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Kaplan-Neeman R, Greenbom T, Habiballah S, Henkin Y. Biomarkers of auditory cortical plasticity and development of binaural pathways in children with unilateral hearing loss using a hearing aid. Hear Res 2024; 451:109096. [PMID: 39116708 DOI: 10.1016/j.heares.2024.109096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 07/13/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024]
Abstract
Congenital or early-onset unilateral hearing loss (UHL) can disrupt the normal development of the auditory system. In extreme cases of UHL (i.e., single sided deafness), consistent cochlear implant use during sensitive periods resulted in cortical reorganization that partially reversed the detrimental effects of unilateral sensory deprivation. There is a gap in knowledge, however, regarding cortical plasticity i.e. the brain's capacity to adapt, reorganize, and develop binaural pathways in milder degrees of UHL rehabilitated by a hearing aid (HA). The current study was set to investigate early-stage cortical processing and electrophysiological manifestations of binaural processing by means of cortical auditory evoked potentials (CAEPs) to speech sounds, in children with moderate to severe-to-profound UHL using a HA. Fourteen children with UHL (CHwUHL), 6-14 years old consistently using a HA for 3.5 (±2.3) years participated in the study. CAEPs were elicited to the speech sounds /m/, /g/, and /t/ in three listening conditions: monaural [Normal hearing (NH), HA], and bilateral [BI (NH + HA)]. Results indicated age-appropriate CAEP morphology in the NH and BI listening conditions in all children. In the HA listening condition: (1) CAEPs showed similar morphology to that found in the NH listening condition, however, the mature morphology observed in older children in the NH listening condition was not evident; (2) P1 was elicited in all but two children with severe-to-profound hearing loss, to at least one speech stimuli, indicating effective audibility; (3) A significant mismatch in timing and synchrony between the NH and HA ear was found; (4) P1 was sensitive to the acoustic features of the eliciting stimulus and to the amplification characteristics of the HA. Finally, a cortical binaural interaction component (BIC) was derived in most children. In conclusion, the current study provides first-time evidence for cortical plasticity and partial reversal of the detrimental effects of moderate to severe-to-profound UHL rehabilitated by a HA. The derivation of a cortical biomarker of binaural processing implies that functional binaural pathways can develop when sufficient auditory input is provided to the affected ear. CAEPs may thus serve as a clinical tool for assessing, monitoring, and managing CHwUHL using a HA.
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Affiliation(s)
- Ricky Kaplan-Neeman
- Department of Communication Disorders, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Tzvia Greenbom
- Department of Communication Disorders, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Suhaill Habiballah
- Department of Communication Disorders, Haifa University, Haifa, Israel; Alango Technologies LTD, Tirat Carmel, Israel
| | - Yael Henkin
- Department of Communication Disorders, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel; Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
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Ge X, Xu C, Dai J, Zhou M, Liu J, Wang N. Bidirectional remodeling of the central auditory system caused by unilateral auditory deprivation. Front Neurol 2024; 15:1414738. [PMID: 39081341 PMCID: PMC11286559 DOI: 10.3389/fneur.2024.1414738] [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: 04/09/2024] [Accepted: 06/19/2024] [Indexed: 08/02/2024] Open
Abstract
Unilateral auditory deprivation (UAD) results in cross-modal reorganization of the auditory cortex (AC), which can impair auditory and cognitive functions and diminish the recovery effect of cochlear implantation. Moreover, the subcortical areas provide extensive ascending projections to the AC. To date, a thorough systematic study of subcortical auditory neural plasticity has not been undertaken. Therefore, this review aims to summarize the current evidence on the bidirectional remodeling of the central auditory system caused by UAD, particularly the changes in subcortical neural plasticity. Lateral changes occur in the cochlear nucleus, lateral superior olive, medial nucleus of the trapezoid body, inferior colliculus, and AC of individuals with UAD. Moreover, asymmetric neural activity becomes less prominent in the higher auditory nuclei, which may be due to cross-projection regulation of the bilateral pathway. As a result, subcortical auditory neural plasticity caused by UAD may contribute to the outcomes of cochlear implantation in patients with single-sided deafness (SSD), and the development of intervention strategies for patients with SSD is crucial. Considering that previous studies have focused predominantly on the neural plasticity of the AC, we believe that bidirectional remodeling of subcortical areas after UAD is also crucial for investigating the mechanisms of interventions.
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Affiliation(s)
| | | | | | | | - Jinfeng Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Ningyu Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Garcia A, Haleem A, Chari DA, Morse-Fortier C, Arenberg JG, Lee DJ. Influence of listening environment on usage patterns in cochlear implant patients with single-sided deafness. Cochlear Implants Int 2023; 24:335-341. [PMID: 36846887 DOI: 10.1080/14670100.2023.2176990] [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] [Indexed: 03/01/2023]
Abstract
OBJECTIVE To compare cochlear implant (CI) data logging of patients with single-sided deafness (SSD) and bilateral sensorineural hearing loss (biSNHL) in various acoustic environments and study the implications of data logging on auditory performance. STUDY DESIGN Retrospective case control study. METHODS Adult CI patients with SSD or biSNHL from 2010 to 2021 with usage data collected at 3-, 6-, and 12-months following device activation were identified. The CI listening environment was defined as speech in noise, speech in quiet, quiet, music or noise. Auditory performance was measured using the CNC word, AzBio sentence tests and the Tinnitus Handicap Index (THI). RESULTS 60 adults with SSD or biSNHL were included. CI patients with biSNHL wore their devices more than those with SSD at 3-months post-activation (11.18 versus 8.97 hours/day, p = 0.04), though there were no significant differences at 6-12 months. Device usage was highest in the speech in quiet environment. In SSD CI users, there was a positive correlation (p = 0.03) between device use and CNC scores at 12-months and an improvement in THI scores at 12-months (p = 0.0004). CONCLUSIONS CI users with SSD and biSNHL have comparable duration of device usage at longer follow-up periods with greatest device usage recorded in speech in quiet environments.
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Affiliation(s)
- Alejandro Garcia
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Afash Haleem
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Divya A Chari
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Charlotte Morse-Fortier
- Department of Audiology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Julie G Arenberg
- Department of Audiology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Daniel J Lee
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
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Ward KM, Coughran AJ, Lee M, Fitzgerald MB, Cheng AG, Chang KW, Ahmad IN. Prevalence of Cochlear Nerve Deficiency and Hearing Device Use in Children With Single-Sided Deafness. Otolaryngol Head Neck Surg 2023. [PMID: 36939463 DOI: 10.1002/ohn.255] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/13/2022] [Accepted: 12/17/2022] [Indexed: 02/10/2023]
Abstract
OBJECTIVE This study aimed to assess the prevalence of cochlear nerve deficiency (CND) in a cohort of pediatric patients with single-sided deafness (SSD). A secondary objective was to investigate trends in intervention and hearing device use in these children. STUDY DESIGN Case series with chart review. SETTING Pediatric tertiary care center. METHODS Children ages 0 to 21 years with SSD (N = 190) who underwent computerized tomography (CT) and/or magnetic resonance imaging (MRI) were included. Diagnostic criteria for SSD included unilateral severe-to-profound sensorineural hearing loss with normal hearing sensitivity in the contralateral ear. Diagnostic criteria for CND included neuroradiologist report of an "aplastic or hypoplastic nerve" on MRI or a "stenotic cochlear aperture" on CT. RESULTS The prevalence of CND was 42% for children with CT only, 76% for children with MRI only, and 63% for children with both MRI and CT. Of the children with MRI and CT, there was a 90% concordance across imaging modalities. About 36% of children with SSD had hearing devices that routed sound to the normal hearing ear (ie, bone conduction hearing device/contralateral routing of signal), while only 3% received a cochlear implant. Approximately 40% did not have a hearing device. Hearing device wear time averaged 2.9 hours per day and did not differ based on cochlear nerve status. CONCLUSION There is a high prevalence of CND in children with SSD. Cochlear nerve status should be confirmed via MRI in children with SSD. The limited implementation and use of hearing devices observed for children with SSD reinforce the need for increased support for early and continuous intervention.
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Affiliation(s)
- Kristina M Ward
- Department of Pediatric Audiology, Stanford Medicine Children's Health, Palo Alto, California, USA.,Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Alanna J Coughran
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Monterosa Lee
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Matthew B Fitzgerald
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Alan G Cheng
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Kay W Chang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Iram N Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
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Bassiouni M, Häußler SM, Gräbel S, Szczepek AJ, Olze H. Lateralization Pattern of the Weber Tuning Fork Test in Longstanding Unilateral Profound Hearing Loss: Implications for Cochlear Implantation. Audiol Res 2022; 12:347-356. [PMID: 35892662 PMCID: PMC9326649 DOI: 10.3390/audiolres12040036] [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: 05/22/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/10/2022] Open
Abstract
The Weber tuning fork test is a standard otologic examination tool in patients with unilateral hearing loss. Sound should typically lateralize to the contralateral side in unilateral sensorineural hearing loss. The observation that the Weber test does not lateralize in some patients with longstanding unilateral deafness has been previously described but remains poorly understood. In the present study, we conducted a retrospective analysis of the medical records of patients with unilateral profound hearing loss (single-sided deafness or asymmetric hearing loss) for at least ten years. In this patient cohort, childhood-onset unilateral profound hearing loss was significantly associated with the lack of lateralization of the Weber tuning fork test (Fisher’s exact test, p < 0.05) and the absence of tinnitus in the affected ear (Fisher’s exact test, p < 0.001). The findings may imply a central adaptation process due to chronic unilateral auditory deprivation starting before the critical period of auditory maturation. This notion may partially explain the poor outcome of adult cochlear implantation in longstanding single-sided deafness. The findings may suggest a role for the Weber test as a simple, quick, and economical tool for screening poor cochlear implant candidates, thus potentially supporting the decision-making and counseling of patients with longstanding single-sided deafness.
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Affiliation(s)
- Mohamed Bassiouni
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
- Correspondence: ; Tel.: +49-30-450-555-072
| | - Sophia Marie Häußler
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany;
| | - Stefan Gräbel
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
| | - Agnieszka J. Szczepek
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
| | - Heidi Olze
- Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charitéplatz 1, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (S.G.); (A.J.S.); (H.O.)
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McSweeny C, Cushing SL, Campos JL, Papsin BC, Gordon KA. Functional Consequences of Poor Binaural Hearing in Development: Evidence From Children With Unilateral Hearing Loss and Children Receiving Bilateral Cochlear Implants. Trends Hear 2021; 25:23312165211051215. [PMID: 34661482 PMCID: PMC8527588 DOI: 10.1177/23312165211051215] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Poor binaural hearing in children was hypothesized to contribute to related cognitive and
academic deficits. Children with unilateral hearing have normal hearing in one ear but no
access to binaural cues. Their cognitive and academic deficits could be unique from
children receiving bilateral cochlear implants (CIs) at young ages who have poor access to
spectral cues and impaired binaural sensitivity. Both groups are at risk for
vestibular/balance deficits which could further contribute to memory and learning
challenges. Eighty-eight children (43 male:45 female, aged 9.89 ± 3.40 years), grouped
by unilateral hearing loss (n = 20), bilateral CI
(n = 32), and typically developing (n = 36), completed a
battery of sensory, cognitive, and academic tests. Analyses revealed that children in both
hearing loss groups had significantly poorer skills (accounting for age) on most tests
than their normal hearing peers. Children with unilateral hearing loss had more asymmetric
speech perception than children with bilateral CIs (p < .0001) but
balance and language deficits (p = .0004, p < .0001,
respectively) were similar in the two hearing loss groups (p > .05).
Visuospatial memory deficits occurred in both hearing loss groups
(p = .02) but more consistently across tests in children with unilateral
hearing loss. Verbal memory was not significantly different than normal
(p > .05). Principal component analyses revealed deficits in a main
cluster of visuospatial memory, oral language, mathematics, and reading measures
(explaining 46.8% data variability). The remaining components revealed clusters of
self-reported hearing, balance and vestibular function, and speech perception deficits.
The findings indicate significant developmental impacts of poor binaural hearing in
children.
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Affiliation(s)
- Claire McSweeny
- Archie's Cochlear Implant Lab, 7979Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon L Cushing
- Archie's Cochlear Implant Lab, 7979Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Otolaryngology, Head & Neck Surgery, Faculty of Medicine, University of Toronto, Ontario, Canada.,Department of Otolaryngology, Head & Neck Surgery, 7979Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer L Campos
- KITE-Toronto Rehabilitation Institute, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Blake C Papsin
- Archie's Cochlear Implant Lab, 7979Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Otolaryngology, Head & Neck Surgery, Faculty of Medicine, University of Toronto, Ontario, Canada.,Department of Otolaryngology, Head & Neck Surgery, 7979Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen A Gordon
- Archie's Cochlear Implant Lab, 7979Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Otolaryngology, Head & Neck Surgery, Faculty of Medicine, University of Toronto, Ontario, Canada
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刘 锦, 原 晶, 周 沫, 闫 占, 王 宁. [Rehabilitation of sound localization ability in patients with unilateral hearing loss or single-sided deafness]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2021; 35:472-476;480. [PMID: 34304479 PMCID: PMC10128470 DOI: 10.13201/j.issn.2096-7993.2021.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/01/2021] [Indexed: 11/12/2022]
Abstract
The prevalence of unilateral hearing loss(UHL) is higher, and the clinical attention to the hearing rehabilitation of UHL is not enough, resulting in many UHL patients cannot get rehabilitation timely and effectively. Severe to profound UHL(also known as single-sided deafness) patients lack binaural hearing superiority, especially the inadequate ability of sound localization, which will seriously affect their daily life and academic performance. At present, the main rehabilitation methods of UHL include various kinds of bone conduction hearing aids, vibrant soundbridge and cochlear implantation, etc. However, the rehabilitation effect of UHL patients' ability to locate the sound source is affected by the occurrence age, the type, the degree and the duration of the hearing loss. The results of rehabilitation in different literature vary greatly. This paper reviews the effects of different rehabilitation strategies on the ability of sound location and analyzes its possible causes and mechanisms.
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Affiliation(s)
- 锦峰 刘
- 首都医科大学附属北京朝阳医院耳鼻咽喉头颈外科(北京,100020)
| | | | - 沫 周
- 首都医科大学附属北京朝阳医院耳鼻咽喉头颈外科(北京,100020)
| | | | - 宁宇 王
- 首都医科大学附属北京朝阳医院耳鼻咽喉头颈外科(北京,100020)
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Wasmann J, Janssen A, Agterberg M. A mobile sound localization setup. MethodsX 2020; 7:101131. [PMID: 33251123 PMCID: PMC7677125 DOI: 10.1016/j.mex.2020.101131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/02/2020] [Indexed: 02/01/2023] Open
Abstract
In this paper, a mobile sound localization setup is described that can be used to measure a persons' localization performance in a sophisticated way. With this mobile setup, researchers can travel to subjects, and studies are not limited by the willingness of participants to visit the clinic. In the setup, sounds are presented within a partial sphere in both the horizontal (-70° to 70° azimuth) and vertical (-35° to 40° elevation) plane. Participants are asked to indicate the perceived sound origin by pointing with a head-mounted LED. Head movements are recorded and instantly visualized (i.e. online target response plots). Depending on the research question, the setup can be adjusted for more advanced or simplified measurements, making the setup suitable for a wide range of research questions. The rationale for building this mobile setup was to test horizontal sound localization abilities (binaural hearing) and vertical sound localization abilities (monaural hearing) of children and patients who were otherwise not accessible for testing. In this setup loudspeakers are not visible and subjects are asked to indicate the perceived sound direction by a natural head-pointing response towards the perceived location. An advantage of the implemented pointing-method is the playful manner in which children are tested. They are 'shooting' at the perceived sound target location with a head-mounted LED and have fun while performing the test. •We present a mobile sound localization setup suitable for measuring horizontal and vertical sound localization in children and adult patients in the convenience of their own environment.
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Affiliation(s)
- J.A. Wasmann
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - A.M. Janssen
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - M.J.H. Agterberg
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
- Department of Biophysics, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, the Netherlands
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