Anderson Carly A, Lazard Diane S, Hartley Douglas E H
National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, United Kingdom; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.
Institut Arthur Vernes, ENT Surgery, Paris, 75006, France; Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, United Kingdom.
Hear Res. 2017 Jan;343:138-149. doi: 10.1016/j.heares.2016.07.013. Epub 2016 Jul 26.
While many individuals can benefit substantially from cochlear implantation, the ability to perceive and understand auditory speech with a cochlear implant (CI) remains highly variable amongst adult recipients. Importantly, auditory performance with a CI cannot be reliably predicted based solely on routinely obtained information regarding clinical characteristics of the CI candidate. This review argues that central factors, notably cortical function and plasticity, should also be considered as important contributors to the observed individual variability in CI outcome. Superior temporal cortex (STC), including auditory association areas, plays a crucial role in the processing of auditory and visual speech information. The current review considers evidence of cortical plasticity within bilateral STC, and how these effects may explain variability in CI outcome. Furthermore, evidence of audio-visual interactions in temporal and occipital cortices is examined, and relation to CI outcome is discussed. To date, longitudinal examination of changes in cortical function and plasticity over the period of rehabilitation with a CI has been restricted by methodological challenges. The application of functional near-infrared spectroscopy (fNIRS) in studying cortical function in CI users is becoming increasingly recognised as a potential solution to these problems. Here we suggest that fNIRS offers a powerful neuroimaging tool to elucidate the relationship between audio-visual interactions, cortical plasticity during deafness and following cochlear implantation, and individual variability in auditory performance with a CI.
虽然许多人能从人工耳蜗植入中大幅受益，但成年人工耳蜗植入受者通过人工耳蜗感知和理解听觉言语的能力仍存在很大差异。重要的是，仅根据关于人工耳蜗候选者临床特征的常规获取信息，无法可靠预测人工耳蜗的听觉表现。本综述认为，中枢因素，尤其是皮质功能和可塑性，也应被视为人工耳蜗结果中观察到的个体差异的重要影响因素。颞上皮质（STC），包括听觉联合区，在听觉和视觉言语信息处理中起关键作用。本综述探讨了双侧STC内皮质可塑性的证据，以及这些效应如何解释人工耳蜗结果的差异。此外，还研究了颞叶和枕叶皮质中视听交互的证据，并讨论了其与人工耳蜗结果的关系。迄今为止，对人工耳蜗康复期间皮质功能和可塑性变化的纵向研究受到方法学挑战的限制。功能近红外光谱（fNIRS）在研究人工耳蜗使用者皮质功能方面的应用日益被视为解决这些问题的潜在方法。在此我们认为，fNIRS提供了一个强大的神经成像工具，以阐明视听交互、耳聋及人工耳蜗植入后皮质可塑性与人工耳蜗听觉表现个体差异之间的关系。
