Effects of Training on Adult Cochlear Implant Users

培训对成人人工耳蜗使用者的影响

• 批准号: 8435970
• 负责人: Qian-Jie Fu
• 金额: $ 17万
• 依托单位: HOUSE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-05-01 至 2013-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8435970
• 关键词: Acoustics; Address; Adult; Affect; Attention; Auditory; Bilateral; Cochlear Implants; Cochlear implant procedure; Contralateral; Cross-Over Studies; Cues; Data; Devices; Ear; Experimental Designs; Frequencies; Goals; Hearing; Hearing Aids; Home environment; Learning; Measures; Methods; Noise; Outcome; Patients; Pattern; Perception; Performance; Peripheral; Personal Computers; Phonetics; Process; Psychophysics; Rehabilitation Research; Rehabilitation therapy; Research; Resolution; Signal Transduction; Space Perception; Speech; Technology; Training; clinically relevant; clinically significant; cost effective; implantation; improved; insight; novel strategies; programs; public health relevance; research study; segregation; sound

DESCRIPTION (provided by applicant): Despite the advantages of listening with two ears, localization and spatial segregation of speech and noise remain difficult for patients who use two cochlear implants (CIs) or a CI in combination with a hearing aid. These difficulties may be due to: 1) poor spectral and/or temporal processing, 2) distorted peripheral patterns, and/or 3) poor binaural integration of peripheral patterns. Auditory training may mitigate these deficits. Our long-term goal is to develop training methods that improve CI patients' binaural perception. It is as yet unclear whether training should target unilateral peripheral processing or bilateral integration of peripheral signals or both. We hypothesize that the difference in unilateral performance across ears ("asymmetry") must be reduced to maximize the binaural benefit. Unilateral training with the poorer ear alone, followed by bilateral training will provide the best training outcome. For spatial binaural perception (localization and squelch), we further hypothesize that localization requires greater spatial precision than segregation of speech and noise; improving localization will improve spatial segregation. Localization training, followed by spatial segregation training will provide the best outcomes for spatial hearing. In all three Aims, we will use a crossover experimental design to see whether the training sequence affects outcomes. Auditory training has not been extensively studied in bilateral CI or bimodal listeners, and there are few (if any) targeted rehabilitation programs for these patient groups. By addressing these deficits in research and rehabilitation, the proposed research offer novel approaches to increasingly commonplace difficulties for CI patients. The research seeks to identify the best training approach for bilateral CI and bimodal patients, as well as understand how differences in the peripheral input may influence binaural perception as well as the training outcomes. The conceptual framework addresses different factors that may limit performance: auditory resolution, peripheral representation and/or integration of peripheral inputs. Experiments 1 and 2 address whether unilateral psychophysical or speech training is more effective. Experiments 3 and 4 address a fundamental question facing all bilateral CI and bimodal patients: Is it better to train with one ear or two? Experiments 5 and 6 addresses whether spatial training is task-specific (localization vs. spatial segregation). The proposal is o great clinical significance, as the research will guide efficient training methods to maximize CI users' binaural perception. The research is also of great theoretical significance, as it seeks to better understand connections between psychophysical and speech measures, binaural benefits and unilateral performance, as well as localization and spatial segregation in electric hearing. As advances in CI technology seem to be reaching a point of diminishing returns, auditory training may provide the most cost-effective approach to maximize the benefit of cochlear implantation.

描述（由申请人提供）：尽管用两只耳朵聆听有很多优点，但对于使用两个人工耳蜗 (CI) 或将 CI 与助听器结合使用的患者来说，语音和噪声的定位和空间隔离仍然很困难。这些困难可能是由于：1）较差的频谱和/或时间处理，2）扭曲的外围模式，和/或3）较差的外围模式的双耳集成。听觉训练可以减轻这些缺陷。我们的长期目标是开发改善 CI 患者双耳感知的训练方法。目前尚不清楚训练应该针对单侧外周处理还是双边外周信号整合或两者兼而有之。我们假设必须减少双耳单侧性能差异（“不对称”），以最大限度地提高双耳效益。仅对较差的耳朵进行单侧训练，然后进行双边训练将提供最佳效果 培训成果。对于空间双耳感知（定位和静噪），我们进一步假设定位需要比语音和噪声隔离更高的空间精度；改善本地化将改善空间隔离。定位训练和随后的空间隔离训练将为空间听力提供最佳结果。在所有三个目标中， 我们将使用交叉实验设计来观察训练序列是否会影响结果。听觉训练尚未在双侧 CI 或双模式听者中进行广泛研究，并且针对这些患者群体的有针对性的康复计划很少（如果有的话）。通过解决研究和康复方面的这些缺陷，拟议的研究为解决脑梗死患者日益常见的困难提供了新的方法。该研究旨在确定双耳 CI 和双模患者的最佳训练方法，并了解外周输入的差异如何影响双耳感知和训练结果。该概念框架解决了可能限制性能的不同因素：听觉分辨率、外围表示和/或外围输入的集成。实验 1 和 2 探讨单边心理物理训练或言语训练是否更有效。实验 3 和 4 解决了所有双侧 CI 和双峰患者面临的一个基本问题：用一只耳朵训练还是用两只耳朵训练更好？实验 5 和 6 讨论了空间训练是否是特定于任务的（定位与空间隔离）。该提案具有重要的临床意义，因为该研究将指导有效的训练方法，以最大限度地提高 CI 用户的双耳感知。这项研究也具有重要的理论意义，因为它旨在更好地理解心理物理和言语测量之间的联系、双耳益处和单侧表现，以及电听觉的定位和空间隔离。随着 CI 技术的进步似乎已达到收益递减点，听觉训练可能提供最具成本效益的方法，以最大限度地发挥人工耳蜗植入的益处。