time. Our study will use a laptop-based hearing testing system that includes: native-language questionnaire administration to assess self-reported hearing capability and exposure to noise, drugs and toxins; threshold audiometry to assess overall hearing ability; adaptive gap detection testing to measure temporal processing; speech-in-noise testing in Kiswahili to assess speech perception; tympanometry to determine middle ear status; staggered spondaic word testing in Kiswahili to assess binaural speech processing. Complex auditory brainstem response measures to assess auditory processing will be done with a dedicated commercial evoked potential system (Smart-EP). HIV- and HIV+ adults and children will be enrolled, and studied longitudinally with both a central-auditory- processing-focused protocol and tests of neurocognitive function using the T.O.V.A. and Cogstate test battery. Plasma will be collected for analysis for sCD14 and IL-6. The combination of the hearing testing systems with the research-experienced, high-volume clinic in Tanzania, will provide an excellent environment to confirm and expand knowledge about the central auditory processing deficits in HIV infection, and ascertain how these findings are related to neurocognitive findings and inflammation.

 描述（由申请人提供）：我们在坦桑尼亚正在进行的由 NIDCD 资助的研究结果表明，HIV 阳性成人和儿童的主要听觉问题出现在中枢神经系统中，这些缺陷的发生原因可能与 HIV 相关的神经认知障碍相同。 HAND）（即由于对中枢神经系统通路的影响）。这些数据还表明，中枢听觉处理的听力学测试可能是研究和跟踪 HIV 感染和 HIV 治疗对中枢神经系统影响的有用工具。但是，没有数据将中枢听觉过程的听力学测试结果与认知功能的标准测量相关联，并且不知道这些测试是否比现有测试更敏感或更早地检测神经并发症。测试通常标准化良好且易于执行，它们可以提供改进的方法来检测 HIV+ 患者的神经功能障碍。拟议研究的目的是评估中枢听觉处理（例如间隙检测阈值、噪声中的语音阈值、交错）。自发词听觉测试结果和复杂的听觉脑干反应）在坦桑尼亚达累斯萨拉姆传染病中心的一组经过充分研究的 HIV+ 和 HIV- 成人和儿童群体中进行。听觉测试的结果将与来自坦桑尼亚的患者的结果相关联。认知测试（T.O.V.A. 和 Cogstate 电池）以及炎症标志物水平（IL-6、sCD14），并随时间推移跟踪听力测试方案与神经认知测试结果的结合。炎症标志物水平（全部纵向跟踪）将提供一个强大的组合来评估中枢神经系统并发症随时间的出现和进展。我们的研究将使用基于笔记本电脑的听力测试系统，其中包括： 使用母语问卷管理来评估自我。 -报告听力能力和接触噪音、药物和毒素的情况；阈值测听，以评估整体听力能力；自适应间隙检测测试，以斯瓦希里语测量噪声中的语音测试，以评估语音感知，以确定中耳状态；交错将使用专用的商业诱发电位系统（Smart-EP）进行斯瓦希里语的spondaic单词测试，以评估双耳言语处理。将招募并纵向研究。将收集以中枢听觉处理为中心的协议以及使用 T.O.V.A. 和 Cogstate 测试电池进行的神经认知功能测试，以进行 sCD14 分析。听力测试系统与坦桑尼亚研究经验丰富的大容量诊所相结合，将为确认和扩展有关艾滋病毒感染中枢听觉处理缺陷的知识提供良好的环境，并确定这些发现如何发挥作用。有关系 神经认知发现和炎症。