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很强的临床推动力，不仅是为了导航安全 不仅是为了在主流环境中最大限度地学习和社交，而且还为了在主流环境中实现最大限度的学习和社交。虽然本主题是一个 在活跃的研究领域，我们缺乏关于如何评估和解释年龄的影响的至关重要的信息 双侧人工耳蜗术后儿童耳聋的发病情况和听觉体验。四组 将招募相同年龄段的双边CI使用者和正常听力(NH)参与者进行测试 关于听觉经验和植入物间延迟在双耳听力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，旨在获得对 听觉体验和种植体间延迟对结果的影响。我们将把感性和 双耳完整性的脑电(EEG)测量(目标1)和双耳功能听力 线索(目标2)。此外，执行功能的认知测量(EF)被引入以促进新的发现 双耳听力测量与EF之间的联系(目标3)。通过协同结合这些 方法，该项目将是第一个为及时和临床危急情况提供急需的答案的项目 关于儿科人工耳蜗术的问题。最大化结果的一个重要障碍来自于 工程上的限制，使配置式缺乏双耳协调。此外，虽然语音包络(ENV) 线索被保存在语音信号中，这些线索对双耳听力很重要，即时间精细 结构(TFS)提示，在CI处理中不会保留。我们将系统地操纵ENV的控制 和TFS提示，通过使用允许精确控制每个刺激到达的时间的研究处理器 电极或向临床处理机和自由野提供刺激，其中刺激更类似于今天的 CI加工。用知觉、眼球对双侧顺应性脑损伤儿童预后的全面调查 跟踪和脑电在多个层次的听觉处理上进行测量。循序渐进的神经评估 轴心，从脑干到听觉皮质，再到皮质连接和全脑连贯性分析，将使 我们需要了解哪些知觉缺陷与异常的神经处理有关。认知测量 是为了促进对异常神经发育如何与EF相关的新发现，以及如果这些 效应表现出超越基于听觉的EF任务的普遍效应。这些信息对于理解 双边CI的时间与一系列认知过程的关系--调节注意力、记忆和 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可供临床医生使用的临床评估工具箱 来评估双耳听力，我们的发现将进一步确定哪些认知EF测量应该是 与听觉测量一起用于临床评估儿童的结果。结果将通知设计的选择 工程配置信息系统的特点，重点是双声道处理机，从而旨在缩小 相对于NH听众的性能。