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）确定植入耳蜗的健康状况，即单个耳蜗植入电极附近的生物条件如何影响电听力的特定心理物理和电生理测量;（2）确定这些特定测量与人工耳蜗语音识别的关系;以及（3）使用这些信息来增加听力受损患者从他们的假肢中获得的益处。这些研究的数据可以通过两种方式用于改善人工耳蜗使用者的语音识别。首先，基于将病理模式与功能措施相关联的动物工作，我们将为听力学家提供简单的临床适用措施，他们可以使用这些措施来深入了解个体患者耳蜗的特征，并更好地识别和选择个体患者语音处理器MAP的最佳刺激部位。其次，这些数据可以帮助生物学家和外科医生确定最佳解剖目标，通过组织保存和组织工程策略改善植入功能，使受损的耳蜗更容易接受人工耳蜗刺激。我们的方法包括豚鼠的心理物理学和电生理学实验以及人类的心理物理学，电生理学和语音识别研究。我们测量心理物理性能，如脉冲串的感知整合，和电生理性能，如诱发神经反应增长的速度作为刺激水平的函数。这些测量是在豚鼠和人类的单个刺激部位进行的。在豚鼠中，我们确定了与这些措施相关的耳聋或听力受损耳蜗的特定解剖学特征。在人类中，我们确定了这些相同的措施与语音识别在安静和嘈杂的背景。然后，我们可以使用这些措施在人类中选择最好的刺激部位，为个别受试者的语音处理器。我们之前的研究支持这种方法，表明受试者使用处理器MAP和使用适当功能测量仔细选择的刺激部位子集通常比使用所有可用部位的处理器表现更好。本申请中提出的工作将加深我们对人工耳蜗用户语音识别性能变化的机制的理解，并作为建立和测试临床程序的指南，以提高个体患者的性能。

 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.