EEG-based diagnostics of the auditory system using cochlear implant electrodes as sensors

The cochlear implant is one of the most successful medical prostheses, allowing deaf and severely hearing-impaired persons to hear again by electrically stimulating the auditory nerve. A trained audiologist adjusts the stimulation settings for good speech understanding, known as fitting the implant. This process is based on subjective feedback from the user, making it time-consuming and challenging, especially in paediatric or communication-impaired populations. Furthermore, fittings only happen during infrequent sessions at a clinic, and therefore cannot take into account variable factors that affect the user's hearing, such as physiological changes and different listening environments. Objective audiometry, in which brain responses evoked by auditory stimulation are collected and analysed, removes the need for active patient participation. However, recording of brain responses still requires expensive equipment that is cumbersome to use. An elegant solution is to record the neural signals using the implant itself. We demonstrate for the first time the recording of continuous electroencephalographic (EEG) signals from the implanted intracochlear electrode array in human subjects, using auditory evoked potentials originating from different brain regions. This was done using a temporary recording set-up with a percutaneous connector used for research purposes. Furthermore, we show that the response morphologies and amplitudes depend crucially on the recording electrode configuration. The integration of an EEG system into cochlear implants paves the way towards chronic neuro-monitoring of hearing-impaired patients in their everyday environment, and neuro-steered hearing prostheses, which can autonomously adjust their output based on neural feedback.

Automated summary

Cochlear implants are successful medical prostheses that help deaf individuals hear again by stimulating the auditory nerve. The fitting process, based on subjective feedback, can be time-consuming and challenging, as it relies on infrequent clinic sessions for adjustments. Objective audiometry offers a solution by analyzing brain responses to auditory stimulation, but still requires costly equipment. Recording neural signals using the implant itself shows promise for chronic neuro-monitoring of hearing-impaired patients and neuro-steered hearing prostheses.