Optimizing Bilateral and Single-Sided Deafness Cochlear Implants for Functioning in Complex Auditory Environments

优化双侧和单侧耳聋人工耳蜗植入物以在复杂的听觉环境中发挥作用

• 批准号: 9216078
• 负责人: Joshua Gary Bernstein
• 金额: $ 42.86万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-12-01 至 2021-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9216078
• 关键词: Acute; Adopted; Adoption; Auditory; Auditory system; Basic Science; Bilateral; Binaural; Bionics; Brain Stem; Clinical; Cochlea; Cochlear Implants; Communication; Complex; Data; Devices; Discrimination; Ear; Electric Stimulation; Electrodes; Electrophysiology (science); Environment; Equilibrium; Failure; Frequencies; Future; Goals; Hand; Hearing; Hearing Impaired Persons; Hour; Impairment; Implant; Individual; Intervention; Knowledge; Learning; Location; Longitudinal Studies; Maps; Measurement; Measures; Methods; Mission; National Institute on Deafness and Other Communication Disorders; Noise; Outcome; Patients; Pattern; Performance; Plasticizers; Population; Public Health; Quality of life; Research; Sensory; Side; Sound Localization; Source; Speech; Stimulus; Technology; Testing; Time; Translational Research; United States National Institutes of Health; X-Ray Computed Tomography; base; clinical practice; deafness; disability; effective therapy; hearing impairment; implantable device; improved; innovation; novel; programs; relating to nervous system; sound; standard of care; stem; tool; virtual

ABSTRACT: The vast majority of the roughly 100,000 cochlear-implant (CI) users have severe-to-profound hear- ing loss, but only receive a single CI in one ear. Yet, not having access to sound in two ears severely hampers the auditory systems' ability to overcome background noise, which has many consequences including increasing the amount of effort it takes to communicate. Even with access to sound in both ears, two-ear or “binaural” benefits for bilateral CI (BI-CI) and single-sided deaf CI (SSD-CI) users are small compared to normal-hearing listeners. Because of possible frequency mismatch between the two ears, it is unclear if the current standard approach of programming the CIs maximizes speech understanding for two ears, particularly in environments with multiple sound sources. Our long-term goal is to understand and maximize speech understanding and bin- aural benefits imparted by CIs by improving interaural frequency, level, and timing encoding. The next steps toward this goal and the objectives here are to evaluate interaural frequency mismatch and to develop novel CI programs (MAPs) to correct for mismatch. Our central hypothesis is that binaural function in BI-CI and SSD-CI users is suboptimal because of interaural frequency mismatch. Our approach will be to optimize the frequency- allocation in the poorer ear to minimize the mismatch and potentially improve speech understanding and spatial hearing. With strong preliminary data in hand, the central hypothesis will be tested by pursuing three specific aims: (1) Assess interaural frequency mismatch for individual electrodes in BI-CI and SSD-CI users. (2) Compare the acute functional benefits and limitations for the standard MAP and novel MAPs that minimize interaural fre- quency mismatch in BI-CI and SSD-CI users. (3) In a longitudinal study, evaluate the extent to which standard MAP and novel MAPs cause changes in pitch processing, binaural processing, and speech understanding in BI- CI and SSD-CI users. The expected outcome is improved binaural function for BI-CI and SSD-CI users, without sacrificing speech understanding. This research is significant because it will produce a positive impact in CI users' quality of life by improving communication in quiet and noisy environments. This proposal is innovative because it uses knowledge of binaural neural processing to provide a novel, non-invasive, and inexpensive method to reprogram CIs for bilateral hearing.

摘要：大约 100,000 名人工耳蜗 (CI) 用户中的绝大多数患有重度至极重度听力损失。 听力损失，但只能在一只耳朵中接收到单个 CI 然而，无法在两只耳朵中接收声音会严重妨碍。 听觉系统克服背景噪音的能力，这会产生许多后果，包括增加 即使双耳、双耳或“双耳”都能听到声音，也需要付出很大的努力。 与听力正常的用户相比，双侧 CI (BI-CI) 和单侧聋人 CI (SSD-CI) 用户的获益较小 由于两耳之间可能存在频率不匹配，目前尚不清楚当前标准是否有效。 CI 编程方法可最大限度地提高两只耳朵的语音理解能力，尤其是在环境中 我们的长期目标是理解并最大化语音理解和分类。 CI 通过改善耳间频率、电平和定时编码带来的听觉益处。 为了实现这一目标，这里的目标是评估耳间频率不匹配并开发新颖的 CI 我们的中心假设是 BI-CI 和 SSD-CI 中的双耳功能。 由于耳间频率不匹配，用户的效果不是最佳的，我们的方法是优化频率。 在较差的耳朵中进行分配，以最大程度地减少不匹配并可能提高语音理解和空间 有了强有力的初步数据，中心假设将通过追求三个具体的内容来检验。 目标：(1) 评估 BI-CI 和 SSD-CI 用户的各个电极的耳间频率不匹配。 标准 MAP 和新型 MAP 的急性功能优势和局限性可最大限度地减少耳间频率 BI-CI 和 SSD-CI 用户的频率不匹配 (3) 在纵向研究中，评估标准的程度。 MAP 和新颖的 MAP 导致 BI 中的音调处理、双耳处理和语音理解发生变化 CI 和 SSD-CI 用户的预期结果是改善 BI-CI 和 SSD-CI 用户的双耳功能，而无需 这项研究意义重大，因为它将对 CI 产生积极影响。 该提案通过改善安静和嘈杂环境中的通信来提高用户的生活质量。 因为它利用双耳神经处理的知识来提供一种新颖的、非侵入性的、廉价的 重新编程 CI 以实现双侧听力的方法。