PHYSIOLOGY AS A POTENTIAL PREDICTOR OF PERCEPTION IN COCHLEAR IMPLANTS

 描述(由申请人提供)：我们的研究计划旨在改进生理测量的使用，以预测人工耳蜗术(CI)的知觉。长期目标是在个人基础上客观地确定最佳语音处理器设置，以提高语音理解能力。尽管一些研究表明客观指标和行为指标之间存在适度的相关性，但这些关系还不足以支持单独使用生理指标来预测行为结果。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；Undraraga等人，2010年、2013年)。相反，使用相反的(阳极引导的)极性进行生理和知觉测量，已经证明了更有效的刺激。这些发现提出了一个重要的问题，即如何解释现有的旨在将生理和感知措施联系起来的研究，这些研究使用了标准的阴极引导脉冲。虽然最近的研究表明，阳极刺激对知觉(即固定电流水平下的更响亮的知觉)和生理反应(即更短的潜伏期、更大的幅度、更有效的掩蔽)反应都具有更好的效果，但到目前为止，还没有研究使用标准的临床脉冲来检验极性效应，也没有研究生理和知觉之间的关系作为刺激极性的函数。这就是本项目的目标。如果极性对生理测量的影响程度不同于感知测量，则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，以确定极性对知觉和生理测量的影响程度，以及两者之间的关系。研究刺激极性对标准脉冲形状的影响将使我们更好地理解顺式知觉测量的潜在生理因素，并将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该从阴极主导刺激转变为阳极主导刺激。

 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.