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A systematic review of acoustic change complex (ACC) measurements and applicability in children for the assessment of the neural capacity for sound and speech discrimination 声学变化综合体 (ACC) 测量的系统性综述及其在儿童声音和语音辨别神经能力评估中的适用性
IF 2.5 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-07-17 DOI: 10.1016/j.heares.2024.109090

Objective

The acoustic change complex (ACC) is a cortical auditory evoked potential (CAEP) and can be elicited by a change in an otherwise continuous sound. The ACC has been highlighted as a promising tool in the assessment of sound and speech discrimination capacity, and particularly for difficult-to-test populations such as infants with hearing loss, due to the objective nature of ACC measurements. Indeed, there is a pressing need to develop further means to accurately and thoroughly establish the hearing status of children with hearing loss, to help guide hearing interventions in a timely manner. Despite the potential of the ACC method, ACC measurements remain relatively rare in a standard clinical settings. The objective of this study was to perform an up-to-date systematic review on ACC measurements in children, to provide greater clarity and consensus on the possible methodologies, applications, and performance of this technique, and to facilitate its uptake in relevant clinical settings.

Design

Original peer-reviewed articles conducting ACC measurements in children (< 18 years). Data were extracted and summarised for: (1) participant characteristics; (2) ACC methods and auditory stimuli; (3) information related to the performance of the ACC technique; (4) ACC measurement outcomes, advantages, and challenges. The systematic review was conducted using PRISMA guidelines for reporting and the methodological quality of included articles was assessed.

Results

A total of 28 studies were identified (9 infant studies). Review results show that ACC responses can be measured in infants (from < 3 months), and there is evidence of age-dependency, including increased robustness of the ACC response with increasing childhood age. Clinical applications include the measurement of the neural capacity for speech and non-speech sound discrimination in children with hearing loss, auditory neuropathy spectrum disorder (ANSD) and central auditory processing disorder (CAPD). Additionally, ACCs can be recorded in children with hearing aids, auditory brainstem implants, and cochlear implants, and ACC results may guide hearing intervention/rehabilitation strategies. The review identified that the time taken to perform ACC measurements was often lengthy; the development of more efficient ACC test procedures for children would be beneficial. Comparisons between objective ACC measurements and behavioural measures of sound discrimination showed significant correlations for some, but not all, included studies.

Conclusions

ACC measurements of the neural capacity to discriminate between speech and non-speech sounds are feasible in infants and children, and a wide range of possible clinical applications exist, although more time-efficient procedures would be advantageous for clinical uptake. A consideration of age and maturational effects is recommended, and further research is r

目的声变化复合体(ACC)是一种皮层听觉诱发电位(CAEP),可由原本连续的声音变化引起。由于 ACC 测量的客观性,ACC 已成为评估声音和言语分辨能力的一种很有前途的工具,特别是对于听力损失婴儿等难以测试的人群。事实上,我们迫切需要开发更多的方法来准确、全面地确定听力损失儿童的听力状况,以帮助及时指导听力干预措施。尽管 ACC 方法很有潜力,但在标准临床环境中,ACC 测量仍相对罕见。本研究的目的是对儿童 ACC 测量方法进行最新的系统综述,以便就该技术的可能方法、应用和性能达成更清晰的共识,并促进其在相关临床环境中的应用。提取并总结了以下数据(1) 参与者特征;(2) ACC 方法和听觉刺激;(3) 与 ACC 技术性能相关的信息;(4) ACC 测量结果、优势和挑战。系统综述采用 PRISMA 报告指南进行,并对纳入文章的方法学质量进行了评估。综述结果表明,可以测量婴儿(3 个月以上)的 ACC 反应,而且有证据表明存在年龄依赖性,包括随着儿童年龄的增加,ACC 反应的稳健性也会增加。临床应用包括测量听力损失、听觉神经病谱系障碍(ANSD)和中枢听觉处理障碍(CAPD)儿童的语言和非语言声音分辨神经能力。此外,助听器、听觉脑干植入体和人工耳蜗植入体也可记录听觉神经元的听觉分辨能力,听觉神经元的听觉分辨能力结果可为听力干预/康复策略提供指导。审查发现,进行 ACC 测量通常需要很长时间;为儿童开发更高效的 ACC 测试程序将大有裨益。客观的 ACC 测量结果与声音辨别行为测量结果之间的比较显示,部分(但非全部)纳入研究的结果存在显著相关性。建议考虑年龄和成熟度的影响,还需要进一步研究 ACC 客观测量与声音和语言感知行为测量之间的关系,以便有效地应用于临床。
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引用次数: 0
Binaural interaction in human auditory brainstem and middle-latency responses affected by sound frequency band, lateralization predictability, and attended modality 人类听觉脑干和中耳反应中的双耳交互作用受声音频段、侧向可预测性和听觉模式的影响
IF 2.5 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-07-17 DOI: 10.1016/j.heares.2024.109089

The binaural interaction component (BIC) of the auditory evoked potential is the difference between the waveforms of the binaural response and the sum of left and right monaural responses. This investigation examined BICs of the auditory brainstem (ABR) and middle-latency (MLR) responses concerning three objectives: 1) the level of the auditory system at which low-frequency dominance in BIC amplitudes begins when the binaural temporal fine structure is more influential with lower- than higher-frequency content; 2) how BICs vary as a function of frequency and lateralization predictability, as could relate to the improved lateralization of high-frequency sounds; 3) how attention affects BICs. Sixteen right-handed participants were presented with either low-passed (< 1000 Hz) or high-passed (> 2000 Hz) clicks at 30 dB SL with a 38 dB (A) masking noise, at a stimulus onset asynchrony of 180 ms. Further, this repeated-measures design manipulated stimulus presentation (binaural, left monaural, right monaural), lateralization predictability (unpredictable, predictable), and attended modality (either auditory or visual). For the objectives, respectively, the results were: 1) whereas low-frequency dominance in BIC amplitudes began during, and continued after, the Na-BIC, binaural (center) as well as summed monaural (left and right) amplitudes revealed low-frequency dominance only after the Na wave; 2) with a predictable position that was fixed, no BIC exhibited equivalent amplitudes between low- and high-passed clicks; 3) whether clicks were low- or high-passed, selective attention affected the ABR-BIC yet not MLR-BICs. These findings indicate that low-frequency dominance in lateralization begins at the Na latency, being independent of the efferent cortico-collicular pathway's influence.

听觉诱发电位的双耳交互成分(BIC)是双耳反应波形与左右单耳反应波形之和的差值。本研究就三个目标对听觉脑干(ABR)和中频段(MLR)反应的双耳交互分量进行了研究:1)当双耳时间精细结构对低频内容的影响大于高频内容时,BIC 振幅中的低频优势开始于听觉系统的哪个层次;2)BIC 如何随频率和侧化可预测性的变化而变化,这可能与高频声音的侧化改善有关;3)注意力如何影响 BIC。研究人员向 16 名右撇子参与者展示了低通(1000 Hz)或高通(2000 Hz)的咔嗒声,频率为 30 dB SL,并伴有 38 dB (A) 的掩蔽噪声,刺激开始时的异步时间为 180 ms。此外,这种重复测量设计还操纵了刺激呈现(双耳、左单耳、右单耳)、侧向可预测性(不可预测、可预测)和被试模式(听觉或视觉)。结果分别为1)虽然 BIC 振幅中的低频优势开始于 Na-BIC 期间,并持续于 Na-BIC 之后,但双耳(中央)以及单耳(左侧和右侧)振幅总和仅在 Na 波之后才显示出低频优势;2)在可预测位置固定的情况下,低通和高通点击之间没有任何 BIC 显示出相同的振幅;3)无论点击是低通还是高通,选择性注意都会影响 ABR-BIC,但不会影响 MLR-BIC。这些发现表明,侧化中的低频优势始于 Na 潜伏期,与传出皮质-脑室通路的影响无关。
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引用次数: 0
The contribution of short-term memory for sound features to speech-in-noise perception and cognition 声音特征的短期记忆对噪声中语音感知和认知的贡献。
IF 2.5 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-07-11 DOI: 10.1016/j.heares.2024.109081

Speech-in-noise (SIN) perception is a fundamental ability that declines with aging, as does general cognition. We assess whether auditory cognitive ability, in particular short-term memory for sound features, contributes to both. We examined how auditory memory for fundamental sound features, the carrier frequency and amplitude modulation rate of modulated white noise, contributes to SIN perception. We assessed SIN in 153 healthy participants with varying degrees of hearing loss using measures that require single-digit perception (the Digits-in-Noise, DIN) and sentence perception (Speech-in-Babble, SIB). Independent variables were auditory memory and a range of other factors including the Pure Tone Audiogram (PTA), a measure of dichotic pitch-in-noise perception (Huggins pitch), and demographic variables including age and sex. Multiple linear regression models were compared using Bayesian Model Comparison. The best predictor model for DIN included PTA and Huggins pitch (r2 = 0.32, p < 0.001), whereas the model for SIB included the addition of auditory memory for sound features (r2 = 0.24, p < 0.001). Further analysis demonstrated that auditory memory also explained a significant portion of the variance (28 %) in scores for a screening cognitive test for dementia. Auditory memory for non-speech sounds may therefore provide an important predictor of both SIN and cognitive ability.

噪音中的语音(SIN)感知是一种基本能力,但随着年龄的增长,这种能力也会下降,一般认知能力也是如此。我们评估了听觉认知能力,尤其是对声音特征的短期记忆,是否对两者都有影响。我们研究了对基本声音特征的听觉记忆,即调制白噪声的载波频率和振幅调制率是如何影响 SIN 感知的。我们使用需要个位数感知(Digits-in-Noise,DIN)和句子感知(Speech-in-Babble,SIB)的测量方法,对 153 名不同程度听力损失的健康参与者进行了 SIN 评估。自变量是听觉记忆和一系列其他因素,包括纯音听力图(PTA)、噪声中二分音高感知测量(Huggins 音高)以及包括年龄和性别在内的人口统计学变量。使用贝叶斯模型比较法对多元线性回归模型进行了比较。DIN 的最佳预测模型包括 PTA 和 Huggins pitch(r2 = 0.32,p < 0.001),而 SIB 的预测模型则包括对声音特征的听觉记忆(r2 = 0.24,p < 0.001)。进一步的分析表明,听觉记忆也能解释痴呆筛查认知测试得分的很大一部分差异(28%)。因此,对非语音声音的听觉记忆可能是预测 SIN 和认知能力的重要指标。
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引用次数: 0
Adaptive Strategies of Single-Sided Deaf Cochlear-Implant Users Revealed Through Resting State Activity: an Auditory PET Brain Imaging Study 静息状态和任务相关活动对 SSD-CI 患者适应策略的启示:PET 脑成像研究。
IF 2.5 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-07-11 DOI: 10.1016/j.heares.2024.109079

Brain plasticity refers to the brain's ability to reorganize its structure or function in response to experiences, learning, and environmental influences. This phenomenon is particularly significant in individuals with deafness, as the brain adapts to compensate for the lack of auditory stimulation. The aim of this study is to investigate whether cochlear implantation can restore a normal pattern of brain activation following auditory stimulation in cases of asymmetric hearing loss. We used a PET-scan technique to assess brain activity after cochlear implantation, specifically during an auditory voice/non-voice discrimination task. The results indicated a nearly normal pattern of brain activity during the auditory discrimination task, except for increased activation in areas related to attentional processes compared to controls. Additionally, brain activity at rest showed significant changes in implanted participants, including cross modal visuo-auditory processing. Therefore, cochlear implants can restore the brain's activation pattern through long-term adaptive adjustments in intrinsic brain activity.

大脑可塑性是指大脑根据经验、学习和环境影响重组其结构或功能的能力。这种现象对耳聋患者尤为重要,因为大脑会进行调整以补偿听觉刺激的缺失。本研究旨在探讨人工耳蜗植入是否能使非对称听力损失患者的大脑在受到听觉刺激后恢复正常的激活模式。我们使用 PET 扫描技术评估人工耳蜗植入后的大脑活动,特别是在听觉声音/非声音辨别任务中的大脑活动。结果表明,与对照组相比,听觉辨别任务中的大脑活动几乎正常,只是与注意力过程相关的区域的激活增加了。此外,植入者在休息时的大脑活动也发生了显著变化,包括跨模态视听处理。因此,人工耳蜗可以通过对大脑固有活动的长期适应性调整来恢复大脑的激活模式。
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引用次数: 0
Effect of stimulus duration on estimates of human cochlear tuning 刺激持续时间对人类耳蜗调谐估计值的影响
IF 2.5 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-07-11 DOI: 10.1016/j.heares.2024.109080

Auditory masking methods originally employed to assess behavioral frequency selectivity have evolved over the years to infer cochlear tuning. Behavioral forward masking thresholds for spectrally notched noise maskers and a fixed, low-level probe tone provide accurate estimates of cochlear tuning. Here, we use this method to investigate the effect of stimulus duration on human cochlear tuning at 500 Hz and 4 kHz. Probes were 20-ms sinusoids at 10 dB sensation level. Maskers were noises with a spectral notch symmetrically and asymmetrically placed around the probe frequency. For seven participants with normal hearing, masker levels at masking threshold were measured in forward masking for various notch widths and for masker durations of 30 and 400 ms. Measurements were fitted assuming rounded exponential filter shapes and the power spectrum model of masking, and equivalent rectangular bandwidths (ERBs) were inferred from the fits. At 4 kHz, masker thresholds were higher for the shorter maskers but ERBs were not significantly different for the two masker durations (ERB30ms=294 Hz vs. ERB400ms=277 Hz). At 500 Hz, by contrast, notched-noise curves were shallower for the 30-ms than the 400-ms masker, and ERBs were significantly broader for the shorter masker (ERB30ms=126 Hz vs. ERB400ms=55 Hz). We discuss possible factors that may underlay the duration effect at low frequencies and argue that it may not be possible to fully control for those factors. We conclude that tuning estimates are not affected by maker duration at high frequencies but should be measured and interpreted with caution at low frequencies.

最初用于评估行为频率选择性的听觉掩蔽方法经过多年的发展,已经可以用来推断耳蜗调谐。对频谱缺口噪声掩蔽器和固定的低水平探测音的行为前向掩蔽阈值可以准确估计耳蜗调谐。在这里,我们使用这种方法来研究刺激持续时间对人类耳蜗在 500 Hz 和 4 kHz 频率上的调谐的影响。探头为 20 毫秒的正弦波,感度为 10 分贝。掩蔽物是在探头频率周围对称和不对称放置的带有频谱缺口的噪音。对 7 名听力正常的参与者进行了前向掩蔽测量,测量了不同缺口宽度和掩蔽持续时间(30 和 400 毫秒)下掩蔽阈值的掩蔽水平。测量结果被假定为圆形指数滤波器形状和掩蔽的功率谱模型,并根据拟合结果推断出等效矩形带宽(ERB)。在 4 kHz 时,较短掩蔽器的掩蔽阈值较高,但两种掩蔽器持续时间的等效矩形带宽没有显著差异(ERB30ms=294 Hz vs. ERB400ms=277 Hz)。相比之下,在 500 Hz 时,30 毫秒掩蔽器的缺口噪声曲线比 400 毫秒掩蔽器的缺口噪声曲线浅,而较短掩蔽器的 ERB 明显较宽(ERB30 毫秒=126 Hz vs. ERB400 毫秒=55 Hz)。我们讨论了可能导致低频时长效应的因素,并认为不可能完全控制这些因素。我们的结论是,调谐估计值在高频率时不受制音器持续时间的影响,但在低频时应谨慎测量和解释。
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引用次数: 0
Musicians have an advantage on a spatial-hearing task only when they are highly trained, start training early, and continue to play 音乐家只有在训练有素、很早就开始训练并持续演奏的情况下,才会在空间听觉任务中具有优势
IF 2.5 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-07-10 DOI: 10.1016/j.heares.2024.109078

Musicians perform better than non-musicians on a variety of non-musical sound-perception tasks. Whether that musicians’ advantage extends to spatial hearing is a topic of increasing interest. Here we investigated one facet of that topic by assessing musicians’ and non-musicians’ sensitivity to the two primary cues to sound-source location on the horizontal plane: interaural-level-differences (ILDs) and interaural-time-differences (ITDs). Specifically, we measured discrimination thresholds for ILDs at 4 kHz (n =246) and ITDs at 0.5 kHz (n = 137) in participants whose musical-training histories covered a wide range of lengths, onsets, and offsets. For ILD discrimination, when only musical-training length was considered in the analysis, no musicians’ advantage was apparent. However, when thresholds were compared between subgroups of non-musicians (<2 years of training) and extreme musicians (≥10 years of training, started ≤ age 7, still playing) a musicians’ advantage emerged. Threshold comparisons between the extreme musicians and other subgroups of highly trained musicians (≥10 years of training) further indicated that the advantage required both starting young and continuing to play. In addition, the advantage was larger in males than in females, by some measures, and was not evident in an assessment of learning. For ITD discrimination, in contrast to ILD discrimination, parallel analyses revealed no apparent musicians’ advantage. The results suggest that musicianship is associated with greater sensitivity to ILDs, a fundamental sound-localization cue, even though that sensitivity is not central to music, that this musicians’ advantage arises, at least in part, from nurture, and that it is governed by a neural substrate where ILDs are processed separately from, and more malleably than, ITDs.

在各种非音乐性声音感知任务中,音乐家的表现都优于非音乐家。音乐家的这种优势是否会延伸到空间听觉上,这是一个越来越受关注的话题。在这里,我们通过评估音乐家和非音乐家对水平面上声源位置的两个主要线索的敏感度:耳间级差(ILDs)和耳间时差(ITDs),对该课题的一个方面进行了研究。具体来说,我们测量了参与者对 4 kHz 的 ILD(n = 246)和 0.5 kHz 的 ITD(n = 137)的辨别阈值。对于 ILD 的辨别能力,如果分析中只考虑音乐训练的长度,则音乐家的优势并不明显。然而,当比较非音乐家(2 年训练)和极端音乐家(≥10 年训练,7 岁以下开始,仍在演奏)两个亚组之间的阈值时,音乐家的优势就显现出来了。极端音乐家与其他训练有素的音乐家(训练时间≥10 年)分组之间的阈值比较进一步表明,音乐家的优势需要从小开始并持续演奏。此外,从某些指标来看,男性的优势大于女性,这在学习评估中并不明显。在 ITD 辨别力方面,与 ILD 辨别力相反,平行分析没有发现明显的音乐家优势。这些结果表明,音乐家的身份与对 ILD(一种基本的声音定位线索)更高的敏感性有关,尽管这种敏感性并非音乐的核心;音乐家的这种优势至少部分来自于后天的培养;而且这种优势受神经基质的支配,在神经基质中,ILD 与 ITD 分开处理,而且比 ITD 更易加工。
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引用次数: 0
Parallel EEG assessment of different sound predictability levels in tinnitus 对耳鸣中不同声音可预测性水平的平行脑电图评估
IF 2.5 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-07-06 DOI: 10.1016/j.heares.2024.109073
Pia Brinkmann , Jana V.P. Devos , Jelle H.M. van der Eerden , Jasper V. Smit , Marcus L.F. Janssen , Sonja A. Kotz , Michael Schwartze

Tinnitus denotes the perception of a non-environmental sound and might result from aberrant auditory prediction. Successful prediction of formal (e.g., type) and temporal sound characteristics facilitates the filtering of irrelevant information, also labelled as ‘sensory gating’ (SG). Here, we explored if and how parallel manipulations of formal prediction violations and temporal predictability affect SG in persons with and without tinnitus. Age-, education- and sex-matched persons with and without tinnitus (N = 52) participated and listened to paired-tone oddball sequences, varying in formal (standard vs. deviant pitch) and temporal predictability (isochronous vs. random timing). EEG was recorded from 128 channels and data were analyzed by means of temporal spatial principal component analysis (tsPCA). SG was assessed by amplitude suppression for the 2nd tone in a pair and was observed in P50-like activity in both timing conditions and groups. Correspondingly, deviants elicited overall larger amplitudes than standards. However, only persons without tinnitus displayed a larger N100-like deviance response in the isochronous compared to the random timing condition. This result might imply that persons with tinnitus do not benefit similarly as persons without tinnitus from temporal predictability in deviance processing. Thus, persons with tinnitus might display less temporal sensitivity in auditory processing than persons without tinnitus.

耳鸣表示对非环境声音的感知,可能是由于听觉预测失常造成的。成功预测声音的形式特征(如类型)和时间特征有助于过滤无关信息,这也被称为 "感觉门控"(SG)。在此,我们探讨了并行处理形式预测违规和时间可预测性是否以及如何影响耳鸣患者和非耳鸣患者的 SG。年龄、学历和性别相匹配的耳鸣患者和非耳鸣患者(N = 52)参与并聆听了配对音奇数序列,这些序列在形式(标准音高与偏差音高)和时间可预测性(等时与随机计时)方面各不相同。脑电图由 128 个通道记录,数据通过时空主成分分析法(tsPCA)进行分析。SG 通过一对音调中第二个音调的振幅抑制进行评估,并在两种计时条件和两组中观察到类似 P50 的活动。相应地,偏差者引起的振幅总体上大于标准者。然而,与随机计时条件相比,只有没有耳鸣的人在等时计时条件下表现出更大的 N100 类偏差反应。这一结果可能意味着,在偏差处理过程中,耳鸣患者无法像无耳鸣患者一样从时间可预测性中获益。因此,与没有耳鸣的人相比,耳鸣患者在听觉处理过程中对时间的敏感性可能较低。
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引用次数: 0
Duration of cochlear implant use in children with prelingual single-sided deafness is a predictor of word perception in the CI ear 语前单侧耳聋儿童使用人工耳蜗的持续时间可预测 CI 耳的字词感知能力
IF 2.5 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-07-05 DOI: 10.1016/j.heares.2024.109076
Tine Arras , An Boudewyns , Ingeborg Dhooge , Andrzej Zarowski , Birgit Philips , Christian Desloovere , Jan Wouters , Astrid van Wieringen

As part of a longitudinal study regarding the benefit of early cochlear implantation for children with single-sided deafness, the current work explored the children's daily device use, potential barriers to full-time device use, and the children's ability to understand speech with the cochlear implant (CI). Data were collected from 20 children with prelingual SSD who received a CI before the age of 2.5 years, from the initial activation of the sound processor until the children were 4.8 to 11.0 years old. Daily device use was extracted from the CI's data logging, while word perception in quiet was assessed using direct audio input to the children's sound processor. The children's caregivers completed a questionnaire about habits, motivations, and barriers to device use.

The children with SSD and a CI used their device on average 8.3 h per day, corresponding to 63 % of their time spent awake. All children except one could understand speech through the CI, with an average score of 59 % on a closed-set test and 73 % on an open-set test. More device use was associated with higher speech perception scores. Parents were happy with their decision to pursue a CI for their child. Certain habits, like taking off the sound processor during illness, were associated with lower device use. Providing timely counselling to the children's parents, focused on SSD-specific challenges, may be helpful to improve daily device use in these children.

作为一项关于单侧耳聋儿童早期植入人工耳蜗的益处的纵向研究的一部分,本研究探讨了儿童的日常设备使用情况、全日制设备使用的潜在障碍以及儿童使用人工耳蜗(CI)理解语言的能力。我们收集了 20 名在 2.5 岁前接受 CI 的舌前 SSD 儿童的数据,这些儿童从最初激活声音处理器到 4.8 至 11.0 岁。从人工耳蜗的数据记录中提取了设备的日常使用情况,同时使用直接输入到儿童声音处理器的音频对安静环境中的字词感知进行了评估。患有 SSD 并配有 CI 的儿童平均每天使用设备 8.3 小时,相当于其清醒时间的 63%。除一名儿童外,所有儿童都能通过 CI 理解语音,在封闭集测试中的平均得分为 59%,在开放集测试中的平均得分为 73%。使用设备越多,语言感知得分越高。家长们对为孩子安装人工耳蜗的决定感到满意。某些习惯(如生病时关闭声音处理器)与设备使用率较低有关。为儿童的父母提供及时的辅导,重点关注额外听力障碍的具体挑战,可能有助于提高这些儿童的日常设备使用率。
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引用次数: 0
Neurocognitive outcomes in young adults with cochlear implants: The role of early language access and crossmodal plasticity 植入人工耳蜗的年轻成人的神经认知结果:早期语言接触和跨模态可塑性的作用
IF 2.5 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-07-03 DOI: 10.1016/j.heares.2024.109074

Many children with profound hearing loss have received cochlear implants (CI) to help restore some sense of hearing. There is, however, limited research on long-term neurocognitive outcomes in young adults who have grown up hearing through a CI. This study compared the cognitive outcomes of early-implanted (n = 20) and late-implanted (n = 21) young adult CI users, and typically hearing (TH) controls (n=56), all of whom were enrolled in college. Cognitive fluidity, nonverbal intelligence, and American Sign Language (ASL) comprehension were assessed, revealing no significant differences in cognition and nonverbal intelligence between the early and late-implanted groups. However, there was a difference in ASL comprehension, with the late-implanted group having significantly higher ASL comprehension. Although young adult CI users showed significantly lower scores in a working memory and processing speed task than TH age-matched controls, there were no significant differences in tasks involving executive function shifting, inhibitory control, and episodic memory between young adult CI and young adult TH participants. In an exploratory analysis of a subset of CI participants (n = 17) in whom we were able to examine crossmodal plasticity, we saw greater evidence of crossmodal recruitment from the visual system in late-implanted compared with early-implanted CI young adults. However, cortical visual evoked potential latency biomarkers of crossmodal plasticity were not correlated with cognitive measures or ASL comprehension. The results suggest that in the late-implanted CI users, early access to sign language may have served as a scaffold for appropriate cognitive development, while in the early-implanted group early access to oral language benefited cognitive development. Furthermore, our results suggest that the persistence of crossmodal neuroplasticity into adulthood does not necessarily impact cognitive development. In conclusion, early access to language – spoken or signed – may be important for cognitive development, with no observable effect of crossmodal plasticity on cognitive outcomes.

许多患有深度听力损失的儿童都接受了人工耳蜗植入(CI),以帮助他们恢复一定程度的听觉。然而,对通过 CI 获得听力的年轻成人的长期神经认知结果的研究却很有限。本研究比较了早期植入(20 人)和晚期植入(21 人)的年轻成年 CI 使用者与典型听力(TH)对照组(56 人)的认知结果,所有这些人都在大学就读。对认知流畅性、非语言智能和美国手语(ASL)理解能力进行了评估,结果显示早期植入组和晚期植入组在认知和非语言智能方面没有显著差异。然而,美国手语(ASL)的理解能力存在差异,晚植入组的美国手语(ASL)理解能力明显较高。虽然年轻的成年 CI 使用者在工作记忆和处理速度任务中的得分明显低于与 TH 年龄匹配的对照组,但在涉及执行功能转移、抑制控制和外显记忆的任务中,年轻的成年 CI 参与者和年轻的成年 TH 参与者之间没有明显差异。在对能够检查跨模态可塑性的一部分 CI 参与者(n = 17)进行的探索性分析中,我们发现与早期植入 CI 的年轻人相比,晚期植入 CI 的年轻人视觉系统的跨模态招募证据更多。然而,皮层视觉诱发电位潜伏期的跨模态可塑性生物标记与认知测量或 ASL 理解能力并不相关。这些结果表明,在晚期植入 CI 的使用者中,早期接触手语可能是适当认知发展的支架,而在早期植入 CI 的群体中,早期接触口语则有利于认知发展。此外,我们的研究结果表明,跨模态神经可塑性持续到成年并不一定会影响认知发展。总之,早期接触语言--口语或手语--可能对认知发展很重要,而跨模态可塑性对认知结果没有明显影响。
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引用次数: 0
Effects of pulse shape on pitch sensitivity of cochlear implant users 脉冲形状对人工耳蜗使用者音高敏感度的影响
IF 2.5 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Pub Date : 2024-07-03 DOI: 10.1016/j.heares.2024.109075
Niyazi O. Arslan, Xin Luo

Contemporary cochlear implants (CIs) use cathodic-leading symmetric biphasic (C-BP) pulses for electrical stimulation. It remains unclear whether asymmetric pulses emphasizing the anodic or cathodic phase may improve spectral and temporal coding with CIs. This study tested place- and temporal-pitch sensitivity with C-BP, anodic-centered triphasic (A-TP), and cathodic-centered triphasic (C-TP) pulse trains on apical, middle, and basal electrodes in 10 implanted ears. Virtual channel ranking (VCR) thresholds (for place-pitch sensitivity) were measured at both a low and a high pulse rate of 99 (Experiment 1) and 1000 (Experiment 2) pulses per second (pps), and amplitude modulation frequency ranking (AMFR) thresholds (for temporal-pitch sensitivity) were measured at a 1000-pps pulse rate in Experiment 3. All stimuli were presented in monopolar mode. Results of all experiments showed that detection thresholds, most comfortable levels (MCLs), VCR thresholds, and AMFR thresholds were higher on more basal electrodes. C-BP pulses had longer active phase duration and thus lower detection thresholds and MCLs than A-TP and C-TP pulses. Compared to C-TP pulses, A-TP pulses had lower detection thresholds at the 99-pps but not the 1000-pps pulse rate, and had lower MCLs at both pulse rates. A-TP pulses led to lower VCR thresholds than C-BP pulses, and in turn than C-TP pulses, at the 1000-pps pulse rate. However, pulse shape did not affect VCR thresholds at the 99-pps pulse rate (possibly due to the fixed temporal pitch) or AMFR thresholds at the 1000-pps pulse rate (where the overall high performance may have reduced the changes with different pulse shapes). Notably, stronger polarity effect on VCR thresholds (or more improvement in VCR with A-TP than with C-TP pulses) at the 1000-pps pulse rate was associated with stronger polarity effect on detection thresholds at the 99-pps pulse rate (consistent with more degeneration of auditory nerve peripheral processes). The results suggest that A-TP pulses may improve place-pitch sensitivity or spectral coding for CI users, especially in situations with peripheral process degeneration.

现代人工耳蜗(CI)使用阴极引导的对称双相(C-BP)脉冲进行电刺激。强调阳极或阴极相位的非对称脉冲是否能改善 CI 的频谱和时间编码,目前仍不清楚。本研究在 10 个植入耳的顶端、中间和基底电极上使用 C-BP、阳极中心三相(A-TP)和阴极中心三相(C-TP)脉冲串测试了位置和时间音高灵敏度。虚拟通道排序(VCR)阈值(表示位置-音调敏感度)是在每秒 99(实验 1)和 1000(实验 2)脉冲的低脉冲率和高脉冲率下测量的,而振幅调制频率排序(AMFR)阈值(表示时间-音调敏感度)是在实验 3 的 1000pps 脉冲率下测量的。所有刺激均以单极模式呈现。所有实验的结果都表明,在较基底的电极上,检测阈值、最舒适水平(MCL)、VCR阈值和AMFR阈值都较高。与 A-TP 和 C-TP 脉冲相比,C-BP 脉冲的活动相位持续时间更长,因此检测阈值和 MCL 更低。与 C-TP 脉冲相比,A-TP 脉冲在 99-pps 脉冲速率下的检测阈值较低,但在 1000-pps 脉冲速率下的检测阈值较低,并且在两种脉冲速率下的 MCL 都较低。在 1000pps 脉冲频率下,A-TP 脉冲的 VCR 阈值低于 C-BP 脉冲,进而低于 C-TP 脉冲。然而,脉冲形状并不影响 99-pps 脉冲频率下的 VCR 阈值(可能是由于固定的时间间距),也不影响 1000-pps 脉冲频率下的 AMFR 阈值(在这种情况下,整体的高性能可能会降低不同脉冲形状的变化)。值得注意的是,在 1000pps 脉冲频率下,VCR阈值的极性效应更强(或 A-TP 脉冲比 C-TP 脉冲对 VCR 的改善更大),而在 99pps 脉冲频率下,检测阈值的极性效应也更强(这与听觉神经外周过程的退化程度更高一致)。这些结果表明,A-TP 脉冲可能会提高 CI 用户的位置-音高灵敏度或频谱编码,尤其是在外周过程退化的情况下。
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引用次数: 0
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Hearing Research
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