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单侧聋患者的人工耳蜗植入:接近正常的高阶处理。

Cochlear implants in single-sided deaf recipients: Near normal higher-order processing.

机构信息

Otolaryngology, Head and Neck Surgery, Medical School. University of Western Australia, Perth, Australia; Department of Audiology, Fiona Stanley Hospital, Perth, Australia.

Otolaryngology, Head and Neck Surgery, Medical School. University of Western Australia, Perth, Australia; Department of Audiology, Fiona Stanley Hospital, Perth, Australia.

出版信息

Clin Neurophysiol. 2021 Feb;132(2):449-456. doi: 10.1016/j.clinph.2020.11.038. Epub 2020 Dec 29.

Abstract

OBJECTIVE

Single-sided deafness (SSD) is a condition where an individual has a severe to profound sensorineural hearing loss in one ear and normal hearing on the contralateral side. The use of cochlear implants in individuals with SSD leads to functional improvements in hearing. However, it is relatively unclear how sounds incoming via the cochlear implant (independent of the hearing ear) are processed and interpreted by higher-order processes in the brain.

METHODS

Scalp electroencephalography and auditory event-related potentials were recorded monaurally from nine experienced single sided cochlear implant users. Speech-in-noise and localisation tests were used to measure functional changes in hearing.

RESULTS

cochlear implant use was associated with improvement in speech-in-noise and localisation tests (compared to cochlear implant off). Significant N2 and P3b effects were observed in both cochlear implant and normal hearing ear conditions, with similar waveform morphology and scalp distribution across conditions. Delayed response times and a reduced N2 (but not P3b) effect was measured in the CI condition.

CONCLUSION

The brain is capable of using processes similar to those in normal hearing to discriminate sounds presented to the cochlear implant. There was evidence of processing difficulty in the cochlear implant condition which could be due to the relatively degraded signals produced by the cochlear implant compared to the normal hearing ear.

SIGNIFICANCE

Understanding how the brain processes sound provided by a cochlear implant highlights how cortical responses can be used to guide implantation candidacy guidelines and influence rehabilitation recommendations.

摘要

目的

单侧聋(SSD)是一种个体在一只耳朵中患有严重至深度感觉神经性听力损失,而对侧耳朵听力正常的情况。在 SSD 个体中使用人工耳蜗会导致听力方面的功能改善。然而,相对不清楚的是,大脑中的高阶过程如何处理和解释通过人工耳蜗传入的声音(与听力耳无关)。

方法

从 9 名经验丰富的单侧人工耳蜗使用者中,单耳记录头皮脑电图和听觉事件相关电位。使用语音噪声和定位测试来测量听力的功能变化。

结果

与人工耳蜗关闭相比,人工耳蜗的使用与语音噪声和定位测试的改善相关。在人工耳蜗和正常听力耳条件下均观察到显著的 N2 和 P3b 效应,在不同条件下具有相似的波形形态和头皮分布。在人工耳蜗条件下测量到反应时间延迟和 N2(但不是 P3b)效应减小。

结论

大脑能够使用类似于正常听力的过程来区分向人工耳蜗呈现的声音。在人工耳蜗条件下存在处理困难的证据,这可能是由于与正常听力耳相比,人工耳蜗产生的信号相对较差。

意义

了解大脑如何处理人工耳蜗提供的声音突出了皮质反应如何用于指导植入候选指南,并影响康复建议。

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