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慢性单侧耳蜗内电刺激后中枢听觉通路内自发活动的双侧变化

Bilateral Changes of Spontaneous Activity Within the Central Auditory Pathway Upon Chronic Unilateral Intracochlear Electrical Stimulation.

作者信息

Basta Dietmar, Götze Romy, Gröschel Moritz, Jansen Sebastian, Janke Oliver, Tzschentke Barbara, Boyle Patrick, Ernst Arne

机构信息

*Department of Otolaryngology at ukb, University of Berlin, Charité Medical School, Berlin †Institute of Biology, Humboldt University of Berlin, Berlin ‡Advanced Bionics GmbH, Hannover, Germany.

出版信息

Otol Neurotol. 2015 Dec;36(10):1759-65. doi: 10.1097/MAO.0000000000000894.

Abstract

OBJECTIVES

In recent years, cochlear implants have been applied successfully for the treatment of unilateral hearing loss with quite surprising benefit. One reason for this successful treatment, including the relief from tinnitus, could be the normalization of spontaneous activity in the central auditory pathway because of the electrical stimulation. The present study, therefore, investigated at a cellular level, the effect of a unilateral chronic intracochlear stimulation on key structures of the central auditory pathway.

DESIGN

Normal-hearing guinea pigs were mechanically single-sided deafened through a standard HiFocus1j electrode array (on a HiRes 90k cochlear implant) being inserted into the first turn of the cochlea. Four to five electrode contacts could be used for the stimulation. Six weeks after surgery, the speech processor (Auria) was fitted, based on tNRI values and mounted on the animal's back. The two experimental groups were stimulated 16 hours per day for 90 days, using a HiRes strategy based on different stimulation rates (low rate (275 pps/ch), high rate (5000 pps/ch)). The results were compared with those of unilateral deafened controls (implanted but not stimulated), as well as between the treatment groups. All animals experienced a standardized free field auditory environment.

RESULTS

The low-rate group showed a significantly lower average spontaneous activity bilaterally in the dorsal cochlear nucleus and the medial geniculate body than the controls. However, there was no difference in the inferior colliculus and the primary auditory cortex. Spontaneous activity of the high-rate group was also reduced bilaterally in the dorsal cochlear nucleus and in the primary auditory cortex. No differences could be observed between the high-rate group and the controls in the contra-lateral inferior colliculus and medial geniculate body. The high-rate group showed bilaterally a higher activity in the CN and the MGB compared with the low-rate group, whereas in the IC and in the AC a trend for an opposite effect could be determined.

CONCLUSIONS

Unilateral intracochlear electrical stimulation seems to facilitate the homeostasis of the network activity, since it decreases the spontaneous activity that is usually elevated upon deafferentiation. The electrical stimulation per se seems to be responsible for the bilateral changes described above, rather than the particular nature of the electrical stimulation (e.g., rate). The normalization effects of electrical stimulation found in the present study are of particular importance in cochlear implant recipients with single-sided deafness.

摘要

目的

近年来,人工耳蜗已成功应用于单侧听力损失的治疗,疗效颇为惊人。这种成功治疗的一个原因,包括耳鸣缓解,可能是由于电刺激使中枢听觉通路的自发活动恢复正常。因此,本研究在细胞水平上,研究了单侧慢性耳蜗内刺激对中枢听觉通路关键结构的影响。

设计

通过将标准的HiFocus1j电极阵列(在HiRes 90k人工耳蜗上)插入耳蜗第一圈,使听力正常的豚鼠机械性单侧耳聋。四到五个电极触点可用于刺激。术后六周,根据tNRI值安装言语处理器(Auria)并置于动物背部。两个实验组每天刺激16小时,持续90天,采用基于不同刺激率(低刺激率(275次/秒/通道),高刺激率(5000次/秒/通道))的HiRes策略。将结果与单侧耳聋对照组(植入但未刺激)以及各治疗组之间的结果进行比较。所有动物都经历标准化的自由场听觉环境。

结果

低刺激率组双侧耳蜗背侧核和内侧膝状体的平均自发活动明显低于对照组。然而,下丘和初级听觉皮层没有差异。高刺激率组双侧耳蜗背侧核和初级听觉皮层的自发活动也降低。在对侧下丘和内侧膝状体中,高刺激率组与对照组之间未观察到差异。与低刺激率组相比,高刺激率组双侧耳蜗核和内侧膝状体的活动更高,而在下丘和初级听觉皮层中,可确定存在相反作用的趋势。

结论

单侧耳蜗内电刺激似乎有助于网络活动的稳态,因为它降低了通常在去传入后升高的自发活动。电刺激本身似乎是上述双侧变化的原因,而不是电刺激的特定性质(例如刺激率)。本研究中发现的电刺激的正常化作用在单侧耳聋的人工耳蜗接受者中尤为重要。

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