The overall goal of this project is to determine how to optimize benefit from a cochlear implant for every patient.
Specific aims are to: 1) evaluate the effect of using speech-processor programming parameters other than default values on speech recognition and usefulness in everyday life; 2) evaluate the relation between intracochlear electrode position and behavioral measures of threshold and dynamic range; 3) evaluate new speech processing strategies; and 4) monitor long-term benefit with cochlear implants. Approximately 65 deaf adults implanted with the Nucleus device will participate in experiments to evaluate these aims. (1) Four speech- processor programming parameters will be evaluated: different electrode pairings within the same program, assignment of frequency bands according to characteristic frequency of neurons near electrodes, selection of electrodes that carry more encoded information, and choice of function (Q- value) for manning sound amplitude onto each electrode's dynamic range. Comparison of performance on audition-only speech tests in quiet and noise will be made between the value presently used and a range of values for each parameter listed above. Responses to a questionnaire will reflect perceived usefulness in everyday life. Prior to data collection, each subject's speech-processor program will be fine-tuned and used for at least three weeks. (2) Multiple regression analysis will be employed to determine whether there is a predictive relation between intracochlear electrode position (measured from 3D reconstructions of CT scans) and behavioral thresholds and dynamic range. This information will be compared with models of electrical field generation, neural recruitment, and predicted thresholds and dynamic ranges. (3) New speech processing strategies, such as A plus MultiPeak and Spectral Maxima Sound Processor, will be compared with the strategy in current use with the same procedures described in (1). 4) Evaluation of long-term benefit will include measures of retest variability to determine if there are significant changes in an individual's performance. Default parameters for programming the Nucleus device are expedient but do not necessarily provide the best hearing. Results from the proposed studies will provide a scientific basis for selecting an individualized set of parameters and speech processing strategy to optimize each patient's benefit. Incorporation of this information into the programming software will make it clinically feasible to significantly improve speech recognition and ease of communication for many patients.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
2R01DC000581-04A1
Application #
2125815
Study Section
Hearing Research Study Section (HAR)
Project Start
1989-12-01
Project End
1997-11-30
Budget Start
1993-12-01
Budget End
1994-11-30
Support Year
4
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Washington University
Department
Otolaryngology
Type
Schools of Medicine
DUNS #
062761671
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Long, Christopher J; Holden, Timothy A; McClelland, Gary H et al. (2014) Examining the electro-neural interface of cochlear implant users using psychophysics, CT scans, and speech understanding. J Assoc Res Otolaryngol 15:293-304
Holden, Laura K; Finley, Charles C; Firszt, Jill B et al. (2013) Factors affecting open-set word recognition in adults with cochlear implants. Ear Hear 34:342-60
Moog, Jean S; Geers, Ann E; Gustus, Christine H et al. (2011) Psychosocial adjustment in adolescents who have used cochlear implants since preschool. Ear Hear 32:75S-83S
Geers, Ann E; Strube, Michael J; Tobey, Emily A et al. (2011) Epilogue: factors contributing to long-term outcomes of cochlear implantation in early childhood. Ear Hear 32:84S-92S
Davidson, Lisa S; Geers, Ann E; Blamey, Peter J et al. (2011) Factors contributing to speech perception scores in long-term pediatric cochlear implant users. Ear Hear 32:19S-26S
Tobey, Emily A; Geers, Ann E; Sundarrajan, Madhu et al. (2011) Factors influencing speech production in elementary and high school-aged cochlear implant users. Ear Hear 32:27S-38S
Geers, Ann E; Sedey, Allison L (2011) Language and verbal reasoning skills in adolescents with 10 or more years of cochlear implant experience. Ear Hear 32:39S-48S
Meshik, Xenia; Holden, Timothy A; Chole, Richard A et al. (2010) Optimal cochlear implant insertion vectors. Otol Neurotol 31:58-63
Holstad, Beth A; Sonneveldt, Valerie G; Fears, Beverly T et al. (2009) Relation of electrically evoked compound action potential thresholds to behavioral T- and C-levels in children with cochlear implants. Ear Hear 30:115-27
Davidson, Lisa S; Skinner, Margaret W; Holstad, Beth A et al. (2009) The effect of instantaneous input dynamic range setting on the speech perception of children with the nucleus 24 implant. Ear Hear 30:340-9

Showing the most recent 10 out of 50 publications