The Electrically Evoked Auditory Change Complex Evoked by Temporal Gaps Using Cochlear Implants or Auditory Brainstem Implants in Children With Cochlear Nerve Deficiency.
The Electrically Evoked Auditory Change Complex Evoked by Temporal Gaps Using Cochlear Implants or Auditory Brainstem Implants in Children With Cochlear Nerve Deficiency.
复制标题
DOI：
10.1097/aud.0000000000000498
复制
发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Buchman CA
中科院分区：
文献类型：
--
作者：
He S;McFayden TC;Shahsavarani BS;Teagle HFB;Ewend M;Henderson L;Buchman CA
本研究的目的是 1) 建立测量电诱发听觉变化复合体 (eACC) 的可行性，以响应使用人工耳蜗 (CI) 和/或听觉脑干植入 (ABI) 的耳蜗神经缺陷 (CND) 儿童的颞间隙； 2）探索这些患者的时间间隙的神经编码和感知敏感性之间的关联。研究参与者包括五名儿童（S1-S5），测试时年龄从 3.8 岁到 8.2 岁（平均：6.3 岁）。由于 CND，所有受试者均单侧植入 Nucleus 24M ABI。对于每个受试者，测试了两个或多个 ABI 刺激电极。 S2、S3 和 S5 之前在对侧耳朵接受过 CI。对于这三名受试者，还测试了他们 CI 的至少两个刺激电极。对于电生理测量，刺激是以最大舒适水平（C 水平）传送到各个电极的 800 毫秒双相脉冲序列。在两种刺激条件下测量电诱发反应，包括起始反应和 eACC。在标准条件下，800 毫秒的脉冲序列不间断地传送到各个刺激电极。在间隙条件下，在 400 毫秒的刺激后，将时间间隙插入到脉冲序列中。本研究中测试的间隙持续时间范围为 2 至 128 毫秒。能够可靠地唤起 eACC 的最短间隙被定义为客观间隙检测阈值 (GDT)。对于行为 GDT 测量，刺激是 C 级呈现的 500 毫秒双相脉冲串。使用一个间隔、两个交替的强制选择程序来测量单个刺激电极的行为 GDT。使用 ABI 或 CI 成功记录了所有受试者至少一个刺激电极的 eACC 时间间隙。客观 GDT 显示受试者间差异，以及每个受试者内 ABI 或 CI 刺激电极之间的差异。在 S2 中测量一个 ABI 电极的行为 GDT，在 S5 中测量多个 ABI 和 CI 电极的行为 GDT。所有其他受试者均无法完成任务。 S5 显示 CI 电极的行为 GDT 比 ABI 电极测量的行为 GDT 更小。 S5 中的一个 CI 电极和两个 ABI 电极显示出类似的客观和行为 GDT。相比之下，S5 中的一个 CI 和两个 ABI 电极以及 S2 中的一个 ABI 电极显示出可测量的行为 GDT，但没有可识别的 eACC。使用 ABI 或 CI 记录 CND 儿童的 eACC 到时间间隙。客观和行为 GDT 都显示出受试者间和受试者内的差异。在这些受试者中，部分但不是所有 ABI 或 CI 电极观察到 eACC 记录结果与 GDT 心理物理测量结果之间的一致性。
This study aimed to 1) establish the feasibility of measuring the electrically evoked auditory change complex (eACC) in response to temporal gaps in children with cochlear nerve deficiency (CND) who are using cochlear implants (CIs) and/or auditory brainstem implants (ABIs); and 2) explore the association between neural encoding of, and perceptual sensitivity to, temporal gaps in these patients. Study participants included five children (S1–S5) ranging in age from 3.8 to 8.2 years (mean: 6.3 years) at the time of testing. All subjects were unilaterally implanted with a Nucleus 24M ABI due to CND. For each subject, two or more stimulating electrodes of the ABI were tested. S2, S3 and S5 previously received a CI in the contralateral ear. For these three subjects, at least two stimulating electrodes of their CIs were also tested. For electrophysiological measures, the stimulus was an 800-ms biphasic pulse train delivered to individual electrodes at the maximum comfortable level (C level). The electrically evoked responses, including the onset response and the eACC, were measured for two stimulation conditions. In the standard condition, the 800-ms pulse train was delivered uninterrupted to individual stimulating electrodes. In the gapped condition, a temporal gap was inserted into the pulse train after 400 ms of stimulation. Gap durations tested in this study ranged from 2 up to 128 ms. The shortest gap that could reliably evoke the eACC was defined as the objective gap detection threshold (GDT). For behavioral GDT measures, the stimulus was a 500-ms biphasic pulse train presented at the C level. The behavioral GDT was measured for individual stimulating electrodes using a one-interval, two-alternative forced-choice procedure. The eACCs to temporal gaps were recorded successfully in all subjects for at least one stimulating electrode using either the ABI or the CI. Objective GDTs showed inter-subject variations, as well as variations across stimulating electrodes of the ABI or the CI within each subject. Behavioral GDTs were measured for one ABI electrode in S2 and for multiple ABI and CI electrodes in S5. All other subjects could not complete the task. S5 showed smaller behavioral GDTs for CI electrodes than those measured for ABI electrodes. One CI and two ABI electrodes in S5 showed comparable objective and behavioral GDTs. In contrast, one CI and two ABI electrodes in S5 and one ABI electrode in S2 showed measurable behavioral GDTs but no identifiable eACCs. The eACCs to temporal gaps were recorded in children with CND using either ABIs or CIs. Both objective and behavioral GDTs showed inter- and intra-subject variations. Consistency between results of eACC recordings and psychophysical measures of GDT was observed for some but not all ABI or CI electrodes in these subjects.