Binaural Spectral Integration with Hearing Loss and Hearing Devices

描述（由申请人提供）：大约2200万美国人有听力障碍。虽然助听器（HAs）和人工耳蜗（CIs）等听力设备成功地改善了许多听力受损（HI）个体的语音识别，但在效益上仍然存在显著的差异，噪声中的语音识别仍然是一个问题。可能限制获益的一个因素是双侧佩戴的助听器之间的干扰，无论这些助听器是双侧HA、双侧CI还是单侧CI与对侧耳HA（双峰CI+HA）。在HI个体中，由于听力损失和听力设备编程导致的不对称，频谱信息不一定在耳朵之间匹配。因此，与正常听力（NH）听众不同，HI听众在我们称为双耳频谱积分（BSI）的过程中整合了耳朵之间不匹配的频谱信息。我们的初步研究表明，BSI适应于减少HI个体的耳间频谱不匹配的感知；双耳融合增加了，因此两只耳朵之间频率差异很大的音调仍然作为一个单一的感知器被听到。然而，增强双耳融合的一个副作用是，不匹配的频谱信息在双耳之间被平均，这可能导致语音感知混淆增加和频率识别恶化。本研究项目的长期目标是调查HI和NH听者的BSI差异，以及这些差异对康复的临床意义。具体而言，在本提案中，我们将研究1)HI和NH听者之间双耳融合的差异，以及HI组内不同设备组合的差异：双侧HAs，双侧CIs和双峰CI+HA；2) BSI异常对声调和言语刺激感知的影响；3)儿童发育过程中BSI的变化，因为发育中的大脑对BSI的适应可能与成人不同。本研究将增加我们对听觉处理的一个方面——双耳频谱整合——如何导致HA和CI用户双耳语音感知困难的理解。研究结果还将表明，儿童的助听器是否应该与成人的不同。最后，研究结果将为未来计划的研究建立理论框架，使用特定频率的设备编程和培训计划来减少任何有害的BSI，同时保持或增加双耳处理在安静和噪音下语音感知的好处。

DESCRIPTION (provided by applicant): Approximately 22 million Americans have a hearing impairment. While hearing devices such as hearing aids (HAs) and cochlear implants (CIs) are successful in improving speech recognition for many hearing-impaired (HI) individuals, there is still significant variability in benefit, and speech recognition in noise remains a problem. One factor that may limit benefit is interference between bilaterally worn hearing devices, whether the devices are bilateral HAs, bilateral CIs, or a unilateral CI worn with a HA in the contralatera ear (bimodal CI+HA). In HI individuals, spectral information is not necessarily matched between ears due to asymmetries introduced by hearing loss and hearing device programming. Thus, unlike normal-hearing (NH) listeners, HI listeners integrate mismatched spectral information between ears, in a process that we can call binaural spectral integration (BSI). Our preliminary studies suggest that BSI adapts to reduce perception of interaural spectral mismatch in HI individuals; binaural fusion is increased so that pitches that differ greatly in frequency between the two ears are still heard as a single percept. However, a side effect of increased binaural fusion is that mismatched spectral information is averaged between ears, which may lead to increased speech perception confusions and worsened frequency discrimination. The long-term goal of this research program is to investigate how BSI differs between HI and NH listeners, and the clinical implications of these differences for rehabilitation. Specifically, in this proposal w will examine 1) differences in binaural fusion between HI and NH listeners, as well as across different device combinations within the HI group: bilateral HAs, bilateral CIs, and bimodal CI+HA; 2) how abnormal BSI affects the perception of tone and speech stimuli; and 3) how BSI changes as children develop, because developing brains may adapt BSI differently than adults. The proposed research will increase our understanding of how one aspect of auditory processing, binaural spectral integration, contributes to difficulties with binaural speech perception in HA and CI users. The results will also indicate whether hearing devices should be programmed differently for children than adults. Finally, the results will build the theoretical framework for future planned studies using frequency-specific device programming and training programs to reduce any detrimental BSI, while maintaining or increasing the benefits of binaural processing for speech perception in quiet and noise.