Binaural Spectral Integration with Hearing Loss and Hearing Devices

描述(由申请人提供)：大约2200万美国人患有听力障碍。虽然助听器(HAS)和人工耳蜗(CI)等听力设备成功地改善了许多听力受损(HI)患者的语音识别，但益处仍然存在显著的变异性，噪声中的语音识别仍然是一个问题。一个可能限制益处的因素是双侧佩戴的听力装置之间的干扰，无论该装置是双侧HAS、双侧顺式耳机，还是在对侧耳朵配戴HA的单侧CI(双峰CI HA)。在HI患者中，由于听力损失和听力设备编程引起的不对称，耳朵之间的光谱信息不一定匹配。因此，与正常听力(NH)听者不同，HI听者在我们称为双耳频谱整合(BSI)的过程中整合耳朵之间不匹配的光谱信息。我们的初步研究表明，BSI适用于减少HI患者耳间光谱失配的感知；双耳融合增加，因此两耳之间频率差异很大的音调仍可作为单一感知听到。然而，增加双耳融合的一个副作用是，不匹配的频谱信息在耳朵之间平均，这可能导致语音感知混乱增加和频率辨别恶化。这项研究计划的长期目标是调查HI和NH听众之间的BSI差异，以及这些差异对康复的临床意义。具体地说，在这项提案中，w将检验1)HI和NH听者之间以及HI组内不同设备组合之间的双耳融合的差异：双侧HAS、双侧CI和双峰CI HA；2)BSI异常如何影响对音调和语音刺激的感知；以及3)BSI如何随着儿童的发育而变化，因为发育中的大脑可能会以不同于成人的方式适应BSI。这项拟议的研究将增加我们对听觉处理的一个方面--双耳频谱整合--如何导致HA和CI用户的双耳言语感知困难的理解。研究结果还将表明，儿童听力设备的编程方式是否应该与成人不同。最后，这些结果将为未来的计划研究建立理论框架，使用特定频率的设备编程和培训计划来减少任何有害的BSI，同时保持或增加双耳处理对安静和噪声中的语音感知的好处。

DESCRIPTION (provided by applicant): Approximately 22 million Americans have a hearing impairment. While hearing devices such as hearing aids (HAs) and cochlear implants (CIs) are successful in improving speech recognition for many hearing-impaired (HI) individuals, there is still significant variability in benefit, and speech recognition in noise remains a problem. One factor that may limit benefit is interference between bilaterally worn hearing devices, whether the devices are bilateral HAs, bilateral CIs, or a unilateral CI worn with a HA in the contralatera ear (bimodal CI+HA). In HI individuals, spectral information is not necessarily matched between ears due to asymmetries introduced by hearing loss and hearing device programming. Thus, unlike normal-hearing (NH) listeners, HI listeners integrate mismatched spectral information between ears, in a process that we can call binaural spectral integration (BSI). Our preliminary studies suggest that BSI adapts to reduce perception of interaural spectral mismatch in HI individuals; binaural fusion is increased so that pitches that differ greatly in frequency between the two ears are still heard as a single percept. However, a side effect of increased binaural fusion is that mismatched spectral information is averaged between ears, which may lead to increased speech perception confusions and worsened frequency discrimination. The long-term goal of this research program is to investigate how BSI differs between HI and NH listeners, and the clinical implications of these differences for rehabilitation. Specifically, in this proposal w will examine 1) differences in binaural fusion between HI and NH listeners, as well as across different device combinations within the HI group: bilateral HAs, bilateral CIs, and bimodal CI+HA; 2) how abnormal BSI affects the perception of tone and speech stimuli; and 3) how BSI changes as children develop, because developing brains may adapt BSI differently than adults. The proposed research will increase our understanding of how one aspect of auditory processing, binaural spectral integration, contributes to difficulties with binaural speech perception in HA and CI users. The results will also indicate whether hearing devices should be programmed differently for children than adults. Finally, the results will build the theoretical framework for future planned studies using frequency-specific device programming and training programs to reduce any detrimental BSI, while maintaining or increasing the benefits of binaural processing for speech perception in quiet and noise.