Physiological Assessment of Auditory Processing Disorders in TBI

TBI 中听觉处理障碍的生理评估

• 批准号: 10058217
• 负责人: Melissa Papesh
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10058217
• 关键词: Adult; Affect; Age; Assessment tool; Attention; Auditory; Auditory Evoked Potentials; Auditory Perceptual Disorders; Auditory Physiology; Auditory Threshold; Auditory area; Auditory system; Behavioral; Binaural; Blast Injuries; Central Auditory Processing Disorder; Characteristics; Chronic; Clinical Management; Cognition; Cognition Disorders; Cognitive; Conflict (Psychology); Craniocerebral Trauma; Diagnosis; Dichotic Listening Tests; Dimensions; Discrimination; Disease; Electrophysiology (science); Emotional; Environment; Exposure to; Freedom; Frequencies; Goals; Hearing; Impaired cognition; Impairment; Injury; Instruction; Intervention; Knowledge; Measures; Nervous system structure; Outcome; Outcomes Research; Participant; Patient Care; Patients; Pattern Recognition; Performance; Physiological; Population; Predisposition; Psychometrics; Rehabilitation therapy; Reporting; Research; Research Proposals; Risk; Running; Shapes; Signal Transduction; Speech; Symptoms; Telephone; Traumatic Brain Injury; Veterans; Work; attentional control; auditory discrimination; auditory processing; base; behavior measurement; behavior test; clinical Diagnosis; clinical care; cognitive control; cognitive process; comorbidity; help-seeking behavior; improved; indexing; information processing; mild traumatic brain injury; normal hearing; operation; programs; relating to nervous system; response; social; sound; stem; tool

Mild traumatic brain injury (TBI) stemming from exposure to high-intensity blasts is one of the most prevalent injuries sustained by Veterans of Operation Enduring Freedom and Operation Iraqi Freedom. Recent research indicates that many of these Veterans can suffer from chronic difficulties processing auditory information in spite of normal hearing thresholds. Some of the most commonly reported problems include difficulty with speech in noisy or distracting environments, problems with long running speech and recalling lists of instructions, and difficulties on the telephone. Currently, little is known regarding how blast exposure affects the physiology of the auditory system to produce such deficits, nor the potential contributions of comorbid cognitive disorders to auditory processing concerns. In the current study, we aim to use electrophysiology in combination with behavioral testing to better understand how blast- exposure and TBI shape the neural encoding and discrimination of sound, and to probe the influence of cognitive factors on auditory processing. The long term goal of our research program is to develop electrophysiological tools which accurately and reliably reflect auditory function and can be used to improve clinical diagnosis and rehabilitation efforts of adult patients with acquired auditory processing disorder. Our overall objective for this CDA-2 research plan, which is the next step toward attainment of our long-term goal, is to systematically evaluate the utility of cortical and cognitive auditory evoked potentials (AEP) measures to reveal chronic physiological changes in auditory processing in Veterans with previous blast-exposure/TBI, and examine the relationship between these objective physiological measures and behavioral measures of hearing ability. Specifically, we will 1) determine how blast exposure and TBI affect neural discrimination of sound across domains including frequency, timing, intensity, and binaural integration at the level of the auditory cortex, 2) the impact of blast exposure/TBI on cognitive modulation of auditory encoding using cognitive AEPs, and 3) Assess the relationship between cortical and cognitive AEP measures and psychometrically based behavioral measures of auditory processing. We hypothesize that blast-exposed Veterans will demonstrate deficits in both cortical encoding of sound characteristics as evidenced by higher thresholds for detecting changes in sound and reduced amplitudes to changes in sound characteristics in blast- exposed/TBI Veterans compared to age- and hearing-matched control participants. We further predict that blast-exposed/TBI Veterans will show decreased cognitive control of sound encoding compared to control participants, and that cortical and cognitive AEP indices will be well correlated with behavioral measures of hearing ability. The outcomes of this research proposal include a better understanding of the bottom-up vs top-down contributions to auditory processing disorders in Veterans with previous blast-exposure and TBI and will serve as a starting point for developing physiological tools to evaluate auditory concerns in this population. These outcomes are expected to have a positive impact because they increase our knowledge of the impact of blast exposure and TBI on auditory function and will provide a significant step forward towards improved clinical care for these patients. This work will be significant because it is expected to have broad translational implications on the diagnosis and management of adult patients suffering from acquired auditory processing disorders.

暴露于高强度爆炸的轻度创伤性脑损伤（TBI）是 大多数普遍的伤害受到持久自由和行动行动的退伍军人所遭受的伤害 伊拉克自由。最近的研究表明，这些退伍军人中有许多可能患有慢性 尽管有正常的听力阈值，但处理听觉信息的困难。一些 最常见的问题包括在嘈杂或分心的语音困难 环境，长期运行的语音问题以及回忆说明列表以及 电话上的困难。目前，关于爆炸暴露如何影响 听觉系统的生理学产生此类缺陷，也不是 合并的认知障碍是听觉处理问题的。在当前的研究中，我们的目标是 将电生理学与行为测试结合使用，以更好地了解爆炸 暴露和TBI塑造了声音的神经编码和歧视，并探测 认知因素对听觉处理的影响。我们研究的长期目标 程序是开发电生理工具，以准确可靠地反映听觉 功能，可用于改善成年患者的临床诊断和康复工作 患有获得的听觉处理障碍。我们对CDA-2研究计划的总体目标， 这是实现我们长期目标的下一步，是系统地评估 皮质和认知听觉诱发电位（AEP）的效用，以揭示慢性 先前暴露/TBI的退伍军人的听觉加工的生理变化， 检查这些客观生理措施与行为之间的关系 听力能力的度量。具体而言，我们将1）确定爆炸暴露和TBI如何 影响跨域中声音的神经歧视，包括频率，时机，强度和 听觉皮层水平的双耳整合，2）爆炸暴露/TBI对 使用认知AEP的听觉编码的认知调制，3）评估关系 在皮质和认知AEP措施和基于心理的行为措施之间 听觉处理。我们假设暴露于爆炸的退伍军人将证明 较高的检测阈值证明了两种声音特征的皮质编码 声音的变化和幅度降低了BLAST声音特征变化的振幅 - 与年龄和听力匹配的对照参与者相比，暴露/TBI退伍军人相比。我们进一步 预测，爆炸暴露/TBI退伍军人将显示出声音的认知控制降低 与对照参与者相比编码，皮质和认知AEP指数将是 与听力能力的行为度量相关。这项研究的结果 建议包括更好地了解自下而上的对听觉的自上而下的贡献 以前的爆炸曝光和TBI的退伍军人的处理障碍，将作为一个 开发生理工具以评估该人群中听觉问题的起点。 这些结果有望产生积极的影响，因为它们增加了我们的知识 爆炸曝光和TBI对听觉功能的影响，将提供重要的一步 向前迈进这些患者的临床护理。这项工作将是重要的，因为 预计它将对诊断和管理具有广泛的翻译意义 成年患者患有获得的听觉处理障碍。