Interactions between Auditory and Vestibular Modalities during Stimulation with a Combined Vestibular and Cochlear Prosthesis.
Interactions between Auditory and Vestibular Modalities during Stimulation with a Combined Vestibular and Cochlear Prosthesis.
复制标题
使用组合前庭和耳蜗假体进行刺激期间听觉和前庭模式之间的相互作用。
DOI：
10.1159/000503846
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发表时间：
2020
影响因子：
1.6
通讯作者：
Rubinstein,JayT
中科院分区：
文献类型：
--
作者：
Phillips,JamesO;Ling,Leo;Nowack,Amy;Rebollar,Brenda;Rubinstein,JayT
背景：前庭和耳蜗联合人工耳蜗可以恢复失去听力和平衡的患者的听力和平衡。要做到这一点，设备应该独立激活每个感觉系统。在这项研究中，我们量化了听力和前庭功能均受损的人类受试者在使用16通道人工耳蜗和6通道前庭假体进行交叉刺激时听觉和前庭功能的相互作用。方法对3例受试者进行前庭人工耳蜗联合人工耳蜗植入。所有受试者在植入耳内都有严重到深度的耳聋。我们提供了耳蜗和前庭阵列的联合刺激，并寻找这些单独输入之间的相互作用。我们的主要结果测量是在有和没有同时刺激耳蜗的情况下，前庭终末器官的短暂双相脉冲刺激引起的眼球震颤期间电诱发的慢相眼速度，以及在有和没有同时刺激前庭壶腹的情况下，耳蜗刺激期间感知的响度和音高的李克特量表评估。结果所有受试者均无单独刺激半规管引起的听觉感觉，无单独刺激耳蜗引起的运动或慢相眼动感觉。然而，交错耳蜗刺激确实会引起电刺激引起的慢相眼速度的变化。同样，交错半规管刺激确实引起了耳蜗多个部位的刺激所引起的音调和响度的变化。结论在前庭人工耳蜗联合人工耳蜗刺激过程中，不同感觉形态之间存在显著的相互作用。这种相互作用对刺激策略提出了潜在的挑战，以同时恢复这种植入物的听觉和前庭功能。
BackgroundA combined vestibular and cochlear prosthesis may restore hearing and balance to patients who have lost both. To do so, the device should activate each sensory system independently.ObjectivesIn this study, we quantify auditory and vestibular interactions during interleaved stimulation with a combined 16-channel cochlear and 6-channel vestibular prosthesis in human subjects with both hearing and vestibular loss.MethodsThree human subjects were implanted with a combined vestibular and cochlear implant. All subjects had severe-to-profound deafness in the implanted ear. We provided combined stimulation of the cochlear and vestibular arrays and looked for interactions between these separate inputs. Our main outcome measures were electrically evoked slow-phase eye velocities during nystagmus elicited by brief trains of biphasic pulse stimulation of the vestibular end organs with and without concurrent stimulation of the cochlea, and Likert scale assessments of perceived loudness and pitch during stimulation of the cochlea, with and without concurrent stimulation of the vestibular ampullae.ResultsAll subjects had no auditory sensation resulting from semicircular canal stimulation alone, and no sensation of motion or slow-phase eye movement resulting from cochlear stimulation alone. However, interleaved cochlear stimulation did produce changes in the slow-phase eye velocities elicited by electrical stimulation. Similarly, interleaved semicircular canal stimulation did elicit changes in the perceived pitch and loudness resulting from stimulation at multiple sites in the cochlea.ConclusionsThere are significant interactions between different sensory modalities during stimulation with a combined vestibular and cochlear prosthesis. Such interactions present potential challenges for stimulation strategies to simultaneously restore auditory and vestibular function with such an implant.