Across-Site Patterns of Cochlear Implant Function: Importance of Cochlear Health

 描述(由申请人提供)：我们研究的目的是(1)确定植入人工耳蜗的健康状况，即单个人工耳蜗电极附近的生物状况如何影响电听力的特定心理物理和电生理指标；(2)确定这些具体措施与人工耳蜗术中语音识别的关系；以及(3)利用这些信息增加听力障碍患者从假体中获得的益处。来自这些研究的数据可以用于两种方式来改善人工耳蜗使用者的语音识别能力。首先，基于将病理模式与功能测量相关联的动物工作，我们将为听力学专家提供简单的临床适用测量，他们可以使用这些测量来洞察单个患者的耳蜗特性，并更好地识别和选择单个患者的语音处理器图的最佳刺激位置。其次，这些数据可以帮助生物学家和外科医生通过组织保存和组织工程策略来确定改善植入功能的最佳解剖目标，使受损的耳蜗更容易接受人工耳蜗的刺激。我们的方法包括豚鼠的心理物理和电生理实验，以及人类的心理物理、电生理和语音识别研究。我们测量心理物理表现，如脉冲序列的知觉整合，以及电生理表现，如诱发神经反应作为刺激水平的函数增长的速度。这些测量是在豚鼠和人类的个体刺激点进行的。在豚鼠身上，我们确定了与这些测量相关的耳聋或听力受损的特定解剖特征。在人类中，我们确定了在安静和嘈杂背景下，这些相同的测量与语音识别的相关性。然后，我们可以在人类身上使用这些测量方法，为单个受试者的语音处理器选择最佳刺激位置。这一方法得到了我们之前的研究的支持，该研究表明，与使用使用所有可用位置的处理器相比，使用带有刺激点子集的处理器图通常表现得更好，这些刺激点子集是通过适当的功能测量精心选择的。这项申请中提出的工作将加深我们对人工耳蜗使用者之间语音识别性能差异的潜在机制的理解，并作为建立和测试临床程序的指南，这些程序将提高个别患者的性能。

 DESCRIPTION (provided by applicant): The objectives of our research are (1) to determine how the health of the implanted cochlea, i.e. the biological conditions near the individual cochlear-implant electrodes, affects specific psychophysical and electrophysiological measures of electrical hearing; (2) to determine the relationships of these specific measures to speech recognition with the cochlear prosthesis; and (3) to use this information to increase the benefit that hearing impaired patients receive from their prostheses. The data from these studies can be used in two ways to improve speech recognition in cochlear implant users. First, based on animal work that will correlate the pattern of pathology with functional measures, we will provide audiologists with simple clinically applicable measures they can use to gain insight into the characteristics of the individual patient's cochlea and better identify and select the best stimulation sites for an individual patient's speech processor MAP. Second the data can help the biologist and the surgeon to determine the best anatomical targets for improving implant function through tissue-preservation and tissue-engineering strategies to make the impaired cochlea more receptive to cochlear implant stimulation. Our approach involves psychophysical and electrophysiological experiments in guinea pigs as well as psychophysical, electrophysiological and speech recognition studies in humans. We measure psychophysical performance, such as perceptual integration of pulse trains, and electrophysiological performance such as the rate at which evoked neural responses grow as a function of stimulus level. These measurements are made at individual stimulation sites in guinea pigs and humans. In guinea pigs we determine the specific anatomical features in the deaf or hearing-impaired cochlea that are correlated with these measures. In humans we determine the correlation of these same measures with speech recognition in quiet and in noisy backgrounds. We can then use these measures in humans to select the best stimulation sites for an individual subject's speech processor. This approach is supported by our previous studies showing that subjects usually perform better using a processor MAP with a subset of stimulation sites, carefully selected using appropriate functional measures, than they do with a processor that uses all available sites. The work proposed in this application will deepen our understanding of the mechanisms underlying variation in speech recognition performance across users of cochlear implants and serve as a guide for establishing and testing clinical procedures that will improve performance in individual patients.