Nearinfrared spettrography in evaluating brain plasticity in deaf

Dati identificativi pnrr  (es: mission component investment) PNRR-MAD 2022-12376739  M6C2: Innovazione, ricerca e digitalizzazione del servizio sanitario - I2.1:Rafforzamento e potenziamento della ricerca biomedica del SSN
Data di inizio: 28 maggio 2023
Data di fine: 27 maggio 2025
Durata: 2 anni
Finanziamento a UNIPD: euro 375.444,10

Despite the enormous potential of cochlear implants to improve hearing, social integration and life quality for implanted individuals, outcomes vary considerably, and some CI users never develop functional oral language skills, even when implanted early in life, during the critical period for language development. Our project brings together interdisciplinary expertise from otorhinolaryngology, speech therapy, developmental psychology and neuroscience available in our two participating units to identify how individual variation in neuroplasticity early in development impacts the restoration of auditory and speech perception after implantation. We will use state-of-the-art neuroimaging to test infants before implantation and follow them up afterwards to assess the predictive relationship between individual-level neural variables and later language outcomes and test how therapeutic choices mediate these in order to provide evidence-based recommendations to improve clinical practices.
Maximizing deaf children's developmental potential and to achieve a language learning trajectories similar to their hearing peers is a goal that engages researchers and clinicians from a variety of disciplines as we include in this project.One of the hallmarks of deaf children outcomes, however, is the enormous variability reported in auditory, speech, and language functioning after implantation. No large-scale, multi-dimensional database currently exists documenting auditory and language development in hearing-impaired infants prior to and after CI aggregating across a wide spectrum of data from family demographics to behavioral and language development data to neuroimaging recordings. The project uses a new technology combined NIRS-EEG neuroimaging and a complex statistical modeling enabling causal inference and will produce innovative results for diffusion and publication. The results coud improve the quality of life of patients and their family decreasiing public health costs.
Expected Outcome:
Permanent Hearing impairment (PHI) is the most frequent sensory deficit, and deafness reduces access to spoken language. The aim of overcoming deafness by CIs is to support meaningful speech perception and maximize the potential of living a productive life and successful integration into society. Brain neuroplasticity and language learning are depended by auditory experience. Therefore, the possibility to improve the knowledge on the effect of hearing deprivation on the language development and neuroplasticityand its sequelae including the cognitive development, academic abilities, social interactions, parent-child interaction is challenging. PHI is a major burden for the welfare for developed Countries. In US it has been calculated that severe to profound hearing loss is expected to cost society $297,000 over the lifetime for each individual. Lifetime costs for those with prelingual onset exceed $1 million. Children underwent to early rehabilitation can develop a normal language and normal expectance for lifetime and social inclusion. This project addresses major obstacles for a language learning and consequent quality of life in children born deaf with long term impact.
The expected outcomes of the project are twofold, one theoretical and one translational.
(i) At the theoretical level, we aim to further out theoretical understanding of how hearing and language develop in atypical children, especially prior to and after cochlear implantation in an attempt to uncover the perceptual, cognitive and neural mechanisms that are responsible for highly variable outcomes in this population. Related to this, we expect to publish our findings in peer-reviewed international journals as well as to create an open science inspired publically available database (complying with the FAIR principles: Findable, Accessible, Interoperable, and Reusable data) made available to the entire research community.
(ii) At the translational level, we expect to formulate concrete, evidence-based recommendations for best practices in CI therapy, management and use.
The outcomes will be communicated to the larger scientific community through publications and conference presentations.
While the theoretical outcomes are relevant for the broader neuroscience community, our translational results will be more specifically targeted at the ENT / audiology / speech therapy / CI communities. Our results will also be relevant for the families of children with hearing impairments and CI, as well as to educational policy-makers and stakeholders. We will thus also target these groups through specific outreach and public engagement actions.