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March 2005 Issue

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New Test Helps Identify Deaf Infants Before Speech Difficulties Occur

Published March 2005

MRI determines who might benefit from implants

Formerly the only way to know if a hearing-impaired infant might benefit from a cochlear implant was to actually do the surgery.

The costs and stress of surgery on child and family, however, led scientists to search for an early and minimally invasive way of predicting the need for an implant.

Now a preliminary study suggests that a technique called functional magnetic resonance imaging (fMRI) could be the solution, and a follow-up study is under way in UC's Department of Otolaryngology and the Imaging Research Center at Cincinnati Children's Hospital Medical Center to confirm it.

Being able to evaluate hearing and speech recognition in very young children is crucial to the success of cochlear implants, says Daniel Choo, MD,ÊUC associate professor of otology/neurotology and physician at Cincinnati Children's.

"In optimal cases, children successfully implanted at 12 months can perform as well as their normally hearing peers," Dr. Choo says. "Early identification and treatment for all hearing-impaired infants can prevent permanent language delays and allow children to reach their full communication and education potential."

Funded by a $3 million, five-year National Institutes of Health grant, the study involves 90 patients, including 30 normally hearing infants serving as controls.

The fMRI scan not only reveals the anatomy of cochlear and other structures. The test also shows activation of the areas responsible for auditory detection, speech perception and language processing, says Scott Holland, PhD, professor of radiology, pediatrics, physics and neuroscience at UC and the Imaging Research Center at Cincinnati Children's.

"If we see brain activation, we expect the child to do well," Dr. Holland says. "By the end of the research project, we hope to know definitively if fMRI is an accurate predictor of deafness."

The researchers will correlate pre-implant brain activation patterns revealed by fMRI with hearing performance two years after cochlear implantation.

A new law requiring universal neonatal screening for hearing loss has brought more hearing-impaired children to Cincinnati Children's, a leader in the treatment of their condition.

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