Optimizing bilateral and single-sided-deafness cochlear implants for functioning in complex auditory environments

优化双侧和单侧耳聋人工耳蜗植入物以在复杂的听觉环境中发挥作用

• 批准号: 10654316
• 负责人: Joshua Gary Bernstein
• 金额: $ 58.62万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10654316
• 关键词: Acoustics; Affect; Amblyopia; Auditory; Auditory Perception; Auditory Perceptual Disorders; Auditory system; Bilateral; Binaural; Bionics; Cochlear Implants; Communication; Complex; Contralateral; Cues; Data; Ear; Electrodes; Environment; Eye; Goals; Hearing; Impairment; Individual; Influentials; Intervention; Knowledge; Link; Loudness; Maps; Measures; Mediating; Mission; Modality; Modeling; National Institute on Deafness and Other Communication Disorders; Nerve Degeneration; Outcome; Perception; Performance; Peripheral; Persons; Population; Predisposition; Prevalence; Public Health; Publishing; Rehabilitation therapy; Research; Role; Side; Speech; Stimulus; Systems Integration; Techniques; Technology; Testing; United States National Institutes of Health; Work; aural rehabilitation; binaural hearing; clinical practice; deafness; disability; experience; experimental study; hearing impairment; hearing restoration; implantation; improved; innovation; negative affect; neural; programs; rehabilitation strategy; remediation; selective attention; sound; stem; tool

ABSTRACT: This research aims to optimize speech-understanding and spatial-hearing outcomes for cochlear- implant (CI) users, specifically bilateral (BI-CI) and single-sided-deafness (SSD-CI) users. The gap in knowledge is that it is unknown what causes contralateral disruption, how it affects speech understanding and binaural benefits, and how it might be remediated. The long-term goal of our research program is to optimize hearing performance for CI users with two inputs. The overall objective of this application is to determine the mechanisms underlying functional consequences of asymmetry, specifically through two phenomena that are manifestations of contralateral disruption: “bilateral speech interference” (speech presented in one ear impedes speech under- standing in the other, usually the better ear interfering with the poorer) and “interaural loudness mismatch” (bi- lateral stimuli that are equally loud when presented sequentially produce a distorted spatial map when presented simultaneously). Our overarching functional hypothesis is that asymmetric hearing, manifesting in contralateral disruption, is a major factor stunting real-world CI performance. Our overarching mechanistic hypothesis is that the two phenomena stem from asymmetric peripheral distortion, central auditory maladaptive plasticity, or both. We will test our overarching hypotheses through three specific aims: (1) Measure the consequences of contra- lateral disruption (bilateral speech interference and interaural loudness mismatch) from interaural asymmetry for increasingly realistic situations; (2) Determine the extent to which peripheral asymmetry explains contralateral disruption; (3) Determine if contralateral disruption is influenced by central auditory plasticity. These aims will yield the following expected outcomes: (1) identify the situations, prevalence, and magnitude where BI-CI and SSD-CI spatial-hearing outcomes are limited by contralateral disruption; (2) extend objective techniques—pre- viously applied to understand monaural CI performance—to characterize the link between peripheral neural sur- vival and binaural processing; (3) determine if abnormal across-ear processing is susceptible to central plasticity. This contribution is significant because contralateral disruption, viewed through the two asymmetry phenomena of bilateral speech interference and interaural loudness mismatch, is a major roadblock to good binaural hearing. Understanding the causes and negative consequences of contralateral disruption will provide tools to optimize rehabilitation for the 30-50% of BI-CI and nearly 100% of SSD-CI users with asymmetric hearing. The work is innovative because (1) it seeks to understand the roadblock in hearing outcomes based on asymmetry effects, rather than optimizing each ear individually, (2) it compares BI-CI and SSD-CI users to distinguish the mecha- nisms underlying contralateral disruption, and (3) it pairs perceptual and objective measures to differentiate be- tween peripheral and central contributions to poor hearing outcomes in asymmetric cases.

摘要：本研究旨在优化人工耳蜗植入者的言语理解和空间听力结果。 植入（CI）用户，特别是双侧（BI-CI）和单侧耳聋（SSD-CI）用户。知识上的差距 是什么原因导致对侧中断，它如何影响语音理解和双耳 好处，以及如何补救。我们研究计划的长期目标是优化听力 为CI用户提供两个输入。本申请的总体目标是确定 不对称的潜在功能后果，特别是通过两种现象， 对侧干扰：“双侧言语干扰”（一只耳朵的言语妨碍了另一只耳朵的言语）。 站在另一个，通常是较好的耳朵干扰较差的耳朵）和“耳间响度失配”（双 当顺序呈现时同等响亮的横向刺激在呈现时产生扭曲的空间图 同时）。我们的总体功能假设是，不对称的听力，表现在对侧 中断，是阻碍现实世界CI性能的主要因素。我们首要的机械假设是， 这两种现象源于不对称的周边失真、中枢听觉适应不良可塑性或两者。 我们将通过三个具体目标来测试我们的总体假设：（1）测量反作用的后果， 由于耳间不对称造成的侧向干扰（双侧语音干扰和耳间响度失配）， 越来越现实的情况;（2）确定外周不对称在多大程度上解释了对侧 （3）确定对侧中断是否受到中枢听觉可塑性的影响。这些目标将 产生以下预期结果：（1）确定BI-CI和 SSD-CI空间听力结果受到对侧干扰的限制;（2）扩展客观技术-预 单耳CI表现的研究--表征外周神经表面和外周神经表面之间的联系-- （3）确定异常的跨耳加工是否易受中枢可塑性的影响。 这一贡献是重要的，因为通过两种不对称现象来看， 双侧语音干扰和耳间响度不匹配是获得良好双耳听力的主要障碍。 了解对侧中断的原因和负面后果将提供优化 为30-50%的BI-CI和近100%的SSD-CI非对称听力用户提供康复。这项工作是 创新的原因是（1）它试图理解基于不对称效应的听力结果中的障碍， 而不是单独优化每只耳朵，（2）它比较BI-CI和SSD-CI用户以区分机制， 对侧破坏的潜在的nisms，和（3）它配对的感知和客观的措施，以区分是- 在不对称病例中，外周和中枢对听力不良结果的影响。