My DEPOSITION in JAN 2019 started with the TURNING ---ON of the COCHLEAR IMPLANT which was installed a 10-12 years ago but TURNED OFF to me----the VICTIM. JAN 2019 that COCHLEAR IMPLANT was TURNED ON and all that FEEDBACK from many different sources flooded my hearing-----I interpreted these FEEDBACK as coming from SURVEILLANCE STRUCTURES inside and outside my living space.
The TURNING ON of this COCHLEAR IMPLANT was not done to HELP me---it was done for PSYCHO-SEXUAL TORTURE to get rid of me because HOSTING SERVER NOSY NEIGHBORS AND THE GANG were tired of LOOKING AT MY STUFF.
NOSY NEIGHBORS AND THE GANG tied to black market criminal 24/7 video PORN and messaging through COCHLEAR IMPLANT were getting sick of 'LISTENING AND LOOKING AT' me wanted to get rid of me ----while global banking 1% needed IMPLANT UPDATE wanted to keep me----although in institutional restrictions.
PORN PEOPLE NOT ABLE TO MAKE MONEY ON OLD CHICK LIKE ME-------GLOBAL MEDICAL CORPORATIONS COULDN'T USE IMPLANTS---WANTED UPDATES.
This is why JAN 2019 was used as HITTING ===TURNING ON that COCHLEAR IMPLANT.
THAT WAS WHAT WAS GOING THROUGH MY BRAIN VERY SUDDENLY AS FEEDBACK WAS COMING FROM SEVERAL DIFFERENT SOURCES.
'Cochlear Implants: The Big 'Switch On' - Hearing Like Mewww.hearinglikeme.com/cochlear-implants-the-big...
Cochlear Implants: The Big ‘Switch On’.
However, after his second and third appointments at the Auditory Implant Centre we suddenly started to see some changes in Harry, and within the first month of activation he turned to us when we called his name, which was one the best moments for us to see'.
I caution our US 99% WE THE PEOPLE---don't think you are not IMPLANTED-----I went a dozen years not knowing. Also, when the SWITCH ON was done----all I knew was there were CAMERAS and MICROPHONES inside and outside my living space. I did not suspect those BRAIN IMPLANTS until several months later.
NOSY NEIGHBORS AND THE GANG wanted new TENET for better STUFF for DARK WEB PORN-------while HOSTING SERVER NOSY NEIGHBORS wanted better video capacity for IMPLANTS---neither could care less ABOUT ME.
Cochlear Implants: The Big ‘Switch On’
by Lucie Herridge at February 29, 2016
After Harry had his cochlear implant operation
I found myself flooded with messages of congratulations that Harry could now hear. Unfortunately, of course, this wasn’t quite the case just yet. The operation was just the beginning and without the external hardware Harry still wasn’t able to access sound. It took a while to explain this to people, and on top of it was the fact we had no idea how successful the op would be until his “magic ears” were activated.The big ‘switch on’ loomed over us like a ridiculously exciting – but nerve wrecking – bubble. We could barely sleep with the anticipation of what the day might bring.
I found myself watching endless videos on YouTube of other babies and adults having their cochlear implants activated, which made that bubble of emotion almost explode. It’s so amazing to see some of the dramatic reactions that you can get from people on their activation day, however it’s also important to remember that everybody responds completely differently.
In fact, most babies and children have barely any reaction at all. I realized quite quickly that I needed to calm down a bit and that it was quite likely we wouldn’t see the huge reaction we had first expected from Harry when he heard his first sound.
Harry healed from his operation extremely quickly. Within a week he was back to his usual, chirpy self and running up and down the house like a little bulldozer!
We were so panicked that he would knock his Advanced Bionic cochlear implant “ears” off his head, but somehow we managed to keep him safe and his scars were soon almost invisible! It was quite difficult keeping Harry away from the park and play grounds, but we knew he needed to heal before risking any unnecessary knocks! It was also tough not letting him have a bath, as he loves the water so much, but we were under strict instruction not to let his scars get wet.
After we had a post op appointment with Harry’s surgeon to remove any stubborn stitches that hadn’t dissolved, we got the all clear for the big ‘switch on’!
The March 4 quickly came around and we headed down to The Auditory Implant Centre in Southampton, England, for what was one of the best moments of our lives. Harry settled into the highchair with a few toys to chew on, then our audiologists attached the external parts of his cochlear implants. This was the first time we had even seen Harry with his co clear implants on. It made me really emotional, but also so proud that my little boy was possibly about to hear his first ever sound!
As they slowly switched his cochlear implants they explained to us that the volume would be kept as low as possible, but hopefully at a level where he could hear it. (The reason they do this is because if they went straight in at quite a loud volume he could have become scared and therefore rejected his new ‘magic ears,’ which of course we didn’t want to happen! It’s best to start off very, very quietly, then let him adjust to this new sense that he previously had not experienced.)
The first beeps were played and we all held our breaths to see a jump, smile, laugh or cry from Harry but we didn’t see any of those.
What we did see was the widest little eyes staring at us almost asking us, “What the hell was that?!” He continued on like this at every beep, and it became quickly very clear that our gorgeous little man was hearing and his CI’s were working!
His audiologists had a few tries at playing some instruments with him to make sure he was at a comfortable level with the volume they would be leaving his new ears on for us to go home and he happily listened along.
_________________________
This article shows the DEVICE I experienced during PSYCHO-SEXUAL TORTURE-------I was trying to locate CAMERA sources and was made aware of LASER LIGHTS dashing from one side of room to another---bedroom and bathroom. I was able to understand this was probably INFRARED CAMERA----needed by NOSY NEIGHBOR PORN mules for video of SEX AND TOILETING when dark.
While listening to SEX TRADE SEX TALK from NOSY NEIGHBORS making fun of SEEING MY STUFF----making sure I knew these PORN images were being seen by ANY MAN AROUND---I was also hearing in FEEDBACK------
WE NEED TO SEE THE EYES-----EYES MOVEMENTS----SHE CANNOT COVER HERSELF.
A normal COCHLEAR IMPLANT adds 8 electrodes of hearing giving a normal range of eight frequencies of sound.
'Eight electrodes can deliver only eight frequencies of sound, Rabbitt says.
What NOSY NEIGHBORS AND THE GANG illegal surveillance and PORN were trying to do was to use INFRARED CAMERAS AND LASERS to tap into MY COCHLEAR IMPLANT-----ergo, they needed to HIT MY EAR while I was sleeping. This was done to create MULTIPLE FREQUENCIES having the ability to SEND MESSAGES on any number of frequencies-----so, SPY CAMERA AND MICROPHONE become SPY MESSAGING via hitting cochlear implants with INFRARED CAMERA/LASERS.
NOSY NEIGHBORS SAY----NO, WE ARE TELEMEDICINE WORKERS ------NOT SPY MESSAGING PEOPLE. WELL, I WAS HEARING FEEDBACK FROM MANY DIFFERENT SOUND FREQUENCIES PEOPLE HAVING DIFFERENT CONVERSATIONS---NOT MEDICAL.
These were simply FRAGMENTS of conversations---I have no inside information from global SEX TRADE CARTEL---- SO, DON'T COME AFTER ME. That's why all this WE HAVE TO KILL HER started for some months.
"A healthy adult can hear more than 3,000 different frequencies. With optical stimulation, there’s a possibility of hearing hundreds or thousands of frequencies instead of eight'.
Meanwhile, HOSTING SERVER NOSY NEIGHBORS tied to being IMPLANT BARBER SURGEONS----could be heard saying------SHE WILL NOW REMEMBER ALL THOSE CONVERSATIONS WE HAD WHILE LOOKING AT HER STUFF.
BOTH BARBER SURGEONS AND PORN SEX TRADE CARTELS WERE WORRIED ABOUT MY REMEMBERING-----WHAT WAS HEARD WHILE COCHLEAR IMPLANT WAS TURNED ---OFF.
This ties to our discussion of BRAIN IMPLANTS and DEMENTIA------the damage done while 24/7 streaming video for each implant over a dozen years.....COGNITIVE LOAD ------SEX TRADE AND MEDICAL ----but, also marketing for corporate product subliminal messaging.
Infrared Light Used to Stimulate Heart and Inner-Ear Cells
March 29th, 2011 Wouter Stomp
Researchers from the University of Utah have succeeded in using infrared light to make rat heart cells contract and toadfish inner-ear cells send signals to the brain. This opens up many possibilities for implants using infrared light instead of electrical impulses to stimulate neurons and body functions.
From the press release:
The scientists exposed the cells to infrared light in the laboratory. The heart cells in the study were newborn rat heart muscle cells called cardiomyocytes, which make the heart pump. The inner-ear cells are hair cells, and came from the inner-ear organ that senses motion of the head. The hair cells came from oyster toadfish, which are well-establish models for comparison with human inner ears and the sense of balance.
Inner-ear hair cells "convert the mechanical vibration from sound, gravity or motion into the signal that goes to the brain" via adjacent nerve cells, says Rabbitt [Richard Rabbitt, professor of bioengineering and senior author of the heart-cell and inner-ear-cell studies].
Using infrared radiation, "we were stimulating the hair cells, and they dumped neurotransmitter onto the neurons that sent signals to the brain," Rabbitt says.
He believes the inner-ear hair cells are activated by infrared radiation because "they are full of mitochondria, which are a primary target of this wavelength."
The infrared radiation affects the flow of calcium ions in and out of mitochondria – something shown by the companion study in neonatal rat heart cells.
That is important because for "excitable" nerve and muscle cells, "calcium is like the trigger for making these cells contract or release neurotransmitter," says Rabbitt.
The heart cell study found that an infrared pulse lasting a mere one-5,000th of a second made mitochondria rapidly suck up calcium ions within a cell, then slowly release them back into the cell – a cycle that makes the cell contract.
Rabbitt believes the research – including a related study of the cochlea last year – could lead to better cochlear implants that would use optical rather than electrical signals.
Existing cochlear implants convert sound into electrical signals, which typically are transmitted to eight electrodes in the cochlea, a part of the inner ear where sound vibrations are converted to nerve signals to the brain. Eight electrodes can deliver only eight frequencies of sound, Rabbitt says.
"A healthy adult can hear more than 3,000 different frequencies. With optical stimulation, there’s a possibility of hearing hundreds or thousands of frequencies instead of eight. Perhaps someday an optical cochlear implant will allow deaf people to once again enjoy music and hear all the nuances in sound that a hearing person would enjoy."
Unlike electrical current, which spreads through tissue and cannot be focused to a point, infrared light can be focused, so numerous wavelengths (corresponding to numerous frequencies of sound) could be aimed at different cells in the inner ear.
Nerve cells that send sound signals from the ears to the brain can fire more than 300 times per second, so ideally, a cochlear implant using infrared light would be able to perform as well. In the Utah experiments, the researchers were able to apply laser pulses to hair cells to make adjacent nerve cells fire up to 100 times per second. For a cochlear implant, the nerve cells would be activated within infrared light instead of the hair cells.
___________________________________
FEEDBACK from NOSY NEIGHBORS had group speak chatter say----
SHE HAS TO READ LIPS HER HEARING IS SO BAD. The subliminal messaging through COCHLEAR IMPLANT does indeed get ME to SAY or REPEAT things I did not think of------ergo, I was saying
BOTH EAR DRUMS WERE BROKEN DURING DIVING----or I HAVE TO READ LIPS MY HEARING IS SO BAD.
"cognitive load" — essentially, that the effort of constantly straining to understand stresses the brain.
If all of the content is processed visually i.e. via text, pictures or animations, the visual channel can become overloaded'.
Different frequencies according to how deep these implants go------one frequency can be turned off----another can be left on.
When my COCHLEAR IMPLANT was installed illegally, unconsented, without my knowledge-----the implants place microchip arrays NEAR AND FAR down ear canal. So, a microphone chip near my EARDRUM could be turned ON or OFF-----as well as a microphone chip FAR from ear drum----cochlea/auditory nerve can be turned ON or OFF.
'In the Utah experiments, the researchers were able to apply laser pulses to hair cells to make adjacent nerve cells fire up to 100 times per second. For a cochlear implant, the nerve cells would be activated within infrared light instead of the hair cells'.
So, from JAN 2019 to today, I could hear FEEDBACK from different sources some days and not hear FEEDBACK from sources another day.
THIS IS INCREDIBLY DISORIENTING. AN AVERAGE PERSON HAVING NO CONCEPT OF THE SCIENCE INVOLVED WOULD NOT BE ABLE TO COMPREHEND WHERE THESE VOICES WERE COMING FROM.
My concern as usual beside LAWSUIT for CRIMINAL ASSAULT-----is how much body damage was done. The big problem with COCHLEAR IMPLANTS is damage to AUDITORY HAIR where all sensations are captured and AUDITORY NERVE.
Ergo, I had minimal hearing loss in one ear but 15 years of COCHLEAR IMPLANT microchip radiation would have destroyed those EAR HAIRS/AUDITORY NERVE.
LOST HEARING FROM IMPLANTS.
Basic science said about COCHLEAR IMPLANTS----they should only be used in people with PROFOUND HEARING LOSS. When implants are used on people with ordinary hearing-----that healthy hearing is DAMAGED/DESTROYED.
This is not rocket science---as well, for seniors these COCHLEAR IMPLANTS are ripe for use in PSYCHO-SEXUAL TORTURE-------driving DOWN physical and mental health-----
OH, SHE IS CRAZY-----LOOK SHE IS DEMENTED.
Please glance through a long, boring article to become familiar with research terms and understand much of this DATA IS FAKE NEWS.
May 2015
Improvement of Cognitive Function After Cochlear Implantation in Elderly Patients
JAMA Otolaryngol Head Neck Surg. 2015;141(5):442-450. doi:10.1001/jamaoto.2015.129
Abstract
Importance
The association between hearing impairment and cognitive decline has been established; however, the effect of cochlear implantation on cognition in profoundly deaf elderly patients is not known.
Objective
To analyze the relationship between cognitive function and hearing restoration with a cochlear implant in elderly patients.
Design, Setting, and Participants Prospective longitudinal study performed in 10 tertiary referral centers between September 1, 2006, and June 30, 2009. The participants included 94 patients aged 65 to 85 years with profound, postlingual hearing loss who were evaluated before, 6 months after, and 12 months after cochlear implantation.
Interventions Cochlear implantation and aural rehabilitation program.
Main Outcomes and Measures
Speech perception was measured using disyllabic word recognition tests in quiet and in noise settings. Cognitive function was assessed using a battery of 6 tests evaluating attention, memory, orientation, executive function, mental flexibility, and fluency (Mini-Mental State Examination, 5-word test, clock-drawing test, verbal fluency test, d2 test of attention, and Trail Making test parts A and B). Quality of life and depression were evaluated using the Nijmegen Cochlear Implant Questionnaire and the Geriatric Depression Scale-4.
Results
Cochlear implantation led to improvements in speech perception in quiet and in noise (at 6 months: in quiet, 42% score increase [95% CI, 35%-49%; P < .001]; in noise, at signal to noise ratio [SNR] +15 dB, 44% [95% CI, 36%-52%, P < .001], at SNR +10 dB, 37% [95% CI 30%-44%; P < .001], and at SNR +5 dB, 27% [95% CI, 20%-33%; P < .001]), quality of life, and Geriatric Depression Scale-4 scores (76% of patients gave responses indicating no depression at 12 months after implantation vs 59% before implantation; P = .02). Before cochlear implantation, 44% of the patients (40 of 91) had abnormal scores on 2 or 3 of 6 cognition tests. One year after implant, 81% of the subgroup (30 of 37) showed improved global cognitive function (no or 1 abnormal test score). Improved mean scores in all cognitive domains were observed as early as 6 months after cochlear implantation. Cognitive performance remained stable in the remaining 19% of the participants (7 of 37). Among patients with the best cognitive performance before implantation (ie, no or 1 abnormal cognitive test score), 24% (12 of 50) displayed a slight decline in cognitive performance. Multivariate analysis to examine the association between cognitive abilities before implantation and the variability in cochlear implant outcomes demonstrated a significant effect only between long-term memory and speech perception in noise at 12 months (SNR +15 dB, P = .01; SNR +10 dB, P < .001; and SNR +5 dB, P = .02).
Conclusions and Relevance
Rehabilitation of hearing communication through cochlear implantation in elderly patients results in improvements in speech perception and cognitive abilities and positively influences their social activity and quality of life. Further research is needed to assess the long-term effect of cochlear implantation on cognitive decline.
Introduction
Large prospective studies have established an independent association between hearing impairment and cognitive decline.1,2 Individuals with mild to severe hearing loss have a 2- to 5-fold increased risk of developing dementia compared with those with normal hearing.1 Moreover, neuroimaging studies3,4 report an association between peripheral hearing impairment and temporal lobe cortex and whole brain atrophy. A combination of several interdependent mechanisms could account for this association, such as vascular risk factors, neurodegenerative processes affecting both peripheral auditory pathways and the cerebral cortex, social isolation, and reduced cognitive stimulation. Based on these reports, hearing rehabilitation using conventional hearing aids has logically been proposed as a treatment to help improve neurocognitive performance; however, the impact of the rehabilitation generated controversial results, with a beneficial effect reported in only half of the elderly groups presented in the 6 published analyses.5-10
In cases of acquired severe to profound hearing loss with no benefit from conventional amplification, cochlear implantation that uses direct electrical stimulation of the auditory nerve has proved to be successful; patients 80 years or older are one of the groups receiving benefit.11,12 Retrospective studies13-24 in the geriatric population report improvement for auditory performance in quiet and noise despite prolonged duration of deafness, as well as age-related degeneration of the spiral ganglion and central auditory pathways. Moreover, similar to younger patients with cochlear implants, most elderly patients who have received implants show an increase in social activities and improved confidence.15,20,25 To the best of our knowledge, the relationship between hearing benefit following cochlear implantation and cognitive abilities in elderly patients has not been investigated.
The objective of this prospective, longitudinal multicenter study was to assess speech perception, cognitive abilities, and quality-of-life scores before implantation and at 6 and 12 months after cochlear implant activation in patients 65 years or older. The focus was to determine the effect of hearing rehabilitation including the cochlear implant on cognitive function in addition to the influence of cognitive factors on cochlear implantation outcomes over time.
Methods
Selection Criteria
Patients enrolled in this study were postlingually deafened, 65 years or older, and candidates for cochlear implantation (ie, bilateral severe to profound sensorineural hearing loss and speech recognition scores of ≤50% for French open-set disyllabic words presented at 60 dB sound pressure level in quiet, in the best-aided condition after verification of the optimal hearing aid fitting). Patients were excluded from the study if they were unable to complete the required procedures owing either to evidence of severe cognitive or medical disorders diagnosed during routine medical and psychological evaluation performed before implantation.
This study was approved by the ethics committee (Comité Consultatif de Protection des Personnes dans la Recherche Biomédicale, Groupe Hospitalier, Pitié-Salpêtrière, Paris, 2007). Written informed consent was obtained from each patient before their enrollment in the study. Participants did not receive financial compensation.
Participants
Ninety-four patients were enrolled between September 1, 2006, and June 30, 2009, in 10 tertiary referral centers in this prospective study. The mean age at implantation was 72 years (range, 65-85 years; median, 71 years). Demographic data, hearing loss information, and the educational level of all patients are summarized in eTable 1 in the Supplement.
Ninety-three patients underwent a unilateral cochlear implantation (50 in the right ear, 43 in the left ear), and 1 patient received simultaneous bilateral implantation. Four implant devices were used (Neurelec, 29 patients MED-EL, 26; Cochlear, 23; and Advanced Bionics, 17). The brand of the device was decided primarily by each referral center during patient counseling, with a view to ensure adequate representation of each of the 4 devices available across the study group. Cochlear implants were activated 2 to 4 weeks after the operation, and subsequent programming sessions were planned to optimize the individual map. All patients entered a postactivation aural rehabilitation program that consisted of individual sessions with a speech therapist, twice weekly, for at least 6 months. This training was based on speech perception tasks and on semantic and cognition tasks that engage memory, attention span, speed of processing, and mental flexibility.
Speech Perception Measures
Speech perception was scored before implantation and at 6 and 12 months after activation in quiet with the device only (hearing aid or cochlear implant) and in best-aided conditions in quiet and in noise. The best-aided condition reflected the patient’s daily listening condition, defined as cochlear implant and a contralateral hearing aid when available or cochlear implant alone, if no contralateral hearing aid was used. Measurements were assessed in a sound-treated room using recorded materials presented at 60 dB sound pressure level from a loudspeaker placed at 0° azimuth. Tests in noise were administrated at a signal to noise ratio (SNR) ranging from +15 dB to 0 dB, with the speech stimuli and a competing white-noise signal presented from the front speaker. Test materials consisted of lists of 10 open-set disyllabic words (Fournier lists26). Two lists of words were presented at each level and responses were scored as the percentage of words correctly identified. The ability of patients to communicate on the telephone with familiar speakers or with strangers was assessed by the use of a questionnaire developed specifically for the study.
Cognitive Measures, Quality-of-Life Assessment, and Depression Scale
Evaluations were performed before implantation and at 6 and 12 months after cochlear implant activation. Participants were assessed by a neuropsychologist with a battery of cognitive tests currently used in the elderly population to explore episodic memory visuospatial abilities, attention span, speed of processing, mental flexibility, rule of compliance, and executive function: Mini-Mental State Examination (MMSE), 5-word test (FWT), clock-drawing test, verbal fluency test, d2 test of attention, and Trail Making Test parts A and B (TMT-A and TMT-B) (descriptions of the tests and relevant references are presented in the eMethods in the Supplement). Before testing, written instructions were given to participants to avoid an overdiagnosis of cognitive impairment due to a misunderstanding of the test procedure in this hearing-impaired population. Results of each test were expressed as normal or abnormal with respect to the published normative data.
Quality of life was assessed using the Nijmegen Cochlear Implant Questionnaire (NCIQ)27 (eMethods in the Supplement). Depressive symptoms were evaluated using the 4-item version of the Geriatric Depression Scale (GDS-4), which is a widely used validated questionnaire for the detection of these symptoms.27,28
Statistical Analysis
Patients’ characteristics and clinical data are reported as the mean (SD) or median (first through third quartiles) for continuous variables and as percentages and 95% CIs for categorical variables. The χ2 and Fisher exact tests (for categorical variables) and paired t test (for continuous variables) were computed to compare the audiologic, cognitive, and quality-of-life scores measured at the different time intervals. All comparisons were 2-tailed, and the level of significance was set at P < .05. The Spearman correlation coefficient was used to identify and quantify relationships between NCIQ scores and speech perception scores. For each variable of interest (cognitive scores), a univariate analysis followed by a multivariate analysis was performed using a generalized linear model to explain the audiologic results (speech perception in quiet and noise) at 12 months after implantation. For univariate analysis, each independent factor was tested and included in a multivariate model if P < .20. Backward selection was then performed, keeping variables with a significance level of α = .05; P < .05 was considered significant. All analyses were performed using SAS, version 9.2 (SAS Institute Inc).
Results
Auditory Rehabilitation
Twelve months after cochlear implantation, 97% of the patients (n = 91) used their cochlear implant all day long. The 3% (3 of 94) who did not use it throughout the day wanted to save battery life. Fifty-seven percent of the patients (54 of 94) still used their hearing aid in the contralateral, nonimplanted ear compared with 64% (60 of 94) before implantation (Fisher exact test, P = .46). Mean speech perception for disyllabic words in quiet and in noise are shown in Figure 1. In quiet, mean speech perception clearly improved 6 months after cochlear implantation compared with the preimplantation scores, both with the cochlear implant only (paired difference, 52% score increase [95% CI, 45%-57%; P < .001]) and in best-aided conditions (paired difference, 42% [95% CI, 35%-49%; P < .001]). Between 6 and 12 months, speech perception scores continued to improve with the cochlear implant alone (paired difference, 6% score increase [95% CI, 1%-10.3%; P = .02]) and in best-aided conditions (paired difference, 6.7% [95% CI, 2.05%-11%; P = .005]). In noise, speech perception scores increased 6 months after cochlear implantation compared with preimplantation scores at each SNR (SNR +15 dB: difference, 44% score increase [95% CI, 36%-52%; P < .001], SNR +10 dB: difference, 37% [95% CI, 30%-44%; P < .001], SNR +5 dB: difference, 27% [95% CI, 20%-33%; P < .001], and SNR 0 dB: difference, 18% [95% CI, 12%-25%; P < .001]). No further significant improvement was observed between 6 and 12 months. Speech perception scores at 12 months in quiet and in noise were similar between patients aged 65 to 74 years and those older than 75 years (unpaired t test).
Before cochlear implantation, 23 of the 94 patients (22%) used the telephone only with familiar speakers. Twelve months after cochlear implantation, 65% of the patients (n = 61) indicated that they were able to use the telephone (P < .001, Fisher exact test), and half of these could do so with unfamiliar speakers. Sixty-one percent (37) of the 61 telephone users were female (P = .03, Fisher exact test).
Discussion
Impact of Hearing
Rehabilitation on Cognitive Functions
This prospective study demonstrates that cochlear implantation improves speech perception in an elderly population in quiet and in noise at 6 months after implantation, which is consistent with previously reported research.11-24 Speech perception continues to improve in quiet between 6 and 12 months, and was shown to remain stable for performance in noise after 6 months. At the same time, our study provides evidence that hearing rehabilitation using cochlear implantation is associated with an improvement in cognitive function in all cognitive domains as early as 6 months after implantation in elderly patients who had abnormal test scores at baseline. More than 80% of the patients (30 of 37) who had the poorest cognitive scores before implantation improved their cognitive function at the 1-year postimplantation interval. In contrast, patients with the best cognitive performance before implantation demonstrated stable results (≤1 abnormal test score), although a slight decline was observed in 24% of the patients. Mean age at implantation was similar between patients with poorer cognitive test results and those with stable or better cognitive test results. Results indicate that cochlear implantation is associated with an improvement in impaired cognitive function early on but may not systematically prevent further deterioration over time.
The effect of cognitive training in older adults has been debated in the literature,29 although, to our knowledge, never investigated specifically in hearing-impaired patients. In the present study, we cannot rule out that improvement in cognitive abilities could be affected by a combined effect of speech perception improvement and cognitive training, the latter being an integral part of aural rehabilitation performed after cochlear implantation. A randomized clinical trial, aimed at additionally analyzing the cognitive benefit of cognitive training with conventional amplification used prior to implantation, could assess the effect of speech therapy alone on cognitive abilities in elderly patients with severe to profound hearing loss.
A learning effect through repeated cognitive testing cannot be ruled out, especially for the tests including the clock-drawing test and FWT. In any case, scores were observed to improve only for 2 patients for the clock-drawing task and decreased for the FWT task. For verbal fluency tests, lists were changed at each session and other cognitive tests are clearly too complex to be learned; therefore, it is unlikely that a test learning effect could influence the outcome of this study.
To date, the effect of hearing rehabilitation on cognitive abilities has been studied only in patients fitted with hearing aids, with a beneficial effect reported in 3 of the 6 published studies.5,7,8 Heterogeneity in the population and variability in methodology across studies are likely to explain the discrepancies in these results. In our work, despite variability in hearing loss duration and in hearing aid use before implantation, participants represent a homogeneous population characterized by a preimplantation, severe to profound sensorineural hearing loss, and a similar postimplantation auditory training program.
The association between peripheral hearing loss and cognitive decline and dementia has been well established in several cross-sectional and longitudinal studies.1,2,9,30-36 Lin36 showed that a greater level of hearing loss is significantly associated with lower scores on cognitive tests, especially for memory and executive function, and concluded that the decline in cognitive performance associated with a 25-dB hearing loss is equivalent to the reduction associated with an older age difference of 7 years. Individuals having hearing loss demonstrated a 30% to 40% accelerated rate of cognitive decline and a 24% increased risk for incident cognitive impairment during a 6-year period compared with participants with normal hearing.9
Mechanisms underlying this association are probably multifactorial. Some studies1-3 suggest that hearing impairment and cognitive decline may share a neurodegenerative process. Histologic changes involved in central auditory dysfunction are unknown; nonetheless, the association between central auditory dysfunction and executive dysfunction and dementia in elderly patients supports this hypothesis.38,39 The evaluation of central auditory disorders was not possible in our cochlear implantation candidates because of the severity of the hearing loss; however, with respect to the significant improvement for speech perception in noise after cochlear implantation, we can speculate that a central auditory dysfunction is unlikely for most of the patients included in this study.
In hearing-impaired patients, the listening effort required to improve communication leads to mental fatigue with a negative effect on cognitive resources being available for other cognitive tasks, resulting in cognitive decline.22,39 Our results suggest that, by improving hearing for verbal communication, cochlear implantation decreases the cognitive load and, as a consequence, may have a positive effect on attention, concentration, and executive function.
OH, REALLY??????????
A socially active lifestyle can prevent cognitive decline in old age, suggesting that social isolation can be an additional causal pathway for cognitive impairment.9,40 Hearing loss impairs social relationships, leading to loneliness and degraded quality of life in elderly persons.9,41,42 The findings of our study demonstrate an improvement in the NCIQ scores in each of its subdomains as early as 6 months after implantation, correlated with the speech perception benefit in quiet and in noise at 12 months. Through these results, which are consistent with those of previous retrospective studies,15,20,25,43,44 we can hypothesize that by improving verbal communication, cochlear implantation restores the possibility for social networking and, as a consequence, has a positive effect on quality of life and social activity that contributes to better cognitive function.
Although an association between hearing impairment and depression in the elderly is still debated, depression has been recognized as a major risk factor for mild cognitive impairment and dementia.30,31,45,46 As a consequence, we can also hypothesize that the reduction in depressive symptoms observed 12 months after implantation could contribute to the improvement of cognitive abilities.
A limitation of our study is the short postimplantation observation interval. A recent study47 reported that at 13.5 years after implantation, 83% of elderly patients who received cochlear implants at age 60 years or older continued to use the implant consistently. In another study,23 elderly patients with unilateral implants maintained their earlier speech perception ability in noise 10 years or more after receiving an implant. Further research is needed within our population to assess the long-term effect of cochlear implant use on cognitive abilities, quality of life, and depression.
Influence of Cognitive Factors on Cochlear Implantation Outcomes
The role of cognitive processing in listening performance in noise and hearing-aid benefit for speech perception tasks has been clearly demonstrated in the elderly population.48-51
Consequently, we examined, via multivariate analysis, whether cognitive abilities before implantation can contribute to variability in cochlear implantation outcomes. We observed that results for the verbal fluency test for letters, which evaluates long-term memory, was the only cognitive test that correlated with speech perception scores in noise. Unexpectedly, neither attention deficit nor executive dysfunction showed a correlation with speech perception scores in noise. Very few studies have evaluated the influence of cognitive factors in adult cochlear implant recipients. Heydebrand et al52 found that better scores for word recognition in quiet were observed in adults with good verbal working memory and learning before implantation (mean age, 54 years; range, 24-80 years).
Poorer speech perception in quiet was observed 2 years after implantation in patients with lower cognitive scores.53 A key limitation of our study is that working memory was not assessed, although it plays a major role in cases of degraded speech information and might account for the correlation between cognition and speech perception scores in the aforementioned studies.51,52 Another limitation of the present study is that we applied basic tests used to evaluate cognitive function in the elderly population. Additional studies more precisely examining the role of specific cognitive factors involved in speech perception in difficult conditions are needed. Finally, one of the selection criteria routinely used in the investigating clinics for cochlear implantation was the absence of major cognitive impairment; indeed, cognitive problems, as well as low motivation, may influence the outcome of hearing rehabilitation.
Conclusions
Epidemiologic studies54 demonstrate that the anticipated number of people aged 60 years or older will double by the year 2050. As a consequence, the number of people with cognitive impairment and dementia will dramatically increase, reaching more than 100 million worldwide by 2050. Because there is no curative treatment available for cognitive decline, clinical research is needed that focuses on identification of risk factors to establish preventive measures that may reduce the burden of the disease. Interventions that could delay dementia onset by 1 year, as well as its progression, would lead to a decrease of more than 9 million in the worldwide prevalence of dementia by 2050.55 Our study demonstrates that hearing rehabilitation using cochlear implants in the elderly is associated with improvements in impaired cognitive function. Further research is needed to evaluate the long-term influence of hearing restoration on cognitive decline and its effect on public health.
_____________________________________
The damage to EAR HAIR is irreplaceable----they don't grow back and the installation of COCHLEAR DEVICE itself can damage those structures. Think of continuous sound stimulation 24/7 natural and messaging coming through IMPLANTS. The radiation from CHIP ARRAYS----along with WEAR AND TEAR on these very soft tissues.
'All of your inner hair cells can occupy the tip of a pin, yet they’re responsible for every single sound you hear—around 100,000 different sound modalities. With so few receptors it makes the ear especially vulnerable'.
Someone with low-level hearing loss---LIKE ME-----with these implants could end being made COMPLETE DEAF.
'Spectral information in the original acoustic signal is encoded in the spatial pattern of stimulation along the implant array.
Mimicking the tonotopic organization of the cochlea, each electrode carries information in a frequency range that, in normal hearing, would be transduced by hair cells and nerve fibers at the portion of the basilar membrane nearest the electrode: electrodes deeper in the cochlea (apical) carry lower frequency information, whereas those closer to the round window (basal) carry higher frequency information (Waltzman & Roland, 2006, chap. 4)'.
'The etiology of this delayed hearing loss after implantation is not well understood.
Possible etiologies include (1) inflammatory cascade (O'Leary et al., 2013) and immunogenic response (Nadol et al., 2008), (2) excitotoxicity from electrical stimulation (Kopelovich et al., 2015), (3)delayed degeneration of hair cells (Eshraghi et al., 2007), spiral ganglion neurons, or their synapses, (4) delayed effects of trauma to intracochlear structures such as the stria vascularis or spiral ligament, (5) progressive alterations in cochlear mechanics due to intracochlear fibrosis and/or new bone formation, or other disease processes such as intracochlear otosclerosis, and (6) post-implantation conductive hearing loss (Chole et al., 2014). Understanding the etiology of delayed post implantation hearing loss is critical for guiding both clinical management of cochlear implant patients with significant residual hearing and future research directed toward improving hearing preservation with cochlear implantation'.
Long term exposure to elements of COCHLEAR IMPLANT kill normal ear hair and other structures ===this is why COCHLEAR IMPLANTS should only be done in people with PROFOUND HEARING LOSS.
I may very well not have hearing in my left ear today WITHOUT an implant.
'High frequencies produce maxima near thebase of the cochlea, whereas low frequencies producemaxima near the apex'.
A Deaf Ear is Not a Dead Ear: Looking Inside the Cochlea With Prof. Helge Rask-Andersen
By MED-EL
Posted 16.05.2018
Today, we are sharing a fascinating contribution from Professor Helge Rask-Andersen, one of the leading researchers in cochlear anatomy and physiology.
Prof. Rask-Andersen is a specialist in ENT & Audiology, an anatomist and electron microscopist, and he is a senior Professor in experimental Otology at the Uppsala University and the Academic Hospital in Uppsala, Sweden. He currently runs the Research Department at the Academic Hospital.
In this article, Prof. Rask-Andersen explains the intricate functions of the cochlea and why structure preservation should be a priority for every cochlear implant surgery—even if there is no residual hearing. He shows why damage to the delicate cochlear structures can have such an adverse effect on the health of the underlying neural structures, and the impact this can have on outcomes with a cochlear implant.
Let’s turn over to Prof. Rask-Andersen and hear his perspective on the importance of respecting and protecting the structures of every cochlea.
The Importance of Structure Preservation in Cochlear Implantation
During my medical studies, I learned electron microscopy and I have been devoted to human inner ear anatomy ever since. My first interest was Meniere’s disease and endolymphatic sac. I have been examining the human cochlea for 30 years now. Since I performed skull base surgery with my teacher, the extremely skilled surgeon Dr. Anders Kinnefors, I have had a deep interest in cochlear and auditory nerve anatomy. At first it was more academic, but with CI it turned into applied anatomy with clinical orientations.
In my research, my most interesting finding was the unique structure and the remarkable conservation of the human auditory nerve. This did not adhere with animal studies. I found that the human auditory nerve cell soma are unmyelinated, denied by many experimentalists. This was not a new finding but together with molecular work, it seemed to explain why the human nerve behaves differently and persists after hair cell loss and deafness; a blessing for the deaf and implanted.
Incredible Intricacy
There are scant and tremendously vulnerable tissue membranes in the inner ear—the Reissner´s membrane is only 3 microns thick—yet they are surrounded by the hardest bone in the body. This makes studies of the human cochlea so difficult. It is the most challenging tissue to study in the entire body and explains why so little is known in humans!
The cilia, often known as hair cells, are around 150–200 nanometer (1 nanometer = 1 one-millionth of a millimeter) in diameter. One can compare it with the diameter of a human hair; that is 30–100 microns (one thousand nanometers = one micron), making hair cells less than a 1/100th the diameter of a human hair.
This image shows the natural beauty of the human organ of hearing—the organ of corti. The green membrane is called the basilar membrane which helps to filter the acoustic frequencies. The cilia project from the surface of the inner (red) and outer (blue) hair cells to the tectorial membrane (lilac). Nerve fibers are yellow. These structures are so precise that a movement equal to the diameter of a hydrogen atom is enough to trigger a neural response. Image taken in Innsbruck, Austria with a Zeiss field emission microscope by Prof. Rask-Andersen together with Annelies Schrott-Fischer, Rudolph Glueckert, and Kristian Pfaller.
At hearing threshold, the shearing forces bend the hair cells less than a nanometer—which is the diameter of a hydrogen atom. Even more intriguing is that we only possess around 3,400 inner hair cells, which are the principal message-conducting cells to the brain; compare that to millions of photoreceptors in the eye. All of your inner hair cells can occupy the tip of a pin, yet they’re responsible for every single sound you hear—around 100,000 different sound modalities. With so few receptors it makes the ear especially vulnerable.
Stria Vascularis: Power Plant of the Cochlea
Our recent findings provide fascinating insight into the molecular structure of the so-called “electric power plant” or stria vascularis located in the lateral wall of the cochlea. It is responsible for the energy production and ion concentration in endolymph and essential for hair cell function.
The lateral wall is called “spiral ligament” (ligamentum spirale). This is wrong! It is not like a ligament, like in the knee, but an amazing architecture of cells that serves like an electric power plant or telephone battery—functioning with potassium ions instead of lithium. Another difference is that it does not need re-charging! All cells have different functions and are extremely well supplied with arterial blood. It is extremely vulnerable and at risk in inner ear surgery.
If the cochlear structures are damaged, the dendrites or nerve fibers connecting hair cells with the cell bodies will likely disappear. Fortunately, this degenerative process seems to stop at the level of the cell bodies but there is probably some degeneration of the cell bodies, at least with time. This cell damage induced by potassium intoxication has little healing capacity.
Immunehistochemistry of the lateral wall of the human cochlea. The different proteins involved in the generation of electricity (know as the endocochlear potential or EP) important for hair cell function are shown in colors. The tissue produces high concentrations of potassium ions (K+) used by the hair cells. The green, red and yellow represent different molecular arrangements of ion transporters. They can also be found in the kidney. Like a car battery, the elements are surrounded by an insulator; here composed of the protein Claudin-11 (green in upper graphic picture). (Liu et al. 2017)
The stria vascularis is partly destroyed in the base during conventional cochleostomies, because drilling damages the inner ear tissues. Bone dust enters the cochlea, and inflammation and fibrosis develop more easily. Today, I think it is valuable to use a technique where drilling of the bone is avoided and the inner surface of the cochlea (endosteum) is not traumatized. However, I must confess that I also sometimes make a cochleostomy, when finding the round window is challenging due to cochlear rotations. Nonetheless, I think it is important to realize the degree of trauma it infers in connection with hearing preservation surgery.
The beautiful “cochlear battery” in the lateral wall of the human cochlea. It is surrounded by an insulator; a protein called Claudin-11. The connexin proteins are abundant here and are of two types (mutated in most cased of congenital deafness). They likely help to transport and recirculate the potassium ions. (Liu et al. 2017)
Staying in the Scala Tympani
It is also important that electrodes do not perforate the structures of the cochlea, especially near the first turn. If the electrode deviates into the scala vestibule, it usually penetrates the scala media, which contains the hair cells. A macrofistula develops and potassium ions will leak out and hair cells will stop working.
Potassium ions also leak around the hair cell bodies and nerve cells which is toxic for them and they will degenerate near the perforation. Several reports suggest that cochlear implant results are better when electrode does not deviate into the scala vestibuli.
This image shows the proper positioning of a cochlear implant electrode array in the scala tympani. This picture was taken in Innsbruck, Austria with a Zeiss field emission microscope by Prof. Rask-Andersen together with Annelies Schrott-Fischer, Rudolph Glueckert and Kristian Pfaller, with rending by Peter Bauer.
The modiolus is also vulnerable and the surface wall (where the CI electrode is located), faces the nerve cell bodies which can easily be damaged. The fluid in the cochlea also mix with the fluid surrounding the ganglion cells, meaning that a toxic inflammation in the cochlea will spread to the nerve.
From everything said, it seems pertinent to say that structural preservation in cochlear implantation surgery should be motivated for every patient, even if there is no residual hearing.
_____________________________________________
OH, WAIT SAY GLOBAL BANKING 1% BARBER SURGEONS-----THERE IS A MEDICAL DEVICE OR PROCEDURE TO FIX WHAT HOSTING SERVER NOSY NEIGHBORS ----DESTROYED IN FAKE RESEARCH STUDIES.
HOSTING SERVER NOSY NEIGHBORS say-----SHE WON'T GET ANY HELP FOR ANY HEALTH ISSUE---because I am REAL LEFT SOCIAL PROGRESSIVE----I care about PEOPLE not PROFITS.
Please assume all of this is FAKE DATA---FAKE NEWS----do not get involved with IMPLANTS or GENETIC MANIPULATIONS---the basic science IS NOT THERE.
'Cochlear Implant Also Uses Gene ... - MIT Technology Review
www.technologyreview.com/s/526906/cochlear...
When the ear’s hair cells degrade and die, the associated neurons also degrade and shrink back into the cochlea. So there’s a physical gap between these atrophied neurons and the electrodes in the...'
REWRITING LIFE say TRANSHUMANISTS ------forcing BLIND AMBITION GOALS on HUMANS without any BASIC SCIENCE creating FAKE evidence-based science DATA to pretend there is SOCIAL BENEFIT----in goals of GMO HUMANS.
Rewriting Life
Cochlear Implant Also Uses Gene Therapy to Improve Hearing
The electrodes in a cochlear implant can be used to direct gene therapy and regrow neurons.
by Katherine Bourzac
Apr 24, 2014
Researchers have demonstrated a new way to restore lost hearing: with a cochlear implant that helps the auditory nerve regenerate by delivering gene therapy.
Growth factor: The cochlear nerve regenerates after gene therapy (top) versus the untreated cochlea from the same animal (bottom).The researchers behind the work are investigating whether electrode-triggered gene therapy could improve other machine-body connections—for example, the deep-brain stimulation probes that are used to treat Parkinson’s disease, or retinal prosthetics.
More than 300,000 people worldwide have cochlear implants.
THAT WOULD BE FAKE DATA----FAKE NEWS----COCHLEAR IMPLANTS ARE COMMON.
The devices are implanted in patients who are profoundly deaf, having lost most or all of the ear’s hair cells, which detect sound waves through mechanical vibrations, and convert those vibrations into electrical signals that are picked up by neurons in the auditory nerve and passed along to the brain. Cochlear implants use up to 22 platinum electrodes to stimulate the auditory nerve; the devices make a tremendous difference for people but they restore only a fraction of normal hearing.
“Cochlear implants are very effective for picking up speech, but they struggle to reproduce pitch, spectral range, and dynamics,” says Gary Housley, a neuroscientist at the University of New South Wales in Sydney, Australia, who led development of the new implant.
Cyborg cavy: An Xray image shows the cochlear implant in the left ear of a guinea pig.When the ear’s hair cells degrade and die, the associated neurons also degrade and shrink back into the cochlea. So there’s a physical gap between these atrophied neurons and the electrodes in the cochlear implant. Improving the interface between nerves and electrodes should make it possible to use weaker electrical stimulation, opening up the possibility of stimulating multiple parts of the auditory nerve at once, using more electrodes, and improving the overall quality of sound.
Peptides called neurotrophins can encourage regeneration of the neurons in the auditory nerve. Housley used a common process, called electroporation, to cause pores to open up in cells, allowing DNA to get inside. It usually requires high voltages, and it hasn’t found much clinical use, but Housley wanted to see whether the small, distributed electrodes of the cochlear implant could be used to achieve the effect.
Housley’s group used deafened guinea pigs, which are commonly used as a hearing model because their cochleas are similar in size to those found in humans. During surgery to place the cochlear implant, they injected the cochlea with a neurotrophin gene vector. Once the implant was placed, they applied an electroporation voltage using the electrodes. The process, which took only a few seconds during surgery, resulted in nerve regeneration in the animals. And weeks after implantation, the nerves of treated animals showed stronger responses to signals from the implant, which suggests they are able to hear more. This research is described this week in the journal Science Translational Medicine.
“Clearly this works—in a guinea pig,” says Lawrence Lustig, director of the Cochlear Implant Center at the University of California, San Francisco Medical Center. Lustig’s group and others have been exploring gene therapy, but they use a virus to deliver the neurotrophin gene.
Robert Shepherd, director of the Bionics Institute, a nonprofit medical research center in Melbourne, Australia, says electrode-directed gene therapy could improve other kinds of neural interfaces. “Wherever we’re applying electrodes, whether it’s for deep-brain stimulation in Parkinson’s disease, or retinal implants for the blind, there is already neural damage,” he says.
Housley’s group is working with Cochlear, a major maker of cochlear implants headquartered in Sydney, to test the electrode and gene-therapy combination in a clinical trial.
The TURNING ON of this COCHLEAR IMPLANT was not done to HELP me---it was done for PSYCHO-SEXUAL TORTURE to get rid of me because HOSTING SERVER NOSY NEIGHBORS AND THE GANG were tired of LOOKING AT MY STUFF.
NOSY NEIGHBORS AND THE GANG tied to black market criminal 24/7 video PORN and messaging through COCHLEAR IMPLANT were getting sick of 'LISTENING AND LOOKING AT' me wanted to get rid of me ----while global banking 1% needed IMPLANT UPDATE wanted to keep me----although in institutional restrictions.
PORN PEOPLE NOT ABLE TO MAKE MONEY ON OLD CHICK LIKE ME-------GLOBAL MEDICAL CORPORATIONS COULDN'T USE IMPLANTS---WANTED UPDATES.
This is why JAN 2019 was used as HITTING ===TURNING ON that COCHLEAR IMPLANT.
THAT WAS WHAT WAS GOING THROUGH MY BRAIN VERY SUDDENLY AS FEEDBACK WAS COMING FROM SEVERAL DIFFERENT SOURCES.
'Cochlear Implants: The Big 'Switch On' - Hearing Like Mewww.hearinglikeme.com/cochlear-implants-the-big...
Cochlear Implants: The Big ‘Switch On’.
However, after his second and third appointments at the Auditory Implant Centre we suddenly started to see some changes in Harry, and within the first month of activation he turned to us when we called his name, which was one the best moments for us to see'.
I caution our US 99% WE THE PEOPLE---don't think you are not IMPLANTED-----I went a dozen years not knowing. Also, when the SWITCH ON was done----all I knew was there were CAMERAS and MICROPHONES inside and outside my living space. I did not suspect those BRAIN IMPLANTS until several months later.
NOSY NEIGHBORS AND THE GANG wanted new TENET for better STUFF for DARK WEB PORN-------while HOSTING SERVER NOSY NEIGHBORS wanted better video capacity for IMPLANTS---neither could care less ABOUT ME.
Cochlear Implants: The Big ‘Switch On’
by Lucie Herridge at February 29, 2016
After Harry had his cochlear implant operation
I found myself flooded with messages of congratulations that Harry could now hear. Unfortunately, of course, this wasn’t quite the case just yet. The operation was just the beginning and without the external hardware Harry still wasn’t able to access sound. It took a while to explain this to people, and on top of it was the fact we had no idea how successful the op would be until his “magic ears” were activated.The big ‘switch on’ loomed over us like a ridiculously exciting – but nerve wrecking – bubble. We could barely sleep with the anticipation of what the day might bring.
I found myself watching endless videos on YouTube of other babies and adults having their cochlear implants activated, which made that bubble of emotion almost explode. It’s so amazing to see some of the dramatic reactions that you can get from people on their activation day, however it’s also important to remember that everybody responds completely differently.
In fact, most babies and children have barely any reaction at all. I realized quite quickly that I needed to calm down a bit and that it was quite likely we wouldn’t see the huge reaction we had first expected from Harry when he heard his first sound.
Harry healed from his operation extremely quickly. Within a week he was back to his usual, chirpy self and running up and down the house like a little bulldozer!
We were so panicked that he would knock his Advanced Bionic cochlear implant “ears” off his head, but somehow we managed to keep him safe and his scars were soon almost invisible! It was quite difficult keeping Harry away from the park and play grounds, but we knew he needed to heal before risking any unnecessary knocks! It was also tough not letting him have a bath, as he loves the water so much, but we were under strict instruction not to let his scars get wet.
After we had a post op appointment with Harry’s surgeon to remove any stubborn stitches that hadn’t dissolved, we got the all clear for the big ‘switch on’!
The March 4 quickly came around and we headed down to The Auditory Implant Centre in Southampton, England, for what was one of the best moments of our lives. Harry settled into the highchair with a few toys to chew on, then our audiologists attached the external parts of his cochlear implants. This was the first time we had even seen Harry with his co clear implants on. It made me really emotional, but also so proud that my little boy was possibly about to hear his first ever sound!
As they slowly switched his cochlear implants they explained to us that the volume would be kept as low as possible, but hopefully at a level where he could hear it. (The reason they do this is because if they went straight in at quite a loud volume he could have become scared and therefore rejected his new ‘magic ears,’ which of course we didn’t want to happen! It’s best to start off very, very quietly, then let him adjust to this new sense that he previously had not experienced.)
The first beeps were played and we all held our breaths to see a jump, smile, laugh or cry from Harry but we didn’t see any of those.
What we did see was the widest little eyes staring at us almost asking us, “What the hell was that?!” He continued on like this at every beep, and it became quickly very clear that our gorgeous little man was hearing and his CI’s were working!
His audiologists had a few tries at playing some instruments with him to make sure he was at a comfortable level with the volume they would be leaving his new ears on for us to go home and he happily listened along.
_________________________
This article shows the DEVICE I experienced during PSYCHO-SEXUAL TORTURE-------I was trying to locate CAMERA sources and was made aware of LASER LIGHTS dashing from one side of room to another---bedroom and bathroom. I was able to understand this was probably INFRARED CAMERA----needed by NOSY NEIGHBOR PORN mules for video of SEX AND TOILETING when dark.
While listening to SEX TRADE SEX TALK from NOSY NEIGHBORS making fun of SEEING MY STUFF----making sure I knew these PORN images were being seen by ANY MAN AROUND---I was also hearing in FEEDBACK------
WE NEED TO SEE THE EYES-----EYES MOVEMENTS----SHE CANNOT COVER HERSELF.
A normal COCHLEAR IMPLANT adds 8 electrodes of hearing giving a normal range of eight frequencies of sound.
'Eight electrodes can deliver only eight frequencies of sound, Rabbitt says.
What NOSY NEIGHBORS AND THE GANG illegal surveillance and PORN were trying to do was to use INFRARED CAMERAS AND LASERS to tap into MY COCHLEAR IMPLANT-----ergo, they needed to HIT MY EAR while I was sleeping. This was done to create MULTIPLE FREQUENCIES having the ability to SEND MESSAGES on any number of frequencies-----so, SPY CAMERA AND MICROPHONE become SPY MESSAGING via hitting cochlear implants with INFRARED CAMERA/LASERS.
NOSY NEIGHBORS SAY----NO, WE ARE TELEMEDICINE WORKERS ------NOT SPY MESSAGING PEOPLE. WELL, I WAS HEARING FEEDBACK FROM MANY DIFFERENT SOUND FREQUENCIES PEOPLE HAVING DIFFERENT CONVERSATIONS---NOT MEDICAL.
These were simply FRAGMENTS of conversations---I have no inside information from global SEX TRADE CARTEL---- SO, DON'T COME AFTER ME. That's why all this WE HAVE TO KILL HER started for some months.
"A healthy adult can hear more than 3,000 different frequencies. With optical stimulation, there’s a possibility of hearing hundreds or thousands of frequencies instead of eight'.
Meanwhile, HOSTING SERVER NOSY NEIGHBORS tied to being IMPLANT BARBER SURGEONS----could be heard saying------SHE WILL NOW REMEMBER ALL THOSE CONVERSATIONS WE HAD WHILE LOOKING AT HER STUFF.
BOTH BARBER SURGEONS AND PORN SEX TRADE CARTELS WERE WORRIED ABOUT MY REMEMBERING-----WHAT WAS HEARD WHILE COCHLEAR IMPLANT WAS TURNED ---OFF.
This ties to our discussion of BRAIN IMPLANTS and DEMENTIA------the damage done while 24/7 streaming video for each implant over a dozen years.....COGNITIVE LOAD ------SEX TRADE AND MEDICAL ----but, also marketing for corporate product subliminal messaging.
Infrared Light Used to Stimulate Heart and Inner-Ear Cells
March 29th, 2011 Wouter Stomp
Researchers from the University of Utah have succeeded in using infrared light to make rat heart cells contract and toadfish inner-ear cells send signals to the brain. This opens up many possibilities for implants using infrared light instead of electrical impulses to stimulate neurons and body functions.
From the press release:
The scientists exposed the cells to infrared light in the laboratory. The heart cells in the study were newborn rat heart muscle cells called cardiomyocytes, which make the heart pump. The inner-ear cells are hair cells, and came from the inner-ear organ that senses motion of the head. The hair cells came from oyster toadfish, which are well-establish models for comparison with human inner ears and the sense of balance.
Inner-ear hair cells "convert the mechanical vibration from sound, gravity or motion into the signal that goes to the brain" via adjacent nerve cells, says Rabbitt [Richard Rabbitt, professor of bioengineering and senior author of the heart-cell and inner-ear-cell studies].
Using infrared radiation, "we were stimulating the hair cells, and they dumped neurotransmitter onto the neurons that sent signals to the brain," Rabbitt says.
He believes the inner-ear hair cells are activated by infrared radiation because "they are full of mitochondria, which are a primary target of this wavelength."
The infrared radiation affects the flow of calcium ions in and out of mitochondria – something shown by the companion study in neonatal rat heart cells.
That is important because for "excitable" nerve and muscle cells, "calcium is like the trigger for making these cells contract or release neurotransmitter," says Rabbitt.
The heart cell study found that an infrared pulse lasting a mere one-5,000th of a second made mitochondria rapidly suck up calcium ions within a cell, then slowly release them back into the cell – a cycle that makes the cell contract.
Rabbitt believes the research – including a related study of the cochlea last year – could lead to better cochlear implants that would use optical rather than electrical signals.
Existing cochlear implants convert sound into electrical signals, which typically are transmitted to eight electrodes in the cochlea, a part of the inner ear where sound vibrations are converted to nerve signals to the brain. Eight electrodes can deliver only eight frequencies of sound, Rabbitt says.
"A healthy adult can hear more than 3,000 different frequencies. With optical stimulation, there’s a possibility of hearing hundreds or thousands of frequencies instead of eight. Perhaps someday an optical cochlear implant will allow deaf people to once again enjoy music and hear all the nuances in sound that a hearing person would enjoy."
Unlike electrical current, which spreads through tissue and cannot be focused to a point, infrared light can be focused, so numerous wavelengths (corresponding to numerous frequencies of sound) could be aimed at different cells in the inner ear.
Nerve cells that send sound signals from the ears to the brain can fire more than 300 times per second, so ideally, a cochlear implant using infrared light would be able to perform as well. In the Utah experiments, the researchers were able to apply laser pulses to hair cells to make adjacent nerve cells fire up to 100 times per second. For a cochlear implant, the nerve cells would be activated within infrared light instead of the hair cells.
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FEEDBACK from NOSY NEIGHBORS had group speak chatter say----
SHE HAS TO READ LIPS HER HEARING IS SO BAD. The subliminal messaging through COCHLEAR IMPLANT does indeed get ME to SAY or REPEAT things I did not think of------ergo, I was saying
BOTH EAR DRUMS WERE BROKEN DURING DIVING----or I HAVE TO READ LIPS MY HEARING IS SO BAD.
"cognitive load" — essentially, that the effort of constantly straining to understand stresses the brain.
If all of the content is processed visually i.e. via text, pictures or animations, the visual channel can become overloaded'.
Different frequencies according to how deep these implants go------one frequency can be turned off----another can be left on.
When my COCHLEAR IMPLANT was installed illegally, unconsented, without my knowledge-----the implants place microchip arrays NEAR AND FAR down ear canal. So, a microphone chip near my EARDRUM could be turned ON or OFF-----as well as a microphone chip FAR from ear drum----cochlea/auditory nerve can be turned ON or OFF.
'In the Utah experiments, the researchers were able to apply laser pulses to hair cells to make adjacent nerve cells fire up to 100 times per second. For a cochlear implant, the nerve cells would be activated within infrared light instead of the hair cells'.
So, from JAN 2019 to today, I could hear FEEDBACK from different sources some days and not hear FEEDBACK from sources another day.
THIS IS INCREDIBLY DISORIENTING. AN AVERAGE PERSON HAVING NO CONCEPT OF THE SCIENCE INVOLVED WOULD NOT BE ABLE TO COMPREHEND WHERE THESE VOICES WERE COMING FROM.
My concern as usual beside LAWSUIT for CRIMINAL ASSAULT-----is how much body damage was done. The big problem with COCHLEAR IMPLANTS is damage to AUDITORY HAIR where all sensations are captured and AUDITORY NERVE.
Ergo, I had minimal hearing loss in one ear but 15 years of COCHLEAR IMPLANT microchip radiation would have destroyed those EAR HAIRS/AUDITORY NERVE.
LOST HEARING FROM IMPLANTS.
Basic science said about COCHLEAR IMPLANTS----they should only be used in people with PROFOUND HEARING LOSS. When implants are used on people with ordinary hearing-----that healthy hearing is DAMAGED/DESTROYED.
This is not rocket science---as well, for seniors these COCHLEAR IMPLANTS are ripe for use in PSYCHO-SEXUAL TORTURE-------driving DOWN physical and mental health-----
OH, SHE IS CRAZY-----LOOK SHE IS DEMENTED.
Please glance through a long, boring article to become familiar with research terms and understand much of this DATA IS FAKE NEWS.
May 2015
Improvement of Cognitive Function After Cochlear Implantation in Elderly Patients
JAMA Otolaryngol Head Neck Surg. 2015;141(5):442-450. doi:10.1001/jamaoto.2015.129
Abstract
Importance
The association between hearing impairment and cognitive decline has been established; however, the effect of cochlear implantation on cognition in profoundly deaf elderly patients is not known.
Objective
To analyze the relationship between cognitive function and hearing restoration with a cochlear implant in elderly patients.
Design, Setting, and Participants Prospective longitudinal study performed in 10 tertiary referral centers between September 1, 2006, and June 30, 2009. The participants included 94 patients aged 65 to 85 years with profound, postlingual hearing loss who were evaluated before, 6 months after, and 12 months after cochlear implantation.
Interventions Cochlear implantation and aural rehabilitation program.
Main Outcomes and Measures
Speech perception was measured using disyllabic word recognition tests in quiet and in noise settings. Cognitive function was assessed using a battery of 6 tests evaluating attention, memory, orientation, executive function, mental flexibility, and fluency (Mini-Mental State Examination, 5-word test, clock-drawing test, verbal fluency test, d2 test of attention, and Trail Making test parts A and B). Quality of life and depression were evaluated using the Nijmegen Cochlear Implant Questionnaire and the Geriatric Depression Scale-4.
Results
Cochlear implantation led to improvements in speech perception in quiet and in noise (at 6 months: in quiet, 42% score increase [95% CI, 35%-49%; P < .001]; in noise, at signal to noise ratio [SNR] +15 dB, 44% [95% CI, 36%-52%, P < .001], at SNR +10 dB, 37% [95% CI 30%-44%; P < .001], and at SNR +5 dB, 27% [95% CI, 20%-33%; P < .001]), quality of life, and Geriatric Depression Scale-4 scores (76% of patients gave responses indicating no depression at 12 months after implantation vs 59% before implantation; P = .02). Before cochlear implantation, 44% of the patients (40 of 91) had abnormal scores on 2 or 3 of 6 cognition tests. One year after implant, 81% of the subgroup (30 of 37) showed improved global cognitive function (no or 1 abnormal test score). Improved mean scores in all cognitive domains were observed as early as 6 months after cochlear implantation. Cognitive performance remained stable in the remaining 19% of the participants (7 of 37). Among patients with the best cognitive performance before implantation (ie, no or 1 abnormal cognitive test score), 24% (12 of 50) displayed a slight decline in cognitive performance. Multivariate analysis to examine the association between cognitive abilities before implantation and the variability in cochlear implant outcomes demonstrated a significant effect only between long-term memory and speech perception in noise at 12 months (SNR +15 dB, P = .01; SNR +10 dB, P < .001; and SNR +5 dB, P = .02).
Conclusions and Relevance
Rehabilitation of hearing communication through cochlear implantation in elderly patients results in improvements in speech perception and cognitive abilities and positively influences their social activity and quality of life. Further research is needed to assess the long-term effect of cochlear implantation on cognitive decline.
Introduction
Large prospective studies have established an independent association between hearing impairment and cognitive decline.1,2 Individuals with mild to severe hearing loss have a 2- to 5-fold increased risk of developing dementia compared with those with normal hearing.1 Moreover, neuroimaging studies3,4 report an association between peripheral hearing impairment and temporal lobe cortex and whole brain atrophy. A combination of several interdependent mechanisms could account for this association, such as vascular risk factors, neurodegenerative processes affecting both peripheral auditory pathways and the cerebral cortex, social isolation, and reduced cognitive stimulation. Based on these reports, hearing rehabilitation using conventional hearing aids has logically been proposed as a treatment to help improve neurocognitive performance; however, the impact of the rehabilitation generated controversial results, with a beneficial effect reported in only half of the elderly groups presented in the 6 published analyses.5-10
In cases of acquired severe to profound hearing loss with no benefit from conventional amplification, cochlear implantation that uses direct electrical stimulation of the auditory nerve has proved to be successful; patients 80 years or older are one of the groups receiving benefit.11,12 Retrospective studies13-24 in the geriatric population report improvement for auditory performance in quiet and noise despite prolonged duration of deafness, as well as age-related degeneration of the spiral ganglion and central auditory pathways. Moreover, similar to younger patients with cochlear implants, most elderly patients who have received implants show an increase in social activities and improved confidence.15,20,25 To the best of our knowledge, the relationship between hearing benefit following cochlear implantation and cognitive abilities in elderly patients has not been investigated.
The objective of this prospective, longitudinal multicenter study was to assess speech perception, cognitive abilities, and quality-of-life scores before implantation and at 6 and 12 months after cochlear implant activation in patients 65 years or older. The focus was to determine the effect of hearing rehabilitation including the cochlear implant on cognitive function in addition to the influence of cognitive factors on cochlear implantation outcomes over time.
Methods
Selection Criteria
Patients enrolled in this study were postlingually deafened, 65 years or older, and candidates for cochlear implantation (ie, bilateral severe to profound sensorineural hearing loss and speech recognition scores of ≤50% for French open-set disyllabic words presented at 60 dB sound pressure level in quiet, in the best-aided condition after verification of the optimal hearing aid fitting). Patients were excluded from the study if they were unable to complete the required procedures owing either to evidence of severe cognitive or medical disorders diagnosed during routine medical and psychological evaluation performed before implantation.
This study was approved by the ethics committee (Comité Consultatif de Protection des Personnes dans la Recherche Biomédicale, Groupe Hospitalier, Pitié-Salpêtrière, Paris, 2007). Written informed consent was obtained from each patient before their enrollment in the study. Participants did not receive financial compensation.
Participants
Ninety-four patients were enrolled between September 1, 2006, and June 30, 2009, in 10 tertiary referral centers in this prospective study. The mean age at implantation was 72 years (range, 65-85 years; median, 71 years). Demographic data, hearing loss information, and the educational level of all patients are summarized in eTable 1 in the Supplement.
Ninety-three patients underwent a unilateral cochlear implantation (50 in the right ear, 43 in the left ear), and 1 patient received simultaneous bilateral implantation. Four implant devices were used (Neurelec, 29 patients MED-EL, 26; Cochlear, 23; and Advanced Bionics, 17). The brand of the device was decided primarily by each referral center during patient counseling, with a view to ensure adequate representation of each of the 4 devices available across the study group. Cochlear implants were activated 2 to 4 weeks after the operation, and subsequent programming sessions were planned to optimize the individual map. All patients entered a postactivation aural rehabilitation program that consisted of individual sessions with a speech therapist, twice weekly, for at least 6 months. This training was based on speech perception tasks and on semantic and cognition tasks that engage memory, attention span, speed of processing, and mental flexibility.
Speech Perception Measures
Speech perception was scored before implantation and at 6 and 12 months after activation in quiet with the device only (hearing aid or cochlear implant) and in best-aided conditions in quiet and in noise. The best-aided condition reflected the patient’s daily listening condition, defined as cochlear implant and a contralateral hearing aid when available or cochlear implant alone, if no contralateral hearing aid was used. Measurements were assessed in a sound-treated room using recorded materials presented at 60 dB sound pressure level from a loudspeaker placed at 0° azimuth. Tests in noise were administrated at a signal to noise ratio (SNR) ranging from +15 dB to 0 dB, with the speech stimuli and a competing white-noise signal presented from the front speaker. Test materials consisted of lists of 10 open-set disyllabic words (Fournier lists26). Two lists of words were presented at each level and responses were scored as the percentage of words correctly identified. The ability of patients to communicate on the telephone with familiar speakers or with strangers was assessed by the use of a questionnaire developed specifically for the study.
Cognitive Measures, Quality-of-Life Assessment, and Depression Scale
Evaluations were performed before implantation and at 6 and 12 months after cochlear implant activation. Participants were assessed by a neuropsychologist with a battery of cognitive tests currently used in the elderly population to explore episodic memory visuospatial abilities, attention span, speed of processing, mental flexibility, rule of compliance, and executive function: Mini-Mental State Examination (MMSE), 5-word test (FWT), clock-drawing test, verbal fluency test, d2 test of attention, and Trail Making Test parts A and B (TMT-A and TMT-B) (descriptions of the tests and relevant references are presented in the eMethods in the Supplement). Before testing, written instructions were given to participants to avoid an overdiagnosis of cognitive impairment due to a misunderstanding of the test procedure in this hearing-impaired population. Results of each test were expressed as normal or abnormal with respect to the published normative data.
Quality of life was assessed using the Nijmegen Cochlear Implant Questionnaire (NCIQ)27 (eMethods in the Supplement). Depressive symptoms were evaluated using the 4-item version of the Geriatric Depression Scale (GDS-4), which is a widely used validated questionnaire for the detection of these symptoms.27,28
Statistical Analysis
Patients’ characteristics and clinical data are reported as the mean (SD) or median (first through third quartiles) for continuous variables and as percentages and 95% CIs for categorical variables. The χ2 and Fisher exact tests (for categorical variables) and paired t test (for continuous variables) were computed to compare the audiologic, cognitive, and quality-of-life scores measured at the different time intervals. All comparisons were 2-tailed, and the level of significance was set at P < .05. The Spearman correlation coefficient was used to identify and quantify relationships between NCIQ scores and speech perception scores. For each variable of interest (cognitive scores), a univariate analysis followed by a multivariate analysis was performed using a generalized linear model to explain the audiologic results (speech perception in quiet and noise) at 12 months after implantation. For univariate analysis, each independent factor was tested and included in a multivariate model if P < .20. Backward selection was then performed, keeping variables with a significance level of α = .05; P < .05 was considered significant. All analyses were performed using SAS, version 9.2 (SAS Institute Inc).
Results
Auditory Rehabilitation
Twelve months after cochlear implantation, 97% of the patients (n = 91) used their cochlear implant all day long. The 3% (3 of 94) who did not use it throughout the day wanted to save battery life. Fifty-seven percent of the patients (54 of 94) still used their hearing aid in the contralateral, nonimplanted ear compared with 64% (60 of 94) before implantation (Fisher exact test, P = .46). Mean speech perception for disyllabic words in quiet and in noise are shown in Figure 1. In quiet, mean speech perception clearly improved 6 months after cochlear implantation compared with the preimplantation scores, both with the cochlear implant only (paired difference, 52% score increase [95% CI, 45%-57%; P < .001]) and in best-aided conditions (paired difference, 42% [95% CI, 35%-49%; P < .001]). Between 6 and 12 months, speech perception scores continued to improve with the cochlear implant alone (paired difference, 6% score increase [95% CI, 1%-10.3%; P = .02]) and in best-aided conditions (paired difference, 6.7% [95% CI, 2.05%-11%; P = .005]). In noise, speech perception scores increased 6 months after cochlear implantation compared with preimplantation scores at each SNR (SNR +15 dB: difference, 44% score increase [95% CI, 36%-52%; P < .001], SNR +10 dB: difference, 37% [95% CI, 30%-44%; P < .001], SNR +5 dB: difference, 27% [95% CI, 20%-33%; P < .001], and SNR 0 dB: difference, 18% [95% CI, 12%-25%; P < .001]). No further significant improvement was observed between 6 and 12 months. Speech perception scores at 12 months in quiet and in noise were similar between patients aged 65 to 74 years and those older than 75 years (unpaired t test).
Before cochlear implantation, 23 of the 94 patients (22%) used the telephone only with familiar speakers. Twelve months after cochlear implantation, 65% of the patients (n = 61) indicated that they were able to use the telephone (P < .001, Fisher exact test), and half of these could do so with unfamiliar speakers. Sixty-one percent (37) of the 61 telephone users were female (P = .03, Fisher exact test).
Discussion
Impact of Hearing
Rehabilitation on Cognitive Functions
This prospective study demonstrates that cochlear implantation improves speech perception in an elderly population in quiet and in noise at 6 months after implantation, which is consistent with previously reported research.11-24 Speech perception continues to improve in quiet between 6 and 12 months, and was shown to remain stable for performance in noise after 6 months. At the same time, our study provides evidence that hearing rehabilitation using cochlear implantation is associated with an improvement in cognitive function in all cognitive domains as early as 6 months after implantation in elderly patients who had abnormal test scores at baseline. More than 80% of the patients (30 of 37) who had the poorest cognitive scores before implantation improved their cognitive function at the 1-year postimplantation interval. In contrast, patients with the best cognitive performance before implantation demonstrated stable results (≤1 abnormal test score), although a slight decline was observed in 24% of the patients. Mean age at implantation was similar between patients with poorer cognitive test results and those with stable or better cognitive test results. Results indicate that cochlear implantation is associated with an improvement in impaired cognitive function early on but may not systematically prevent further deterioration over time.
The effect of cognitive training in older adults has been debated in the literature,29 although, to our knowledge, never investigated specifically in hearing-impaired patients. In the present study, we cannot rule out that improvement in cognitive abilities could be affected by a combined effect of speech perception improvement and cognitive training, the latter being an integral part of aural rehabilitation performed after cochlear implantation. A randomized clinical trial, aimed at additionally analyzing the cognitive benefit of cognitive training with conventional amplification used prior to implantation, could assess the effect of speech therapy alone on cognitive abilities in elderly patients with severe to profound hearing loss.
A learning effect through repeated cognitive testing cannot be ruled out, especially for the tests including the clock-drawing test and FWT. In any case, scores were observed to improve only for 2 patients for the clock-drawing task and decreased for the FWT task. For verbal fluency tests, lists were changed at each session and other cognitive tests are clearly too complex to be learned; therefore, it is unlikely that a test learning effect could influence the outcome of this study.
To date, the effect of hearing rehabilitation on cognitive abilities has been studied only in patients fitted with hearing aids, with a beneficial effect reported in 3 of the 6 published studies.5,7,8 Heterogeneity in the population and variability in methodology across studies are likely to explain the discrepancies in these results. In our work, despite variability in hearing loss duration and in hearing aid use before implantation, participants represent a homogeneous population characterized by a preimplantation, severe to profound sensorineural hearing loss, and a similar postimplantation auditory training program.
The association between peripheral hearing loss and cognitive decline and dementia has been well established in several cross-sectional and longitudinal studies.1,2,9,30-36 Lin36 showed that a greater level of hearing loss is significantly associated with lower scores on cognitive tests, especially for memory and executive function, and concluded that the decline in cognitive performance associated with a 25-dB hearing loss is equivalent to the reduction associated with an older age difference of 7 years. Individuals having hearing loss demonstrated a 30% to 40% accelerated rate of cognitive decline and a 24% increased risk for incident cognitive impairment during a 6-year period compared with participants with normal hearing.9
Mechanisms underlying this association are probably multifactorial. Some studies1-3 suggest that hearing impairment and cognitive decline may share a neurodegenerative process. Histologic changes involved in central auditory dysfunction are unknown; nonetheless, the association between central auditory dysfunction and executive dysfunction and dementia in elderly patients supports this hypothesis.38,39 The evaluation of central auditory disorders was not possible in our cochlear implantation candidates because of the severity of the hearing loss; however, with respect to the significant improvement for speech perception in noise after cochlear implantation, we can speculate that a central auditory dysfunction is unlikely for most of the patients included in this study.
In hearing-impaired patients, the listening effort required to improve communication leads to mental fatigue with a negative effect on cognitive resources being available for other cognitive tasks, resulting in cognitive decline.22,39 Our results suggest that, by improving hearing for verbal communication, cochlear implantation decreases the cognitive load and, as a consequence, may have a positive effect on attention, concentration, and executive function.
OH, REALLY??????????
A socially active lifestyle can prevent cognitive decline in old age, suggesting that social isolation can be an additional causal pathway for cognitive impairment.9,40 Hearing loss impairs social relationships, leading to loneliness and degraded quality of life in elderly persons.9,41,42 The findings of our study demonstrate an improvement in the NCIQ scores in each of its subdomains as early as 6 months after implantation, correlated with the speech perception benefit in quiet and in noise at 12 months. Through these results, which are consistent with those of previous retrospective studies,15,20,25,43,44 we can hypothesize that by improving verbal communication, cochlear implantation restores the possibility for social networking and, as a consequence, has a positive effect on quality of life and social activity that contributes to better cognitive function.
Although an association between hearing impairment and depression in the elderly is still debated, depression has been recognized as a major risk factor for mild cognitive impairment and dementia.30,31,45,46 As a consequence, we can also hypothesize that the reduction in depressive symptoms observed 12 months after implantation could contribute to the improvement of cognitive abilities.
A limitation of our study is the short postimplantation observation interval. A recent study47 reported that at 13.5 years after implantation, 83% of elderly patients who received cochlear implants at age 60 years or older continued to use the implant consistently. In another study,23 elderly patients with unilateral implants maintained their earlier speech perception ability in noise 10 years or more after receiving an implant. Further research is needed within our population to assess the long-term effect of cochlear implant use on cognitive abilities, quality of life, and depression.
Influence of Cognitive Factors on Cochlear Implantation Outcomes
The role of cognitive processing in listening performance in noise and hearing-aid benefit for speech perception tasks has been clearly demonstrated in the elderly population.48-51
Consequently, we examined, via multivariate analysis, whether cognitive abilities before implantation can contribute to variability in cochlear implantation outcomes. We observed that results for the verbal fluency test for letters, which evaluates long-term memory, was the only cognitive test that correlated with speech perception scores in noise. Unexpectedly, neither attention deficit nor executive dysfunction showed a correlation with speech perception scores in noise. Very few studies have evaluated the influence of cognitive factors in adult cochlear implant recipients. Heydebrand et al52 found that better scores for word recognition in quiet were observed in adults with good verbal working memory and learning before implantation (mean age, 54 years; range, 24-80 years).
Poorer speech perception in quiet was observed 2 years after implantation in patients with lower cognitive scores.53 A key limitation of our study is that working memory was not assessed, although it plays a major role in cases of degraded speech information and might account for the correlation between cognition and speech perception scores in the aforementioned studies.51,52 Another limitation of the present study is that we applied basic tests used to evaluate cognitive function in the elderly population. Additional studies more precisely examining the role of specific cognitive factors involved in speech perception in difficult conditions are needed. Finally, one of the selection criteria routinely used in the investigating clinics for cochlear implantation was the absence of major cognitive impairment; indeed, cognitive problems, as well as low motivation, may influence the outcome of hearing rehabilitation.
Conclusions
Epidemiologic studies54 demonstrate that the anticipated number of people aged 60 years or older will double by the year 2050. As a consequence, the number of people with cognitive impairment and dementia will dramatically increase, reaching more than 100 million worldwide by 2050. Because there is no curative treatment available for cognitive decline, clinical research is needed that focuses on identification of risk factors to establish preventive measures that may reduce the burden of the disease. Interventions that could delay dementia onset by 1 year, as well as its progression, would lead to a decrease of more than 9 million in the worldwide prevalence of dementia by 2050.55 Our study demonstrates that hearing rehabilitation using cochlear implants in the elderly is associated with improvements in impaired cognitive function. Further research is needed to evaluate the long-term influence of hearing restoration on cognitive decline and its effect on public health.
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The damage to EAR HAIR is irreplaceable----they don't grow back and the installation of COCHLEAR DEVICE itself can damage those structures. Think of continuous sound stimulation 24/7 natural and messaging coming through IMPLANTS. The radiation from CHIP ARRAYS----along with WEAR AND TEAR on these very soft tissues.
'All of your inner hair cells can occupy the tip of a pin, yet they’re responsible for every single sound you hear—around 100,000 different sound modalities. With so few receptors it makes the ear especially vulnerable'.
Someone with low-level hearing loss---LIKE ME-----with these implants could end being made COMPLETE DEAF.
'Spectral information in the original acoustic signal is encoded in the spatial pattern of stimulation along the implant array.
Mimicking the tonotopic organization of the cochlea, each electrode carries information in a frequency range that, in normal hearing, would be transduced by hair cells and nerve fibers at the portion of the basilar membrane nearest the electrode: electrodes deeper in the cochlea (apical) carry lower frequency information, whereas those closer to the round window (basal) carry higher frequency information (Waltzman & Roland, 2006, chap. 4)'.
'The etiology of this delayed hearing loss after implantation is not well understood.
Possible etiologies include (1) inflammatory cascade (O'Leary et al., 2013) and immunogenic response (Nadol et al., 2008), (2) excitotoxicity from electrical stimulation (Kopelovich et al., 2015), (3)delayed degeneration of hair cells (Eshraghi et al., 2007), spiral ganglion neurons, or their synapses, (4) delayed effects of trauma to intracochlear structures such as the stria vascularis or spiral ligament, (5) progressive alterations in cochlear mechanics due to intracochlear fibrosis and/or new bone formation, or other disease processes such as intracochlear otosclerosis, and (6) post-implantation conductive hearing loss (Chole et al., 2014). Understanding the etiology of delayed post implantation hearing loss is critical for guiding both clinical management of cochlear implant patients with significant residual hearing and future research directed toward improving hearing preservation with cochlear implantation'.
Long term exposure to elements of COCHLEAR IMPLANT kill normal ear hair and other structures ===this is why COCHLEAR IMPLANTS should only be done in people with PROFOUND HEARING LOSS.
I may very well not have hearing in my left ear today WITHOUT an implant.
'High frequencies produce maxima near thebase of the cochlea, whereas low frequencies producemaxima near the apex'.
A Deaf Ear is Not a Dead Ear: Looking Inside the Cochlea With Prof. Helge Rask-Andersen
By MED-EL
Posted 16.05.2018
Today, we are sharing a fascinating contribution from Professor Helge Rask-Andersen, one of the leading researchers in cochlear anatomy and physiology.
Prof. Rask-Andersen is a specialist in ENT & Audiology, an anatomist and electron microscopist, and he is a senior Professor in experimental Otology at the Uppsala University and the Academic Hospital in Uppsala, Sweden. He currently runs the Research Department at the Academic Hospital.
In this article, Prof. Rask-Andersen explains the intricate functions of the cochlea and why structure preservation should be a priority for every cochlear implant surgery—even if there is no residual hearing. He shows why damage to the delicate cochlear structures can have such an adverse effect on the health of the underlying neural structures, and the impact this can have on outcomes with a cochlear implant.
Let’s turn over to Prof. Rask-Andersen and hear his perspective on the importance of respecting and protecting the structures of every cochlea.
The Importance of Structure Preservation in Cochlear Implantation
During my medical studies, I learned electron microscopy and I have been devoted to human inner ear anatomy ever since. My first interest was Meniere’s disease and endolymphatic sac. I have been examining the human cochlea for 30 years now. Since I performed skull base surgery with my teacher, the extremely skilled surgeon Dr. Anders Kinnefors, I have had a deep interest in cochlear and auditory nerve anatomy. At first it was more academic, but with CI it turned into applied anatomy with clinical orientations.
In my research, my most interesting finding was the unique structure and the remarkable conservation of the human auditory nerve. This did not adhere with animal studies. I found that the human auditory nerve cell soma are unmyelinated, denied by many experimentalists. This was not a new finding but together with molecular work, it seemed to explain why the human nerve behaves differently and persists after hair cell loss and deafness; a blessing for the deaf and implanted.
Incredible Intricacy
There are scant and tremendously vulnerable tissue membranes in the inner ear—the Reissner´s membrane is only 3 microns thick—yet they are surrounded by the hardest bone in the body. This makes studies of the human cochlea so difficult. It is the most challenging tissue to study in the entire body and explains why so little is known in humans!
The cilia, often known as hair cells, are around 150–200 nanometer (1 nanometer = 1 one-millionth of a millimeter) in diameter. One can compare it with the diameter of a human hair; that is 30–100 microns (one thousand nanometers = one micron), making hair cells less than a 1/100th the diameter of a human hair.
This image shows the natural beauty of the human organ of hearing—the organ of corti. The green membrane is called the basilar membrane which helps to filter the acoustic frequencies. The cilia project from the surface of the inner (red) and outer (blue) hair cells to the tectorial membrane (lilac). Nerve fibers are yellow. These structures are so precise that a movement equal to the diameter of a hydrogen atom is enough to trigger a neural response. Image taken in Innsbruck, Austria with a Zeiss field emission microscope by Prof. Rask-Andersen together with Annelies Schrott-Fischer, Rudolph Glueckert, and Kristian Pfaller.
At hearing threshold, the shearing forces bend the hair cells less than a nanometer—which is the diameter of a hydrogen atom. Even more intriguing is that we only possess around 3,400 inner hair cells, which are the principal message-conducting cells to the brain; compare that to millions of photoreceptors in the eye. All of your inner hair cells can occupy the tip of a pin, yet they’re responsible for every single sound you hear—around 100,000 different sound modalities. With so few receptors it makes the ear especially vulnerable.
Stria Vascularis: Power Plant of the Cochlea
Our recent findings provide fascinating insight into the molecular structure of the so-called “electric power plant” or stria vascularis located in the lateral wall of the cochlea. It is responsible for the energy production and ion concentration in endolymph and essential for hair cell function.
The lateral wall is called “spiral ligament” (ligamentum spirale). This is wrong! It is not like a ligament, like in the knee, but an amazing architecture of cells that serves like an electric power plant or telephone battery—functioning with potassium ions instead of lithium. Another difference is that it does not need re-charging! All cells have different functions and are extremely well supplied with arterial blood. It is extremely vulnerable and at risk in inner ear surgery.
If the cochlear structures are damaged, the dendrites or nerve fibers connecting hair cells with the cell bodies will likely disappear. Fortunately, this degenerative process seems to stop at the level of the cell bodies but there is probably some degeneration of the cell bodies, at least with time. This cell damage induced by potassium intoxication has little healing capacity.
Immunehistochemistry of the lateral wall of the human cochlea. The different proteins involved in the generation of electricity (know as the endocochlear potential or EP) important for hair cell function are shown in colors. The tissue produces high concentrations of potassium ions (K+) used by the hair cells. The green, red and yellow represent different molecular arrangements of ion transporters. They can also be found in the kidney. Like a car battery, the elements are surrounded by an insulator; here composed of the protein Claudin-11 (green in upper graphic picture). (Liu et al. 2017)
The stria vascularis is partly destroyed in the base during conventional cochleostomies, because drilling damages the inner ear tissues. Bone dust enters the cochlea, and inflammation and fibrosis develop more easily. Today, I think it is valuable to use a technique where drilling of the bone is avoided and the inner surface of the cochlea (endosteum) is not traumatized. However, I must confess that I also sometimes make a cochleostomy, when finding the round window is challenging due to cochlear rotations. Nonetheless, I think it is important to realize the degree of trauma it infers in connection with hearing preservation surgery.
The beautiful “cochlear battery” in the lateral wall of the human cochlea. It is surrounded by an insulator; a protein called Claudin-11. The connexin proteins are abundant here and are of two types (mutated in most cased of congenital deafness). They likely help to transport and recirculate the potassium ions. (Liu et al. 2017)
Staying in the Scala Tympani
It is also important that electrodes do not perforate the structures of the cochlea, especially near the first turn. If the electrode deviates into the scala vestibule, it usually penetrates the scala media, which contains the hair cells. A macrofistula develops and potassium ions will leak out and hair cells will stop working.
Potassium ions also leak around the hair cell bodies and nerve cells which is toxic for them and they will degenerate near the perforation. Several reports suggest that cochlear implant results are better when electrode does not deviate into the scala vestibuli.
This image shows the proper positioning of a cochlear implant electrode array in the scala tympani. This picture was taken in Innsbruck, Austria with a Zeiss field emission microscope by Prof. Rask-Andersen together with Annelies Schrott-Fischer, Rudolph Glueckert and Kristian Pfaller, with rending by Peter Bauer.
The modiolus is also vulnerable and the surface wall (where the CI electrode is located), faces the nerve cell bodies which can easily be damaged. The fluid in the cochlea also mix with the fluid surrounding the ganglion cells, meaning that a toxic inflammation in the cochlea will spread to the nerve.
From everything said, it seems pertinent to say that structural preservation in cochlear implantation surgery should be motivated for every patient, even if there is no residual hearing.
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OH, WAIT SAY GLOBAL BANKING 1% BARBER SURGEONS-----THERE IS A MEDICAL DEVICE OR PROCEDURE TO FIX WHAT HOSTING SERVER NOSY NEIGHBORS ----DESTROYED IN FAKE RESEARCH STUDIES.
HOSTING SERVER NOSY NEIGHBORS say-----SHE WON'T GET ANY HELP FOR ANY HEALTH ISSUE---because I am REAL LEFT SOCIAL PROGRESSIVE----I care about PEOPLE not PROFITS.
Please assume all of this is FAKE DATA---FAKE NEWS----do not get involved with IMPLANTS or GENETIC MANIPULATIONS---the basic science IS NOT THERE.
'Cochlear Implant Also Uses Gene ... - MIT Technology Review
www.technologyreview.com/s/526906/cochlear...
When the ear’s hair cells degrade and die, the associated neurons also degrade and shrink back into the cochlea. So there’s a physical gap between these atrophied neurons and the electrodes in the...'
REWRITING LIFE say TRANSHUMANISTS ------forcing BLIND AMBITION GOALS on HUMANS without any BASIC SCIENCE creating FAKE evidence-based science DATA to pretend there is SOCIAL BENEFIT----in goals of GMO HUMANS.
Rewriting Life
Cochlear Implant Also Uses Gene Therapy to Improve Hearing
The electrodes in a cochlear implant can be used to direct gene therapy and regrow neurons.
by Katherine Bourzac
Apr 24, 2014
Researchers have demonstrated a new way to restore lost hearing: with a cochlear implant that helps the auditory nerve regenerate by delivering gene therapy.
Growth factor: The cochlear nerve regenerates after gene therapy (top) versus the untreated cochlea from the same animal (bottom).The researchers behind the work are investigating whether electrode-triggered gene therapy could improve other machine-body connections—for example, the deep-brain stimulation probes that are used to treat Parkinson’s disease, or retinal prosthetics.
More than 300,000 people worldwide have cochlear implants.
THAT WOULD BE FAKE DATA----FAKE NEWS----COCHLEAR IMPLANTS ARE COMMON.
The devices are implanted in patients who are profoundly deaf, having lost most or all of the ear’s hair cells, which detect sound waves through mechanical vibrations, and convert those vibrations into electrical signals that are picked up by neurons in the auditory nerve and passed along to the brain. Cochlear implants use up to 22 platinum electrodes to stimulate the auditory nerve; the devices make a tremendous difference for people but they restore only a fraction of normal hearing.
“Cochlear implants are very effective for picking up speech, but they struggle to reproduce pitch, spectral range, and dynamics,” says Gary Housley, a neuroscientist at the University of New South Wales in Sydney, Australia, who led development of the new implant.
Cyborg cavy: An Xray image shows the cochlear implant in the left ear of a guinea pig.When the ear’s hair cells degrade and die, the associated neurons also degrade and shrink back into the cochlea. So there’s a physical gap between these atrophied neurons and the electrodes in the cochlear implant. Improving the interface between nerves and electrodes should make it possible to use weaker electrical stimulation, opening up the possibility of stimulating multiple parts of the auditory nerve at once, using more electrodes, and improving the overall quality of sound.
Peptides called neurotrophins can encourage regeneration of the neurons in the auditory nerve. Housley used a common process, called electroporation, to cause pores to open up in cells, allowing DNA to get inside. It usually requires high voltages, and it hasn’t found much clinical use, but Housley wanted to see whether the small, distributed electrodes of the cochlear implant could be used to achieve the effect.
Housley’s group used deafened guinea pigs, which are commonly used as a hearing model because their cochleas are similar in size to those found in humans. During surgery to place the cochlear implant, they injected the cochlea with a neurotrophin gene vector. Once the implant was placed, they applied an electroporation voltage using the electrodes. The process, which took only a few seconds during surgery, resulted in nerve regeneration in the animals. And weeks after implantation, the nerves of treated animals showed stronger responses to signals from the implant, which suggests they are able to hear more. This research is described this week in the journal Science Translational Medicine.
“Clearly this works—in a guinea pig,” says Lawrence Lustig, director of the Cochlear Implant Center at the University of California, San Francisco Medical Center. Lustig’s group and others have been exploring gene therapy, but they use a virus to deliver the neurotrophin gene.
Robert Shepherd, director of the Bionics Institute, a nonprofit medical research center in Melbourne, Australia, says electrode-directed gene therapy could improve other kinds of neural interfaces. “Wherever we’re applying electrodes, whether it’s for deep-brain stimulation in Parkinson’s disease, or retinal implants for the blind, there is already neural damage,” he says.
Housley’s group is working with Cochlear, a major maker of cochlear implants headquartered in Sydney, to test the electrode and gene-therapy combination in a clinical trial.
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