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Hung Thai-Van

Publications and source records attributed to Hung Thai-Van.

8 recordsLinked to original sources
PubMed2007

The pattern of auditory brainstem response wave V maturation in cochlear-implanted children.

OBJECTIVE: Maturation of acoustically evoked brainstem responses (ABR) in hearing children is not complete at birth but rather continues over the first two years of life. In particular, it has been established that the decrease in ABR wave V latency can be modeled as the sum of two decaying exponential functions with respective time-constants of 4 and 50 weeks [Eggermont, J.J., Salamy, A., 1988a. Maturational time-course for the ABR in preterm and full term infants. Hear Res 33, 35-47; Eggermont, J.J., Salamy, A., 1988b. Development of ABR parameters in a preterm and a term born population. Ear Hear 9, 283-9]. Here, we investigated the maturation of electrically evoked auditory brainstem responses (EABR) in 55 deaf children who recovered hearing after cochlear implantation, and proposed a predictive model of EABR maturation depending on the onset of deafness. The pattern of EABR maturation over the first 2 years of cochlear implant use was compared with the normal pattern of ABR maturation in hearing children. METHODS: Changes in EABR wave V latency over the 2 years following cochlear implant connection were analyzed in two groups of children. The first group (n=41) consisted of children with early-onset of deafness (mostly congenital), and the second (n=14) of children who had become profoundly deaf after 1 year of age. The modeling of changes in EABR wave V latency with time was based on the mean values from each of the two groups, allowing comparison of the rates of EABR maturation between groups. Differences between EABRs elicited at the basal and apical ends of the implant electrode array were also tested. RESULTS: There was no influence of age at implantation on the rate of wave V latency change. The main factor for EABR changes was the time in sound. Indeed, significant maturation was observed over the first 2 years of implant use only in the group with early-onset deafness. In this group maturation of wave V progressed as in the ABR model of [Eggermont, J.J., Salamy, A., 1988a. Maturational time-course for the ABR in preterm and full term infants. Hear Res 33, 35-47; Eggermont, J.J., Salamy, A., 1988b. Development of ABR parameters in a preterm and a term born population. Ear Hear 9, 283-9] of normal hearing children: a sum of two decaying exponential functions, one showing an early rapid decrease in latency and the other a slower decrease. Remarkably, the time-constants fell well within the ranges described by Eggermont and Salamy (i.e., 3.9 and 68 weeks), consistent with the time-course of the neurophysiological mechanisms presumably involved in auditory pathway maturation during the first 2 years of life: i.e., myelination and increased synaptic efficacy. In contrast, relatively little change in wave V was evident in children with late-onset deafness. In agreement with the notion that EABR maturation follows an apex-to-base gradient as described for ABR, we observed that wave V latencies were longer for the basal than the apical end of the implant electrode array and remained so throughout the study period, whatever the time of onset of deafness. CONCLUSIONS: The findings in the early-onset of deafness group support the theory that auditory pathways remain "frozen" during the period of sensory deprivation until cochlear implant rehabilitation restores the normal chronology of maturational processes. In children with late-onset deafness, however, some maturational processes may occur before the onset of deafness, and thus less additional maturation is required during the first two years of implant use resulting in no significant EABR latency changes being observed in this period. The results suggest that the rehabilitation-induced plasticity of the auditory pathways is, in case of late auditory deprivation, unlikely to result in neurophysiological outcomes similar to those observed in children with early auditory deprivation. SIGNIFICANCE: Changes in EABR wave V latency over the first 2 years of cochlear implant use were found to be well fitted by the sum of two decaying exponential functions in children with early-onset deafness. This is in line with the maturation of ABR wave V latency in normal-hearing children over the first two years of life. Further studies are needed to assess whether the differences observed in terms of auditory pathways maturation are associated with consistent differences in terms of language development.

Adolescent↗
PubMed2004

Automatic analysis of auditory nerve electrically evoked compound action potential with an artificial neural network.

The auditory nerve's electrically evoked compound action potential is recorded in deaf patients equipped with the Nucleus 24 cochlear implant using a reverse telemetry system (NRT). Since the threshold of the NRT response (NRT-T) is thought to reflect the psychophysics needed for programming cochlear implants, efforts have been made by specialized management teams to develop its use. This study aimed at developing a valid tool, based on artificial neural networks (ANN) technology, for automatic estimation of NRT-T. The ANN used was a single layer perceptron, trained with 120 NRT traces. Learning traces differed from data used for the validation. A total of 550 NRT traces from 11 cochlear implant subjects were analyzed separately by the system and by a group of physicians with expertise in NRT analysis. Both worked to determine 37 NRT-T values, using the response amplitude growth function (AGF) (linear regression of response amplitudes obtained at decreasing stimulus intensity levels). The validity of the system was assessed by comparing the NRT-T values automatically determined by the system with those determined by the physicians. A strong correlation was found between automatic and physician-obtained NRT-T values (Pearson r correlation coefficient >0.9). ANOVA statistics confirmed that automatic NRT-Ts did not differ from physician-obtained values (F = 0.08999, P = 0.03). Moreover, the average error between NRT-Ts predicted by the system and NRT-Ts measured by the physicians (3.6 stimulation units) did not differ significantly from the average error between NRT-Ts measured by each of the three physicians (4.2 stimulation units). In conclusion, the automatic system developed in this study was found to be as efficient as human experts for fitting the amplitude growth function and estimating NRT-T, with the advantage of considerable time-saving.

Cochlear Implants↗
PubMed2004

Modeling the relationship between psychophysical perception and electrically evoked compound action potential threshold in young cochlear implant recipients: clinical implications for implant fitting.

OBJECTIVE: In cochlear implant recipients, the threshold of the electrically evoked compound action potential (ECAP) has been shown to correlate with the perceptual detection threshold and maximum comfortable loudness levels (respectively, T- and C-levels) used for implant programming. Our general objective was to model the relationship between ECAP threshold and T/C-levels by taking into account their relative changes within each subject. In particular, we were interested in investigating further the validity of ECAP threshold as a predictor of psychophysical levels, depending on intra-cochlear electrode location and time of testing (from 1 to 18 months post-implantation). METHODS: A total of 370 ECAP thresholds, measured in 49 children, using a Nucleus 24 cochlear implant, were compared with the corresponding T- and C-levels obtained at the same visit, for the same electrode. Response profiles for the whole group of patients were modeled across four test electrodes spaced equally along the electrode array from base towards apex. A linear regression model was constructed and the quality of the ECAP threshold-based predictions was assessed by testing for correlation between measured and predicted psychophysics. Comparison was made with a more simplistic model (described here as the 'parallel profiles method') stipulating, within each subject, a 1 microA increase in psychophysical levels for every 1 microA increase in ECAP threshold. RESULTS: Offset between ECAP threshold and psychophysics profiles was found to vary significantly along the electrode array for the T-, but not for the C-level. In contrast with the parallel profiles method, our regression model predicted, within each subject, an average increase of 0.23 microA (95% confidence interval: 0.18-0.28) in T-level for every 1 microA increase in ECAP threshold. This correction improved the quality of T-level prediction when our model was run using measured T-level and ECAP threshold from a reference electrode (r=0.77 vs. r=0.62). The shorter the distance between the electrode for which T-level was predicted and the one used as reference, the stronger the correlation between measured and predicted T-levels. In addition, poorer T-level predictions were obtained at the basal end of the array during the first 3 months post-implantation. In contrast to T-level, individual changes in C-level with ECAP threshold exhibited heterogeneous patterns across subjects so that no common coefficient could account for these changes. However, applying the parallel profiles method led to high-quality C-level prediction. CONCLUSIONS AND SIGNIFICANCE: The results suggest that covariation between ECAP thresholds and psychophysics plays a decisive role in the relationship of ECAP threshold with T-, but not with C-level. Therefore, our regression model and the parallel profiles method should both be used for predicting, respectively, the T- and the C-levels. Although the predictability of our regression model seems to be better for middle and apical electrodes, its utilization should be extended to basal electrodes after 6 months' implant use.

Action Potentials↗
PubMed2003

Enhanced frequency discrimination near the hearing loss cut-off: a consequence of central auditory plasticity induced by cochlear damage?

Patients with steeply sloping hearing losses of cochlear origin may exhibit enhanced difference limens for frequency (DLFs) near the cut-off frequency (Fc) of their hearing loss. This effect has been related to observations in deafened animals of an over-representation of Fc in the primary auditory cortex. However, alternative interpretations in terms of peripheral mechanisms have not been eliminated. In the present study, we assessed the possible role of two peripheral mechanisms [loudness cues and spontaneous otoacoustic emissions (SOAEs)] in a group of patients with high-frequency hearing loss. We tested first whether the DLF enhancement effect was still observed under conditions where subjects could not rely on loudness cues to perform the frequency discrimination task. To achieve this, we adjusted the nominal level of each stimulus so that it fell on an equal loudness contour measured at very fine (1/8 octave) frequency intervals, and we roved the level of each stimulus over a large range (12 dB). Under these conditions, the DLF enhancement was still observed in all patients; this demonstrates that the effect cannot be explained simply by loudness cues. We then screened the patients for SOAEs to test whether the DLF enhancement effect could be explained by the presence of such emissions in the vicinity of the Fc. None of the patients exhibited SOAEs. Finally, we tested whether the patients had cochlear dead regions, i.e. regions lacking functional inner hair cells and/or auditory nerve fibres. Using a refined version of a non-invasive clinical test for the identification of dead regions, we assessed the presence of such regions in fine frequency steps (1/4 octave) up to very high frequencies. All of the patients had cochlear dead regions. The first two findings support the hypothesis that DLF enhancement is due to injury-induced central reorganization in the auditory system. The last one is consistent with neurophysiological data in animals, which suggest that complete deprivation from auditory input at certain cochlear sites may be a necessary condition for the occurrence of injury-induced cortical reorganization.

Aged↗
PubMed2003

Assessing auditory nerve recovery function with a modified subtraction method: results and mathematical modeling.

OBJECTIVE: One of the main difficulties in electrical compound action potential (ECAP) recordings is to reduce the stimulus artifact due to electrical stimulation. The neural response telemetry (NRT) system of the Nucleus 24 cochlear implant extracts the ECAP response using a forward-masking (standard) subtraction technique. However, it has been shown that this subtraction technique may distort the ECAP responses in certain situations. In order to improve ECAP recordings, a modified forward-masking subtraction technique was recently proposed (Ear Hear. 21 (2000) 280). This modified subtraction technique can be applied to recovery function measurement. The objective of this study is to compare results obtained with the modified method to those obtained using the standard method. METHODS: ECAP responses were recorded in 4 adult patients using a Nucleus 24 cochlear implant. Data were collected for the 20 active electrodes. For each electrode, measurements consisted of the recovery function recording using 16 different Masker-Probe intervals. The modified method was then applied and the results compared with the standard method. RESULTS: Comparison between the two methods revealed that results were different when using the standard or modified method. Using the modified method, more ECAP responses were obtained (61.8 vs. 44.2%), but the P1 peak was sometimes attenuated; when using the standard method, N1 peak was missing in many cases. A mathematical model has been established and the mathematical simulation confirms the results obtained in patients. CONCLUSIONS: The results suggest that both methods have limitations and advantages. The modified subtraction method seems to be better for analyzing ECAP recordings in recovery function measurement because of the higher number of responses obtained compared to the standard method.

Adult↗
PubMed2002

Local improvement in auditory frequency discrimination is associated with hearing-loss slope in subjects with cochlear damage.

Earlier data in the literature have shown local improvements in frequency discrimination performance near the cut-off frequency of steeply sloping, high-frequency hearing loss in subjects with cochlear damage. The general objective of the present study was to characterize further the relationships between this effect and various audiometric variables: namely, the slope, extent and shape of the hearing loss. In particular, we were interested in determining whether the effect was present in subjects with more moderately sloping hearing loss and/or other patterns of loss. Frequency difference limens (DLFs) were measured in 20 subjects (eight female, 12 male, median age 55.5 years) with high-frequency hearing loss. At least 12 frequencies were tested at intervals of 1/8 octave over a range of 1.5 octaves around the cut-off frequency for hearing loss (Fc). The Fc corresponded to the audiogram edge frequency and was defined as the highest test frequency, at the beginning of the slope, with a hearing threshold of no more than 5 dB HL above that of the best hearing frequency. The level of the test tones was randomized over a range of 6 dB around a nominal level, following an equal-loudness contour curve measured at 1/2-octave intervals. Results showed that DLFs were significantly smaller in a frequency band 1/4 octave wide centred on Fc than in the other bands. Furthermore, the average DLF measured in this band proved to be negatively correlated with the slope of hearing loss. No such significant relationship was found with the other audiometric indices considered, namely, the extent and maximum amount of hearing loss and the log-transformed cut-off frequency. The 20 subjects were divided into three groups according to the slope of their hearing loss relative to Fc (steep, >25 dB/1/2 octave; medium, between 12 and 25 dB/1/2 octave; and shallow, <12 dB/1/2 octave). A local improvement in DLF around Fc was observed in the steep- and medium-slope groups and was confirmed statistically in the steep-slope group. Similar measurements in subjects with low-frequency or notched hearing loss allowed us to establish the presence of similar local improvements in DLFs around audiogram edges. These results, which suggest the slope of the hearing loss to be the most important factor for the occurrence of local DLF improvements, are consistent with both an interpretation in terms of peripheral mechanisms and one in terms of central mechanisms, i.e. injury-induced neural reorganization.

Acoustic Stimulation↗
PubMed2002

Electrophysiological findings in two bilateral cochlear implant cases: does the duration of deafness affect electrically evoked auditory brain stem responses?

Bilateral cochlear implantation provides an interesting model for in vivo study of the effect of long-term profound deafness on neural transmission. We present electrophysiological observations on 2 patients implanted with the MXM Binaural Digisonic Convex system. This uncommon design consists of 2 electrode arrays placed bilaterally into the scala tympani and controlled by a single speech processor. In both patients, the duration of deafness before cochlear implantation clearly differed from one ear to the other. Electrically evoked auditory brain stem responses (EABRs) were measured and the EABRs from the ear with the longer deafness duration showed a lengthening of wave V latency. In I patient, recordings from this ear also showed a lack of reproducibility of wave III. The data suggest that neural responsiveness in the peripheral and intermediate auditory pathways is adversely affected by deafness duration. Poor EABRs on one ear possibly result from the total duration of deafness in this ear and/or compensation by the other ear.

Adult↗