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。虽然诸如助听器（HA）和人工耳蜗（CI）之类的听力设备成功地改善了许多听力受损（HI）个体的语音识别，但是在益处方面仍然存在显著的差异，并且噪声中的语音识别仍然是一个问题。可能限制受益的一个因素是双侧佩戴听力设备之间的干扰，无论设备是双侧HA、双侧CI还是单侧CI佩戴，对侧耳中有HA（双峰CI+HA）。在HI个体中，由于听力损失和听力设备编程引入的不对称性，两耳之间的频谱信息不一定匹配。因此，与正常听力（NH）的听众不同，HI听众在我们称为双耳频谱整合（BSI）的过程中整合耳朵之间不匹配的频谱信息。我们的初步研究表明，BSI适应，以减少HI个人的耳间频谱不匹配的感知;双耳融合增加，使音高，两耳之间的频率差异很大，仍然听到作为一个单一的听觉感受。然而，增加的双耳融合的副作用是失配的频谱信息在两耳之间被平均，这可能导致增加的语音感知混乱和恶化的频率辨别。 本研究计划的长期目标是调查HI和NH听众之间BSI的差异，以及这些差异对康复的临床意义。具体而言，在本提案中，我们将检查1）HI和NH听者之间的双耳融合差异，以及HI组内不同设备组合之间的差异：双侧HA、双侧CI和双峰CI+HA; 2）异常BSI如何影响音调和语音刺激的感知; 3）BSI如何随着儿童发育而变化，因为发育中的大脑可能会以不同于成人的方式适应BSI。拟议中的研究将增加我们的理解，如何听觉处理的一个方面，双耳频谱整合，有助于困难与双耳语音感知HA和CI用户。研究结果还将表明，听力设备是否应该为儿童和成人设置不同的程序。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，以减少任何有害的BSI，同时保持或增加双耳处理在安静和噪音中的语音感知的好处。

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.