Understanding the benefits of electric-acoustic stimulation

描述(申请人提供)：听力被限制在500-750赫兹以下频率区域的个人可以从低频区域的声刺激和高频区域的电刺激的组合中显著受益。电声刺激(EAS)的优势在存在竞争语音的情况下收听时尤为明显，这是听力损失患者最难听的情况之一。当将声音加到电刺激中时，语音清晰度通常会显著提高，即使单靠声刺激通常提供的清晰度很低或根本没有清晰度。这项拟议研究的广泛、长期目标是更好地了解EAS益处背后的声学提示和听觉处理。具体地说，具体目标包括确定语音中负责从低频声刺激中获得益处的声学线索；确定能够支持成功的EAS的低频听力的频率范围和幅度；确定是否可以通过增加低频区域中的刺激通道数量在EAS的声学模拟中观察到与EAS相似的益处；确定低频声刺激是否有助于处理中断的语音；以及确定在存在空间分离的背景的情况下，植入耳朵中的低频听力是否保留了用于理解语音的重要线索。这里提出的研究将包括听力正常的受试者，听植入过程模拟的受试者，以及残留低频听力的人工耳蜗术患者。这项研究将有助于更好地了解EAS，并可能改善许多现有和潜在患者的语音接收，并增加可能从这项相对较新和极具前景的技术中受益的个人数量。 在美国，大约有2800万人患有听力损失。一种很有前途的听力康复的新方法包括对听神经进行声刺激和直接电刺激的组合。在这一重要的新领域还需要进一步的研究，以扩大我们对电声刺激的理论理解，并提高其临床疗效。最近，安装了人工耳蜗的人收到了相对较短的电极阵列，旨在保护他们在植入的耳朵中剩余的低频听力。这种低频声刺激的加入已被证明在实际和模拟植入听中都能显著改善语音接收，特别是在背景噪声中。这个项目的目标是更好地了解低频区域中提供这一益处的线索。

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.