Effects of long-term use of a cochlear implant on the electrically evoked compound action potential.
Effects of long-term use of a cochlear implant on the electrically evoked compound action potential.
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DOI：
10.3766/jaaa.21.1.2
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发表时间：
2010-01
影响因子：
1.2
通讯作者：
Oleson JJ
中科院分区：
文献类型：
--
作者：
Brown CJ;Abbas PJ;Etlert CP;O'Brient S;Oleson JJ
自 20 世纪 90 年代初以来，已经可以测量 Nucleus 人工耳蜗用户的电诱发复合动作电位 (ECAP)。记录ECAP不需要受试者的积极参与，并且记录不会受到注意力或睡眠的不利影响，使得这种反应成为监测长期变化的理想工具。我们实验室之前的研究表明，ECAP 阈值和 ECAP 增长函数的斜率随着时间的推移相对稳定。然而，这一结论是基于从相当有限的研究参与者中获得的结果，每个参与者都使用 Nucleus CI24M 人工耳蜗，并且随访时间不到两年。评估长期使用人工耳蜗对儿童和成人人工耳蜗植入者的 ECAP 阈值和 ECAP 输入/输出函数斜率的影响。一项纵向研究，描述 ECAP 阈值和生长函数在初始激活后 96 个月的时间内如何变化。分析了 ECAP 阈值和 ECAP 生长函数斜率随时间的变化，并分析了受试者年龄、CI（人工耳蜗）类型和刺激电极的影响。 134 名 Nucleus CI 用户参与了这项研究。所有人都彻底聋了。该受试者库包括使用 Nucleus CI24M 人工耳蜗的 84 名个体（40 名成人和 44 名儿童）和使用 Nucleus CI24R 人工耳蜗的 50 名个体（21 名成人和 29 名儿童）。电极 5、10、15 和 20 受到刺激，并在设备初始激活后定期测量每个受试者的 ECAP 生长功能。在连接后 3-6 个月内发生的“早期”就诊和 4.8-6 年后发生的“晚期”就诊之间，儿童和成人 CI 用户的平均 ECAP 阈值略有增加。对于成人，ECAP 阈值平均增加为 3.94 CL（Nucleus CI 的临床编程单位）。对于儿童来说，平均增加了 4.16 CL。这些差异虽然很小，但具有统计学意义。在同一时间间隔内测量的 ECAP 增长函数的斜率没有显着变化。平均而言，儿童 CI 使用者的 ECAP 阈值比成人 CI 使用者高 4-5 CL 个单位。然而，这项研究最引人注目的结果是，与语后聋成人相比，儿科 CI 用户的 ECAP 生长函数要陡峭得多。从儿童身上获得的结果与从成人身上获得的结果之间的差异具有统计学意义，并且很大程度上与设备类型或刺激电极无关。这项研究的结果显示，ECAP 阈值和生长函数在 5-6 年的观察间隔内变化很小，这表明长期使用 CI 不太可能对周围听觉系统的反应产生显着的负面影响。与语后聋的成年 CI 用户相比，儿童 CI 用户平均具有更高的 ECAP 阈值和更陡峭的 ECAP 增长函数。这一发现表明，两个患者群体之间在耳蜗内的电流场或刺激电极与可刺激神经组织之间的有效距离方面存在潜在差异。
Since the early 1990s, it has been possible to measure electrically evoked compound action potentials (ECAPs) from Nucleus cochlear implant users. Recording the ECAP does not require active participation by the subject, and the recordings are not adversely affected by attention or sleep, making this response an ideal tool for monitoring long-term changes. Previous research from our laboratory has shown that ECAP thresholds and slope of the ECAP growth functions are relatively stable over time. However, this conclusion was based on results obtained from a fairly limited number of study participants, each of whom used the Nucleus CI24M cochlear implant and were followed for less than two years. To evaluate the effect of long-term use of a cochlear implant on ECAP thresholds and slope of the ECAP input/output function for both pediatric and adult cochlear implant recipients. A longitudinal study that describes how ECAP thresholds and growth functions change over a period of 96 mo following initial activation. Changes over time in ECAP threshold and slope of the ECAP growth function were analyzed, and effects of the subject’s age, type of CI (cochlear implant), and stimulating electrode are included in the analysis. 134 Nucleus CI users participated in this study. All were profoundly deaf. This subject pool included 84 individuals (40 adults and 44 children) who used the Nucleus CI24M cochlear implant and 50 individuals (21 adults and 29 children) who used the Nucleus CI24R cochlear implant. Electrodes 5, 10, 15, and 20 were stimulated, and ECAP growth functions were measured for each subject at regular intervals following the initial activation of the device. Small increases in mean ECAP thresholds were observed for both pediatric and adult CI users between an “early” visit that occurred within 3–6 mo following hookup and a “late” visit that occurred 4.8–6 yr later. For adults, the average increase in ECAP threshold was 3.94 CL (clinical programming units for Nucleus CIs). For children, the average increase was 4.16 CL. These differences, while small, were statistically significant. Slope of the ECAP growth functions measured over the same time interval did not change significantly. On average, pediatric CI users had ECAP thresholds that were 4–5 CL units higher than the adult CI recipients. The most striking outcome from this study, however, was the finding that when compared with postlingually deafened adults, pediatric CI users had ECAP growth functions that were substantially steeper. The differences between the results obtained from children and those obtained from adults were statistically significant and largely independent of device type or stimulating electrode. Results from this study show ECAP thresholds and growth functions to change very little over a 5–6 yr observation interval suggesting that long-term use of a CI is not likely to have a significant negative impact on the response of the peripheral auditory system. Pediatric CI users were shown to have, on average, higher ECAP thresholds and steeper ECAP growth functions than postlingually deafened adult CI users. This finding suggests potential differences between the two patient populations either in terms of the current fields within the cochlea or the effective distance between the stimulating electrode and the stimulable neural tissue.
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影响因子：
2.6
作者：
Ruffin, Chad V.;Tyler, Richard S.;Rubinstein, Jay T.
通讯作者：
Rubinstein, Jay T.
影响因子：
2.1
作者：
Zwolan, Teresa A.;O'Sullivan, Mary Beth;Niparko, John K.
通讯作者：
Niparko, John K.
影响因子：
6.5
作者：
LINARES, HA;KISCHER, CW;DOBRKOVSKY, M
通讯作者：
DOBRKOVSKY, M
DOI：
10.1016/s0165-5876(01)00426-8
发表时间：
2001-04-27
影响因子：
1.5
作者：
Thai-Van, H;Chanal, JM;Collet, L
通讯作者：
Collet, L
影响因子：
2.8
作者：
MILLER, CA;ABBAS, PJ;ROBINSON, BK
通讯作者：
ROBINSON, BK