Clinical programming can limit access to binaural cues in children with bilateral cochlear implants

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY Clinical Neurophysiology Pub Date : 2025-05-01 Epub Date: 2025-03-10 DOI:10.1016/j.clinph.2025.02.271

Angela L. Fung , Alan W. Blakeman , Robel Z. Alemu , Jaina Negandhi , Sharon L. Cushing , Blake C. Papsin , Karen A. Gordon

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Abstract

Objective

In children with bilateral cochlear implants(CIs): 1) quantify cortical access and sensitivity to inter-aural level differences(ILDs); 2) determine if cortical ILD detection predicts ILD perception; and 3) assess demographic and clinical factors that could limit ILD access.

Methods

Cortical detection responses evoked by ILD changes were measured in 22/24 children with bilateral CIs(7 female) using their clinically programmed devices and in 8 children(3 female) with normal hearing. Behavioral lateralization(left vs right perception) to ILDs was also measured.

Results

Increased cortical sensitivity(amplitude) to ILD changes did not predict more accurate behavioral perception; rather children with CIs were able to lateralize ILDs with fair accuracy but with increased cognitive effort(reaction times) compared to normal hearing children (p = 0.0004, Cohen’s d = 1.17). While demographic factors did not significantly contribute to response measures, symmetry of programmed levels in the left and right CIs predicted better cortical and behavioral sensitivity to ILDs (ps < 0.05).

Conclusions

the developing auditory system can detect ILD cues when provided with bilateral cochlear implants; however, this access can be altered by programming and may not translate to normal binaural processing.

Significance

There is potential for clinical programming to improve spatial hearing in children with bilateral CIs.

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临床程序设计可以限制双侧耳蜗植入儿童获得双耳线索

目的：对双侧人工耳蜗（CIs）患儿：1)量化皮质通路和对耳间水平差异（ILDs）的敏感性；2)确定皮层ILD检测是否预测ILD感知；3)评估可能限制ILD获取的人口统计学和临床因素。方法对22/24名双侧CIs患儿（7名女性）和8名听力正常的患儿（3名女性）进行临床程序化装置的皮质检测。对儿童的行为侧化（左感知vs右感知）也进行了测量。结果皮质对ILD变化的敏感性（振幅）增加并不能预测更准确的行为知觉；相反，与正常听力儿童相比，ci儿童能够以相当的准确性偏侧化ild，但认知努力（反应时间）增加（p = 0.0004, Cohen 's d = 1.17）。虽然人口统计学因素对反应测量没有显著影响，但左、右ci编程水平的对称性预示着对ILDs有更好的皮层和行为敏感性(ps <；0.05)。结论双侧人工耳蜗植入后，发育中的听觉系统可检测ILD线索；然而，这种访问可以通过编程改变，并且可能无法转化为正常的双耳处理。意义临床规划有可能改善双侧CIs患儿的空间听力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurophysiology 医学-临床神经学

CiteScore

8.70

自引率

6.40%

发文量

932

审稿时长

59 days

期刊介绍： As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.