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.

项目概要 采用微创手术技术和无创电极阵列的人工耳蜗植入已导致 成人和儿童人工耳蜗 (CI) 接受者的患病率不断增加，有可能合并 电和双耳声刺激 (EAS)。许多研究表明，成人 EAS 用户 在噪声和空间听力任务中始终表现出对语音理解的显着益处，例如 与仅与对侧 HA 配对的 CI 相比。我们还证明了对耳间的敏感性 时间差 (ITD) 和耳间电平差 (ILD) 线索与 EAS 对语后治疗的益处相关 聋哑的成年听众。尽管处于这一活跃的发现阶段，但对这方面的研究仍然严重缺乏 儿科 CI 用户的 EAS 结果、EAS 安装后的预期获益轨迹，以及 推动所有人群 EAS 受益（或缺乏）的根本机制。之间存在脱节 所有 CI 接受者中的 EAS 可用性和 EAS 使用率以及当前 EAS 的听力学管理 候选人不是数据驱动的。考虑到双耳系统的长期成熟和 事实上，我们不了解感音神经性听力损失和联合 EAS 可能产生哪些额外影响 对正在发展的双耳系统有影响。拟议的研究活动将描述的时间进程 双耳发育利用对耳间时间（相位）差异的行为和客观反应 水平以及允许对临床干预进行自然因素调查，EAS 配件， 发展。在临床试验中，我们将比较急性和慢性 EAS 的结果： 语音识别和空间听觉与双耳提示敏感性、提示权重和潜在相关 ITD 解析所需的神经同步。我们建议成人进行单组作业 和儿科 EAS 用户，还包括按时间顺序和听力年龄匹配且具有正常听力的听众。 听力（NH）。针对 EAS 和 NH 听众的受试者内加速纵向设计将为 深入了解NH儿童双耳系统的发展轨迹，并提供基准 用于解释感音神经性听力损失、耳蜗导致的听觉不对称的影响 植入，以及 EAS 在所述轨迹上的使用。我们提出的研究活动将有助于缩小之间的差距 EAS 技术在技术上可行以及耳科医生在临床上实施了什么 听力学家研究双耳敏感性和空间听力能力的发展。结果数据 将首次全面描述双耳的行为和电生理测量 患有 NH 和 EAS 的成人和儿童的听力，并将揭示有关我们的 EAS 临床的信息 在设备配件以及听力学和耳科临床应用方面具有较高潜力的人群 有关人工耳蜗植入的临床建议。