视听多感觉联合训练作用听力损伤患者声源定位的中枢神经网络连接机制研究

The decrease of spatial localization capability is one of the common auditory functional disabilities for individuals with hearing impairment (HI). Audiological intervention using hearing assistant devices (e.g., hearing aids) to compensate the hearing loss is a key management method for the improvement. However, evidence showed that the conventional audiological intervention appears less effective, which is most likely due to unclear mechanisms underlying this disability. Our previous studies have shown reduced spatial discrimination capability in HI individuals, together with reduced neural network connectivity and abnormally activated cortex areas. In addition, our recent study showed that visual-auditory multisensory training can significantly improve the spatial localization ability and neural network connectivity in normal hearing individuals. Therefore, the hypothesis is that the cortical plasticity and abnormal neural network connectivity occurs after hearing impairment, which may be the main reason for spatial localization disability. The visual-auditory multisensory training could be regarded as an alternative intervention for improving spatial localization capability through specific induction of cortical plasticity and subsequently building up effective central connectivity of cortices. In this project, psychoacoustic, electroneurophysiological event related potential measurements and neural network connectivity computing technology will be used to explore the central mechanisms of spatial localization disability in individuals with hearing impairment. Additionally, the effectiveness and mechanism of visual-auditory multisensory training will be examined. The important outcomes derived from this study will contribute significantly towards the theoretical basis and technical foundation establishment of rehabilitation therapy for spatial localization disability.

声源定位能力的下降是听力损伤患者常见的一种功能障碍，而且，在通过听力补偿（如佩戴助听器）等干预手段后效果仍然不佳，这提示听力损伤后声源定位障碍存在未知的发生机制。我们前期研究发现听力损伤患者的声源分辨能力明显下降，且大脑功能性网络连接水平降低与相应某些脑区异常激活。最近的预实验结果表明视听多感觉联合训练可提高正常人群的声源定位能力，相应视听脑功能区域网络连接增强。我们据此作出假设：听力损伤后发生脑区间功能重塑及神经网络连接异常，可能是导致声源定位障碍的主要原因。由于视听多感觉联合训练可针对性地诱导中枢可塑性改变，建立脑区间有效网络连接，可能作为潜在改善听力损伤患者声源定位的康复手段。本项目拟采用心理声学和脑电事件相关电位方法，结合脑功能网络连接计算技术，进一步研究听力损伤后声源定位障碍的中枢机制，揭示视听多感觉联合训练的有效性及作用机理，为声源定位障碍的康复治疗提供理论依据和奠定技术基础。

本项目的研究内容主要包括三大块。. 研究一探讨了视听结合声源定位训练对人群定位能力的影响及中枢机制。结果表明视听结合声源定位训练可提高被试声源定位能力；视听结合声源定位通过晚期认知过程中多阶段的中枢改变提高被试声源定位能力。这一研究结果阐明了多感觉定位训练对声源定位行为学表现的影响及其中枢神经机制，为进一步干预听力损失患者声源定位障碍提供了研究基础及思路。. 研究二分析了听力损伤伴耳鸣患者影响治疗效果相关因素分析及中枢网络连接机制。这一研究综合评估了影响耳鸣治疗效果的相关因素，为进一步提高听力损伤伴耳鸣疗效及提高日常行为能力提供了理论支持。本研究部分成果已成功申请专利并处在成果转化阶段，在不久的将来将进行前期临床设备研究阶段，并大规模投入临床使用，具有良好的经济效益与社会效益。. 研究三分析耳鸣患者微状态参数的异常及其与行为学的关系，从全脑水平探究耳鸣内在的神经生理机制。结果提示脑电图微观状态的异常动态及其与特发性突发性耳聋（ISSNHL）和耳鸣特征的相关性；EEG 微状态可作为一种有价值的研究全脑网络的方法探究耳鸣内在的神经生理机制工具。