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Kartheiser G, Cormier K, Bell-Souder D, Dye M, Sharma A. Neurocognitive outcomes in young adults with cochlear implants: The role of early language access and crossmodal plasticity. Hear Res 2024; 451:109074. [PMID: 39018768 DOI: 10.1016/j.heares.2024.109074] [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: 06/03/2024] [Accepted: 07/02/2024] [Indexed: 07/19/2024]
Abstract
Many children with profound hearing loss have received cochlear implants (CI) to help restore some sense of hearing. There is, however, limited research on long-term neurocognitive outcomes in young adults who have grown up hearing through a CI. This study compared the cognitive outcomes of early-implanted (n = 20) and late-implanted (n = 21) young adult CI users, and typically hearing (TH) controls (n=56), all of whom were enrolled in college. Cognitive fluidity, nonverbal intelligence, and American Sign Language (ASL) comprehension were assessed, revealing no significant differences in cognition and nonverbal intelligence between the early and late-implanted groups. However, there was a difference in ASL comprehension, with the late-implanted group having significantly higher ASL comprehension. Although young adult CI users showed significantly lower scores in a working memory and processing speed task than TH age-matched controls, there were no significant differences in tasks involving executive function shifting, inhibitory control, and episodic memory between young adult CI and young adult TH participants. In an exploratory analysis of a subset of CI participants (n = 17) in whom we were able to examine crossmodal plasticity, we saw greater evidence of crossmodal recruitment from the visual system in late-implanted compared with early-implanted CI young adults. However, cortical visual evoked potential latency biomarkers of crossmodal plasticity were not correlated with cognitive measures or ASL comprehension. The results suggest that in the late-implanted CI users, early access to sign language may have served as a scaffold for appropriate cognitive development, while in the early-implanted group early access to oral language benefited cognitive development. Furthermore, our results suggest that the persistence of crossmodal neuroplasticity into adulthood does not necessarily impact cognitive development. In conclusion, early access to language - spoken or signed - may be important for cognitive development, with no observable effect of crossmodal plasticity on cognitive outcomes.
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Affiliation(s)
- Geo Kartheiser
- Rochester Institute of Technology, Rochester, NY, United States of America
| | - Kayla Cormier
- Department of Speech Language and Hearing Sciences, University of Colorado Boulder, Boulder, CO, United States of America
| | - Don Bell-Souder
- Department of Speech Language and Hearing Sciences, University of Colorado Boulder, Boulder, CO, United States of America
| | - Matthew Dye
- Rochester Institute of Technology, Rochester, NY, United States of America
| | - Anu Sharma
- Department of Speech Language and Hearing Sciences, University of Colorado Boulder, Boulder, CO, United States of America.
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Heinrichs-Graham E, Walker EA, Lee WH, Benavente AA, McCreery RW. Somatosensory gating is related to behavioral and verbal outcomes in children with mild-to-severe hearing loss. Cereb Cortex 2023; 33:5228-5237. [PMID: 36310092 PMCID: PMC10151872 DOI: 10.1093/cercor/bhac412] [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: 06/10/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/12/2022] Open
Abstract
Sensory gating is a process by which the brain filters out redundant information to preserve neural resources for behaviorally relevant stimuli. Although studies have shown alterations in auditory and visual processing in children who are hard-of-hearing (CHH) relative to children with normal hearing (CNH), it is unclear whether these alterations extend to the somatosensory domain, and how aberrations in sensory processing affect sensory gating. In this study, CHH and CNH were presented with a paired-pulse median nerve stimulation during magnetoencephalography. Stimulus-related gamma neural activity was imaged and virtual time series from peak somatosensory responses were extracted. We found significant effects of both stimulus and group, as well as a significant group-by-stimulus interaction. CHH showed a larger response to stimulation overall, as well as greater differences in gamma power from the first to the second stimulus. However, when looking at the ratio rather than the absolute difference in power, CHH showed comparable gating to CNH. In addition, smaller gating ratios were correlated with better classroom behavior and verbal ability in CHH, but not CNH. Taken together, these data underscore the importance of considering how CHH experience their multisensory environment when interpreting outcomes and designing interventions.
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Affiliation(s)
- Elizabeth Heinrichs-Graham
- Cognitive and Sensory Imaging Laboratory, Institute for Human Neuroscience, Department of Research, Boys Town National Research Hospital (BTNRH), 14090 Mother Teresa Ln., Omaha, NE 68010, United States
- Department of Pharmacology and Neuroscience, College of Medicine, Creighton University, 2500 California Plaza, Omaha, NE 68178, United States
| | - Elizabeth A Walker
- Wendell Johnson Speech and Hearing Center, Department of Communication Sciences and Disorders, University of Iowa, 250 Hawkins Dr., Iowa City, IA 52242, United States
| | - Wai Hon Lee
- Cognitive and Sensory Imaging Laboratory, Institute for Human Neuroscience, Department of Research, Boys Town National Research Hospital (BTNRH), 14090 Mother Teresa Ln., Omaha, NE 68010, United States
| | - Amanda A Benavente
- Cognitive and Sensory Imaging Laboratory, Institute for Human Neuroscience, Department of Research, Boys Town National Research Hospital (BTNRH), 14090 Mother Teresa Ln., Omaha, NE 68010, United States
| | - Ryan W McCreery
- Audibility, Perception, and Cognition Laboratory, Department of Research, BTNRH, 555 N. 30th St., Omaha, NE 68131, United States
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Huber M. Cochlear implant-specific risks should be considered, when assessing the quality of life of children and adolescents with hearing loss and cochlear implants–not just cochlear implant-specific benefits–Perspective. Front Neurosci 2022; 16:985230. [DOI: 10.3389/fnins.2022.985230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
Cochlear implants (CIs) are electronic medical devices that enable hearing in cases where traditional hearing aids are of minimal or no use. Quality of life (QoL) studies of children and adolescents with a CI have so far focused on the CI-specific benefits. However, the CI-specific risks listed by the U.S. Food and Drug Administration have not yet been considered. From this list, medical and device-related complications, lifelong dependency on the implanted device, and neurosecurity risks (CI technology is an interface technology) may be particularly relevant for young CI users. Medical and device-related complications can cause physical discomfort (e.g., fever, pain), as well as functioning problems (e.g., in speech discrimination, social behavior, and mood). In the worst case, reimplantation is required. Clinical experience shows that these complications are perceived as a burden for young CI users. Furthermore, many young patients are worried about possible complications. Additionally, CIs can be at least a temporary burden when children, typically at the age of 8–9 years, realize that they need the CI for life, or when they become peer victims because of their CI. Concerning neurosecurity risks, it is still unknown how young CI recipients perceive them. In summary, CI-specific risks can be perceived as a burden by young CI users that impairs their QoL. Therefore, they should not be ignored. There is an urgent need for studies on this topic, which would not only be important for professionals and parents, but also for the design of CI-specific QoL instruments.
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Lee SY, Han JH, Song HK, Kim NJ, Yi N, Kyong JS, Choi BY. Central auditory maturation and behavioral outcomes after cochlear implantation in prelingual auditory neuropathy spectrum disorder related to OTOF variants (DFNB9): Lessons from pilot study. PLoS One 2021; 16:e0252717. [PMID: 34097718 PMCID: PMC8183996 DOI: 10.1371/journal.pone.0252717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 05/20/2021] [Indexed: 11/26/2022] Open
Abstract
The cortical auditory evoked potential (CAEP)-based P1 component acts as a biomarker for cochlear implantation (CI) outcomes in children with auditory neuropathy spectrum disorder (ANSD). To date, early intervention primarily before the age of two years and six months of CI usage is necessary and sufficient to achieve age-appropriate cortical maturation and good prognosis. However, varying degrees of neural dyssynchrony, resulting from the etiological heterogeneity of ANSD, may preclude uniform application of this hypothesis to ensure auditory cortical maturation. Thus, a focused evaluation of those carrying OTOF variants, which may be the salient molecular etiology of prelingual ANSD, would circumvent the issue of heterogeneity. Here, we sought to provide a much better understanding of the brain perspectives (i.e., P1 maturation) in OTOF-associated ANSD subjects and set the stage for an optimal strategy to enhance language development. We conducted a preliminary study comprising 10 subjects diagnosed with OTOF-related ANSD who underwent CI by a single surgeon and subsequently underwent measurements of the P1 component. We observed that DFNB9 subjects who received CI after 2 years of age exhibited “absent” or “anomalous” P1 components that correspond to delayed language development. However, timely implantation, as early as 12 months of age per se, might be insufficient to achieve age-appropriate cortical maturation of DFNB9 in cases with six to seven months of device use. This suggests the importance of sustained rehabilitation in DFNB9 than in other etiologies. Indeed, an additional follow-up study showed that a reduction in P1 latency was linked to an improvement in auditory performance. Collectively, our results suggest that central auditory maturation and successful outcome of CI in DFNB9 may have more demanding requirements, that is, earlier implantation and more sustained rehabilitation. We believe that the current study opens a new path toward genome-based neuroimaging in the field of hearing research.
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Affiliation(s)
- Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Jin Hee Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hoo-Kang Song
- Department of Audiology and Speech Language Pathology, HUGS Center for Hearing and Speech Research, Hallym University of Graduate Studies, Seoul, South Korea
| | - Namju Justin Kim
- Department of Biological Sciences, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Nayoung Yi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jeong-Sug Kyong
- Department of Audiology and Speech Language Pathology, HUGS Center for Hearing and Speech Research, Hallym University of Graduate Studies, Seoul, South Korea
- * E-mail: (JSK); (BYC)
| | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
- * E-mail: (JSK); (BYC)
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Coez A, Fillon L, Saitovitch A, Rutten C, Marlin S, Boisgontier J, Vinçon-Leite A, Lemaitre H, Grévent D, Roux CJ, Dangouloff-Ros V, Levy R, Bizaguet E, Rouillon I, Garabédian EN, Denoyelle F, Zilbovicius M, Loundon N, Boddaert N. Arterial spin labeling brain MRI study to evaluate the impact of deafness on cerebral perfusion in 79 children before cochlear implantation. Neuroimage Clin 2020; 29:102510. [PMID: 33369563 PMCID: PMC7777537 DOI: 10.1016/j.nicl.2020.102510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 11/06/2020] [Accepted: 11/16/2020] [Indexed: 01/06/2023]
Abstract
Age at implantation is considered to be a major factor, influencing outcomes after pediatric cochlear implantation. In the absence of acoustic input, it has been proposed that cross-modal reorganization can be detrimental for adaptation to the new electrical input provided by a cochlear implant. Here, through a retrospective study, we aimed to investigate differences in cerebral blood flow (CBF) at rest prior to implantation in children with congenital deafness compared to normally hearing children. In addition, we looked at the putative link between pre-operative rest-CBF and the oral intelligibility scores at 12 months post-implantation. Finally, we observed the evolution of perfusion with age, within brain areas showing abnormal rest-CBF associated to deafness, in deaf children and in normally hearing children. In children older than 5 years old, results showed a significant bilateral hypoperfusion in temporal regions in deaf children, particularly in Heschl's gyrus, and a significant hyperperfusion of occipital regions. Furthermore, in children older than 5 years old, whole brain voxel-by-voxel correlation analysis between pre-operative rest-CBF and oral intelligibility scores at 12 months post-implantation, showed significant negative correlation localized in the occipital regions: children who performed worse in the speech perception test one year after implantation were those presenting higher preoperative CBF values in these occipital regions. Finally, when comparing mean relative perfusion (extracted from the temporal regions found abnormal on whole-brain voxel-based analysis) across ages in patients and controls, we observed that the temporal perfusion evolution was significantly different in deaf children than in normally hearing children. Indeed, while temporal perfusion increased with age in normally hearing children, it remained stable in deaf children. We showed a critical period around 4 years old, where in the context of auditory deprivation, there is a lack of synaptic activity in auditory regions. These results support the benefits of early cochlear implantation to maximize the effectiveness of auditory rehabilitation and to avoid cross-modal reorganization.
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Affiliation(s)
- Arnaud Coez
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France; Service d'oto-rhino-laryngologie pédiatrique, Centre de Réference des Surdités Génétiques, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France; Laboratoire de correction auditive, Bizaguet, Paris, France; Institut de l'Audition, Paris, France.
| | - Ludovic Fillon
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France
| | - Ana Saitovitch
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France
| | - Caroline Rutten
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France
| | - Sandrine Marlin
- Service de Génétique Médicale, Centre de Référence des Surdités Génétiques, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France
| | - Jennifer Boisgontier
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France
| | - Alice Vinçon-Leite
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France
| | - Hervé Lemaitre
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France
| | - David Grévent
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France
| | - Charles-Joris Roux
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France
| | - Volodia Dangouloff-Ros
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France
| | - Raphaël Levy
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France
| | - Eric Bizaguet
- Service d'oto-rhino-laryngologie pédiatrique, Centre de Réference des Surdités Génétiques, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France; Laboratoire de correction auditive, Bizaguet, Paris, France
| | - Isabelle Rouillon
- Service d'oto-rhino-laryngologie pédiatrique, Centre de Réference des Surdités Génétiques, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France
| | - Eréa Noël Garabédian
- Service d'oto-rhino-laryngologie pédiatrique, Centre de Réference des Surdités Génétiques, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France
| | - Françoise Denoyelle
- Service d'oto-rhino-laryngologie pédiatrique, Centre de Réference des Surdités Génétiques, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France; Institut de l'Audition, Paris, France
| | - Monica Zilbovicius
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France; INSERM ERL "Developmental Trajectories & Psychiatry", Université Paris Saclay, Ecole Normale Supérieure Paris-Saclay, Université de Paris, CNRS, Centre Borelli, France
| | - Natalie Loundon
- Service d'oto-rhino-laryngologie pédiatrique, Centre de Réference des Surdités Génétiques, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France; Institut de l'Audition, Paris, France
| | - Nathalie Boddaert
- Service de radiologie pédiatrique, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, APHP, Université de Paris, INSERM U1163, Institut Imagine, Paris, France; INSERM ERL "Developmental Trajectories & Psychiatry", Université Paris Saclay, Ecole Normale Supérieure Paris-Saclay, Université de Paris, CNRS, Centre Borelli, France
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