Delayed Auditory Brainstem Responses in Prelingually Deaf and Late-Implanted Cochlear Implant Users

Lammers, Marc J. W.; Eijl, Ruben H. M. van; Zanten, G. A. Van; Versnel, Huib; Grolman, Wilko

doi:10.1007/s10162-015-0532-x

Cited by 15 publications

(7 citation statements)

References 35 publications

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“…Median PTA of the six NH ears was 14 dB HL (range 5 to 21 dB HL). Full insertion was achieved in all subjects with various implant types from Cochlear Ltd. Four BD subjects were prelingually deaf, defined as severe to profound binaural hearing loss with its onset before the age of 2 years (based on medical charts including diagnostic audiometry and self-reported patient information) and insufficient residual hearing during childhood for normal speech and language development ( Lammers et al 2015a , 2015 b). Duration of deafness ranged from 0.7 to 44.2 years, with a median of 7.2 years in the BD group and 1.8 years in the SSD group, which was not significantly different (Mann-Whitney U = 19, p = 0.08).…”

Section: Methodsmentioning

confidence: 99%

“…It can be recorded in an awake and passive listening situation and it has the same typical waveform as the cortical P1-N1-P2 complex observed in response to a stimulus onset ( Kim 2015 ; Martin & Boothroyd 2000 ; Vonck et al 2019 ). The ACC mirrors auditory discrimination ( Martin et al 2008 ) and might better relate to perceptual measures ( He et al 2012 , 2014 ; Kim 2015 ; Liang et al 2018 ; Mathew et al 2017 ) than other objective measures such as electrocochleography ( Kim et al 2017 ), electrically evoked compound action potentials ( Smoorenburg et al 2002 ; van Eijl et al 2017 ), electrically evoked auditory brainstem responses ( Lammers et al 2015a ), or CAEPs in response to onset stimuli ( Barlow et al 2016 ; Brown et al 2015 ; Lammers et al 2015 b).…”

Section: Introductionmentioning

confidence: 99%

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The Acoustic Change Complex Compared to Hearing Performance in Unilaterally and Bilaterally Deaf Cochlear Implant Users

et al. 2022

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Objectives: Clinical measures evaluating hearing performance in cochlear implant (CI) users depend on attention and linguistic skills, which limits the evaluation of auditory perception in some patients. The acoustic change complex (ACC), a cortical auditory evoked potential to a sound change, might yield useful objective measures to assess hearing performance and could provide insight in cortical auditory processing. The aim of this study is to examine the ACC in response to frequency changes as an objective measure for hearing performance in CI users.Design: Thirteen bilaterally deaf and six single-sided deaf subjects were included, all having used a unilateral CI for at least 1 year. Speech perception was tested with a consonant-vowel-consonant test (+10 dB signal-to-noise ratio) and a digits-in-noise test. Frequency discrimination thresholds were measured at two reference frequencies, using a 3-interval, 2-alternative forced-choice, adaptive staircase procedure. The two reference frequencies were selected using each participant's frequency allocation table and were centered in the frequency band of an electrode that included 500 or 2000 Hz, corresponding to the apical electrode or the middle electrode, respectively. The ACC was evoked with pure tones of the same two reference frequencies with varying frequency increases: within the frequency band of the middle or the apical electrode (+0.25 electrode step), and steps to the center frequency of the first (+1), second (+2), and third (+3) adjacent electrodes.Results: Reproducible ACCs were recorded in 17 out of 19 subjects. Most successful recordings were obtained with the largest frequency change (+3 electrode step). Larger frequency changes resulted in shorter N1 latencies and larger N1-P2 amplitudes. In both unilaterally and bilaterally deaf subjects, the N1 latency and N1-P2 amplitude of the CI ears correlated to speech perception as well as frequency discrimination, that is, short latencies and large amplitudes were indicative of better speech perception and better frequency discrimination. No significant differences in ACC latencies or amplitudes were found between the CI ears of the unilaterally and bilaterally deaf subjects, but the CI ears of the unilaterally deaf subjects showed substantially longer latencies and smaller amplitudes than their contralateral normal-hearing ears. Conclusions:The ACC latency and amplitude evoked by tone frequency changes correlate well to frequency discrimination and speech perception capabilities of CI users. For patients unable to reliably perform behavioral tasks, the ACC could be of added value in assessing hearing performance.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Acoustic Change Complex Compared to Hearing Performance in Unilaterally and Bilaterally Deaf Cochlear Implant Users

et al. 2022

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“…So far, attempts have been made to find a good model to predict speech in noise with different brainstem and cortical response paradigms, like the cortical auditory evoked potential (CAEP) and P300. However, due to a lack of clinically useful and consistent correlations, none of these objective measures have made it beyond research applications [ 23 – 27 ]. The prognostic ACC model is the first objective measure to predict speech in noise perception with high accuracy [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Validation of the acoustic change complex (ACC) prediction model to predict speech perception in noise in adult patients with hearing loss: a study protocol

Biot,

Jacxsens,

Cardon

et al. 2024

Diagn Progn Res

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Background Speech perception tests are essential to measure the functional use of hearing and to determine the effectiveness of hearing aids and implantable auditory devices. However, these language-based tests require active participation and are influenced by linguistic and neurocognitive skills limiting their use in patients with insufficient language proficiency, cognitive impairment, or in children. We recently developed a non-attentive and objective speech perception prediction model: the Acoustic Change Complex (ACC) prediction model. The ACC prediction model uses electroencephalography to measure alterations in cortical auditory activity caused by frequency changes. The aim is to validate this model in a large-scale external validation study in adult patients with varying degrees of sensorineural hearing loss (SNHL) to confirm the high predictive value of the ACC model and to assess its test–retest reliability. Methods A total of 80 participants, aged 18–65 years, will be enrolled in the study. The categories of severity of hearing loss will be used as a blocking factor to establish an equal distribution of patients with various degrees of sensorineural hearing loss. During the first visit, pure tone audiometry, speech in noise tests, a phoneme discrimination test, and the first ACC measurement will be performed. During the second visit (after 1–4 weeks), the same ACC measurement will be performed to assess the test–retest reliability. The acoustic change stimuli for ACC measurements consist of a reference tone with a base frequency of 1000, 2000, or 4000 Hz with a duration of 3000 ms, gliding to a 300-ms target tone with a frequency that is 12% higher than the base frequency. The primary outcome measures are (1) the level of agreement between the predicted speech reception threshold (SRT) and the behavioral SRT, and (2) the level of agreement between the SRT calculated by the first ACC measurement and the SRT of the second ACC measurement. Level of agreement will be assessed with Bland–Altman plots. Discussion Previous studies by our group have shown the high predictive value of the ACC model. The successful validation of this model as an effective and reliable biomarker of speech perception will directly benefit the general population, as it will increase the accuracy of hearing evaluations and improve access to adequate hearing rehabilitation.

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“…Patients with prelingual deafness are particularly vulnerable to delays in CI because of a critical window for speech and language development. 20 , 21 , 22 , 23 On average, the interval between CI candidacy evaluation to CI surgery was 6 months longer for patients with prelingual deafness that were implanted during COVID‐19 compared with those implanted pre‐COVID. Numerous studies have demonstrated that timing of CI impacts speech, language, functional and social outcomes in children.…”

Section: Discussionmentioning

confidence: 99%

Trends in Timing and Provision of Pediatric Cochlear Implant Care During COVID‐19

et al. 2023

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Objectives To identify trends in timing of pediatric cochlear implant (CI) care during COVID‐19. Study Design Retrospective cohort. Setting Tertiary care center. Methods Patients under 18 years of age who underwent CI between 1/1/2016 and 2/29/2020 were included in the pre‐COVID‐19 group, and patients implanted between 3/1/2020 and 12/31/2021 comprised the COVID‐19 group. Revision and sequential surgeries were excluded. Time intervals between care milestones including severe‐to‐profound hearing loss diagnosis, initial CI candidacy evaluation, and surgery were compared among groups, as were the number and type of postoperative visits. Results A total of 98 patients met criteria; 70 were implanted pre‐COVID‐19 and 28 during COVID‐19. A significant increase in the interval between CI candidacy evaluation and surgery was seen among patients with prelingual deafness during COVID‐19 compared with pre‐COVID‐19 ( µ = 47.3 weeks, 95% confidence interval [CI]: 34.8‐59.9 vs µ = 20.5 weeks, 95% CI: 13.1‐27.9; p < .001). Patients in the COVID‐19 group attended fewer in‐person rehabilitation visits in the 12 months after surgery ( µ = 14.9 visits, 95% CI: 9.7‐20.1 vs µ = 20.9, 95% CI: 18.1‐23.7; p = .04). Average age at implantation in the COVID‐19 group was 5.7 years (95% CI: 4.0‐7.5) versus 3.7 years in the pre‐COVID‐19 group (95% CI: 2.9‐4.6; p = .05). The time interval between hearing loss confirmation and CI surgery was on average 99.7 weeks for patients implanted during COVID‐19 (95% CI: 48.8‐150) versus 54.2 weeks for patients implanted pre‐COVID (95% CI: 39.6‐68.8), which was not a statistically significant difference ( p = .1). Conclusion During the COVID‐19 pandemic patients with prelingual deafness experienced delays in care relative to patients implanted before the pandemic.

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Delayed Auditory Brainstem Responses in Prelingually Deaf and Late-Implanted Cochlear Implant Users

Cited by 15 publications

References 35 publications

The Acoustic Change Complex Compared to Hearing Performance in Unilaterally and Bilaterally Deaf Cochlear Implant Users

The Acoustic Change Complex Compared to Hearing Performance in Unilaterally and Bilaterally Deaf Cochlear Implant Users

Validation of the acoustic change complex (ACC) prediction model to predict speech perception in noise in adult patients with hearing loss: a study protocol

Trends in Timing and Provision of Pediatric Cochlear Implant Care During COVID‐19

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