Electrophysiology

人工耳蜗植入物在过去的20年里有了很大的进步，然而，仍然有一个 植入后性能的所有测量指标都有很大的变异性。这些实验的总体目标是 提出的是找出新的方法来使用电生理措施来更好地了解 这种可变性。我们实验室之前的研究集中在测量 听神经对电刺激的反应。拟议的研究将扩大这一早期工作，不仅包括 从听神经记录的神经活动的测量，以及记录的皮质诱发反应 在相同的个体中。然后将这些回答与广泛范围内的 听力任务，包括言语和音乐感知。 虽然许多拟议的研究将在成人植入物使用者中进行，但结果将直接 适用于儿科人群。外周测量，如电诱发复合动作 使用遥测系统记录的潜在(ECAP)被整合到商业人工耳蜗中 成为对幼儿进行初步规划和监测的重要工具。这不仅是可能的 来记录我们在幼儿中提出的皮质反应，但这些反应的特定特征 已经被证明遵循儿童的发展趋势，并且是表现的指标(夏尔马 等人的研究。2002年；Ponton等人，2000年)。这项提案中概述的研究很重要，因为它们扩展了 关于先前发表的工作，包括使用脑电变化诱发的皮质电位的评估 持续电刺激的模式，这是一种更接近于 是日常收听的典型。 然而，许多拟议的实验都集中在使用标准人工耳蜗的患者身上， 还包括在新的人工耳蜗使用者群体中使用这些技术的实验，如 使用混合型人工耳蜗术和双侧人工耳蜗术的患者 植入物。对于每一组受试者，我们都提出了一些实验，以解决 电生理测量和性能。我们还将评估随着时间的推移发生的变化 在儿科和老年人群中继续使用植入物。我们预计，基于以下结果 研究表明，我们将能够更全面地描述我们在 个人和使用这些信息来帮助临床决策，通知候选人选择和 影响语音处理器的编程方式，以最大化个人的性能 用户。

Cochlear implants have improved considerably over the course of the past 20 years, however, there is still a great deal of variability on all measures of post-implant performance. The general goal of the experiments proposed is to identify new ways to use electrophysiological measures to better understand the sources of that variability. Previous research from our laboratory has focused on measuring the response of the auditory nerve to electrical stimulation. The proposed studies will expand that early work to include not only measures of neural activity recorded from the auditory nerve but also cortically evoked responses recorded in the same individuals. These responses will then be compared with performance on a broad range of listening tasks including speech and music perception. While much of the research proposed will be conducted with adult implant users, the results will be directly applicable to pediatric populations. Peripheral measures such as the electrically evoked compound action potential (ECAP) recorded using telemetry systems incorporated into commercial cochlear implants have become important tools for both initial programming and monitoring of young children. It is not only possible to record the cortical responses we propose in young children but specific features of these responses have already been shown to follow developmental trends in children and to be indicative of performance (Sharma et al. 2002a; Ponton et al., 2000). The studies outlined in this proposal are important because they expand on previously published work to include assessment of cortical potentials evoked using a change in the pattern of ongoing electrical stimulation, a feature that simulates more closely the type of stimulation that is typical of everyday listening. Many of the proposed experiments focus on patients who use standard cochlear implants, however, experiments are also included that use these techniques in new populations of cochlear implant users such as those patients who use the Hybrid cochlear implant system and patients who receive bilateral cochlear implants. For each subject group, we have proposed experiments addressing the relationship between electrophysiological measures and performance. We will also assess changes that occur over time with continued implant use in both pediatric as well as geriatric populations. We expect that, based on results of the studies proposed, we will be able to more fully characterize the differences we observe across individuals and use that information to assist with clinical decision making, inform candidate selection and influence the ways the speech processor is programmed in order to maximize performance for an individual user.