|
1
|
Moon PK, Qian JZ, McKenna E, Xi K, Rowe NC, Ng NN, Zheng J, Tam LT, MacEachern SJ, Ahmad I, Cheng AG, Forkert ND, Yeom KW. Cerebral volume and diffusion MRI changes in children with sensorineural hearing loss. NEUROIMAGE-CLINICAL 2020; 27:102328. [PMID: 32622314 PMCID: PMC7334366 DOI: 10.1016/j.nicl.2020.102328] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/19/2020] [Accepted: 06/20/2020] [Indexed: 12/11/2022]
Abstract
Microstructural and macrostructural changes in sensorineural hearing loss. Magnetic resonance imaging as tool to assess cerebral volume and diffusion. Greater diffusion in cortex, thalamus, caudate, brainstem with hearing loss. Smaller brainstem volume with hearing loss. Connexin 26, Pendrin mutations show diffusion changes in brainstem and thalamus.
Purpose Sensorineural hearing loss (SNHL) is the most prevalent congenital sensory deficit in children. Information regarding underlying brain microstructure could offer insight into neural development in deaf children and potentially guide therapies that optimize language development. We sought to quantitatively evaluate MRI-based cerebral volume and gray matter microstructure children with SNHL. Methods & Materials We conducted a retrospective study of children with SNHL who obtained brain MRI at 3 T. The study cohort comprised 63 children with congenital SNHL without known focal brain lesion or structural abnormality (33 males; mean age 5.3 years; age range 1 to 11.8 years) and 64 age-matched controls without neurological, developmental, or MRI-based brain macrostructure abnormality. An atlas-based analysis was used to extract quantitative volume and median diffusivity (ADC) in the following brain regions: cerebral cortex, thalamus, caudate, putamen, globus pallidus, hippocampus, amygdala, nucleus accumbens, brain stem, and cerebral white matter. SNHL patients were further stratified by severity scores and hearing loss etiology. Results Children with SNHL showed higher median ADC of the cortex (p = .019), thalamus (p < .001), caudate (p = .005), and brainstem (p = .003) and smaller brainstem volumes (p = .007) compared to controls. Patients with profound bilateral SNHL did not show any significant differences compared to patients with milder bilateral SNHL, but both cohorts independently had smaller brainstem volumes compared to controls. Children with unilateral SNHL showed greater amygdala volumes compared to controls (p = .021), but no differences were found comparing unilateral SNHL to bilateral SNHL. Based on etiology for SNHL, patients with Pendrin mutations showed higher ADC values in the brainstem (p = .029, respectively); patients with Connexin 26 showed higher ADC values in both the thalamus (p < .001) and brainstem (p < .001) compared to controls. Conclusion SNHL patients showed significant differences in diffusion and volume in brain subregions, with region-specific findings for patients with Connexin 26 and Pendrin mutations. Future longitudinal studies could examine macro- and microstructure changes in children with SNHL over development and potential predictive role for MRI after interventions including cochlear implant outcome.
Collapse
Affiliation(s)
- Peter K Moon
- Stanford University School of Medicine, Stanford, CA, USA
| | - Jason Z Qian
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA
| | - Emily McKenna
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA
| | - Kevin Xi
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA
| | - Nathan C Rowe
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Nathan N Ng
- Stanford University School of Medicine, Stanford, CA, USA
| | - Jimmy Zheng
- Stanford University School of Medicine, Stanford, CA, USA
| | - Lydia T Tam
- Stanford University School of Medicine, Stanford, CA, USA
| | - Sarah J MacEachern
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Iram Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA
| | - Alan G Cheng
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA
| | - Nils D Forkert
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Kristen W Yeom
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA.
| |
Collapse
|
|
2
|
Philips B, Maes LK, Keppler H, Dhooge I. Cochlear implants in children deafened by congenital cytomegalovirus and matched Connexin 26 peers. Int J Pediatr Otorhinolaryngol 2014; 78:410-5. [PMID: 24485973 DOI: 10.1016/j.ijporl.2013.11.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 11/07/2013] [Accepted: 11/09/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the long-term speech perception and production outcomes after cochlear implantation (CI) in children deafened by congenital cytomegalovirus (cCMV) with a matched group of Cx26-CI children by controlling for chronological age and magnetic resonance imaging (MRI) findings. METHODS Retrospective review of 12 cCMV-CI children and matched Cx26-CI children for speech perception and speech production outcomes. RESULTS Two trends were seen in our data. First, cCMV-CI children with normal MRI scans perform equally or even slightly better on speech perception tests compared to their Cx26-CI peers during the first three years. The majority of cCMV-CI children with normal MRI scans (5 out of 7), suffered from a delayed-onset SNHL. Their mean age at first implantation (2y9m, range 15-82m) was higher compared to their matched Cx26 peers (9m, range 7-12m). Before being implanted, the majority of these delayed-onset hearing impaired children had benefited from a certain period of normal hearing (with or without amplification of a hearing aid). Possibly, this input might have led to an advantage the first three years after CI. Second, results between cCMV-CI children with and cCMV-CI children without MRI abnormalities and their matched Cx26-CI counterparts tentatively suggest that, over a 5-yr follow-up period, cCMV-CI children with abnormalities on MRI scans catch up for speech perception, but lag behind for speech production. CONCLUSION cCMV-CI children with normal MRI scans perform equally or even slightly better on speech perception tests compared to their Cx26-CI peers during the first three years, whereas results between cCMV-CI children with and cCMV-CI children without MRI abnormalities and their matched Cx26-CI counterparts tentatively suggest that, over a 5-yr follow-up period, cCMV-CI children with abnormal MRI scans catch up for speech perception, but lag behind for speech production. In future, the inclusion of MRI results may assist in improved counseling of parents with cCMV deafened children seeking CI.
Collapse
Affiliation(s)
- Birgit Philips
- Ghent University, Faculty of Medicine and Health Sciences, Belgium.
| | - Leen K Maes
- Ghent University, Faculty of Medicine and Health Sciences, Belgium
| | - Hannah Keppler
- Ghent University, Faculty of Medicine and Health Sciences, Belgium
| | - Ingeborg Dhooge
- Ghent University, Faculty of Medicine and Health Sciences, Belgium; Ghent University Hospital, ENT-Department, De Pintelaan 185, 1P1, 9000 Ghent, Belgium
| |
Collapse
|
|
3
|
Abstract
PURPOSE OF REVIEW Over the last decade, the selection criteria for cochlear implantation have expanded to include children with special auditory, otologic, and medical problems. Included within this expanded group of candidates are those children with auditory neuropathy spectrum disorder, cochleovestibular malformations, cochlear nerve deficiency, associated syndromes, as well as multiple medical and developmental disorders. Definitive indications for cochlear implantation in these unique pediatric populations are in evolution. This review will provide an overview of managing and habilitating hearing loss within these populations with specific focus on cochlear implantation as a treatment option. RECENT FINDINGS Cochlear implants have been successfully implanted in children within unique populations with variable results. Evaluation for cochlear implant candidacy includes the core components of a full medical, audiologic, and speech and language evaluations. When considering candidacy in these children, additional aspects to consider include disorder-specific surgical considerations and child/caregiver counseling regarding reasonable postimplantation outcome expectations. SUMMARY Cochlear implants are accepted as the standard of care for improving hearing and speech development in children with severe-to-profound hearing loss. However, children with sensorineural hearing loss who meet established audiologic criteria for cochlear implantation may have unique audiologic, medical, and anatomic characteristics that necessitate special consideration regarding cochlear implantation candidacy and outcome. Individualized preoperative candidacy and counseling, surgical evaluation, and reasonable postoperative outcome expectations should be taken into account in the management of these children.
Collapse
|