A Korean study has found that the success of cochlear implantation in older adults depends on their brain health.
Researchers led by Bae Seong-hoon, a professor of otolaryngology at Gangnam Severance Hospital, and Kim Jun-yup, a former professor of rehabilitation medicine at Hanyang University Medical Center, reported on Friday that brain health can predict the outcome of cochlear implant surgery in elderly patients with hearing loss.
Bae Seong-hoon (left), a professor of otolaryngology at Gangnam Severance Hospital, and Kim Jun-yup, a former professor of rehabilitation medicine at Hanyang University Medical Center (Courtesy of Gangnam Severance Hospital)
Bae Seong-hoon (left), a professor of otolaryngology at Gangnam Severance Hospital, and Kim Jun-yup, a former professor of rehabilitation medicine at Hanyang University Medical Center (Courtesy of Gangnam Severance Hospital)
Cochlear implantation is widely recognized as the most effective treatment for patients with severe hearing loss. However, many individuals hesitate to undergo the procedure due to their advanced age or low expectations of success. Additionally, hearing ability varies greatly among individuals, and no objective indicators exist to predict surgical outcomes.
The researchers highlighted a link between hearing and the cerebellum. Although the cerebellum is primarily associated with motor function and balance, recent studies suggest it also plays a role in cognitive functions, including speech perception.
The researchers examined pre- and post-operative brain MRIs of 52 cochlear implant patients over the age of 70. They precisely measured gray matter volume in the 'Crus I' region of the cerebellum, which is associated with language function, and analyzed its correlation with hearing outcomes using tests of monosyllabic and syllabic words, as well as sentence recognition.
Comparison of the degree of cerebellar atrophy in a group of normal hearing and hearing loss patients of the same age and gender. It can be seen that the average gray matter thickness of the hearing-impaired patients (blue) is significantly smaller (more elongated violin shape downward) than that of the normal-hearing group (red).
Comparison of the degree of cerebellar atrophy in a group of normal hearing and hearing loss patients of the same age and gender. It can be seen that the average gray matter thickness of the hearing-impaired patients (blue) is significantly smaller (more elongated violin shape downward) than that of the normal-hearing group (red).
The analysis revealed that patients with reduced gray matter and atrophy in the cerebellar Crus I region tended to have poorer postoperative speech recognition. Age had no significant impact on cochlear implant outcomes. Notably, the researchers found that the degree of cerebellar atrophy was a stronger predictor of surgical success than the duration of deafness (DoD), which was previously considered an important factor in forecasting outcomes.
The research team hopes this study will serve as a new benchmark for patient selection and surgical outcome prediction, enabling them to assess the likelihood of cochlear implant success in advance.
“In the future, we will be able to develop customized treatment plans by assessing the status of the cerebellar Crus I through preoperative brain MRI,” said Professor Bae, who led the study. “Since age had no significant impact on cochlear implant outcomes, we hope older patients will feel confident in pursuing aggressive treatment.”
The study, funded by the Ministry of Science and ICT, was published in Scientific Reports, a sister journal of Nature.
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