退化电信号对人工耳蜗使用儿童听中枢音调拓扑组构发育的影响及机制研究

人工耳蜗（CI）传输的退化电信号基本可以满足CI植入者在安静环境中的言语识别，但不能满足音高相关感知任务。鉴于中枢发育存在关键期，假设长期退化电刺激对听中枢发育关键期聋儿的音高拓扑组构可能产生非正常重塑。故本研究首先通过应用心理物理学测试手段客观评估音高感知表现，并创新性结合近红外脑成像（fNIRS）技术探究退化电信号对发育关键期的CI儿童听皮层可塑性的可能负面影响及神经生理机制。其次基于听皮层可塑性，应用心理物理测试作为听觉训练方法改善音高感知表现，探究通过精细化听觉训练是否改善皮层非正常重塑从而提高CI使用儿童的音高感知能力。最后应用fNIRS对不同听损患儿的听中枢在发育关键期的重塑轨迹进行长期监测，验证fNIRS检测CI术后脑激活模式的可行性，尝试是否可用皮层反应尽早给予临床调机一定的指导和反馈。本研究可望为CI术后较大康复差异的析因研究提供证据，指导CI植入者针对性地进行康复训练。

Cochlear implant (CI) users are often able to understand speech under ideal listening conditions even with distorted chronic electrical stimulation transmitted by the plasticity cochlear implant. However, pitch perception and/or pitch related perception task remains quite poor. In view of the critical period of cortical development, we hypothesized that chronic degenerated electrical stimulation may produce distorted plasticity of tonotopic organization tonopological in immature developing auditory system. Therefore, in this study, firstly, we are going to use psychophysical testing methods to objectively evaluate pitch perception performance, and put forward using Near-InfraRed Spectroscopy (fNIRS) technology to explore the possible influence of degenerated electrical signals on the plasticity of auditory cortex and its neurophysiological mechanism in CI children at critical development stage. Secondly, we propose to use psychophysical testing as an auditory training method to improve pitch perception performance aiming to explore whether training with one stimulus domain at a time in a fine-grained way may be more advantageous than listening to a complex and time varying signal. Finally, we try to use fNIRS to monitor the development track of the auditory center in the critical period in children with different hearing loss, aiming to verify the feasibility of fNIRS to detect the brain activation mode after CI implantation, and try to give some guidance and feedback to the clinical mapping as early as possible using the cortical response by fNIRS. This study is expected to provide evidence for the factorial study of the great difference in rehabilitation after CI implantation, and provide some suggestion regarding to rehabilitation training for CI users.