Physiology as a Potential Predictor of Perception in Cochlear Implants

项目总结/摘要 我们的研究计划旨在改善使用生理措施来预测感知， 人工耳蜗植入体（CI）。长期目标是客观地确定最佳的语音处理器设置， 个人基础，提高言语理解能力。尽管一些研究表明， 在客观和行为衡量标准之间，这些关系不足以支持排他性使用 来预测行为结果。最近的研究表明，标准脉冲 用于CI刺激的极性（阴极引导）不是理想的（例如，Carlyon等人，2013年; Undurraga等人，2010, 2013年）。相反，使用相反（阳极主导）极性已证明更有效的刺激 无论是生理上还是感知上这些发现提出了关于如何 解释现有的研究机构，旨在相关的生理和知觉的措施，其中使用 标准阴极超前脉冲。虽然最近的研究表明，阳极 对于感知（即，对于固定电流电平的更大感知）和生理（即，短 更大的振幅，更有效的掩蔽）反应，迄今为止还没有研究检查极性 使用标准临床脉冲的影响，也没有任何研究检查生理学和 感知是刺激极性的函数。这是本项目的目标。如果极性影响 生理措施在不同程度上比知觉措施，那么客观的可预测性 措施将受到影响。在这个项目中，我们将研究刺激极性的影响， 标准脉冲形状以确定极性影响感知和生理测量的程度， 以及两者之间的关系。检查刺激极性对标准脉冲波形的影响 将使我们能够更好地了解潜在的生理贡献者的知觉措施与CI， 并且将对未来的临床刺激范例具有重要意义。最重要的是， 研究将确定当前的临床刺激模式是否应从阴极引导转变为阳极引导 刺激.

PROJECT SUMMARY/ABSTRACT Our research program is aimed at improving the use of physiological measures to predict perception with a cochlear implant (CI). The long-term goal is to objectively determine optimal speech-processor settings on an individual basis to improve speech understanding. Although some studies have shown modest correlations between objective and behavioral measures, these relations are not sufficiently strong to support exclusive use of physiological measures to predict behavioral outcomes. Recent studies have shown that the standard pulse polarity (cathodic-leading) used for CI stimulation is not ideal (e.g., Carlyon et al. 2013; Undurraga et al., 2010, 2013). Rather, more effective stimulation has been demonstrated using the opposite (anodic-leading) polarity for both physiological and perceptual measures. These findings raise significant questions about how to interpret the existing body of research aimed at relating physiological and perceptual measures, which used standard cathodic-leading pulses. Although the recent studies demonstrated greater effectiveness with anodic stimulation for both perceptual (i.e., louder percepts for a fixed current level) and physiological (i.e., shorter latencies, larger amplitudes, more effective masking) responses, no studies to date have examined polarity effects using standard clinical pulses, nor have any studies examined the relation between physiology and perception as a function of stimulus polarity. This is the goal of the present project. If polarity affects physiological measures to a different degree than perceptual measures, then the predictability of objective measures will be affected. In this project, we will examine the effect of stimulus polarity using clinically standard pulse shapes to determine the extent to which polarity affects perceptual and physiological measures, as well as the relation between the two. Examining the effects of stimulus polarity for standard pulse shapes will allow us to better understand the underlying physiological contributors to perceptual measures with CIs, and will have important implications for future clinical stimulation paradigms. Most importantly, results from this study will determine whether current clinical stimulation modes should shift from cathodic- to anodic-leading stimulation.