Department of Otolaryngology, New York University School of Medicine, New York, New York, USA.
Ear Hear. 2018 Jan/Feb;39(1):60-68. doi: 10.1097/AUD.0000000000000463.
A postlingually implanted adult typically develops hearing with an intact auditory system, followed by periods of deafness (or near deafness) and adaptation to the implant. For an early implanted child whose brain is highly plastic, the auditory system matures with consistent input from a cochlear implant. It is likely that the auditory system of early implanted cochlear implant users is fundamentally different than postlingually implanted adults. The purpose of this study is to compare the basic psychophysical capabilities and limitations of these two populations on a spectral resolution task to determine potential effects of early deprivation and plasticity.
Performance on a spectral resolution task (Spectral-temporally Modulated Ripple Test [SMRT]) was measured for 20 bilaterally implanted, prelingually deafened children (between 5 and 13 years of age) and 20 hearing children within the same age range. Additionally, 15 bilaterally implanted, postlingually deafened adults, and 10 hearing adults were tested on the same task. Cochlear implant users (adults and children) were tested bilaterally, and with each ear alone. Hearing listeners (adults and children) were tested with the unprocessed SMRT and with a vocoded version that simulates an 8-channel cochlear implant.
For children with normal hearing, a positive correlation was found between age and SMRT score for both the unprocessed and vocoded versions. Older hearing children performed similarly to hearing adults in both the unprocessed and vocoded test conditions. However, for children with cochlear implants, no significant relationship was found between SMRT score and chronological age, age at implantation, or years of implant experience. Performance by children with cochlear implants was poorer than performance by cochlear implanted adults. It was also found that children implanted sequentially tended to have better scores with the first implant compared with the second implant. This difference was not observed for adults. An additional finding was that SMRT score was negatively correlated with age for adults with implants.
Results from this study suggest that basic psychophysical capabilities of early implanted children and postlingually implanted adults differ when assessed in the sound field using their personal implant processors. Because spectral resolution does not improve with age for early implanted children, it seems likely that the sparse representation of the signal provided by a cochlear implant limits spectral resolution development. These results are supported by the finding that postlingually implanted adults, whose auditory systems matured before the onset of hearing loss, perform significantly better than early implanted children on the spectral resolution test.
后天植入人工耳蜗的成年人通常在听觉系统完好的情况下获得听力,随后经历一段时间的耳聋(或接近耳聋)并适应植入物。对于大脑具有高度可塑性的早期植入人工耳蜗的儿童,听觉系统会随着人工耳蜗的持续输入而成熟。早期植入人工耳蜗的使用者的听觉系统可能与后天植入人工耳蜗的成年人有根本的不同。本研究的目的是通过比较这两个群体在频谱分辨率任务上的基本心理物理能力和局限性,来确定早期剥夺和可塑性的潜在影响。
为 20 名双侧植入、先天性耳聋的儿童(年龄在 5 至 13 岁之间)和 20 名年龄相同的听力正常儿童测量了频谱分辨率任务(频谱-时变调制纹波测试 [SMRT])的表现。此外,还对 15 名双侧植入、后天性耳聋的成年人和 10 名听力正常的成年人进行了相同任务的测试。人工耳蜗使用者(成人和儿童)双侧测试,每只耳朵单独测试。听力正常者(成人和儿童)使用未处理的 SMRT 和模拟 8 通道人工耳蜗的语音编码版本进行测试。
对于听力正常的儿童,无论未处理还是语音编码版本,年龄与 SMRT 得分均呈正相关。年龄较大的听力正常儿童在未处理和语音编码测试条件下的表现与听力正常成年人相似。然而,对于植入人工耳蜗的儿童,SMRT 得分与实际年龄、植入年龄或植入年限之间没有显著关系。植入人工耳蜗的儿童的表现不如植入人工耳蜗的成年人。还发现,顺序植入的儿童在第一个植入体上的得分往往优于第二个植入体。这一差异在成年人中并未观察到。另外一个发现是,植入人工耳蜗的成年人的 SMRT 得分与年龄呈负相关。
本研究结果表明,使用个人植入处理器在声场中评估时,早期植入人工耳蜗的儿童和后天植入人工耳蜗的成年人的基本心理物理能力存在差异。由于早期植入人工耳蜗的儿童的频谱分辨率随年龄增长而不提高,因此人工耳蜗提供的信号稀疏表示可能限制了频谱分辨率的发展。这些结果得到了以下发现的支持:后天植入人工耳蜗的成年人的听觉系统在听力丧失之前已经成熟,他们在频谱分辨率测试中的表现明显优于早期植入人工耳蜗的儿童。