PHYSIOLOGY AS A POTENTIAL PREDICTOR OF PERCEPTION IN COCHLEAR IMPLANTS

 描述（由申请人提供）：我们的研究项目旨在改善使用生理测量来预测人工耳蜗（CI）的感知。长期目标是客观地确定个人基础上的最佳语音处理器设置，以提高语音理解。虽然一些研究表明，客观和行为措施之间的适度相关性，这些关系不足以支持专门使用生理措施来预测行为结果。最近的研究表明，用于CI刺激的标准脉冲极性（阴极导联）并不理想（例如，Carlyon等人，2013年; Undurraga等人，2010年，2013年）。相反，更有效的刺激已被证明使用相反的（阳极主导）极性的生理和感知的措施。这些发现提出了关于如何解释现有研究机构的重要问题，这些研究旨在将生理和感知措施联系起来，这些措施使用标准的阴极导联脉冲。虽然最近的研究表明，阳极刺激对知觉（即，对于固定电流水平的更大感知）和生理（即，更短的潜伏期、更大的振幅、更有效的掩蔽）响应，迄今为止没有研究使用标准临床脉冲检查极性效应，也没有任何研究检查生理学和感知之间的关系作为刺激极性的函数。这是本项目的目标。如果极性对生理测量的影响程度不同于感知测量，那么客观测量的可预测性将受到影响。在这个项目中，我们将使用临床标准脉冲形状来检查刺激极性的影响，以确定极性影响感知和生理测量的程度，以及两者之间的关系。检查刺激极性对标准脉冲形状的影响将使我们能够更好地了解CI感知测量的潜在生理贡献者，并对未来的临床刺激范式具有重要意义。最重要的是，这项研究的结果将决定 当前的临床刺激模式是否应从阴极引导刺激转变为阳极引导刺激。

 DESCRIPTION (provided by applicant): Our research program is aimed at improving the use of physiological measures to predict perception with a cochlear implant (CI). The long-term goal is to objectively determine optimal speech-processor settings on an individual basis to improve speech understanding. Although some studies have shown modest correlations between objective and behavioral measures, these relations are not sufficiently strong to support exclusive use of physiological measures to predict behavioral outcomes. Recent studies have shown that the standard pulse polarity (cathodic-leading) used for CI stimulation is not ideal (e.g., Carlyon et al. 2013; Undurraga et al., 2010, 2013). Rather, more effective stimulation has been demonstrated using the opposite (anodic-leading) polarity for both physiological and perceptual measures. These findings raise significant questions about how to interpret the existing body of research aimed at relating physiological and perceptual measures, which used standard cathodic-leading pulses. Although the recent studies demonstrated greater effectiveness with anodic stimulation for both perceptual (i.e., louder percepts for a fixed curren level) and physiological (i.e., shorter latencies, larger amplitudes, more effective masking) responses, no studies to date have examined polarity effects using standard clinical pulses, nor have any studies examined the relation between physiology and perception as a function of stimulus polarity. This is the goal of the present project. If polarity affects physiological measures to a different degree than perceptual measures, then the predictability of objective measures will be affected. In this project, we will examine the effect of stimulus polarity using clinically standard pulse shapes to determine the extent to which polarity affects perceptual and physiological measures, as well as the relation between the two. Examining the effects of stimulus polarity for standard pulse shapes will allow us to better understand the underlying physiological contributors to perceptual measures with CIs, and will have important implications for future clinical stimulation paradigms. Most importantly, results from this study will determine whether current clinical stimulation modes should shift from cathodic- to anodic-leading stimulation.