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ARC 22 Virtual- AM Sessions

8:00 AM - 8:15 AM CDT
Welcome and Overview of Conference- Part 1

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Conference Chair
Professor Karen P Steel, FMedSci, FRS
Wolfson Centre for Age-Related Diseases
King’s College London, Guy’s Campus

Conference Co-Chair
Judy R. Dubno, PhD
Distinguished University Professor and Vice Chair for Research
Department of Otolaryngology-Head and Neck Surgery
Medical University of South Carolina
Charleston, SC

8:20-9:10 AM CDT
Social and Economic Costs of Untreated Hearing and Vestibular Loss

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Speaker Info:

Howard Francis, MD and Kristal Riska, AuD, PhD

Learner Objectives: 
Upon completion, each ARC participant will be able to:

  1. Name the consequences of unaddressed hearing and vestibular impairment in older adults
  2. Identify how social barriers may create disparities in access and health outcome
  3. Describe approaches to mitigate these effects

Summary Description: 
As the population ages, declining hearing and vestibular function are barriers to sustained independence, accompanied by increasing risks of social isolation with consequences to health and economic wellbeing.

9:15-10:05 AM CDT
Whole-person Care: The Broad Impact of Age-related Hearing Loss and Vestibular Decline

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Speaker Info:
Sara K. Mamo
Assistant Professor
University of Massachusetts Amherst

Learner Objectives: 
Upon completion, each ARC participant will be able to:

  1. Describe the population-based evidence for the broad impacts of age-related hearing loss and vestibular decline
  2. Identify alternative approaches to integrate audiology into comprehensive care plans for older adults
  3. Summarize the problems with the paucity of audiology research in non-White populations as it relates to issues around access to care and healthy aging

Summary Description:
Sara Mamo present research findings related to how age-related hearing loss and balance dysfunction lead to cognitive and functional declines. The presentation will focus on the broad health impacts of living with multiple chronic conditions. She will present support for more holistic and integrated service delivery models to improve and maintain healthy functioning for older adults.

10:10-11:00 AM CDT
Auditory Processing in Older Adults: Assessment Needs and Opportunities

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Speaker Info: 

Frederick Gallun
Professor, Oregon Hearing Research Center, Dept. of Otolaryngology/Head and Neck Surgery
Neuroscience Graduate Program, Oregon Health and Science University

Learning Objectives:
Upon completion, each ARC participant will be able to:

  1. Describe specific ways in which suprathreshold auditory processing is important for communication in realistic environments
  2. Explain which neural mechanisms are impaired by aging and how this can impair auditory processing beyond the detection of tones.
  3. Summarize the remaining knowledge gaps relating auditory processing and aging, including the need for normative data representative of the populations of patients for whom these tools are relevant, including those from diverse ethnic, racial, and linguistic backgrounds.

Summary Description:
The aging process is known to limit the ability of the auditory pathways to process sound, but the translation of this knowledge to clinical practice is limited by multiple factors. One barrier that has recently been surmounted is the lack of appropriate tools. Still remaining is the need for research-based evidence supporting the integration of suprathreshold testing into clinical practice, including the fitting of hearing aids. The other important barrier is the lack of training on administering and interpreting tests of suprathreshold abilities by clinical practitioners. This talk will describe new tools that are freely available and that run on inexpensive, calibratable hardware. In addition, this presentation will make the case for 1) more extensive training in the use of such tools, 2) further research that will allow their integration into clinical practice, and 3) normative data representative of the populations of patients with potential auditory processing difficulties, including those from diverse ethnic, racial, and linguistic backgrounds.

11:00-11:30 AM CDT
Guided Discussion

11:30-12:30 PM CDT
Lunch

ARC 22 Virtual- PM Sessions

12:30-12:40 PM CDT
Welcome and Overview- Part 2

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Conference Chair
Professor Karen P Steel, FMedSci, FRS
Wolfson Centre for Age-Related Diseases
King’s College London, Guy’s Campus

Conference Co-Chair
Judy R. Dubno, PhD
Distinguished University Professor and Vice Chair for Research
Department of Otolaryngology-Head and Neck Surgery
Medical University of South Carolina
Charleston, SC

12:45-1:35 PM CDT
The Diverse Pathologies underlying Age-Related Hearing and Vestibular Loss

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Speaker Info: 

Michael G. Heinz, PhD
Professor of Speech, Language, and Hearing Sciences
Professor of Biomedical Engineering Purdue University

1:40-2:30 PM CDT
Identifying Pathophysiology of Human Age-related Hearing Loss

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Speaker Info:
Kelly C. Harris, PhD/CCC-A Associate Professor Medical University of South Carolina

Learning Objectives:
Upon completion, each ARC participant will be able to:

  1. Describe the types of presbyacusis
  2. Contrast the underlying pathology associated with each type of presbyacusis
  3. Describe  demographic differences, including age and sex, that are associated with metabolic versus sensory presbyacusis

Summary Description:
Age-related hearing loss in humans is complex because many factors in addition to aging can produce hearing loss in older persons, such as the accumulated effects of a lifetime of exposure to noise, ototoxic drugs, or otologic disease. Thus, targeted treatments for age-related hearing loss must address the multiple sources of pathology and their complex impact on communication. Three primary sites of pathology, sensory cells and the stria vascularis in the cochlea, and the auditory nerve (AN) underlie age-related changes in hearing thresholds and suprathreshold auditory function. Attempts to classify the sites of pathology have been based largely on the configuration of the audiogram. These studies show classic patterns of hearing loss seen in animal models of sensory and strial deficits and are consistent with demographic and noise history patterns. However, the audiogram represents only one aspect of functional abilities, ignores suprathreshold auditory processing, and is insensitive to neural loss.  Thus, a multi-metric differential approach that incorporates multiple measures from each individual that may be validated in animal models may greatly improve sensitivity and specificity in identifying underlying pathologies. This electrophysiologic approach assumes that sensory cell and strial deficits differentially affect cochlear measures, including otoacoustic emissions and the cochlear microphonic. The effects of these cochlear deficits are predicted to propagate through the auditory system and result in unique patterns of AN dysfunction, as characterized by compound action potentials (CAP). In contrast, neural deficits can be characterized by the CAP but will not affect cochlear measures. Establishing the appropriate set of measures for characterizing cochlear and AN dysfunction in older adults will help move beyond the audiogram to identify the underlying pathophysiology associated with age-related hearing loss. [Work supported by NIH/NIDCD]. 

2:30-2:45 PM CDT
Break

2:45-3:35 PM CDT
Molecular Pathways Involved in Age-Related Hearing Loss

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Speaker Info:

Cynthia C. Morton
William Lambert Richardson Professor of Obstetrics, Gynecology and Reproductive Biology and Professor of Pathology, Harvard Medical School

Kenneth J. Ryan, M.D. Distinguished Chair in Obstetrics and Gynecology and Director of Cytogenetics, Brigham and Women’s Hospital Institute Member, Broad Institute of MIT and Harvard Chair in Auditory Genetics, University of Manchester, UK

Learning Objectives:
Upon completion, each ARC participant will be able to:

  1. Be familiar with the genetic method GWAS (Genome Wide Association Study) to identify loci likely to have a role in age-related hearing loss
  2. Become acquainted with the genetic methods of Mendelian Randomization and Genome Polygenic Scores in assessing causality and risk, respectively, for age-related hearing loss
  3. Recognize the importance of ethnic diversity in interpreting genetic variants for hearing loss

3:40-4:30 PM CDT
Prospects for Treatments for Progressive Hearing Loss and Balance Dysfunction of Genetic Origins

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Speaker Info: 

Gwenaëlle S.G. Géléoc
Boston Children’s Hospital and Harvard Medical School

Learning Objectives:
Upon completion, each ARC participant will be able to:

  1. Describe novel therapies that can target genes associated with progressive hearing loss and balance deficits
  2. Understand the importance of spatio-temporal expression of the causative gene, i.e. which cell type expresses the gene of interest and when therapy may be delivered to provide optimal benefit
  3. Identify the limitations of our current understanding before moving such therapy to the clinic.

Summary Description:
Building on recent progress in gene transfer and the development of new gene editing tools, numerous studies have emerged, over the past decade, validating, preclinical use of novel therapies for genetic hearing loss and balance deficits. These include gene replacement, or mutation specific interventions that may correct, knock-down or knockout a given gene mitigating the consequences of causal pathogenic variants. The inner ear is a suitable target for such treatment as it offers a unique accessible and relatively immune-privileged environment. The spatio-temporal pattern of expression of the causal gene dictates which cell type should be targeted and when the therapy should be delivered, in some cases requiring several treatments to obtain long term protection. This presentation will summarize the current status of preclinical studies, their potential and limitations, and how these may translate to viable treatments in patients who suffer from genetic hearing loss and balance dysfunction.

4:30-4:45 PM CDT
Guided Discussion

4:45– 5:00 PM CDT
Closing Remarks