Tracking Early Emergence of Sound Perception Impairments in FXS With Multimodal fNIRS/EEG- Infant
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 30
- 试验地点
- 2
- 主要终点
- Changes in oxygenated and deoxygenated hemoglobin concentration in response to sounds in language regions of the brain
研究概览
简要总结
Individuals with Fragile X Syndrome show differences in how they understand and learn language from infancy. They frequently have lifelong delays in speech and language as well. In addition, they experience other auditory symptoms, including being very sensitive to certain sounds as well as being more sensitive than others to loud sounds. The underlying brain activity for sound perception and speech learning in Fragile X is not well understood, especially in the infant and toddler years. This study uses behavioral assessment of speech and language abilities, neuroimaging, and hearing tests to understand how speech and hearing are different in children with Fragile X Syndrome.
详细描述
Fragile X Syndrome (FXS) is the leading monogenic cause of intellectual disability and autism and is associated with extremely high risk for early delays in speech and language. While infancy is essential for speech and language development, neural mechanisms for language impairments have been studied entirely in older children and adults with FXS. Therefore, markers for speech and language impairments are unavailable in infants and toddlers with FXS to predict severity, test potential mechanisms, and track response to intervention. The investigators have identified a hallmark brain-based phenotype of hyperresponsiveness to sounds in adolescents and adults with FXS. This fundamental alteration in cortical responses to sound could influence early language delays, but this phenotype has not been explored in infants or toddlers with FXS.
Specifically, in this study the investigators will use simultaneous EEG/fNIRS during presentation of simple speech, stories, and nonspeech sounds to quantify and localize auditory hypersensitivity and neural differentiation in 30 infants and toddlers, including 15 with FXS and 15 controls. Infants will complete visits at different ages, with possible visits at 6 months, 12 months, 18 months, and 24 months, so that changes with development can be tracked over time.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Basic Science
- 盲法
- None
入排标准
- 年龄范围
- 6 Months 至 26 Months（Child）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Diagnoses of Fragile X Syndrome, Typical Development, or History of Premature Birth
- •able to sit independently
- •English is spoken at home
排除标准
- •For all participants: no seizures in the past 6 months
- •For typical development group and Fragile X group: not born prior to 32 weeks gestation
研究组 & 干预措施
Speech Sounds
Participants listen to speech sounds while the investigators measure electrical and hemodynamic changes in the brain.
干预措施: Speech discrimination (Other)
结局指标
主要结局
Changes in oxygenated and deoxygenated hemoglobin concentration in response to sounds in language regions of the brain
时间窗: at 12 month, 18 month, and 24 month visits
Relative increase in oxygenated versus deoxygenated hemoglobin for no sounds, low intensity sounds, and medium intensity sounds. Measured via functional Near Infrared Spectroscopy with optodes placed over frontal, temporal, and parietal language regions.
Changes in amplitude of mismatch negativity response during sound discrimination
时间窗: at 12 month, 18 month, and 24 month visits
Electroencephalography is measured over the scalp while participant listens to speech sounds with infrequent "oddball" stimuli. Amplitude of the P100 for all stimuli as well as amplitude of the mismatch negativity response (frequent minus infrequent response) as well as change in these metrics over development are tracked in all groups.
Changes in hearing thresholds
时间窗: at 12 month, 18 month, and 24 month visits
Hearing thresholds in dB as assessed using Conditioned Play Audiometry (CPA) or Visual Reinforced Audiometry (VRA) dependent on child age and developmental ability.
Change in Mullen Scales of Early Learning
时间窗: at 12 month, 18 month, and 24 month visits
change in Mullen Scales scores (age-corrected) from baseline on all subscales, including Expressive Language, Receptive Language, FIne Motor, Gross Motor, and Visual Reception. T-Scores from the Mullen Scales of Early Learning (MSEL) have a mean of 50 and a standard deviation of 10. Range=20-80. Higher scores indicate more advanced developmental skills.
Otoacoustic Emissions (OAEs)
时间窗: at 12 month, 18 month, and 24 month visits
Signals produced by excitation of hair cells in cochlea are measured for a range of frequencies.
Changes in tympanometric pressure profile in the inner ear
时间窗: at 12 month, 18 month, and 24 month visits
Wide Band Tympanometry is completed to measure variability in tympanometric pressure for left and right ears that may affect hearing profile.
Changes in LENA vocalizations and conversational turns
时间窗: at 12 month, 18 month, and 24 month visits
LENA is a voice recording system and proprietary program that records a child's home language environment. This recording is then digitally processed to model aspects of the child's own vocalizations and those of others'.
次要结局
- Sensory profile 2 Auditory Processing subtest(at 6 month, 12 month, 18 month, and 24 month visits)
- Sensory Profile 2 Attentional subtest(at 6 month, 12 month, 18 month, and 24 month visits)
研究者
Elizabeth Smith
Assistant Professor of Pediatrics
Children's Hospital Medical Center, Cincinnati