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利用心理物理强度-持续时间函数和电极配置评估植入耳蜗的健康状况。

Estimating health of the implanted cochlea using psychophysical strength-duration functions and electrode configuration.

机构信息

Department of Hearing and Speech Sciences, The University of Jordan, Amman 11942, Jordan; Department of Otolaryngology-Head and Neck Surgery, Kresge Hearing Research Institute, University of Michigan, Ann Arbor, MI 48109-5616, USA.

Department of Otolaryngology-Head and Neck Surgery, Kresge Hearing Research Institute, University of Michigan, Ann Arbor, MI 48109-5616, USA.

出版信息

Hear Res. 2022 Feb;414:108404. doi: 10.1016/j.heares.2021.108404. Epub 2021 Nov 27.

Abstract

It is generally believed that the efficacy of cochlear implants is partly dependent on the condition of the stimulated neural population. Cochlear pathology is likely to affect the manner in which neurons respond to electrical stimulation, potentially resulting in differences in perception of electrical stimuli across cochlear implant recipients and across the electrode array in individual cochlear implant users. Several psychophysical and electrophysiological measures have been shown to predict cochlear health in animals and were used to assess conditions near individual stimulation sites in humans. In this study, we examined the relationship between psychophysical strength-duration functions and spiral ganglion neuron density in two groups of guinea pigs with cochlear implants who had minimally-overlapping cochlear health profiles. One group was implanted in a hearing ear (N = 10) and the other group was deafened by cochlear perfusion of neomycin, inoculated with an adeno-associated viral vector with an Ntf3-gene insert (AAV.Ntf3) and implanted (N = 14). Psychophysically measured strength-duration functions for both monopolar and tripolar electrode configurations were then compared for the two treatment groups. Results were also compared to their histological outcomes. Overall, there were considerable differences between the two treatment groups in terms of their psychophysical performance as well as the relation between their functional performance and histological data. Animals in the neomycin-deafened, neurotrophin-treated, and implanted group (NNI) exhibited steeper strength-duration function slopes; slopes were positively correlated with SGN density (steeper slopes in animals that had higher SGN densities). In comparison, the implanted hearing (IH) group had shallower slopes and there was no relation between slopes and spiral ganglion density. Across all animals, slopes were negatively correlated with ensemble spontaneous activity levels (shallower slopes with higher ensemble spontaneous activity levels). We hypothesize that differences in strength-duration function slopes between the two treatment groups were related to the condition of the inner hair cells, which generate spontaneous activity that could affect the across-fiber synchrony and/or the size of the population of neural elements responding to electrical stimulation. In addition, it is likely that spiral ganglion neuron peripheral processes were present in the IH group, which could affect membrane properties of the stimulated neurons. Results suggest that the two treatment groups exhibited distinct patterns of variation in conditions near the stimulating electrodes that altered detection thresholds. Overall, the results of this study suggest a complex relationship between psychophysical detection thresholds for cochlear implant stimulation and nerve survival in the implanted cochlea. This relationship seems to depend on the characteristics of the electrical stimulus, the electrode configuration, and other biological features of the implanted cochlea such as the condition of the inner hair cells and the peripheral processes.

摘要

人们普遍认为,人工耳蜗的疗效在一定程度上取决于所刺激的神经元群体的状况。耳蜗病理学可能会影响神经元对电刺激的反应方式,从而导致人工耳蜗植入者之间以及个体人工耳蜗使用者的电极阵列之间对电刺激的感知存在差异。已经有几项心理物理学和电生理学测量方法被证明可以预测动物的耳蜗健康状况,并被用于评估个体刺激部位附近的情况。在这项研究中,我们研究了两组具有人工耳蜗植入物的豚鼠之间的心理物理学强度-持续时间功能与螺旋神经节神经元密度之间的关系,这两组豚鼠的耳蜗健康状况有最小的重叠。一组植入正常听力耳(N=10),另一组用新霉素耳蜗灌流致聋,并用携带 Ntf3 基因插入物的腺相关病毒载体(AAV.Ntf3)接种,并植入(N=14)。然后,比较了两种处理组的单极和三极电极配置的心理物理学测量强度-持续时间功能。结果还与组织学结果进行了比较。总体而言,两组在心理物理学表现以及功能表现与组织学数据之间的关系方面存在很大差异。新霉素致聋、神经营养因子治疗和植入组(NNI)的动物表现出更陡峭的强度-持续时间功能斜率;斜率与 SGN 密度呈正相关(SGN 密度较高的动物斜率较大)。相比之下,植入听力(IH)组的斜率较浅,斜率与螺旋神经节密度之间没有关系。在所有动物中,斜率与集合自发性活动水平呈负相关(集合自发性活动水平较高的斜率较浅)。我们假设,两个处理组之间的强度-持续时间功能斜率差异与内毛细胞的状况有关,内毛细胞产生自发性活动,这可能会影响纤维间的同步性和/或对电刺激产生反应的神经元群体的大小。此外,IH 组中可能存在螺旋神经节神经元的外周过程,这可能会影响刺激神经元的膜特性。结果表明,两个处理组在刺激电极附近的条件变化中表现出不同的模式,从而改变了检测阈值。总体而言,这项研究的结果表明,人工耳蜗刺激的心理物理学检测阈值与植入耳蜗中的神经存活之间存在复杂的关系。这种关系似乎取决于电刺激的特征、电极配置以及植入耳蜗的其他生物学特征,例如内毛细胞的状况和外周过程。

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