Idiopathic auditory dysfunction in children: nature and mechanisms

儿童特发性听觉功能障碍：性质和机制

• 批准号: 9313232
• 负责人: David Moore
• 金额: $ 60.54万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9313232
• 关键词: 9 year old; Address; Adult; Affect; Age; Attention; Audiology; Auditory; Auditory Brainstem Responses; Auditory Perceptual Disorders; Auditory system; Back; Behavioral; Biological; Brain Stem; Caregivers; Cerebral cortex; Child; Clinic; Clinical; Clinical Research; Code; Cognition; Cognitive; Cognitive deficits; Communication; Data; Development; Diagnosis; Dichotic Listening Tests; Digit structure; Disease; Ear; Evaluation; Family; Functional disorder; Goals; Hearing; Hospital Records; Human; Human Development; Impaired cognition; Impairment; Individual; Inner Hair Cells; Labyrinth; Language; Lead; Learning; Learning Disorders; Life; Link; Magnetic Resonance Imaging; Matched Group; Measures; Medial; Memory; Methods; National Institute on Deafness and Other Communication Disorders; Nature; Nervous System Physiology; Nervous system structure; Noise; Parents; Participant; Pathogenesis; Pediatric Hospitals; Perception; Physiological; Questionnaires; Reporting; Research; Sampling; Sensory; Short-Term Memory; Signal Transduction; Speech; Speech Intelligibility; Speed; Standardization; Stimulus; Symptoms; Synapses; System; Testing; Time; Training; Variant; Work; aged; base; clinical Diagnosis; clinical practice; cognitive control; cognitive function; cognitive testing; communication device; cost; data modeling; design; executive function; hearing impairment; improved; improved functioning; innovation; longitudinal design; multimodality; neural circuit; neuroimaging; novel; public health relevance; relating to nervous system; research clinical testing; response; sensorimotor system; skills; sound; source localization; teacher; theories; white matter

 DESCRIPTION (provided by applicant): Auditory processing disorder (APD), a poorly defined and understood listening difficulty, is diagnosed in about 50,000 children in the US annually. The primary goal of this research is to increase understanding of APD and to provide more rational diagnosis and better management of children with listening difficulties. There are two major theories of APD, that it is a problem with `bottom-up' processing of sounds by the central auditory nervous system (CANS) or, alternately, that it is due to `top-down', more general cognitive difficulties resulting in impaired attention, working memory and executive function. The proposed research will examine these theories in detail in children aged 6-12 years attending clinics at Cincinnati Children's Hospital because of suspected listening difficulty (LiD), but with clinically normal hearing thresholds. Children will be screened using a novel, well-validated, caregiver questionnaire (the ECLiPS) specifically designed to identify LiD in everyday life. Specific hypotheses are that, (i) current clinical methods to diagnose APD do not distinguish between bottom-up and top-down impairments, (ii) children with LiD have impaired speech-in-noise and spatial processing due to impaired, bottom-up auditory function deriving from the ear or the CANS, and (iii) children with LiD have impaired auditory cognition, reflected in auditory attention, working memory and executive function and their biological correlates in the cerebral cortex. The study will be novel through its use of a wide variety of sensitive, cutting-edge behavioral and physiological approaches that specifically address these hypotheses. Baseline data will be collected from 6-9 year olds in three demographically matched groups (each n=50) who are typically developing (TD), or who have LiD with (AP+) or without (AP-) a clinical diagnosis of APD. Quantitative modeling of data in a longitudinal design will be used to establish maturational trajectories for each group and the individuals within them. It is predicted that most children with LiD will have a variety of both CANS and cognitive dysfunction, but that some distinct profiles will emerge. Based on our previous research and on clinical reports, we expect that most children with LiD will have a generalized cognitive deficit that is common to a variety of language-based learning difficulties. However, we also expect to find some children who have identifiable disorders (e.g. of the inner hair cell afferent synapse, brainstem conduction speed, or cortical white matter integrity) underlying impaired ability of the ear, CANS or cortex to generate, integrate or transmit supra-threshold, time-sensitive signals. Our methods will enable us to localize the source of those disorders. The data obtained from this study will have immediate impact on the diagnosis of APD, with implications for differential management, dependent on the specific nature of the problems identified. They will also provide novel information on the normal, integrated function and development of the human auditory system, with implications for other sensorimotor systems, human development, learning and learning disorders.

 描述（由申请人提供）： 听觉处理障碍 (APD) 是一种定义不清且理解不清的听力困难，每年在美国约有 50,000 名儿童被诊断出来。这项研究的主要目标是增加对 APD 的理解并提供更合理的解释。 APD 有两种主要理论，即中枢听觉神经系统 (CANS) 对声音的“自下而上”处理存在问题，或者，它是听力障碍儿童的诊断和更好的管理。是由于“自上而下”的更普遍的认知困难导致注意力、工作记忆和执行功能受损。拟议的研究将在辛辛那提儿童医院就诊的 6 至 12 岁儿童中详细检验这些理论，这些儿童因怀疑听力而就诊。困难（LiD），但是 临床上正常的听力阈值将使用专门设计用于识别日常生活中的 LiD 的新型、经过充分验证的护理者调查问卷 (ECLiPS) 进行筛查。自下而上和自上而下的障碍，(ii) 患有 LiD 的儿童由于耳朵或 CANS 产生的自下而上的听觉功能受损，因此在噪声中言语和空间处理受损，以及 (iii) 患有 LiD 的儿童听觉注意力、工作记忆和执行功能及其在大脑皮层中的生物相关性受到听觉注意力受损的影响，这项研究将通过使用各种专门解决这些问题的敏感、尖端的行为和生理方法而变得新颖。基线数据将从三个人口统计学匹配组（每个组 n = 50）中的 6-9 岁儿童中收集，这些组通常患有（TD）或患有 LiD（AP+）或不具有（AP-）临床诊断的 LiD。定量。纵向设计中的数据建模将用于为每个群体及其中的个人建立成熟轨迹。据预测，大多数群体。 患有 LiD 的儿童会出现各种 CANS 和认知功能障碍，但根据我们之前的研究和临床报告，我们预计大多数患有 LiD 的儿童都会出现普遍的认知缺陷。然而，我们也期望发现一些患有可识别疾病（例如内毛细胞传入突触、脑干传导速度或皮质白质完整性）的潜在耳朵、CANS 或能力受损的儿童。皮质生成、整合或传输超阈值、时间敏感的信号将使我们能够定位这些疾病的来源，从这项研究中获得的数据将对 APD 的诊断产生直接影响，并对差异化治疗产生影响。它们还将提供有关人类听觉系统的正常、综合功能和发育的新信息，并对其他感觉运动系统、人类发育、学习和学习障碍产生影响。