Understanding the benefits of electric-acoustic stimulation

描述（由申请人提供）：听力限于低于约500-750 Hz频率区域的个体可从低频区域中的声刺激和高频区域中的电刺激的组合中显著受益。电声刺激（EAS）的优势在存在竞争语音的情况下听语音时特别明显，这是听力损失患者最困难的听力情况之一。当将声学刺激添加到电刺激时，即使单独的声学刺激通常提供很少或不提供可懂度，也会发生语音可懂度的通常戏剧性的改善。广泛的，长期的目标，拟议的研究是获得更好地了解的声学线索和听觉处理的好处EAS。具体而言，具体目标包括识别语音中的声学线索，其负责从低频声学刺激获得的益处;确定可以支持成功EAS的低频听觉的频率范围和幅度;确定是否可以通过增加低频区域中的刺激通道的数量在EAS的声学模拟中观察到与EAS所见的益处类似的益处;确定低频声学刺激是否有助于处理中断的语音;并确定植入耳朵中的低频听力是否保留了在空间分离的背景下理解语音的重要线索。这里提出的研究将包括听力正常的受试者听植入处理的模拟和耳蜗植入患者残留的低频听力。这项研究应该导致更好地了解EAS，并可能导致改善许多当前和潜在患者的语音接收，并增加可能从这种相对较新且极具前景的技术中受益的人数。 在美国，大约有2800万人患有听力损失。一种有前途的新方法，其中一些听觉康复包括声刺激和直接电刺激的听觉神经的组合。需要在这个重要的新领域进行更多的研究，以拓宽我们对电声刺激的理论理解，并提高其临床疗效。最近，安装人工耳蜗的个体已经接受了相对较短的电极阵列，旨在保留植入耳中残留的低频听力。这种低频声刺激的添加已被证明可以显著改善真实的和模拟植入物收听中的语音接收，特别是在背景噪声中。该项目的目标是更好地了解低频区域中提供这种好处的线索。

DESCRIPTION (provided by applicant): Individuals with hearing restricted to the frequency region below about 500-750 Hz may benefit significantly from a combination of acoustic stimulation in the low-frequency region and electric stimulation in the higher frequency region. The advantage of electric-acoustic stimulation (EAS) is particularly apparent when listening to speech in the presence of competing speech, one of the most difficult listening situations for individuals with hearing loss. The often dramatic improvement in speech intelligibility when adding acoustic to electric stimulation occurs even though the acoustic stimulation alone often provides little or no intelligibility. The broad, long-term goal of the proposed research is to gain a better understanding of the acoustic cues and auditory processing underlying the benefits of EAS. In particular, the specific aims include identifying the acoustic cues in speech that are responsible for the benefits gained from low-frequency acoustic stimulation; determining the frequency extent and magnitude of low-frequency hearing that can support successful EAS; determining whether benefits similar to those seen with EAS can be observed in acoustic simulations of EAS by increasing the number of channels of stimulation in the low-frequency region; determining whether low-frequency acoustic stimulation helps the processing of interrupted speech; and determining whether low-frequency hearing in the implanted ear preserves important cues for understanding speech in the presence of spatially separated backgrounds. The research proposed here will include normal-hearing subjects listening to simulations of implant processing and cochlear implant patients with residual low-frequency hearing. This research should lead to a better understanding of EAS and could lead to improved speech reception for many current and potential patients and an increase in the number of individuals who might benefit from this relatively new and extremely promising technology. There are approximately 28 million individuals who suffer from hearing loss in the United States. A promising new approach to auditory rehabilitation for some of these includes a combination of acoustic stimulation and direct electrical stimulation of the auditory nerve. Additional research in this important new area is needed to broaden our theoretical understanding of electric-acoustic stimulation and to enhance its clinical efficacy.Recently, individuals fitted with cochlear implants have received a relatively short electrode array, intended to preserve their residual low-frequency hearing in the implanted ear. The addition of this low-frequency acoustic stimulation has been shown to dramatically improve speech reception both in real and simulated implant listening, particularly in background noise. The goal of this project is to gain a better understanding of the cues present in the low-frequency region that provide this benefit.