EFFECTS OF ASYMMETRIC HEARING IN ACOUSTIC LISTENERS AND COCHLEAR IMPLANT USERS

描述（由申请人提供）：只用一只耳朵听会严重降低信号隔离和通信。许多患者的听力功能明显不对称。我们建议在三个患者群体中研究不对称听力的影响。在每一组中，每个人都有一只耳朵失聪;然而，他们的听力“更好”的耳朵不同，听力正常，中度听力损失或人工耳蜗植入听力。在目标1中，我们检验了单侧听力损失成年人完整（正常）耳朵的听觉处理中断的假设。具体来说，我们预测减少处理频谱和时间调制的声音在个人与单侧耳聋相比，正常听力控制听一只耳朵。在目标2中，使用成像方法，我们测试的假设，单侧耳聋导致重组的正常皮层不对称处理频谱和时间的声音。我们还将研究单侧耳聋对剥夺听觉皮层和大脑其他区域中选定听觉区域之间相关活动的影响。在目标3a中，我们假设一只耳朵的残余听力减少了对侧未治疗耳朵耳聋的负面影响。成年患者有一只耳朵符合当前人工耳蜗植入候选资格，另一只耳朵有中度听力损失。较差的耳朵被植入。结果进行了比较，在双耳耳聋的人谁接受一个植入物。在目标3b中，我们假设通过一只耳朵中的人工耳蜗植入物进行电听觉可以减少对侧未治疗耳朵的耳聋的负面影响。对于接受顺序人工耳蜗植入的儿童和成人（一只耳朵在第一只植入数月至数年后植入），我们使用流动源语音识别，真实世界噪声环境的多源模拟和听力障碍调查来确定顺序植入耳朵之间的关系。从这些研究中获得的信息将为扩大单耳植入标准和建立儿童和成人双耳植入的新标准提供迫切需要的基础。此外，拟议的转化研究将促进对耳聋神经通路的可塑性和主导性的理解，并指导对听力不对称患者的干预，无论是由于声学不对称还是单侧人工耳蜗植入。只用一只耳朵听会导致噪音中的言语理解能力差，无法定位声音，并且全天都要付出巨大的努力进行沟通。这项研究将满足以下迫切的临床需求：1）了解单侧听力损失的后果，2）扩大单耳人工耳蜗植入的标准，3）建立儿童和成人双侧植入的新标准。行为和成像研究结果将促进对不对称听力影响的理解，并指导对患者的干预。

DESCRIPTION (provided by applicant): Listening with just one ear seriously degrades signal segregation and communication. Many patients function with noticeable asymmetry in hearing. We propose to study the effects of asymmetric hearing in three patient populations. In each group, individuals have one deaf ear; however, they differ in their "better" hearing ear, which has either normal hearing, moderate hearing loss, or hears with a cochlear implant. In Aim 1, we test the hypothesis that auditory processing in the intact (normal) ear is disrupted in adults with unilateral hearing loss. Specifically, we predict decreased processing of spectrally and temporally modulated sounds in individuals with unilateral deafness compared to normal hearing controls listening with one ear. In Aim 2, using imaging methods, we test the hypothesis that unilateral deafness leads to reorganization in the normal cortical asymmetry in processing spectral and temporal sounds. We will also examine the consequences of unilateral deafness on correlated activity between selected auditory regions in the deprived auditory cortex and the rest of the brain. In Aim 3a, we hypothesize that residual hearing in one ear reduces the negative effect of deafness in the opposite, untreated ear. Adult patients have one ear that meets current cochlear implant candidacy and one ear with moderate hearing loss. The poorer ear is implanted. Results are compared to individuals with deafness in both ears who receive one implant. In Aim 3b, we hypothesize that electric hearing through a cochlear implant in one ear reduces the negative effect of deafness in the opposite, untreated ear. For both children and adults who receive sequential cochlear implants (one ear implanted months to years after the first), we determine the relationship between sequentially implanted ears using roving-source speech recognition, multi-source simulation of real-world noise environments, and investigation of hearing handicap. The information obtained from these studies will provide an urgently needed basis for expanding criteria for implantation in one ear and establishing new criteria for implantation in both ears for children and adults. In addition, the proposed translational research will advance understanding of plasticity and dominance of the neural pathways in deafness and guide intervention for patients with asymmetric hearing, either due to acoustic asymmetry or unilateral cochlear implantation. Listening with just one ear results in poor speech understanding in noise, inability to localize sound and tremendous effort to communicate throughout the day. This research will meet urgent clinical needs to 1) understand the consequences of unilateral hearing loss, 2) expand criteria for cochlear implantation in one ear, and 3) establish new criteria for bilateral implantation in children and adults. Behavioral and imaging study results will advance understanding of the effects of asymmetric hearing and guide intervention for patients.