Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy.
IMT School for Advanced Studies Lucca, Lucca, Italy.
Handb Clin Neurol. 2022;187:89-108. doi: 10.1016/B978-0-12-823493-8.00016-X.
The auditory cortex of people with sensorineural hearing loss can be re-afferented using a cochlear implant (CI): a neural prosthesis that bypasses the damaged cells in the cochlea to directly stimulate the auditory nerve. Although CIs are the most successful neural prosthesis to date, some CI users still do not achieve satisfactory outcomes using these devices. To explain variability in outcomes, clinicians and researchers have increasingly focused their attention on neuroscientific investigations that examined how the auditory cortices respond to the electric signals that originate from the CI. This chapter provides an overview of the literature that examined how the auditory cortex changes its functional properties in response to inputs from the CI, in animal models and in humans. We focus first on the basic responses to sounds delivered through electrical hearing and, next, we examine the integrity of two fundamental aspects of the auditory system: tonotopy and processing of binaural cues. When addressing the effects of CIs in humans, we also consider speech-evoked responses. We conclude by discussing to what extent this neuroscientific literature can contribute to clinical practices and help to overcome variability in outcomes.
感音神经性听力损失患者的听觉皮层可以通过人工耳蜗（CI）重新传入：这是一种神经假体，可以绕过耳蜗中受损的细胞，直接刺激听神经。尽管 CI 是迄今为止最成功的神经假体，但一些 CI 用户使用这些设备仍未获得满意的效果。为了解释结果的可变性，临床医生和研究人员越来越关注神经科学研究，这些研究检查了听觉皮层如何对源自 CI 的电信号做出反应。本章概述了检查听觉皮层如何响应来自 CI 的输入而改变其功能特性的文献，包括动物模型和人类。我们首先关注通过电听觉传递的声音的基本反应，接下来，我们检查听觉系统的两个基本方面的完整性：音调拓扑和双耳线索的处理。在讨论 CI 对人类的影响时，我们还考虑了言语诱发的反应。最后，我们讨论了这种神经科学文献在多大程度上可以为临床实践做出贡献，并有助于克服结果的可变性。
