Electrophysiology

过去 20 年来，人工耳蜗已经取得了很大进步，但仍然存在一些问题。 植入后性能的所有指标都有很大的可变性。实验的总体目标 提议的目的是确定使用电生理测量的新方法，以更好地了解电生理的来源 那种可变性。我们实验室之前的研究重点是测量 听觉神经受到电刺激。拟议的研究将扩大早期工作范围，不仅包括 测量从听觉神经记录的神经活动，还记录皮质诱发反应 在同一个个体中。然后将这些响应与广泛的表现进行比较 听力任务包括言语和音乐感知。 虽然提议的大部分研究将针对成年植入物使用者进行，但结果将直接 适用于儿科人群。电诱发复合动作等外围措施 使用纳入商业人工耳蜗的遥测系统记录的电势（ECAP）已 成为幼儿初始规划和监测的重要工具。这不仅是可能的 记录我们在幼儿中提出的皮质反应，但这些反应的具体特征 已经被证明可以遵循儿童的发展趋势并表明表现（Sharma 等人。 2002a；庞顿等人，2000）。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使用变化引起的皮质电位评估 持续电刺激的模式，该功能可以更接近地模拟刺激类型 典型的日常聆听。 许多拟议的实验都针对使用标准人工耳蜗的患者，然而， 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，例如 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 植入物。对于每个主题组，我们提出了解决之间关系的实验 电生理测量和表现。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 根据提出的研究，我们将能够更全面地描述我们观察到的差异 个人并使用该信息来协助临床决策、为候选人选择提供信息和 影响语音处理器的编程方式，以最大限度地提高个人的性能 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.