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. 2017 May:348:138-142.
doi: 10.1016/j.heares.2017.02.008. Epub 2017 Feb 15.

Genetic variants in the peripheral auditory system significantly affect adult cochlear implant performance

A Eliot Shearer  1 , Robert W Eppsteiner  1 , Kathy Frees  1 , Viral Tejani  1 , Christina M Sloan-Heggen  1 , Carolyn Brown  2 , Paul Abbas  2 , Camille Dunn  1 , Marlan R Hansen  1 , Bruce J Gantz  1 , Richard J H Smith  3
Affiliations

Genetic variants in the peripheral auditory system significantly affect adult cochlear implant performance

A Eliot Shearer et al. Hear Res. 2017 May.

Abstract

Background: Cochlear implantation is an effective habilitation modality for adults with significant hearing loss. However, post-implant performance is variable. A portion of this variance in outcome can be attributed to clinical factors. Recent physiological studies suggest that the health of the spiral ganglion also impacts post-operative cochlear implant outcomes. The goal of this study was to determine whether genetic factors affecting spiral ganglion neurons may be associated with cochlear implant performance.

Methods: Adults with post-lingual deafness who underwent cochlear implantation at the University of Iowa were studied. Pre-implantation evaluation included comprehensive genetic testing for genetic diagnosis. A novel score of genetic variants affecting genes with functional effects in the spiral ganglion was calculated. A Z-scored average of up to three post-operative speech perception tests (CNC, HINT, and AzBio) was used to assess outcome.

Results: Genetically determined spiral ganglion health affects cochlear implant outcomes, and when considered in conjunction with clinically determined etiology of deafness, accounts for 18.3% of the variance in postoperative speech recognition outcomes. Cochlear implant recipients with deleterious genetic variants that affect the cochlear sensory organ perform significantly better on tests of speech perception than recipients with deleterious genetic variants that affect the spiral ganglion.

Conclusion: Etiological diagnosis of deafness including genetic testing is the single largest predictor of postoperative speech outcomes in adult cochlear implant recipients. A detailed understanding of the genetic underpinning of hearing loss will better inform pre-implant counseling. The method presented here should serve as a guide for further research into the molecular physiology of the peripheral auditory system and cochlear implants.

Keywords: Cochlear implant; Deafness; Genetics; Genomics.

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Conflict of interest statement

Conflicts of Interest

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Overview of division of peripheral auditory system based on function and known effect of genes causing deafness at these sites. A cochlear implant bypasses the sensory partition (including the organ of Corti and the synapse).
Figure 2
Figure 2
Post-implantation speech understanding varies significantly based on etiology of deafness and genetic testing results. Comprehensive genetic analysis is included with subject groups as defined in the text. Speech values are average Z scores derived from the mean of CNC, HINT and Azbio audiometric testing. SSNHL, sudden sensorineural hearing loss; SSD, single-sided deafness).
See this image and copyright information in PMC

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