Functional near-infrared spectroscopy as a tool for assessing speech and spoken language processing in pediatric and adult cochlear implant users

Speech-Processing Network Formation of Cochlear-Implanted Toddlers With Early Hearing Experiences

To reveal the formation process of speech processing with early hearing experiences, we tracked the development of functional connectivity in the auditory and language-related cortical areas of 84 (36 female) congenitally deafened toddlers using repeated functional near-infrared spectroscopy for up to 36 months post cochlear implantation (CI). Upon hearing restoration, the CI children lacked the modular organization of the mature speech-processing network and demonstrated a higher degree of immaturity in temporo-parietal than temporo-frontal connections. The speech-processing network appeared to form rapidly with early CI experiences, with two-thirds of the developing connections following nonlinear trajectories reflecting possibly more than one synaptogenesis-pruning cycle. A few key features of the mature speech-processing network emerged within the first year of CI hearing, including left-hemispheric advantage, differentiation of the dorsal and ventral processing streams, and functional state (speech listening vs. resting) specific patterns of connectivity development. The developmental changes were predictable of future auditory and verbal communication skills of the CI children, with prominent contribution from temporo-parietal connections in the dorsal stream, suggesting a mediating role of speech-processing network formation with early hearing experiences in speech acquisition.

Speech-evoked cortical activities and speech recognition in adult cochlear implant listeners: a review of functional near-infrared spectroscopy studies

Cochlear implants (CIs) are the most successful neural prostheses, enabling individuals with severe to profound hearing loss to access sounds and understand speech. While CI has demonstrated success, speech perception outcomes vary largely among CI listeners, with significantly reduced performance in noise. This review paper summarizes prior findings on speech-evoked cortical activities in adult CI listeners using functional near-infrared spectroscopy (fNIRS) to understand (a) speech-evoked cortical processing in CI listeners compared to normal-hearing (NH) individuals, (b) the relationship between these activities and behavioral speech recognition scores, (c) the extent to which current fNIRS-measured speech-evoked cortical activities in CI listeners account for their differences in speech perception, and (d) challenges in using fNIRS for CI research. Compared to NH listeners, CI listeners had diminished speech-evoked activation in the middle temporal gyrus (MTG) and in the superior temporal gyrus (STG), except one study reporting an opposite pattern for STG. NH listeners exhibited higher inferior frontal gyrus (IFG) activity when listening to CI-simulated speech compared to natural speech. Among CI listeners, higher speech recognition scores correlated with lower speech-evoked activation in the STG, higher activation in the left IFG and left fusiform gyrus, with mixed findings in the MTG. fNIRS shows promise for enhancing our understanding of cortical processing of speech in CI listeners, though findings are mixed. Challenges include test-retest reliability, managing noise, replicating natural conditions, optimizing montage design, and standardizing methods to establish a strong predictive relationship between fNIRS-based cortical activities and speech perception in CI listeners.

Functional near-infrared spectrometry for auditory speech stimuli in cochlear implant users: a systematic literature review

OBJECTIVE

This study aims to identify the acquisition features of functional near-infrared spectroscopy (fNIRS) in cochlear implant users.

METHODS

A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, LILACS, Web of Science, Scopus, PsycINFO, IEEE Xplore, Google Scholar, and ProQuest Dissertations & Theses Global were searched using the PECOS acronym. Inclusion criteria encompassed studies involving fNIRS with speech stimuli in cochlear implant users of any age, with information on acquisition parameters and features. Risk of bias assessment was performed using the Joanna Briggs Institute tool.

RESULTS

Nineteen studies were included, with thirteen exhibiting a low risk of bias. Noteworthy uniformity was observed in certain fNIRS acquisition features among cochlear implant users, including the waking state (awake), auditory stimuli of words or phrases presented in a free field, visual stimuli displayed during data collection as a secondary task, recording of responses in the bilateral temporal lobe, and a three-centimeter distance between optodes. Variations in acquisition were attributed to differing study purposes.

CONCLUSION

This review identifies common acquisition characteristics for fNIRS in cochlear implant users. Multicenter research efforts are advocated to further advance the utility of fNIRS in this population.

Cortical Responses to Mother's Voice in Comparison with Unfamiliar Voice in the First Trimester of Life: A fNIRS Study

Introduction  The use of functional near-infrared light spectroscopy (fNIRS) may be applied to study cortical responses in children and could offer insight into auditory and speech perception during the early stages of life. Some literature suggests that babies are already able to identify familiar voices at birth, and fNIRS is a non-invasive technique that can be used to study this population. Objective  To characterize the cortical responses of infants during their first trimester of life to infant-directed speech using near-infrared light spectroscopy and to verify whether there is a difference in responses when infant-directed speech is performed by their mother compared with an unknown person. Methods  Twenty-three children between 0 and 3 months, healthy, without risk indicators for hearing loss, and with results considered normal in the audiological evaluation were tested with near-infrared spectroscopy using infant-directed speech as an auditory stimulus produced by their own mother and by an unknown source. Results  Bilateral cortical activation was observed. The responses were present in the temporal, frontal, and parietal regions. Regarding the familiarity aspect, no significant difference was observed for the mother's voice compared with an unknown voice. Conclusion  Infant-directed speech has prosodic characteristics capable of activating several cortical regions in the infant's first trimester of life, especially the temporal region. The familiarity effect needs to be better defined for this type of stimulus during this period.

Audiovisual integration in children with cochlear implants revealed through EEG and fNIRS

Sensory deprivation can offset the balance of audio versus visual information in multimodal processing. Such a phenomenon could persist for children born deaf, even after they receive cochlear implants (CIs), and could potentially explain why one modality is given priority over the other. Here, we recorded cortical responses to a single speaker uttering two syllables, presented in audio-only (A), visual-only (V), and audio-visual (AV) modes. Electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) were successively recorded in seventy-five school-aged children. Twenty-five were children with normal hearing (NH) and fifty wore CIs, among whom 26 had relatively high language abilities (HL) comparable to those of NH children, while 24 others had low language abilities (LL). In EEG data, visual-evoked potentials were captured in occipital regions, in response to V and AV stimuli, and they were accentuated in the HL group compared to the LL group (the NH group being intermediate). Close to the vertex, auditory-evoked potentials were captured in response to A and AV stimuli and reflected a differential treatment of the two syllables but only in the NH group. None of the EEG metrics revealed any interaction between group and modality. In fNIRS data, each modality induced a corresponding activity in visual or auditory regions, but no group difference was observed in A, V, or AV stimulation. The present study did not reveal any sign of abnormal AV integration in children with CI. An efficient multimodal integrative network (at least for rudimentary speech materials) is clearly not a sufficient condition to exhibit good language and literacy.

Dynamic networks differentiate the language ability of children with cochlear implants

Background

Cochlear implantation (CI) in prelingually deafened children has been shown to be an effective intervention for developing language and reading skill. However, there is a substantial proportion of the children receiving CI who struggle with language and reading. The current study-one of the first to implement electrical source imaging in CI population was designed to identify the neural underpinnings in two groups of CI children with good and poor language and reading skill.

Methods

Data using high density electroencephalography (EEG) under a resting state condition was obtained from 75 children, 50 with CIs having good (HL) or poor language skills (LL) and 25 normal hearing (NH) children. We identified coherent sources using dynamic imaging of coherent sources (DICS) and their effective connectivity computing time-frequency causality estimation based on temporal partial directed coherence (TPDC) in the two CI groups compared to a cohort of age and gender matched NH children.

Findings

Sources with higher coherence amplitude were observed in three frequency bands (alpha, beta and gamma) for the CI groups when compared to normal hearing children. The two groups of CI children with good (HL) and poor (LL) language ability exhibited not only different cortical and subcortical source profiles but also distinct effective connectivity between them. Additionally, a support vector machine (SVM) algorithm using these sources and their connectivity patterns for each CI group across the three frequency bands was able to predict the language and reading scores with high accuracy.

Interpretation

Increased coherence in the CI groups suggest overall that the oscillatory activity in some brain areas become more strongly coupled compared to the NH group. Moreover, the different sources and their connectivity patterns and their association to language and reading skill in both groups, suggest a compensatory adaptation that either facilitated or impeded language and reading development. The neural differences in the two groups of CI children may reflect potential biomarkers for predicting outcome success in CI children.

Brightening the Study of Listening Effort with Functional Near-Infrared Spectroscopy: A Scoping Review

Listening effort is a long-standing area of interest in auditory cognitive neuroscience. Prior research has used multiple techniques to shed light on the neurophysiological mechanisms underlying listening during challenging conditions. Functional near-infrared spectroscopy (fNIRS) is growing in popularity as a tool for cognitive neuroscience research, and its recent advances offer many potential advantages over other neuroimaging modalities for research related to listening effort. This review introduces the basic science of fNIRS and its uses for auditory cognitive neuroscience. We also discuss its application in recently published studies on listening effort and consider future opportunities for studying effortful listening with fNIRS. After reading this article, the learner will know how fNIRS works and summarize its uses for listening effort research. The learner will also be able to apply this knowledge toward generation of future research in this area.

Functional near-infrared spectroscopy in pediatric clinical research: Different pathophysiologies and promising clinical applications

Over its 30 years of existence, functional near-infrared spectroscopy (fNIRS) has matured into a highly versatile tool to study brain function in infants and young children. Its advantages, amongst others, include its ease of application and portability, the option to combine it with electrophysiology, and its relatively good tolerance to movement. As shown by the impressive body of fNIRS literature in the field of cognitive developmental neuroscience, the method's strengths become even more relevant for (very) young individuals who suffer from neurological, behavioral, and/or cognitive impairment. Although a number of studies have been conducted with a clinical perspective, fNIRS cannot yet be considered as a truly clinical tool. The first step has been taken in this direction by studies exploring options in populations with well-defined clinical profiles. To foster further progress, here, we review several of these clinical approaches to identify the challenges and perspectives of fNIRS in the field of developmental disorders. We first outline the contributions of fNIRS in selected areas of pediatric clinical research: epilepsy, communicative and language disorders, and attention-deficit/hyperactivity disorder. We provide a scoping review as a framework to allow the highlighting of specific and general challenges of using fNIRS in pediatric research. We also discuss potential solutions and perspectives on the broader use of fNIRS in the clinical setting. This may be of use to future research, targeting clinical applications of fNIRS in children and adolescents.

Using functional near-infrared spectroscopy to study the early developing brain: future directions and new challenges

Significance

Functional near-infrared spectroscopy (fNIRS) is a frequently used neuroimaging tool to explore the developing brain, particularly in infancy, with studies spanning from birth to toddlerhood (0 to 2 years). We provide an overview of the challenges and opportunities that the developmental fNIRS field faces, after almost 25 years of research.

Aim

We discuss the most recent advances in fNIRS brain imaging with infants and outlines the trends and perspectives that will likely influence progress in the field in the near future.

Approach

We discuss recent progress and future challenges in various areas and applications of developmental fNIRS from methodological and technological innovations to data processing and statistical approaches.

Results and Conclusions

The major trends identified include uses of fNIRS "in the wild," such as global health contexts, home and community testing, and hyperscanning; advances in hardware, such as wearable technology; assessment of individual variation and developmental trajectories particularly while embedded in studies examining other environmental, health, and context specific factors and longitudinal designs; statistical advances including resting-state network and connectivity, machine learning and reproducibility, and collaborative studies. Standardization and larger studies have been, and will likely continue to be, a major goal in the field, and new data analysis techniques, statistical methods, and collaborative cross-site projects are emerging.

Controlling jaw-related motion artifacts in functional near-infrared spectroscopy

BACKGROUND

Functional near-infrared spectroscopy (fNIRS) as a non-invasive optical neuroimaging technique has demonstrated great potential in monitoring cerebral activity. Due to its portability and compatibility with medical implants, fNIRS has seen increasing applications in studying the hearing, language and cognitive functions. However, fNIRS is susceptible to artifacts related to jaw movements, such as teeth clenching, swallowing and speaking, which affect recordings over the temporal, parietal and frontal/prefrontal cortices.

NEW METHOD

We investigated two new approaches to control the jaw-related motion artifacts, an individually customized bite bar apparatus and a denoising algorithm namely PCA-GLM based on multi-channel fNIRS recordings from long-separation and short-separation montage. We first recorded data while subjects performed a clenching task, then an auditory task and a resting-state task with and without the bite bar.

RESULTS

Our results have shown that jaw clenching can introduce spurious, task-evoked-like responses in fNIRS signals. A bite bar customized for each participant effectively suppressed the movement-related activities in fNIRS, at both task and resting-state conditions. Moreover, the bite bar and the PCA-GLM denoising method are shown to improve auditory responses, by significantly reducing the within-subject standard deviation, increasing the task-related contrast-to-noise ratio, and yielding stronger activations to the auditory stimuli.

COMPARISON WITH EXISTING METHOD(S)

The current study has demonstrated a novel method to control the jaw-related motion artifacts in fNIRS signals.

CONCLUSIONS

Our method will benefit the study of the hearing, language and cognitive functions in normal healthy subjects and patients.

Exploring neurocognitive factors and brain activation in adult cochlear implant recipients associated with speech perception outcomes-A scoping review

Background

Cochlear implants (CIs) are considered an effective treatment for severe-to-profound sensorineural hearing loss. However, speech perception outcomes are highly variable among adult CI recipients. Top-down neurocognitive factors have been hypothesized to contribute to this variation that is currently only partly explained by biological and audiological factors. Studies investigating this, use varying methods and observe varying outcomes, and their relevance has yet to be evaluated in a review. Gathering and structuring this evidence in this scoping review provides a clear overview of where this research line currently stands, with the aim of guiding future research.

Objective

To understand to which extent different neurocognitive factors influence speech perception in adult CI users with a postlingual onset of hearing loss, by systematically reviewing the literature.

Methods

A systematic scoping review was performed according to the PRISMA guidelines. Studies investigating the influence of one or more neurocognitive factors on speech perception post-implantation were included. Word and sentence perception in quiet and noise were included as speech perception outcome metrics and six key neurocognitive domains, as defined by the DSM-5, were covered during the literature search (Protocol in open science registries: 10.17605/OSF.IO/Z3G7W of searches in June 2020, April 2022).

Results

From 5,668 retrieved articles, 54 articles were included and grouped into three categories using different measures to relate to speech perception outcomes: (1) Nineteen studies investigating brain activation, (2) Thirty-one investigating performance on cognitive tests, and (3) Eighteen investigating linguistic skills.

Conclusion

The use of cognitive functions, recruiting the frontal cortex, the use of visual cues, recruiting the occipital cortex, and the temporal cortex still available for language processing, are beneficial for adult CI users. Cognitive assessments indicate that performance on non-verbal intelligence tasks positively correlated with speech perception outcomes. Performance on auditory or visual working memory, learning, memory and vocabulary tasks were unrelated to speech perception outcomes and performance on the Stroop task not to word perception in quiet. However, there are still many uncertainties regarding the explanation of inconsistent results between papers and more comprehensive studies are needed e.g., including different assessment times, or combining neuroimaging and behavioral measures.

Systematic review registration

https://doi.org/10.17605/OSF.IO/Z3G7W.

Spectrotemporal Modulation Discrimination in Infants With Normal Hearing

OBJECTIVES

Spectral resolution correlates with speech understanding in post-lingually deafened adults with cochlear implants (CIs) and is proposed as a non-linguistic measure of device efficacy in implanted infants. However, spectral resolution develops gradually through adolescence regardless of hearing status. Spectral resolution relies on two different factors that mature at markedly different rates: Resolution of ripple peaks (frequency resolution) matures during infancy whereas sensitivity to across-spectrum intensity modulation (spectral modulation sensitivity) matures by age 12. Investigation of spectral resolution as a clinical measure for implanted infants requires understanding how each factor develops and constrains speech understanding with a CI. This study addresses the limitations of the present literature. First, the paucity of relevant data requires replication and generalization across measures of spectral resolution. Second, criticism that previously used measures of spectral resolution may reflect non-spectral cues needs to be addressed. Third, rigorous behavioral measurement of spectral resolution in individual infants is limited by attrition. To address these limitations, we measured discrimination of spectrally modulated, or rippled, sounds at two modulation depths in normal hearing (NH) infants and adults. Non-spectral cues were limited by constructing stimuli with spectral envelopes that change in phase across time. Pilot testing suggested that dynamic spectral envelope stimuli appeared to hold infants' attention and lengthen habituation time relative to previously used static ripple stimuli. A post-hoc condition was added to ensure that the stimulus noise carrier was not obscuring age differences in spectral resolution. The degree of improvement in discrimination at higher ripple depth represents spectral frequency resolution independent of the overall threshold. It was hypothesized that adults would have better thresholds than infants but both groups would show similar effects of modulation depth.

DESIGN

Participants were 53 6- to 7-month-old infants and 23 adults with NH with no risk factors for hearing loss who passed bilateral otoacoustic emissions screening. Stimuli were created from complexes with 33- or 100-tones per octave, amplitude-modulated across frequency and time with constant 5 Hz envelope phase-drift and spectral ripple density from 1 to 20 ripples per octave (RPO). An observer-based, single-interval procedure measured the highest RPO (1 to 19) a listener could discriminate from a 20 RPO stimulus. Age-group and stimulus pure-tone complex were between-subjects variables whereas modulation depth (10 or 20 dB) was within-subjects. Linear-mixed model analysis was used to test for the significance of the main effects and interactions.

RESULTS

All adults and 94% of infants provided ripple density thresholds at both modulation depths. The upper range of threshold approached 17 RPO with the 100-tones/octave carrier and 20 dB depth condition. As expected, mean threshold was significantly better with the 100-tones/octave compared with the 33-tones/octave complex, better in adults than in infants, and better at 20 dB than 10 dB modulation depth. None of the interactions reached significance, suggesting that the effect of modulation depth on the threshold was not different for infants or adults.

CONCLUSIONS

Spectral ripple discrimination can be measured in infants with minimal listener attrition using dynamic ripple stimuli. Results are consistent with previous findings that spectral resolution is immature in infancy due to immature spectral modulation sensitivity rather than frequency resolution.

The Effects of Cortical Reorganization and Applications of Functional Near-Infrared Spectroscopy in Deaf People and Cochlear Implant Users

A cochlear implant (CI) is currently the only FDA-approved biomedical device that can restore hearing for the majority of patients with severe-to-profound sensorineural hearing loss (SNHL). While prelingually and postlingually deaf individuals benefit substantially from CI, the outcomes after implantation vary greatly. Numerous studies have attempted to study the variables that affect CI outcomes, including the personal characteristics of CI candidates, environmental variables, and device-related variables. Up to 80% of the results remained unexplainable because all these variables could only roughly predict auditory performance with a CI. Brain structure/function differences after hearing deprivation, that is, cortical reorganization, has gradually attracted the attention of neuroscientists. The cross-modal reorganization in the auditory cortex following deafness is thought to be a key factor in the success of CI. In recent years, the adaptive and maladaptive effects of this reorganization on CI rehabilitation have been argued because the neural mechanisms of how this reorganization impacts CI learning and rehabilitation have not been revealed. Due to the lack of brain processes describing how this plasticity affects CI learning and rehabilitation, the adaptive and deleterious consequences of this reorganization on CI outcomes have recently been the subject of debate. This review describes the evidence for different roles of cross-modal reorganization in CI performance and attempts to explore the possible reasons. Additionally, understanding the core influencing mechanism requires taking into account the cortical changes from deafness to hearing restoration. However, methodological issues have restricted longitudinal research on cortical function in CI. Functional near-infrared spectroscopy (fNIRS) has been increasingly used for the study of brain function and language assessment in CI because of its unique advantages, which are considered to have great potential. Here, we review studies on auditory cortex reorganization in deaf patients and CI recipients, and then we try to illustrate the feasibility of fNIRS as a neuroimaging tool in predicting and assessing speech performance in CI recipients. Here, we review research on the cross-modal reorganization of the auditory cortex in deaf patients and CI recipients and seek to demonstrate the viability of using fNIRS as a neuroimaging technique to predict and evaluate speech function in CI recipients.

Individual-Specific Characterization of Event-Related Hemodynamic Responses during an Auditory Task: An Exploratory Study

Functional near-infrared spectroscopy (fNIRS) has been established as an informative modality for understanding the hemodynamic-metabolic correlates of cortical auditory processing. To date, such knowledge has shown broad clinical applications in the diagnosis, treatment, and intervention procedures in disorders affecting auditory processing; however, exploration of the hemodynamic response to auditory tasks is yet incomplete. This holds particularly true in the context of auditory event-related fNIRS experiments, where preliminary work has shown the presence of valid responses while leaving the need for more comprehensive explorations of the hemodynamic correlates of event-related auditory processing. In this study, we apply an individual-specific approach to characterize fNIRS-based hemodynamic changes during an auditory task in healthy adults. Oxygenated hemoglobin (HbO₂) concentration change time courses were acquired from eight participants. Independent component analysis (ICA) was then applied to isolate individual-specific class discriminative spatial filters, which were then applied to HbO₂ time courses to extract auditory-related hemodynamic features. While six of eight participants produced significant class discriminative features before ICA-based spatial filtering, the proposed method identified significant auditory hemodynamic features in all participants. Furthermore, ICA-based filtering improved correlation between trial labels and extracted features in every participant. For the first time, this study demonstrates hemodynamic features important in experiments exploring auditory processing as well as the utility of individual-specific ICA-based spatial filtering in fNIRS-based feature extraction techniques in auditory experiments. These outcomes provide insights for future studies exploring auditory hemodynamic characteristics and may eventually provide a baseline framework for better understanding auditory response dysfunctions in clinical populations.

Investigating effortful speech perception using fNIRS and pupillometry measures

The current study examined the neural mechanisms for mental effort and its correlation to speech perception using functional near-infrared spectroscopy (fNIRS) in listeners with normal hearing (NH). Data were collected while participants listened and responded to unprocessed and degraded sentences, where words were presented in grammatically correct or shuffled order. Effortful listening and task difficulty due to stimulus manipulations was confirmed using a subjective questionnaire and a well-established objective measure of mental effort - pupillometry. fNIRS measures focused on cortical responses in two a priori regions of interest, the left auditory cortex (AC) and lateral frontal cortex (LFC), which are closely related to auditory speech perception and listening effort, respectively. We examined the relations between the two objective measures and behavioral measures of speech perception (task performance) and task difficulty.

Results

demonstrated that changes in pupil dilation were positively correlated with the self-reported task difficulty levels and negatively correlated with the task performance scores. A significant and negative correlation between the two behavioral measures was also found. That is, as perceived task demands increased and task performance scores decreased, pupils dilated more. fNIRS measures (cerebral oxygenation) in the left AC and LFC were both negatively correlated with the self-reported task difficulty levels and positively correlated with task performance scores. These results suggest that pupillometry measures can indicate task demands and listening effort; whereas, fNIRS measures using a similar paradigm seem to reflect speech processing, but not effort.

Lawrence K, Tachtsidis I, Tong Y, Torricelli A, Urner T, Wabnitz H, Wolf M, Wolf U, Xu S, Yang C, Yodh AG, Yücel MA, Zhou W. Optical imaging and spectroscopy for the study of the human brain: status report

This report is the second part of a comprehensive two-part series aimed at reviewing an extensive and diverse toolkit of novel methods to explore brain health and function. While the first report focused on neurophotonic tools mostly applicable to animal studies, here, we highlight optical spectroscopy and imaging methods relevant to noninvasive human brain studies. We outline current state-of-the-art technologies and software advances, explore the most recent impact of these technologies on neuroscience and clinical applications, identify the areas where innovation is needed, and provide an outlook for the future directions.

Functional localization of audiovisual speech using near infrared spectroscopy

Visual cues are especially vital for hearing impaired individuals such as cochlear implant (CI) users to understand speech in noise. Functional Near Infrared Spectroscopy (fNIRS) is a light-based imaging technology that is ideally suited for measuring the brain activity of CI users due to its compatibility with both the ferromagnetic and electrical components of these implants. In a preliminary step toward better elucidating the behavioral and neural correlates of audiovisual (AV) speech integration in CI users, we designed a speech-in-noise task and measured the extent to which 24 normal hearing individuals could integrate the audio of spoken monosyllabic words with the corresponding visual signals of a female speaker. In our behavioral task, we found that audiovisual pairings provided average improvements of 103% and 197% over auditory-alone listening conditions in -6 and -9 dB signal-to-noise ratios consisting of multi-talker background noise. In an fNIRS task using similar stimuli, we measured activity during auditory-only listening, visual-only lipreading, and AV listening conditions. We identified cortical activity in all three conditions over regions of middle and superior temporal cortex typically associated with speech processing and audiovisual integration. In addition, three channels active during the lipreading condition showed uncorrected correlations associated with behavioral measures of audiovisual gain as well as with the McGurk effect. Further work focusing primarily on the regions of interest identified in this study could test how AV speech integration may differ for CI users who rely on this mechanism for daily communication.

Language development in infants with hearing loss: Benefits of infant-directed speech

The majority of infants with permanent congenital hearing loss fall significantly behind their normal hearing peers in the development of receptive and expressive oral communication skills. Independent of any prosthetic intervention ("hardware") for infants with hearing loss, the social and linguistic environment ("software") can still be optimal or sub-optimal and so can exert significant positive or negative effects on speech and language acquisition, with far-reaching beneficial or adverse effects, respectively. This review focusses on the nature of the social and linguistic environment of infants with hearing loss, in particular others' speech to infants. The nature of this "infant-directed speech" and its effects on language development has been studied extensively in hearing infants but far less comprehensively in infants with hearing loss. Here, literature on the nature of infant-directed speech and its impact on the speech perception and language acquisition in infants with hearing loss is reviewed. The review brings together evidence on the little-studied effects of infant-directed speech on speech and language development in infants with hearing loss, and provides suggestions, over and above early screening and external treatment, for a natural intervention at the level of the carer-infant microcosm that may well optimize the early linguistic experiences and mitigate later adverse effects for infants born with hearing loss.

Speech token detection and discrimination in individual infants using functional near-infrared spectroscopy

Speech detection and discrimination ability are important measures of hearing ability that may inform crucial audiological intervention decisions for individuals with a hearing impairment. However, behavioral assessment of speech discrimination can be difficult and inaccurate in infants, prompting the need for an objective measure of speech detection and discrimination ability. In this study, the authors used functional near-infrared spectroscopy (fNIRS) as the objective measure. Twenty-three infants, 2 to 10 months of age participated, all of whom had passed newborn hearing screening or diagnostic audiology testing. They were presented with speech tokens at a comfortable listening level in a natural sleep state using a habituation/dishabituation paradigm. The authors hypothesized that fNIRS responses to speech token detection as well as speech token contrast discrimination could be measured in individual infants. The authors found significant fNIRS responses to speech detection in 87% of tested infants (false positive rate 0%), as well as to speech discrimination in 35% of tested infants (false positive rate 9%). The results show initial promise for the use of fNIRS as an objective clinical tool for measuring infant speech detection and discrimination ability; the authors highlight the further optimizations of test procedures and analysis techniques that would be required to improve accuracy and reliability to levels needed for clinical decision-making.

Use of Functional Near-Infrared Spectroscopy to Predict and Measure Cochlear Implant Outcomes: A Scoping Review

Outcomes following cochlear implantation vary widely for both adults and children, and behavioral tests are currently relied upon to assess this. However, these behavioral tests rely on subjective judgements that can be unreliable, particularly for infants and young children. The addition of an objective test of outcome following cochlear implantation is therefore desirable. The aim of this scoping review was to comprehensively catalogue the evidence for the potential of functional near infrared spectroscopy (fNIRS) to be used as a tool to objectively predict and measure cochlear implant outcomes. A scoping review of the literature was conducted following the PRISMA extension for scoping review framework. Searches were conducted in the MEDLINE, EMBASE, PubMed, CINAHL, SCOPUS, and Web of Science electronic databases, with a hand search conducted in Google Scholar. Key terms relating to near infrared spectroscopy and cochlear implants were used to identify relevant publications. Eight records met the criteria for inclusion. Seven records reported on adult populations, with five records only including post-lingually deaf individuals and two including both pre- and post-lingually deaf individuals. Studies were either longitudinal or cross-sectional, and all studies compared fNIRS measurements with receptive speech outcomes. This review identified and collated key work in this field. The homogeneity of the populations studied so far identifies key gaps for future research, including the use of fNIRS in infants. By mapping the literature on this important topic, this review contributes knowledge towards the improvement of outcomes following cochlear implantation.

Correcting physiological noise in whole-head functional near-infrared spectroscopy

BACKGROUND

Functional near-infrared spectroscopy (fNIRS) has been increasingly employed to monitor cerebral hemodynamics in normal and diseased conditions. However, fNIRS suffers from its susceptibility to superficial activity and systemic physiological noise. The objective of the study was to establish a noise reduction method for fNIRS in a whole-head montage.

NEW METHOD

We have developed an automated denoising method for whole-head fNIRS. A high-density montage consisting of 109 long-separation channels and 8 short-separation channels was used for recording. Auxiliary sensors were also used to measure motion, respiration and pulse simultaneously. The method incorporates principal component analysis and general linear model to identify and remove a globally uniform superficial component. Our denoising method was evaluated in experimental data acquired from a group of healthy human subjects during a visually cued motor task and further compared with a minimal preprocessing method and three established denoising methods in the literature. Quantitative metrics including contrast-to-noise ratio, within-subject standard deviation and adjusted coefficient of determination were evaluated.

RESULTS

After denoising, whole-head topography of fNIRS revealed focal activations concurrently in the primary motor and visual areas.

COMPARISON WITH EXISTING METHODS

Analysis showed that our method improves upon the four established preprocessing methods in the literature.

CONCLUSIONS

An automatic, effective and robust preprocessing pipeline was established for removing physiological noise in whole-head fNIRS recordings. Our method can enable fNIRS as a reliable tool in monitoring large-scale, network-level brain activities for clinical uses.

Brain-wide functional diffuse optical tomography of resting state networks

Objective.Diffuse optical tomography (DOT) has the potential in reconstructing resting state networks (RSNs) in human brains with high spatio-temporal resolutions and multiple contrasts. While several RSNs have been reported and successfully reconstructed using DOT, its full potential in recovering a collective set of distributed brain-wide networks with the number of RSNs close to those reported using functional magnetic resonance imaging (fMRI) has not been demonstrated.Approach.The present study developed a novel brain-wide DOT (BW-DOT) framework that integrates a cap-based whole-head optode placement system with multiple computational approaches, i.e. finite-element modeling, inverse source reconstruction, data-driven pattern recognition, and statistical correlation tomography, to reconstruct RSNs in dual contrasts of oxygenated (HbO) and deoxygenated hemoglobins (HbR).Main results.Our results from the proposed framework revealed a comprehensive set of RSNs and their subnetworks, which collectively cover almost the entire neocortical surface of the human brain, both at the group level and individual participants. The spatial patterns of these DOT RSNs suggest statistically significant similarities to fMRI RSN templates. Our results also reported the networks involving the medial prefrontal cortex and precuneus that had been missed in previous DOT studies. Furthermore, RSNs obtained from HbO and HbR suggest similarity in terms of both the number of RSN types reconstructed and their corresponding spatial patterns, while HbR RSNs show statistically more similarity to fMRI RSN templates and HbO RSNs indicate more bilateral patterns over two hemispheres. In addition, the BW-DOT framework allowed consistent reconstructions of RSNs across individuals and across recording sessions, indicating its high robustness and reproducibility, respectively.Significance.Our present results suggest the feasibility of using the BW-DOT, as a neuroimaging tool, in simultaneously mapping multiple RSNs and its potential values in studying RSNs, particularly in patient populations under diverse conditions and needs, due to its advantages in accessibility over fMRI.

Hemodynamic responses during standing and sitting activities: a study toward fNIRS-BCI

In this paper, we utilized functional near-infrared spectroscopy (fNIRS) technology to examine the hemodynamic responses in the motor cortex for two conditions, namely standing and sitting tasks. Nine subjects performed five trials of standing and sitting (SAS) tasks with both real movements and imagery thinking of SAS. A group level of statistical parametric mapping (SPM) analysis during these tasks showed bilateral activation of oxy-hemoglobin for both real movements and imagery experiments. Interestingly, the SPM analysis clearly revealed that the sitting tasks induced a higher oxy-hemoglobin level activation compared to the standing task. Remarkably, this finding is persistent across the 22 measured channels at the individual and group levels for both experiments. Furthermore, six features were extracted from pre-processed HbO signals and the performance of four different classifiers was examined in order to test the viability of using SAS tasks in future fNIRS-brain-computer interface (fNIRS-BCI) systems. In particular, two features-combination tests revealed that the signal slope with signal variance represents one of the three best two-combined features for its consistency in providing high accuracy results for both real and imagery experiments. This study shows the potential of implementing such tasks into the fNIRS-BCI system. In the future, the results of this work could pave the way towards the application of fNIRS-BCI in lower limb rehabilitation.

Parental use of multimodal cues in the initiation of joint attention as a function of child hearing status

In the current study, we examine how hearing parents use multimodal cuing to establish joint attention with their hearing (N=9) or deaf (N=9) children during a free-play session. The deaf children were all candidates for cochlear implantation who had not yet been implanted, and each hearing child was age-matched to a deaf child. We coded parents' use of auditory, visual, and tactile cues, alone and in different combinations, during both successful and failed bids for children's attention. Although our findings revealed no clear quantitative differences in parents' use of multimodal cues as a function of child hearing status, secondary analyses revealed that hearing parents of deaf children used shorter utterances while initiating joint attention than did hearing parents of hearing children. Hearing parents of deaf children also touched their children twice as often throughout the play session than did hearing parents of hearing children. These findings demonstrate that parents differentially accommodate the specific needs of their hearing and deaf children in subtle ways to establish communicative intent.

Structural neuroimaging of the altered brain stemming from pediatric and adolescent hearing loss-Scientific and clinical challenges

There has been a spurt in structural neuroimaging studies of the effect of hearing loss on the brain. Specifically, magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) technologies provide an opportunity to quantify changes in gray and white matter structures at the macroscopic scale. To date, there have been 32 MRI and 23 DTI studies that have analyzed structural differences accruing from pre- or peri-lingual pediatric hearing loss with congenital or early onset etiology and postlingual hearing loss in pre-to-late adolescence. Additionally, there have been 15 prospective clinical structural neuroimaging studies of children and adolescents being evaluated for cochlear implants. The results of the 70 studies are summarized in two figures and three tables. Plastic changes in the brain are seen to be multifocal rather than diffuse, that is, differences are consistent across regions implicated in the hearing, speech and language networks regardless of modes of communication and amplification. Structures in that play an important role in cognition are affected to a lesser extent. A limitation of these studies is the emphasis on volumetric measures and on homogeneous groups of subjects with hearing loss. It is suggested that additional measures of morphometry and connectivity could contribute to a greater understanding of the effect of hearing loss on the brain. Then an interpretation of the observed macroscopic structural differences is given. This is followed by discussion of how structural imaging can be combined with functional imaging to provide biomarkers for longitudinal tracking of amplification. This article is categorized under: Developmental Biology > Developmental Processes in Health and Disease Translational, Genomic, and Systems Medicine > Translational Medicine Laboratory Methods and Technologies > Imaging.

Assessment of age-related decline of neurovascular coupling responses by functional near-infrared spectroscopy (fNIRS) in humans

Preclinical studies provide strong evidence that age-related impairment of neurovascular coupling (NVC) plays a causal role in the pathogenesis of vascular cognitive impairment (VCI). NVC is a critical homeostatic mechanism in the brain, responsible for adjustment of local cerebral blood flow to the energetic needs of the active neuronal tissue. Recent progress in geroscience has led to the identification of critical cellular and molecular mechanisms involved in neurovascular aging, identifying these pathways as targets for intervention. In order to translate the preclinical findings to humans, there is a need to assess NVC in geriatric patients as an endpoint in clinical studies. Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging technique that enables the investigation of local changes in cerebral blood flow, quantifying task-related changes in oxygenated and deoxygenated hemoglobin concentrations. In the present overview, the basic principles of fNIRS are introduced and the application of this technique to assess NVC in older adults with implications for the design of studies on the mechanistic underpinnings of VCI is discussed.