Understanding the benefits of electric-acoustic stimulation

描述（由申请人提供）：听力限制在500- 750hz以下频率区域的个体可能会从低频区域的声刺激和高频区域的电刺激组合中获益。电声刺激（EAS）的优势在有竞争语音的情况下听语音时尤为明显，这是听力损失患者最困难的听力情况之一。当在电刺激的基础上增加声学刺激时，即使单独的声学刺激很少或根本没有提供可理解性，语音可理解性也会得到显著改善。这项研究的长远目标是更好地理解声信号和听觉处理对EAS的好处。具体而言，具体目标包括识别语音中的声音线索，这些线索负责从低频声刺激中获得益处；确定能够支持成功的EAS的低频听力的频率范围和大小；通过增加低频区刺激通道的数量，确定是否可以在EAS的声学模拟中观察到与EAS类似的益处；确定低频声刺激是否有助于对中断语音的处理；确定植入耳中的低频听力是否保留了在空间分离背景下理解语音的重要线索。本研究拟包括听力正常的受试者听模拟人工耳蜗加工和人工耳蜗患者残余低频听力。这项研究将有助于更好地理解EAS，并可能改善许多当前和潜在患者的言语接收能力，并增加可能从这项相对较新且极具前景的技术中受益的个人数量。

DESCRIPTION (provided by applicant): Individuals with hearing restricted to the frequency region below about 500-750 Hz may benefit significantly from a combination of acoustic stimulation in the low-frequency region and electric stimulation in the higher frequency region. The advantage of electric-acoustic stimulation (EAS) is particularly apparent when listening to speech in the presence of competing speech, one of the most difficult listening situations for individuals with hearing loss. The often dramatic improvement in speech intelligibility when adding acoustic to electric stimulation occurs even though the acoustic stimulation alone often provides little or no intelligibility. The broad, long-term goal of the proposed research is to gain a better understanding of the acoustic cues and auditory processing underlying the benefits of EAS. In particular, the specific aims include identifying the acoustic cues in speech that are responsible for the benefits gained from low-frequency acoustic stimulation; determining the frequency extent and magnitude of low-frequency hearing that can support successful EAS; determining whether benefits similar to those seen with EAS can be observed in acoustic simulations of EAS by increasing the number of channels of stimulation in the low-frequency region; determining whether low-frequency acoustic stimulation helps the processing of interrupted speech; and determining whether low-frequency hearing in the implanted ear preserves important cues for understanding speech in the presence of spatially separated backgrounds. The research proposed here will include normal-hearing subjects listening to simulations of implant processing and cochlear implant patients with residual low-frequency hearing. This research should lead to a better understanding of EAS and could lead to improved speech reception for many current and potential patients and an increase in the number of individuals who might benefit from this relatively new and extremely promising technology. There are approximately 28 million individuals who suffer from hearing loss in the United States. A promising new approach to auditory rehabilitation for some of these includes a combination of acoustic stimulation and direct electrical stimulation of the auditory nerve. Additional research in this important new area is needed to broaden our theoretical understanding of electric-acoustic stimulation and to enhance its clinical efficacy.Recently, individuals fitted with cochlear implants have received a relatively short electrode array, intended to preserve their residual low-frequency hearing in the implanted ear. The addition of this low-frequency acoustic stimulation has been shown to dramatically improve speech reception both in real and simulated implant listening, particularly in background noise. The goal of this project is to gain a better understanding of the cues present in the low-frequency region that provide this benefit.