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：本研究旨在优化耳蜗的言语理解和空间听力结果 植入耳聋 (CI) 用户，特别是双侧耳聋 (BI-CI) 和单侧耳聋 (SSD-CI) 用户 知识差距。 是目前尚不清楚是什么导致对侧干扰，它如何影响言语理解和双耳 好处以及如何补救 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 该应用程序的总体目标是确定机制。 不对称的潜在功能后果，特别是通过两种现象表现出来 对侧干扰：“双边言语干扰”（在一只耳朵中呈现的言语会阻碍言语） 站在另一只耳朵中，通常较好的耳朵会干扰较差的耳朵）和“耳间响度不匹配”（双耳） 依次呈现时同样响亮的横向刺激会产生扭曲的空间图 我们的总体功能假设是听力不对称，表现在对侧。 破坏是阻碍现实世界 CI 性能的一个主要因素，我们的总体机制假设是： 这两种现象源于不对称的周边扭曲、中枢听觉适应不良的可塑性，或两者兼而有之。 我们将通过三个具体目标来检验我们的总体假设：（1）衡量相反的后果 耳间不对称造成的横向干扰（双边语音干扰和耳间响度不匹配） 越来越现实的情况；（2）确定外周不对称在多大程度上解释对侧 (3) 确定对侧干扰是否受到中枢听觉可塑性的影响。 产生以下预期结果：(1) 确定 BI-CI 和 SSD-CI 空间听力结果受到对侧干扰的限制；(2) 扩展客观技术——预- 明显应用于理解单耳 CI 性能——表征周围神经表面之间的联系 (3)确定异常的跨耳处理是否容易受到中央可塑性的影响。 这一贡献意义重大，因为从两种不对称现象来看，对侧破坏 双耳语音干扰和耳间响度不匹配是双耳听力良好的主要障碍。 了解对侧破坏的原因和负面后果将为优化提供工具 为 30-50% 的 BI-CI 和近 100% 的 SSD-CI 用户提供不对称听力的康复服务。 创新是因为 (1) 它试图了解基于不对称效应的听力结果的障碍， (2) 它不是单独优化每个耳朵，而是比较 BI-CI 和 SSD-CI 用户来区分机械 （3）它将感知和客观措施结合起来，以区分不同的行为 在不对称情况下，外周和中枢对听力结果不良的影响。