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: 10654316
• 负责人: Joshua Gary Bernstein
• 金额: $ 58.62万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10654316
• 关键词: Acoustics; Affect; Amblyopia; Auditory; Auditory Perception; Auditory Perceptual Disorders; Auditory system; Bilateral; Binaural; Bionics; Cochlear Implants; Communication; Complex; Contralateral; Cues; Data; Ear; Electrodes; Environment; Eye; Goals; Hearing; Impairment; Individual; Influentials; Intervention; Knowledge; Link; Loudness; Maps; Measures; Mediating; Mission; Modality; Modeling; National Institute on Deafness and Other Communication Disorders; Nerve Degeneration; Outcome; Perception; Performance; Peripheral; Persons; Population; Predisposition; Prevalence; Public Health; Publishing; Rehabilitation therapy; Research; Role; Side; Speech; Stimulus; Systems Integration; Techniques; Technology; Testing; United States National Institutes of Health; Work; aural rehabilitation; binaural hearing; clinical practice; deafness; disability; experience; experimental study; hearing impairment; hearing restoration; implantation; improved; innovation; negative affect; neural; programs; rehabilitation strategy; remediation; selective attention; sound; stem; tool

ABSTRACT: This research aims to optimize speech-understanding and spatial-hearing outcomes for cochlear- implant (CI) users, specifically bilateral (BI-CI) and single-sided-deafness (SSD-CI) users. The gap in knowledge is that it is unknown what causes contralateral disruption, how it affects speech understanding and binaural benefits, and how it might be remediated. The long-term goal of our research program is to optimize hearing performance for CI users with two inputs. The overall objective of this application is to determine the mechanisms underlying functional consequences of asymmetry, specifically through two phenomena that are manifestations of contralateral disruption: “bilateral speech interference” (speech presented in one ear impedes speech under- standing in the other, usually the better ear interfering with the poorer) and “interaural loudness mismatch” (bi- lateral stimuli that are equally loud when presented sequentially produce a distorted spatial map when presented simultaneously). Our overarching functional hypothesis is that asymmetric hearing, manifesting in contralateral disruption, is a major factor stunting real-world CI performance. Our overarching mechanistic hypothesis is that the two phenomena stem from asymmetric peripheral distortion, central auditory maladaptive plasticity, or both. We will test our overarching hypotheses through three specific aims: (1) Measure the consequences of contra- lateral disruption (bilateral speech interference and interaural loudness mismatch) from interaural asymmetry for increasingly realistic situations; (2) Determine the extent to which peripheral asymmetry explains contralateral disruption; (3) Determine if contralateral disruption is influenced by central auditory plasticity. These aims will yield the following expected outcomes: (1) identify the situations, prevalence, and magnitude where BI-CI and SSD-CI spatial-hearing outcomes are limited by contralateral disruption; (2) extend objective techniques—pre- viously applied to understand monaural CI performance—to characterize the link between peripheral neural sur- vival and binaural processing; (3) determine if abnormal across-ear processing is susceptible to central plasticity. This contribution is significant because contralateral disruption, viewed through the two asymmetry phenomena of bilateral speech interference and interaural loudness mismatch, is a major roadblock to good binaural hearing. Understanding the causes and negative consequences of contralateral disruption will provide tools to optimize rehabilitation for the 30-50% of BI-CI and nearly 100% of SSD-CI users with asymmetric hearing. The work is innovative because (1) it seeks to understand the roadblock in hearing outcomes based on asymmetry effects, rather than optimizing each ear individually, (2) it compares BI-CI and SSD-CI users to distinguish the mecha- nisms underlying contralateral disruption, and (3) it pairs perceptual and objective measures to differentiate be- tween peripheral and central contributions to poor hearing outcomes in asymmetric cases.

摘要：该研究旨在优化人工耳蜗的语音理解和空间听力结果 植入物（CI）用户，特别是双侧（BI-CI）和单面聋（SSD-CI）用户。知识的差距 是尚不清楚是什么造成对侧破坏，如何影响言语理解和双耳 好处，以及如何修复它。我们研究计划的长期目标是优化听力 具有两个输入的CI用户的性能。该应用的总体目的是确定机制 不对称的潜在功能后果，特别是通过两种现象是表现 对侧破坏：“双边言语干扰”（在一只耳朵中呈现的言语阻碍了言语不足 站在另一个，通常会更好地干扰较贫穷的差异）和“响声不匹配”（bi-- 当呈现时，横向刺激依次产生扭曲的空间图时同样响亮的刺激 我们的总体功能假设是不对称听力，在对侧表现 破坏是阻碍现实世界中CI性能的主要因素。我们的总体机械假设是 这两种现象源于不对称的外围扭曲，中央听觉不良适应性可塑性或两者兼而有之。 我们将通过三个特定目的测试我们的总体假设：（1）衡量相反的后果 互动不对称的横向破坏（双边语音干扰和交互式响度不匹配） 越来越现实的情况； （2）确定周围不对称性的程度 破坏（3）确定对侧破坏是否受中央听觉可塑性的影响。这些目标会 产生以下预期结果：（1）确定BI-CI和 SSD-CI空间听力结果受对侧破坏的限制； （2）扩展客观技术 - 最近应用于了解单膜CI性能，以表征周围神经表面之间的联系 Vival和双耳处理； （3）确定异常的跨摩托处理是否易于中央可塑性。 这种贡献很重要，因为通过两种不对称现象观察的对侧破坏 双边言语干扰和互动响度不匹配的是良好双耳听力的主要障碍。 了解对侧干扰的原因和负面后果将提供优化的工具 30-50％的BI-CI和近100％的SSD-CI使用者的康复，具有不对称的听力。工作是 创新性是因为（1）试图了解基于不对称效应的听力结果中的障碍， （2）与其分别优化每个耳朵，而是比较BI-CI和SSD-CI用户，以区分机甲 - 对侧破坏的基础，以及（3）它成对的感知和客观测量，以区分 在不对称病例中，推文外围和中心贡献对听力不良的结果。