TY - JOUR
T1 - Electrical stimulation of the midbrain for hearing restoration
T2 - Insight into the functional organization of the human central auditory system
AU - Lim, Hubert H.
AU - Lenarz, Thomas
AU - Joseph, Gert
AU - Battmer, Rolf Dieter
AU - Samii, Amir
AU - Samii, Madjid
AU - Patrick, James F.
AU - Lenarz, Minoo
PY - 2007/12/5
Y1 - 2007/12/5
N2 - 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.
AB - 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.
KW - Auditory brainstem implant
KW - Auditory midbrain implant
KW - Auditory pathways
KW - Deep brain stimulation
KW - Inferior colliculus
KW - NF2
UR - http://www.scopus.com/inward/record.url?scp=37149012706&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=37149012706&partnerID=8YFLogxK
U2 - 10.1523/JNEUROSCI.3123-07.2007
DO - 10.1523/JNEUROSCI.3123-07.2007
M3 - Article
C2 - 18057212
AN - SCOPUS:37149012706
SN - 0270-6474
VL - 27
SP - 13541
EP - 13551
JO - Journal of Neuroscience
JF - Journal of Neuroscience
IS - 49
ER -