The overarching goal of this project is to develop and validate patient-specific computational models of cochlear implant (CI) stimulation and to use these models to create patient-customized, MOdel-based CI Programming (MOCIP) strategies that optimize implant performance. CIs are a neuroprosthetic devices that use an array of implanted electrodes to stimulated the auditory nerve and induce hearing sensation. With over 500,000 recipients worldwide, CI are considered the standard of care treatment for severe-to-profound sensory-based hearing loss. While results with these devices have been remarkably successful, a significant number of CI recipients experience poor speech understanding, and, even among the best performers, restoration to normal auditory fidelity is rare. It is estimated that only 5% of those who could benefit from this technology pursue implantation, in large part due to the high-degree of uncertainty in outcomes. A substantial portion of the variability in outcomes with CIs is due to a sub-optimal electro-neural interface (ENI); however, approaches for estimating the patient- specific ENI have thus far been unreliable. The overarching hypothesis of this study is that an accurate estimation of the patient-specific ENI can be obtained with patient-specific computational models and used to customize CI settings for improved and less variable implant performance. To test this hypothesis, first, novel image processing and patient-specific anatomical models, which are tuned using biofeedback signals and permit estimating the ENI by determining which auditory nerve fibers are healthy and localizing which nerve fibers are stimulated by each electrode, will be developed and validated. Next, the performance of patient-customized MOCIP strategies that aim to address sub-optimal conditions found in the ENI will be clinically tested. Finally, MOCIP techniques will be automated and integrated into software that can be deployed into the clinical workflow. Since MOCIP strategies require only a change of settings on the CI, they work with existing device technology, do not require further surgery, and are reversible. If successful, a suite of MOCIP techniques that can objectively guide the programming of CIs towards optimized settings and improve hearing restoration for new and existing CI recipients will be developed in this project.

Public Health Relevance

The goal of this project is to develop patient-personalized cochlear implant stimulation models that could provide useful programming-assistance to clinicians and lead to better device settings. Thus, the methods developed in this project could potentially be used to improve hearing outcomes for new and existing cochlear implant recipients and improve the efficiency of the clinical programming process.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
2R01DC014037-06
Application #
9973809
Study Section
Bioengineering of Neuroscience, Vision and Low Vision Technologies Study Section (BNVT)
Program Officer
Miller, Roger
Project Start
2014-06-01
Project End
2025-04-30
Budget Start
2020-06-20
Budget End
2021-04-30
Support Year
6
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Vanderbilt University Medical Center
Department
Engineering (All Types)
Type
Biomed Engr/Col Engr/Engr Sta
DUNS #
965717143
City
Nashville
State
TN
Country
United States
Zip Code
37203
Gifford, René H; Noble, Jack H; Camarata, Stephen M et al. (2018) The Relationship Between Spectral Modulation Detection and Speech Recognition: Adult Versus Pediatric Cochlear Implant Recipients. Trends Hear 22:2331216518771176
Zhang, Dongqing; Zhao, Yiyuan; Noble, Jack H et al. (2018) Selecting electrode configurations for image-guided cochlear implant programming using template matching. J Med Imaging (Bellingham) 5:021202
Koka, Kanthaiah; Riggs, William Jason; Dwyer, Robert et al. (2018) Intra-Cochlear Electrocochleography During Cochear Implant Electrode Insertion Is Predictive of Final Scalar Location. Otol Neurotol 39:e654-e659
McRackan, Theodore R; Noble, Jack H; Wilkinson, Eric P et al. (2017) Implementation of Image-Guided Cochlear Implant Programming at a Distant Site. Otolaryngol Head Neck Surg 156:933-937
O'Connell, Brendan P; Hunter, Jacob B; Haynes, David S et al. (2017) Insertion depth impacts speech perception and hearing preservation for lateral wall electrodes. Laryngoscope 127:2352-2357
Cakir, Ahmet; Dwyer, Robert T; Noble, Jack H (2017) Evaluation of a high-resolution patient-specific model of the electrically stimulated cochlea. J Med Imaging (Bellingham) 4:025003
Wang, Jianing; Dawant, Benoit M; Labadie, Robert F et al. (2017) Retrospective Evaluation of a Technique for Patient-Customized Placement of Precurved Cochlear Implant Electrode Arrays. Otolaryngol Head Neck Surg 157:107-112
O'Connell, Brendan P; Holder, Jourdan T; Dwyer, Robert T et al. (2017) Intra- and Postoperative Electrocochleography May Be Predictive of Final Electrode Position and Postoperative Hearing Preservation. Front Neurosci 11:291
Chakravorti, Srijata; Bussey, Brian J; Zhao, Yiyuan et al. (2017) Cochlear implant phantom for evaluating computed tomography acquisition parameters. J Med Imaging (Bellingham) 4:045002
Zuniga, M Geraldine; Rivas, Alejandro; Hedley-Williams, Andrea et al. (2017) Tip Fold-over in Cochlear Implantation: Case Series. Otol Neurotol 38:199-206

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