Central auditory processing abnormalities as an indicator of pediatric heavy metal neurotoxicity

中枢听觉处理异常作为儿童重金属神经毒性的指标

基本信息

批准号：
10053901
负责人：
James E Saunders
金额：
$ 21.89万
依托单位：
DARTMOUTH-HITCHCOCK CLINIC
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-01 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10053901
关键词：
Address Adult Affect Aluminum Alzheimer&apos s Disease Analysis of Variance Area Arsenic Attenuated Auditory Auditory Brainstem Responses Blood Brain Central Auditory Processing Disorder Child Childhood China Collaborations Communities Complement Congenital neurologic anomalies Data Databases Detection Digit structure Early Intervention Early identification Educational workshop Environment Environmental Health Epidemiology Equipment Exposure to Foundations Frequencies Future Gold Grant HIV Health Hearing Hearing Tests Heavy Metals Hispanic Americans Human Resources Inductively Coupled Plasma Mass Spectrometry Industry Institution International Latin American Lead Lead levels Link Manganese Measures Mentors Mercury Metal exposure Metals Mining Nail plate Nervous System Trauma Neuraxis Neurocognitive Nicaragua Nicaraguan Noise Occupations Otoscopy Pathway interactions Patients Performance Peripheral Pilot Projects Population Populations at Risk Process Protocols documentation Reference Values Regression Analysis Regulation Research Research Design Research Methodology Research Personnel Research Training Resources Risk Risk Factors Running Rural Sampling Schools Series Signal Transduction Smelts Socioeconomic Factors Solvents Spottings Structure of nail of toe System Tablets Tanzania Test Result Testing Time Tissues Toxic Environmental Substances Toxic effect Toxin Training Tympanometry Wireless Technology Work auditory pathway auditory processing base cognitive performance cohort database design epidemiology study experience field study follow-up hearing impairment hearing screening high risk improved innovation instrument interest low and middle-income countries metal poisoning neurocognitive disorder neurocognitive test neurotoxicity operation performance tests portability screening speech in noise tool

项目摘要

Project Abstract Artisanal small-scale gold mining (ASGM) communities are at extremely high risk for heavy metal / metalloid exposure including mercury (Hg), lead (Pb), arsenic (As), and manganese (Mn) with potential irreversible effects on the developing central nervous system (CNS). Exposure to these metals in childhood could lead to a lifelong reduction in educational and job opportunities. Early identification of heavy metal neurotoxicity has been challenging, but preliminary work suggests central auditory processing (CAP) may correlate with heavy metal exposure and correlate with early neurocognitive changes. Through our previous work we have: 1) developed a wireless, field deployable peripheral and central hearing assessment system suitable for the developing world, 2) established research collaborations in Nicaragua and 3) demonstrated that central auditory testing can be used to assess brain function. This study will determine whether portable, mobile central auditory testing can identify children with significant heavy metal neurotoxicity. Minimally trained technicians will utilize an innovative mobile tablet-based platform to perform audiometry and comprehensive CAP tests [Dichotic Digits (DD), antiphase noise and signal testing (N0Spi), Gap Detection Threshold (GDT), Latin American Spanish Hearing in Noise Testing (LASHINT), and Fixed Level Frequency Testing (FLFT)] on a large cohort (200) of children (6 – 18 years) living in a Nicaraguan ASGM communities. Data will be uploaded to a mobile database platform (REDCap) along with detailed socioeconomic and risk factor data. In addition, toenail and dried blood spot (DBS) samples will be collected and analyzed for concentrations of 5 heavy metals (Pb, Hg, As, Mn, and Al) using inductively coupled plasma mass spectrometry (ICP-MS) analysis. The concentrations of these metals will be correlated with CAP test performance using regression analysis and non-parametric ANOVA (Kruskal-Wallis) analysis will be used to assess differences between children with metal levels above compared to those within the reference range. The proposed work will build upon existing research capacities and collaboration with two major collaborating institutions in Nicaragua by: 1) developing research capabilities and providing instruments that are ideally suited to remote impoverished environments, 2) adapting and training research personnel in database (REDCap) design and implementation, 3) providing a foundation for future comprehensive epidemiological studies through training, 4) mentoring Nicaraguan researchers in advanced research design and methodology, 5) providing additional expertise in specialized areas of interest (e.g. central auditory processing disorders, heavy metal neurotoxicity), 6) facilitating the research partnership between MMO and UNAN-Leon CISTA. This project will provide preliminary data on heavy metal exposure and central auditory test performance that would form the basis for a follow-up grant submission from our Nicaraguan colleagues to address this important environmental health issue.

项目摘要手工小规模金矿开采 (ASGM) 社区面临着极高的重金属/类金属风险接触汞 (Hg)、铅 (Pb)、砷 (As) 和锰 (Mn) 可能造成不可逆的后果对中枢神经系统 (CNS) 的影响可能会导致儿童期接触这些金属。重金属神经毒性的早期发现导致终身教育和工作机会的减少。一直具有挑战性，但初步研究表明中枢听觉处理（CAP）可能与重度相关通过我们之前的工作，我们发现金属暴露与早期神经认知变化相关：1）开发了一种无线、可现场部署的外围和中央听力评估系统，适用于发展中国家，2) 在尼加拉瓜建立了研究合作，3) 表明中央听觉测试可用于评估大脑功能，这项研究将确定是否便携、移动。中枢听觉测试可以识别患有严重重金属神经毒性的儿童。技术人员将利用基于移动平板电脑的创新平台进行听力测量和综合 CAP 测试 [双色数字 (DD)、反相噪声和信号测试 (N0Spi)、间隙检测阈值 (GDT)、拉丁美洲西班牙语听力噪声测试 (LASHINT) 和固定电平频率测试 (FLFT)] 将上传生活在尼加拉瓜手工和小规模采金社区的大量 (200) 儿童（6 - 18 岁）数据。移动数据库平台（REDCap）以及详细的社会经济和风险因素数据此外，将收集脚趾甲和干血斑 (DBS) 样本并分析 5 种重金属的浓度使用电感耦合等离子体质谱 (ICP-MS) 分析金属（Pb、Hg、As、Mn 和 Al）。使用回归分析将这些金属的浓度与 CAP 测试性能相关联非参数方差分析 (Kruskal-Wallis) 分析将用于评估患有以下疾病的儿童之间的差异：与参考范围内的金属水平相比，拟议的工作将建立在现有的基础上。研究能力以及与尼加拉瓜两个主要合作机构的合作：1）开发研究能力并提供非常适合偏远贫困环境的仪器，2) 调整和培训数据库 (REDCap) 设计和实施方面的研究人员，3) 提供通过培训为未来综合流行病学研究奠定基础，4）指导尼加拉瓜高级研究设计和方法论的研究人员，5）提供专业领域的额外专业知识感兴趣的领域（例如中枢听觉处理障碍、重金属神经毒性），6）促进 MMO 和 UNAN-Leon CISTA 之间的研究合作伙伴关系该项目将提供有关的初步数据。重金属暴露和中枢听觉测试表现将构成后续补助金的基础我们的尼加拉瓜同事为解决这一重要的环境健康问题提交了意见书。