Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, USA and.
Department of Audiology, Nationwide Children's Hospital, Columbus, Ohio, USA.
Ear Hear. 2023;44(5):1202-1211. doi: 10.1097/AUD.0000000000001362. Epub 2023 Apr 5.
As a step toward identifying the origin of the across-electrode variation in within-channel gap detection thresholds (GDTs) measured in individual cochlear implant (CI) users, this study assessed the relationships between the auditory nerve's (AN's) ability to recover from neural adaptation, cortical encoding of and perceptual sensitivity to within-channel temporal gaps in postlingually deafened adult CI users.
Study participants included 11 postlingually deafened adults with Cochlear Nucleus devices, including three bilaterally implanted participants. In each of the 14 ears tested, recovery from neural adaptation of the AN was measured using electrophysiological measures of the electrically evoked compound action potential at up to four electrode locations. The two CI electrodes in each ear showing the largest difference in the speed of adaptation recovery were selected for assessing within-channel temporal GDT. GDTs were measured using both psychophysical and electrophysiological procedures. Psychophysical GDTs were evaluated using a three-alternative, forced-choice procedure, targeting 79.4% correct on the psychometric function. Electrophysiological GDTs were measured using the electrically evoked auditory event-related potential (eERP) evoked by temporal gaps embedded in electrical pulse trains (i.e., the gap-eERP). Objective GDT was defined as the shortest temporal gap that could evoke a gap-eERP. Related-samples Wilcoxon Signed Rank test was used to compare psychophysical GDTs and objective GDTs measured at all CI electrode locations. It was also used to compare psychophysical GDTs and objective GDTs measured at the two CI electrode locations with different speeds or amounts of adaptation recovery of the AN. A Kendall Rank correlation test was used to assess the correlation between GDTs measured at the same CI electrode location using psychophysical or electrophysiological procedures.
Objective GDTs were significantly larger than those measured using psychophysical procedures. There was a significant correlation between objective and psychophysical GDTs. GDTs could not be predicted based on the amount or the speed of adaptation recovery of the AN.
Electrophysiological measures of the eERP evoked by temporal gaps can potentially be used to assess within-channel GDT in CI users who cannot provide reliable behavioral responses. The difference in adaptation recovery of the AN is not the primary factor accounting for the across-electrode variation in GDT in individual CI users.
为了确定个体人工耳蜗(CI)使用者在通道内间隙检测阈值(GDT)的跨电极变化的起源,本研究评估了听觉神经(AN)从神经适应中恢复的能力、成年后天聋 CI 用户对通道内时间间隙的皮层编码和感知敏感性之间的关系。
研究参与者包括 11 名后天聋的成年 Cochlear Nucleus 装置使用者,包括 3 名双侧植入者。在测试的 14 只耳朵中,通过测量电诱发复合动作电位的电生理测量,在多达四个电极位置测量 AN 的神经适应恢复。在每只耳朵中,选择适应恢复速度差异最大的两个 CI 电极来评估通道内的时间 GDT。使用心理物理和电生理程序测量 GDT。使用三择一、强制选择程序评估 GDT,在心理测量函数上目标正确率为 79.4%。使用包含在电脉冲串中的时间间隙诱发的电诱发听觉事件相关电位(eERP)(即间隙-eERP)测量电生理 GDT。客观 GDT 定义为可以诱发间隙-eERP 的最短时间间隙。使用相关样本 Wilcoxon 符号秩检验比较所有 CI 电极位置测量的心理物理 GDT 和客观 GDT。还比较了 AN 适应恢复速度或幅度不同的两个 CI 电极位置测量的心理物理 GDT 和客观 GDT。使用 Kendall 等级相关检验评估使用心理物理或电生理程序在同一 CI 电极位置测量的 GDT 之间的相关性。
客观 GDT 明显大于使用心理物理程序测量的 GDT。客观 GDT 和心理物理 GDT 之间存在显著相关性。无法根据 AN 的适应恢复量或速度预测 GDT。
可以使用时间间隙诱发的 eERP 的电生理测量来评估无法提供可靠行为反应的 CI 用户的通道内 GDT。AN 适应恢复的差异不是个体 CI 用户 GDT 跨电极变化的主要因素。