Physiology as a Potential Predictor of Perception in Cochlear Implants

项目摘要/摘要 我们的研究计划旨在改进生理测量方法的使用，以预测感知 人工耳蜗术(CI)。长期目标是客观地确定语音处理器的最佳设置 提高语音理解能力的个别化基础。尽管一些研究表明两者之间存在一定的相关性 在目标指标和行为指标之间，这些关系不足以支持独占使用 生理指标来预测行为结果。最近的研究表明，标准脉搏 用于CI刺激的极性(阴极引导)并不理想(例如Carlyon等人)。2013年；Unduraga等人，2010年， 2013)。相反，使用相反的(阳极引导的)极性已经证明了更有效的刺激 无论是生理上还是知觉上。这些发现提出了一些重大问题，即如何 解释现有的旨在将生理和知觉措施联系起来的研究，这些研究使用了 标准的阴极引导脉冲。尽管最近的研究表明，阳极治疗的效果更好 对知觉(即，对于固定电流水平更大的知觉)和生理(即，更短)的刺激 潜伏期、更大的幅度、更有效的掩蔽)反应，到目前为止还没有研究检查过极性 使用标准临床脉搏的效果，也没有任何研究检查生理学和 知觉是刺激极性的函数。这就是本项目的目标。如果极性影响 生理测量以不同于感性测量的程度，那么客观的可预测性 措施将受到影响。在这个项目中，我们将在临床上检验刺激极性的影响。 用于确定极性对感知和生理测量的影响程度的标准脉冲形状， 以及两者之间的关系。检查刺激极性对标准脉冲形状的影响 将使我们能够更好地理解认知测量的潜在生理因素， 并将对未来的临床刺激范例具有重要的意义。最重要的是，由此产生的结果 研究将确定当前的临床刺激模式是否应该从阴极主导转变为阳极主导 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.