Advancing and applying peripheral and central auditory findings in HIV/AIDS.

推进和应用艾滋病毒/艾滋病的外周和中枢听觉发现。

• 批准号: 10647813
• 负责人: JAY C BUCKEY
• 金额: $ 71.18万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10647813
• 关键词: Acceleration; Address; Affect; Age; Aging; Anti-Retroviral Agents; Audiology; Auditory; Auditory system; Biometry; Brain; Central Nervous System; Clinical; Cognition; Cognitive; Cognitive deficits; Collaborations; Complex; Data; Development; Digit structure; Education; Evaluation; Future; Goals; HIV; HIV Infections; HIV/AIDS; Hearing; Hearing Tests; Human Resources; Impaired cognition; Individual; International; Longitudinal Studies; Longitudinal cohort; Longitudinal cohort study; Machine Learning; Measures; Mission; National Institute on Deafness and Other Communication Disorders; Neurocognitive; Neurocognitive Deficit; Noise; Otolaryngology; Participant; Patients; Performance; Peripheral; Persons; Pharmaceutical Preparations; Positioning Attribute; Research; Sensitivity and Specificity; Tanzania; Techniques; Test Result; Testing; Time; Training; United States National Institutes of Health; Work; age effect; antiretroviral therapy; auditory processing; clinical practice; cognitive performance; cognitive process; cognitive testing; cohort; comorbidity; comparison control; detection test; experience; follow-up; innovation; interest; literacy; longitudinal dataset; neurocognitive test; ototoxicity; performance tests; programs; response; screening; sound; speech in noise; treatment response

With NIH support, the Ubongo Sikivu cohort of both people living with HIV (PLWH) and uninfected controls was established in Tanzania and has had regular assessments of their peripheral hearing ability over 10+ years with detailed central auditory and neurocognitive assessments added over the last 5 years. This cohort is uniquely positioned to address the issues posed by PAR-20-127 “Advancing HIV/AIDS Research within the Mission of the NIDCD.” Data from the cohort has already answered important questions about the ototoxicity of anti-retrovirals, the effects of HIV infection and treatment on both peripheral and central hearing parameters, and the relationship of central auditory test (CAT) results to neurocognitive performance. By following this cohort longitudinally questions about how CATs could be used to predict or track neurocognitive performance and how age and long-term anti-retroviral treatment affect the auditory system can be answered. To date, the most significant result has been demonstrating that CAT results correlate with cognitive performance. This suggests CAT results might be useful for forecasting or tracking cognitive decline over time. The next important steps are determining whether worsening CAT performance precedes the later development of cognitive deficits in PLWH and which central auditory tests and other variables can predict neurocognitive deficits accurately. Neurocognitive screening tests are often sensitive to education, literacy, and culture. Full neurocognitive test batteries can be difficult to employ, particularly in the developing world where clinician time is limited, few trained personnel are available, and normative data often do not exist. Using CATs would be a major advance for following HIV+ patients because the CATs can be short (a gap detection test takes 5 minutes), easy to explain (the hearing-in-noise test and triple digit task involve identifying words or numbers in background noise), or effortless for the subject (the FFR test requires no subject input at all). This project’s goal is tracking the trajectory of peripheral auditory, central auditory, and neurocognitive performance over time by continuing to follow this cohort. With these longitudinal data machine learning and other statistical techniques will be applied to assess which factors forecast the subsequent development of cognitive deficits and which factors or combination of factors identify those with existing neurocognitive deficits. An international team with experience in central auditory testing and neurocognitive testing in PLWH has been assembled. Dr. Nina Kraus and her Northwestern team are internationally recognized experts in the auditory FFR. The Dar es Salaam team has extensive experience in otolaryngology and performing peripheral auditory, central auditory, and neurocognitive tests. Drs. Roth and Boivin are experts in assessing neurocognitive function. Dr. Gui has diverse biostatistical experience. Dr. Niemczak is an expert in peripheral and central auditory processing. This team and longitudinal cohort offer the unique ability to assess the use of CATs in evaluating cognition as well as the effects of aging and medications on both central and peripheral auditory function in PLWH.

在 NIH 的支持下，Ubongo Sikivu 队列中的艾滋病毒感染者 (PLWH) 和未感染对照者 成立于坦桑尼亚，定期评估其周边听力能力超过10+ 该队列在过去 5 年中添加了详细的中枢听觉和神经认知评估。 具有独特的优势来解决 PAR-20-127“在国家范围内推进艾滋病毒/艾滋病研究”所提出的问题 NIDCD 的使命。”队列数据已经回答了有关耳毒性的重要问题。 抗逆转录病毒药物、艾滋病毒感染和治疗对周围和中枢听力参数的影响， 以及中枢听觉测试（CAT）结果与神经认知表现的关系。 关于如何使用 CAT 来预测或跟踪神经认知表现的纵向队列问题 以及年龄和长期抗逆转录病毒治疗如何影响听觉系统都可以得到解答。 最重要的结果是证明 CAT 结果与认知表现相关。 表明 CAT 结果可能有助于预测或跟踪随着时间的推移认知能力下降。 步骤是确定延长 CAT 表现是否先于后来的认知发展 感染者的缺陷以及哪些中枢听觉测试和其他变量可以预测神经认知缺陷 神经认知筛查测试通常对教育、读写能力和文化很敏感。 神经认知测试组可能很难使用，特别是在发展中国家，临床医生的时间 有限，受过培训的人员很少，并且通常不存在使用 CAT 的规范数据。 对于后续 HIV+ 患者来说是一项重大进步，因为 CAT 可能很短（间隙检测测试需要 5 分钟），易于解释（噪音听力测试和三位数任务涉及识别单词或数字 背景噪音），或者对于受试者来说毫不费力（FFR 测试根本不需要受试者输入）。 目标是跟踪外周听觉、中枢听觉和神经认知表现随时间的变化轨迹 通过继续跟踪这个队列，利用这些纵向数据进行机器学习和其他统计。 将应用技术来评估哪些因素可以预测认知缺陷的后续发展 以及哪些因素或因素组合可以识别出患有现有神经认知缺陷的人。 已经组建了在 PLWH 中枢听觉测试和神经认知测试方面经验丰富的团队。 Nina Kraus 和她的西北大学团队是国际公认的听觉 FFR 专家。 Salaam 团队在耳鼻喉科和执行外周听觉、中枢听觉、 Roth 博士和 Boivin 博士是评估神经认知功能的专家。 Niemczak 博士拥有丰富的生物统计学经验，是外周和中枢听觉处理领域的专家。 团队和纵向队列提供了评估 CAT 在认知评估中的使用的独特能力 衰老和药物对 PLWH 中枢和外周听觉功能的影响。