Cortical binaural interaction during speech processing in children with bilateral cochlear implants

Henkin, Yael; Givon, Lihi; Yaar-Soffer, Yifat; Hildesheimer, Minka

doi:10.1179/146701011x13001035753182

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…134 Furthermore, although speech perception was gained in the weaker ear, the progress was slow and did not match the stronger ear even after 5 to 9 years of implant use. 58 Poor speech perception 55 together with absent cortical binaural interaction 135 in children receiving the second implant as adolescents suggest that there are continued difficulties in processing input from the second-treated ear. Overall, the data indicate that an early period of monaural hearing as brief as 1.5 years has long-lasting consequences.…”

Section: Figurementioning

confidence: 99%

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options

2015

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Deafness affects ∼2 in 1000 children and is one of the most common congenital impairments. Permanent hearing loss can be treated by fitting hearing aids. More severe to profound deafness is an indication for cochlear implantation. Although newborn hearing screening programs have increased the identification of asymmetric hearing loss, parents and caregivers of children with single-sided deafness are often hesitant to pursue therapy for the deaf ear. Delayed intervention has consequences for recovery of hearing. It has long been reported that asymmetric hearing loss/single-sided deafness compromises speech and language development and educational outcomes in children. Recent studies in animal models of deafness and in children consistently show evidence of an "aural preference syndrome" in which singlesided deafness in early childhood reorganizes the developing auditory pathways toward the hearing ear, with weaker central representation of the deaf ear. Delayed therapy consequently compromises benefit for the deaf ear, with slow rates of improvement measured over time. Therefore, asymmetric hearing needs early identification and intervention. Providing early effective stimulation in both ears through appropriate fitting of auditory prostheses, including hearing aids and cochlear implants, within a sensitive period in development has a cardinal role for securing the function of the impaired ear and for restoring binaural/spatial hearing. The impacts of asymmetric hearing loss on the developing auditory system and on spoken language development have often been underestimated. Thus, the traditional minimalist approach to clinical management aimed at 1 functional ear should be modified on the basis of current evidence.Deafness is one of the most common congenital impairments. 1,2 Newborn hearing screening programs, implemented in many countries, have decreased the age at diagnosis of hearing loss. When hearing loss occurs in only 1 ear, the screening result may be overlooked or dismissed as unimportant, particularly when hearing in the opposite ear is normal (unilateral or single-sided deafness). The consequence will be a failure to intervene until long after major developmental effects have set in, which causes significant negative clinical implications. Screening programs will also miss children who acquire deafness in 1 ear from infection, trauma, or worsening of preexisting hearing loss. 3-6 Acquired unilateral deafness can go unidentified until educational, social, or other impairments push families and caregivers to seek medical consult. Because the prevalence of permanent unilateral hearing loss in neonates is reported to vary from 0.45 to 2.7 in 1000 7,8 In this State-of-the-Art Review, we present evidence from basic and applied neuroscience, audiology, and otology that points to the existence of an impairment of the central representation of the poorer hearing ear if developmental asymmetric hearing is left untreated for years. First, we review the current state of the problem as viewed in the clin...

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Section: Figurementioning

confidence: 99%

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options

2015

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“…Clinically, BICs from the brainstem level have been successfully used in recent years to assess binaural processing in children with auditory processing disorders (Delb et al, 2003) and in hearing-impaired children who received bilateral cochlear implants sequentially, with variable time delays between implantations (Gordon et al, 2007). Moreover, we reported first-time evidence showing a P3-BIC in two children who lost hearing because of meningitis at early childhood and were simultaneously implanted shortly afterward (Henkin et al, 2011). In contrast, three additional children who were prelingually deafened and implanted sequentially with long delay (9 yr) between implantations did not exhibit the P3-BIC.…”

Section: T Hementioning

confidence: 65%

Hearing with Two Ears: Evidence for Cortical Binaural Interaction during Auditory Processing

Henkin¹,

Yaar-Soffer²,

Givon³

et al. 2015

J Am Acad Audiol

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The current AERP data provides evidence for the occurrence of cortical BICs during perceptual and postperceptual stages, presumably reflecting ongoing integration of information presented to the two ears at the final stages of auditory processing. Increasing binaural interaction with the progression of the auditory processing sequence (N1 to LNC) may support the notion that cortical BICs reflect inherited interactions from preceding stages of upstream processing together with discrete cortical neural activity involved in binaural processing. Clinically, an objective measure of cortical binaural processing has the potential of becoming an appealing neural correlate of binaural behavioral performance.

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“…These differences are reduced in children with bilateral CIs (Easwar et al 2017a, 2017c) perhaps due to abnormal coupling of the auditory cortices during bilateral stimulation (Smieja et al 2020). Cortical integration of bilateral input measured by comparing the bilateral CAEP with the sum of both unilaterally evoked CAEPs also suggest impaired cortical processing of bilateral input in children receiving bilateral CIs (Henkin et al 2011, 2015). Thus, the bilateral Cz-CAEPs appear to monitor response to overall input from both CIs over time but may not be adequate to assess potential differences in cortical activity evoked by bilateral than unilateral CI use or to predict bilateral benefits in speech perception.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Effects of Simultaneous and Sequential Bilateral Cochlear Implantation on Cortical Auditory-Evoked Potentials Recorded at Cz in a Large Cohort of Children

et al. 2022

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Objectives: Auditory development after bilateral cochlear implantation in children has been measured using source localization of multi-channel late latency responses. It is not clear, however, whether this development can be tracked using a more clinically feasible method of recording from one active recording electrode placed at mid-line center of the head (Cz). Design: In this prospective cohort study, cortical auditory-evoked potential responses (CAEPs) were recorded from Cz referenced to each earlobe (Cz-CAEP) from 222 children with bilateral cochlear implant (CI); 128 (mean ± SD age: 2.78 ± 3.30 years) received both CIs in the same surgery (simultaneous group) and 94 (aged 7.72 ± 4.45 years) received a second CI after 4.21 ± 2.98 years of unilateral CI use. We sought to (1) identify cortical development over the first couple of years of bilateral CI use; (2) measure known asymmetries in auditory development between the CIs; and (3) detect the effects of bilateral rather than unilateral CI use. 4556 Cz-CAEPs were recorded across the cohort over 33.50 ± 7.67 months duration of bilateral CI use. Given concerns related to peak picking, amplitude areas were measured across two response time windows (50 to 199 ms and 200 to 400 ms). Results: Results indicated that small response amplitudes occur at initial CI use and amplitudes increase in the negative or positive direction rapidly over the first months of CI use in both time windows. Asymmetries between Cz-CAEPs evoked by each CI were found in the sequential group and reduced with bilateral CI use, particularly in the first time window; these differences increased with longer inter-implant delay. Bilaterally evoked Cz-CAEPs were larger in amplitude than unilateral responses from either CI in the simultaneous group. In the sequential group, bilateral responses were similar to responses from the first implanted side but increased in relative amplitude with bilateral CI use. The Cz-CAEP measures were not able to predict asymmetries or bilateral benefits in speech perception measures. Conclusions: The Cz-CAEP was able to indicate cortical detection of CI input and showed gross morphological changes with bilateral CI use. Findings indicate Cz-CAEPs can be used to identify gross changes in auditory development in children with bilateral CIs, but they are less sensitive to tracking the remaining abnormalities that are measured by multi-channel CAEPs and speech perception testing.

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Cortical binaural interaction during speech processing in children with bilateral cochlear implants

Cited by 5 publications

References 10 publications

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options

Asymmetric Hearing During Development: The Aural Preference Syndrome and Treatment Options

Hearing with Two Ears: Evidence for Cortical Binaural Interaction during Auditory Processing

Longitudinal Effects of Simultaneous and Sequential Bilateral Cochlear Implantation on Cortical Auditory-Evoked Potentials Recorded at Cz in a Large Cohort of Children

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