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Across-site patterns of electrically evoked compound action potential amplitude-growth functions in multichannel cochlear implant recipients and the effects of the interphase gap

机译:多通道人工耳蜗受者的电诱发复合动作电位振幅-增长函数的跨站点模式和相间间隙的影响

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摘要

Electrically evoked compound action potential (ECAP) measures of peak amplitude, and amplitude-growth function (AGF) slope have been shown to reflect characteristics of cochlear health (primarily spiral ganglion density) in anesthetized cochlear-implanted guinea pigs. Likewise, the effect of increasing the interphase gap (IPG) in each of these measures also reflects SGN density in the implanted guinea pig. Based on these findings, we hypothesize that suprathreshold ECAP measures, and also how they change as the IPG is increased, have the potential to be clinically applicable in human subjects. However, further work is first needed in order to determine the characteristics of these measures in humans who use cochlear implants.The current study examined across-site patterns of suprathreshold ECAP measures in 10 bilaterally-implanted, adult cochlear implant users. Results showed that both peak amplitude and slope of the AGF varied significantly from electrode to electrode in ear-specific patterns across the subjects’ electrode arrays. The pattern of across-site performance within each measure (e.g., peak amplitude or slope) varied across subjects and ears. As expected, increasing the IPG on average increased the peak amplitude and slope. Across ears, there was a significant, negative correlation between the slope of the ECAP AGF and the duration of hearing loss. Across-site patterns of ECAP peak amplitude and AGF slopes were also compared with common ground impedance values and significant correlations were observed in some cases, depending on the subject and condition. The results of this study, coupled with previous studies in animals, suggest that it is feasible to measure the change in suprathreshold ECAP measures as the IPG increases on most electrodes. Further work is needed to investigate the relationship between these measures and cochlear implant outcomes, and determine how these measures might be used when programming a cochlear-implant processor.
机译:峰值振幅的电诱发复合动作电位(ECAP)量度和振幅增长函数(AGF)斜率已显示出可反映麻醉的人工耳蜗豚鼠的耳蜗健康特征(主要是螺旋神经节密度)。同样,在这些方法中的每一种中增加相间间隙(IPG)的效果也反映了植入的豚鼠的SGN密度。基于这些发现,我们假设超阈值ECAP措施以及随着IPG的增加而发生的变化有可能在人类受试者中临床应用。然而,首先需要进一步的工作来确定使用人工耳蜗的人的这些措施的特征。本研究在10个双边植入的成人人工耳蜗使用者中检查了阈上ECAP措施的跨站点模式。结果表明,在受试者的电极阵列中,AGF的峰值幅度和斜率在电极之间以耳朵特定的模式变化很大。每个指标内的跨站点性能模式(例如,峰值幅度或斜率)在对象和耳朵之间会有所不同。不出所料,平均增加IPG会增加峰值幅度和斜率。在整个耳朵中,ECAP AGF的斜率与听力下降的持续时间之间存在显着的负相关。还将ECAP峰值幅度和AGF斜率的跨站点模式与常见的接地阻抗值进行了比较,并且在某些情况下,根据对象和状况,观察到了显着的相关性。这项研究的结果以及先前在动物中的研究表明,随着大多数电极上IPG的增加,测量阈上ECAP措施的变化是可行的。需要做进一步的工作来研究这些措施与人工耳蜗结果之间的关系,并确定在对人工耳蜗处理器进行编程时如何使用这些措施。

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