Electrically-evoked neural responses in children with auditory neuropathy

听神经病儿童的电诱发神经反应

• 批准号: 8663215
• 负责人: Shuman He
• 金额: $ 15.2万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-20 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8663215
• 关键词: Accounting; Acoustic Nerve; Action Potentials; Adopted; Adult; Affect; Age; Auditory; Auditory area; Behavioral; Child; Childhood; Clinical; Cochlear Implants; Cochlear implant procedure; Detection; Development; Devices; Disease; Electric Stimulation; Etiology; Goals; Hearing; Hearing Aids; Hearing Impaired Persons; Implant; Individual; Language; Lead; Measures; Medical; Modification; Nature; Nerve; Neuropathy; Outcome; Pathology; Patients; Pattern; Performance; Peripheral; Process; Property; Protocols documentation; Research; Sensorineural Hearing Loss; Source; Speech; Speech Perception; Staging; Subgroup; System; Techniques; Testing; Time; Variant; Work; behavior measurement; clinical practice; expectation; experience; hearing impairment; improved; multiple disability; nerve gap; patient population; programs; public health relevance; relating to nervous system; research study; response; restoration; signal processing; skills; tool

DESCRIPTION (provided by applicant): Cochlear implantation (CI) has been used as a treatment option for children with auditory neuropathy spectrum disorder (ANSD) who do not benefit from conventional hearing aids. Up to date, there is no robust indicator for predicting CI outcomes in these patients. In addition, programming settings selected for individual ANSD patients might not be optimal since many ANSD children are not able to provide reliable behavioral responses due to their young ages and/or comorbid conditions. These conditions make the audiologic management of implanted ANSD children extremely challenging and at many times uncertain. The long-term goal of this program of research is to develop objective tools that can be used in clinical settings for accurately predicting post-implant speech perception performance and optimizing programming settings for individual ANSD children. As the first step towards fulfilling this long-term goal, this project aims to evaluate how well electrical stimulation is transmitted by the auditory nerve by evaluating temporal response properties of the nerve in implanted ANSD children. In addition, this project also aims to explore the extent to which neural responses recorded at a peripheral and more central level are correlated with each other and whether they are correlated with speech perception performance in ANSD patients. Specific Aim 1 characterizes temporal response properties of the auditory nerve in pediatric CI users by measuring the electrically evoked auditory compound action potential (ECAP) at different stimulation rates. Both children with ANSD and children with sensorineural hearing loss will be tested. Results from these experiments will provide a better understanding of sources of across-patient variations in post-implant speech perception performance among ANSD children. Specific Aim 2 evaluates the association among temporal response properties of the auditory nerve, gap detection threshold and speech perception performance in implanted ANSD children. Results of these studies should expand understandings of how auditory processing in the central auditory cortex is affected by the input from the auditory nerve. Overall, results of this project could potentially lead to the development of an objective tool for identifying a subgroup of ANSD patients who are unlikely to receive substantial benefit from their devices at an early post-implant stage. In addition, these results could also potentially lead to the development of specific signal processing modifications that might result in improved performance for individual implanted ANSD patients. Therefore, this project has tremendous translational significance.

描述（由申请人提供）：人工耳蜗植入 (CI) 已被用作患有听神经病谱系障碍 (ANSD) 且无法从传统助听器中受益的儿童的治疗选择。迄今为止，还没有强有力的指标来预测这些患者的 CI 结局。此外，为个别 ANSD 患者选择的编程设置可能不是最佳的，因为许多 ANSD 儿童由于年龄小和/或合并症而无法提供可靠的行为反应。这些条件使得植入 ANSD 儿童的听力学管理极具挑战性，并且很多时候都具有不确定性。该研究计划的长期目标是开发可用于临床环境的客观工具，以准确预测植入后言语感知表现并优化个别 ANSD 儿童的编程设置。作为实现这一长期目标的第一步，该项目旨在通过评估植入 ANSD 儿童神经的时间响应特性，来评估听觉神经传输电刺激的效果。此外，该项目还旨在探讨外周和更中枢水平记录的神经反应相互关联的程度，以及它们是否与 ANSD 患者的言语感知表现相关。具体目标 1 通过测量不同刺激速率下的电诱发听觉复合动作电位 (ECAP) 来表征儿科 CI 用户听觉神经的时间响应特性。患有 ANSD 的儿童和患有感音神经性听力损失的儿童都将接受测试。这些实验的结果将有助于更好地理解 ANSD 儿童植入后言语感知表现的跨患者差异来源。具体目标 2 评估植入 ANSD 儿童的听神经时间响应特性、间隙检测阈值和言语感知表现之间的关联。这些研究的结果应该会加深人们对中央听觉皮层的听觉处理如何受到听觉神经输入的影响的理解。总体而言，该项目的结果可能会导致发展 一种客观工具，用于识别 ANSD 患者亚组，这些患者不太可能在植入后早期阶段从其设备中获得实质性益处。此外，这些结果还可能导致特定信号处理修改的发展，从而提高个体植入 ANSD 患者的表现。因此，该项目具有巨大的转化意义。