Mechanism-Based Measures of Otologic Pathology

基于机制的耳科病理学测量

• 批准号: 7850259
• 负责人: MANUEL DON
• 金额: $ 19.33万
• 依托单位: HOUSE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-17 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7850259
• 关键词: Acoustic Nerve; Acoustic Neuroma; Acoustics; Affect; Anxiety; Auditory; Auditory Brainstem Responses; Auditory system; Blood Vessels; Brain Stem; Characteristics; Clinical; Cochlea; Detection; Diagnosis; Differential Diagnosis; Disease; Disease regression; Ear; Early Diagnosis; Early identification; Edema; Effectiveness; Equilibrium; Financial compensation; Funding; Goals; Handedness; Health Care Costs; Hearing; Hemifacial Spasm; Human; Life; MRI Scans; Masks; Measurement; Measures; Meniere' s Disease; Methods; Monitor; Nerve; Noise; Normal Range; Operative Surgical Procedures; Output; Pathology; Patients; Performance; Peripheral; Physiological; Population; Procedures; Process; Progress Reports; Public Health; Running; Sampling; Screening procedure; Sensitivity and Specificity; Side; Specific qualifier value; Specificity; Staging; Stimulus; Symptoms; Techniques; Testing; Time; Tinnitus; Travel; Treatment Effectiveness; Validation; Vertigo; Vestibular Nerve; Work; base; cost; disease diagnosis; experience; hearing impairment; improved; relating to nervous system; response; sound; tumor

DESCRIPTION (provided by applicant): The project's long-term goal is to understand the effects of otologic pathology on mechanisms underlying human cochlear and brainstem auditory processes. We propose a mechanism-based approach that will provide (1) critical neuro-patho-physiological information, (2) a scientific framework for early diagnoses of difficult-to-identify otologic diseases, and (3) measures that will help assess the effectiveness of treatments. We use newly-developed non-invasive auditory brainstem response (ABR) measures to investigate known and hypothesized pathological changes in the mechanisms underlying specific processes in the peripheral auditory system caused by small acoustic tumors, microvascular compression of the cochleo-vestibular nerve, and Meniere's disease/cochlear hydrops. The specific aims are: (1) To continue our work with the Stacked ABR (SABR) and to investigate a chirp stimulus which is a more efficient method of synchronizing neural activity. We will compare the SABR and chirp responses in terms of the sensitivity for screening for small acoustic tumors and to see if a compensation function for hearing loss will improve the specificity of both the SABR and the response to chirp stimuli, (2) To demonstrate that the SABR and chirp response measures can be extended to assessing the presence and the laterality of microvascular compression of the auditory nerve in humans, and (3) To demonstrate that other new ABR measurements investigated in the first funding period can be used not only to diagnose patients with Meniere's disease/cochlear hydrops, but also to monitor the effectiveness of the treatments prescribed. Methods Used: The small tumor and microvascular compression studies use measures of the SABR and responses to chirp stimuli that represent essentially the total amount of synchronous neural activity in response to sound stimulation. The methods for tracking the treatment of patients with Meniere's disease involves special ABR measures. These reflect how cochlear hydrops affect the cochlea's ability to utilize special noises to mask the response to click stimuli. Relevance to Public health: One study will seek ways to improve a comfortable low cost method for screening for small tumors in order to reduce the number of patients who are sent for an MRI scan but do not have a tumor (roughly 999 out of 1000). This will save on healthcare cost and patient anxiety. Another study will provide a method for determining if a patient's hearing and/or balance symptoms are due to a blood vessel that is compressing the hearing and balance nerve, and if so, on which side the compression is occurring. This will reduce the number of needless surgeries and help specify the correct side that should, if desired, be surgically treated. The final study will help monitor treatment of Meniere's disease/cochlear hydrops to determine if the treatments simply affect the symptoms or are truly effecting a cure of the underlying disease.

描述（由申请人提供）：该项目的长期目标是了解耳诺病理学对人耳蜗和脑干听觉过程基础机制的影响。我们提出了一种基于机制的方法，该方法将提供（1）关键的神经性神经生理学信息，（2）用于早期诊断难以识别的耳科疾病的科学框架，以及（3）有助于评估治疗有效性的措施。我们使用新开发的非侵入性听觉脑干反应（ABR）措施来研究周围听觉系统中特定过程的已知和假设的病理变化，这是由小声学肿瘤引起的。具体目的是：（1）继续使用堆叠的ABR（SABR）进行我们的工作，并研究CHIRP刺激，这是同步神经活动的一种更有效的方法。 We will compare the SABR and chirp responses in terms of the sensitivity for screening for small acoustic tumors and to see if a compensation function for hearing loss will improve the specificity of both the SABR and the response to chirp stimuli, (2) To demonstrate that the SABR and chirp response measures can be extended to assessing the presence and the laterality of microvascular compression of the auditory nerve in humans, and (3) To证明在第一个资金期间研究的其他新的ABR测量值不仅可以用于诊断梅尼尔氏病/人工耳蜗的患者，还可以监测规定的治疗方法的有效性。所使用的方法：小肿瘤和微血管压缩研究使用SABR的度量以及对Chirp刺激的反应，这些刺激本质上代表了同步神经活动的总量，以响应声音刺激。跟踪Meniere病患者治疗的方法涉及特殊的ABR措施。这些反映了人工耳蜗如何影响耳蜗利用特殊噪音来掩盖对点击刺激的响应的能力。与公共卫生相关：一项研究将寻求改善舒适的低成本方法进行小肿瘤的筛查，以减少送去进行MRI扫描但没有肿瘤的患者数量（大约有1000人中的999个）。这将节省医疗费用和患者焦虑。另一项研究将提供一种方法，以确定患者的听力和/或平衡症状是否是由于压缩听力和平衡神经的血管引起的，如果是的，则在压缩的哪一侧发生。这将减少不必要的手术的数量，并帮助指定应进行手术治疗的正确方面。最终研究将有助于监测梅尼尔氏病/人工耳蜗的治疗方法，以确定治疗方法是否仅仅影响症状或真正影响基本疾病的治疗方法。