Institut Pasteur, Université Paris Cité, INSERM AU06, Institut de l'Audition, Paris, France.
ENT department, Institut Arthur Vernes, Paris, France.
Trends Hear. 2023 Jan-Dec;27:23312165231156412. doi: 10.1177/23312165231156412.
Age-related hearing loss, presbycusis, is an unavoidable sensory degradation, often associated with the progressive decline of cognitive and social functions, and dementia. It is generally considered a natural consequence of the inner-ear deterioration. However, presbycusis arguably conflates a wide array of peripheral and central impairments. Although hearing rehabilitation maintains the integrity and activity of auditory networks and can prevent or revert maladaptive plasticity, the extent of such neural plastic changes in the aging brain is poorly appreciated. By reanalyzing a large-scale dataset of more than 2200 cochlear implant users (CI) and assessing the improvement in speech perception from 6 to 24 months of use, we show that, although rehabilitation improves speech understanding on average, age at implantation only minimally affects speech scores at 6 months but has a pejorative effect at 24 months post implantation. Furthermore, older subjects (>67 years old) were significantly more likely to degrade their performances after 2 years of CI use than the younger patients for each year increase in age. Secondary analysis reveals three possible plasticity trajectories after auditory rehabilitation to account for these disparities: Awakening, reversal of deafness-specific changes; Counteracting, stabilization of additional cognitive impairments; or Decline, independent pejorative processes that hearing rehabilitation cannot prevent. The role of complementary behavioral interventions needs to be considered to potentiate the (re)activation of auditory brain networks.
年龄相关性听力损失，即老年性聋，是一种不可避免的感觉退化，常与认知和社会功能的逐渐下降以及痴呆有关。它通常被认为是内耳恶化的自然结果。然而，老年性聋可能混淆了广泛的外围和中枢损伤。尽管听力康复可以维持听觉网络的完整性和活性，并防止或逆转适应不良的可塑性，但衰老大脑中这种神经可塑性变化的程度还没有得到很好的理解。通过重新分析超过 2200 名人工耳蜗使用者（CI）的大型数据集，并评估使用 6 至 24 个月后的言语感知改善情况，我们表明，尽管康复平均改善了言语理解能力，但植入年龄仅对 6 个月时的言语评分有轻微影响，但在植入后 24 个月时则产生负面影响。此外，与年轻患者相比，年龄每增加 1 岁，年龄较大（>67 岁）的受试者在使用 CI 2 年后言语表现更有可能恶化。二次分析揭示了听觉康复后可能存在三种不同的可塑性轨迹，以解释这些差异：觉醒，逆转耳聋特异性变化；抵消，稳定额外的认知障碍；或下降，听觉康复无法预防的独立恶化过程。需要考虑互补的行为干预措施的作用，以增强听觉大脑网络的（重新）激活。
