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Inguscio BMS, Cartocci G, Sciaraffa N, Nicastri M, Giallini I, Aricò P, Greco A, Babiloni F, Mancini P. Two are better than one: Differences in cortical EEG patterns during auditory and visual verbal working memory processing between Unilateral and Bilateral Cochlear Implanted children. Hear Res 2024; 446:109007. [PMID: 38608331 DOI: 10.1016/j.heares.2024.109007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024]
Abstract
Despite the proven effectiveness of cochlear implant (CI) in the hearing restoration of deaf or hard-of-hearing (DHH) children, to date, extreme variability in verbal working memory (VWM) abilities is observed in both unilateral and bilateral CI user children (CIs). Although clinical experience has long observed deficits in this fundamental executive function in CIs, the cause to date is still unknown. Here, we have set out to investigate differences in brain functioning regarding the impact of monaural and binaural listening in CIs compared with normal hearing (NH) peers during a three-level difficulty n-back task undertaken in two sensory modalities (auditory and visual). The objective of this pioneering study was to identify electroencephalographic (EEG) marker pattern differences in visual and auditory VWM performances in CIs compared to NH peers and possible differences between unilateral cochlear implant (UCI) and bilateral cochlear implant (BCI) users. The main results revealed differences in theta and gamma EEG bands. Compared with hearing controls and BCIs, UCIs showed hypoactivation of theta in the frontal area during the most complex condition of the auditory task and a correlation of the same activation with VWM performance. Hypoactivation in theta was also observed, again for UCIs, in the left hemisphere when compared to BCIs and in the gamma band in UCIs compared to both BCIs and NHs. For the latter two, a correlation was found between left hemispheric gamma oscillation and performance in the audio task. These findings, discussed in the light of recent research, suggest that unilateral CI is deficient in supporting auditory VWM in DHH. At the same time, bilateral CI would allow the DHH child to approach the VWM benchmark for NH children. The present study suggests the possible effectiveness of EEG in supporting, through a targeted approach, the diagnosis and rehabilitation of VWM in DHH children.
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Affiliation(s)
- Bianca Maria Serena Inguscio
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy.
| | - Giulia Cartocci
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy
| | | | - Maria Nicastri
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
| | - Ilaria Giallini
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
| | - Pietro Aricò
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy; Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, Via Ariosto 125, Rome 00185, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
| | - Fabio Babiloni
- Department of Molecular Medicine, Sapienza University of Rome, Viale Regina Elena 291, Rome 00161, Italy; BrainSigns Srl, Via Tirso, 14, Rome 00198, Italy; Department of Computer Science, Hangzhou Dianzi University, Xiasha Higher Education Zone, Hangzhou 310018, China
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale dell'Università 31, Rome 00161, Italy
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Lima JVDS, de Morais CFM, Zamberlan-Amorim NE, Mandrá PP, Reis ACMB. Neurocognitive function in children with cochlear implants and hearing aids: a systematic review. Front Neurosci 2023; 17:1242949. [PMID: 37859761 PMCID: PMC10582571 DOI: 10.3389/fnins.2023.1242949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/15/2023] [Indexed: 10/21/2023] Open
Abstract
Purpose To systematically review the existing literature that examines the relationship between cognition, hearing, and language in children using cochlear implants and hearing aids. Method The review has been registered in Prospero (Registration: CRD 42020203974). The review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and examined the scientific literature in VHL, MEDLINE, CINAHL, Scopus, WOS, and Embase. It included original observational studies in children using hearing aids and/or cochlear implants who underwent cognitive and auditory and/or language tests. Data were extracted from the studies and their level of evidence was graded with the Oxford Center for Evidence-Based Medicine: Levels of Evidence. Meta-analysis could not be performed due to data heterogeneity. Outcomes are described in narrative and tables synthesis. Results The systematic search and subsequent full-text evaluation identified 21 studies, conducted in 10 different countries. Altogether, their samples comprised 1,098 individuals, aged 0.16-12.6 years. The studies assessed the following cognitive domains: memory, nonverbal cognition, reasoning, attention, executive functions, language, perceptual-motor function, visuoconstructive ability, processing speed, and phonological processing/phonological memory. Children with hearing loss using cochlear implants and hearing aids scored significantly lower in many cognitive functions than normal hearing (NH) children. Neurocognitive functions were correlated with hearing and language outcomes. Conclusion Many cognitive tools were used to assess cognitive function in children with hearing devices. Results suggest that children with cochlear implants and hearing aids have cognitive deficits; these outcomes are mainly correlated with vocabulary. This study highlights the need to understand children's cognitive function and increase the knowledge of the relationship between cognition, language, and hearing in children using cochlear implants and hearing aids.
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Affiliation(s)
- Jefferson Vilela da Silva Lima
- Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Caroline Favaretto Martins de Morais
- Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Nelma Ellen Zamberlan-Amorim
- Clinics Hospital of the Ribeirão Preto Medical School (HCFMRP-USP), University of São Paulo, Ribeirão Preto, Brazil
| | - Patricia Pupin Mandrá
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Polikowsky HG, Shaw DM, Petty LE, Chen HH, Pruett DG, Linklater JP, Viljoen KZ, Beilby JM, Highland HM, Levitt B, Avery CL, Mullan Harris K, Jones RM, Below JE, Kraft SJ. Population-based genetic effects for developmental stuttering. HGG ADVANCES 2021; 3:100073. [PMID: 35047858 PMCID: PMC8756529 DOI: 10.1016/j.xhgg.2021.100073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Despite a lifetime prevalence of at least 5%, developmental stuttering, characterized by prolongations, blocks, and repetitions of speech sounds, remains a largely idiopathic speech disorder. Family, twin, and segregation studies overwhelmingly support a strong genetic influence on stuttering risk; however, its complex mode of inheritance combined with thus-far underpowered genetic studies contribute to the challenge of identifying and reproducing genes implicated in developmental stuttering susceptibility. We conducted a trans-ancestry genome-wide association study (GWAS) and meta-analysis of developmental stuttering in two primary datasets: The International Stuttering Project comprising 1,345 clinically ascertained cases from multiple global sites and 6,759 matched population controls from the biobank at Vanderbilt University Medical Center (VUMC), and 785 self-reported stuttering cases and 7,572 controls ascertained from The National Longitudinal Study of Adolescent to Adult Health (Add Health). Meta-analysis of these genome-wide association studies identified a genome-wide significant (GWS) signal for clinically reported developmental stuttering in the general population: a protective variant in the intronic or genic upstream region of SSUH2 (rs113284510, protective allele frequency = 7.49%, Z = -5.576, p = 2.46 × 10-8) that acts as an expression quantitative trait locus (eQTL) in esophagus-muscularis tissue by reducing its gene expression. In addition, we identified 15 loci reaching suggestive significance (p < 5 × 10-6). This foundational population-based genetic study of a common speech disorder reports the findings of a clinically ascertained study of developmental stuttering and highlights the need for further research.
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Affiliation(s)
- Hannah G. Polikowsky
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Douglas M. Shaw
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lauren E. Petty
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hung-Hsin Chen
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dillon G. Pruett
- Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
| | | | | | - Janet M. Beilby
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Heather M. Highland
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brandt Levitt
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christy L. Avery
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathleen Mullan Harris
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robin M. Jones
- Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA
| | - Jennifer E. Below
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA,Corresponding author
| | - Shelly Jo Kraft
- Communication Sciences and Disorders, Wayne State University, Detroit, MI, USA,Corresponding author
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Lammers D, Rocker A, Chan DS, Couchman D, Wang Y, Fraser A, MacCormick J, Bromwich M. iHear: Canadian medical student based hearing assessment program for grade school children using a tablet audiometer. J Otolaryngol Head Neck Surg 2021; 50:60. [PMID: 34715947 PMCID: PMC8556998 DOI: 10.1186/s40463-021-00542-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate the progress and challenges of a hearing screening program as well as review the incidence of pediatric hearing loss in grade school children participating in this program. Methods Medical students from the University of Ottawa established iHear, a grade school hearing assessment program that uses novel tablet audiometry. Over 3 years, children in grades 1 and 2 were assessed and those found to have abnormal results on iHear assessment were then referred to audiology for formal testing, and to otolaryngology if needed. Results From 2014 to 2017, 753 children aged 5–9 years old were assessed for hearing loss. Mean age of participants was 6.7 years, 51.9% of whom were female. Of the children assessed, 86 (11.4%) had abnormal results and 6 (0.8%) had inconsistent results, necessitating 92 referrals for assessment by a professional audiologist. Of the 65 participants who completed secondary audiologic assessment, 54 (83.1%) were normal and 11 (16.9%) had a definitive hearing loss or abnormal tympanometry. A total of 32 children were lost to follow-up. A total of 118 medical students were involved in the iHear program. Conclusions Hearing loss in grade school populations continues to go undetected across Canada. Programs such as iHear demonstrate that gaps in the provision of hearing assessment can be filled effectively by medical students equipped with tablet audiometry. Medical student exposure to audiology and otolaryngology increased through the iHear program. Graphical Abstract ![]()
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Affiliation(s)
- Deanna Lammers
- Division of Otolaryngology - Head and Neck Surgery, Dalhousie University, Halifax, Canada
| | - Adam Rocker
- Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - David S Chan
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Canada
| | - Deema Couchman
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Yiqiao Wang
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Amy Fraser
- Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Johnna MacCormick
- Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Matthew Bromwich
- Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.
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Wright B, Hargate R, Garside M, Carr G, Wakefield T, Swanwick R, Noon I, Simpson P. A systematic scoping review of early interventions for parents of deaf infants. BMC Pediatr 2021; 21:467. [PMID: 34686176 PMCID: PMC8532316 DOI: 10.1186/s12887-021-02893-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/03/2021] [Indexed: 02/14/2023] Open
Abstract
Background Over 90% of the 50,000 deaf children in the UK have hearing parents, many of whom were not expecting a deaf child and may require specialist support. Deaf children can experience poorer long-term outcomes than hearing children across a range of domains. After early detection by the Universal Newborn Hearing Screening Programme, parents in the UK receive support from Qualified Teachers of the Deaf and audiologists but resources are tight and intervention support can vary by locality. There are challenges faced due to a lack of clarity around what specific parenting support interventions are most helpful. Methods The aim of this research was to complete a systematic scoping review of the evidence to identify early support interventions for parents of deaf infants. From 5577 identified records, 54 met inclusion criteria. Two reviewers screened papers through three rounds before completing data extraction and quality assessment. Results Identified parent support interventions included both group and individual sessions in various settings (including online). They were led by a range of professionals and targeted various outcomes. Internationally there were only five randomised controlled trials. Other designs included non-randomised comparison groups, pre / post and other designs e.g. longitudinal, qualitative and case studies. Quality assessment showed few high quality studies with most having some concerns over risk of bias. Conclusion Interventions commonly focused on infant language and communication followed by parental knowledge and skills; parent wellbeing and empowerment; and parent/child relationship. There were no interventions that focused specifically on parent support to understand or nurture child socio-emotional development despite this being a well-established area of poor outcome for deaf children. There were few UK studies and research generally was not of high quality. Many studies were not recent and so not in the context of recent healthcare advances. Further research in this area is urgently needed to help develop evidence based early interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02893-9.
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Affiliation(s)
- B Wright
- Leeds and York Partnership NHS Foundation Trust, COMIC Research, IT Centre, Science Park, University of York, Innovation Way, Heslington, York, YO10 5NP, UK
| | - R Hargate
- Leeds and York Partnership NHS Foundation Trust, COMIC Research, IT Centre, Science Park, University of York, Innovation Way, Heslington, York, YO10 5NP, UK
| | - M Garside
- Leeds and York Partnership NHS Foundation Trust, COMIC Research, IT Centre, Science Park, University of York, Innovation Way, Heslington, York, YO10 5NP, UK.
| | - G Carr
- The University College London Ear Institute, 332 Grays Inn Rd, London, WC1X 8EE, UK
| | - T Wakefield
- National Deaf Children's Society and NatSIP, Ground Floor South, Castle House 37-45 Paul Street, London, EC2A 4LS, UK
| | - R Swanwick
- University of Leeds, School of Education, Hillary Place, Woodhouse, Leeds, LS2 9JT, UK
| | - I Noon
- National Deaf Children's Society and NatSIP, Ground Floor South, Castle House 37-45 Paul Street, London, EC2A 4LS, UK
| | - P Simpson
- British Association of Teachers of the Deaf, 21, Keating Close, Rochester, ME1 1EQ, UK
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Okely JA, Akeroyd MA, Deary IJ. Associations Between Hearing and Cognitive Abilities From Childhood to Middle Age: The National Child Development Study 1958. Trends Hear 2021; 25:23312165211053707. [PMID: 34747273 PMCID: PMC8581793 DOI: 10.1177/23312165211053707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Previous cross-sectional findings indicate that hearing and cognitive abilities are positively correlated in childhood, adulthood, and older age. We used an unusually valuable longitudinal dataset from a single-year birth cohort study, the National Child Development Study 1958, to test how hearing and cognitive abilities relate to one another across the life course from childhood to middle age. Cognitive ability was assessed with a single test of general cognitive ability at age 11 years and again with multiple tests at age 50. Hearing ability was assessed, using a pure tone audiogram, in childhood at ages 11 and 16 and again at age 44. Associations between childhood and middle-age hearing and cognitive abilities were investigated using structural equation modelling. We found that higher cognitive ability was associated with better hearing (indicated by a lower score on the hearing ability variables); this association was apparent in childhood (r = -0.120, p <0.001) and middle age (r = -0.208, p <0.001). There was a reciprocal relationship between hearing and cognitive abilities over time: better hearing in childhood was weakly associated with a higher cognitive ability in middle age (β = -0.076, p = 0.001), and a higher cognitive ability in childhood was associated with better hearing in middle age (β = -0.163, p <0.001). This latter, stronger effect was mediated by occupational and health variables in adulthood. Our results point to the discovery of a potentially life-long relationship between hearing and cognitive abilities and demonstrate how these variables may influence one another over time.
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Affiliation(s)
- Judith A Okely
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, UK
| | - Michael A Akeroyd
- Hearing Sciences, Division of Clinical Neurosciences, School of
Medicine, University of Nottingham, UK
| | - Ian J Deary
- Lothian Birth Cohort Studies, Department of Psychology, University of Edinburgh, UK
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Bortfeld H. Functional near-infrared spectroscopy as a tool for assessing speech and spoken language processing in pediatric and adult cochlear implant users. Dev Psychobiol 2018; 61:430-443. [PMID: 30588618 DOI: 10.1002/dev.21818] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 11/04/2018] [Accepted: 11/16/2018] [Indexed: 11/11/2022]
Abstract
Much of what is known about the course of auditory learning in following cochlear implantation is based on behavioral indicators that users are able to perceive sound. Both prelingually deafened children and postlingually deafened adults who receive cochlear implants display highly variable speech and language processing outcomes, although the basis for this is poorly understood. To date, measuring neural activity within the auditory cortex of implant recipients of all ages has been challenging, primarily because the use of traditional neuroimaging techniques is limited by the implant itself. Functional near-infrared spectroscopy (fNIRS) is an imaging technology that works with implant users of all ages because it is non-invasive, compatible with implant devices, and not subject to electrical artifacts. Thus, fNIRS can provide insight into processing factors that contribute to variations in spoken language outcomes in implant users, both children and adults. There are important considerations to be made when using fNIRS, particularly with children, to maximize the signal-to-noise ratio and to best identify and interpret cortical responses. This review considers these issues, recent data, and future directions for using fNIRS as a tool to understand spoken language processing in children and adults who hear through a cochlear implant.
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Affiliation(s)
- Heather Bortfeld
- Psychological Sciences, University of California, Merced, Merced, California
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8
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Fitzpatrick EM, Al-Essa RS, Whittingham J, Fitzpatrick J. Characteristics of children with unilateral hearing loss. Int J Audiol 2017. [PMID: 28639843 DOI: 10.1080/14992027.2017.1337938] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The purpose of this study was to describe the clinical characteristics of children with unilateral hearing loss (UHL), examine deterioration in hearing, and explore amplification decisions. DESIGN Population-based data were collected prospectively from time of diagnosis. Serial audiograms and amplification details were retrospectively extracted from clinical charts to document the trajectory and management of hearing loss. SAMPLE The study included all children identified with UHL in one region of Canada over a 13-year period (2003-2015) after implementation of universal newborn hearing screening. RESULTS Of 537 children with permanent hearing loss, 20.1% (108) presented with UHL at diagnosis. They were identified at a median age of 13.9 months (IQR: 2.8, 49.0). Children with congenital loss were identified at 2.8 months (IQR: 2.0, 3.6) and made up 47.2% (n = 51), reflecting that a substantial portion had late-onset, acquired or late-identified loss. A total of 42.4% (n = 39) showed deterioration in hearing, including 16 (17.4%) who developed bilateral loss. By study end, 73.1% (79/108) of children had received amplification recommendations. CONCLUSIONS Up to 20% of children with permanent HL are first diagnosed with UHL. About 40% are at risk for deterioration in hearing either in the impaired ear and/or in the normal hearing ear.
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Affiliation(s)
- Elizabeth M Fitzpatrick
- a Faculty of Health Sciences , University of Ottawa , Ottawa , Canada.,b Children's Hospital of Eastern Ontario Research Institute , Ottawa , Canada
| | - Rakan S Al-Essa
- c College of Medicine , King Saud bin Abdulaziz University for Health Sciences , Riyadh , Kingdom of Saudi Arabia , and
| | - JoAnne Whittingham
- b Children's Hospital of Eastern Ontario Research Institute , Ottawa , Canada
| | - Jessica Fitzpatrick
- d Dalla Lana School of Public Health Sciences , University of Toronto , Toronto , Canada
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Downie L, Halliday JL, Burt RA, Lunke S, Lynch E, Martyn M, Poulakis Z, Gaff C, Sung V, Wake M, Hunter M, Saunders K, Rose E, Rehm HL, Amor DJ. A protocol for whole-exome sequencing in newborns with congenital deafness: a prospective population-based cohort. BMJ Paediatr Open 2017; 1:e000119. [PMID: 29637142 PMCID: PMC5862171 DOI: 10.1136/bmjpo-2017-000119] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/31/2017] [Accepted: 08/02/2017] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The aetiology of congenital hearing loss is heterogeneous, and in many infants a genetic cause is suspected. Parents face a diagnostic odyssey when searching for a cause of their infant's hearing loss. Through the Melbourne Genomics Health Alliance, a prospective cohort of infants will be offered whole-exome sequencing (WES) with targeted analysis in conjunction with chromosome microarray to determine the genetic causes of congenital hearing loss. Parents will also be offered the opportunity to receive additional results from their infant's WES. METHODS Eligible infants will be identified through the Victorian Infant Hearing Screening Program and offered an appointment in a paediatrician-run clinic, a genetics assessment and enrolment in the Victorian Childhood Hearing Impairment Longitudinal Databank. If parents consent to WES, genes causing deafness will be analysed and they can choose to obtain additional findings. For the additional results component, a modified laboratory protocol has been designed for reporting of results in the absence of a relevant phenotype. Parents' experience of being offered WES will be evaluated using surveys. DISCUSSION This project will provide descriptive analysis of the genetic aetiology of congenital hearing loss in this cohort and may provide data on genotype-phenotype correlations. Additionally, choices regarding additional findings will be analysed. Participants will represent a diverse cross section of the population, increasing the ability to generalise results beyond the study group. Evaluation surveys will allow analysis of preferences around counselling, usefulness of a decision aid and adequacy of information provision.
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Affiliation(s)
- Lilian Downie
- Victorian Clinical Genetics Services, Victoria, Melbourne, Australia.,Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Royal Children's Hospital, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Jane L Halliday
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Rachel A Burt
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Sebastian Lunke
- Victorian Clinical Genetics Services, Victoria, Melbourne, Australia.,Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Elly Lynch
- Melbourne Genomics Health Alliance, Victoria, Melbourne, Australia.,Austin Health, Victoria, Melbourne, Australia
| | - Melissa Martyn
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Melbourne Genomics Health Alliance, Victoria, Melbourne, Australia
| | - Zeffie Poulakis
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Royal Children's Hospital, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Clara Gaff
- Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia.,Melbourne Genomics Health Alliance, Victoria, Melbourne, Australia
| | - Valerie Sung
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Royal Children's Hospital, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia.,University of Auckland, Auckland, New Zealand
| | - Matthew Hunter
- Monash Health, Victoria, Melbourne, Australia.,Monash University, Victoria, Melbourne, Australia
| | - Kerryn Saunders
- Monash Health, Victoria, Melbourne, Australia.,Monash University, Victoria, Melbourne, Australia
| | - Elizabeth Rose
- Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Royal Children's Hospital, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
| | - Heidi L Rehm
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - David J Amor
- Victorian Clinical Genetics Services, Victoria, Melbourne, Australia.,Murdoch Children's Research Institute, Victoria, Melbourne, Australia.,Royal Children's Hospital, Victoria, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Melbourne, Australia
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