Method and apparatus for optimizing parameters for a sensory prosthesis

Abstract

The present disclosure proposes a method for optimizing parameters for a sensory prosthesis, comprising: evaluating the cognitive sensory capabilities of a recipient of the sensory prosthesis to quantify the capabilities of the recipient's sensory brain regions for processing corresponding sensory modality information; and determining a plurality of parameters used by the sensory prosthesis based on the capabilities of the recipient's sensory brain regions; and providing the plurality of parameters to the sensory prosthesis for instantiation at the sensory prosthesis.

Description

[0001] Cross-references

[0002] This application is a divisional application of the invention patent application with international application number PCT / IB2016 / 054980, international application date August 19, 2016, date of entry into the Chinese national phase April 27, 2018, Chinese national application number 201680063077.0, and invention name “Stimulation Parameter Optimization”.

[0003] This application claims priority to U.S. Provisional Application No. 62 / 210,498, filed on August 27, 2015, entitled “STIMULATION PARAMETER OPTIMIZATION,” the contents of which are incorporated herein by reference. Technical Field

[0004] The present invention generally relates to optimization of parameters in sensory prostheses. Background Art

[0005] Hearing loss can be caused by many different reasons, and there are generally two types: conductive and / or sensorineural. Conductive hearing loss occurs when the normal mechanical pathways of the outer and / or middle ear are impeded, for example due to damage to the ossicular chain or the ear canal. Sensorineural hearing loss occurs when the inner ear or the neural pathways from the inner ear to the brain are damaged.

[0006] Because the hair cells in the cochlea are not damaged, individuals with conductive hearing loss typically have some form of residual hearing. Therefore, individuals with conductive hearing loss typically receive hearing prostheses that generate movement of cochlear fluid. Such hearing prostheses include, for example, acoustic hearing aids, bone conduction devices, and direct acoustic stimulators.

[0007] However, in many people with profound hearing loss, the cause of their hearing loss is sensorineural hearing loss. People with certain forms of sensorineural hearing loss cannot obtain appropriate benefits from hearing prostheses that generate mechanical movement of cochlear fluid. These individuals may benefit from implantable hearing prostheses that stimulate the nerve cells of the recipient's auditory system in other ways (e.g., electrically, optically, etc.). Cochlear implants are generally proposed for the following situations: sensorineural hearing loss is due to the absence or destruction of cochlear hair cells, which convert acoustic signals into nerve impulses. Auditory brainstem stimulators are another type of stimulating hearing prosthesis that can also be proposed when a recipient experiences sensorineural hearing loss due to damage to the auditory nerve. Summary of the invention

[0008] In one aspect, a method of optimizing parameters for a sensory prosthesis is provided. The method includes: assessing cognitive sensory capabilities of a recipient of the sensory prosthesis to quantify capabilities of sensory brain regions of the recipient for processing corresponding sensory modality information; and determining a plurality of parameters used by the sensory prosthesis based on the capabilities of the sensory brain regions of the recipient; and providing the plurality of parameters to the sensory prosthesis for instantiation at the sensory prosthesis.

[0009] In another aspect, a method of optimizing parameters for a sensory prosthesis is provided. The method includes: performing an assessment of cognitive sensory capabilities of a recipient of the sensory prosthesis; generating a sensory capability profile based on the assessment of the cognitive sensory capabilities of the recipient, the sensory capability profile representing an estimated impact of cross-modal recombination on the recipient's ability to process information received via the sensory prosthesis; determining a plurality of parameters used by the sensory prosthesis based on the estimated impact of cross-modal recombination on the recipient's ability to process information received via the sensory prosthesis; and transmitting the plurality of parameters to the sensory prosthesis.

[0010] In another aspect, an apparatus for optimizing parameters for a sensory prosthesis is provided. The apparatus includes a memory and one or more processors. The one or more processors are configured to: obtain results of one or more evaluations of cognitive sensory capabilities of a recipient of a sensory prosthesis; generate a sensory capability profile based on the one or more evaluations of the cognitive sensory capabilities of the recipient, the sensory capability profile representing an effect of cross-modal recombination on the recipient's ability to process information received via the sensory prosthesis; analyze the sensory capability profile to select a plurality of parameters for use by the sensory prosthesis, wherein the parameters are related to the cognitive sensory capabilities of the recipient; and provide the plurality of parameters to the sensory prosthesis. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] Embodiments of the present invention are described herein with reference to the accompanying drawings, in which:

[0012] Figure 1 is a schematic diagram illustrating a cochlear implant system configured to operate using the generated associated stimulation parameters according to embodiments presented herein;

[0013] Figure 2 is a detailed flow chart of a method according to an embodiment presented herein;

[0014] Figure 3 is a block diagram of an adaptation system configured to perform techniques according to embodiments of the present invention;

[0015] Figure 4 is a block diagram of a mobile phone configured to perform techniques according to an embodiment of the present invention;

[0016] Figure 5 is a flow chart of a method according to an embodiment presented herein; and

[0017] Figure 6 is a flow chart of another method according to embodiments presented herein. DETAILED DESCRIPTION

[0018] Embodiments of the present invention generally relate to techniques for optimizing stimulation parameters for stimulating a hearing prosthesis based on the recipient's auditory cognitive abilities. As used herein, a recipient's "auditory cognitive abilities" refers to the functional operation of the recipient's auditory brain areas when processing sound input, including how the recipient's brain analyzes, categorizes, and interprets meaningful sounds, particularly in the presence of substantial degradation; how contextual cues facilitate this process, including how semantic context as well as simple temporal or spectral regularities of sounds shape neural processing; and how cognitive mechanisms compensate for degradation in sound processing abilities, including executive functions (such as working memory and cognitive control that support successful coping with degradation).

[0019] As further described below, embodiments of the present invention are specifically directed to adapting cochlear implant stimulation programs (stimulation parameters) to the objectively determined (or semi-objectively determined) cognitive auditory abilities (cognitive auditory states) of the recipient. In general, cochlear implant stimulation parameters are adapted to the cognitive auditory abilities of the recipient so as to provide as much auditory information as possible that the recipient can reasonably process and benefit from accordingly. This situation will change over time as the recipient's abilities increase or decrease (e.g., organically, facilitated by rehabilitation / training, or due to progression of the disease). The time window for making program changes in the context of the embodiments presented herein is on the order of weeks, months, and years. In this way, the techniques presented herein enable the stimulation parameters of the recipient to be improved and adapted as the recipient's cognitive auditory abilities improve (e.g., through rehabilitation / training) or deteriorate (e.g., due to aging).

[0020] There are several types of stimulating hearing prostheses that operate by delivering electrical / current stimulation signals to a recipient to compensate for defects in the recipient's nerves, tissues, etc. For ease of illustration only, the technology presented herein is primarily described herein with reference to one type of stimulating hearing prosthesis (i.e., a cochlear implant). However, it should be understood that the technology presented herein can be used in other stimulating hearing prostheses (e.g., an auditory brainstem stimulator), or in other implantable tissue stimulation systems (which include, for example, visual prostheses).

[0021] Figure 11 is a schematic diagram illustrating an exemplary cochlear implant system 100 configured to operate using stimulation parameters optimized based on the cognitive hearing abilities of a recipient in accordance with an embodiment of the present invention. Cochlear implant system 100 includes an external component 102 and an internal / implantable component 104. In this example, implantable component 104 is a cochlear implant.

[0022] The external component 102 is attached directly or indirectly to the recipient's body and typically includes an external coil 106 and a magnet ( Figure 1 The external component 102 further includes one or more sound input elements 108 (e.g., microphones, audio coils, etc.) for detecting sound signals or inputting audio signals, and a sound processing unit 112. The sound processing unit 112 includes, for example, a power supply (not shown). Figure 1 ) and a sound processor (also not shown in Figure 1 1 ). The sound processor is configured to process electrical signals generated by a sound input element 108, which in the illustrated embodiment is located by the recipient's auricle 110. The sound processor is connected to the recipient's ear via, for example, a cable (not shown). Figure 1 ) provides the processed signal to the external coil 106.

[0023] The cochlear implant 104 includes an implant body 114, a guide region 116, and an elongated intra-cochlear stimulation assembly 118. The implant body 114 includes a stimulator unit 120, an internal / implantable coil 122, and an internal receiver / transceiver unit 124 (sometimes referred to herein as a transceiver unit 124). The transceiver unit 124 is connected to the implantable coil 122 and is typically connected to a magnet (not shown) that is fixed relative to the internal coil 122.

[0024] The magnets in the external component 102 and the cochlear implant 104 facilitate operational alignment of the external coil 106 with the implantable coil 122. The operational alignment of the coils enables the implantable coil 122 to send power and data to / receive power and data from the external coil 106. More specifically, in some examples, the external coil 106 sends electrical signals (e.g., power and stimulation data) to the implantable coil 122 via a radio frequency (RF) link. The implantable coil 122 is typically a wire antenna coil consisting of multiple turns of electrically insulated single or multiple strands of platinum or gold wire. Electrical insulation of the implantable coil 122 is provided by flexible molding (e.g., silicone molding). In use, the transceiver unit 124 can be positioned in a recess of the recipient's temporal bone. Various other types of energy transmission (such as infrared (IR) transmission, electromagnetic transmission, capacitive transmission, and inductive transmission, etc.) can be used to transmit power and / or data from an external device to the cochlear implant, and thus, Figure 1Only one example arrangement is shown.

[0025] The elongated stimulation assembly 118 is configured to be at least partially implanted in the cochlea 130 and includes a plurality of longitudinally spaced intracochlear electrical stimulation contacts (electrical contacts) 128 that collectively form a contact array 126. The stimulation assembly 118 extends through an opening (e.g., cochleostomy 132, round window 134, etc.) in the cochlea 130 and has a proximal end connected to the stimulator unit 120 via a guide region 116 that extends through the mastoid bone 119. The guide region 116 couples the stimulation assembly 118 to the implant body 114 (more specifically, the stimulator unit 120).

[0026] Typically, the sound processor in sound processing unit 112 is configured to perform sound processing and encoding to convert the detected sound into an encoded signal representing the detected sound signal. Because these encoded data are used by cochlear implant 104 to generate stimulation signals, and because these signals dynamically change according to the sound signals, the encoded data signals generated by the sound processor are sometimes referred to herein as "processed audio signals".

[0027] The processed audio signals generated by the sound processor are provided to the stimulator unit 120 via an RF link between the external coil 106 and the internal coil 122. The stimulator unit 120 includes one or more circuits that convert the processed audio signals received via the transceiver unit 124 into a set of electrical stimulation signals (current stimulation) delivered via one or more stimulation channels, which terminate at the stimulation contacts 128 (i.e., the stimulation signal sets are delivered to the recipient via the stimulation contacts 128). In this way, the cochlear implant system 100 stimulates the auditory nerve cells of the recipient, bypassing the lack or defect of hair cells that normally convert acoustic vibrations into neural activity. Each stimulation signal set represents a "stimulation cycle" that provides audio information to the recipient.

[0028] The stimulator unit 120 uses various predetermined, recipient-specific stimulation parameters / settings to convert the processed audio data into one or more stimulation signal sets. These stimulation parameters include, for example, channel-to-electrode mapping, stimulation / pulse rate, pulse timing (electrical pulse width and pulse interval), stimulation mode (polarity, reference electrode), compression law or compression setting, amplitude mapping, etc. Amplitude mapping refers to mapping the sound intensity to the following current level, which is between the threshold (T) level of the recipient (i.e., at this level, he / she can just hear the stimulation) and the maximum comfort (C) level. Typically, the stimulation parameters determine how the processed audio signal is used to generate a set of stimulation signals (current pulses) for delivery to the recipient.

[0029] The human brain is organized into different specialized areas, each of which is typically dedicated to relatively higher functions of brain activity. For example, the sensory areas of the brain (sensory brain areas) are collectively referred to as cerebral cortical areas, which are associated with receiving and interpreting sensory information from various parts of the body. The sensory areas of the brain include somatic, auditory, visual and olfactory cortical areas / regions. In particular, the auditory areas of the brain (auditory brain areas) are the parts of the brain that process sound information delivered by the cochlea and the auditory nerve.

[0030] Individuals who experience sensory loss often do not fully utilize the sensory areas of their brains associated with the sense they are missing. For example, individuals with hearing impairment may lack the ability to fully utilize the functional capabilities of the auditory brain areas. The human brain is adaptive, so when a particular sensory area is underutilized, the brain will reorganize to account for the underutilization.

[0031] For example, congenitally blind research subjects have shown an enhanced ability to perform two auditory tasks, meaning that visual brain areas have been reorganized to enhance the subject's hearing. This physiological phenomenon (sometimes referred to herein as cross-modal brain reorganization, or more simply cross-modal reorganization) is most pronounced in early development (i.e., younger than 7 years of age, when neuroplasticity is most prevalent), but continues to a lesser extent into adulthood.

[0032] Although cross-modal reorganization enhances the behavioral performance of the modality recruited, cross-modal reorganization also weakens the performance of the modality recruited. In other words, reorganization from less utilized brain areas to enhance another sense organ will have a negative impact on less utilized brain areas because it consumes the available resources of less utilized areas. For example, reorganizing auditory brain areas in individuals with sound loss (deafness or partial deafness) to strengthen visual ability will lead to greater hearing impairment. Therefore, if auditory information is subsequently introduced by, for example, cochlear implants, people who have experienced auditory brain area reorganization due to hearing impairment will find that it is more difficult to process auditory information compared to individuals who have not experienced the same degree of cross-modal reorganization. This is because the reorganized auditory brain areas have less or suboptimally regulated cortical resources for processing auditory information. Fewer cognitive resources lead to reduced cognitive ability, which leads to an increase in cognitive load and / or listening effort.

[0033] Cross-modal reorganization and associated loss of auditory brain regions can manifest in different forms and occur for different reasons, resulting in different auditory cognitive abilities / skills in different recipients. Thus, at least in part due to different cognitive auditory abilities, the performance of cochlear implants is different among recipient populations. Therefore, techniques for selecting / determining stimulation parameters based on the auditory cognitive abilities / skills of the recipient are presented herein. In other words, the techniques presented herein determine stimulation parameters of a cochlear implant that are optimized / customized for the unique cognitive auditory abilities of the recipient.

[0034] Figure 2 is a flowchart of a detailed method 250 according to an embodiment presented herein. For ease of illustration, reference is made to Figure 1 Method 250 is described for cochlear implant system 100 .

[0035] Method 250 begins at 252 by performing an initial assessment of the cognitive hearing abilities / skills of a cochlear implant recipient. Generally speaking, two methodological categories of tests / assessments are used to identify cognitive hearing abilities, namely objective assessments and subjective assessments. Thus, the initial assessment of the cognitive hearing abilities of a recipient may include one or more objective and / or subjective assessments that generate information that can be used to identify cross-modal recombination and determine an estimated impact of the cross-modal recombination on the recipient's hearing abilities.

[0036] Objective evaluation of cognitive auditory ability includes, for example, functional near infrared spectrum (fNIRS), functional magnetic resonance imaging (fMRI), magnetoencephalogram (MEG), electroencephalogram (EEG), etc. of the recipient's brain to evaluate the recipient's auditory brain configuration. More specifically, the imaging system generates the following results: the results can be used to characterize the metabolism of dynamic glucose in different cortical areas in response to different sensory activities and the metabolic activity thereby. For example, when the recipient performs an auditory task / exercise, the undamaged auditory brain area (i.e., the auditory area of ​​the brain that has not undergone cross-modal reorganization) will show increased metabolic activity. On the contrary, if the auditory area of ​​the brain has undergone significant cross-modal reorganization to support the visual system, the auditory area of ​​the brain will show increased metabolic activity when the recipient performs a visual task, but little or no activity when performing a pure auditory task. The degree of metabolic activity detected in response to different types of stimuli (e.g., auditory, visual, etc.) is used to objectively quantify how the auditory area of ​​the brain is affected by cross-modal reorganization (i.e., determine how much of the auditory area of ​​the brain is used by other non-auditory brain functions).

[0037] When fewer dedicated resources are available for the cognitive task of listening, the listening task becomes more difficult or laborious for the recipient. Therefore, subjective evaluation of cognitive auditory ability can involve an assessment of cognitive load or listening effort to highlight reduced auditory cognitive ability or increases in other sensory modalities. In one embodiment, a reading span task and a digit span task are used to assess the working memory of cochlear implant recipients. The reading span task is a dual-task paradigm in which the subject is asked to read aloud printed sentences and remember the last word of each sentence for later recall in the order presented. After each sentence, the subject states whether the sentence is true or false. The length range of 2 to 6 sentences is set, and at the end of each set, the subject is asked to recall the last word of each sentence. The forward or backward digit span task measures working memory in a similar manner. The subject repeats a list of digits spoken in real-time speech at a rate of one digit per second. The forward span task simply repeats a series of digits, while the backward span task requires repeating the digits in reverse order. Both lists start with a length of two digits, and the length increases by one digit after each successful repetition of at least one list of a given length.

[0038] It has been observed that there is a high degree of consistency between hearing problems and other sensory problems. Therefore, certain embodiments also include specific sensory tests / assessments in assessing the recipient's cognitive hearing abilities. Sensory assessments are subjective in nature and can take many different forms, but are primarily designed to provide an understanding of the functional sensory difficulties experienced by the recipient. Such an understanding can be important because recipients with different sensory problems are uniquely affected in different sensory environments. In general, sensory assessments involve eliciting and observing the recipient's responses to different senses and looking for evidence of difficulty using sensory input appropriately.

[0039] In general, the initial assessment of the recipient's cognitive hearing abilities will include both objective and subjective evaluations performed in a clinical setting. For example, a medical practitioner (e.g., a physician, audiologist, clinician, etc.) performs an EEG on a cochlear implant recipient to objectively determine the extent of cross-modal recombination. Within the same time frame (e.g., during the same one-week or two-week time window), the cochlear implant recipient is given a cognitive load test (e.g., a reading span break), and possibly a sensory evaluation.

[0040] The results of the objective and subjective evaluations are correlated with each other to generate a "hearing ability profile" of the recipient. As used herein, the hearing ability profile of the recipient represents the estimated impact of cross-modal recombination on the recipient's ability to process information received via a stimulating hearing prosthesis. In other words, cross-modal recombination is analyzed in conjunction with a measure of cognitive load or listening effort to assess how the recipient's auditory brain areas are able to process electrical audio information, which can determine how stimulation parameters should be selected, as further described below.

[0041] Back to Figure 2 , at 254, the results of the initial assessment of the recipient's cognitive hearing abilities, as represented in the recipient's hearing ability profile, are analyzed and used to determine stimulation parameters for the recipient's cochlear implant 104. As described above, the recipient's stimulation parameters are the settings / parameters that determine how the stimulator unit 120 of the cochlear implant 100 converts processed audio data into stimulation signals for delivery to the recipient's cochlea 130. The stimulation signals generated and delivered to the recipient's cochlea 130 operate in the form of electrical audio information that is presented to the recipient's auditory brain region via the cochlear nerve cells. The various stimulation parameters control the amount of electrical audio information presented to the recipient at any given time.

[0042] Due to cross-modal recombination and other factors, the auditory cortex of different recipients has different abilities to process electrical audio information. Therefore, according to the embodiments presented herein, the auditory ability profile of the recipient is analyzed to select stimulation parameters, which will generate an electrical stimulation signal, and when the electrical stimulation signal is delivered to the recipient, the amount of electrical audio information presented to the recipient will be optimized according to the cognitive auditory ability of the recipient (that is, the measure of the information expected to be presented by the stimulation parameters is matched / correlated with the estimated ability of the auditory brain area of ​​the recipient to process electrical audio information). In other words, the stimulation parameters are related to the cognitive auditory ability of the recipient and are selected based on the cognitive auditory ability of the recipient. As used herein, the stimulation parameters selected based on the cognitive auditory ability of the recipient are referred to as "relevant stimulation parameters" in this article. The relevant stimulation parameters currently used by cochlear implants are sometimes referred to as "current" or "current" relevant stimulation parameters in this article.

[0043] At 254, the initial relevant stimulation parameters are customized for the recipient based on the recipient's cognitive hearing ability. This reflects the potential advantages compared to the conventional techniques for selecting the recipient's initial stimulation parameters. More specifically, as described above, there are many stimulation parameters that can be selected for cochlear implant recipients. In conventional techniques, the audiologist selects the initial stimulation parameters for the recipient based on, for example, the clinical knowledge of the audiologist, parameters / procedures known to be useful for other cochlear implant recipients, research results, etc. Since in this conventional arrangement, the stimulation parameters are not customized according to the recipient at all, it is likely that the selected stimulation parameters will be unacceptable to the recipient. Therefore, after selecting the initial stimulation parameters, in the conventional arrangement, the audiologist and the recipient conduct a time-consuming, expensive and difficult trial and error process, in which the sound is delivered to the recipient, and using verbal feedback, the audiologist evaluates and changes / adjusts the initial stimulation parameters. Although this is difficult for many recipients, this trial and error process is not feasible for young children because they lack the ability to provide the necessary feedback to the audiologist.

[0044] However, as described above, according to the embodiments presented herein, the initial relevant stimulation parameters are customized for the recipient based on the recipient's cognitive hearing abilities. Therefore, there is a greater likelihood that the initial relevant stimulation parameters selected at 254 are appropriate for the recipient. This reflects an advantage that the trial and error process can be eliminated (e.g., for young children) or greatly reduced because the audiologist is less likely to have to make significant parameter changes.

[0045] Back to Figure 2 In an example, after selecting the recipient's initial relevant stimulation parameters at 254, the recipient is allowed to use the relevant stimulation parameters for a period of time at 256. In one example, the relevant stimulation parameters are used during several hearing tests performed in a short period of time before performing a supplemental assessment of the recipient's cognitive hearing ability (e.g., a shortened parameter evaluation process with an audiologist). In other embodiments, the recipient is allowed to use the relevant stimulation parameters for a longer period of time (e.g., several days or weeks).

[0046] At 258, a supplementary assessment of the recipient's cognitive hearing ability is performed. The supplementary assessment of the recipient's cognitive hearing ability can take a variety of different forms, but typically includes one or more subjective initial assessments of the cognitive hearing ability of the recipient as described above. According to the embodiments presented herein, the supplementary assessment can be performed in a clinical setting, or in some examples can be performed in the recipient's home or other remote (i.e., non-clinical) settings. For example, in a follow-up clinical appointment, a subjective evaluation is performed to identify changes in functional cognitive ability (cognitive load). The results of the supplementary assessment are used to update the hearing ability profile of the recipient (i.e., related to the results of the previous subjective and objective evaluations).

[0047] Supplemental assessments may include objective evaluations (e.g., imaging), but in general, objective evaluations will be repeated less frequently because they are more time-consuming and may require more resources than subjective cognitive load evaluations. Nevertheless, correlations between objective and subjective evaluations may need to be checked and readjusted periodically.

[0048] In some embodiments, the supplemental assessment includes a subjective evaluation (e.g., a cognitive load test) performed in a remote (i.e., non-clinical) environment via, for example, a smartphone, computer, or other consumer electronic device. In such examples, the recipient may be able to initiate changes in stimulation parameters based on the self-evaluation of auditory ability as long as the subjective evaluation performed remotely is correlated / consistent with the subjective evaluation conducted in the clinical setting. Figure 4 Provide more details about your self-evaluation.

[0049] The supplemental assessment (or possibly the initial assessment) may be accompanied by one or more hearing tests that evaluate the performance of the cochlear implant objectively (e.g., neural response telemetry tests that rely on electrically evoked compound action potential (ECAP) measurements) or subjectively (e.g., verbal feedback tests). Such tests are not designed to evaluate cognitive auditory abilities, but rather attempt to determine how effective the current relevant stimulation parameters are for the recipient (i.e., whether the recipient is able to understand the information presented in each stimulation cycle when the relevant stimulation parameters are used). For example, these hearing tests may help determine whether the recipient has general hearing difficulties, difficulties in noise, difficulties in certain frequency ranges, etc.

[0050] After performing the supplemental assessment of the recipient's cognitive hearing abilities, the current relevant stimulation parameters are evaluated to determine whether changes to the relevant stimulation parameters are appropriate at 260. That is, the results of the supplemental assessment (i.e., the recipient's updated hearing ability profile) may be utilized, possibly in conjunction with the results of one or more other hearing tests, to determine whether the relevant stimulation parameters currently used by cochlear implant 104 are appropriately associated with the recipient's cognitive hearing abilities.

[0051] Since cognitive changes, as measured by subjective assessments (task load), objective assessments, or both, reflect an increase or decrease in the ability of cognitive resources to adequately process information presented by the cochlear implant, Figure 2 260 indicates determining whether there is a long-term change in the recipient's hearing ability in order to warrant a change in the stimulation parameters. If it is determined at 260 that a change in the relevant stimulation parameters should not be made, then method 250 proceeds to 264, the operation of which is further described below. However, if it is determined at 260 that a change in the relevant stimulation parameters is warranted, then method 250 proceeds to 262, where the relevant stimulation parameters are adjusted.

[0052] More specifically, at 262, the relevant stimulation parameters are adjusted to increase or decrease the amount of information presented by using the stimulation parameters. In other words, the stimulation parameters can be made more or less "information dense" by, for example, changing the stimulation rate, changing the number of spectral maxima, adjusting the spectral masking threshold, adjusting the temporal masking offset, etc.

[0053] Certain stimulation parameters have been shown to cause greater hearing difficulties than others. For example, presenting electrical stimulation to the cochlea in a more spectrally / physiologically dense configuration is generally more difficult for the recipient to process than a more sparse presentation with better spectral contrast. Although dense presentation provides more information to the recipient, not all recipients are able to benefit effectively from it. Similarly, when listening to music (which can be considered structured noise), higher stimulation rates, while providing more information, are also associated with hearing difficulties in some recipients (e.g., recipients generally prefer programs with lower stimulation rates and a smaller number of maxima). Competing auditory inputs (e.g., multiple speakers, music, noise, etc.) can also lead to the creation of difficult listening conditions if they are not appropriately mitigated through stimulation parameter selection. For example, noise reduction schemes that reduce competing / confounding inputs are generally easier to listen to because information overload is suppressed.

[0054] Thus, in some examples, reducing the stimulation rate and / or the number of spectral maxima reduces the amount of information delivered to the recipient in each stimulation cycle, while conversely, increasing the stimulation rate and / or the number of spectral maxima increases the amount of information delivered to the recipient in each stimulation cycle. The above adjustments are illustrative, and it should be understood that other adjustments to the stimulation parameters are possible in order to increase / decrease the amount of information delivered to the recipient in each stimulation cycle.

[0055] Similarly, recipients with different sensory issues perform differently in different sensory environments. Selecting stimulation parameters to mitigate factors to which these recipients are sensitive will improve hearing. For example, if a recipient with sensory issues (particularly those who are sensitive to loud noises or noise in general) may benefit from a program that includes substantial limitation or includes general noise reduction.

[0056] After adjusting the relevant stimulation parameters, the method 250 proceeds to 264 to determine whether an additional assessment of the recipient's cognitive hearing ability is approved. If the additional assessment is approved, the method 250 returns to 256, where the recipient is allowed to use the relevant stimulation parameters for a period of time before repeating steps 258-264. If it is determined that the additional assessment of the recipient's cognitive hearing ability is not approved, the method 250 ends at 266.

[0057] Figure 2The description has been made with reference to an assessment of cognitive hearing and using the results of the assessment to select and / or optimize cochlear implant stimulation parameters. However, it should be understood that the results of the cognitive hearing ability assessment can also be used to determine whether an individual is a candidate for a cochlear implant. More specifically, information collected from a pre-implantation cognitive hearing ability assessment can be used to characterize the cochlear implant candidacy of a prospective recipient and / or predict the outcome of a cochlear implant. In general, if the information collected from the pre-implantation cognitive hearing ability assessment indicates that the potential recipient has not experienced significant cross-modal reorganization, the potential recipient may have greater success with a cochlear implant.

[0058] As described above, individuals with hearing impairment are susceptible to cross-modal reorganization, which adversely affects the auditory areas of the brain. However, the introduction of auditory input (such as electrical audio information provided via a cochlear implant) can reclaim some of the auditory resources that the recipient had previously reconfigured, and thus can increase the recipient's cognitive auditory ability. Therefore, not only does hearing performance decline with age, but as the brain adapts to stimulation, the recipient's hearing may also improve. Therefore, understanding long-term cognitive auditory ability changes (i.e., changes in weeks, months, or even years) makes it possible to give medical advice on dynamic stimulation strategies and / or parameters. For example, if the recipient shows that cognitive ability is rising, the recipient may be able to use more aggressive stimulation parameters (e.g., higher rates, higher spectral density, etc.).

[0059] Thus, in addition to adjusting the stimulation parameters to the recipient's current cognitive auditory abilities and sensory state, it is also possible to generate a rehabilitation strategy for the recipient. For example, a recipient may be given an order with dynamic stimulation parameters that adapt over time to provide increasingly dense representations of the sound spectrum in an adaptive manner designed to challenge and improve the recipient's cognitive auditory abilities. In other words, the stimulation parameters may be arranged to push the limits of how much information the recipient can process periodically, randomly, progressively, etc., in order to restore additional resources in the auditory brain regions.

[0060] In some examples, the rehabilitation strategy may involve auditory training sessions or sessions specifically designed to challenge the recipient and improve auditory function. Again, these rehabilitation sessions are configured so that the auditory training tasks that occur therein are modified according to the recipient's auditory cognitive abilities and can be updated as auditory abilities improve.

[0061] While performing rehabilitation, the recipient's response to auditory training sessions or sessions can be monitored over a period of time to see if any improvements occur. If improvements are detected, stimulation parameters that provide a greater amount of information can be selected.

[0062] As described above, method 250 includes an initial assessment of the recipient's cognitive hearing ability and one or more supplemental assessments of the recipient's cognitive hearing ability. Also as described above, since the initial assessment includes both objective and subjective evaluations, the initial assessment of the recipient's cognitive hearing ability is usually conducted in a clinical setting. Figure 3 is a block diagram illustrating an example adaptation system 370 configured to perform the techniques presented herein.

[0063] Generally, the adapter system 370 is a computing device that includes a plurality of interfaces / ports 378(1)-378(N), a memory 380, a processor 384, and a user interface 386. The interfaces 378(1)-378(N) may include, for example, any combination of network ports (e.g., Ethernet ports), wireless network interfaces, Universal Serial Bus (USB) ports, Institute of Electrical and Electronics Engineers (IEEE) 1394 interfaces, PS / 2 ports, etc. Figure 3 In the example of , interface 378(1) is connected to cochlear implant system 100 having components implanted in recipient 371. Interface 378(1) may be connected directly to cochlear implant system 100 or to an external device that communicates with the cochlear implant system. Interface 378(1) may be configured to communicate with cochlear implant system 100 via a wired or wireless connection (e.g., telemetry, Bluetooth, etc.).

[0064] The user interface 386 includes one or more output devices, such as a liquid crystal display (LCD) and a speaker, for presenting visual or auditory information to a clinician, audiologist, or other user. The user interface 386 may also include one or more input devices, including, for example, a keypad, a keyboard, a mouse, a touch screen, etc.

[0065] The memory 380 includes a hearing ability profile management logic 381 that can be executed to generate or update a hearing ability profile 383 of a recipient stored in the memory 380. The hearing profile management logic 381 can be executed to receive a hearing ability profile 383 from an external device (such as an imaging system) via one of the other interfaces 378(2)-378(N). Figure 3 In some embodiments, the memory 380 includes subjective evaluation logic 385 configured to perform a subjective evaluation of the recipient's cognitive hearing ability and provide the result for use by the hearing ability profile management logic 381. In other embodiments, the subjective evaluation logic 385 is omitted and the hearing profile management logic 381 is executed to receive the result from an external device (eg, a hearing profile) via one of the other interfaces 378(2)-378(N). Figure 3 (not shown) to obtain the results of the subjective evaluation of the recipient's cognitive hearing ability.

[0066] The memory 380 also includes profile analysis logic 387. The profile analysis logic 387 is executed to analyze the recipient's auditory profile (ie, the relevant results of the objective and subjective evaluations) to identify relevant stimulation parameters that are optimized for the recipient's cognitive auditory abilities.

[0067] The memory 380 may include read-only memory (ROM), random access memory (RAM), magnetic disk storage media devices, optical storage media devices, flash memory devices, electrical, optical, or other physical / tangible memory storage devices. The processor 384 is, for example, a microprocessor or microcontroller that executes instructions for the auditory profile management logic 381, the subjective evaluation logic 385, and the profile analysis logic 387. Thus, in general, the memory 380 may include one or more tangible (non-transitory) computer-readable storage media (e.g., memory devices) encoded with software including computer-executable instructions, and when the software is executed (by the processor 384), it is operable to perform the techniques described herein.

[0068] The relevant stimulation parameters identified by executing profile analysis logic 387 are sent to cochlear implant system 100 for instantiation as the current relevant stimulation parameters for the cochlear implant. However, in some embodiments, the relevant stimulation parameters identified by executing profile analysis logic 387 are first displayed at user interface 386 for further evaluation and / or adjustment by the user. Thus, the user has the ability to improve the relevant stimulation parameters before the stimulation parameters are sent to cochlear implant system 100.

[0069] The general operation for analyzing the auditory profile of a recipient to identify relevant stimulation parameters optimized for the cognitive hearing ability of the recipient has been described above. However, it should be understood that the profile analysis logic 387 can operate according to one or more selected criteria set by the user via the user interface 386. For example, the user can configure the stimulation parameters that can be adjusted, or set limits on how the stimulation parameters can be adjusted.

[0070] As described above, the supplementary assessment of the recipient's cognitive hearing ability may include both objective and subjective assessments, or only subjective assessments. When both objective and subjective assessments are performed, the supplementary assessment is typically performed using, for example, Figure 3 The fitting system shown is performed in a clinical setting. However, when only subjective evaluation is used, a supplementary assessment can be performed in a remote setting using, for example, a computer, mobile phone or other consumer electronic device.

[0071] Figure 4is a block diagram of an illustrative arrangement for a mobile phone 403 configured to perform a subjective self-assessment and potentially initiate changes to the recipient's relevant stimulation parameters in accordance with embodiments presented herein. It should be understood that Figure 4 are illustrative only and supplementary assessments may be Figure 4 The different arrangements shown are performed on other devices.

[0072] The mobile phone 403 includes an antenna 405 and a telecommunication interface 407, which is configured for communication over a wireless communication network for telephone services (e.g., a Global System for Mobile Communications (GSM) network, a Code Division Multiple Access (CDMA) network, a Time Division Multiple Access (TDMA) network, or other types of networks). The mobile phone 403 also includes a wireless LAN interface 409, and an infrared (IR) or Interface 411. Trademark SIG. The wireless LAN interface 409 allows the mobile phone 403 to exchange data or connect to the Internet using, for example, 2.4 GHz ultra high frequency (UHF) and / or 5 GHz super high frequency (SHF) radio waves. Interface 411 enables mobile phone 403 to communicate wirelessly (ie, directly receive data from and transmit data to another device via a wireless connection). Interface 411 can be used to wirelessly connect mobile phone 403 to cochlear implant system 100 ( Figure 1 ). It should be understood that the wireless LAN interface and The combination of interfaces used is merely illustrative, and any other interface now known or later developed (including but not limited to Institute of Electrical and Electronics Engineers (IEEE) 802.11, IEEE802.16 (WiMAX), fixed line, Long Term Evolution (LTE), etc. interfaces) may also or alternatively form part of mobile phone 403.

[0073] The mobile phone 403 also includes an audio port 413, one or more sound input elements (such as a microphone 415), a speaker 417, a camera 421, a user interface 423, a subscriber identity module or a subscriber identification module (SIM) card 425, a battery 427, a processor 431, and a memory 433. The memory 433 includes a copy of the recipient's hearing ability profile 383 and a hearing ability profile management logic 481, which can be executed to update the recipient's hearing ability profile. The hearing profile management logic 481 can be executed to download a copy of the recipient's hearing ability profile from an external device (such as an adaptation system 370 or a cochlear implant system 100) using, for example, one of the interfaces 407, 409, or 411. The memory 433 also includes a subjective evaluation logic 485, which is configured to perform a subjective evaluation of the recipient's cognitive hearing ability and provide a result used by the hearing ability profile management logic 481.

[0074] The memory 433 also includes profile analysis logic 487. The profile analysis logic 487 is executed to analyze the hearing ability profile of the recipient to determine whether changes to the recipient's relevant stimulation parameters are appropriate, and in some embodiments, to initiate changes to the recipient's relevant stimulation parameters.

[0075] The memory 433 may include ROM, RAM, magnetic disk storage media devices, optical storage media devices, flash memory devices, electrical, optical or other physical / tangible storage devices. The processor 431 is, for example, a microprocessor or microcontroller that executes instructions for the auditory profile management logic 481, the subjective evaluation logic 485, and the profile analysis logic 487. Thus, in general, the memory 433 may include one or more tangible (non-transitory) computer-readable storage media (e.g., memory devices) encoded with software including computer-executable instructions, and when the software is executed (by the processor 431), it is operable to perform the techniques described herein.

[0076] In general, due in part to health / safety issues, recipients are provided with limited capabilities to initiate changes to their / his stimulation parameters. In one example, the recipient performs a subjective evaluation logic 485 to perform a self-evaluation, and the results of the self-evaluation are used by the hearing profile management logic 481 to update the recipient's hearing ability profile 383. The updated hearing ability profile 383 can then be analyzed by the profile analysis logic 487 to generate adjusted relevant stimulation parameters. These adjusted stimulation parameters can be uploaded to a database for evaluation and approval by a clinician or audiologist, and if approved, are provided to the cochlear implant system 100 for instantiation. In another embodiment, self-evaluation, profile updates, and profile analysis can be remotely monitored by a clinician or audiologist for real-time reprogramming based on self-determined relevant stimulation parameters. In other embodiments, the profile analysis logic 487 is only allowed to change a limited number of stimulation parameters, such as a threshold or comfort level of the recipient, which can be changed without the approval of a clinician or audiologist.

[0077] In embodiments utilizing remote supplemental assessment of cognitive auditory abilities, the results of self-assessment, profile updates, and profile analysis are uploaded to one or more databases to ensure alignment between the remote environment and the clinical environment.

[0078] Figure 5 is a high-level flow chart of method 551 according to an embodiment presented herein. Method 551 begins at 553 by assessing the cognitive hearing ability of a recipient of a stimulating hearing prosthesis. As described above, an initial or supplemental assessment of the recipient's cognitive hearing ability can include: one or more objective assessments configured to objectively quantify how the recipient's auditory brain regions have been affected by cross-modal reorganization; and / or one or more subjective assessments configured to assess at least one of cognitive load or listening effort. In some examples, the supplemental assessment of the recipient's cognitive hearing ability can be accompanied by a sensory assessment and / or a hearing test.

[0079] Returning to method 551, the results of the assessment of the recipient's cognitive hearing ability are used to determine a plurality of stimulation parameters for use in stimulating the hearing prosthesis at 555. The stimulation parameters are related to the recipient's cognitive hearing ability such that an electrical stimulation signal generated using the stimulation parameters, when delivered to the recipient, will present to the recipient an amount of electrical audio information that is consistent with the recipient's cognitive hearing ability.

[0080] Figure 6657 is a high-level flow chart of another method 657 according to embodiments presented herein. The method 657 begins at 659 by assessing the cognitive hearing ability of an individual. At 661, a hearing ability profile is generated based on the assessment of the cognitive hearing ability of the individual. The hearing ability profile represents the impact of cross-modal recombination on the individual's ability to process information received via stimulation of a hearing prosthesis.

[0081] The invention described and claimed herein is not limited in scope by the specific preferred embodiments disclosed herein, because these embodiments are intended to be illustrative of several aspects of the present invention and not limiting. Any equivalent embodiments are intended to be within the scope of the present invention. In fact, various modifications of the present invention will become clear to those skilled in the art, except those shown and described herein, according to the foregoing description. These modifications are also intended to fall within the scope of the appended claims.

Claims

1. A method for optimizing stimulation parameters for a sensory prosthesis, comprising: At one or more processors: assessing cognitive sensory abilities of a recipient of the sensory prosthesis to quantify the ability of the recipient's sensory brain regions to process information of the corresponding sensory modality; as well as determining a plurality of stimulation parameters for use by the sensory prosthesis based on the capabilities of the sensory brain region of the recipient; as well as The plurality of stimulation parameters are provided to the sensory prosthesis for instantiation at the sensory prosthesis.

2. The method according to claim 1, further comprising: Signals are generated using the plurality of stimulation parameters instantiated at the sensory prosthesis that, when delivered to the recipient, optimize an amount of corresponding sensory modality information presented to the recipient to the cognitive sensory capabilities of the recipient.

3. The method of claim 1, wherein assessing the cognitive sensory abilities of the recipient comprises: At least one subjective assessment is performed, the at least one subjective assessment configured to assess at least one of cognitive load or effort.

4. The method of claim 1, wherein assessing the cognitive sensory abilities of the recipient comprises: At least one objective assessment is performed, the at least one objective assessment configured to quantify how a sensory brain region of the recipient is affected by cross-modal reorganization.

5. The method of claim 1, wherein assessing the cognitive sensory abilities of the recipient further comprises: How the recipient's sensory brain regions are affected by cross-modal reorganization is analyzed in conjunction with one or more measures of cognitive load or effort to estimate the ability of the recipient's sensory brain regions to process information of the corresponding sensory modality.

6. The method of claim 5, wherein determining the plurality of stimulation parameters comprises: A measure of the information expected to be presented by the stimulation parameters is matched to a measure of the estimated capacity of a sensory brain region of the recipient for processing corresponding sensory modality information.

7. The method according to claim 1, further comprising: At least one sensory evaluation is performed to identify functional sensory difficulties experienced by the recipient.

8. The method of claim 1 , wherein assessing the cognitive sensory abilities of the recipient of the sensory prosthesis comprises: A recipient-initiated self-assessment of said cognitive sensory abilities is performed at a non-clinical location.

9. The method according to claim 1, further comprising: performing a supplemental assessment of said cognitive sensory abilities of said recipient; identifying a change in the cognitive sensory ability of the recipient; as well as The plurality of stimulation parameters are adjusted based on the change in the cognitive sensory ability of the recipient.

10. The method of claim 9, wherein adjusting the plurality of stimulation parameters comprises: The stimulation parameters are adjusted to increase the amount of the corresponding sensory modality information presented to the recipient by each signal set generated using the stimulation parameters.

11. The method of claim 9, wherein adjusting the plurality of stimulation parameters comprises: The stimulation parameters are adjusted to reduce an amount of the corresponding sensory modality information presented to the recipient by each signal set generated using the stimulation parameters.

12. The method according to claim 1, further comprising: A set of signals generated using adaptive stimulation parameters is delivered to achieve rehabilitation of the recipient's cognitive sensory abilities.

13. The method of claim 1, wherein the sensory prosthesis comprises at least one of an auditory prosthesis and a visual prosthesis.

14. The method of claim 1, wherein the stimulation parameters comprise electrical stimulation parameters.

15. A method for optimizing stimulation parameters for a sensory prosthesis, comprising: At one or more processors: Performing assessments of cognitive sensory abilities in recipients of sensory prostheses; generating a sensory capability profile based on the assessment of the recipient's cognitive sensory capabilities, the sensory capability profile representing an estimated impact of cross-modal recombination on the recipient's ability to process information received via the sensory prosthesis; determining a plurality of stimulation parameters for use by the sensory prosthesis based on the estimated effect of cross-modal recombination on the recipient's ability to process information received via the sensory prosthesis; as well as The plurality of stimulation parameters are transmitted to the sensory prosthesis.

16. The method of claim 15, wherein performing an assessment of the recipient's cognitive sensory abilities comprises: At least one subjective assessment is performed, the at least one subjective assessment configured to assess at least one of cognitive load or effort.

17. The method of claim 15, wherein performing an assessment of the recipient's cognitive sensory abilities comprises: At least one objective assessment is performed, the at least one objective assessment configured to objectively quantify how a sensory brain region of the recipient is affected by cross-modal recombination.

18. The method of claim 15, wherein generating the sensory capability profile comprises: How the recipient's sensory brain region is affected by cross-modal reorganization is analyzed in conjunction with one or more measures of cognitive load or effort to generate an estimate of the recipient's sensory brain region's capacity to process corresponding sensory modality information.

19. The method according to claim 18, further comprising: The sensory capability profile is used to generate stimulation parameters that are related to an estimated capability of a sensory brain region of the recipient for corresponding sensory modality information.

20. The method of claim 15, further comprising: At least one sensory evaluation is performed to identify functional sensory difficulties experienced by the recipient.

21. The method of claim 15, further comprising: A determination is made based on the sensory capability profile whether the recipient is a candidate for the sensory prosthesis.

22. The method of claim 15, further comprising: performing a supplemental assessment of the recipient's cognitive sensory abilities at a non-clinical location, wherein the supplemental assessment is initiated by the recipient using a consumer electronic device; as well as The sensory capability profile is updated based on the supplemental assessment of the recipient's cognitive sensory capabilities.

23. The method of claim 15, wherein the sensory prosthesis comprises at least one of an auditory prosthesis and a visual prosthesis.

24. The method of claim 15, wherein the stimulation parameters comprise electrical stimulation parameters.

25. An apparatus for optimizing stimulation parameters for a sensory prosthesis, comprising: Memory; as well as One or more processors configured to: obtaining results of one or more evaluations of cognitive sensory abilities of a recipient of the sensory prosthesis; generating a sensory capability profile based on the one or more evaluations of the recipient's cognitive sensory capabilities, the sensory capability profile representing an effect of cross-modal recombination on the recipient's ability to process information received via the sensory prosthesis; analyzing the sensory capability profile to select a plurality of stimulation parameters for use by the sensory prosthesis, wherein the stimulation parameters are related to the cognitive sensory capabilities of the recipient; as well as The plurality of stimulation parameters are provided to the sensory prosthesis.

26. The apparatus of claim 25, wherein to obtain one or more assessments of the recipient's cognitive sensory abilities, the processor is configured to: At least one subjective assessment is performed that evaluates at least one of cognitive load or effort.

27. The apparatus of claim 25, wherein to obtain one or more assessments of the recipient's cognitive sensory abilities, the processor is configured to: Results of at least one objective assessment are obtained, the at least one objective assessment objectively quantifying how a sensory brain region of the recipient is affected by cross-modal reorganization.

28. The apparatus of claim 25, wherein to generate the sensory capability profile, the processor is configured to: How the recipient's sensory brain regions are affected by cross-modal reorganization is analyzed in conjunction with one or more measures of cognitive load or effort to estimate the ability of the recipient's sensory brain regions to process information of the corresponding sensory modality.

29. The apparatus of claim 27, wherein to analyze the sensory capability profile to select a plurality of stimulation parameters for use by the sensory prosthesis, the processor is configured to: A measure of the information expected to be presented by the stimulation parameters is matched to a measure of the estimated capacity of a sensory brain region of the recipient for processing corresponding sensory modality information.

30. The apparatus of claim 25, wherein the processor is further configured to: Results of at least one sensory evaluation are obtained to identify a functional sensory difficulty experienced by the recipient.

31. The apparatus of claim 25, wherein the processor is configured to: performing a supplemental assessment of said cognitive sensory abilities of said recipient; identifying changes in the cognitive sensory abilities of the recipient; and The plurality of stimulation parameters are adjusted based on the change in the cognitive sensory ability of the recipient.

32. The apparatus of claim 25, wherein the sensory prosthesis comprises at least one of an auditory prosthesis and a visual prosthesis.

33. The apparatus of claim 25, wherein the stimulation parameters comprise electrical stimulation parameters.

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