双侧人工耳蜗植入患者的电诱发反应与响度增长之间的关系。
Relationships between electrically evoked potentials and loudness growth in bilateral cochlear implant users.
机构信息
Department of Communication Sciences and Disorders, University of Iowa, 250 Hawkins Drive, Iowa City, IA 52242, USA.
出版信息
Ear Hear. 2012 May-Jun;33(3):389-98. doi: 10.1097/AUD.0b013e318239adb8.
OBJECTIVES
The goals of this study were (1) to describe the relationship between electrically evoked compound action potential (ECAP) and electrically evoked auditory brainstem response (EABR) amplitude growth functions and loudness growth functions in bilateral cochlear implant (CI) users, and (2) to determine whether matching the stimulus levels in the two ears of bilateral CI users based on equal ECAP amplitude, EABR amplitude, or current level resulted in the smallest discrepancy in loudness rating across the two ears.
DESIGN
Ten adult, bilateral CI users participated in this study. The stimulus used to elicit loudness judgments and generate ECAP and EABR growth functions was a train of biphasic current pulses (32 μs/phase) presented at a rate of 23 pps. Loudness growth functions were obtained with a method of constant stimuli. ECAPs were measured using the implant telemetry system. EABR growth functions were recorded using surface electrodes and standard averaging techniques. Both ears of each subject were tested. For each ear, ECAP, EABR, and loudness functions were recorded using both an apical and basal stimulating electrode. Both the physiologic and psychophysical growth functions were fit using linear regression techniques.
RESULTS
Comparison of the regression equations obtained for the two ears revealed that stimulus levels that yielded approximately equal ECAP amplitudes in the two ears were judged to differ in loudness, on average, by 20% for electrode 3 and 14% for electrode 13. Stimulation levels that evoked similar amplitude EABRs differed in loudness, on average, by 50% for electrode 3 and 13% for electrode 13. Matched stimulus current levels were judged to differ in loudness, on average, by 14% for electrode 3 and 16% for electrode 13. No significant differences in loudness discrepancy across ears derived from equal amplitude ECAP, EABR, or matched current levels were found.
CONCLUSIONS
This study demonstrated that stimuli that evoke equal amplitude neural responses in both ears of a bilateral CI user or which are matched in current level cannot be assumed to be perceived as equally loud. No statistically significant differences in accuracy were found between ECAP, EABR, or matched current levels or between the basal and apical electrode in approximations of equal loudness.
目的
本研究的目的是：(1)描述双侧人工耳蜗植入（CI）使用者的电诱发复合动作电位（ECAP）和电诱发听觉脑干反应（EABR）幅度增长函数与响度增长函数之间的关系；(2)确定根据双侧 CI 使用者的 ECAP 幅度、EABR 幅度或电流水平匹配双耳刺激水平是否会导致双耳响度评定的差异最小。
设计
本研究纳入了 10 名成年双侧 CI 用户。用于诱发响度判断并产生 ECAP 和 EABR 增长函数的刺激是一个双相电流脉冲（32 μs/相）的序列，以 23pps 的速率呈现。响度增长函数采用恒定刺激法获得。ECAP 通过植入遥测系统进行测量。EABR 增长函数使用表面电极和标准平均技术记录。每位受试者的双耳均进行测试。对于每只耳朵，使用尖端和基底刺激电极记录 ECAP、EABR 和响度函数。使用线性回归技术拟合生理和心理物理增长函数。
结果
比较双耳得到的回归方程发现，在双耳产生大致相等的 ECAP 幅度的刺激水平，被平均判断为在响度上相差 20%，电极 3 为 14%，电极 13 为 14%。引起相似 EABR 幅度的刺激水平，在响度上相差 50%，电极 3 为 13%，电极 13 为 13%。被判断为在响度上相差 14%，电极 3 为 16%，电极 13 为 16%的匹配刺激电流水平。在双耳的响度差异方面，没有发现来自相等 ECAP 幅度、EABR 幅度或匹配电流水平的显著差异。
结论
本研究表明，在双侧 CI 用户的双耳中引起相等幅度的神经反应或匹配电流水平的刺激，不能被认为是同样响亮的。在等响度的近似值中，ECAP、EABR 或匹配电流水平之间或基底和尖端电极之间，没有发现准确性的统计学显著差异。
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