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Journal Club: Musical training improves the ability to understand speech-in-noise in older adults

October 30, 2019
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Research updates

By Justin Piraino, Au.D, Sr. Manager Data Strategy and Analytics, Cochlear Americas

In today’s busy clinical environment, clinicians who value research-based practice often struggle to keep up with current literature.  To help, we’re excited to offer a new ProNews Blog monthly feature – Journal Club!  Each month, rotating guest authors will present a current journal article summary.

This month’s Journal Club explores a recent Canadian study published in the Neurobiology of Aging, Musical training improves the ability to understand speech-in-noise in older adults.As an audiologist and individual with hearing loss (hearing aid and cochlear implant user), any way to improve the ability to hear in noise for patients or myself is certainly worth my attention.  This research can encourage patients who aren’t feeling successful with their hearing loss treatment to engage in rehabilitation exercises.

What did the study investigate?

This study looked at the causal impact of music lessons on older adults. The researchers were interested to determine whether the causal relationship between short-term musical training and performance on auditory test improved hearing and therefore could be suggested to improve hearing in non-musicians.

Why is this important? 

These findings support the idea that musical training provides a causal benefit to hearing abilities. Importantly, these findings suggest that musical training could be used as a foundation to develop auditory rehabilitation programs for older adults.

How did they do it?

Below summarizes the key elements of study design and demographics:

  • A three-arm, single-blind longitudinal training study with random assignment
  • 34 individuals aged between 55 and 75
  • Participants were randomized into three groups using a stratified covariate-adaptive procedure. The groups include:
    • Piano training group (Music)
    • Video game training group (Video)
    • No-contact control group (No-contact)
  • Participants took part in three testing sessions:
    • The pre-training session (Pre) took place before the intervention, the mid-training session (Mid) took place three months after the start of the intervention and the post-training session (Post) took place six months after the onset of the intervention. During the Pre, Mid and Post sessions, participants completed a series of auditory and cognitive assessments.

Results

Based on the study, six months of self-directed music lessons improved the ability to understand speech in background noise in older adults.

This improvement was related to an increased positivity over frontal-left electrodes from 200 to 1000 ms after the onset of a word. These results suggest that musical training can be used to improve the ability to understand speech-in-noise in older adults by improving how older adults process speech and deploy their attentional resources to speech stimuli.

Discussion

The most critical finding from this study is that music lessons improved the ability to understand speech in noise for older adults.

First, it demonstrates that musical training may have a causal role in improving hearing abilities in older adults. This provides support for previous cross-sectional work demonstrating that older musicians have an advantage in understanding speech in noise compared with older non-musicians1.

Second, it highlights that the brain remains plastic in older adults and is susceptible to modification based on one’s life experiences. In the current context, this is critical as hearing difficulties in older adults are nearly universal2, and one of the most commonly reported hearing difficulties is understanding speech in noisy environments.

Accordingly, the results of this study demonstrate that music-based auditory rehabilitation is likely to be successful in older adults in improving their hearing abilities.

Learn more about musical rehabilitation implications by accessing the publication here and stay tuned for next month’s edition of Journal Club!

References

  1. Parbery-Clark, A., Anderson, S., Hittner, E., Kraus, N., 2012. Musical experience offsets age-related delays in neural timing. Neurobiol. Aging 33, 1483.e1-4.
  2. Gates, G.A., Mills, J.H., 2005. Presbycusis. Lancet 366, 1111e1120.

*All figures and tables are from the reviewed article.

Author

Cochlear Guest Author

In an effort to keep our content fresh and reflective of a diverse industry, Cochlear Americas features a mix of employees and professional partners to contribute to Cochlear ProNews as Guest Authors.

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Artificial Intelligence – Use in Healthcare by Brian Kaplan, MD

August 31, 2018

Research updates

 

By guest author: Brian Kaplan, M.D. – Chair, Department of Otolaryngology-Head and Neck Surgery at Greater Baltimore Medical Center Director, Cochlear Implant Program at Greater Baltimore Medical Center

Artificial Intelligence (AI) has been around for some time. Every day we see another story about the use of artificial intelligence, machine learning or big data in the news. Advances in medicine have often relied on new discoveries in science and now healthcare is being transformed by the use of these advanced technologies.

In 1959, Arthur Samuel was credited with being the first person to realize that we could not teach a computer everything we know in order to complete given tasks. We needed to teach computers how to learn for themselves1. This discovery, along with the advent of the internet, set into motion the ability for computers to take the next step into current state-of-the-art AI and machine learning. In the 1960s, researchers developed the first problem-solving systems in organic chemistry, which is considered the first application of artificial intelligence. By the 1970s, researchers moved from basic science to applications in medicine with attempts to automate diagnosis2. Today, most AI employed in healthcare revolves around classification using deep learning technologies. It is not that AI systems cannot diagnose certain conditions, but the requirement for machine learning has changed from high cognitive function to classifications tasks. This step in the use of technology requires convincing humans that the classifications are accurate, consistent and repeatable. In a recent study, AI systems were found to be able to identify melanomas (through classification) at a higher rate than expert dermatologists and with greater sensitivity and specificity3. However, the most successful AI solutions are those that augment human action rather than replace it.

There was a time when some experts predicted the use of robots in all areas of healthcare, specifically in surgery. Granted there are some rote aspects of surgery that a robot can certainly handle, but the state-of-the-art techniques employed today are robot-assisted surgery. In LASIK surgery, a skilled surgeon uses a robotic device to complete most of the procedure. The surgeon is still responsible for all of the measurements and calculations required during the surgical procedure and is certainly the crucial asset in the case of an emergency or unexpected anatomy. Machines have an innate advantage during rote tasks of being fast, accurate and operate with a lack of bias, but human discernment provides a successful outcome when unanticipated events occur. Robotic capabilities in surgery may eventually allow remote-robotic surgery. This could change clinical care by providing care to patients who may not otherwise receive advanced care. This increase in access to care is beneficial to remote patients and the clinicians who care for them.

New AI tools help medical professionals change their clinical practice and to standardize care. Allowing AI systems to assist professionals can not only standardize care, it can increase productivity. The key to successful use of AI systems is to ensure the human factor never fades from the healthcare appointment. In the study mentioned previously, once the dermatologists were provided with additional information from the patients, their diagnostic accuracy increased and the article concludes that there was no substitute for a thorough clinical examination to provide a full healthcare picture for patients and their providers.

AI is integrated into many aspects of our lives and we should expect that to continue. Growth in the healthcare sector continues to be strong with one source estimating that artificial intelligence in US healthcare will continue at 35% rate for the next eight years4. Many predictors bemoan the hurdles needed to fully integrate AI into mainstream healthcare. Using AI to standardize care provides assistance to professionals, which allows for enhancing the lives of patients and healthcare professionals.

See the references below for more information.

About our guest author: Brian Kaplan, M.D. – Chair, Department of Otolaryngology-Head and Neck Surgery at Greater Baltimore Medical Center Director, Cochlear Implant Program at Greater Baltimore Medical Center

Dr. Kaplan was born and raised in Boston, Massachusetts. He attended Cornell University before enrolling at the University of Virginia for both medical school and residency training. He currently serves as the Chairman of the Department of Otolaryngology, and Director of the Cochlear Implant Program, at the Greater Baltimore Medical Center.

Past research interests have included cartilage and inner ear hair cell regeneration. Clinical studies have involved various ototopical agents, along with hybrid and traditional cochlear implantation.

Dr. Kaplan spent over ten years consulting in the medical device and services space, working with venture, public and private equity. In 2013 he cofounded the technology company Everseat, providing a novel, mobile platform optimizing scheduling efficiency for medical practices, hospitals and health systems. He was a consultant for several years for Cochlear before becoming the Global Head of Clinical Innovation, focusing on modernizing the delivery mechanism and creating the standard of care for cochlear implantation.

He currently resides in Baltimore, Maryland, USA, with his wife and three children.

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  1. https://en.wikipedia.org/wiki/Arthur_Samuel
  2. Uchan, S. February 8th, 2018, blogpost “AI in Medicine – A Historical Perspective” https://rowanalytics.com/blog-post/ai-in-medicine-a-historical-perspective/
  3. Welch, A. May, 29, 2018, CBS NEWS “AI better than dermatologists at detecting skin cancer, study finds” https://www.cbsnews.com/news/ai-better-than-dermatologists-at-detecting-skin-cancer-study-finds/
  4. Taylor, Phil April 13th, 2018, PMLive “Artificial intelligence in healthcare ‘set for 40% growth to 2024’” https://www.pmlive.com/pharma_news/artificial_intelligence_in_healthcare_set_for_40_growth_to_2024_1231723?es_p=6544595
Nucleus System

Cochlear expands treatment options for individuals with single-sided deafness

March 24, 2022

By Ryan Lopez, Director, Nucleus Product Management & Marketing

In January 2022, Cochlear received FDA approval to treat patients with single-sided deafness (SSD) with the Cochlear™ Nucleus® System. This approval expands treatment options to include both bone conduction solutions and cochlear implants for these patients.

“This indication allows patients experiencing UHL/SSD to get as close to the normal condition as possible as a cochlear implant restores hearing ability to the ear that has hearing loss. This allows me to provide for my patients so they can get back to the condition that they had been used to before their hearing loss.”

-Eric Lupo, MD Rocky Mountain Ear Center

While this is an extremely important landmark, we want to ensure that professionals have the resources they need to provide the best treatment option for each individual’s unique hearing loss and needs. The first step in the counseling process is to help candidates understand the potential impact of single-sided deafness within their daily lives. While individuals with SSD can function well in relatively easy listening situations, bringing awareness to the disruption in their ability to understand speech in adverse listening situations, their ability to localize sound, and the mental fatigue associated with daily listening efforts, is vital.

Age and duration of hearing loss is a key consideration and starting point for determining the best solution for individuals with single-sided deafness. For children under five years of age, Cochlear offers Softbands and SoundArcs™, non-surgical bone conduction solutions. This is important because early access to improving speech understanding is of highest priority. For children ages five to twelve, Cochlear expands the bone conduction offering with the Baha® Connect and Attract Systems, as well as a portfolio of Nucleus cochlear implant solutions. Finally, for individuals twelve and older, in addition to cochlear implants, the Cochlear Osia® System combines the best high frequency amplification with unique piezoelectric stimulation without a percutaneous abutment.

With regard to cochlear implants, one of the core advantages is the restoration of binaural hearing and improved ability to localize. Candidacy is dependent on the presence of a functioning nerve in the impacted ear and a duration of less than 10 years since the onset of the hearing loss. With acoustic neuroma being one of the leading causes of unilateral hearing loss, the FDA has approved Cochlear to remove the acoustic neuroma contraindication from its labeling.

This ensures that individuals with a functioning nerve, pre- or post-acoustic neuroma removal, can still have a cochlear implant option.

With more options come more decision points. This is why we’re committed to partnering with leading professionals in the industry and developing clinical guidance tools to support you and your patients throughout the journey to better hearing

Please reach out to your local Cochlear Representative to learn more about these solutions and clinical guidance resources.

Read more about the treatment pathway for SSD patients here.

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