Binaural cue sensitivity in children and adults with combined electric and acoustic stimulation

电和声相结合刺激儿童和成人的双耳提示敏感性

• 批准号: 10585556
• 负责人: Rene H Gifford
• 金额: $ 69.09万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-01 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585556
• 关键词: Acceleration; Acoustic Stimulation; Acoustics; Acute; Adolescence; Adult; Age; Audiology; Auditory; Auditory Evoked Potentials; Auditory area; Auditory system; Automobile Driving; Behavioral; Benchmarking; Bilateral; Binaural; Brain Stem; Child; Childhood; Chronic; Chronology; Clinical; Clinical Management; Clinical Trials; Cochlear Implants; Cochlear implant procedure; Complex; Contralateral; Cues; Data; Development; Devices; Diffuse; Ear; Electric Stimulation; Electrodes; Electrophysiology (science); Environment; Exhibits; Frequencies; Hearing; Hearing Aids; Implant; Inherited; Intervention; Intervention Studies; Investigation; Knowledge; Low Frequency Deafness; Measures; Mediating; Mediation; Modality; Noise; Operative Surgical Procedures; Outcome; Performance; Phase; Population; Positioning Attribute; Prevalence; Process; Recommendation; Research; Research Activity; Resolution; Scientist; Sensorineural Hearing Loss; Space Perception; Speech; Speech Discrimination; System; Techniques; Technology; Time; Weight; With laterality; binaural hearing; clinical application; clinical translation; deaf; evidence based guidelines; hearing impairment; hearing preservation; improved; innovation; insight; longitudinal design; neural; normal hearing; novel; response; speech recognition

PROJECT SUMMARY Cochlear implantation with minimally traumatic surgical techniques and atraumatic electrode arrays has led to an increasing prevalence of adult and pediatric cochlear implant (CI) recipients with the potential for combined Electric and binaural Acoustic Stimulation (EAS). Many studies have demonstrated that adult EAS users consistently exhibit significant benefits for speech understanding in noise and spatial hearing tasks as compared to a CI paired only with a contralateral HA. We have also demonstrated that sensitivity to interaural time difference (ITD) and interaural level difference (ILD) cues is correlated with EAS benefit for postlingually deafened adult listeners. Despite this active phase of discovery, there is still a striking paucity of research on EAS outcomes in pediatric CI users, the expected trajectory of benefit following EAS fitting, as well as underlying mechanisms driving EAS benefit (or lack thereof) in all populations. There is a disconnect between EAS availability and EAS utilization in all CI recipients and current audiological management of EAS candidates is not data driven. This is problematic given the protracted maturation of the binaural system and the fact that we do not understand what additional effects sensorineural hearing loss and combined EAS may have on the developing binaural system. The proposed research activities will describe the time course of binaural development using behavioral and objective responses to interaural differences in timing (phase) and level as well as allow for a natural factor investigation of a clinical intervention, the EAS fitting, on said development. Within the context of a clinical trial, we will compare acute and chronic EAS outcomes for speech recognition and spatial hearing as related to binaural cue sensitivity, cue weighting, and underlying neural synchrony necessary for ITD resolution. We have proposed a single-group assignment for both adult and pediatric EAS users and will also include chronological- and hearing-age-matched listeners with normal hearing (NH). A within-subjects, accelerated longitudinal design for both EAS and NH listeners will provide insight into the developmental trajectory of the binaural system for children NH and will provide a benchmark for interpreting effects of sensorineural hearing loss, asymmetry in audibility resulting from cochlear implantation, and EAS use on said trajectory. Our proposed research activities will help close the gap between what is technologically possible with EAS technology and what is clinically implemented by otologists and audiologists investigating development of binaural sensitivity and spatial hearing abilities. The resultant data will comprise the first comprehensive description of behavioral and electrophysiologic measures of binaural hearing in adults and children both with NH and EAS and will uncover information about our EAS clinical populations holding high potential for clinical application in device fittings as well as audiologic and otologic clinical recommendations regarding cochlear implantation.

项目摘要 用微小创伤性手术技术和漫画电极阵列的人工耳蜗植入已导致 成人和小儿耳蜗植入物（CI）受体的越来越多的患病率有可能合并 电气和双耳声刺激（EAS）。许多研究表明，成年EAS使用者 始终在噪音和空间听力任务中的语音理解表现出重大的好处 与仅与对侧HA配对的CI相比。我们还证明了对室内的敏感性 时间差（ITD）和室内级别差异（ILD）提示与后的EAS益处相关 聋的成人听众。尽管有一个积极的发现阶段，但仍然存在着惊人的研究 儿科CI用户的EAS成果，EAS配套后的预期福利轨迹以及 在所有人群中推动EAS益处（或缺乏）的基本机制。之间有一个脱节 所有CI接收者的EAS可用性和EAS利用率以及EAS的当前听力学管理 候选人不是数据驱动的。鉴于双耳系统的长期成熟，这是有问题的 我们不了解我们不了解什么其他效果感官听力损失和EAS结合的事实可能 具有发展中的双耳系统。拟议的研究活动将描述 使用行为和客观响应对定时（阶段）和 水平以及允许对临床干预的自然因素调查，EAS拟合，上述 发展。在临床试验的背景下，我们将比较急性和慢性EAS结果 语音识别和空间听力与双耳提示敏感性，提示权重和基础有关 ITD解决所需的神经同步。我们已经为两个成年人提出了一个单组分配 和小儿EAS用户，还将包括正常的年代和听觉匹配的听众 听力（NH）。一个受试者内，EA和NH听众的加速纵向设计将提供 深入了解儿童双耳系统的发展轨迹，并将提供基准 为了解释感官听力损失的影响，人工耳蜗导致的可听性不对称性 植入和EAS在上述轨迹上使用。我们提出的研究活动将有助于缩小 EAS技术在技术上可能实现了什么以及耳科医生和 听力学家调查了双耳敏感性和空间听力能力的发展。结果数据 将构成双耳的行为和电生理测量的第一个全面描述 NH和EAS的成人和儿童听证会，并将发现有关我们EAS临床的信息 人群在设备配件以及听力学和耳科中具有很高的临床应用潜力 有关人工耳蜗的临床建议。