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Lou Y, Ma J, Hu Y, Yao X, Liu Y, Wu M, Jia G, Chen Y, Chai R, Xia M, Li W. Integration of Functional Human Auditory Neural Circuits Based on a 3D Carbon Nanotube System. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024:e2309617. [PMID: 38889308 DOI: 10.1002/advs.202309617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 04/27/2024] [Indexed: 06/20/2024]
Abstract
The physiological interactions between the peripheral and central auditory systems are crucial for auditory information transmission and perception, while reliable models for auditory neural circuits are currently lacking. To address this issue, mouse and human neural pathways are generated by utilizing a carbon nanotube nanofiber system. The super-aligned pattern of the scaffold renders the axons of the bipolar and multipolar neurons extending in a parallel direction. In addition, the electrical conductivity of the scaffold maintains the electrophysiological activity of the primary mouse auditory neurons. The mouse and human primary neurons from peripheral and central auditory units in the system are then co-cultured and showed that the two kinds of neurons form synaptic connections. Moreover, neural progenitor cells of the cochlea and auditory cortex are derived from human embryos to generate region-specific organoids and these organoids are assembled in the nanofiber-combined 3D system. Using optogenetic stimulation, calcium imaging, and electrophysiological recording, it is revealed that functional synaptic connections are formed between peripheral neurons and central neurons, as evidenced by calcium spiking and postsynaptic currents. The auditory circuit model will enable the study of the auditory neural pathway and advance the search for treatment strategies for disorders of neuronal connectivity in sensorineural hearing loss.
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Affiliation(s)
- Yiyun Lou
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Jiaoyao Ma
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Yangnan Hu
- State Key Laboratory of Digital Medical Engineering, Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, School of Life Sciences and Technology, Advanced Institute for Life and Health, Jiangsu Province High-Tech Key Laboratory for Bio-Medical Research, Southeast University, Nanjing, 210096, China
- Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, 226001, China
| | - Xiaoying Yao
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, 200011, China
| | - Yaoqian Liu
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Mingxuan Wu
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Gaogan Jia
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Yan Chen
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, China
- The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, 200032, China
| | - Renjie Chai
- State Key Laboratory of Digital Medical Engineering, Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital, School of Life Sciences and Technology, Advanced Institute for Life and Health, Jiangsu Province High-Tech Key Laboratory for Bio-Medical Research, Southeast University, Nanjing, 210096, China
- Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, 226001, China
| | - Mingyu Xia
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, China
- The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, 200032, China
| | - Wenyan Li
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, China
- The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, 200032, China
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Weglage A, Layer N, Meister H, Müller V, Lang-Roth R, Walger M, Sandmann P. Changes in visually and auditory attended audiovisual speech processing in cochlear implant users: A longitudinal ERP study. Hear Res 2024; 447:109023. [PMID: 38733710 DOI: 10.1016/j.heares.2024.109023] [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: 01/31/2024] [Revised: 03/25/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024]
Abstract
Limited auditory input, whether caused by hearing loss or by electrical stimulation through a cochlear implant (CI), can be compensated by the remaining senses. Specifically for CI users, previous studies reported not only improved visual skills, but also altered cortical processing of unisensory visual and auditory stimuli. However, in multisensory scenarios, it is still unclear how auditory deprivation (before implantation) and electrical hearing experience (after implantation) affect cortical audiovisual speech processing. Here, we present a prospective longitudinal electroencephalography (EEG) study which systematically examined the deprivation- and CI-induced alterations of cortical processing of audiovisual words by comparing event-related potentials (ERPs) in postlingually deafened CI users before and after implantation (five weeks and six months of CI use). A group of matched normal-hearing (NH) listeners served as controls. The participants performed a word-identification task with congruent and incongruent audiovisual words, focusing their attention on either the visual (lip movement) or the auditory speech signal. This allowed us to study the (top-down) attention effect on the (bottom-up) sensory cortical processing of audiovisual speech. When compared to the NH listeners, the CI candidates (before implantation) and the CI users (after implantation) exhibited enhanced lipreading abilities and an altered cortical response at the N1 latency range (90-150 ms) that was characterized by a decreased theta oscillation power (4-8 Hz) and a smaller amplitude in the auditory cortex. After implantation, however, the auditory-cortex response gradually increased and developed a stronger intra-modal connectivity. Nevertheless, task efficiency and activation in the visual cortex was significantly modulated in both groups by focusing attention on the visual as compared to the auditory speech signal, with the NH listeners additionally showing an attention-dependent decrease in beta oscillation power (13-30 Hz). In sum, these results suggest remarkable deprivation effects on audiovisual speech processing in the auditory cortex, which partially reverse after implantation. Although even experienced CI users still show distinct audiovisual speech processing compared to NH listeners, pronounced effects of (top-down) direction of attention on (bottom-up) audiovisual processing can be observed in both groups. However, NH listeners but not CI users appear to show enhanced allocation of cognitive resources in visually as compared to auditory attended audiovisual speech conditions, which supports our behavioural observations of poorer lipreading abilities and reduced visual influence on audition in NH listeners as compared to CI users.
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Affiliation(s)
- Anna Weglage
- Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Centre, University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Germany.
| | - Natalie Layer
- Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Centre, University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Germany
| | - Hartmut Meister
- Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Centre, University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Germany; Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Germany
| | - Verena Müller
- Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Centre, University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Germany
| | - Ruth Lang-Roth
- Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Centre, University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Germany
| | - Martin Walger
- Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Centre, University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Germany; Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Germany
| | - Pascale Sandmann
- Department of Otolaryngology, Head and Neck Surgery, Carl von Ossietzky University of Oldenburg, Germany; Research Center Neurosensory Science University of Oldenburg, Germany; Cluster of Excellence "Hearing4all", University of Oldenburg, Germany
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Gioiosa Maurno N, Phillips-Silver J, Daza González MT. Research of visual attention networks in deaf individuals: a systematic review. Front Psychol 2024; 15:1369941. [PMID: 38800679 PMCID: PMC11120974 DOI: 10.3389/fpsyg.2024.1369941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
The impact of deafness on visual attention has been widely discussed in previous research. It has been noted that deficiencies and strengths of previous research can be attributed to temporal or spatial aspects of attention, as well as variations in development and clinical characteristics. Visual attention is categorized into three networks: orienting (exogenous and endogenous), alerting (phasic and tonic), and executive control. This study aims to contribute new neuroscientific evidence supporting this hypothesis. This paper presents a systematic review of the international literature from the past 15 years focused on visual attention in the deaf population. The final review included 24 articles. The function of the orienting network is found to be enhanced in deaf adults and children, primarily observed in native signers without cochlear implants, while endogenous orienting is observed only in the context of gaze cues in children, with no differences found in adults. Results regarding alerting and executive function vary depending on clinical characteristics and paradigms used. Implications for future research on visual attention in the deaf population are discussed.
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Affiliation(s)
- Nahuel Gioiosa Maurno
- Department of Psychology, University of Almería, Almería, Spain
- CIBIS Research Center, University of Almería, Almería, Spain
| | | | - María Teresa Daza González
- Department of Psychology, University of Almería, Almería, Spain
- CIBIS Research Center, University of Almería, Almería, Spain
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Valentin O, Lehmann A, Nguyen D, Paquette S. Integrating Emotion Perception in Rehabilitation Programs for Cochlear Implant Users: A Call for a More Comprehensive Approach. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1635-1642. [PMID: 38619441 DOI: 10.1044/2024_jslhr-23-00660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
PURPOSE Postoperative rehabilitation programs for cochlear implant (CI) recipients primarily emphasize enhancing speech perception. However, effective communication in everyday social interactions necessitates consideration of diverse verbal social cues to facilitate language comprehension. Failure to discern emotional expressions may lead to maladjusted social behavior, underscoring the importance of integrating social cues perception into rehabilitation initiatives to enhance CI users' well-being. After conventional rehabilitation, CI users demonstrate varying levels of emotion perception abilities. This disparity notably impacts young CI users, whose emotion perception deficit can extend to social functioning, encompassing coping strategies and social competence, even when relying on nonauditory cues such as facial expressions. Knowing that emotion perception abilities generally decrease with age, acknowledging emotion perception impairments in aging CI users is crucial, especially since a direct correlation between quality-of-life scores and vocal emotion recognition abilities has been observed in adult CI users. After briefly reviewing the scope of CI rehabilitation programs and summarizing the mounting evidence on CI users' emotion perception deficits and their impact, we will present our recommendations for embedding emotional training as part of enriched and standardized evaluation/rehabilitation programs that can improve CI users' social integration and quality of life. CONCLUSIONS Evaluating all aspects, including emotion perception, in CI rehabilitation programs is crucial because it ensures a comprehensive approach that enhances speech comprehension and the emotional dimension of communication, potentially improving CI users' social interaction and overall well-being. The development of emotion perception training holds promises for CI users and individuals grappling with various forms of hearing loss and sensory deficits. Ultimately, adopting such a comprehensive approach has the potential to significantly elevate the overall quality of life for a broad spectrum of patients.
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Affiliation(s)
- Olivier Valentin
- International Laboratory for Brain, Music and Sound Research and Centre for Research on Brain, Language and Music (BRAMS and CRBLM), Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Music Media and Technology, Montréal, Québec, Canada
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Alexandre Lehmann
- International Laboratory for Brain, Music and Sound Research and Centre for Research on Brain, Language and Music (BRAMS and CRBLM), Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Music Media and Technology, Montréal, Québec, Canada
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Don Nguyen
- International Laboratory for Brain, Music and Sound Research and Centre for Research on Brain, Language and Music (BRAMS and CRBLM), Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Music Media and Technology, Montréal, Québec, Canada
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Sébastien Paquette
- International Laboratory for Brain, Music and Sound Research and Centre for Research on Brain, Language and Music (BRAMS and CRBLM), Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Music Media and Technology, Montréal, Québec, Canada
- Department of Psychology, Faculty of Arts and Science, Trent University, Peterborough, Ontario, Canada
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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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Schulz KV, Gauer J, Martin R, Völter C. [Influence of overtones and undertones on melody recognition with a cochlear implant with SSD]. Laryngorhinootologie 2024; 103:279-288. [PMID: 37748501 DOI: 10.1055/a-2123-4315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Many cochlear implant (CI) users have difficulties recognising pitches and melodies because pitch transmission is blurred and shifted. This study investigates whether postlingually deafened adult CI users recognize melodies better when overtones are removed or undertones are added.Fifteen unilaterally postlingually deafened CI users (single sided deafness = SSD) were included aged 22 to 73 years (MW 52, SD 11.6) with CI hearing experience between 3 and 75 months (MW 33, SD 21.0) with varying MED-EL devices. Three short piano melodies were presented to them firstly to the normal-hearing ear and then in modified overtone or undertone variants and the original variant to the CI ear. These variants should be identified as one of the three original melodies. In addition, musical experience and ability were assessed by the Munich Music Questionnaire and the MiniPROMS music tests.The CI users showed the best melody recognition in the fundamental frequency variant. The overtone variant with the third overtone was as good as the original variant with all overtones with regard to melody recognition (p=1). However, the undertone variant with the first undertone was recognised significantly worse than the fundamental version (p=0.032). Furthermore, there was no correlation between musical experience or musical ability and the number of melodies recognised (p>0.1).Since a reduction of overtones did not worsen the melody recognition, overtone reduction should be considered in future music processing programs for the CI. This could reduce the energy consumption of the CI.
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Affiliation(s)
- Kira Viviane Schulz
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde und Kopf- und Halschirurgie der Ruhr-Universität Bochum, Sankt Elisabeth Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Johannes Gauer
- Fakultät für Elektrotechnik und Informationstechnik, Institut für Kommunikationsakustik, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Rainer Martin
- Fakultät für Elektrotechnik und Informationstechnik, Institut für Kommunikationsakustik, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Christiane Völter
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde und Kopf- und Halschirurgie der Ruhr-Universität Bochum, Sankt Elisabeth Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
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Cychosz M, Winn MB, Goupell MJ. How to vocode: Using channel vocoders for cochlear-implant research. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2024; 155:2407-2437. [PMID: 38568143 PMCID: PMC10994674 DOI: 10.1121/10.0025274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/23/2024] [Indexed: 04/05/2024]
Abstract
The channel vocoder has become a useful tool to understand the impact of specific forms of auditory degradation-particularly the spectral and temporal degradation that reflect cochlear-implant processing. Vocoders have many parameters that allow researchers to answer questions about cochlear-implant processing in ways that overcome some logistical complications of controlling for factors in individual cochlear implant users. However, there is such a large variety in the implementation of vocoders that the term "vocoder" is not specific enough to describe the signal processing used in these experiments. Misunderstanding vocoder parameters can result in experimental confounds or unexpected stimulus distortions. This paper highlights the signal processing parameters that should be specified when describing vocoder construction. The paper also provides guidance on how to determine vocoder parameters within perception experiments, given the experimenter's goals and research questions, to avoid common signal processing mistakes. Throughout, we will assume that experimenters are interested in vocoders with the specific goal of better understanding cochlear implants.
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Affiliation(s)
- Margaret Cychosz
- Department of Linguistics, University of California, Los Angeles, Los Angeles, California 90095, USA
| | - Matthew B Winn
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Matthew J Goupell
- Department of Hearing and Speech Sciences, University of Maryland, College Park, College Park, Maryland 20742, USA
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Di Bari M, Law-Ye B, Bernardeschi D, Lahlou G, Sterkers O, Colombo G, Mosnier I, Alciato L. Long-term clinical and radiological results for fat graft obliteration in subtotal petrosectomy and cochlear implant surgery: a retrospective clinical study. Eur Arch Otorhinolaryngol 2024; 281:1789-1798. [PMID: 37906365 DOI: 10.1007/s00405-023-08297-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE The study aimed to evaluate the long-term clinical, radiological, and functional results for subtotal petrosectomy and cochlear implant surgery with closure of the external auditory canal and fat obliteration. METHODS We retrospectively included all consecutive cases of simultaneous subtotal petrosectomy and cochlear implant surgery performed at a tertiary referral center between 2009 and 2016 using the same surgical technique. All patients underwent postoperative high-resolution computed tomography (HRCT) and annual audiological assessments. A 5-year minimum clinical, radiological, and audiological follow-up was performed. The early and late postoperative results were compared. The main outcome measures were complications, postauricular retraction, fat graft reabsorption, and audiological outcomes. RESULTS Twenty-nine procedures performed in 23 patients (six bilateral) met the inclusion criteria. The mean age of the patients was 67 ± 13.4 years and mean follow-up duration was 7.5 ± 2 years. At follow-up, postauricular retraction was detected in 24 cases (82.8%), including five cases (17.1%) with subcutaneous protrusion of implant and array. Fat graft volume was significantly reduced at late-HRCT in terms of maximum diameter (2.24 ± 1.0 cm vs 3.69 ± 0.7 cm; p < 0.0005) and surface area (1.88 ± 1.2 vs 4.24 ± 1.6 cm2, p < 0.0005). Six patients had extracochlear electrodes at late-HRCT (3/6 had an increased number of extracochlear electrodes), with a lowering of this group's performance of - 15% (p < 0.005) in the follow-up speech comprehension test. CONCLUSIONS Subtotal petrosectomy with cochlear implantation is an effective long-term technique in selected cases. Fat grafts showed significant reabsorption at long-term follow-up with reaeration of the middle ear spaces. Prolonged clinical and radiological follow-up is recommended for monitoring implant performances and late complications.
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Affiliation(s)
- Matteo Di Bari
- Unité Fonctionnelle Implants Auditifs, ORL, Service d'Oto-Rhino-Laryngologie, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 75013, Paris, France
- Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy
| | - Bruno Law-Ye
- AP-HP, Neuroradiology Department, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, 75013, Paris, France
| | - Daniele Bernardeschi
- Unité Fonctionnelle Implants Auditifs, ORL, Service d'Oto-Rhino-Laryngologie, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 75013, Paris, France.
| | - Ghizlène Lahlou
- Unité Fonctionnelle Implants Auditifs, ORL, Service d'Oto-Rhino-Laryngologie, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 75013, Paris, France
- Technologies et therapie genique pour la Surdité, Institut de l'audition, Institut Pasteur/Inserm/Université Paris Cité, 75012, Paris, France
| | - Olivier Sterkers
- Unité Fonctionnelle Implants Auditifs, ORL, Service d'Oto-Rhino-Laryngologie, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 75013, Paris, France
| | - Giovanni Colombo
- Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy
- Otorhinolaryngology, Head and Neck Department, Ospedale Nuovo di Legnano, ASST Ovest Milanese, Via Papa Giovanni Paolo II, 20025, Legnano, MI, Italy
| | - Isabelle Mosnier
- Unité Fonctionnelle Implants Auditifs, ORL, Service d'Oto-Rhino-Laryngologie, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 75013, Paris, France
- Technologies et therapie genique pour la Surdité, Institut de l'audition, Institut Pasteur/Inserm/Université Paris Cité, 75012, Paris, France
| | - Lauranne Alciato
- Unité Fonctionnelle Implants Auditifs, ORL, Service d'Oto-Rhino-Laryngologie, Hôpital Pitié-Salpêtrière, AP-HP, Sorbonne Université, 75013, Paris, France
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Sharma A, Prinja S, Thakur R, Gupta D, Kaur R, Sharma S, Munjal S, Panda N. Healthcare Cost of Cochlear Implantation in India. Indian J Otolaryngol Head Neck Surg 2024; 76:1716-1723. [PMID: 38566707 PMCID: PMC10982277 DOI: 10.1007/s12070-023-04389-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/18/2023] [Indexed: 04/04/2024] Open
Abstract
Making evidence-based policy decisions is challenging when there is a lack of information, especially when deciding provider payment rates for publicly funded health insurance plans. Therefore, the goal of this study was to estimate the cost of a cochlear implant operation in a tertiary care setting in India. We also looked at the patients' out-of-pocket (OOP) expenses for the cochlear implant surgery. From the perspectives of the patients and the healthcare systems, we assessed the financial costs of the cochlear implantation procedure. A bottom-up pricing model was used to assess the cost that the healthcare system would bear for a cochlear implant procedure. Information on all the resources (both capital and ongoing) required to offer cochlear implantation services for hearing loss was gathered over the course of a year. 120 individuals with hearing loss who had cochlear implantation surgery disclosed their out-of-pocket (OOP) costs, which included both direct medical and non-medical expenses. All costs for the budgetary year 2018-2019 were anticipated. The unit health system spent ₹ 151($2), ₹ 578($7.34) and ₹ 37,449($478) on ear exams, audiological evaluations, and cochlear implant surgeries, respectively. Per bed-day in the otolaryngology ward, hospitalization cost ₹ 202($2.6), or ₹ 1211($15.5). The estimated average out-of-pocket cost for a cochlear implant operation was ₹ 682,230($8710). Our research can be used to establish package rates for publicly funded insurance plans in India, plan the growth of public sector hearing care services, and do cost-effectiveness assessments on various hearing care models. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-04389-7.
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Affiliation(s)
- Anuradha Sharma
- Department of Otolaryngology, Speech and Hearing Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Shankar Prinja
- Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ravinder Thakur
- Department of Otolaryngology, Speech and Hearing Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Dharna Gupta
- Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajwinder Kaur
- Department of Otolaryngology, Speech and Hearing Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Sameer Sharma
- Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Munjal
- Department of Otolaryngology, Speech and Hearing Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Naresh Panda
- Department of Otolaryngology, Speech and Hearing Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
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10
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Dennison SR, Thakkar T, Kan A, Svirsky MA, Azadpour M, Litovsky RY. A Mixed-Rate Strategy on a Bilaterally-Synchronized Cochlear Implant Processor Offering the Opportunity to Provide Both Speech Understanding and Interaural Time Difference Cues. J Clin Med 2024; 13:1917. [PMID: 38610682 PMCID: PMC11012985 DOI: 10.3390/jcm13071917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Background/Objective: Bilaterally implanted cochlear implant (CI) users do not consistently have access to interaural time differences (ITDs). ITDs are crucial for restoring the ability to localize sounds and understand speech in noisy environments. Lack of access to ITDs is partly due to lack of communication between clinical processors across the ears and partly because processors must use relatively high rates of stimulation to encode envelope information. Speech understanding is best at higher stimulation rates, but sensitivity to ITDs in the timing of pulses is best at low stimulation rates. Methods: We implemented a practical "mixed rate" strategy that encodes ITD information using a low stimulation rate on some channels and speech information using high rates on the remaining channels. The strategy was tested using a bilaterally synchronized research processor, the CCi-MOBILE. Nine bilaterally implanted CI users were tested on speech understanding and were asked to judge the location of a sound based on ITDs encoded using this strategy. Results: Performance was similar in both tasks between the control strategy and the new strategy. Conclusions: We discuss the benefits and drawbacks of the sound coding strategy and provide guidelines for utilizing synchronized processors for developing strategies.
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Affiliation(s)
| | - Tanvi Thakkar
- Department of Psychology, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA;
| | - Alan Kan
- School of Engineering, Macquarie University, Sydney, NSW 2109, Australia;
| | - Mario A. Svirsky
- Department of Otolaryngology, New York University, New York, NY 10016, USA; (M.A.S.); (M.A.)
| | - Mahan Azadpour
- Department of Otolaryngology, New York University, New York, NY 10016, USA; (M.A.S.); (M.A.)
| | - Ruth Y. Litovsky
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53706, USA;
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11
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Aljazeeri IA, Hagr A. Application of anatomy-based spacing of electrode contacts for achieving a uniform semitonal resolution: A novel concept in cochlear implant electrode design. Sci Rep 2024; 14:2645. [PMID: 38302541 PMCID: PMC10834526 DOI: 10.1038/s41598-024-53070-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/27/2024] [Indexed: 02/03/2024] Open
Abstract
Using anatomy-based fitting, we can determine the place-specific map with individualized center frequencies for each electrode contact that is a closer match to the natural pitch-place of the cochlea. The primary objective of this study is to evaluate the tonal presentation across the electrode array and to calculate the semitone difference between each adjacent pair of contacts according to their anatomy-based map. The secondary objective is to determine the distancing of the contacts that would result in an equal semitone difference with a uniform tonal presentation. A total of 167 ears were included in this retrospective study. The frequencies across the electrode arrays were found to be unequally presented. The semitonal condensations were higher in the apical inter-contact spaces compared to the basal inter-contact spaces, being 3.0-2.3 semitones/mm (Kruskal Wallis test, p < 0.000). The anatomy-based spacing of the electrode contacts was larger in the basal inter-contact spaces compared to the apical inter-contact spaces, ranging from 1.92 to 1.48 mm. In conclusion, the current electrode designs do not have uniform tonal representation throughout the electrode array. There is a more condensed tonal presentation in the apical electrodes than in the basal electrodes, resulting in a lower tonal resolution in the apical region.
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Affiliation(s)
- Isra Ali Aljazeeri
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, PO Box 245, 11411, Riyadh, Saudi Arabia.
- Otolaryngology and Ophthalmology Specialized Aljaber Hospital, Ministry of Health, Ahsa, Saudi Arabia.
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, PO Box 245, 11411, Riyadh, Saudi Arabia
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12
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Leong F, Rahmani B, Psaltis D, Moser C, Ghezzi D. An actor-model framework for visual sensory encoding. Nat Commun 2024; 15:808. [PMID: 38280912 PMCID: PMC10821921 DOI: 10.1038/s41467-024-45105-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/15/2024] [Indexed: 01/29/2024] Open
Abstract
A fundamental challenge in neuroengineering is determining a proper artificial input to a sensory system that yields the desired perception. In neuroprosthetics, this process is known as artificial sensory encoding, and it holds a crucial role in prosthetic devices restoring sensory perception in individuals with disabilities. For example, in visual prostheses, one key aspect of artificial image encoding is to downsample images captured by a camera to a size matching the number of inputs and resolution of the prosthesis. Here, we show that downsampling an image using the inherent computation of the retinal network yields better performance compared to learning-free downsampling methods. We have validated a learning-based approach (actor-model framework) that exploits the signal transformation from photoreceptors to retinal ganglion cells measured in explanted mouse retinas. The actor-model framework generates downsampled images eliciting a neuronal response in-silico and ex-vivo with higher neuronal reliability than the one produced by a learning-free approach. During the learning process, the actor network learns to optimize contrast and the kernel's weights. This methodological approach might guide future artificial image encoding strategies for visual prostheses. Ultimately, this framework could be applicable for encoding strategies in other sensory prostheses such as cochlear or limb.
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Affiliation(s)
- Franklin Leong
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland
| | - Babak Rahmani
- Laboratory of Applied Photonics Devices, Institute of Electrical and Micro Engineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Microsoft Research, Cambridge, UK
| | - Demetri Psaltis
- Optics Laboratory, Institute of Electrical and Micro Engineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Christophe Moser
- Laboratory of Applied Photonics Devices, Institute of Electrical and Micro Engineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Diego Ghezzi
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland.
- Ophthalmic and Neural Technologies Laboratory, Department of Ophthalmology, University of Lausanne, Hôpital ophtalmique Jules-Gonin, Fondation Asile des Aveugles, Lausanne, Switzerland.
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13
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Wang J, Chu J, Song J, Li Z. The application of impantable sensors in the musculoskeletal system: a review. Front Bioeng Biotechnol 2024; 12:1270237. [PMID: 38328442 PMCID: PMC10847584 DOI: 10.3389/fbioe.2024.1270237] [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: 07/31/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
As the population ages and the incidence of traumatic events rises, there is a growing trend toward the implantation of devices to replace damaged or degenerated tissues in the body. In orthopedic applications, some implants are equipped with sensors to measure internal data and monitor the status of the implant. In recent years, several multi-functional implants have been developed that the clinician can externally control using a smart device. Experts anticipate that these versatile implants could pave the way for the next-generation of technological advancements. This paper provides an introduction to implantable sensors and is structured into three parts. The first section categorizes existing implantable sensors based on their working principles and provides detailed illustrations with examples. The second section introduces the most common materials used in implantable sensors, divided into rigid and flexible materials according to their properties. The third section is the focal point of this article, with implantable orthopedic sensors being classified as joint, spine, or fracture, based on different practical scenarios. The aim of this review is to introduce various implantable orthopedic sensors, compare their different characteristics, and outline the future direction of their development and application.
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Affiliation(s)
- Jinzuo Wang
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, Liaoning, China
| | - Jian Chu
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Jinhui Song
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Zhonghai Li
- Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopaedic Diseases, Dalian, Liaoning, China
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14
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Chen Y, Wang S, Yang L, Liu Y, Fu X, Wang Y, Zhang X, Wang S. Features of the speech processing network in post- and prelingually deaf cochlear implant users. Cereb Cortex 2024; 34:bhad417. [PMID: 38163443 DOI: 10.1093/cercor/bhad417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/13/2023] [Accepted: 10/14/2023] [Indexed: 01/03/2024] Open
Abstract
The onset of hearing loss can lead to altered brain structure and functions. However, hearing restoration may also result in distinct cortical reorganization. A differential pattern of functional remodeling was observed between post- and prelingual cochlear implant users, but it remains unclear how these speech processing networks are reorganized after cochlear implantation. To explore the impact of language acquisition and hearing restoration on speech perception in cochlear implant users, we conducted assessments of brain activation, functional connectivity, and graph theory-based analysis using functional near-infrared spectroscopy. We examined the effects of speech-in-noise stimuli on three groups: postlingual cochlear implant users (n = 12), prelingual cochlear implant users (n = 10), and age-matched individuals with hearing controls (HC) (n = 22). The activation of auditory-related areas in cochlear implant users showed a lower response compared with the HC group. Wernicke's area and Broca's area demonstrated differences network attributes in speech processing networks in post- and prelingual cochlear implant users. In addition, cochlear implant users maintain a high efficiency of the speech processing network to process speech information. Taken together, our results characterize the speech processing networks, in varying noise environments, in post- and prelingual cochlear implant users and provide new insights for theories of how implantation modes impact remodeling of the speech processing functional networks.
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Affiliation(s)
- Younuo Chen
- Beijing Institute of Otolaryngology, Otolaryngology-Head and Neck Surgery, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
| | - Songjian Wang
- Beijing Institute of Otolaryngology, Otolaryngology-Head and Neck Surgery, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
| | - Liu Yang
- School of Biomedical Engineering, Capital Medical University, No. 10, Xitoutiao, YouAnMen, Fengtai District, Beijing 100069, China
| | - Yi Liu
- Beijing Institute of Otolaryngology, Otolaryngology-Head and Neck Surgery, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
| | - Xinxing Fu
- Beijing Institute of Otolaryngology, Otolaryngology-Head and Neck Surgery, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
| | - Yuan Wang
- Beijing Institute of Otolaryngology, Otolaryngology-Head and Neck Surgery, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
| | - Xu Zhang
- School of Biomedical Engineering, Capital Medical University, No. 10, Xitoutiao, YouAnMen, Fengtai District, Beijing 100069, China
| | - Shuo Wang
- Beijing Institute of Otolaryngology, Otolaryngology-Head and Neck Surgery, Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
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15
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Haumann S, Mynarek (née Bradler) M, Maier H, Helmstaedter V, Büchner A, Lenarz T, Teschner MJ. Does Intraoperative Extracochlear Electrocochleography Correlate With Postoperative Audiometric Hearing Thresholds in Cochlear Implant Surgery? A Retrospective Analysis of Cochlear Monitoring. Trends Hear 2024; 28:23312165241252240. [PMID: 38715410 PMCID: PMC11080760 DOI: 10.1177/23312165241252240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 04/09/2024] [Accepted: 04/16/2024] [Indexed: 05/12/2024] Open
Abstract
In recent years, tools for early detection of irreversible trauma to the basilar membrane during hearing preservation cochlear implant (CI) surgery were established in several clinics. A link with the degree of postoperative hearing preservation in patients was investigated, but patient populations were usually small. Therefore, this study's aim was to analyze data from intraoperative extracochlear electrocochleography (ECochG) recordings for a larger group.During hearing preservation CI surgery, extracochlear recordings were made before, during, and after CI electrode insertion using a cotton wick electrode placed at the promontory. Before and after insertion, amplitudes and stimulus response thresholds were recorded at 250, 500, and 1000 Hz. During insertion, response amplitudes were recorded at one frequency and one stimulus level. Data from 121 patient ears were analyzed.The key benefit of extracochlear recordings is that they can be performed before, during, and after CI electrode insertion. However, extracochlear ECochG threshold changes before and after CI insertion were relatively small and did not independently correlate well with hearing preservation, although at 250 Hz they added some significant information. Some tendencies-although no significant relationships-were detected between amplitude behavior and hearing preservation. Rising amplitudes seem favorable and falling amplitudes disadvantageous, but constant amplitudes do not appear to allow stringent predictions.Extracochlear ECochG measurements seem to only partially realize expected benefits. The questions now are: do gains justify the effort, and do other procedures or possible combinations lead to greater benefits for patients?
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Affiliation(s)
- Sabine Haumann
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4All”, Hannover, Germany
| | - Marlene Mynarek (née Bradler)
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4All”, Hannover, Germany
| | - Hannes Maier
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4All”, Hannover, Germany
| | - Victor Helmstaedter
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4All”, Hannover, Germany
| | - Andreas Büchner
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4All”, Hannover, Germany
| | - Thomas Lenarz
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4All”, Hannover, Germany
| | - Magnus J. Teschner
- Department of Otorhinolaryngology, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4All”, Hannover, Germany
- Department of Otorhinolaryngology, Proselis Klinikum Recklinghausen, Recklinghausen, Germany
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16
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Pesantez Torres F, Tokranova N, Amodeo E, Bertucci T, Kiehl TR, Xie Y, Cady NC, Sharfstein ST. Interfacing neural cells with typical microelectronics materials for future manufacturing. Biosens Bioelectron 2023; 242:115749. [PMID: 37839350 DOI: 10.1016/j.bios.2023.115749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/01/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023]
Abstract
The biocompatibility of materials used in electronic devices is critical for the development of implantable devices like pacemakers and neuroprosthetics, as well as in future biomanufacturing. Biocompatibility refers to the ability of these materials to interact with living cells and tissues without causing an adverse response. Therefore, it is essential to evaluate the biocompatibility of metals and semiconductor materials used in electronic devices to ensure their safe use in medical applications. Here, we evaluated the biocompatibility of a collection of diced silicon chips coated with a variety of metal thin films, interfacing them with different cell types, including murine mastocytoma cells in suspension culture, adherent NIH 3T3 fibroblasts, and human induced pluripotent stem cell (iPSC)-derived neural progenitor cells (NPCs). All materials tested were biocompatible and showed the potential to support neural differentiation of iPSC-NPCs, creating an opportunity to use these materials in a scalable production of a range of biohybrid devices such as electronic devices to study neural behaviors and neuropathies.
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Affiliation(s)
- Fernando Pesantez Torres
- Department of Nanoscale Science and Engineering, College of Nanotechnology, Science and Engineering, University at Albany, State University of New York, 257 Fuller Road, Albany, NY, 12203, USA
| | - Natalya Tokranova
- Department of Nanoscale Science and Engineering, College of Nanotechnology, Science and Engineering, University at Albany, State University of New York, 257 Fuller Road, Albany, NY, 12203, USA
| | - Eleanor Amodeo
- Department of Nanoscale Science and Engineering, College of Nanotechnology, Science and Engineering, University at Albany, State University of New York, 257 Fuller Road, Albany, NY, 12203, USA
| | - Taylor Bertucci
- Neural Stem Cell Institute, One Discovery Drive, Rensselaer, NY, 12144, USA
| | - Thomas R Kiehl
- Neural Stem Cell Institute, One Discovery Drive, Rensselaer, NY, 12144, USA
| | - Yubing Xie
- Department of Nanoscale Science and Engineering, College of Nanotechnology, Science and Engineering, University at Albany, State University of New York, 257 Fuller Road, Albany, NY, 12203, USA
| | - Nathaniel C Cady
- Department of Nanoscale Science and Engineering, College of Nanotechnology, Science and Engineering, University at Albany, State University of New York, 257 Fuller Road, Albany, NY, 12203, USA
| | - Susan T Sharfstein
- Department of Nanoscale Science and Engineering, College of Nanotechnology, Science and Engineering, University at Albany, State University of New York, 257 Fuller Road, Albany, NY, 12203, USA.
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17
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Azees AA, Thompson AC, Thomas R, Zhou J, Ruther P, Wise AK, Ajay EA, Garrett DJ, Quigley A, Fallon JB, Richardson RT. Spread of activation and interaction between channels with multi-channel optogenetic stimulation in the mouse cochlea. Hear Res 2023; 440:108911. [PMID: 37977051 DOI: 10.1016/j.heares.2023.108911] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/19/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
For individuals with severe to profound hearing loss resulting from irreversibly damaged hair cells, cochlear implants can be used to restore hearing by delivering electrical stimulation directly to the spiral ganglion neurons. However, current spread lowers the spatial resolution of neural activation. Since light can be easily confined, optogenetics is a technique that has the potential to improve the precision of neural activation, whereby visible light is used to stimulate neurons that are modified with light-sensitive opsins. This study compares the spread of neural activity across the inferior colliculus of the auditory midbrain during electrical and optical stimulation in the cochlea of acutely deafened mice with opsin-modified spiral ganglion neurons (H134R variant of the channelrhodopsin-2). Monopolar electrical stimulation was delivered via each of four 0.2 mm wide platinum electrode rings at 0.6 mm centre-to-centre spacing, whereas 453 nm wavelength light was delivered via each of five 0.22 × 0.27 mm micro-light emitting diodes (LEDs) at 0.52 mm centre-to-centre spacing. Channel interactions were also quantified by threshold changes during simultaneous stimulation by pairs of electrodes or micro-LEDs at different distances between the electrodes (0.6, 1.2 and 1.8 mm) or micro-LEDs (0.52, 1.04, 1.56 and 2.08 mm). The spread of activation resulting from single channel optical stimulation was approximately half that of monopolar electrical stimulation as measured at two levels of discrimination above threshold (p<0.001), whereas there was no significant difference between optical stimulation in opsin-modified deafened mice and pure tone acoustic stimulation in normal-hearing mice. During simultaneous micro-LED stimulation, there were minimal channel interactions for all micro-LED spacings tested. For neighbouring micro-LEDs/electrodes, the relative influence on threshold was 13-fold less for optical stimulation compared electrical stimulation (p<0.05). The outcomes of this study show that the higher spatial precision of optogenetic stimulation results in reduced channel interaction compared to electrical stimulation, which could increase the number of independent channels in a cochlear implant. Increased spatial resolution and the ability to activate more than one channel simultaneously could lead to better speech perception in cochlear implant recipients.
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Affiliation(s)
- Ajmal A Azees
- The Bionics Institute, East Melbourne, VIC 3002, Australia; Department of Electrical and Biomedical Engineering, RMIT University, Melbourne, VIC 3000, Australia
| | - Alex C Thompson
- The Bionics Institute, East Melbourne, VIC 3002, Australia; Medical Bionics Department, University of Melbourne, East Melbourne, VIC, Australia
| | - Ross Thomas
- The Bionics Institute, East Melbourne, VIC 3002, Australia
| | - Jenny Zhou
- The Bionics Institute, East Melbourne, VIC 3002, Australia
| | - Patrick Ruther
- Department of Microsystems Engineering (IMTEK), University of Freiburg, Freiburg 79110, Germany; BrainLinks-BrainTools Center, University of Freiburg, Freiburg 79110, Germany
| | - Andrew K Wise
- The Bionics Institute, East Melbourne, VIC 3002, Australia; Department of Surgery (Otolaryngology), University of Melbourne, Melbourne, VIC 3002, Australia; Medical Bionics Department, University of Melbourne, East Melbourne, VIC, Australia
| | - Elise A Ajay
- The Bionics Institute, East Melbourne, VIC 3002, Australia; Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, VIC, Australia
| | - David J Garrett
- Department of Electrical and Biomedical Engineering, RMIT University, Melbourne, VIC 3000, Australia
| | - Anita Quigley
- Department of Electrical and Biomedical Engineering, RMIT University, Melbourne, VIC 3000, Australia; Department of Medicine, University of Melbourne, St Vincent's Hospital, Melbourne, VIC 3065, Australia; The Aikenhead Centre for Medical Discovery, St Vincent's Hospital, Melbourne, VIC 3065, Australia
| | - James B Fallon
- The Bionics Institute, East Melbourne, VIC 3002, Australia; Department of Surgery (Otolaryngology), University of Melbourne, Melbourne, VIC 3002, Australia; Medical Bionics Department, University of Melbourne, East Melbourne, VIC, Australia
| | - Rachael T Richardson
- The Bionics Institute, East Melbourne, VIC 3002, Australia; Department of Surgery (Otolaryngology), University of Melbourne, Melbourne, VIC 3002, Australia; Medical Bionics Department, University of Melbourne, East Melbourne, VIC, Australia.
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18
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Paquette S, Deroche MLD, Goffi-Gomez MV, Hoshino ACH, Lehmann A. Predicting emotion perception abilities for cochlear implant users. Int J Audiol 2023; 62:946-954. [PMID: 36047767 DOI: 10.1080/14992027.2022.2111611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 08/05/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE In daily life, failure to perceive emotional expressions can result in maladjusted behaviour. For cochlear implant users, perceiving emotional cues in sounds remains challenging, and the factors explaining the variability in patients' sensitivity to emotions are currently poorly understood. Understanding how these factors relate to auditory proficiency is a major challenge of cochlear implant research and is critical in addressing patients' limitations. DESIGN To fill this gap, we evaluated different auditory perception aspects in implant users (pitch discrimination, music processing and speech intelligibility) and correlated them to their performance in an emotion recognition task. STUDY SAMPLE Eighty-four adults (18-76 years old) participated in our investigation; 42 cochlear implant users and 42 controls. Cochlear implant users performed worse than their controls on all tasks, and emotion perception abilities were correlated to their age and their clinical outcome as measured in the speech intelligibility task. RESULTS As previously observed, emotion perception abilities declined with age (here by about 2-3% in a decade). Interestingly, even when emotional stimuli were musical, CI users' skills relied more on processes underlying speech intelligibility. CONCLUSIONS These results suggest that speech processing remains a clinical priority even when one is interested in affective skills.
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Affiliation(s)
- S Paquette
- International Laboratory for Brain Music and Sound Research, Department of Psychology, University of Montréal, Montreal, Canada
- Centre for Research on Brain, Language and Music, McGill University, Montreal, Canada
- Department of Otolaryngology, Head and Neck Surgery, McGill University, Montreal, Canada
| | - M L D Deroche
- International Laboratory for Brain Music and Sound Research, Department of Psychology, University of Montréal, Montreal, Canada
- Centre for Research on Brain, Language and Music, McGill University, Montreal, Canada
- Department of Otolaryngology, Head and Neck Surgery, McGill University, Montreal, Canada
- Laboratory for Hearing and Cognition, Psychology Department, Concordia University, Montreal, Canada
| | - M V Goffi-Gomez
- Cochlear Implant Group, School of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Canada
| | - A C H Hoshino
- Cochlear Implant Group, School of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Canada
| | - A Lehmann
- International Laboratory for Brain Music and Sound Research, Department of Psychology, University of Montréal, Montreal, Canada
- Centre for Research on Brain, Language and Music, McGill University, Montreal, Canada
- Department of Otolaryngology, Head and Neck Surgery, McGill University, Montreal, Canada
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19
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Layer N, Abdel-Latif KHA, Radecke JO, Müller V, Weglage A, Lang-Roth R, Walger M, Sandmann P. Effects of noise and noise reduction on audiovisual speech perception in cochlear implant users: An ERP study. Clin Neurophysiol 2023; 154:141-156. [PMID: 37611325 DOI: 10.1016/j.clinph.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 06/19/2023] [Accepted: 07/14/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE Hearing with a cochlear implant (CI) is difficult in noisy environments, but the use of noise reduction algorithms, specifically ForwardFocus, can improve speech intelligibility. The current event-related potentials (ERP) study examined the electrophysiological correlates of this perceptual improvement. METHODS Ten bimodal CI users performed a syllable-identification task in auditory and audiovisual conditions, with syllables presented from the front and stationary noise presented from the sides. Brainstorm was used for spatio-temporal evaluation of ERPs. RESULTS CI users revealed an audiovisual benefit as reflected by shorter response times and greater activation in temporal and occipital regions at P2 latency. However, in auditory and audiovisual conditions, background noise hampered speech processing, leading to longer response times and delayed auditory-cortex-activation at N1 latency. Nevertheless, activating ForwardFocus resulted in shorter response times, reduced listening effort and enhanced superior-frontal-cortex-activation at P2 latency, particularly in audiovisual conditions. CONCLUSIONS ForwardFocus enhances speech intelligibility in audiovisual speech conditions by potentially allowing the reallocation of attentional resources to relevant auditory speech cues. SIGNIFICANCE This study shows for CI users that background noise and ForwardFocus differentially affect spatio-temporal cortical response patterns, both in auditory and audiovisual speech conditions.
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Affiliation(s)
- Natalie Layer
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, Germany.
| | | | - Jan-Ole Radecke
- Dept. of Psychiatry and Psychotherapy, University of Lübeck, Germany; Center for Brain, Behaviour and Metabolism (CBBM), University of Lübeck, Germany
| | - Verena Müller
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, Germany
| | - Anna Weglage
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, Germany
| | - Ruth Lang-Roth
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, Germany
| | - Martin Walger
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, Germany; Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Germany
| | - Pascale Sandmann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, Germany; Department of Otolaryngology, Head and Neck Surgery, University of Oldenburg, Oldenburg, Germany
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20
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Gärtner L, Backus BC, Le Goff N, Morgenstern A, Lenarz T, Büchner A. Cochlear Implant Stimulation Parameters Play a Key Role in Reducing Facial Nerve Stimulation. J Clin Med 2023; 12:6194. [PMID: 37834838 PMCID: PMC10573649 DOI: 10.3390/jcm12196194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
A percentage (i.e., 5.6%) of Cochlear Implant (CI) users reportedly experience unwanted facial nerve stimulation (FNS). For some, the effort to control this problem results in changing stimulation parameters, thereby reducing their hearing performance. For others, the only viable solution is to deactivate the CI completely. A growing body of evidence in the form of case reports suggests that undesired FNS can be effectively addressed through re-implantation with an Oticon Medical (OM) Neuro-Zti implant. However, the root of this benefit is still unknown: is it due to surgical adjustments, such as varied array geometries and/or positioning, or does it stem from differences in stimulation parameters and/or grounding? The OM device exhibits two distinct features: (1) unique stimulation parameters, including anodic leading pulses and loudness controlled by pulse duration-not current-resulting in lower overall current amplitudes; and (2) unconventional grounding, including both passive (capacitive) discharge, which creates a pseudo-monophasic pulse shape, and a 'distributed-all-polar' (DAP) grounding scheme, which is thought to reduce current spread. Unfortunately, case reports alone cannot distinguish between surgical factors and these implant-related ones. In this paper, we present a novel follow-up study of two CI subjects who previously experienced FNS before re-implantation with Neuro-Zti implants. We used the Oticon Medical Research Platform (OMRP) to stimulate a single electrode in each subject in two ways: (1) with traditional monopolar biphasic cathodic-first pulses, and (2) with distinct OM clinical stimulation. We progressively increased the stimulation intensity until FNS occurred or the sound became excessively loud. Non-auditory/FNS sensations were observed with the traditional stimulation but not with the OM clinical one. This provides the first direct evidence demonstrating that stimulation parameters and/or grounding-not surgical factors-play a key role in mitigating FNS.
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Affiliation(s)
- Lutz Gärtner
- Department of Otolaryngology, Hannover Medical School, 30625 Hannover, Germany; (L.G.); (A.M.); (T.L.)
| | | | | | - Anika Morgenstern
- Department of Otolaryngology, Hannover Medical School, 30625 Hannover, Germany; (L.G.); (A.M.); (T.L.)
| | - Thomas Lenarz
- Department of Otolaryngology, Hannover Medical School, 30625 Hannover, Germany; (L.G.); (A.M.); (T.L.)
- Cluster of Excellence “Hearing4all”, 30625 Hannover, Germany
| | - Andreas Büchner
- Department of Otolaryngology, Hannover Medical School, 30625 Hannover, Germany; (L.G.); (A.M.); (T.L.)
- Cluster of Excellence “Hearing4all”, 30625 Hannover, Germany
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21
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Cottrell J, Dixon P, Cao X, Kiss A, Smilsky K, Kaminskas K, Ng A, Shipp D, Dimitrijevic A, Chen J, Lin V, Kyriakopoulou L, Le T. Gene mutations as a non-invasive measure of adult cochlear implant performance: Variable outcomes in patients with select TMPRSS3 mutations. PLoS One 2023; 18:e0291600. [PMID: 37713394 PMCID: PMC10503761 DOI: 10.1371/journal.pone.0291600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/04/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND The cochlear implant (CI) has proven to be a successful treatment for patients with severe-to-profound sensorineural hearing loss, however outcome variance exists. We sought to evaluate particular mutations discovered in previously established sensory and neural partition genes and compare post-operative CI outcomes. MATERIALS AND METHODS Utilizing a prospective cohort study design, blood samples collected from adult patients with non-syndromic hearing loss undergoing CI were tested for 54 genes of interest with high-throughput sequencing. Patients were categorized as having a pathogenic variant in the sensory partition, pathogenic variant in the neural partition, pathogenic variant in both sensory and neural partition, or with no variant identified. Speech perception performance was assessed pre- and 12 months post-operatively. Performance measures were compared to genetic mutation and variant status utilizing a Wilcoxon rank sum test, with P<0.05 considered statistically significant. RESULTS Thirty-six cochlear implant patients underwent genetic testing and speech understanding measurements. Of the 54 genes that were interrogated, three patients (8.3%) demonstrated a pathogenic mutation in the neural partition (within TMPRSS3 genes), one patient (2.8%) demonstrated a pathogenic mutation in the sensory partition (within the POU4F3 genes). In addition, 3 patients (8.3%) had an isolated neural partition variance of unknown significance (VUS), 5 patients (13.9%) had an isolated sensory partition VUS, 1 patient (2.8%) had a variant in both neural and sensory partition, and 23 patients (63.9%) had no mutation or variant identified. There was no statistically significant difference in speech perception scores between patients with sensory or neural partition pathogenic mutations or VUS. Variable performance was found within patients with TMPRSS3 gene mutations. CONCLUSION The impact of genetic mutations on post-operative outcomes in CI patients was heterogenous. Future research and dissemination of mutations and subsequent CI performance is warranted to elucidate exact mutations within target genes providing the best non-invasive prognostic capability.
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Affiliation(s)
- Justin Cottrell
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Peter Dixon
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Xingshan Cao
- Department of Research Design and Biostatistics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Alex Kiss
- Department of Research Design and Biostatistics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kari Smilsky
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Kassandra Kaminskas
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Amy Ng
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - David Shipp
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Dimitrijevic
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Joseph Chen
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Lin
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Lianna Kyriakopoulou
- Department of Laboratory Medicine & Pathology–Clinical Chemistry, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Trung Le
- Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
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22
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Gowrishankar SV, Fleet A, Tomasoni M, Durham R, Umeria R, Merchant SA, Shah SFH, Muzaffar J, Mohammed H, Kuhn I, Tysome J, Smith ME, Donnelly N, Axon P, Bance M, Borsetto D. The Risk of Meningitis After Cochlear Implantation: A Systematic Review and Meta-Analysis. Otolaryngol Head Neck Surg 2023; 169:467-481. [PMID: 36864717 DOI: 10.1002/ohn.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVE This study aims to estimate the rate of postoperative meningitis (both immediate and long-term) in patients following cochlear implants (CIs). It aims to do so through a systematic review and meta-analysis of published studies tracking complications after CIs. DATA SOURCES MEDLINE, Embase, and Cochrane Library. REVIEW METHODS This review was performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies tracking complications following CIs in patients were included. Exclusion criteria included non-English language studies and case series reporting <10 patients. Bias risk was evaluated using the Newcastle-Ottawa Scale. Meta-analysis was performed through DerSimonian and Laird random-effects models. RESULTS A total of 116/1931 studies met the inclusion criteria and were included in the meta-analysis. Overall, there were 112 cases of meningitis in 58,940 patients after CIs. Meta-analysis estimated an overall rate of postoperative meningitis of 0.07% (95% confidence interval [CIs], 0.03%-0.1%; I2 = 55%). Subgroup meta-analysis showed this rate had 95% CIs crossing 0% in implanted patients who received the pneumococcal vaccine, antibiotic prophylaxis, those with postoperative acute otitis media (AOM), and those implanted less than 5 years. CONCLUSION Meningitis is a rare complication following CIs. Our estimated rates of meningitis after CIs appear lower than prior estimates based on epidemiological studies in the early 2000s. However, the rate still appears higher than the baseline rate in the general population. The risk was very low in implanted patients who received the pneumococcal vaccine, antibiotic prophylaxis, received unilateral or bilateral implantations, developed AOM, those implanted with a round window or cochleostomy techniques, and those under 5 years.
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Affiliation(s)
- Shravan V Gowrishankar
- Department of Otolaryngology-Head and Neck Surgery, Cambridge University Hospitals NHS Trust, Cambridge, UK
- Department of Clinical Medicine, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Alex Fleet
- Department of Otolaryngology-Head and Neck Surgery, Cambridge University Hospitals NHS Trust, Cambridge, UK
- Department of Clinical Medicine, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Michele Tomasoni
- Department of Otolaryngology-Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Rory Durham
- Department of Clinical Medicine, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Rishi Umeria
- Department of Clinical Medicine, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Serena A Merchant
- Department of Clinical Medicine, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Syed F H Shah
- Department of Clinical Medicine, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Jameel Muzaffar
- Department of Otolaryngology-Head and Neck Surgery, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Hassan Mohammed
- Department of Otolaryngology-Head and Neck Surgery, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Isla Kuhn
- Cambridge University Medical Library, Cambridge, UK
| | - James Tysome
- Department of Otolaryngology-Head and Neck Surgery, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Matthew E Smith
- Department of Otolaryngology-Head and Neck Surgery, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Neil Donnelly
- Department of Otolaryngology-Head and Neck Surgery, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Patrick Axon
- Department of Otolaryngology-Head and Neck Surgery, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Manohar Bance
- Department of Otolaryngology-Head and Neck Surgery, Cambridge University Hospitals NHS Trust, Cambridge, UK
- Department of Clinical Medicine, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Daniele Borsetto
- Department of Otolaryngology-Head and Neck Surgery, Cambridge University Hospitals NHS Trust, Cambridge, UK
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23
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Dennison SR, Thakkar T, Kan A, Litovsky RY. Lateralization of binaural envelope cues measured with a mobile cochlear-implant research processora). THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:3543-3558. [PMID: 37390320 PMCID: PMC10314808 DOI: 10.1121/10.0019879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 07/02/2023]
Abstract
Bilateral cochlear implant (BICI) listeners do not have full access to the binaural cues that normal hearing (NH) listeners use for spatial hearing tasks such as localization. When using their unsynchronized everyday processors, BICI listeners demonstrate sensitivity to interaural level differences (ILDs) in the envelopes of sounds, but interaural time differences (ITDs) are less reliably available. It is unclear how BICI listeners use combinations of ILDs and envelope ITDs, and how much each cue contributes to perceived sound location. The CCi-MOBILE is a bilaterally synchronized research processor with the untested potential to provide spatial cues to BICI listeners. In the present study, the CCi-MOBILE was used to measure the ability of BICI listeners to perceive lateralized sound sources when single pairs of electrodes were presented amplitude-modulated stimuli with combinations of ILDs and envelope ITDs. Young NH listeners were also tested using amplitude-modulated high-frequency tones. A cue weighting analysis with six BICI and ten NH listeners revealed that ILDs contributed more than envelope ITDs to lateralization for both groups. Moreover, envelope ITDs contributed to lateralization for NH listeners but had negligible contribution for BICI listeners. These results suggest that the CCi-MOBILE is suitable for binaural testing and developing bilateral processing strategies.
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Affiliation(s)
| | - Tanvi Thakkar
- University of Wisconsin-La Crosse, La Crosse, Wisconsin 54601, USA
| | - Alan Kan
- Macquarie University, Macquarie Park, New South Wales, Australia
| | - Ruth Y Litovsky
- University of Wisconsin-Madison, Madison, Wisconsin 53711, USA
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24
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Colby S, Seedorff M, McMurray B. Audiological and Demographic Factors that Impact the Precision of Speech Categorization in Cochlear Implant Users. Ear Hear 2023; 44:572-587. [PMID: 36542839 PMCID: PMC10101869 DOI: 10.1097/aud.0000000000001307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The ability to adapt to subtle variations in acoustic input is a necessary skill for successful speech perception. Cochlear implant (CI) users tend to show speech perception benefits from the maintenance of their residual acoustic hearing. However, previous studies often compare CI users in different listening conditions within-subjects (i.e., in their typical Acoustic + Electric configuration compared with Acoustic-only or Electric-only configurations) and comparisons among different groups of CI users do not always reflect an Acoustic + Electric benefit. Existing work suggests that CI users with residual acoustic hearing perform similarly to Electric-only listeners on phonetic voicing contrasts and unexpectedly poorer with fricative contrasts which have little energy in the range of the Acoustic + Electric listeners' acoustic hearing. To further investigate how residual acoustic hearing impacts sensitivity to phonetic ambiguity, we examined whether device configuration, age, and device experience influenced phonetic categorization in a large individual differences study. DESIGN CI users with various device configurations (Electric-only N = 41; Acoustic + Electric N = 95) categorized tokens from five /b-p/ and five /s-ʃ/ minimal pair continua (e.g., bet-pet; sock-shock). We investigated age, device experience, and when applicable, residual acoustic hearing (pure tone hearing thresholds) as predictors of categorization. We also examined the relationship between phonetic categorization and clinical outcomes (CNC, AzBio) in a subset of our sample. RESULTS Acoustic + Electric CI users were better able to categorize along the voicing contrast (steeper categorization slope) compared with Electric-only users, but there was no group-level difference for fricatives. There were differences within the subgroups for fricatives: bilateral users showed better categorization than unilateral users and bimodal users had better categorization than hybrid users. Age was a significant factor for voicing, while device experience was significant for fricatives. Critically, within the Acoustic + Electric group, hybrid CI users had shallower slopes than bimodal CI users. CONCLUSIONS Our findings suggest residual acoustic hearing is beneficial for categorizing stop voicing, but not frication. Age impacts the categorization of voicing, while device experience matters for fricatives. For CI users with ipsilateral residual acoustic hearing, those with better hearing thresholds may be over-relying on their acoustic hearing rather than extracting as much information as possible from their CI, and thus have shallower fricative categorization.
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Affiliation(s)
- Sarah Colby
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
- Department of Otolaryngology, University of Iowa, Iowa City, Iowa, USA
| | - Michael Seedorff
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, USA
- Alphabet, Inc., Mountain View, California, USA
| | - Bob McMurray
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
- Department of Otolaryngology, University of Iowa, Iowa City, Iowa, USA
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA
- Department of Linguistics, University of Iowa, Iowa City, Iowa, USA
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25
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Findlay C, Edwards M, Hough K, Grasmeder M, Newman TA. Leveraging real-world data to improve cochlear implant outcomes: Is the data available? Cochlear Implants Int 2023:1-12. [PMID: 37088565 DOI: 10.1080/14670100.2023.2198792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
OBJECTIVES A small but persistent proportion of individuals do not gain the expected benefit from cochlear implants(CI). A step-change in the understanding of factors affecting outcomes could come through data science. This study evaluates clinical data capture to assess the quality and utility of CI user's health records for data science, by assessing the recording of otitis media. Otitis media was selected as it is associated with the development of sensorineural hearing loss and may affect cochlear implant outcomes. METHODS A retrospective service improvement project evaluating the medical records of 594 people with a CI under the care of the University of Southampton Auditory Implant Service between 2014 and 2020. RESULTS The clinical records are suitable for data science research. Of the cohort studied 20% of Adults and more than 40% of the paediatric cases have a history of middle ear inflammation. DISCUSSION Data science has potential to improve cochlear implant outcomes and improve understanding of the mechanisms underlying poor performance, through retrospective secondary analysis of real-world data. CONCLUSION Implant centres and the British Cochlear Implant Group National Hearing Implant Registry are urged to consider the importance of consistently and accurate recording of patient data over time for each CI user. Data where links to hearing loss have been identified, such as middle ear inflammation, may be particularly valuable in future analyses and to inform clinical trials.
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Affiliation(s)
- Callum Findlay
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Building 85, Highfield Campus, Southampton S017 1BJ, UK
- Department of Otolaryngology, University Hospital Southampton NHS FT, Tremona Road, Southampton SO16 6YD, UK
| | - Mathew Edwards
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Building 85, Highfield Campus, Southampton S017 1BJ, UK
| | - Kate Hough
- Faculty of Engineering and Physical Sciences, Highfield Campus, University of Southampton, Building 85, Southampton, UK
| | - Mary Grasmeder
- Faculty of Physical Sciences, Highfield Campus, University of Southampton Auditory Implant Services, B19, Southampton SO171BJ, UK
| | - Tracey A Newman
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Building 85, Highfield Campus, Southampton S017 1BJ, UK
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Gauer J, Nagathil A, Lentz B, Völter C, Martin R. A subjective evaluation of different music preprocessing approaches in cochlear implant listeners. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:1307. [PMID: 36859137 DOI: 10.1121/10.0017249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Cochlear implants (CIs) can partially restore speech perception to relatively high levels in listeners with moderate to profound hearing loss. However, for most CI listeners, the perception and enjoyment of music remains notably poor. Since a number of technical and physiological restrictions of current implant designs cannot be easily overcome, a number of preprocessing methods for music signals have been proposed recently. They aim to emphasize the leading voice and rhythmic elements and to reduce their spectral complexity. In this study, CI listeners evaluated five remixing approaches in comparison to unprocessed signals. To identify potential explaining factors of CI preference ratings, different signal quality criteria of the processed signals were additionally assessed by normal-hearing listeners. Additional factors were investigated based on instrumental signal-level features. For three preprocessing methods, a significant improvement over the unprocessed reference was found. Especially, two deep neural network-based remix strategies proved to enhance music perception in CI listeners. These strategies provide remixes of the respective harmonic and percussive signal components of the four source stems "vocals," "bass," "drums," and "other accompaniment." Moreover, the results demonstrate that CI listeners prefer an attenuation of sustained components of drum source signals.
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Affiliation(s)
- Johannes Gauer
- Institute of Communication Acoustics, Ruhr-Universität Bochum, Bochum, Germany
| | - Anil Nagathil
- Institute of Communication Acoustics, Ruhr-Universität Bochum, Bochum, Germany
| | - Benjamin Lentz
- Institute of Communication Acoustics, Ruhr-Universität Bochum, Bochum, Germany
| | - Christiane Völter
- Department of Otorhinolaringology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Germany
| | - Rainer Martin
- Institute of Communication Acoustics, Ruhr-Universität Bochum, Bochum, Germany
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27
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Mamun N, Ghosh R, Hansen JHL. Familiar and unfamiliar speaker recognition assessment and system emulation for cochlear implant users. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:1293. [PMID: 36859118 PMCID: PMC10162836 DOI: 10.1121/10.0017216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/02/2023] [Accepted: 01/26/2023] [Indexed: 05/07/2023]
Abstract
In the area of speech processing, human speaker identification under naturalistic environments is a challenging task, especially for hearing-impaired individuals with cochlear implants (CIs) or hearing aids (HAs). Motivated by the fact that electrodograms reflect direct CI stimulation of input audio, this study proposes a speaker identification (ID) investigation using two-dimensional electrodograms constructed from the responses of a CI auditory system to emulate CI speaker ID capabilities. Features are extracted from electrodograms through an identity vector (i-vector) framework to train and generate identity models for each speaker using a Gaussian mixture model-universal background model followed by probabilistic linear discriminant analysis. To validate the proposed system, perceptual speaker ID for 20 normal hearing (NH) and seven CI listeners was evaluated with a total of 41 different speakers and compared with the scores from the proposed system. A one-way analysis of variance showed that the proposed system can reliably predict the speaker ID capability of CI (F[1,10] = 0.18, p = 0.68) and NH (F[1,20] = 0, p = 0.98) listeners in naturalistic environments. The impact of speaker familiarity is also addressed, and the results show a reduced performance for speaker recognition by CI subjects using their CI processor, highlighting limitations of current speech processing strategies used in CIs/HAs.
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Affiliation(s)
- Nursadul Mamun
- Cochlear Implant Processing Laboratory-Center for Robust Speech Systems (CRSS-CILab), The University of Texas at Dallas, 800 West Campbell Road, Richardson, Texas 75080, USA
| | - Ria Ghosh
- Cochlear Implant Processing Laboratory-Center for Robust Speech Systems (CRSS-CILab), The University of Texas at Dallas, 800 West Campbell Road, Richardson, Texas 75080, USA
| | - John H L Hansen
- Cochlear Implant Processing Laboratory-Center for Robust Speech Systems (CRSS-CILab), The University of Texas at Dallas, 800 West Campbell Road, Richardson, Texas 75080, USA
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28
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Muacevic A, Adler JR, Chu TSM, Chan J. The 100 Most-Cited Manuscripts in Hearing Implants: A Bibliometrics Analysis. Cureus 2023; 15:e33711. [PMID: 36793822 PMCID: PMC9925031 DOI: 10.7759/cureus.33711] [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] [Accepted: 01/12/2023] [Indexed: 01/13/2023] Open
Abstract
The aim of the study was to characterise the most frequently cited articles on the topic of hearing implants. A systematic search was carried out using the Thomson Reuters Web of Science Core Collection database. Eligibility criteria restricted the results to primary studies and reviews published from 1970 to 2022 in English dealing primarily with hearing implants. Data including the authors, year of publication, journal, country of origin, number of citations and average number of citations per year were extracted, as well as the impact factors and five-year impact factor of journals publishing the articles. The top 100 papers were published across 23 journals and were cited 23,139 times. The most-cited and influential article describes the first use of the continuous interleaved sampling (CIS) strategy utilised in all modern cochlear implants. More than half of the studies on the list were produced by authors from the United States, and the Ear and Hearing journal had both the greatest number of articles and the greatest number of total citations. To conclude, this research serves as a guide to the most influential articles on the topic of hearing implants, although bibliometric analyses mainly focus on citations. The most-cited article was an influential description of CIS.
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Effects of number of maxima and electrical dynamic range on speech-in-noise perception with an “n-of-m” cochlear-implant strategy. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ebrahimi-Madiseh A, Nickbakht M, Eikelboom RH, Bennett RJ, Friedland PL, Atlas MD, Jessup RL. Models of service delivery in adult cochlear implantation and evaluation of outcomes: A scoping review of delivery arrangements. PLoS One 2023; 18:e0285443. [PMID: 37163533 PMCID: PMC10171603 DOI: 10.1371/journal.pone.0285443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/23/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND This study aimed to describe available evidence of cochlear implantation delivery arrangements in adults and the outcomes by which these service models are measured. METHODS Scoping review of English language, primary studies conducted on adults (≥18 years) with ten or more subjects, published between January 2000 and June 2022, which assessed the effects of delivery arrangements of cochlear implantation were included. MEDLINE, EMBASE, CINAHL Plus, AMED, PsycINFO, LILACS, KoreaMed, IndMed, Cochrane CRCT, ISRCTN registry, WHO ICTRP and Web of Science were systematically searched. Included studies had to have a method section explicitly measure at least one of the Cochrane Effective Practice and Organization of Care (EPOC) outcome category. Criteria for systematic reviews and delivery arrangement category based on EPOC taxonomy was included in data extraction. Data was narratively synthesized based on EPOC categories. RESULTS A total of 8135 abstracts were screened after exclusion of duplicates, of these 357 studies fulfilled the inclusion criteria. Around 40% of the studies investigated how care is delivered, focusing on quality and safety systems. New care pathways to coordinate care and the use of information and communication technology were emerging areas. There was little evidence on continuity, coordination and integration of care, how the workforce is managed, where care is provided and changes in the healthcare environment. The main outcome measure for various delivery arrangements were the health status and performance in a test. CONCLUSION A substantial body of evidence exists about safety and efficacy of cochlear implantation in adults, predominantly focused on surgical aspects and this area is rapidly growing. There is a lack of evidence on aspects of care delivery that may have more impact on patients' experience such as continuity, coordination and integration of care and should be a focus of future research. This would lead to a better understanding of how patient's view CI experience, associated costs and the value of different care models.
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Affiliation(s)
- Azadeh Ebrahimi-Madiseh
- UWA Medical School, The University of Western Australia, Perth, Australia
- Telethon Speech and Hearing, Perth, Australia
- Ear Science Institute Australia, Perth, Australia
| | - Mansoureh Nickbakht
- Centre for Hearing Research (CHEAR), School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Perth, Australia
- Center for Ear Sciences, The University of Western Australia, Perth, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Rebecca J Bennett
- Ear Science Institute Australia, Perth, Australia
- Centre for Hearing Research (CHEAR), School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Center for Ear Sciences, The University of Western Australia, Perth, Australia
| | - Peter L Friedland
- UWA Medical School, The University of Western Australia, Perth, Australia
- University of Notre Dame Australia, Perth, Australia
| | - Marcus D Atlas
- Ear Science Institute Australia, Perth, Australia
- Center for Ear Sciences, The University of Western Australia, Perth, Australia
| | - Rebecca L Jessup
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- School of Medicine, Nursing and Health Sciences, Rural Health, Monash University, Melbourne, Australia
- Northern Health, Hospital Without Walls Service, Melbourne, Australia
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Hagen R, Rak K, Kurz A, Baumgartner WD, Gavilán J, van de Heyning P. The Online HEARRING Counselling 1.0 Platform Provides Clinicians with Comprehensive Information on Hearing Device Solutions for Conductive, Mixed, and Sensorineural Hearing Loss. J Pers Med 2022; 12:jpm12122027. [PMID: 36556248 PMCID: PMC9781436 DOI: 10.3390/jpm12122027] [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: 10/12/2022] [Revised: 10/27/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
A platform to help clinicians ensure that hearing device candidates are informed about the benefits and drawbacks of their recommended treatment option would be of clinical counselling benefit because it could help each candidate form realistic expectations about life with their treatment option. Following the World Café approach, 54 participants (surgeons, audiologist, and researchers) generated lists of the benefits and drawbacks of each treatment option for single-sided deafness (SSD) and bone conduction (BC) solutions. They then prioritized the benefits and drawbacks. After the World Café, literature research was performed on each topic to check if the statements (on benefits and drawbacks) are supported by quality peer-reviewed publications. Each participant was surveyed to ensure a collective agreement was reached. The HEARRING Counselling 1.0 Platform was developed. Thus far, sections for SSD and BC solutions have been completed. Initial feedback has been highly positive. The platform will be expanded to cover middle ear implant solutions and cochlear implants. A plan is in place to ensure the information continues to be timely. The HEARRING Counselling 1.0 helps clinicians provide comprehensive information to candidates about their treatment option and thereby helps establish that candidates have realistic expectations about the benefits and drawbacks of device use.
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Affiliation(s)
- Rudolf Hagen
- The Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
- Correspondence: ; Tel.: +49-931-201-21701
| | - Kristen Rak
- The Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - Anja Kurz
- The Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | | | - Javier Gavilán
- Department of Otolaryngology, IdiPAZ Research Institute, La Paz University Hospital, Paseo de la Castellana, 262, 28046 Madrid, Spain
| | - Paul van de Heyning
- ENT Department, Antwerp University Hospital, Wilrijkstraat 10, 2650 Antwerp, Belgium
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Löscher W, Worrell GA. Novel subscalp and intracranial devices to wirelessly record and analyze continuous EEG in unsedated, behaving dogs in their natural environments: A new paradigm in canine epilepsy research. Front Vet Sci 2022; 9:1014269. [PMID: 36337210 PMCID: PMC9631025 DOI: 10.3389/fvets.2022.1014269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/26/2022] [Indexed: 11/25/2022] Open
Abstract
Epilepsy is characterized by unprovoked, recurrent seizures and is a common neurologic disorder in dogs and humans. Roughly 1/3 of canines and humans with epilepsy prove to be drug-resistant and continue to have sporadic seizures despite taking daily anti-seizure medications. The optimization of pharmacologic therapy is often limited by inaccurate seizure diaries and medication side effects. Electroencephalography (EEG) has long been a cornerstone of diagnosis and classification in human epilepsy, but because of several technical challenges has played a smaller clinical role in canine epilepsy. The interictal (between seizures) and ictal (seizure) EEG recorded from the epileptic mammalian brain shows characteristic electrophysiologic biomarkers that are very useful for clinical management. A fundamental engineering gap for both humans and canines with epilepsy has been the challenge of obtaining continuous long-term EEG in the patients' natural environment. We are now on the cusp of a revolution where continuous long-term EEG from behaving canines and humans will be available to guide clinicians in the diagnosis and optimal treatment of their patients. Here we review some of the devices that have recently emerged for obtaining long-term EEG in ambulatory subjects living in their natural environments.
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Affiliation(s)
- Wolfgang Löscher
- Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine, Hanover, Germany
- Center for Systems Neuroscience, Hanover, Germany
- *Correspondence: Wolfgang Löscher
| | - Gregory A. Worrell
- Bioelectronics Neurophysiology and Engineering Laboratory, Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
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Winn MB, Teece KH. Effortful Listening Despite Correct Responses: The Cost of Mental Repair in Sentence Recognition by Listeners With Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3966-3980. [PMID: 36112516 PMCID: PMC9927629 DOI: 10.1044/2022_jslhr-21-00631] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 04/20/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Speech recognition percent correct scores fail to capture the effort of mentally repairing the perception of speech that was initially misheard. This study measured the effort of listening to stimuli specifically designed to elicit mental repair in adults who use cochlear implants (CIs). METHOD CI listeners heard and repeated sentences in which specific words were distorted or masked by noise but recovered based on later context: a signature of mental repair. Changes in pupil dilation were tracked as an index of effort and time-locked with specific landmarks during perception. RESULTS Effort significantly increases when a listener needs to repair a misperceived word, even if the verbal response is ultimately correct. Mental repair of words in a sentence was accompanied by greater prevalence of errors elsewhere in the same sentence, suggesting that effort spreads to consume resources across time. The cost of mental repair in CI listeners was essentially the same as that observed in listeners with normal hearing in previous work. CONCLUSIONS Listening effort as tracked by pupil dilation is better explained by the mental repair and reconstruction of words rather than the appearance of correct or incorrect perception. Linguistic coherence drives effort more heavily than the mere presence of mistakes, highlighting the importance of testing materials that do not constrain coherence by design.
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Affiliation(s)
- Matthew B. Winn
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Twin Cities, Minneapolis
| | - Katherine H. Teece
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Twin Cities, Minneapolis
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A Five-Year Update on the Profile of Adults Undergoing Cochlear Implant Evaluation and Surgery-Are We Doing Better? Otol Neurotol 2022; 43:e992-e999. [PMID: 36047696 DOI: 10.1097/mao.0000000000003670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To characterize the influence of expanding indications on the profile of adults undergoing cochlear implantation (CI) at a high-volume CI center. STUDY DESIGN Retrospective review. SETTING Tertiary referral center. PATIENTS 774 adults undergoing CI evaluation from August 2015 to August 2020. MAIN OUTCOME MEASURES Demographics; audiometry; speech recognition; speech, spatial, and qualities of hearing scale (SSQ-12). RESULTS Of 745 (96.3%) patients qualifying for implantation, 642 (86.6%) pursued surgery. Median age at evaluation was 69 years; 56.3% were men; 88.2% were Caucasian. Median distance to our center was 95 miles. The majority (51.8%) had public insurance (Medicare, Medicaid), followed by private (47.8%) and military (0.4%). Mean PTA, CNC, and AzBio in quiet and noise for the ear to be implanted were 85.2 dB HL, 15.0%, and 19.2% and 3.5%, respectively. Hybrid/EAS criteria were met by 138 (18.5%) CI candidates, and 436 (77.0%) unilateral CI recipients had aidable contralateral hearing for bimodal hearing configurations. Younger age (odds ratio [OR], 0.96; 95% confidence interval, 0.93-0.99) and non-Caucasian race (OR, 6.95; 95% confidence interval, 3.22-14.98) predicted candidacy. Likelihood of surgery increased for Caucasian (OR, 8.08; 95% confidence interval, 4.85-13.47) and married (OR, 2.28; 95% confidence interval, 1.50-3.47) patients and decreased for those with public insurance (OR, 0.45; 95% confidence interval, 0.29-0.69). A lower SSQ-12 score predicted both candidacy and surgery. CONCLUSION Despite expansions in criteria, speech understanding remained extremely low at CI evaluation. Younger age and non-Caucasian race predicted candidacy, and Caucasian, married patients with private insurance and lower SSQ scores were more likely to pursue surgery.
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Williams NP, Kushwah N, Dhawan V, Zheng XS, Cui XT. Effects of central nervous system electrical stimulation on non-neuronal cells. Front Neurosci 2022; 16:967491. [PMID: 36188481 PMCID: PMC9521315 DOI: 10.3389/fnins.2022.967491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Over the past few decades, much progress has been made in the clinical use of electrical stimulation of the central nervous system (CNS) to treat an ever-growing number of conditions from Parkinson's disease (PD) to epilepsy as well as for sensory restoration and many other applications. However, little is known about the effects of microstimulation at the cellular level. Most of the existing research focuses on the effects of electrical stimulation on neurons. Other cells of the CNS such as microglia, astrocytes, oligodendrocytes, and vascular endothelial cells have been understudied in terms of their response to stimulation. The varied and critical functions of these cell types are now beginning to be better understood, and their vital roles in brain function in both health and disease are becoming better appreciated. To shed light on the importance of the way electrical stimulation as distinct from device implantation impacts non-neuronal cell types, this review will first summarize common stimulation modalities from the perspective of device design and stimulation parameters and how these different parameters have an impact on the physiological response. Following this, what is known about the responses of different cell types to different stimulation modalities will be summarized, drawing on findings from both clinical studies as well as clinically relevant animal models and in vitro systems.
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Affiliation(s)
- Nathaniel P. Williams
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
| | - Neetu Kushwah
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Vaishnavi Dhawan
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
| | - Xin Sally Zheng
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Xinyan Tracy Cui
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
- Center for the Neural Basis of Cognition, Pittsburgh, PA, United States
- McGowan Institute for Regenerative Medicine, Pittsburgh, PA, United States
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Steinmetzger K, Meinhardt B, Praetorius M, Andermann M, Rupp A. A direct comparison of voice pitch processing in acoustic and electric hearing. Neuroimage Clin 2022; 36:103188. [PMID: 36113196 PMCID: PMC9483634 DOI: 10.1016/j.nicl.2022.103188] [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: 06/02/2022] [Revised: 08/24/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022]
Abstract
In single-sided deafness patients fitted with a cochlear implant (CI) in the affected ear and preserved normal hearing in the other ear, acoustic and electric hearing can be directly compared without the need for an external control group. Although poor pitch perception is a crucial limitation when listening through CIs, it remains unclear how exactly the cortical processing of pitch information differs between acoustic and electric hearing. Hence, we separately presented both ears of 20 of these patients with vowel sequences in which the pitch contours were either repetitive or variable, while simultaneously recording functional near-infrared spectroscopy (fNIRS) and EEG data. Overall, the results showed smaller and delayed auditory cortex activity in electric hearing, particularly for the P2 event-related potential component, which appears to reflect the processing of voice pitch information. Both the fNIRS data and EEG source reconstructions furthermore showed that vowel sequences with variable pitch contours evoked additional activity in posterior right auditory cortex in electric but not acoustic hearing. This surprising discrepancy demonstrates, firstly, that the acoustic detail transmitted by CIs is sufficient to distinguish between speech sounds that only vary regarding their pitch information. Secondly, the absence of a condition difference when stimulating the normal-hearing ears suggests a saturation of cortical activity levels following unilateral deafness. Taken together, these results provide strong evidence in favour of using CIs in this patient group.
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Affiliation(s)
- Kurt Steinmetzger
- Section of Biomagnetism, Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany,Corresponding author.
| | - Bastian Meinhardt
- Section of Biomagnetism, Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Mark Praetorius
- Section of Otology and Neurootology, ENT Clinic, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Martin Andermann
- Section of Biomagnetism, Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - André Rupp
- Section of Biomagnetism, Department of Neurology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Herbert CJ, Pisoni DB, Kronenberger WG, Nelson RF. Exceptional Speech Recognition Outcomes After Cochlear Implantation: Lessons From Two Case Studies. Am J Audiol 2022; 31:552-566. [PMID: 35944073 PMCID: PMC9886164 DOI: 10.1044/2022_aja-21-00261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Individual differences and variability in outcomes following cochlear implantation (CI) in patients with hearing loss remain significant unresolved clinical problems. Case reports of specific individuals allow for detailed examination of the information processing mechanisms underlying variability in outcomes. Two adults who displayed exceptionally good postoperative CI outcomes shortly after activation were administered a novel battery of auditory, speech recognition, and neurocognitive processing tests. METHOD A case study of two adult CI recipients with postlingually acquired hearing loss who displayed excellent postoperative speech recognition scores within 3 months of initial activation. Preoperative City University of New York sentence testing and a postoperative battery of sensitive speech recognition tests were combined with auditory and visual neurocognitive information processing tests to uncover their strengths, weaknesses, and milestones. RESULTS Preactivation CUNY auditory-only (A) scores were < 5% correct while the auditory + visual (A + V) scores were > 74%. Acoustically with their CIs, both participants' scores on speech recognition, environmental sound identification and speech in noise tests exceeded average CI users scores by 1-2 standard deviations. On nonacoustic visual measures of language and neurocognitive functioning, both participants achieved above average scores compared with normal hearing adults in vocabulary knowledge, rapid phonological coding of visually presented words and nonwords, verbal working memory, and executive functioning. CONCLUSIONS Measures of multisensory (A + V) speech recognition and visual neurocognitive functioning were associated with excellent speech recognition outcomes in two postlingual adult CI recipients. These neurocognitive information processing domains may underlie the exceptional speech recognition performance of these two patients and offer new directions for research explaining variability in postimplant outcomes. Results further suggest that current clinical outcome measures should be expanded beyond the conventional speech recognition measures to include more sensitive robust tests of speech recognition as well as neurocognitive measures of working memory, vocabulary, lexical access, and executive functioning.
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Affiliation(s)
- Carolyn J. Herbert
- DeVault Otologic Research Laboratory, Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
| | - David B. Pisoni
- DeVault Otologic Research Laboratory, Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine, Indianapolis,Department of Psychological and Brain Sciences, Indiana University Bloomington
| | - William G. Kronenberger
- DeVault Otologic Research Laboratory, Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine, Indianapolis,Department of Psychiatry, Indiana University School of Medicine, Indianapolis
| | - Rick F. Nelson
- DeVault Otologic Research Laboratory, Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
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Bridging the electrode-neuron gap: finite element modeling of in vitro neurotrophin gradients to optimize neuroelectronic interfaces in the inner ear. Acta Biomater 2022; 151:360-378. [PMID: 36007779 DOI: 10.1016/j.actbio.2022.08.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/13/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022]
Abstract
Although cochlear implant (CI) technology has allowed for the partial restoration of hearing over the last few decades, persistent challenges (e.g., poor performance in noisy environments and limited ability to decode intonation and music) remain. The "electrode-neuron gap" is inherent to these challenges and poses the most significant obstacle to advancing past the current plateau in CI performance. We propose the development of a "neuro-regenerative nexus"-a biological interface that doubly preserves native spiral ganglion neurons (SGNs) while precisely directing the growth of neurites arising from transplanted human pluripotent stem cell (hPSC)-derived otic neuronal progenitors (ONPs) toward the native SGN population. We hypothesized that the Polyhedrin Delivery System (PODS®-recombinant human brain-derived neurotrophic factor [rhBDNF]) could stably provide the adequate BDNF concentration gradient to hPSC-derived late-stage ONPs to facilitate otic neuronal differentiation and directional neurite outgrowth. To test this hypothesis, a finite element model (FEM) was constructed to simulate BDNF concentration profiles generated by PODS®-rhBDNF based on initial concentration and culture device geometry. For biological validation of the FEM, cell culture experiments assessing survival, differentiation, neurite growth direction, and synaptic connections were conducted using a multi-chamber microfluidic device. We were able to successfully generate the optimal BDNF concentration gradient to enable survival, neuronal differentiation toward SGNs, directed neurite extension of hPSC-derived SGNs, and synaptogenesis between two hPSC-derived SGN populations. This proof-of-concept study provides a step toward the next generation of CI technology. STATEMENT OF SIGNIFICANCE: Our study demonstrates that the generation of in vitro neurotrophin concentration gradients facilitates survival, neuronal differentiation toward auditory neurons, and directed neurite extension of human pluripotent stem cell-derived auditory neurons. These findings are indispensable to designing a bioactive cochlear implant, in which stem cell-derived neurons are integrated into a cochlear implant electrode strip, as the strategy will confer directional neurite growth from the transplanted cells in the inner ear. This study is the first to present the concept of a "neuro-regenerative nexus" congruent with a bioactive cochlear implant to eliminate the electrode-neuron gapthe most significant barrier to next-generation cochlear implant technology.
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Bansal M, Vyas Y, Aqrawe Z, Raos B, Cheah E, Montgomery J, Wu Z, Svirskis D. Patternable Gelatin Methacrylate/PEDOT/Polystyrene Sulfonate Microelectrode Coatings for Neuronal Recording. ACS Biomater Sci Eng 2022; 8:3933-3943. [PMID: 35976694 DOI: 10.1021/acsbiomaterials.2c00231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This manuscript addresses the need for new soft biomaterials that can be fabricated on the surface of microelectrodes to reduce the mechanical mismatch between biological tissues and electrodes and improve the performance at the neural interface. By electrochemical polymerization of poly(3,4-dioxythiophene) (PEDOT)/polystyrene sulfonate (PSS) through a gelatin methacrylate (GelMA) hydrogel, we demonstrate the synthesis of a conducting polymer hydrogel (CPH) to meet the performance criteria of bioelectrodes. The hybrid material can be photolithographically patterned and covalently attached to gold microelectrodes, forming an interpenetrating network, as confirmed by infrared spectroscopy. The GelMA/PEDOT/PSS coatings were found to be reversibly electroactive by cyclic voltammetry and had low impedance compared to bare gold and GelMA-coated microelectrodes. The CPH coatings showed impedance at levels similar to conventional PEDOT/PSS coatings at a frequency of 1000 Hz. CPH exhibited electrochemical stability over 1000 CV cycles, and its performance was maintained over 14 days. Biocompatibility of the CPH coatings was confirmed by primary hippocampal neuronal cultures via a neuronal viability assay. The CPH-coated microelectrode arrays (MEAs) successfully recorded neuronal activity from primary hippocampal neuronal cells. The CPH GelMA/PEDOT/PSS is a highly promising coating material to enhance microelectrode performance at the neural interface.
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Affiliation(s)
- Mahima Bansal
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Yukti Vyas
- Department of Physiology and Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Zaid Aqrawe
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Brad Raos
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Ernest Cheah
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Johanna Montgomery
- Department of Physiology and Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Zimei Wu
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Darren Svirskis
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
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Smith S. Translational Applications of Machine Learning in Auditory Electrophysiology. Semin Hear 2022; 43:240-250. [PMID: 36313047 PMCID: PMC9605807 DOI: 10.1055/s-0042-1756166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Machine learning (ML) is transforming nearly every aspect of modern life including medicine and its subfields, such as hearing science. This article presents a brief conceptual overview of selected ML approaches and describes how these techniques are being applied to outstanding problems in hearing science, with a particular focus on auditory evoked potentials (AEPs). Two vignettes are presented in which ML is used to analyze subcortical AEP data. The first vignette demonstrates how ML can be used to determine if auditory learning has influenced auditory neurophysiologic function. The second vignette demonstrates how ML analysis of AEPs may be useful in determining whether hearing devices are optimized for discriminating speech sounds.
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Affiliation(s)
- Spencer Smith
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, Austin, Texas
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Alqahtani A, Alabed A, Alharbi Y, Bakouri M, Lovell NH, Dokos S. A varying-radius cable equation for the modelling of impulse propagation in excitable fibres. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3616. [PMID: 35582823 DOI: 10.1002/cnm.3616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 04/01/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
In this study, we present a varying-radius cable equation for nerve fibres taking into account the varying diameter along the neuronal segments. Finite element neuronal models utilising the classical (fixed-radius) and varying-radius cable formulations were compared using simple and realistic morphologies under intra- and extracellular electrical stimulation protocols. We found that the use of the classical cable equation to model intracellular neural electrical stimulation exhibited an error of 17% in a passive resistive cable model with abrupt change in radius from 1 to 2 μm, when compared to the known analytical solution and varying-radius cable formulation. This error was observed to increase substantially using more realistic neuron morphologies and branching structures. In the case of extracellular stimulation however, the difference between the classical and varying-radius formulations was less pronounced, but we expect this difference will increase under more complex stimulation paradigms such as high-frequency stimulation. We conclude that for computational neuroscience applications, it is essential to use the varying-radius cable equation for accurate prediction of neuronal responses under electrical stimulation.
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Affiliation(s)
- Abdulrahman Alqahtani
- Department of Medical Equipment Technology, College of Applied Medical Science, Majmaah University, AL-Majmaah, Saudi Arabia
| | - Amr Alabed
- Graduate School of Biomedical Engineering, UNSW Sydney, Sydney, New South Wales, Australia
| | - Yousef Alharbi
- Department of Medical Equipment Technology, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mohsen Bakouri
- Department of Medical Equipment Technology, College of Applied Medical Science, Majmaah University, AL-Majmaah, Saudi Arabia
| | - Nigel H Lovell
- Graduate School of Biomedical Engineering, UNSW Sydney, Sydney, New South Wales, Australia
| | - Socrates Dokos
- Graduate School of Biomedical Engineering, UNSW Sydney, Sydney, New South Wales, Australia
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Bissmeyer SRS, Ortiz JR, Gan H, Goldsworthy RL. Computer-based musical interval training program for Cochlear implant users and listeners with no known hearing loss. Front Neurosci 2022; 16:903924. [PMID: 35968373 PMCID: PMC9363605 DOI: 10.3389/fnins.2022.903924] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022] Open
Abstract
A musical interval is the difference in pitch between two sounds. The way that musical intervals are used in melodies relative to the tonal center of a key can strongly affect the emotion conveyed by the melody. The present study examines musical interval identification in people with no known hearing loss and in cochlear implant users. Pitch resolution varies widely among cochlear implant users with average resolution an order of magnitude worse than in normal hearing. The present study considers the effect of training on musical interval identification and tests for correlations between low-level psychophysics and higher-level musical abilities. The overarching hypothesis is that cochlear implant users are limited in their ability to identify musical intervals both by low-level access to frequency cues for pitch as well as higher-level mapping of the novel encoding of pitch that implants provide. Participants completed a 2-week, online interval identification training. The benchmark tests considered before and after interval identification training were pure tone detection thresholds, pure tone frequency discrimination, fundamental frequency discrimination, tonal and rhythm comparisons, and interval identification. The results indicate strong correlations between measures of pitch resolution with interval identification; however, only a small effect of training on interval identification was observed for the cochlear implant users. Discussion focuses on improving access to pitch cues for cochlear implant users and on improving auditory training for musical intervals.
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Affiliation(s)
- Susan Rebekah Subrahmanyam Bissmeyer
- Caruso Department of Otolaryngology, Auditory Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
- *Correspondence: Susan Rebekah Subrahmanyam Bissmeyer,
| | - Jacqueline Rose Ortiz
- Caruso Department of Otolaryngology, Auditory Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Helena Gan
- Caruso Department of Otolaryngology, Auditory Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Raymond Lee Goldsworthy
- Caruso Department of Otolaryngology, Auditory Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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Roux J, Hanekom JJ. Effect of stimulation parameters on sequential current-steered stimuli in cochlear implants. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:609. [PMID: 35931549 DOI: 10.1121/10.0012763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
Manipulation of cochlear implant (CI) place pitch was carried out with current steering by stimulating two CI electrodes sequentially. The objective was to investigate whether shifts in activated neural populations could be achieved to produce salient pitch differences and to determine which stimulation parameters would be more effective in steering of current. These were the pulse rate and pulse width of electrical stimuli and the distance between the two current-steering electrodes. Nine CI users participated, and ten ears were tested. The pattern of pitch changes was not consistent across listeners, but the data suggest that individualized selection of stimulation parameters may be used to effect place pitch changes with sequential current steering. Individual analyses showed that pulse width generally had little influence on the effectiveness of current steering with sequential stimuli, while more salient place pitch shifts were often achieved at wider electrode spacing or when the stimulation pulse rate was the same as that indicated on the clinical MAP (the set of stimulation parameters) of the listener. Results imply that current steering may be used in CIs that allow only sequential stimulation to achieve place pitch manipulation.
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Affiliation(s)
- Johanie Roux
- Bioengineering, Department of Electrical, Electronic, and Computer Engineering, University of Pretoria, University Road, Pretoria 0002, South Africa
| | - Johan J Hanekom
- Bioengineering, Department of Electrical, Electronic, and Computer Engineering, University of Pretoria, University Road, Pretoria 0002, South Africa
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Parameter-Specific Morphing Reveals Contributions of Timbre to the Perception of Vocal Emotions in Cochlear Implant Users. Ear Hear 2022; 43:1178-1188. [PMID: 34999594 PMCID: PMC9197138 DOI: 10.1097/aud.0000000000001181] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objectives: Research on cochlear implants (CIs) has focused on speech comprehension, with little research on perception of vocal emotions. We compared emotion perception in CI users and normal-hearing (NH) individuals, using parameter-specific voice morphing. Design: Twenty-five CI users and 25 NH individuals (matched for age and gender) performed fearful-angry discriminations on bisyllabic pseudoword stimuli from morph continua across all acoustic parameters (Full), or across selected parameters (F0, Timbre, or Time information), with other parameters set to a noninformative intermediate level. Results: Unsurprisingly, CI users as a group showed lower performance in vocal emotion perception overall. Importantly, while NH individuals used timbre and fundamental frequency (F0) information to equivalent degrees, CI users were far more efficient in using timbre (compared to F0) information for this task. Thus, under the conditions of this task, CIs were inefficient in conveying emotion based on F0 alone. There was enormous variability between CI users, with low performers responding close to guessing level. Echoing previous research, we found that better vocal emotion perception was associated with better quality of life ratings. Conclusions: Some CI users can utilize timbre cues remarkably well when perceiving vocal emotions.
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Xie D, Luo J, Chao X, Li J, Liu X, Fan Z, Wang H, Xu L. Relationship Between the Ability to Detect Frequency Changes or Temporal Gaps and Speech Perception Performance in Post-lingual Cochlear Implant Users. Front Neurosci 2022; 16:904724. [PMID: 35757528 PMCID: PMC9213807 DOI: 10.3389/fnins.2022.904724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/17/2022] [Indexed: 12/03/2022] Open
Abstract
Previous studies, using modulation stimuli, on the relative effects of frequency resolution and time resolution on CI users’ speech perception failed to reach a consistent conclusion. In this study, frequency change detection and temporal gap detection were used to investigate the frequency resolution and time resolution of CI users, respectively. Psychophysical and neurophysiological methods were used to simultaneously investigate the effects of frequency and time resolution on speech perception in post-lingual cochlear implant (CI) users. We investigated the effects of psychophysical results [frequency change detection threshold (FCDT), gap detection threshold (GDT)], and acoustic change complex (ACC) responses (evoked threshold, latency, or amplitude of ACC induced by frequency change or temporal gap) on speech perception [recognition rate of monosyllabic words, disyllabic words, sentences in quiet, and sentence recognition threshold (SRT) in noise]. Thirty-one adult post-lingual CI users of Mandarin Chinese were enrolled in the study. The stimuli used to induce ACCs to frequency changes were 800-ms pure tones (fundamental frequency was 1,000 Hz); the frequency change occurred at the midpoint of the tones, with six percentages of frequency changes (0, 2, 5, 10, 20, and 50%). Temporal silences with different durations (0, 5, 10, 20, 50, and 100 ms) were inserted in the middle of the 800-ms white noise to induce ACCs evoked by temporal gaps. The FCDT and GDT were obtained by two 2-alternative forced-choice procedures. The results showed no significant correlation between the CI hearing threshold and speech perception in the study participants. In the multiple regression analysis of the influence of simultaneous psychophysical measures and ACC responses on speech perception, GDT significantly predicted every speech perception index, and the ACC amplitude evoked by the temporal gap significantly predicted the recognition of disyllabic words in quiet and SRT in noise. We conclude that when the ability to detect frequency changes and the temporal gap is considered simultaneously, the ability to detect frequency changes may have no significant effect on speech perception, but the ability to detect temporal gaps could significantly predict speech perception.
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Affiliation(s)
- Dianzhao Xie
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jianfen Luo
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiuhua Chao
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jinming Li
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianqi Liu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhaomin Fan
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Haibo Wang
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lei Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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Goldsworthy RL. Computational Modeling of Synchrony in the Auditory Nerve in Response to Acoustic and Electric Stimulation. Front Comput Neurosci 2022; 16:889992. [PMID: 35782089 PMCID: PMC9249013 DOI: 10.3389/fncom.2022.889992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
Cochlear implants are medical devices that provide hearing to nearly one million people around the world. Outcomes are impressive with most recipients learning to understand speech through this new way of hearing. Music perception and speech reception in noise, however, are notably poor. These aspects of hearing critically depend on sensitivity to pitch, whether the musical pitch of an instrument or the vocal pitch of speech. The present article examines cues for pitch perception in the auditory nerve based on computational models. Modeled neural synchrony for pure and complex tones is examined for three different electric stimulation strategies including Continuous Interleaved Sampling (CIS), High-Fidelity CIS (HDCIS), and Peak-Derived Timing (PDT). Computational modeling of current spread and neuronal response are used to predict neural activity to electric and acoustic stimulation. It is shown that CIS does not provide neural synchrony to the frequency of pure tones nor to the fundamental component of complex tones. The newer HDCIS and PDT strategies restore synchrony to both the frequency of pure tones and to the fundamental component of complex tones. Current spread reduces spatial specificity of excitation as well as the temporal fidelity of neural synchrony, but modeled neural excitation restores precision of these cues. Overall, modeled neural excitation to electric stimulation that incorporates temporal fine structure (e.g., HDCIS and PDT) indicates neural synchrony comparable to that provided by acoustic stimulation. Discussion considers the importance of stimulation rate and long-term rehabilitation to provide temporal cues for pitch perception.
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Weglage A, Müller V, Layer N, Abdel-Latif KHA, Lang-Roth R, Walger M, Sandmann P. Side-of-Implantation Effect on Functional Asymmetry in the Auditory Cortex of Single-Sided Deaf Cochlear-Implant Users. Brain Topogr 2022; 35:431-452. [PMID: 35668310 PMCID: PMC9334411 DOI: 10.1007/s10548-022-00902-3] [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: 11/19/2021] [Accepted: 05/10/2022] [Indexed: 11/25/2022]
Abstract
Cochlear implants (CIs) allow to restore the hearing function in profoundly deaf individuals. Due to the degradation of the stimulus by CI signal processing, implanted individuals with single-sided deafness (SSD) have the specific challenge that the input highly differs between their ears. The present study compared normal-hearing (NH) listeners (N = 10) and left- and right-ear implanted SSD CI users (N = 10 left, N = 9 right), to evaluate cortical speech processing between CI- and NH-ears and to explore for side-of-implantation effects. The participants performed a two-deviant oddball task, separately with the left and the right ear. Auditory event-related potentials (ERPs) in response to syllables were compared between proficient and non-proficient CI users, as well as between CI and NH ears. The effect of the side of implantation was analysed on the sensor and the source level. CI proficiency could be distinguished based on the ERP amplitudes of the N1 and the P3b. Moreover, syllable processing via the CI ear, when compared to the NH ear, resulted in attenuated and delayed ERPs. In addition, the left-ear implanted SSD CI users revealed an enhanced functional asymmetry in the auditory cortex than right-ear implanted SSD CI users, regardless of whether the syllables were perceived via the CI or the NH ear. Our findings reveal that speech-discrimination proficiency in SSD CI users can be assessed by N1 and P3b ERPs. The results contribute to a better understanding of the rehabilitation success in SSD CI users by showing that cortical speech processing in SSD CI users is affected by CI-related stimulus degradation and experience-related functional changes in the auditory cortex.
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Affiliation(s)
- Anna Weglage
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany.
| | - Verena Müller
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany
| | - Natalie Layer
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany
| | - Khaled H A Abdel-Latif
- Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Cologne, Germany
| | - Ruth Lang-Roth
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany
| | - Martin Walger
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany.,Jean-Uhrmacher-Institute for Clinical ENT Research, University of Cologne, Cologne, Germany
| | - Pascale Sandmann
- Faculty of Medicine and University Hospital Cologne, Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, Cochlear Implant Center, University of Cologne, Cologne, Germany
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Wichova H, Shew M, Nelson-Brantley J, Warnecke A, Prentiss S, Staecker H. MicroRNA Profiling in the Perilymph of Cochlear Implant Patients: Identifying Markers that Correlate to Audiological Outcomes. J Am Acad Audiol 2022; 32:627-635. [PMID: 35609590 DOI: 10.1055/s-0041-1742234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
HYPOTHESIS MicroRNA (miRNA) expression profiles from human perilymph correlate to post cochlear implantation (CI) hearing outcomes. BACKGROUND The high inter-individual variability in speech perception among cochlear implant recipients is still poorly understood. MiRNA expression in perilymph can be used to characterize the molecular processes underlying inner ear disease and to predict performance with a cochlear implant. METHODS Perilymph collected during CI from 17 patients was analyzed using microarrays. MiRNAs were identified and multivariable analysis using consonant-nucleus-consonant testing at 6 and 18 months post implant activation was performed. Variables analyzed included age, gender, preoperative pure tone average (PTA), and preoperative speech discrimination (word recognition [WR]). Gene ontology analysis was performed to identify potential functional implications of changes in the identified miRNAs. RESULTS Distinct miRNA profiles correlated to preoperative PTA and WR. Patients classified as poor performers showed downregulation of six miRNAs that potentially regulate pathways related to neuronal function and cell survival. CONCLUSION Individual miRNA profiles can be identified in microvolumes of perilymph. Distinct non-coding RNA expression profiles correlate to preoperative hearing and postoperative cochlear implant outcomes.
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Affiliation(s)
| | - Matthew Shew
- Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - Jennifer Nelson-Brantley
- Department of Anatomy and Cell Biology, School of Medicine, University of Kanas, Kansas City, Kansas
| | - Athanasia Warnecke
- Department of Otolaryngology Head and Neck Surgery, Hannover Medical School, Hannover, Germany
| | - Sandra Prentiss
- Department of Otolaryngology Head and Neck Surgery, University of Miami School of Medicine, Miami, Florida
| | - Hinrich Staecker
- Department of Otolaryngology Head and Neck Surgery, University of Kansas School of Medicine, Kansas City Kansas
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A Modelling Study on the Comparison of Predicted Auditory Nerve Firing Rates for the Personalized Indication of Cochlear Implantation. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12105168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The decision of whether to perform cochlear implantation is crucial because implantation cannot be reversed without harm. The aim of the study was to compare model-predicted time–place representations of auditory nerve (AN) firing rates for normal hearing and impaired hearing with a view towards personalized indication of cochlear implantation. AN firing rates of 1024 virtual subjects with a wide variety of different types and degrees of hearing impairment were predicted. A normal hearing reference was compared to four hearing prosthesis options, which were unaided hearing, sole acoustic amplification, sole electrical stimulation, and a combination of the latter two. The comparisons and the fitting of the prostheses were based on a ‘loss of action potentials’ (LAP) score. Single-parameter threshold analysis suggested that cochlear implantation is indicated when more than approximately two-thirds of the inner hair cells (IHCs) are damaged. Second, cochlear implantation is also indicated when more than an average of approximately 12 synapses per IHC are damaged due to cochlear synaptopathy (CS). Cochlear gain loss (CGL) appeared to shift these thresholds only slightly. Finally, a support vector machine predicted the indication of a cochlear implantation from hearing loss parameters with a 10-fold cross-validated accuracy of 99.2%.
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Yamazaki H, Kohno Y, Kawano S. Oscillation Characteristics of an Artificial Cochlear Sensory Epithelium Optimized for a Micrometer-Scale Curved Structure. MICROMACHINES 2022; 13:mi13050768. [PMID: 35630235 PMCID: PMC9147464 DOI: 10.3390/mi13050768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 02/01/2023]
Abstract
Based on the modern microelectromechanical systems technology, we present a revolutionary miniaturized artificial cochlear sensory epithelium for future implantation tests on guinea pigs. The device was curved to fit the spiral structure of the cochlea and miniaturized to a maximum dimension of <1 mm to be implanted in the cochlea. First, the effect of the curved configuration on the oscillation characteristics of a trapezoidal membrane was evaluated using the relatively larger devices, which had a trapezoidal and a comparable curved shape designed for high-precision in vitro measurements. Both experimental and numerical analyses were used to determine the resonance frequencies and positions, and multiple oscillation modes were clearly observed. Because the maximum oscillation amplitude positions, i.e., the resonance positions, differed depending on the resonance frequencies in both trapezoidal and curved membrane devices, the sound frequency was determined based on the resonance position, thus reproducing the frequency selectivity of the basilar membrane in the organ of Corti. Furthermore, the resonance frequencies and positions of these two devices with different configurations were determined to be quantitatively consistent and similar in terms of mechanical dynamics. This result shows that despite a curved angle of 50−60°, the effect of the curved shape on oscillation characteristics was negligible. Second, the nanometer-scale oscillation of the miniaturized device was successfully measured, and the local resonance frequency in air was varied from 157 to 277 kHz using an experimental system that could measure the amplitude distribution in a two-dimensional (2D) plane with a high accuracy and reproducibility at a high speed. The miniaturized device developed in this study was shown to have frequency selectivity, and when the device was implanted in the cochlea, it was expected to discriminate frequencies in the same manner as the basilar membrane in the biological system. This study established methods for fabricating and evaluating the miniaturized device, and the proposed miniaturized device in a curved shape demonstrated the feasibility of next-generation cochlear implants.
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