Zamaninezhad Ladan, Mert Berkutay, Benav Heval, Tillein Jochen, Garnham Carolyn, Baumann Uwe
MED-EL GmbH, Innsbruck, Austria.
ENT/Audiological Acoustics, University Hospital, Goethe University Frankfurt, Frankfurt, Germany.
Front Integr Neurosci. 2023 May 12;17:1125712. doi: 10.3389/fnint.2023.1125712. eCollection 2023.
One factor which influences the speech intelligibility of cochlear implant (CI) users is the number and the extent of the functionality of spiral ganglion neurons (SGNs), referred to as "cochlear health." To explain the interindividual variability in speech perception of CI users, a clinically applicable estimate of cochlear health could be insightful. The change in the slope of the electrically evoked compound action potentials (eCAP), amplitude growth function (AGF) as a response to increased interphase gap (IPG) (IPGE) has been introduced as a potential measure of cochlear health. Although this measure has been widely used in research, its relationship to other parameters requires further investigation.
This study investigated the relationship between IPGE, demographics and speech intelligibility by (1) considering the relative importance of each frequency band to speech perception, and (2) investigating the effect of the stimulus polarity of the stimulating pulse. The eCAPs were measured in three different conditions: (1) Forward masking with anodic-leading (FMA) pulse, (2) Forward masking with cathodic-leading (FMC) pulse, and (3) with alternating polarity (AP). This allowed the investigation of the effect of polarity on the diagnosis of cochlear health. For an accurate investigation of the correlation between IPGE and speech intelligibility, a weighting function was applied to the measured IPGE on each electrode in the array to consider the relative importance of each frequency band for speech perception. A weighted Pearson correlation analysis was also applied to compensate for the effect of missing data by giving higher weights to the ears with more successful IPGE measurements.
A significant correlation was observed between IPGE and speech perception in both quiet and noise for between-subject data especially when the relative importance of frequency bands was considered. A strong and significant correlation was also observed between IPGE and age when stimulation was performed with cathodic-leading pulses but not for the anodic-leading pulse condition.
Based on the outcome of this study it can be concluded that IPGE has potential as a relevant clinical measure indicative of cochlear health and its relationship to speech intelligibility. The polarity of the stimulating pulse could influence the diagnostic potential of IPGE.
影响人工耳蜗(CI)使用者言语可懂度的一个因素是螺旋神经节神经元(SGN)的数量和功能范围,即“耳蜗健康状况”。为了解释CI使用者言语感知的个体差异,临床上对耳蜗健康状况进行可应用的评估可能具有重要意义。电诱发复合动作电位(eCAP)斜率的变化,即作为对相间间隙(IPG)增加的反应的幅度增长函数(AGF)(IPGE),已被引入作为耳蜗健康状况的一种潜在测量指标。尽管该指标已在研究中广泛应用,但其与其他参数的关系仍需进一步研究。
本研究通过(1)考虑每个频带对言语感知的相对重要性,以及(2)研究刺激脉冲的刺激极性的影响,来探究IPGE、人口统计学特征与言语可懂度之间的关系。在三种不同条件下测量eCAP:(1)阳极领先的前向掩蔽(FMA)脉冲,(2)阴极领先的前向掩蔽(FMC)脉冲,以及(3)交替极性(AP)。这使得能够研究极性对耳蜗健康状况诊断的影响。为了准确研究IPGE与言语可懂度之间的相关性,对阵列中每个电极上测量的IPGE应用加权函数,以考虑每个频带对言语感知的相对重要性。还应用加权Pearson相关分析,通过对IPGE测量更成功的耳朵赋予更高权重来补偿缺失数据的影响。
在受试者间数据中,尤其是考虑频带相对重要性时,在安静和噪声环境下均观察到IPGE与言语感知之间存在显著相关性。当用阴极领先脉冲进行刺激时,还观察到IPGE与年龄之间存在强且显著的相关性,但在阳极领先脉冲条件下未观察到。
基于本研究结果可以得出结论,IPGE有潜力作为一种相关的临床指标,用于指示耳蜗健康状况及其与言语可懂度的关系。刺激脉冲的极性可能会影响IPGE的诊断潜力。