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年轻患者耳蜗埋植电极后身心感知和电刺激诱导的复合动作电位阈值关系的模型:植入设备的临床表现

世界核心医学期刊文摘（神经病学分册） 2005年第4期1卷 22-23页

作者： Thai-Van H. Truy E. Charasse B. 王英鹏

Objective: In cochlear implant recipients, the threshold of the electrically evoked compound action potential (ECAP) has been shown to correlate with the perceptual detection threshold and maximum comfortable loudness levels (respectively, T- and C- levels) used for implant programming. Our general objective was to model the relationship between ECAP threshold and T/C- levels by taking into account their relative changes within each subject. In particular, we were interested in investigating further the validity of ECAP threshold as a predictor of psychophysical levels, depending on intra- cochlear electrode location and time of testing (from 1 to 18 months post- implantation).Methods: A total of 370 ECAP thresholds, measured in 49 children, using a Nucleus 24 cochlear implant, were compared with the corresponding T- and C- levels obtained at the same visit, for the same electrode. Response profiles for the hole group of patients were modeled across four test electrodes spaced equally along the electrode array from base towards apex. A linear regression model was constructed and the quality of the ECAP threshold- based predictions was assessed by testing for correlation between measured and predicted psychophysics. Comparison was made with a more simplistic model (described here as the ’ parallel profiles method’ ) stipulating, within each subject, a 1 μ A increase in psychophysical levels for every 1 μ A increase in ECAP threshold. Results: Offset between ECAP threshold and psychophysics profiles was found to vary significantly along the electrode array for the T- , but not for the C- level. In contrast with the parallel profiles method, our regression model predicted, within each subject, an average increase of 0.23 μ A (95% confidence interval: 0.18- 0.28) in T- level for every 1 μ A increase in ECAP threshold. This correction improved the quality of T- level prediction when our model was run using measured T- level and ECAP threshold from a reference electrode

关键词：耳蜗埋植电极动作电位阈值电刺激电极位置心理物理学探测阈 ECAP 参考电极身心状态相关变异

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