Electrophysiology

在过去的20年里，髋关节植入物有了很大的改进，但是， 植入后性能的所有测量值存在很大的可变性。实验的总体目标是 提出的是确定新的方法，使用电生理措施，以更好地了解来源， 这种可变性。我们实验室以前的研究集中在测量 听觉神经电刺激。拟议的研究将扩大早期工作，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 在同一个人身上。然后将这些反应与广泛的 听力任务包括语音和音乐感知。 虽然大部分研究将在成年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 使用结合到商业耳蜗植入物中的遥测系统记录的ECAP 成为幼儿初步规划和监测的重要工具。它不仅是可能 来记录我们提出的幼儿大脑皮层的反应，但是这些反应的具体特征 已经显示出遵循儿童的发展趋势，并指示性能（夏尔马 等人2002 a; Ponton等人，2000年）。本提案中概述的研究很重要，因为它们扩展了 先前发表的工作，包括评估皮层电位诱发使用的变化， 正在进行的电刺激模式，这是一种更接近模拟刺激类型的功能， 典型的日常听力。 然而，许多拟议中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， 与使用混合人工耳蜗植入系统的患者和接受双侧人工耳蜗植入的患者一样， 植入物.对于每个受试者组，我们提出了解决以下关系的实验： 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，根据结果， 通过这些研究，我们将能够更全面地描述我们观察到的差异。 个人和使用该信息来帮助临床决策，通知候选人的选择， 影响语音处理器的编程方式，以最大限度地提高个人性能 user.

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.