UNDERSTANDING SUPRATHRESHOLD HEARING DEFICITS

了解阈上听力缺陷

基本信息

批准号：
10242166
负责人：
Stephen T Neely
金额：
$ 40.65万
依托单位：
FATHER FLANAGAN'S BOYS' HOME
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-21 至 2023-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10242166
关键词：
Acoustic Nerve Address Affect Age Animals Auditory Auditory Threshold Auditory system Behavioral Clinic Clinical Cognition Data Data Collection Dependence Development Diagnosis Diagnostic Diagnostic Procedure Etiology Exhibits Fiber Foundations Functional disorder Goals Gold Hearing Hearing Tests Hearing problem Human Individual Inner Hair Cells Intervention Knowledge Laboratory Animals Lead Location Measurement Measures Methods Modeling Nerve Fibers Noise Outcome Outer Hair Cells Participant Physiological Population Procedures Public Health Recording of previous events Regression Analysis Reporting Research Sensorineural Hearing Loss Site Speech Statistical Models Synapses Techniques Testing Work auditory pathway base behavior measurement clinical Diagnosis clinical predictors clinically relevant cochlear synaptopathy evidence base hearing impairment hidden hearing loss improved individual variation insight interest normal hearing outcome prediction predictive modeling programs remediation research clinical testing sex speech in noise tool

项目摘要

PROJECT SUMMARY/ABSTRACT Sensorineural hearing loss (SNHL) can occur as a result of dysfunction of outer hair cells, inner hair cells, auditory-nerve fibers or synapses. However, standard clinical techniques are limited in their ability to differentiate these dysfunctions because they focus on threshold elevation and thus provide insufficient information about suprathreshold auditory dysfunction, which has greater ecological validity than threshold elevation. SNHL that does not elevate thresholds, and therefore would be missed by standard clinical techniques, is sometimes referred to as “hidden hearing loss” (HHL). Recent animal studies suggest that noise-induced synaptopathy may underlie HHL and may be the cause of suprathreshold hearing deficits, such as difficulty understanding speech in noise. However, there is limited research to support the diagnosis of HHL in humans beyond reports that some individuals have suprathreshold hearing deficits that cannot be predicted from their audiograms. Understanding HHL in humans will require the use of measurements of auditory function that are specific to the location of the dysfunction in the auditory pathway, including the specific group of auditory-nerve fibers (low vs. high spontaneous-rate fibers) underlying the dysfunction. The long-term goals of this research program are to improve our understanding of suprathreshold hearing deficits and to develop intervention strategies that ameliorate these deficits. The immediate goal of this proposal is to establish a theoretical framework for the development of diagnostic methods for HHL in humans. Unfortunately, a “gold standard” does not exist because synaptopathy cannot be directly observed in humans. Consequently, our approach is to develop a statistical model of HHL that describes the relationship and interdependence between specific behavioral and physiological measures of auditory function that are thought to be indicative of HHL and measures that reflect the functional integrity of sites along the auditory pathway. The goal will be achieved by pursuing three aims: (1) Develop a statistical model of HHL for individuals with normal hearing, (2) Develop a statistical model of HHL for individuals with clinical hearing loss caused by noise exposure, and (3) Validate a predictive model of HHL and demonstrate its relation to speech understanding in noise. We will establish a functional definition of HHL as a component of the variability in measures impacted by HHL that is not due to audiometric threshold. We will then create a statistical model that relates this estimate of HHL to measures that reflect sites of dysfunction along the auditory pathway. Through the aims, we will test the hypothesis that HHL accounts for some of the variability in suprathreshold measures of auditory function. The proposed research will lead to evidence-based models of suprathreshold auditory dysfunction that are capable of predicting hearing deficits, provide further insights into suprathreshold auditory deficits and improve our understanding of potential mechanisms underlying hearing and listening difficulties. The ability to diagnose HHL in the clinic will usher in new methods for clinical evaluation and may lead to better remediation techniques of hearing loss.

项目摘要/摘要感觉神经性听力损失（SNHL）可能是由于外毛细胞，内毛细胞，内部毛细胞功能障碍而发生的听觉障碍纤维或突触。但是，标准临床技术的能力有限区分这些功能障碍是因为它们专注于阈值升高，因此提供了不足有关远处ratherhold听觉功能障碍的信息，该功能障碍的生态有效性高于阈值海拔。不升高阈值的SNHL，因此将通过标准临床遗漏技术有时被称为“隐藏的听力损失”（HHL）。最近的动物研究表明噪声引起的突触病可能是HHL的基础，并且可能是远处雷斯雷斯特雷斯的原因，例如很难理解噪音中的语音。但是，有限的研究以支持HHL的诊断在人类之外，有些人有一些人的听证会定义了无法预测的从他们的听力图。了解人类中的HHL将需要使用听觉的测量特定于听觉途径中功能障碍的位置的功能，包括特定组功能障碍的基础听觉纤维纤维（低赞助商速率纤维）。长期目标该研究计划的旨在提高我们对suprathreshold听证会定义并发展的理解改善这些缺陷的干预策略。该提议的直接目标是建立一个用于开发人类HHL诊断方法的理论框架。不幸的是，“黄金” 不存在标准”是因为在人类中无法直接观察到突触病。因此，我们方法是开发HHL的统计模型，该模型描述了之间的关系和相互依赖性被认为指示HHL的听觉功能的特定行为和物理度量以及反映了沿听觉途径的位点功能完整性的度量。目标将实现通过追求三个目标：（1）为正常听力的个体开发HHL的统计模型，（2） HHL的统计模型，用于噪声暴露引起的临床听力损失的个体，以及（3）验证a HHL的预测模型并证明了其与噪声中语音理解的关系。我们将建立一个 HHL的功能定义是受HHL影响的度量变异性的组成部分，而不是由于HHL的影响听力学阈值。然后，我们将创建一个统计模型，将HHL的估计值与衡量标准有关反射沿听觉路径的功能障碍的位点。通过目标，我们将检验HHL的假设说明了听觉功能的上库量度衡量标准的某些可变性。拟议的研究将导致能够预测的循证上的听觉功能障碍模型听证会定义，进一步了解跨股权听觉定义并提高我们对听力和听力困难的潜在机制。在诊所诊断HHL的能力将迎来了用于临床评估的新方法，并可能导致更好的听力损失补救技术。