Dataset Information

A Cochlear Implant Performance Prognostic Test Based on Electrical Field Interactions Evaluated by eABR (Electrical Auditory Brainstem Responses).

ABSTRACT: BACKGROUND:Cochlear implants (CIs) are neural prostheses that have been used routinely in the clinic over the past 25 years. They allow children who were born profoundly deaf, as well as adults affected by hearing loss for whom conventional hearing aids are insufficient, to attain a functional level of hearing. The "modern" CI (i.e., a multi-electrode implant using sequential coding strategies) has yielded good speech comprehension outcomes (recognition level for monosyllabic words about 50% to 60%, and sentence comprehension close to 90%). These good average results however hide a very important interindividual variability as scores in a given patients' population often vary from 5 to 95% in comparable testing conditions. Our aim was to develop a prognostic model for patients with unilateral CI. A novel method of objectively measuring electrical and neuronal interactions using electrical auditory brainstem responses (eABRs) is proposed. METHODS AND FINDINGS:The method consists of two measurements: 1) eABR measurements with stimulation by a single electrode at 70% of the dynamic range (four electrodes distributed within the cochlea were tested), followed by a summation of these four eABRs; 2) Measurement of a single eABR with stimulation from all four electrodes at 70% of the dynamic range. A comparison of the eABRs obtained by these two measurements, defined as the monaural interaction component (MIC), indicated electrical and neural interactions between the stimulation channels. Speech recognition performance without lip reading was measured for each patient using a logatome test (64 "vowel-consonant-vowel"; VCV; by forced choice of 1 out of 16). eABRs were measured in 16 CI patients (CIs with 20 electrodes, Digisonic SP; Oticon Medical ®, Vallauris, France). Significant correlations were found between speech recognition performance and the ratio of the amplitude of the V wave of the eABRs obtained with the two measurements (Pearson's linear regression model, parametric correlation: r2 = 0.26, p<0.05). CONCLUSIONS:This prognostic model allowed a substantial amount of the interindividual variance in speech recognition scores to be explained. The present study used measurements of electrical and neuronal interactions by eABR to assess patients' bio-electric capacity to use multiple information channels supplied by the implant. This type of prognostic information may be valuable in several ways. On the patient level, it allows customizing of individual treatments. ClinicalTrials.gov Identifier: NCT01805167.

SUBMITTER: Guevara N

PROVIDER: S-EPMC4858145 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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A Cochlear Implant Performance Prognostic Test Based on Electrical Field Interactions Evaluated by eABR (Electrical Auditory Brainstem Responses).

Guevara Nicolas N Hoen Michel M Truy Eric E Gallego Stéphane S

PloS one 20160505 5

<h4>Background</h4>Cochlear implants (CIs) are neural prostheses that have been used routinely in the clinic over the past 25 years. They allow children who were born profoundly deaf, as well as adults affected by hearing loss for whom conventional hearing aids are insufficient, to attain a functional level of hearing. The "modern" CI (i.e., a multi-electrode implant using sequential coding strategies) has yielded good speech comprehension outcomes (recognition level for monosyllabic words about ...[more]

PMID: 27149268

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Project description:We previously reported that auditory nerve projections from the cochlear spiral ganglion (SG) to the cochlear nucleus (CN) exhibit clear cochleotopic organization in adult cats deafened as neonates before hearing onset. However, the topographic specificity of these CN projections in deafened animals is proportionately broader than normal (less precise relative to the CN frequency gradient). This study examined SG-to-CN projections in adult cats that were deafened as neonates and received a unilateral cochlear implant at approximately 7 weeks of age. Following several months of electrical stimulation, SG projections from the stimulated cochleae were compared to projections from contralateral, non-implanted ears. The fundamental organization of SG projections into frequency band laminae was clearly evident, and discrete projections were always observed following double SG injections in deafened cochleae, despite severe auditory deprivation and/or broad electrical activation of the SG. However, when normalized for the smaller CN size after deafness, AVCN, PVCN, and DCN projections on the stimulated side were broader by 32%, 34%, and 53%, respectively, than projections in normal animals (although absolute projection widths were comparable to normal). Further, there was no significant difference between projections from stimulated and contralateral non-implanted cochleae. These findings suggest that early normal auditory experience may be essential for normal development and/or maintenance of the topographic precision of SG-to-CN projections. After early deafness, the CN is smaller than normal, the topographic distribution of these neural projections that underlie frequency resolution in the central auditory system is proportionately broader, and projections from adjacent SG sectors are more overlapping. Several months of stimulation by a cochlear implant (beginning at approximately 7 weeks of age) did not lessen or exacerbate these degenerative changes observed in adulthood. One clinical implication of these findings is that congenitally deaf cochlear implant recipients may have central auditory system alterations that limit their ability to achieve spectral selectivity equivalent to post-lingually deafened subjects.

Project description:: The purpose of this study was to investigate the relationship between electrophysiologic measures of the binaural interaction component (BIC) of the electrically evoked auditory brainstem response and psychophysical measures of interaural pitch comparisons in Nucleus bilateral cochlear implant users.: Data were collected for 10 postlingually deafened adult cochlear implant users. Each subject conducted an interaural pitch-comparison task using a biphasic pulse train with a pulse rate of 1000 pulses per second (pps) at high stimulation levels. Stimuli were presented in a two-interval, two-alternative forced-choice procedure with roving current variations. A subgroup of four subjects repeated the task at low stimulation levels. BICs were measured using loudness balanced, biphasic current pulses presented at a rate of 19.9 pps for each subject by pairing the electrode 12 (out of 22 intracochlear electrodes) in the right ear with each of 11 electrodes spaced across the electrode array in the left ear. The BIC was measured at high stimulation levels in 10 subjects and at low stimulation levels in 7 subjects. Because of differences in stimulation rate used in BIC measures and interaural pitch comparisons, the actual stimulation levels were different in these two measures. The relationship between BIC responses and results of interaural pitch comparisons was evaluated for each of the individual subjects and at the group level. Evaluation was carried out separately for results obtained at high and low stimulation levels.: There was no significant correlation between results of BIC measures and interaural pitch comparisons on either the individual or group levels. Lower stimulation level did not improve the relationship between these two measures.: No significant correlations between psychophysical measures of interaural pitch comparisons and electrophysiologic measures of the BIC of the electrically evoked auditory brainstem response were found. The lack of correlation may be attributed to methods used to quantify the data, small number of subjects retested at low stimulation levels, and central processing components involved in the interaural pitch-comparison task.

Dataset Information

A Cochlear Implant Performance Prognostic Test Based on Electrical Field Interactions Evaluated by eABR (Electrical Auditory Brainstem Responses).

Publications

A Cochlear Implant Performance Prognostic Test Based on Electrical Field Interactions Evaluated by eABR (Electrical Auditory Brainstem Responses).

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