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

• 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
• 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' 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

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 手工小规模的金矿开采（ASGM）社区对重金属 /金属赛的风险极高 汞（HG），铅（PB），砷（AS）和锰（MN）的暴露 对发展中枢神经系统（CNS）的影响。在童年时期接触这些金属可能会导致 终生减少教育和工作机会。重金属神经毒性的早期鉴定具有 是挑战，但是初步工作表明中央听觉处理（CAP）可能与重型 金属暴露并与早期神经认知的变化相关。通过我们以前的工作，我们有：1） 开发了一种无线，可部署的外围和中央听力评估系统 发展中国家2）在尼加拉瓜建立了研究合作，3）证明了中央 听觉测试可用于评估大脑功能。这项研究将确定便携式，移动 中央听觉测试可以鉴定具有重要重金属神经毒性的儿童。受训练的最低训练 技术人员将利用创新的基于移动平板电脑的平台来执行听力计和全面 CAP测试[DICHOTIOT DIGITS（DD），反相噪声和信号测试（N0SPI），GAP检测阈值（GDT）， 拉丁美洲西班牙语在噪声测试（Lashint）和固定水平频率测试（FLFT）中的听证 居住在尼加拉瓜ASGM社区的儿童（6 - 18岁）的大型队列（200）。数据将上传 到移动数据库平台（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点（DBS）样品，并分析5个重量的浓度 金属（Pb，Hg，AS，Mn和Al）使用电感耦合等离子体质谱法（ICP-MS）分析。这 这些金属的浓度将与回归分析和 非参数方差分析（Kruskal-Wallis）分析将用于评估儿童之间的差异 与参考范围内的金属水平相比。拟议的工作将基于现有 研究能力和与尼加拉瓜的两个主要合作机构合作：1）开发 研究功能和提供理想适合偏远贫困环境的工具，2） 数据库（REDCAP）设计和实施中的调整和培训研究人员，3）提供 未来通过培训的未来全面流行病学研究基金会，4）尼加拉瓜的心理 高级研究设计和方法研究人员，5）提供专业的其他专家 感兴趣的领域（例如中央听觉处理障碍，重金属神经毒性），6）促进 MMO和Unan-Leon Cista之间的研究伙伴关系。该项目将提供有关的初步数据 重金属曝光和中央听觉测试表现，这将构成后续资助的基础 我们的尼加拉瓜同事提交，以解决这个重要的环境健康问题。