Relationship between aided cortical auditory evoked responses and aided behavioral thresholds

OBJECTIVES

The present study aimed to determine the relationship between aided cortical auditory evoked potentials and aided behavioral thresholds. Secondary aims of the study were to investigate the relationship between age and Cortical Auditory Evoked Potentials latencies, and to analyze the relationship between the /m/, /g/ and /t/ stimuli.

METHOD

Therefore, 20 subjects (4-8 years old) who diagnosed with moderate to severe hearing loss were included in the study. Behavioral pure-tone audiometry was performed using supra-aural earphones. After verification of the settings of hearing aid settings, aided behavioral thresholds were determined in the free field. Aided CAEPs were recorded using the HEARLab system in a sound-treated room. The /m/, /g/, and /t/ speech stimuli were applied with durations of 30, 20, and 30 ms respectively.

RESULTS

A strong correlation was found between aided cortical auditory evoked responses at the level of 55 dB SPL and aided behavioral thresholds in the free field(r=0.86). We showed that the CAEP latencies were not correlated with the age (/m/ stimulus [r=-0.051; p=0.830], /g/ stimulus [r=-0.053; p=0.825], and /t/ stimulus [r=0.121; p=0,610]). The mean latency of the /m/ stimulus at 55 dB SPL intensity was longer than those of the /g/ and /t/ stimuli.

CONCLUSION

The results of the present study demonstrated that the use of the cortical auditory evoked potentials is clinically useful for measuring the hearing aid benefit. The CAEP can predict the aided behavioral thresholds in children with moderate hearing loss.

Clinically recorded cortical auditory evoked potentials from paediatric cochlear implant users fitted with electrically elicited stapedius reflex thresholds

OBJECTIVES

This study aimed to objectively evaluate access to soft sounds (55 dB SPL) in paediatric CI users, all wearing MED-EL (Innsbruck, Austria) devices who were fitted with the objective electrically elicited stapedius reflex threshold (eSRT) fitting method, to track their cortical auditory evoked potential (CAEP) presence and latency, and to compare their CAEPs to those of normal-hearing peers.

METHODS

Forty-five unilaterally implanted, pre-lingually deafened MED-EL CI users, aged 12-48 months, underwent CAEP testing in the clinic at regular monthly intervals post switch-on. CAEPs were recorded in response to short speech tokens /m/, /g/ and /t/ presented in the free field at 55 dB SPL. Twenty children with normal hearing (NH), similarly aged, underwent CAEP testing once.

RESULTS

The proportion of present CAEPs increased and CAEP P1 latencies reduced significantly with post-implantation duration. CAEPs were scored based on their presence and age-appropriate P1 latency. These CAEP scores increased significantly with post-implantation duration. CAEP scores were significantly worse for the /m/ speech token compared to the other two tokens. Compared to the NH group, CAEP scores were significantly smaller for all post-implantation test intervals.

CONCLUSIONS

This study provides clinicians with a first step towards typical ranges of CAEP presence, latency, and derived CAEP score over the first months of MED-EL CI use. CAEPs within these typical ranges could validate intervention whereas less than optimum CAEPs could prompt clinicians to seek solutions in a timely manner. CAEPs could clinically validate whether a CI provides adequate access to soft sounds. This approach could form an alternative to behavioural soft sound access verification.

Speech processing in children with cochlear implant

Cochlear implants (CIs) can be used effectively in the profoundly impaired children individuals.

OBJECTIVES

This work was designed to assess speech processing at brainstem and cortical level in children fitted with CIs to investigate the possible influence of brainstem processing of speech on the cortical processing in those children.

METHOD

Twenty children fitted with CIs underwent aided sound-field audiologic evaluation, speech evoked cortical auditory evoked potentials (S-CAEPs) and according to the results, children were classified into two groups: group I with good cortical response and group II with poor cortical response. This was followed by speech evoked ABR (S-ABR) recoding.

RESULTS

P1 component of CAEPs was recorded in all children while other component showed variable results. S-ABR was recorded in all children even those with poor S-CAEPs response who showed delayed D, E, F and O latencies. However, S-ABR amplitudes did not show any significant difference between both groups.

CONCLUSIONS

Children fitted with CI showed immediate cortical activation following device programming and this activity depends on the age of implantation as well as the child's age. S-ABR provides a new clinical tool that showed an important role of brainstem in complex sound processing that contribute to cortical processing.

Developmental and cross-modal plasticity in deafness: evidence from the P1 and N1 event related potentials in cochlear implanted children

Cortical development is dependent on extrinsic stimulation. As such, sensory deprivation, as in congenital deafness, can dramatically alter functional connectivity and growth in the auditory system. Cochlear implants ameliorate deprivation-induced delays in maturation by directly stimulating the central nervous system, and thereby restoring auditory input. The scenario in which hearing is lost due to deafness and then reestablished via a cochlear implant provides a window into the development of the central auditory system. Converging evidence from electrophysiologic and brain imaging studies of deaf animals and children fitted with cochlear implants has allowed us to elucidate the details of the time course for auditory cortical maturation under conditions of deprivation. Here, we review how the P1 cortical auditory evoked potential (CAEP) provides useful insight into sensitive period cut-offs for development of the primary auditory cortex in deaf children fitted with cochlear implants. Additionally, we present new data on similar sensitive period dynamics in higher-order auditory cortices, as measured by the N1 CAEP in cochlear implant recipients. Furthermore, cortical re-organization, secondary to sensory deprivation, may take the form of compensatory cross-modal plasticity. We provide new case-study evidence that cross-modal re-organization, in which intact sensory modalities (i.e., vision and somatosensation) recruit cortical regions associated with deficient sensory modalities (i.e., auditory) in cochlear implanted children may influence their behavioral outcomes with the implant. Improvements in our understanding of developmental neuroplasticity in the auditory system should lead to harnessing central auditory plasticity for superior clinical technique.

Effects of various articulatory features of speech on cortical event-related potentials and behavioral measures of speech-sound processing

OBJECTIVE

To investigate the effects of three articulatory features of speech (i.e., vowel-space contrast, place of articulation of stop consonants, and voiced/voiceless distinctions) on cortical event-related potentials (ERPs) (waves N1, mismatch negativity, N2b, and P3b) and their related behavioral measures of discrimination (d-prime sensitivity and reaction time [RT]) in normal-hearing adults to increase our knowledge regarding how the brain responds to acoustical differences that occur within an articulatory speech feature and across articulatory features of speech.

DESIGN

Cortical ERPs were recorded to three sets of consonant-vowel speech stimuli (/bi versus /bu/, /ba/ versus /da/, /da/ versus /ta/) presented at 65 and 80 dB peak-to-peak equivalent SPL from 20 normal-hearing adults. All speech stimuli were presented in an oddball paradigm. Cortical ERPs were recorded from 10 individuals in the active-listening condition and another 10 individuals in the passive-listening condition. All listeners were tested at both stimulus intensities.

RESULTS

Mean amplitudes for all ERP components were considerably larger for the responses to the vowel contrast in comparison with the responses to the two consonant contrasts. Similarly, the mean mismatch negativity, P3b, and RT latencies were significantly shorter for the responses to the vowel versus consonant contrasts. For the majority of ERP components, only small nonsignificant differences occurred in either the ERP amplitude or the latency response measurements for stimuli within a particular articulatory feature of speech.

CONCLUSIONS

The larger response amplitudes and earlier latencies for the cortical ERPs to the vowel versus consonant stimuli are likely related, in part, to the large spectral differences present in these speech contrasts. The measurements of response strength (amplitudes and d-prime scores) and response timing (ERP and RT latencies) for the various cortical ERPs suggest that the brain may have an easier task processing the steady state information present in the vowel stimuli in comparison with the rapidly changing formant transitions in the consonant stimuli.