Binaural processing and hearing in children with cochlear implants

人工耳蜗植入儿童的双耳处理和听力

• 批准号: 10606930
• 负责人: Ruth Y Litovsky
• 金额: $ 57.47万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-01 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10606930
• 关键词: Age; Area; Attention; Auditory; Auditory area; Behavior; Bilateral; Binaural; Brain; Brain Stem; Child; Childhood; Clinical; Clinical assessments; Cochlear Implants; Cochlear implant procedure; Cognition; Cognitive; Cues; Electrodes; Electroencephalography; Electrophysiology (science); Engineering; Environment; Hearing; Implant; Investigation; Learning; Life; Mainstreaming; Measures; Memory; Outcome; Participant; Performance; Research; Role; Safety; Signal Transduction; Socialization; Speech; Stimulus; Structure; Testing; auditory processing; binaural hearing; clinical care; clinical outcome assessment; cognitive control; cognitive process; deafness; design; executive function; experience; insight; neural; neurodevelopment; normal hearing; novel; preservation; recruit; social; stem; success; visual tracking

Abstract There is strong clinical impetus to provide bilateral hearing early in life, not only for safety in navigating the environment, but also to maximize learning and socializing in mainstreamed settings. Although this topic is an active area of research, we lack critically important information on how to assess and interpret the impact of age at onset of deafness and auditory experience in children with bilateral cochlear Implants (CIs). Four groups of bilateral CI users and normal hearing (NH) participants in the same age ranges will be recruited to test hypotheses about the role of auditory experience and inter-implant delay in emergence of binaural hearing, functional listening and cognition. Here we propose novel studies aimed at gaining fresh insight into the role of auditory experience and inter-implant delay on outcomes. We will integrate perceptual and electroencephalographical (EEG) measures of binaural integrity (Aim 1), and functional listening with binaural cues (Aim 2). Further, cognitive measures of executive function (EF) are introduced to promote novel discovery of the association between binaural listening measures and EF (Aim 3). By synergistically combining these approaches, this project will be the first to provide urgently needed answers to timely and clinically critical questions regarding pediatric cochlear implantation. An important barrier to maximizing outcomes stems from engineering limitations whereby CIs are lacking binaural coordination. In addition, while speech envelope (ENV) cues are preserved in speech signals, cues that are significant for binaural hearing, namely temporal fine structure (TFS) cues, are not preserved in CI processing. We will systematically manipulate the control of ENV and TFS cues by using either research processors that allow exquisite control of timing of stimuli reaching each electrode or presenting stimuli to clinical processors and in free field, where stimulation is more akin to today’s CI processing. comprehensive investigation into outcomes in children with bilateral CIs, using perceptual, eye tracking and EEG measures at multiple levels of auditory processing. The stepwise assessment along the neural axis, from brainstem to auditory cortex, to cortical connectivity and whole brain coherence analyses, will enable us to understand which perceptual deficits are associated with abnormal neural processing. Cognitive measures are introduced to promote novel discovery of how abnormal neural development is related to EF, and if these effects show pervasive effects beyond auditory-based EF tasks. This information is important for understanding how the timing of bilateral CIs is related to a set of cognitive processes– regulating attention, memory, and controlling cognitive behaviors – necessary for success across academic, social, and daily living domains. We will harness the tests used in our studies to develop a clinical assessment toolbox that can be used by clinicians to assess binaural hearing abilities, and our findings will further identify which cognitive EF measures should be use along with auditory measures to clinically assess outcomes in children. Results will inform selection of design features in engineering CIs, with an emphasis on binaural processors, thus aiming to reduce the gap in performance relative to NH listeners.

摘要 在生命早期提供双侧听力有强大的临床动力，不仅是为了航行的安全， 这不仅是一种环境，而且是在主流化环境中最大限度地学习和社交。虽然这个话题是一个 作为一个活跃的研究领域，我们缺乏关于如何评估和解释年龄影响的至关重要的信息。 双侧人工耳蜗植入（CI）儿童的耳聋和听觉体验发作时。四组 将招募相同年龄范围的双侧CI用户和正常听力（NH）参与者进行测试 关于听觉体验和植入物间延迟在双耳听觉出现中的作用的假设， 功能性听力和认知。在这里，我们提出了新的研究，旨在获得新的见解的作用， 听觉体验和植入物间延迟对结果的影响。我们将整合知觉和 双耳完整性的脑电图（EEG）测量（目标1）和双耳功能性听力 提示（目标2）。此外，执行功能（EF）的认知措施，以促进新的发现 双耳听力测量和EF之间的关联（目标3）。通过协同结合这些 该项目将是第一个为及时和临床关键问题提供急需答案的项目 关于小儿人工耳蜗植入的问题。实现成果最大化的一个重要障碍来自于 工程限制，CI缺乏双耳协调。此外，虽然语音包络（ENV） 在语音信号中保留线索，即对于双耳听觉重要的线索，即时间精细 结构（TFS）线索，不保留在CI处理。我们将系统地操纵ENV的控制权 和TFS线索，通过使用研究处理器，允许精致的控制时间的刺激达到每个 电极或将刺激呈现给临床处理器和自由场中，其中刺激更类似于今天的 CI处理。使用知觉、眼功能和视觉功能对双侧CI儿童的结局进行全面调查 跟踪和EEG测量在多个层次的听觉处理。逐步评估沿着神经 轴，从脑干到听觉皮质，再到皮质连接和全脑连贯性分析，将使 让我们了解哪些知觉缺陷与异常的神经处理有关。认知测量 被引入以促进异常神经发育如何与EF相关的新发现，如果这些 的影响显示普遍的影响超出了基于认知的EF任务。这些信息对于理解 双侧CI的时机如何与一系列认知过程（调节注意力、记忆力和 控制认知行为--在学术、社交和日常生活领域取得成功所必需的。我们 将利用我们研究中使用的测试来开发临床医生可以使用的临床评估工具箱 评估双耳听力能力，我们的研究结果将进一步确定哪些认知EF措施应该 使用沿着听觉测量来临床评估儿童的结果。结果将为设计选择提供信息 工程CI的功能，重点是双耳处理器，从而旨在缩小 相对于普通听众的表现。