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Sun Y, Xiao Z, Chen B, Zhao Y, Dai J. Advances in Material-Assisted Electromagnetic Neural Stimulation. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2400346. [PMID: 38594598 DOI: 10.1002/adma.202400346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/26/2024] [Indexed: 04/11/2024]
Abstract
Bioelectricity plays a crucial role in organisms, being closely connected to neural activity and physiological processes. Disruptions in the nervous system can lead to chaotic ionic currents at the injured site, causing disturbances in the local cellular microenvironment, impairing biological pathways, and resulting in a loss of neural functions. Electromagnetic stimulation has the ability to generate internal currents, which can be utilized to counter tissue damage and aid in the restoration of movement in paralyzed limbs. By incorporating implanted materials, electromagnetic stimulation can be targeted more accurately, thereby significantly improving the effectiveness and safety of such interventions. Currently, there have been significant advancements in the development of numerous promising electromagnetic stimulation strategies with diverse materials. This review provides a comprehensive summary of the fundamental theories, neural stimulation modulating materials, material application strategies, and pre-clinical therapeutic effects associated with electromagnetic stimulation for neural repair. It offers a thorough analysis of current techniques that employ materials to enhance electromagnetic stimulation, as well as potential therapeutic strategies for future applications.
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Affiliation(s)
- Yuting Sun
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Zhifeng Xiao
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Bing Chen
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Yannan Zhao
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Jianwu Dai
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and developmental Biology, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
- Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, 300192, China
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Skidmore J, Yuan Y, He S. A new method for removing artifacts from recordings of the electrically evoked compound action potential: Single-pulse stimulation. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.17.24301435. [PMID: 38293121 PMCID: PMC10827261 DOI: 10.1101/2024.01.17.24301435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
This report presents a new method for removing electrical artifact contamination from the electrically evoked compound action potential (eCAP) evoked by single cathodic-leading, biphasic-pulse stimulation. The development of the new method is motivated by results recorded in human cochlear implant (CI) users showing that the fundamental assumption of the classic forward masking artifact rejection technique is violated in up to 45% of cases tested at high stimulation levels when using default stimulation parameters. Subsequently, the new method developed based on the discovery that a hyperbola best characterizes the artifacts created during stimulation and recording is described. The eCAP waveforms obtained using the new method are compared to those recorded using the classic forward masking technique. The results show that eCAP waveforms obtained using both methods are comparable when the fundamental assumption of the classic forward masking technique is met. In contrast, eCAP amplitudes obtained using the two methods are significantly different when the fundamental assumption of the classic forward masking technique is violated, with greater differences in the eCAP amplitude for greater assumption violations. The new method also has excellent test-retest reliability (Intraclass correlation > 0.98). Overall, the new method is a viable alternative to the classic forward masking technique for obtaining artifact-free eCAPs evoked by single-pulse stimulation in CI users.
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Affiliation(s)
- Jeffrey Skidmore
- Department of Otolaryngology – Head and Neck Surgery, The Ohio State University, 915 Olentangy River Road, Columbus, OH 43212, USA
| | - Yi Yuan
- Department of Otolaryngology – Head and Neck Surgery, The Ohio State University, 915 Olentangy River Road, Columbus, OH 43212, USA
| | - Shuman He
- Department of Otolaryngology – Head and Neck Surgery, The Ohio State University, 915 Olentangy River Road, Columbus, OH 43212, USA
- Department of Audiology, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA
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Wei X, Lu S, Chen B, Chen J, Zhang L, Li Y, Kong Y. Cochlear implantation programming characteristics and outcomes of cochlear nerve deficiency. Eur Arch Otorhinolaryngol 2023; 280:4409-4418. [PMID: 37036510 DOI: 10.1007/s00405-023-07949-3] [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: 08/16/2022] [Accepted: 03/29/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE Due to the specificity of cochlear implantation (CI) programming parameters and outcomes in cochlear nerve deficiency (CND) patients, this study aimed to investigate the correlation between programming parameters and outcomes and further compare the difference between normal and CND groups. METHODS Ninety (95 ears) CND patients (normal cochlea, 39; malformed cochlea, 56) and seventy-nine (81 ears) normal cochlea patients who underwent CI surgery with either Med-El or Cochlear devices were included. The programming parameters and outcomes evaluated by the questionnaires were collected and compared among the normal CND, malformed CND, and normal groups in the two device groups, and their correlation was analyzed. RESULTS In the CND group, a reduced stimulation rate, higher pulse width, and triphasic pulse were needed in some cases. The stimulus levels of the CND group were significantly higher than that of the normal group (p < 0.05), but the outcomes of the CND group were significantly worse than that of the normal group (p < 0.05), and the stimulus level was significantly correlated with the outcomes (p < 0.05). However, there was no difference between normal and malformed CND groups. The non-auditory response was observed in the CND group, especially the ones with malformations. CONCLUSION The CI programming parameters of some CND patients need to be adjusted, and a slower stimulation rate and higher pulse width are required sometimes. CND patients need a higher stimulus level than normal patients but their outcomes are poorer. Non-auditory response should be noticed in CND patients during programming.
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Affiliation(s)
- Xingmei Wei
- Key Laboratory of Otolaryngology Head and Neck Surgery, Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Simeng Lu
- Key Laboratory of Otolaryngology Head and Neck Surgery, Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Biao Chen
- Key Laboratory of Otolaryngology Head and Neck Surgery, Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Jingyuan Chen
- Key Laboratory of Otolaryngology Head and Neck Surgery, Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Lifang Zhang
- Key Laboratory of Otolaryngology Head and Neck Surgery, Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, People's Republic of China
| | - Yongxin Li
- Key Laboratory of Otolaryngology Head and Neck Surgery, Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, People's Republic of China.
| | - Ying Kong
- Key Laboratory of Otolaryngology Head and Neck Surgery, Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, 1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, People's Republic of China.
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Wang X, Guo L, Tian R, Fei Y, Ji J, Diao C, Zuo L, Zeng Y, Guo Q, Chen K, Zheng Y. Hearing Aids Combined With Educational Counseling Versus Educational Counseling Alone for Tinnitus Treatment in Patients With Hearing Loss: A Longitudinal Follow-Up Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-13. [PMID: 37267442 DOI: 10.1044/2023_jslhr-22-00493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE The effect of hearing aids (HAs) and educational counseling (EC) or their combination on tinnitus is ambiguous. This study aimed to investigate whether the combined use of HAs and EC is more effective than EC alone on tinnitus relief. METHOD A total of 72 adults with chronic, bothersome tinnitus and coexisting sensorineural hearing loss completed at least 1-month and 3-month follow-up. After receiving EC and HA prescriptions, 21 participants selected to purchase HAs (i.e., the HA + EC group), whereas the remaining 51 refused to use HAs despite recommendations (i.e., the EC group). Tinnitus severity was measured by Tinnitus Handicap Inventory (THI), Tinnitus Evaluation Questionnaire (TEQ), and Visual Analog Scale (VAS) for loudness. The primary outcome measure was THI, and tinnitus relief was defined as a 20-point or more reduction in THI. A generalized linear mixed model was used to confirm that the heterogeneity in baseline characteristics between groups did not interfere with the results. RESULTS The THI, TEQ, and VAS scores decreased significantly after treatments, and both groups yielded a similar trend of reduction. There were no significant differences in the incidence of tinnitus relief and time-to-event curves between the two groups. In addition, the length of follow-up did not affect treatment effectiveness. CONCLUSION There was insufficient evidence to support the superiority of the combined use of HA and EC for tinnitus over EC with no device.
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Affiliation(s)
- Xunyi Wang
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Lanxin Guo
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Run Tian
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu
| | - Yingping Fei
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Jinfeng Ji
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Cong Diao
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Lin Zuo
- West China Medical School, Sichuan University, Chengdu
| | - Yuxiao Zeng
- West China Medical School, Sichuan University, Chengdu
| | - Qingxin Guo
- West China Medical School, Sichuan University, Chengdu
| | - Ke Chen
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Yun Zheng
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
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Relationship between electrically evoked compound action potential thresholds and behavioral T-levels in implanted children with cochlear nerve deficiency. Sci Rep 2023; 13:4309. [PMID: 36922582 PMCID: PMC10017809 DOI: 10.1038/s41598-023-31411-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 03/11/2023] [Indexed: 03/17/2023] Open
Abstract
It is challenging to program children with cochlear nerve deficiency (CND) due to limited auditory and speech abilities or concurrent neurological deficits. Electrically evoked compound action potential (ECAP) thresholds have been widely used by many audiologists to help cochlear implant programming for children who cannot cooperate with behavioral testing. However, the relationship between ECAP thresholds and behavioral levels of cochlear nerve in children with CND remains unclear. This study aimed to investigate how well ECAP thresholds are related to behavioral thresholds in the MAP for children with CND. This study included 29 children with CND who underwent cochlear implantation. For each participant, ECAP thresholds and behavioral T-levels were measured at three electrode locations across the electrode array post-activation. The relationship between ECAP thresholds and behavioral T-levels was analyzed using Pearson's correlation coefficient. The results showed that ECAP thresholds were significantly correlated with behavioral T-levels at the basal, middle, and apical electrodes. ECAP thresholds were equal to or higher than the behavioral T-levels for all tested electrodes, and fell within MAP's dynamic range for approximately 90% of the tested electrodes. Moreover, the contour of the ECAP thresholds was similar to the contour of T-levels across electrodes for most participants. ECAP thresholds can help audiologists select stimulation levels more efficiently for children with CND who cannot provide sufficient behavioral response.
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Comparison of response properties of the electrically stimulated auditory nerve reported in human listeners and in animal models. Hear Res 2022; 426:108643. [PMID: 36343534 PMCID: PMC9986845 DOI: 10.1016/j.heares.2022.108643] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/29/2022] [Accepted: 10/20/2022] [Indexed: 11/04/2022]
Abstract
Cochlear implants (CIs) provide acoustic information to implanted patients by electrically stimulating nearby auditory nerve fibers (ANFs) which then transmit the information to higher-level neural structures for further processing and interpretation. Computational models that simulate ANF responses to CI stimuli enable the exploration of the mechanisms underlying CI performance beyond the capacity of in vivo experimentation alone. However, all ANF models developed to date utilize to some extent anatomical/morphometric data, biophysical properties and/or physiological data measured in non-human animal models. This review compares response properties of the electrically stimulated auditory nerve (AN) in human listeners and different mammalian models. Properties of AN responses to single pulse stimulation, paired-pulse stimulation, and pulse-train stimulation are presented. While some AN response properties are similar between human listeners and animal models (e.g., increased AN sensitivity to single pulse stimuli with long interphase gaps), there are some significant differences. For example, the AN of most animal models is typically more sensitive to cathodic stimulation while the AN of human listeners is generally more sensitive to anodic stimulation. Additionally, there are substantial differences in the speed of recovery from neural adaptation between animal models and human listeners. Therefore, results from animal models cannot be simply translated to human listeners. Recognizing the differences in responses of the AN to electrical stimulation between humans and other mammals is an important step for creating ANF models that are more applicable to various human CI patient populations.
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Kim J, Hong SH, Moon IJ. Effect of inner ear malformations on intraoperative ECAP thresholds and postoperative auditory performance. Laryngoscope Investig Otolaryngol 2022; 7:1098-1106. [PMID: 36000038 PMCID: PMC9392413 DOI: 10.1002/lio2.836] [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: 05/04/2022] [Accepted: 05/30/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives This study sought to characterize the influence of inner ear malformations (IEMs) on intraoperative electrically evoked compound action potential (ECAP) and auditory performance to better understand the underlying pathophysiology related to variabilities in cochlear implant (CI) outcomes that individuals with malformed cochlea may present. Methods The medical records of 222 ears implanted with Cochlear Nucleus CI were reviewed. Of the total, 64 ears had radiologic evidence of IEMs, and 158 ears were normal. Individuals with IEMs were grouped based on the severity of anomalies; 38 had mild IEMs (e.g., enlarged vestibular aqueduct, incomplete partition type II, etc.) and 26 had severe IEMs (e.g., cochlear nerve hypoplasia, common cavity, etc.). Intraoperative ECAP thresholds obtained via neural response telemetry (NRT) and the categories of auditory performance (CAP) scores measured at 12 months postoperative were compared and correlated. Results Absent ECAP responses were more apparent in the IEM group. ECAP thresholds were significantly elevated in the severe IEM group, while the mild IEM group had ECAP thresholds comparable to the normal group. The mild IEM group achieved CAP scores similar to the normal control. Patients in the severe IEM group showed significantly lower CAP scores at 12 months postoperative. Significant negative relationships existed between ECAP thresholds and CAP scores obtained from all subjects. Conclusion Measurable ECAP responses and NRT thresholds varied across groups. The inverse relationship between NRT thresholds and CAP scores may suggest that electrophysiological responses measured during surgery may potentially be indicative of postoperative performance in our CI population. Level of Evidence 2b.
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Affiliation(s)
- Jeong‐Seo Kim
- Hearing Research LaboratorySamsung Medical CenterSeoulSouth Korea
| | - Sung Hwa Hong
- Hearing Research LaboratorySamsung Medical CenterSeoulSouth Korea
- Department of Otolaryngology – Head and Neck SurgerySamsung Changwon Hospital, Sungkyunkwan University School of MedicineChangwonSouth Korea
| | - Il Joon Moon
- Hearing Research LaboratorySamsung Medical CenterSeoulSouth Korea
- Department of Otolaryngology – Head and Neck SurgerySamsung Medical Center, Sungkyunkwan University School of MedicineSeoulSouth Korea
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Skidmore J, Ramekers D, Colesa DJ, Schvartz-Leyzac KC, Pfingst BE, He S. A Broadly Applicable Method for Characterizing the Slope of the Electrically Evoked Compound Action Potential Amplitude Growth Function. Ear Hear 2022; 43:150-164. [PMID: 34241983 PMCID: PMC8674380 DOI: 10.1097/aud.0000000000001084] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Amplitudes of electrically evoked compound action potentials (eCAPs) as a function of the stimulation level constitute the eCAP amplitude growth function (AGF). The slope of the eCAP AGF (i.e., rate of growth of eCAP amplitude as a function of stimulation level), recorded from subjects with cochlear implants (CIs), has been widely used as an indicator of survival of cochlear nerve fibers. However, substantial variation in the approach used to calculate the slope of the eCAP AGF makes it difficult to compare results across studies. In this study, we developed an improved slope-fitting method by addressing the limitations of previously used approaches and ensuring its application for the estimation of the maximum slopes of the eCAP AGFs recorded in both animal models and human listeners with various etiologies. DESIGN The new eCAP AGF fitting method was designed based on sliding window linear regression. Slopes of the eCAP AGF estimated using this new fitting method were calculated and compared with those estimated using four other fitting methods reported in the literature. These four methods were nonlinear regression with a sigmoid function, linear regression, gradient calculation, and boxcar smoothing. The comparison was based on the fitting results of 72 eCAP AGFs recorded from 18 acutely implanted guinea pigs, 46 eCAP AGFs recorded from 23 chronically implanted guinea pigs, and 2094 eCAP AGFs recorded from 200 human CI users from 4 patient populations. The effect of the choice of input units of the eCAP AGF (linear versus logarithmic) on fitting results was also evaluated. RESULTS The slope of the eCAP AGF was significantly influenced by the slope-fitting method and by the choice of input units. Overall, slopes estimated using all five fitting methods reflected known patterns of neural survival in human patient populations and were significantly correlated with speech perception scores. However, slopes estimated using the newly developed method showed the highest correlation with spiral ganglion neuron density among all five fitting methods for animal models. In addition, this new method could reliably and accurately estimate the slope for 4 human patient populations, while the performance of the other methods was highly influenced by the morphology of the eCAP AGF. CONCLUSIONS The novel slope-fitting method presented in this study addressed the limitations of the other methods reported in the literature and successfully characterized the slope of the eCAP AGF for various animal models and CI patient populations. This method may be useful for researchers in conducting scientific studies and for clinicians in providing clinical care for CI users.
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Affiliation(s)
- Jeffrey Skidmore
- Department of Otolaryngology – Head and Neck Surgery, The Ohio State University, 915 Olentangy River Road, Columbus, OH 43212, USA
| | - Dyan Ramekers
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht University, Room G.02.531, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
- UMC Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Deborah J. Colesa
- Kresge Hearing Research Institute, Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, 1150 West Medical Center Drive, Ann Arbor, MI 48109-5616, USA
| | - Kara C. Schvartz-Leyzac
- Department of Otolaryngology, Medical University of South Carolina, 135 Rutledge Ave, MSC 550, Charleston, SC 29425, USA
| | - Bryan E. Pfingst
- Kresge Hearing Research Institute, Department of Otolaryngology-Head and Neck Surgery, Michigan Medicine, 1150 West Medical Center Drive, Ann Arbor, MI 48109-5616, USA
| | - Shuman He
- Department of Otolaryngology – Head and Neck Surgery, The Ohio State University, 915 Olentangy River Road, Columbus, OH 43212, USA
- Department of Audiology, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA
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Yuan Y, Skidmore J, He S. Interpreting the interphase gap effect on the electrically evoked compound action potential. JASA EXPRESS LETTERS 2022; 2:027201. [PMID: 35156092 PMCID: PMC8820158 DOI: 10.1121/10.0009383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
This study demonstrated the effects of using different quantification methods and parameter scales on the sensitivity of the electrically evoked compound action potential (eCAP) to changes in the interphase gap (IPG). The IPG effect measured in two groups of cochlear implant (CI) users with different cochlear nerve (CN) health on seven eCAP measures was quantified using an absolute and a proportional difference method. The IPG effect provides an indicator for the functional status of the CN in human CI users. Specifying how the IPG effect is quantified is critical for accurate result interpretation.
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Affiliation(s)
- Yi Yuan
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio 43212, USA
| | - Jeffrey Skidmore
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio 43212, USA
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Estienne P, Scaglia A, Kontides A, Lauss K, Schwarz K, Arauz SL. Comparison of automated and traditional ECAP recording approaches in clinical practice. Int J Audiol 2021; 61:583-591. [PMID: 34187279 DOI: 10.1080/14992027.2021.1928302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The traditional method of recording electrically evoked compound action potentials (ECAPs), as implemented in the MAESTRO clinical software (standard ART), requires manual adjustments during threshold determination through a specialist. The "FineGrain" research tool (FineGrain RT) uses a continuous stimulation paradigm combined with automatic ECAP threshold determination. The aim of this study was to compare the FineGrain RT with standard ART. DESIGN ECAPs were recorded with standard ART and the FineGrain RT in paediatric cochlear implant recipients. Different stimulation rates were used for FineGrain ECAP recordings (40, 60, and 76 Hz). STUDY SAMPLE Thirteen children (6 - 19 years) participated in this study - nine were bilaterally and four unilaterally implanted, resulting in a total of twenty-two implanted ears. RESULTS ECAP threshold determination success rates were similar between the two approaches (92% and 89%) and ECAP thresholds correlated well (r: 0.94, p < 2.2e-16) with average ART thresholds being lower than FineGrain RT thresholds. FineGrain stimulation with different stimulation rates did not have a significant effect on ECAP thresholds but ECAP thresholds at medial and apical contacts were lower compared to basal contacts. CONCLUSIONS TheFineGrain research approach is a reliable replacement for standard ART in clinical practice.
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Affiliation(s)
- Patricia Estienne
- Fundación Arauz- Departamento de implante Coclear, Buenos Aires, Argentina
| | - Ana Scaglia
- Fundación Arauz- Departamento de implante Coclear, Buenos Aires, Argentina
| | | | | | | | - Santiago L Arauz
- Fundación Arauz- Departamento de implante Coclear, Buenos Aires, Argentina
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Moberly AC. A surgeon-scientist's perspective and review of cognitive-linguistic contributions to adult cochlear implant outcomes. Laryngoscope Investig Otolaryngol 2020; 5:1176-1183. [PMID: 33364410 PMCID: PMC7752064 DOI: 10.1002/lio2.494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/29/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Enormous variability in speech recognition outcomes persists in adults who receive cochlear implants (CIs), which leads to a barrier to progress in predicting outcomes before surgery, explaining "poor" outcomes, and determining how to provide tailored rehabilitation therapy for individual CI users. The primary goal of my research program over the past 9 years has been to extend our understanding of the contributions of "top-down" cognitive-linguistic skills to CI outcomes in adults, acknowledging that "bottom-up" sensory processes also contribute substantially. The main objective of this invited narrative review is to provide an overview of this work. A secondary objective is to provide career "guidance points" to budding surgeon-scientists in Otolaryngology. METHODS A narrative, chronological review covers work done by our group to explore top-down and bottom-up processing in adult CI outcomes. A set of ten guidance points is also provided to assist junior Otolaryngology surgeon-scientists. RESULTS Work in our lab has identified substantial contributions of cognitive skills (working memory, inhibition-concentration, speed of lexical access, nonverbal reasoning, verbal learning and memory) as well as linguistic abilities (acoustic cue-weighting, phonological sensitivity) to speech recognition outcomes in adults with CIs. These top-down skills interact with the quality of the bottom-up input. CONCLUSION Although progress has been made in understanding speech recognition variability in adult CI users, future work is needed to predict CI outcomes before surgery, to identify particular patients' strengths and weaknesses, and to tailor rehabilitation approaches for individual CI users. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Aaron C. Moberly
- Department of Otolaryngology Head and Neck SurgeryThe Ohio State University Wexner Medical CenterColumbusOhioUSA
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