Characterizing Polarity Sensitivity in Cochlear Implant Recipients: Demographic Effects and Potential Implications for Estimating Neural Health.
Characterizing Polarity Sensitivity in Cochlear Implant Recipients: Demographic Effects and Potential Implications for Estimating Neural Health.
复制标题
表征人工耳蜗植入者的极性敏感性：人口统计影响和估计神经健康的潜在影响。
DOI：
10.1007/s10162-021-00824-0
复制
发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Hughes,MichelleL
中科院分区：
文献类型：
--
作者：
Hughes,MichelleL
刺激极性可以影响耳蜗植入者的生理和感知测量。各种结果测量的极性之间存在较大差异（例如，eCAP阈值、幅度或斜率）理论上反映较差的神经健康，而较小的差异反映较好的神经健康。因此，我们预计大的极性效应与其他导致神经健康不良的措施相关，如高龄或长期耳聋。我们使用电诱发复合动作电位（eCAP）的早期研究表明，当使用特定于器械的临床脉冲设计时，Cobriar和Advanced Bionics器械用户之间的极性效应存在差异。由于器械之间的刺激略有不同，因此本研究的第一个目标是确定脉冲相位持续时间（PD）的微小临床相关差异是否对eCAP极性效应产生显著影响，从而可能解释之前观察到的器械差异。极性效应被量化为eCAP阈值的差异，平均归一化幅度，和幅度增长函数的斜率获得的阳极第一与阴极第一双相脉冲。结果表明，PD的微小变化不能解释所观察到的器械之间eCAP极性效应的差异。因此，eCAP极性灵敏度测量对于脉冲参数的小差异是相对稳健的。然而，目前尚不清楚所观察到的制造商差异的原因，这可能会限制eCAP极性灵敏度测量的实用性。第二个目标是在一个大的CI收件人（65耳）的极性敏感性的特点与年龄和耳聋的持续时间作为神经健康的代理极性敏感性。两个器械组使用相同的脉冲参数。eCAP极性效应的唯一显著预测因素是年龄，对于Cobalar受体的阈值和振幅极性效应，以及年龄和耳聋持续时间，对于AB受体的斜率。然而，这四种相关性中有三种与预期的方向相反。这些结果表明，eCAP极性敏感性的措施可能反映不同的机制比的影响，年龄和耳聋的持续时间诱导外周听觉系统。
Stimulus polarity can affect both physiological and perceptual measures in cochlear-implant recipients. Large differences between polarities for various outcome measures (e.g., eCAP threshold, amplitude, or slope) theoretically reflect poorer neural health, whereas smaller differences reflect better neural health. Therefore, we expect large polarity effects to be correlated with other measures shown to contribute to poor neural health, such as advanced age or prolonged deafness. Our earlier studies using the electrically evoked compound action potential (eCAP) demonstrated differences in polarity effects between users of Cochlear and Advanced Bionics devices when device-specific clinical pulse designs were used. Since the stimuli differed slightly between devices, the first goal of this study was to determine whether small, clinically relevant differences in pulse phase duration (PD) have a significant impact on eCAP polarity effects to potentially explain the device differences observed previously. Polarity effects were quantified as the difference in eCAP thresholds, mean normalized amplitudes, and slope of the amplitude growth function obtained for anodic-first versus cathodic-first biphasic pulses. The results showed that small variations in PD did not explain the observed differences in eCAP polarity effects between devices. Therefore, eCAP polarity sensitivity measures are relatively robust to small differences in pulse parameters. However, it remains unclear what underlies the observed manufacturer differences, which may limit the utility of eCAP polarity sensitivity measures. The second goal was to characterize polarity sensitivity in a large group of CI recipients (65 ears) to relate polarity sensitivity to age and duration of deafness as a proxy for neural health. The same pulse parameters were used for both device groups. The only significant predictors of eCAP polarity effects were age for threshold and amplitude polarity effects for Cochlear recipients and age and duration of deafness for slope for AB recipients. However, three of these four correlations were in the opposite direction of what was expected. These results suggest that eCAP polarity sensitivity measures likely reflect different mechanisms than the effects that age and duration of deafness induce on the peripheral auditory system.