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

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...

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Bibliographic Details
Published in:PloS one 2016-05, Vol.11 (5), p.e0155008-e0155008
Main Authors: Guevara, Nicolas, Hoen, Michel, Truy, Eric, Gallego, Stéphane
Format: Article
Language:English
Subjects:
Adult
Adults
Aged
Aged, 80 and over
Auditory Threshold - physiology
Bioelectricity
Biology and Life Sciences
Brain stem
Channels
Children
Cochlea
Cochlea - physiopathology
Cochlear Implantation
Cochlear Implants
Coding
Consonants (speech)
Correlation
Deafness
Deafness - therapy
Dynamic range
Electric Stimulation - methods
Electrodes
Electrodes, Implanted
Evoked Potentials, Auditory, Brain Stem - physiology
Female
France
Hearing aids
Hearing loss
Hearing Loss - physiopathology
Hearing Loss - therapy
Hearing Tests - methods
Humans
Lip reading
Male
Medicine and Health Sciences
Middle Aged
Neural coding
Neural prostheses
Otolaryngology
Patients
Physiological aspects
Prognosis
Prosthetics
Regression models
Research and Analysis Methods
Sensory stimulation
Social Sciences
Speech
Speech recognition
Studies
Surgical implants
Transplants & implants
Young Adult
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Summary: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. 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
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0155008