Performance Groups in Adult Cochlear Implant Users

Krüeger, Beate; Joseph, G.; Rost, U; Strau-Schier, Angelika; Lenarz, Thomas; Buechner, Andreas

doi:10.1097/mao.0b013e318171972f

Cited by 99 publications

(37 citation statements)

References 9 publications

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“…Next to these technical improvements, there is increasing evidence that learning constitutes a crucial component for a successful outcome. In the elderly, hearing and especially language perception is often not good after initial activation of the implant, but improves quickly within 10 to 20 weeks [21]. Obviously, a period of adaptation or adjustment is needed, which may more appropriately be called ‘learning’ when it requires an active engagement of the hearer with her acoustic environment (for a review, see [22]).…”

Section: Introductionmentioning

confidence: 99%

When Hearing Is Tricky: Speech Processing Strategies in Prelingually Deafened Children and Adolescents with Cochlear Implants Having Good and Poor Speech Performance

et al. 2017

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Cochlear implants provide individuals who are deaf with access to speech. Although substantial advancements have been made by novel technologies, there still is high variability in language development during childhood, depending on adaptation and neural plasticity. These factors have often been investigated in the auditory domain, with the mismatch negativity as an index for sensory and phonological processing. Several studies have demonstrated that the MMN is an electrophysiological correlate for hearing improvement with cochlear implants. In this study, two groups of cochlear implant users, both with very good basic hearing abilities but with non-overlapping speech performance (very good or very poor speech performance), were matched according to device experience and age at implantation. We tested the perception of phonemes in the context of specific other phonemes from which they were very hard to discriminate (e.g., the vowels in /bu/ vs. /bo/). The most difficult pair was individually determined for each participant. Using behavioral measures, both cochlear implants groups performed worse than matched controls, and the good performers performed better than the poor performers. Cochlear implant groups and controls did not differ during time intervals typically used for the mismatch negativity, but earlier: source analyses revealed increased activity in the region of the right supramarginal gyrus (220–260 ms) in good performers. Poor performers showed increased activity in the left occipital cortex (220–290 ms), which may be an index for cross-modal perception. The time course and the neural generators differ from data from our earlier studies, in which the same phonemes were assessed in an easy-to-discriminate context. The results demonstrate that the groups used different language processing strategies, depending on the success of language development and the particular language context. Overall, our data emphasize the role of neural plasticity and use of adaptive strategies for successful language development with cochlear implants.

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Section: Introductionmentioning

confidence: 99%

When Hearing Is Tricky: Speech Processing Strategies in Prelingually Deafened Children and Adolescents with Cochlear Implants Having Good and Poor Speech Performance

et al. 2017

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“…Compared with normal acoustic hearing, sound transmitted through the CI is degraded (Drennan and Rubinstein, 2008). Many CI users develop good speech intelligibility, in particular in quiet background conditions (Krueger et al, 2008). However, in noisy surroundings, the speech understanding typically decreases remarkably in CI users (Hochmair-Desoyer et al, 1997;Wilson and Dorman, 2008;Zeng et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

On the relationship between auditory cognition and speech intelligibility in cochlear implant users: An ERP study

et al. 2016

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There is a high degree of variability in speech intelligibility outcomes across cochlear-implant (CI) users. To better understand how auditory cognition affects speech intelligibility with the CI, we performed an electroencephalography study in which we examined the relationship between central auditory processing, cognitive abilities, and speech intelligibility. Postlingually deafened CI users (N=13) and matched normal-hearing (NH) listeners (N=13) performed an oddball task with words presented in different background conditions (quiet, stationary noise, modulated noise). Participants had to categorize words as living (targets) or non-living entities (standards). We also assessed participants' working memory (WM) capacity and verbal abilities. For the oddball task, we found lower hit rates and prolonged response times in CI users when compared with NH listeners. Noise-related prolongation of the N1 amplitude was found for all participants. Further, we observed group-specific modulation effects of event-related potentials (ERPs) as a function of background noise. While NH listeners showed stronger noise-related modulation of the N1 latency, CI users revealed enhanced modulation effects of the N2/N4 latency. In general, higher-order processing (N2/N4, P3) was prolonged in CI users in all background conditions when compared with NH listeners. Longer N2/N4 latency in CI users suggests that these individuals have difficulties to map acoustic-phonetic features to lexical representations. These difficulties seem to be increased for speech-in-noise conditions when compared with speech in quiet background. Correlation analyses showed that shorter ERP latencies were related to enhanced speech intelligibility (N1, N2/N4), better lexical fluency (N1), and lower ratings of listening effort (N2/N4) in CI users. In sum, our findings suggest that CI users and NH listeners differ with regards to both the sensory and the higher-order processing of speech in quiet as well as in noisy background conditions. Our results also revealed that verbal abilities are related to speech processing and speech intelligibility in CI users, confirming the view that auditory cognition plays an important role for CI outcome. We conclude that differences in auditory-cognitive processing contribute to the variability in speech performance outcomes observed in CI users. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Hannover, Finke.Mareike@mh-hannover.de AbstractThere is a high degree of variability in speech intelligibility outcomes across cochlear-implant (CI) users. To better understand how auditory cognition aff...

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“…Daher sind nach der Implantation wesentliche Adaptationsleistungen des Zentralnervensystems notwendig, um die elektrischen Signale eines CIs zu verstehen. Gleichwohl lernen viele CI-Träger innerhalb von wenigen Monaten Sprache zu verstehen (Krueger et al, 2008;Lenarz et al, 2012). Neben dieser Verbesserung der Hörleistung (▶ abb.…”

Section: Cochlea-implantation Und Kortikale Anpassungunclassified

“…In den darauffolgenden Wochen nahm der Zuwachs der Diskriminationsleistung stetig ab und stagnierte schließlich. Ähnliche Lernkurven wurden auch von früheren Verhaltensstudien berichtet, die eine schnelle Verbesserung der Hörleistung innerhalb des ersten Jahres nach der CI-Erstanpassung belegen (Krueger et al, 2008;Lenarz et al, 2012…”

Section: Verbesserung Der Auditorischen Diskriminationsleistung Nach unclassified

Kortikale Plastizität nach Hörverlust und Cochlea-Implantation

Sandmann

2015

Klin Neurophysiol

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Zusammenfassung Das Gehirn bleibt ?ber die gesamte Lebensspanne flexibel. Die Eigenschaft des Zentralnervensystems, sich an ver?ndernde Anforderungen anzupassen, wird auch als neuronale Plastizit?t bezeichnet. Bei Personen mit einer hochgradigen oder an Taubheit grenzenden Schwerh?rigkeit ist die neuronale Plastizit?t eine wesentliche Voraussetzung f?r die H?rrehabilitation mit einem Cochlea-Implantat (CI). Nach der Implantation sind Adaptationsleistungen des Zentralnervensystems notwendig, um die neuen, elektrischen Signale eines CIs zu verstehen. Obwohl viele CI-Tr?ger ein gutes Sprachverst?ndnis entwickeln, zeigt sich eine gro?e Variabilit?t im CI-Anpassungserfolg. Es gibt deutliche Hinweise, dass intermodale Plastizit?t, insbesondere die Hinzuziehung des auditorischen Kortex f?r die Verarbeitung von visuellen Informationen, wesentlich zu dieser Variabilit?t beitr?gt. Dieser Artikel gibt einen aktuellen ?berblick ?ber die kortikalen Ver?nderungen bei CI-Patienten. Dabei werden erfahrungsbedingte neuronale Ver?nderungen vor der Implantation (sensorische Deprivation) und danach (elektrisches H?ren mit CI) vorgestellt und anhand relevanter Studienergebnisse aufgezeigt, dass die Auswirkungen von Plastizit?t im Hinblick auf die Restitution der H?rfunktion nicht nur adaptiv, sondern auch maladaptiv sein k?nnen. Ob die maladaptive Plastizit?t bei CI-Tr?gern durch therapeutische Strategien gezielt beeinflusst werden kann, ist bislang unklar. Um die Therapiem?glichkeiten bei CI-Tr?gern weiter zu optimieren, sind zuk?nftige Studien notwendig. Ein besseres Verst?ndnis von adaptiver und maladaptiver Plastizit?t erlaubt es langfristig, therapeutische Strategien zu entwickeln, welche die kortikale Plastizit?t gezielt beeinflussen und so zu einer Optimierung des CI-Anpassungserfolgs beitragen.

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Performance Groups in Adult Cochlear Implant Users

Abstract: In all subgroups, an improvement of speech perception can be observed over time. The current patient group showed significant better performing results than those of the first group.

Cited by 99 publications

References 9 publications

When Hearing Is Tricky: Speech Processing Strategies in Prelingually Deafened Children and Adolescents with Cochlear Implants Having Good and Poor Speech Performance

When Hearing Is Tricky: Speech Processing Strategies in Prelingually Deafened Children and Adolescents with Cochlear Implants Having Good and Poor Speech Performance

On the relationship between auditory cognition and speech intelligibility in cochlear implant users: An ERP study

Kortikale Plastizität nach Hörverlust und Cochlea-Implantation

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