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Pre-operative Brain Imaging Using Functional Near-Infrared Spectroscopy Helps Predict Cochlear Implant Outcome in Deaf Adults

Anderson, CA; Wiggins, IM; Kitterick, PT; Hartley, DEH; (2019) Pre-operative Brain Imaging Using Functional Near-Infrared Spectroscopy Helps Predict Cochlear Implant Outcome in Deaf Adults. Journal of the Association for Research in Otolaryngology , 20 pp. 511-528. 10.1007/s10162-019-00729-z. Green open access

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Abstract

Currently, it is not possible to accurately predict how well a deaf individual will be able to understand speech when hearing is (re)introduced via a cochlear implant. Differences in brain organisation following deafness are thought to contribute to variability in speech understanding with a cochlear implant and may offer unique insights that could help to more reliably predict outcomes. An emerging optical neuroimaging technique, functional near-infrared spectroscopy (fNIRS), was used to determine whether a pre-operative measure of brain activation could explain variability in cochlear implant (CI) outcomes and offer additional prognostic value above that provided by known clinical characteristics. Cross-modal activation to visual speech was measured in bilateral superior temporal cortex of pre- and post-lingually deaf adults before cochlear implantation. Behavioural measures of auditory speech understanding were obtained in the same individuals following 6 months of cochlear implant use. The results showed that stronger pre-operative cross-modal activation of auditory brain regions by visual speech was predictive of poorer auditory speech understanding after implantation. Further investigation suggested that this relationship may have been driven primarily by the inclusion of, and group differences between, pre- and post-lingually deaf individuals. Nonetheless, pre-operative cortical imaging provided additional prognostic value above that of influential clinical characteristics, including the age-at-onset and duration of auditory deprivation, suggesting that objectively assessing the physiological status of the brain using fNIRS imaging pre-operatively may support more accurate prediction of individual CI outcomes. Whilst activation of auditory brain regions by visual speech prior to implantation was related to the CI user's clinical history of deafness, activation to visual speech did not relate to the future ability of these brain regions to respond to auditory speech stimulation with a CI. Greater pre-operative activation of left superior temporal cortex by visual speech was associated with enhanced speechreading abilities, suggesting that visual speech processing may help to maintain left temporal lobe specialisation for language processing during periods of profound deafness.

Type: Article
Title: Pre-operative Brain Imaging Using Functional Near-Infrared Spectroscopy Helps Predict Cochlear Implant Outcome in Deaf Adults
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s10162-019-00729-z
Publisher version: https://doi.org/10.1007/s10162-019-00729-z
Language: English
Additional information: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: cochlear implantation, cross-modal plasticity, functional near-infrared spectroscopy, prognostic imaging, speechreading, superior temporal cortex, Adult, Aged, Brain, Cochlear Implants, Deafness, Humans, Middle Aged, Spectroscopy, Near-Infrared, Speech Perception, Temporal Lobe, Treatment Outcome
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Institute of Cognitive Neuroscience
URI: https://discovery.ucl.ac.uk/id/eprint/10131462
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