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Meta-Analysis
. 2023 Oct;169(4):792-810.
doi: 10.1002/ohn.344. Epub 2023 Jun 27.

Emerging Relations among Cognitive Constructs and Cochlear Implant Outcomes: A Systematic Review and Meta-Analysis

Andrew E Amini  1   2 , James G Naples  1   2 , Tiffany Hwa  3 , Danielle C Larrow  4 , Frank M Campbell  5 , Maylene Qiu  5 , Irina Castellanos  6 , Aaron C Moberly  7
Affiliations
Meta-Analysis

Emerging Relations among Cognitive Constructs and Cochlear Implant Outcomes: A Systematic Review and Meta-Analysis

Andrew E Amini et al. Otolaryngol Head Neck Surg. 2023 Oct.

Abstract

Objective: Hearing loss has a detrimental impact on cognitive function. However, there is a lack of consensus on the impact of cochlear implants on cognition. This review systematically evaluates whether cochlear implants in adult patients lead to cognitive improvements and investigates the relations of cognition with speech recognition outcomes.

Data sources: A literature review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies evaluating cognition and cochlear implant outcomes in postlingual, adult patients from January 1996 to December 2021 were included. Of 2510 total references, 52 studies were included in qualitative analysis and 11 in meta-analyses.

Review methods: Proportions were extracted from studies of (1) the significant impacts of cochlear implantation on 6 cognitive domains and (2) associations between cognition and speech recognition outcomes. Meta-analyses were performed using random effects models on mean differences between pre- and postoperative performance on 4 cognitive assessments.

Results: Only half of the outcomes reported suggested cochlear implantation had a significant impact on cognition (50.8%), with the highest proportion in assessments of memory & learning and inhibition-concentration. Meta-analyses revealed significant improvements in global cognition and inhibition-concentration. Finally, 40.4% of associations between cognition and speech recognition outcomes were significant.

Conclusion: Findings relating to cochlear implantation and cognition vary depending on the cognitive domain assessed and the study goal. Nonetheless, assessments of memory & learning, global cognition, and inhibition-concentration may represent tools to assess cognitive benefit after implantation and help explain variability in speech recognition outcomes. Enhanced selectivity in assessments of cognition is needed for clinical applicability.

Keywords: cochlear implantation; cognition; sensorineural hearing loss; speech recognition.

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References

    1. Lin FR, Yaffe K, Xia J, et al. Hearing loss and cognitive decline in older adults. JAMA Intern Med. 2013;173(4):293. doi:10.1001/jamainternmed.2013.1868
    1. Moberly AC, Mattingly JK, Castellanos I. How does nonverbal reasoning affect sentence recognition in adults with cochlear implants and normal-hearing peers? Audiol Neurotol. 2019;24(3):127-138. doi:10.1159/000500699
    1. O'Neill ER, Kreft HA, Oxenham AJ. Cognitive factors contribute to speech perception in cochlear-implant users and age-matched normal-hearing listeners under vocoded conditions. J Acoust Soc Am. 2019;146(1):195-210. doi:10.1121/1.5116009
    1. Naples JG, Castellanos I, Moberly AC. Considerations for integrating cognitive testing into adult cochlear implant evaluations-foundations for the future. JAMA Otolaryngol Head Neck Surg. 2021;147(5):413-414. doi:10.1001/jamaoto.2020.5487
    1. Lyxell B, Andersson J, Arlinger S, Bredberg G, Harder H, Ronnberg J. Verbal information-processing capabilities and cochlear implants: implications for preoperative predictors of speech understanding. J Deaf Stud Deaf Educ. 1996;1(3):190-201. doi:10.1093/oxfordjournals.deafed.a014294

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