Abstract

The long-term objective of this project is to optimize benefit from a cochlear implant for individual patients. Recent research has shown the importance of individualized selection of speech coding strategy, stimulation rate, and minimum and maximum stimulation levels on each electrode in the speech processor map to optimize speech recognition and preference in everyday life. Further research is needed to determine the efficacy of new input and output speech processing for individualized fitting. Although electrical compound action potential thresholds (obtained with Neural Response Telemetry [NRT]) combined with behavioral responses have proved valuable for selecting map minimum and maximum levels on each electrode, it is unknown how NRT amplitude growth, refractory recovery, and cross-channel forward masking functions can be used to select map parameters best matched to an individual's electrical hearing. There is an urgent clinical need to determine how these NRT/NRI (Neural Response imaging) measures can be combined with behavioral measures in the fitting of implant parameters to optimize speech recognition more efficiently and effectively in adults and children. For the proposed research, electrical stimulation has been divided into two domains: input signal processing and output signal processing.
Specific Aim 1 evaluates effects of changing processing of the input signal to the speech processor on speech recognition and preference in everyday life (e.g., emphasizing transient speech sounds, criteria for assigning frequency boundaries to electrodes).
Specific Aim 2 evaluates effects of changing processing of the output signal on speech recognition and preference in everyday life (e.g., sequential stimulation of all electrodes vs roving stimulation of selected electrodes each cycle, effect of pulse duration and monopolar vs tripolar stimulation on electrodes).
Specific Aim 3 evaluates use of NRT/NRI and behavioral measures for individualized fitting of implant parameters in adults and children.
Specific aim 4 evaluates the effect of various factors (e.g., position of electrodes in the cochlea, response to NRT/NRI measures, cognitive function, verbal abilities, etiology, and biographical factors) on word recognition in adults. Outcome of this research holds promise for marked improvement in clinical care of cochlear implant recipients.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
5R01DC000581-16
Application #
6984052
Study Section
Special Emphasis Panel (ZRG1-IFCN-6 (01))
Program Officer
Donahue, Amy
Project Start
1989-12-01
Project End
2007-11-30
Budget Start
2005-12-01
Budget End
2006-11-30
Support Year
16
Fiscal Year
2006
Total Cost
$714,894
Indirect Cost

  Institution

Name
Washington University
Department
Otolaryngology
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130

  Publications

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

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