A cochlear implant user wears a special hat that records their brain activity in response to sound, allowing researchers to pinpoint where in the hearing pathway their implant is falling short. Cochlear implants restore a sense of sound to people with severe hearing loss, but results vary wildly—some users understand speech almost normally, while others struggle in quiet rooms. Clinicians currently have no objective way to tell why one implant works better than another, or how to adjust the device for a given patient. This research aims to close that gap by using electroencephalography (EEG) to measure electrical signals at multiple stages between the cochlea and the brain, then linking those signals to how well a person actually understands speech. If successful, the project will produce a set of biomarkers—objective, measurable brain responses—that clinicians can use to fine-tune implant settings. For people with one implant, that might mean adjusting how sound is delivered or switching off problematic electrodes. For those with two implants, the guidelines would help balance the devices so both ears work together. The result could be consistently higher speech recognition for thousands of implant users, reducing the guesswork in post-surgical rehabilitation. The research will include both adults and children, ensuring the biomarkers work across all ages.
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For people with insufficient hearing to effectively use hearing aids, cochlear implants can provide great benefit, although they do not restore normal hearing. Cochlear implants stimulate the hearing nerve directly with electrical currents from a set of electrodes surgically implanted into the inner ear (cochlea). Although cochlear implants are a great success, a wide range in speech perception outcomes are observed. The aim of this programme of research is to reduce the variability in performance as well as increasing the levels of speech recognition achieved by all. We propose to achieve this by using a special machine to measure brain activity in response to sound for cochlear implant users. This technique is used routinely in clinical practice and involves wearing a special hat to make the recordings. We will use this method to record responses at different parts of the hearing system between cochlea and brain. By understanding the relationship between these responses and speech understanding it will help us to appreciate the importance of different stages in the hearing pathway. These measures will allow us to observe the brain changes that take place once cochlear implants are switched on. We will define 'biomarkers' that can be used by clinicians to guide implant fitting and rehabilitation. A biomarker is an objective measurement of typical changes in the body. We will develop guidance for adjusting the ways that sounds are sent through the cochlear implant or for switching off electrodes. For those with bilateral cochlear implants we will also develop guidelines for adjusting the implants to make the sounds more similar in each ear to improve the way that the ears work together. This research will be conducted with both adults and children to fully understand how people hear with a cochlear implant.
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