双模人工耳蜗使用者的皮质时间失配补偿:选择性注意解码与瞳孔测量研究。

Cortical temporal mismatch compensation in bimodal cochlear implant users: Selective attention decoding and pupillometry study.

作者信息

Dolhopiatenko Hanna, Nogueira Waldo

机构信息

Hannover Medical School, Cluster of Excellence 'Hearing4all', Hannover, Germany.

Hannover Medical School, Cluster of Excellence 'Hearing4all', Hannover, Germany.

出版信息

Hear Res. 2025 Aug;464:109306. doi: 10.1016/j.heares.2025.109306. Epub 2025 May 15.

Abstract

Bimodal cochlear implant (CI) users combine electrical stimulation from a CI in one ear with acoustic stimulation through either normal hearing or a hearing aid in the opposite ear. While this bimodal stimulation typically improves speech perception, the degree of improvement varies significantly and can sometimes result in interference effects. This variability is associated with the integration of electric and acoustic signals, which can be influenced by several factors, including temporal mismatch between the two sides. In previous work, we utilized cortical auditory evoked potentials (CAEPs) to estimate the temporal mismatch between the CI stimulation (CIS) side and the acoustic stimulation (AS) side, based on differences in N1 latencies when listening with the CIS alone and the AS alone. Building on this approach, the present study estimates individual temporal mismatch at cortical level through N1 latency of CAEPs and investigates the impact of compensating for this mismatch on speech perception. Behavioral and objective measures of speech perception were conducted in bimodal CI users under three bimodal listening conditions: clinical setting, a setting with compensated temporal mismatch between electric and acoustic stimulation and a setting with a large temporal mismatch of 50 ms between electric and acoustic stimulation. The behavioral measure consisted of a speech understanding test. Objective measures included pupillometry, electroencephalography (EEG) based on cortical auditory evoked potentials (CAEPs), EEG based on selective attention decoding including analysis of parietal alpha power. No significant effect of listening condition on behavioral speech understanding performance was observed, even for the condition with a large temporal mismatch of 50 ms. Similarly, pupillometry did not reveal a significant difference across listening conditions, although it was found to be related to behavioral speech understanding. N1P2 amplitude of CAEPs was greatest under the condition with compensated temporal mismatch. The phase-locking value of CAEPs, the temporal response function related to selective attention decoding, and parietal alpha power all showed a significant improvement when applying temporal mismatch compensation, compared to the condition with a substantial 50 ms temporal mismatch. However, these metrics did not exhibit significant effects when compared to the standard clinical setting condition. These findings emphasize that neural metrics are more sensitive than behavioral measures in detecting interaural mismatch effects. A significant enhancement of CAEPs N1P2 amplitude compared to clinical setting was observed. Other neural metrics showed a limited improvement with compensated listening condition, suggesting insufficient compensation solely in temporal domain.

摘要

双耳双模人工耳蜗(CI)使用者将一只耳朵中CI的电刺激与对侧耳朵通过正常听力或助听器进行的声刺激相结合。虽然这种双模刺激通常能改善言语感知,但改善程度差异很大,有时还会产生干扰效应。这种变异性与电信号和声信号的整合有关,这可能受到几个因素的影响,包括两侧之间的时间失配。在之前的研究中,我们利用皮层听觉诱发电位(CAEP),根据单独使用CI刺激(CIS)和单独使用声刺激(AS)时N1潜伏期的差异,来估计CI刺激侧和声刺激侧之间的时间失配。基于这种方法,本研究通过CAEP的N1潜伏期在皮层水平估计个体的时间失配,并研究补偿这种失配对言语感知的影响。在三种双模聆听条件下,对双耳双模CI使用者进行了言语感知的行为和客观测量:临床环境、电刺激和声刺激之间时间失配得到补偿的环境,以及电刺激和声刺激之间存在50毫秒大时间失配的环境。行为测量包括言语理解测试。客观测量包括瞳孔测量、基于皮层听觉诱发电位(CAEP)的脑电图(EEG)、基于选择性注意解码的脑电图(包括顶叶阿尔法功率分析)。即使对于存在50毫秒大时间失配的条件,也未观察到聆听条件对行为言语理解表现有显著影响。同样,瞳孔测量在不同聆听条件下未显示出显著差异,尽管发现它与行为言语理解有关。在时间失配得到补偿的条件下,CAEP的N1P2波幅最大。与存在50毫秒大时间失配的条件相比,当应用时间失配补偿时,CAEP的锁相值、与选择性注意解码相关的时间响应函数以及顶叶阿尔法功率均显示出显著改善。然而**,与标准临床环境条件相比,这些指标未表现出显著影响**。这些发现强调,在检测双耳失配效应方面,神经指标比行为测量更敏感。与临床环境相比,观察到CAEP的N1P2波幅有显著增强。其他神经指标在补偿聆听条件下改善有限,表明仅在时间域进行补偿是不够的。

:原文中“However, these metrics did not exhibit significant effects when compared to the standard clinical setting condition.”一句,从逻辑上看,前文一直在对比不同聆听条件下各指标的表现,这里突然说与标准临床环境条件相比无显著影响,与前文逻辑不连贯,推测可能是表述有误,暂时按原文翻译。

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