Using Psychophysical Methods to Understand and Improve Speech Recognition in Cochlear Implant Users

这项研究的长期目标是使用心理物理学的方法来更好地理解听觉是如何 系统通过人工耳蜗（CI）对电刺激做出反应，以及我们如何利用这些知识 改善设备的语音识别效果。该提案有三个目标;每个目标都有其 临床意义或应用。他们一起回答了一个广泛的问题，为什么研究工作， 在过去，改善CI的结果并没有产生明显或一致的益处， 可能的解决方案是。在aim 1中，中心假设是，时间与时间之间存在权衡关系。 在退化的听觉系统中，神经兴奋的处理和空间分辨率。假设将 解释为什么旨在提高空间分辨率的聚焦电极配置没有提供一致的 效益其思想是，谱域中的改进将损害时间域中的处理。 提出了问题的解决方案，其中应在受试者和通道中应用聚焦刺激， 特定的方式，这样，对于给定的患者或给定的位置，应该避免聚焦刺激。 电极阵列在目标2中，研究了特殊的CI患者群体，即，先天性肥胖的受试者， 或者没有听觉经验。这些受试者可能患有严重的神经变性， 这是新生儿听觉剥夺的结果如果早期植入，广泛和扭曲的CI刺激可能会驱动 幼稚的听觉系统以不受欢迎的方式成熟。这些影响的心理物理学证据将是 提出了所提供的和可替代的刺激策略，并对该群体进行了测试。在目标3中，网站- 将对过去使用过的产生高度可变结果的选择策略进行评估 在同一个样本中。位点选择策略使不太“最佳”的电极失活，基于 各种标准。在同一主题样本中比较选择措施解决了以下问题： 他们是否评估刺激部位的类似属性，如果不是，哪些措施可以评估 电刺激中语音识别重要因素。目的3还评估了使用 心理物理测试作为潜在的听觉训练方法。心理物理测试提供了几个 比音乐训练或用语言刺激本身训练更有优势。拟议的实验， 为CI存在的问题提供解释和解决方案，具有直接和即时的临床意义。 影响

The long-term goal of the research is using a psychophysical approach to better understand how the auditory system responds to electrical stimulation via a cochlear implant (CI) and how we might use this knowledge to improve speech recognition outcomes with the device. There are three aims in the proposal; each has its clinical implications or applications. Together, they answer the broad question of why research efforts made to improve outcomes with CIs in the past have not produced appreciable or consistent benefits and what the possible solutions are. In aim 1, the central hypothesis is that there is a tradeoff relationship between temporal processing and spatial resolution of neural excitation, in a degenerated auditory system. The hypothesis will explain why focused electrode configuration aiming to improve spatial resolution has not provided consistent benefit. The idea is that the improvement in the spectral domain will impair processing in the temporal domain. Solution to the problem is proposed where focused stimulation should be applied in a subject- and channel- specific manner, such that focused stimulation should be avoided for given patients or given locations on the electrode array. In aim 2, a special CI patient population is studied, i.e., congenitally deafened subjects with no or little prior experience with acoustic hearing. These subjects may suffer from severe neural degeneration as a result of neonatal auditory deprivation. If implanted early, the broad and distorted CI stimulation may drive the naïve auditory system to mature in undesirable ways. Psychophysical evidences for these effects will be provided and alternative stimulation strategies are proposed and tested for this population. In aim 3, site- selection strategies that have been used in the past and produced highly variable outcomes, will be evaluated in the same subject sample. Site-selection strategies deactivate electrodes that are less “optimal”, based on various criteria. Comparing the selection measures in the same subject sample addresses the question of whether they assess similar attributes of the stimulation sites, and if not, which measure(s) might assess the important factor for speech recognition in electrical stimulation. Aim 3 also evaluates the efficacy of using psychophysical testing as a potential auditory training method. Psychophysical testing offers several advantages over musical training or training with the speech stimulus itself. The proposed experiments, offering explanations and solutions for the existing problems with CIs, have direct and immediate clinical implications.