Schauwecker Natalie, Tamati Terrin N, Moberly Aaron C
Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Otol Neurotol Open. 2024 Mar 21;4(1):e050. doi: 10.1097/ONO.0000000000000050. eCollection 2024 Mar.
There is significant variability in speech recognition outcomes in adults who receive cochlear implants (CIs). Little is known regarding cognitive influences on very early CI performance, during which significant neural plasticity occurs.
Prospective study of 15 postlingually deafened adult CI candidates tested preoperatively with a battery of cognitive assessments. The mini-mental state exam (MMSE), forward digit span, Stroop measure of inhibition-concentration, and test of word reading efficiency were utilized to assess cognition. consonant-nucleus-consonant words, AZBio sentences in quiet, and AZBio sentences in noise (+10 dB SNR) were utilized to assess speech recognition at 1- and 3-months of CI use.
Performance in all speech measures at 1-month was moderately correlated with preoperative MMSE, but these correlations were not strongly correlated after correcting for multiple comparisons. There were large correlations of forward digit span with 1-month AzBio quiet ( ≤ 0.001, rho = 0.762) and AzBio noise ( ≤ 0.001, rho = 0.860), both of which were strong after correction. At 3 months, forward digit span was strongly predictive of AzBio noise ( ≤ 0.001, rho = 0.786), which was strongly correlated after correction. Changes in speech recognition scores were not correlated with preoperative cognitive test scores.
Working memory capacity significantly predicted early CI sentence recognition performance in our small cohort, while other cognitive functions assessed did not. These results differ from prior studies predicting longer-term outcomes. Findings and further studies may lead to better preoperative counseling and help identify patients who require closer evaluation to ensure optimal CI performance.
接受人工耳蜗植入（CI）的成年人在言语识别结果方面存在显著差异。对于认知对极早期CI性能的影响知之甚少，而在这个阶段会发生显著的神经可塑性。
对15名语后聋成年CI候选者进行前瞻性研究，术前用一系列认知评估进行测试。使用简易精神状态检查表（MMSE）、顺背数字广度、斯特鲁普抑制-注意力测试以及单词阅读效率测试来评估认知。使用辅音-元音-辅音单词、安静环境下的AZBio句子以及噪声环境下（信噪比为+10 dB）的AZBio句子来评估CI使用1个月和3个月时的言语识别。
1个月时所有言语测量的表现与术前MMSE呈中度相关，但在进行多重比较校正后，这些相关性并不强。顺背数字广度与1个月时的安静环境下的AzBio句子（≤0.001，rho = 0.762）和噪声环境下的AzBio句子（≤0.001，rho = 0.860）有很强的相关性，校正后两者均很强。在3个月时，顺背数字广度能强烈预测噪声环境下的AzBio句子（≤0.001，rho = 0.786），校正后相关性很强。言语识别分数的变化与术前认知测试分数无关。
在我们的小队列中，工作记忆容量显著预测了早期CI句子识别性能，而所评估的其他认知功能则不然。这些结果与先前预测长期结果的研究不同。研究结果及进一步的研究可能会带来更好的术前咨询，并有助于识别需要更密切评估以确保最佳CI性能的患者。
