Cortical Activation Patterns Correlate with Speech Understanding After Cochlear Implantation
EAR AND HEARING
2016; 37 (3): E160-E172
Cochlear implants are a standard therapy for deafness, yet the ability of implanted patients to understand speech varies widely. To better understand this variability in outcomes, the authors used functional near-infrared spectroscopy to image activity within regions of the auditory cortex and compare the results to behavioral measures of speech perception.The authors studied 32 deaf adults hearing through cochlear implants and 35 normal-hearing controls. The authors used functional near-infrared spectroscopy to measure responses within the lateral temporal lobe and the superior temporal gyrus to speech stimuli of varying intelligibility. The speech stimuli included normal speech, channelized speech (vocoded into 20 frequency bands), and scrambled speech (the 20 frequency bands were shuffled in random order). The authors also used environmental sounds as a control stimulus. Behavioral measures consisted of the speech reception threshold, consonant-nucleus-consonant words, and AzBio sentence tests measured in quiet.Both control and implanted participants with good speech perception exhibited greater cortical activations to natural speech than to unintelligible speech. In contrast, implanted participants with poor speech perception had large, indistinguishable cortical activations to all stimuli. The ratio of cortical activation to normal speech to that of scrambled speech directly correlated with the consonant-nucleus-consonant words and AzBio sentences scores. This pattern of cortical activation was not correlated with auditory threshold, age, side of implantation, or time after implantation. Turning off the implant reduced the cortical activations in all implanted participants.Together, these data indicate that the responses the authors measured within the lateral temporal lobe and the superior temporal gyrus correlate with behavioral measures of speech perception, demonstrating a neural basis for the variability in speech understanding outcomes after cochlear implantation.
View details for DOI 10.1097/AUD.0000000000000258
View details for PubMedID 26709749
Modality use in joint attention between hearing parents and deaf children
FRONTIERS IN PSYCHOLOGY
The present study examined differences in modality use during episodes of joint attention between hearing parent-hearing child dyads and hearing parent-deaf child dyads. Hearing children were age-matched to deaf children. Dyads were video recorded in a free play session with analyses focused on uni- and multimodality use during joint attention episodes. Results revealed that adults in hearing parent-deaf child dyads spent a significantly greater proportion of time interacting with their children using multiple communicative modalities than adults in hearing parent-hearing child dyads, who tended to use the auditory modality (e.g., oral language) most often. While these findings demonstrate that hearing parents accommodate their children's hearing status, we observed greater overall time spent in joint attention in hearing parent-hearing child dyads than hearing parent-deaf child dyads. Our results point to important avenues for future research on how parents can better accommodate their child's hearing status through the use of multimodal communication strategies.
View details for DOI 10.3389/fpsyg.2015.01556
View details for Web of Science ID 000363490600001
View details for PubMedID 26528214
View details for PubMedCentralID PMC4600903
Auditory cortex activation to natural speech and simulated cochlear implant speech measured with functional near-infrared spectroscopy.
2014; 309: 84-93
The primary goal of most cochlear implant procedures is to improve a patient's ability to discriminate speech. To accomplish this, cochlear implants are programmed so as to maximize speech understanding. However, programming a cochlear implant can be an iterative, labor-intensive process that takes place over months. In this study, we sought to determine whether functional near-infrared spectroscopy (fNIRS), a non-invasive neuroimaging method which is safe to use repeatedly and for extended periods of time, can provide an objective measure of whether a subject is hearing normal speech or distorted speech. We used a 140 channel fNIRS system to measure activation within the auditory cortex in 19 normal hearing subjects while they listed to speech with different levels of intelligibility. Custom software was developed to analyze the data and compute topographic maps from the measured changes in oxyhemoglobin and deoxyhemoglobin concentration. Normal speech reliably evoked the strongest responses within the auditory cortex. Distorted speech produced less region-specific cortical activation. Environmental sounds were used as a control, and they produced the least cortical activation. These data collected using fNIRS are consistent with the fMRI literature and thus demonstrate the feasibility of using this technique to objectively detect differences in cortical responses to speech of different intelligibility.
View details for DOI 10.1016/j.heares.2013.11.007
View details for PubMedID 24342740
View details for PubMedCentralID PMC3939048
Mechanisms of Hearing Loss after Blast Injury to the Ear
2013; 8 (7)
Given the frequent use of improvised explosive devices (IEDs) around the world, the study of traumatic blast injuries is of increasing interest. The ear is the most common organ affected by blast injury because it is the body's most sensitive pressure transducer. We fabricated a blast chamber to re-create blast profiles similar to that of IEDs and used it to develop a reproducible mouse model to study blast-induced hearing loss. The tympanic membrane was perforated in all mice after blast exposure and found to heal spontaneously. Micro-computed tomography demonstrated no evidence for middle ear or otic capsule injuries; however, the healed tympanic membrane was thickened. Auditory brainstem response and distortion product otoacoustic emission threshold shifts were found to be correlated with blast intensity. As well, these threshold shifts were larger than those found in control mice that underwent surgical perforation of their tympanic membranes, indicating cochlear trauma. Histological studies one week and three months after the blast demonstrated no disruption or damage to the intra-cochlear membranes. However, there was loss of outer hair cells (OHCs) within the basal turn of the cochlea and decreased spiral ganglion neurons (SGNs) and afferent nerve synapses. Using our mouse model that recapitulates human IED exposure, our results identify that the mechanisms underlying blast-induced hearing loss does not include gross membranous rupture as is commonly believed. Instead, there is both OHC and SGN loss that produce auditory dysfunction.
View details for DOI 10.1371/journal.pone.0067618
View details for Web of Science ID 000321271900013
View details for PubMedID 23840874
View details for PubMedCentralID PMC3698122
Cognitive Outcomes and Familial Stress After Cochlear Implantation in Deaf Children With and Without Developmental Delays
OTOLOGY & NEUROTOLOGY
2012; 33 (6): 947-956
The benefits of cochlear implantation for children with developmental delays (DD) often are unclear. We compared cognition, adaptive behavior, familial stress, and communication in children with and without DD.Retrospective review.Two tertiary care pediatric hospitals.Two hundred four children who underwent cochlear implantation assessed before and more than 1 year after implantation.The Mullen Scales of Early Learning (MSEL), vineland adaptive behavior scales (VABS), Parental Stress Index, and Preschool Language Scale.We developed a specific definition of DD for hearing-impaired children based upon diagnostic and statistical manual of mental disorders, fourth edition, criteria for mental retardation; 60 children met the criteria for DD, and 144 children did not. Before implantation, multiple linear regression demonstrated that children with DD had lower scores in every domain of the MSEL and VABS (p < 0.05), but no differences in any domains of the parental stress index and preschool language scale (p > 0.1) compared with children without DD. After implantation, children without DD demonstrated significant improvements in intelligence as measured by the MSEL and age-appropriate improvements in adaptive behavior as evaluated by the VABS, and their familial stress levels were not increased after cochlear implantation. In contrast, children with DD underwent implantation at a later age and demonstrated less comprehensive developmental improvements after cochlear implantation and higher stress levels. However, when the age differences were taken into account using multiple linear regression analyses, the differences between the 2 cohorts were reduced.These data indicate that our definition of DD is a reliable method of stratifying deaf children. Although children with DD have a normal developmental rate of adaptive behavior after cochlear implantation, their developmental rate of intelligence is lower, and they have higher stress levels than children without DD. However, our data suggest that if children with DD could be implanted as early as children without DD, their intelligence and stress outcomes would be improved.
View details for DOI 10.1097/MAO.0b013e318259b72b
View details for Web of Science ID 000306703900015
View details for PubMedID 22710555
View details for PubMedCentralID PMC3399955