Electrical stimulation of the midbrain for hearing restoration: Insight into the functional organization of the human central auditory system

Hubert H. Lim, Thomas Lenarz, Gert Joseph, Rolf Dieter Battmer, Amir Samii, Madjid Samii, James F. Patrick, Minoo Lenarz

Research output: Contribution to journalArticle

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Abstract

The cochlear implant can restore speech perception in patients with sensorineural hearing loss. However, it is ineffective for those without an implantable cochlea or a functional auditory nerve. These patients can be implanted with the auditory brainstem implant (ABI), which stimulates the surface of the cochlear nucleus. Unfortunately, the ABI has achieved limited success in its main patient group [i.e., those with neurofibromatosis type 2 (NF2)] and requires a difficult surgical procedure. These limitations have motivated us to develop a new hearing prosthesis that stimulates the midbrain with a penetrating electrode array. We recently implanted three patients with the auditory midbrain implant (AMI), and it has proven to be safe with minimal movement over time. The AMI provides loudness, pitch, temporal, and directional cues, features that have shown to be important for speech perception and more complex sound processing. Thus far, all three patients obtain enhancements in lip reading capabilities and environmental awareness and some improvements in speech perception comparable with that of NF2 ABI patients. Considering that our midbrain target is more surgically exposable than the cochlear nucleus, this argues for the use of the AMI as an alternative to the ABI. Fortunately, we were able to stimulate different midbrain regions in our patients and investigate the functional organization of the human central auditory system. These findings provide some insight into how we may need to stimulate the midbrain to improve hearing performance with the AMI.

LanguageEnglish (US)
Pages13541-13551
Number of pages11
JournalJournal of Neuroscience
Volume27
Issue number49
DOIs
StatePublished - Dec 5 2007

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Mesencephalon
Electric Stimulation
Hearing
Auditory Brain Stem Implants
Speech Perception
Neurofibromatosis 2
Cochlear Nucleus
Lipreading
Cochlear Nerve
Cochlear Implants
Sensorineural Hearing Loss
Cochlea
Prostheses and Implants
Cues
Electrodes

Keywords

  • Auditory brainstem implant
  • Auditory midbrain implant
  • Auditory pathways
  • Deep brain stimulation
  • Inferior colliculus
  • NF2

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Electrical stimulation of the midbrain for hearing restoration : Insight into the functional organization of the human central auditory system. / Lim, Hubert H.; Lenarz, Thomas; Joseph, Gert; Battmer, Rolf Dieter; Samii, Amir; Samii, Madjid; Patrick, James F.; Lenarz, Minoo.

In: Journal of Neuroscience, Vol. 27, No. 49, 05.12.2007, p. 13541-13551.

Research output: Contribution to journalArticle

Lim, Hubert H. ; Lenarz, Thomas ; Joseph, Gert ; Battmer, Rolf Dieter ; Samii, Amir ; Samii, Madjid ; Patrick, James F. ; Lenarz, Minoo. / Electrical stimulation of the midbrain for hearing restoration : Insight into the functional organization of the human central auditory system. In: Journal of Neuroscience. 2007 ; Vol. 27, No. 49. pp. 13541-13551.
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