Electrically-evoked neural responses in children with auditory neuropathy

听神经病儿童的电诱发神经反应

• 批准号: 8663215
• 负责人: Shuman He
• 金额: $ 15.2万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-20 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8663215
• 关键词: Accounting; Acoustic Nerve; Action Potentials; Adopted; Adult; Affect; Age; Auditory; Auditory area; Behavioral; Child; Childhood; Clinical; Cochlear Implants; Cochlear implant procedure; Detection; Development; Devices; Disease; Electric Stimulation; Etiology; Goals; Hearing; Hearing Aids; Hearing Impaired Persons; Implant; Individual; Language; Lead; Measures; Medical; Modification; Nature; Nerve; Neuropathy; Outcome; Pathology; Patients; Pattern; Performance; Peripheral; Process; Property; Protocols documentation; Research; Sensorineural Hearing Loss; Source; Speech; Speech Perception; Staging; Subgroup; System; Techniques; Testing; Time; Variant; Work; behavior measurement; clinical practice; expectation; experience; hearing impairment; improved; multiple disability; nerve gap; patient population; programs; public health relevance; relating to nervous system; research study; response; restoration; signal processing; skills; tool

DESCRIPTION (provided by applicant): Cochlear implantation (CI) has been used as a treatment option for children with auditory neuropathy spectrum disorder (ANSD) who do not benefit from conventional hearing aids. Up to date, there is no robust indicator for predicting CI outcomes in these patients. In addition, programming settings selected for individual ANSD patients might not be optimal since many ANSD children are not able to provide reliable behavioral responses due to their young ages and/or comorbid conditions. These conditions make the audiologic management of implanted ANSD children extremely challenging and at many times uncertain. The long-term goal of this program of research is to develop objective tools that can be used in clinical settings for accurately predicting post-implant speech perception performance and optimizing programming settings for individual ANSD children. As the first step towards fulfilling this long-term goal, this project aims to evaluate how well electrical stimulation is transmitted by the auditory nerve by evaluating temporal response properties of the nerve in implanted ANSD children. In addition, this project also aims to explore the extent to which neural responses recorded at a peripheral and more central level are correlated with each other and whether they are correlated with speech perception performance in ANSD patients. Specific Aim 1 characterizes temporal response properties of the auditory nerve in pediatric CI users by measuring the electrically evoked auditory compound action potential (ECAP) at different stimulation rates. Both children with ANSD and children with sensorineural hearing loss will be tested. Results from these experiments will provide a better understanding of sources of across-patient variations in post-implant speech perception performance among ANSD children. Specific Aim 2 evaluates the association among temporal response properties of the auditory nerve, gap detection threshold and speech perception performance in implanted ANSD children. Results of these studies should expand understandings of how auditory processing in the central auditory cortex is affected by the input from the auditory nerve. Overall, results of this project could potentially lead to the development of an objective tool for identifying a subgroup of ANSD patients who are unlikely to receive substantial benefit from their devices at an early post-implant stage. In addition, these results could also potentially lead to the development of specific signal processing modifications that might result in improved performance for individual implanted ANSD patients. Therefore, this project has tremendous translational significance.

描述（由申请人提供）：人工耳蜗（CI）已被用作听觉神经病谱系障碍儿童（ANSD）的治疗选择，这些儿童不受传统的助听器的受益。最新的，没有可预测这些患者CI结局的强大指标。此外，为个别ANSD患者选择的编程设置可能不是最佳的，因为许多ANSD儿童由于年轻的年龄和/或合并症而无法提供可靠的行为反应。这些条件使植入的ANSD儿童的听力管理极具挑战性，并且很多时候不确定。该研究计划的长期目标是开发客观工具，这些工具可以在临床环境中使用，以准确预测植入后的语音感知表现并优化为个别ANSD儿童的编程设置。作为实现这一长期目标的第一步，该项目旨在通过评估植入的ANSD儿童中神经的时间反应特性来评估听觉神经传递的电刺激。此外，该项目还旨在探索在周围和中央层面上记录的神经反应在多大程度上与彼此相关的，并且它们是否与ANSD患者的语音感知表现相关。特定的目标1通过以不同的刺激速率测量电诱发的听觉化合物动作电位（ECAP）来表征小儿CI使用者中听觉神经的时间响应特性。患有ANSD的孩子和感官听力损失的儿童将进行测试。这些实验的结果将更好地理解ANSD儿童植入后植入后语音感知表现的跨病差异的来源。具体目标2评估了植入ANSD儿童的听觉神经，间隙检测阈值和语音感知表现的时间响应特性之间的关联。这些研究的结果应扩大对中央听觉皮层中的听觉处理如何受到听觉神经输入的影响的理解。总体而言，该项目的结果可能会导致发展 一个客观的工具，用于识别ANSD患者的子组，这些ANSD患者不太可能在早期植入植物阶段从其设备中获得可观的收益。此外，这些结果还可能导致特定信号处理修饰的发展，这可能会导致个体植入的ANSD患者的性能改善。因此，该项目具有巨大的翻译意义。